Search results for: multi criteria inventory classification models
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 14090

Search results for: multi criteria inventory classification models

200 Making Haste Slowly: South Africa's Transition from a Medical to a Social Model regarding Persons with Disabilities

Authors: Leoni Van Der Merwe

Abstract:

Historically, in South Africa, disability has been viewed as a dilemma of the individual. The discourse surrounding the definition of disability and applicable theories are as fluid as the differing needs of persons with disabilities within society. In 1997, the Office of the Deputy President published the White Paper on the Integrated National Disability Strategy (WPINDS) which sought to integrate disability issues in all governmental development strategies, planning and programs as well as to solidify the South African government’s stance that disability was to be considered according to the social model and not the, previously utilized, medical model of disability. The models of disability are conceptual frameworks for understanding disability and can provide some insight into why certain attitudes exist and how they are reinforced in society. Although the WPINDS was regarded as a critical milestone in the history of the disability rights struggle in South Africa; it has taken approximately twenty years for the publication of a similar document taking into account South Africa’s changing social, economic, political and technological dispensation. December 2015 marked the approval of the White Paper on the Rights of Persons with Disabilities (WPRPD) which seeks to update the WPINDS, integrate principles contained in international law instruments and endorse a mainstreaming trajectory for realizing the rights of persons with disabilities. While the WPINDS and the WPRPD were published two decades apart, both documents contain an emphasis on a transition from the medical model to the social model. Whereas, the medical model presupposes that disability is mainly a health and welfare matter and is focused on an individualistic and dependency-based approach; the social model requires a paradigm shift in the manner in which disability is constructed so as to highlight the shortcomings of society in respect of disability and to bring to the fore the capabilities of persons with disabilities. The social model has led to unmatched success in changing the perceptions surrounding disability. This article seeks to investigate the progress made in the implementation of the social model in South Africa by taking into account the effect of the diverse political and cultural landscape in promoting the historically entrenched medical model and the rise of disability activism prior to the new democratic dispensation as well as legislation, case law, policy documents and barriers in respect of persons with disabilities that are pervasive in South African society. The research paper will conclude that although numerous interventions have been identified and implemented to promote the consideration of disability within a social construct in South Africa, such interventions require increased national and international collaboration, resources and pace to ensure that the efforts made lead to sustainable results. For persons with disabilities, what remains to be seen is whether the proliferation of activism by interest groups, social awareness as well as the development of policy documents, legislation and case law will serve as the impetus to dissipate the view that disability is burden to be carried solely on the shoulders of the person with the disability.

Keywords: disability, medical model, social model, societal barriers, South Africa

Procedia PDF Downloads 355
199 The Efficiency Analysis in the Health Sector: Marmara Region

Authors: Hale Kirer Silva Lecuna, Beyza Aydin

Abstract:

Health is one of the main components of human capital and sustainable development, and it is very important for economic growth. Health economics, which is an indisputable part of the science of economics, has five stages in general. These are health and development, financing of health services, economic regulation in the health, allocation of resources and efficiency of health services. A well-developed and efficient health sector plays a major role by increasing the level of development of countries. The most crucial pillars of the health sector are the hospitals that are divided into public and private. The main purpose of the hospitals is to provide more efficient services. Therefore the aim is to meet patients’ satisfaction by increasing the service quality. Health-related studies in Turkey date back to the Ottoman and Seljuk Empires. In the near past, Turkey applied 'Health Sector Transformation Programs' under different titles between 2003 and 2010. Our aim in this paper is to measure how effective these transformation programs are for the health sector, to see how much they can increase the efficiency of hospitals over the years, to see the return of investments, to make comments and suggestions on the results, and to provide a new reference for the literature. Within this framework, the public and private hospitals in Balıkesir, Bilecik, Bursa, Çanakkale, Edirne, Istanbul, Kirklareli, Kocaeli, Sakarya, Tekirdağ, Yalova will be examined by using Data Envelopment Analysis (DEA) for the years between 2000 and 2019. DEA is a linear programming-based technique, which gives relatively good results in multivariate studies. DEA basically estimates an efficiency frontier and make a comparison. Constant returns to scale and variable returns to scale are two most commonly used DEA methods. Both models are divided into two as input and output-oriented. To analyze the data, the number of personnel, number of specialist physicians, number of practitioners, number of beds, number of examinations will be used as input variables; and the number of surgeries, in-patient ratio, and crude mortality rate as output variables. 11 hospitals belonging to the Marmara region were included in the study. It is seen that these hospitals worked effectively only in 7 provinces (Balıkesir, Bilecik, Bursa, Edirne, İstanbul, Kırklareli, Yalova) for the year 2001 when no transformation program was implemented. After the transformation program was implemented, for example, in 2014 and 2016, 10 hospitals (Balıkesir, Bilecik, Bursa, Çanakkale, Edirne, İstanbul, Kocaeli, Kırklareli, Tekirdağ, Yalova) were found to be effective. In 2015, ineffective results were observed for Sakarya, Tekirdağ and Yalova. However, since these values are closer to 1 after the transformation program, we can say that the transformation program has positive effects. For Sakarya alone, no effective results have been achieved in any year. When we look at the results in general, it shows that the transformation program has a positive effect on the effectiveness of hospitals.

Keywords: data envelopment analysis, efficiency, health sector, Marmara region

Procedia PDF Downloads 107
198 Investigations on the Fatigue Behavior of Welded Details with Imperfections

Authors: Helen Bartsch, Markus Feldmann

Abstract:

The dimensioning of steel structures subject to fatigue loads, such as wind turbines, bridges, masts and towers, crane runways and weirs or components in crane construction, is often dominated by fatigue verification. The fatigue details defined by the welded connections, such as butt or cruciform joints, longitudinal welds, welded-on or welded-in stiffeners, etc., are decisive. In Europe, the verification is usually carried out according to EN 1993-1-9 on a nominal stress basis. The basis is the detailed catalog, which specifies the fatigue strength of the various weld and construction details according to fatigue classes. Until now, a relation between fatigue classes and weld imperfection sizes is not included. Quality levels for imperfections in fusion-welded joints in steel, nickel, titanium and their alloys are regulated in EN ISO 5817, which, however, doesn’t contain direct correlations to fatigue resistances. The question arises whether some imperfections might be tolerable to a certain extent since they may be present in the test data used for detail classifications dating back decades ago. Although current standardization requires proof of satisfying limits of imperfection sizes, it would also be possible to tolerate welds with certain irregularities if these can be reliably quantified by non-destructive testing. Fabricators would be prepared to undertake carefully and sustained weld inspection in view of the significant economic consequences of such unfavorable fatigue classes. This paper presents investigations on the fatigue behavior of common welded details containing imperfections. In contrast to the common nominal stress concept, local fatigue concepts were used to consider the true stress increase, i.e., local stresses at the weld toe and root. The actual shape of a weld comprising imperfections, e.g., gaps or undercuts, can be incorporated into the fatigue evaluation, usually on a numerical basis. With the help of the effective notch stress concept, the fatigue resistance of detailed local weld shapes is assessed. Validated numerical models serve to investigate notch factors of fatigue details with different geometries. By utilizing parametrized ABAQUS routines, detailed numerical studies have been performed. Depending on the shape and size of different weld irregularities, fatigue classes can be defined. As well load-carrying welded details, such as the cruciform joint, as non-load carrying welded details, e.g., welded-on or welded-in stiffeners, are regarded. The investigated imperfections include, among others, undercuts, excessive convexity, incorrect weld toe, excessive asymmetry and insufficient or excessive throat thickness. Comparisons of the impact of different imperfections on the different types of fatigue details are made. Moreover, the influence of a combination of crucial weld imperfections on the fatigue resistance is analyzed. With regard to the trend of increasing efficiency in steel construction, the overall aim of the investigations is to include a more economical differentiation of fatigue details with regard to tolerance sizes. In the long term, the harmonization of design standards, execution standards and regulations of weld imperfections is intended.

Keywords: effective notch stress, fatigue, fatigue design, weld imperfections

Procedia PDF Downloads 236
197 Determinants of Life Satisfaction in Canada: A Causal Modelling Approach

Authors: Rose Branch-Allen, John Jayachandran

Abstract:

Background and purpose: Canada is a pluralistic, multicultural society with an ethno-cultural composition that has been shaped over time by immigrants and their descendants. Although Canada welcomes these immigrants, many will endure hardship and assimilation difficulties. Despite these life hurdles, surveys consistently disclose high life satisfaction for all Canadians. Most research studies on Life Satisfaction/ Subjective Wellbeing (SWB) have focused on one main determinant and a variety of social demographic variables to delineate the determinants of life satisfaction. However, very few research studies examine life satisfaction from a holistic approach. In addition, we need to understand the causal pathways leading to life satisfaction, and develop theories that explain why certain variables differentially influence the different components of SWB. The aim this study was to utilize a holistic approach to construct a causal model and identify major determinants of life satisfaction. Data and measures: This study utilized data from the General Social Survey, with a sample size of 19, 597. The exogenous concepts included age, gender, marital status, household size, socioeconomic status, ethnicity, location, immigration status, religiosity, and neighborhood. The intervening concepts included health, social contact, leisure, enjoyment, work-family balance, quality time, domestic labor, and sense of belonging. The endogenous concept life satisfaction was measured by multiple indicators (Cronbach’s alpha = .83). Analysis: Several multiple regression models were run sequentially to estimate path coefficients for the causal model. Results: Overall, above average satisfaction with life was reported for respondents with specific socio-economic, demographic and lifestyle characteristics. With regard to exogenous factors, respondents who were female, younger, married, from high socioeconomic status background, born in Canada, very religious, and demonstrated high level of neighborhood interaction had greater satisfaction with life. Similarly, intervening concepts suggested respondents had greater life satisfaction if they had better health, more social contact, less time on passive leisure activities and more time on active leisure activities, more time with family and friends, more enjoyment with volunteer activities, less time on domestic labor and a greater sense of belonging to the community. Conclusions and Implications: Our results suggest that a holistic approach is necessary for establishing determinants of life satisfaction, and that life satisfaction is not merely comprised of positive or negative affect rather understanding the causal process of life satisfaction. Even though, most of our findings are consistent with previous studies, a significant number of causal connections contradict some of the findings in literature today. We have provided possible explanation for these anomalies researchers encounter in studying life satisfaction and policy implications.

Keywords: causal model, holistic approach, life satisfaction, socio-demographic variables, subjective well-being

Procedia PDF Downloads 332
196 Comparative Analysis of Smart City Development: Assessing the Resilience and Technological Advancement in Singapore and Bucharest

Authors: Sînziana Iancu

Abstract:

In an era marked by rapid urbanization and technological advancement, the concept of smart cities has emerged as a pivotal solution to address the complex challenges faced by urban centres. As cities strive to enhance the quality of life for their residents, the development of smart cities has gained prominence. This study embarks on a comparative analysis of two distinct smart city models, Singapore and Bucharest, to assess their resilience and technological advancements. The significance of this study lies in its potential to provide valuable insights into the strategies, strengths, and areas of improvement in smart city development, ultimately contributing to the advancement of urban planning and sustainability. Methodologies: This comparative study employs a multifaceted approach to comprehensively analyse the smart city development in Singapore and Bucharest: * Comparative Analysis: A systematic comparison of the two cities is conducted, focusing on key smart city indicators, including digital infrastructure, integrated public services, urban planning and sustainability, transportation and mobility, environmental monitoring, safety and security, innovation and economic resilience, and community engagement; * Case Studies: In-depth case studies are conducted to delve into specific smart city projects and initiatives in both cities, providing real-world examples of their successes and challenges; * Data Analysis: Official reports, statistical data, and relevant publications are analysed to gather quantitative insights into various aspects of smart city development. Major Findings: Through a comprehensive analysis of Singapore and Bucharest's smart city development, the study yields the following major findings: * Singapore excels in digital infrastructure, integrated public services, safety, and innovation, showcasing a high level of resilience across these domains; * Bucharest is in the early stages of smart city development, with notable potential for growth in digital infrastructure and community engagement.; * Both cities exhibit a commitment to sustainable urban planning and environmental monitoring, with room for improvement in integrating these aspects into everyday life; * Transportation and mobility solutions are a priority for both cities, with Singapore having a more advanced system, while Bucharest is actively working on improving its transportation infrastructure; * Community engagement, while important, requires further attention in both cities to enhance the inclusivity of smart city initiatives. Conclusion: In conclusion, this study serves as a valuable resource for urban planners, policymakers, and stakeholders in understanding the nuances of smart city development and resilience. While Singapore stands as a beacon of success in various smart city indicators, Bucharest demonstrates potential and a willingness to adapt and grow in this domain. As cities worldwide embark on their smart city journeys, the lessons learned from Singapore and Bucharest provide invaluable insights into the path toward urban sustainability and resilience in the digital age.

Keywords: bucharest, resilience, Singapore, smart city

Procedia PDF Downloads 29
195 How Whatsappization of the Chatbot Affects User Satisfaction, Trust, and Acceptance in a Drive-Sharing Task

Authors: Nirit Gavish, Rotem Halutz, Liad Neta

Abstract:

Nowadays, chatbots are gaining more and more attention due to the advent of large language models. One of the important considerations in chatbot design is how to create an interface to achieve high user satisfaction, trust, and acceptance. Since WhatsApp conversations sometimes substitute for face-to-face communication, we studied whether WhatsAppization of the chatbot -making the conversation resemble a WhatsApp conversation more- will improve user satisfaction, trust, and acceptance, or whether the opposite will occur due to the Uncanny Valley (UV) effect. The task was a drive-sharing task, in which participants communicated with a textual chatbot via WhatsApp and could decide whether to participate in a ride to college with a driver suggested by the chatbot. WhatsAppization of the chatbot was done in two ways: By a dialog-style conversation (Dialog versus No Dialog), and by adding WhatsApp indicators – “Last Seen”, “Connected”, “Read Receipts”, and “Typing…” (Indicators versus No Indicators). Our 120 participants were randomly assigned to one of the four 2 by 2 design groups, with 30 participants in each. They interacted with the WhatsApp chatbot and then filled out a questionnaire. The results demonstrated that, as expected from the manipulation, the interaction with the chatbot was longer for the dialog condition compared to the no dialog. This extra interaction, however, did not lead to higher acceptance -quite the opposite, since participants in the dialog condition were less willing to implement the decision made at the end of the conversation with the chatbot and continue the interaction with the driver they chose. The results are even more striking when considering the Indicators condition. Both for the satisfaction measures and the trust measures, participants’ ratings were lower in the Indicators condition compared to the No Indicators. Participants in the Indicators condition felt that the ride search process was harder to operate, and slower (even though the actual interaction time was similar). They were less convinced that the chatbot suggested real trips and they trusted the person offering the ride and referred to them by the chatbot less. These effects were more evident for participants who preferred to share their rides using WhatsApp compared to participants who preferred chatbots for that purpose. Considering our findings, we can say that the WhatsAppization of the chatbot was detrimental. This is true for the both chatbot WhatsAppization methods – by making the conversation more a dialog and adding WhatsApp indicators. For the chosen drive-sharing task, the results were, in addition to lower satisfaction, less trust in the chatbot’s suggestion and even in the driver suggested by the chatbot, and lower willingness to actually undertake the suggested ride. In addition, it seems that the most problematic WhatsAppization method was using WhatsApp’s indicators during the interaction with the chatbot. The current study suggests that a conversation with an artificial agent should also not imitate a WhatsApp conversation very closely. With the proliferation of WhatsApp use, the emotional and social aspect of face-to face commination are moving to WhatsApp communication. Based on the current study’s findings, it is possible that the UV effect also occurs in WhatsAppization, and not only in humanization, of the chatbot, with a similar feeling of eeriness, and is more pronounced for people who prefer to use WhatsApp over chatbots. The current research can serve as a starting point to study the very interesting and important topic of chatbots WhatsAppization. More methods of WhatsAppization and other tasks could be the focus of further studies.

Keywords: chatbot, WhatsApp, humanization, Uncanny Valley, drive sharing

Procedia PDF Downloads 18
194 Purpose-Driven Collaborative Strategic Learning

Authors: Mingyan Hong, Shuozhao Hou

Abstract:

Collaborative Strategic Learning (CSL) teaches students to use learning strategies while working cooperatively. Student strategies include the following steps: defining the learning task and purpose; conducting ongoing negotiation of the learning materials by deciding "click" (I get it and I can teach it – green card, I get it –yellow card) or "clunk" (I don't get it – red card) at the end of each learning unit; "getting the gist" of the most important parts of the learning materials; and "wrapping up" key ideas. Find out how to help students of mixed achievement levels apply learning strategies while learning content area in materials in small groups. The design of CSL is based on social-constructivism and Vygotsky’s best-known concept of the Zone of Proximal Development (ZPD). The definition of ZPD is the distance between the actual acquisition level as decided by individual problem solution case and the level of potential acquisition level, similar to Krashen (1980)’s i+1, as decided through the problem-solution case under the facilitator’s guidance, or in group work with other more capable members (Vygotsky, 1978). Vygotsky claimed that learners’ ideal learning environment is in the ZPD. An ideal teacher or more-knowledgable-other (MKO) should be able to recognize a learner’s ZPD and facilitates them to develop beyond it. Then the MKO is able to leave the support step by step until the learner can perform the task without aid. Steven Krashen (1980) proposed Input hypothesis including i+1 hypothesis. The input hypothesis models are the application of ZPD in second language acquisition and have been widely recognized until today. Krashen (2019)’s optimal language learning environment (2019) further developed the application of ZPD and added the component of strategic group learning. The strategic group learning is composed of desirable learning materials learners are motivated to learn and desirable group members who are more capable and are therefore able to offer meaningful input to the learners. Purpose-driven Collaborative Strategic Learning Model is a strategic integration of ZPD, i+1 hypothesis model, and Optimal Language Learning Environment Model. It is purpose driven to ensure group members are motivated. It is collaborative so that an optimal learning environment where meaningful input from meaningful conversation can be generated. It is strategic because facilitators in the model strategically assign each member a meaningful and collaborative role, e.g., team leader, technician, problem solver, appraiser, offer group learning instrument so that the learning process is structured, and integrate group learning and team building making sure holistic development of each participant. Using data collected from college year one and year two students’ English courses, this presentation will demonstrate how purpose-driven collaborative strategic learning model is implemented in the second/foreign language classroom, using the qualitative data from questionnaire and interview. Particular, this presentation will show how second/foreign language learners grow from functioning with facilitator or more capable peer’s aid to performing without aid. The implication of this research is that purpose-driven collaborative strategic learning model can be used not only in language learning, but also in any subject area.

Keywords: collaborative, strategic, optimal input, second language acquisition

Procedia PDF Downloads 103
193 Effect of Supplementation with Fresh Citrus Pulp on Growth Performance, Slaughter Traits and Mortality in Guinea Pigs

Authors: Carlos Minguez, Christian F. Sagbay, Erika E. Ordoñez

Abstract:

Guinea pigs (Cavia porcellus) play prominent roles as experimental models for medical research and as pets. However, in developing countries like South America, the Philippines, and sub-Saharan Africa, the meat of guinea pigs is an economic source of animal protein for the poor and malnourished humans because guinea pigs are mainly fed with forage and do not compete directly with human beings for food resources, such as corn or wheat. To achieve efficient production of guinea pigs, it is essential to provide insurance against vitamin C deficiency. The objective of this research was to investigate the effect of the partial replacement of alfalfa with fresh citrus pulp (Citrus sinensis) in a diet of guinea pigs on the growth performance, slaughter traits and mortality during the fattening period (between 20 and 74 days of age). A total of 300 guinea pigs were housed in collective cages of about ten animals (2 x 1 x 0.4 m) and were distributed into two completely randomized groups. Guinea pigs in both groups were fed ad libitum, with a standard commercial pellet diet (10 MJ of digestible energy/kg, 17% crude protein, 11% crude fiber, and 4.5% crude fat). Control group was supplied with fresh alfalfa as forage. In the treatment group, 30% of alfalfa was replaced by fresh citrus pulp. Growth traits, including body weight (BW), average daily gain (ADG), feed intake (FI), and feed conversion ratio (FCR), were measured weekly. On day 74, the animals were slaughtered, and slaughter traits, including live weight at slaughter (LWS), full gastrointestinal tract weight (FGTW), hot carcass weight (with head; HCW), cold carcass weight (with head; CCW), drip loss percentage (DLP) and dressing out carcass yield percentage (DCY), were evaluated. Contrasts between groups were obtained by calculated generalized least squares values. Mortality was evaluated by Fisher's exact test due to low numbers in some cells. In the first week, there were significant differences in the growth traits BW, ADG, FI, and FCR, which were superior in control group. These differences may have been due to the origin of the young guinea pigs, which, before weaning, were all raised without fresh citrus pulp, and they were not familiarized with the new supplement. In the second week, treatment group had significantly increased ADG compared with control group, which may have been the result of a process of compensatory growth. During subsequent weeks, no significant differences were observed between animals raised in the two groups. Neither were any significant differences observed across the total fattening period. No significant differences in slaughter traits or mortality rate were observed between animals from the two groups. In conclusion, although there were no significant differences in growth performance, slaughter traits, or mortality, the use of fresh citrus pulp is recommended. Fresh citrus pulp is a by-product of orange juice industry and it is cheap or free. Forage made with fresh citrus pulp could reduce about of 30 % the quantity of alfalfa in guinea pig for meat and as consequence, reduce the production costs.

Keywords: fresh citrus, growth, Guinea pig, mortality

Procedia PDF Downloads 169
192 Musictherapy and Gardentherapy: A Systemic Approach for the Life Quality of the PsychoPhysical Disability

Authors: Adriana De Serio, Donato Forenza

Abstract:

Aims. In this experimental research the Authors present the methodological plan “Musictherapy and Gardentherapy” that they created interconnected with the garden landscape ecosystems and aimed at PsychoPhysical Disability (MusGarPPhyD). In the context of the environmental education aimed at spreading the landscape culture and its values, it’s necessary to develop a solid perception of the environment sustainability to implement a multidimensional approach that pays attention to the conservation and enhancement of gardens and natural environments. The result is an improvement in the life quality also in compliance with the objectives of the European Agenda 2030. The MusGarPPhyD can help professionals such as musictherapists and environmental and landscape researchers strengthen subjects' motivation to learn to deal with the psychophysical discomfort associated with disability and to cope with the distress and the psychological fragility and the loneliness and the social seclusion and to promote productive social relationships. Materials and Methods. The MusGarPPhyD was implemented in multiple spaces. The musictherapy treatments took place first inside residential therapeutic centres and then in the garden landscape ecosystem. Patients: twenty, set in two groups. Weekly-sessions (50’) for three months. Methodological phases: - Phase P1. MusicTherapy treatments for each group in the indoor spaces. - Phase P2. MusicTherapy sessions inside the gardens. After each Phase, P1 and P2: - a Questionnaire for each patient (ten items / liking-indices) was administrated at t0 time, during the treatment and at tn time at the end of the treatment. - Monitoring of patients' behavioral responses through assessment scales, matrix, table and graph system. MusicTherapy methodology: pazient Sonorous-Musical Anamnesis, Musictherapy Assessment Document, Observation Protocols, Bodily-Environmental-Rhythmical-Sonorous-Vocal-Energy production first indoors and then outside, sonorous-musical instruments and edible instruments made by the Author/musictherapist with some foods; Administration of Patient-Environment-Music Index at time to and tn, to estimate the patient’s behavior evolution, Musictherapeutic Advancement Index. Results. The MusGarPPhyD can strengthen the individual sense of identity and improve the psychophysical skills and the resilience to face and to overcome the difficulties caused by the congenital /acquired disability. The multi-sensory perceptions deriving from contact with the plants in the gardens improve the psychological well-being and regulate the physiological parameters such as blood pressure, cardiac and respiratory rhythm, reducing the cholesterol levels. The secretions of the peptide hormones endorphins and the endogenous opioids enkephalins increase and bring a state of patient’s tranquillity and a better mood. The subjects showed a preference for musictherapy treatments within a setting made up of gardens and peculiar landscape systems. This resulted in greater health benefits. Conclusions. The MusGarPPhyD contributes to reduce psychophysical tensions, anxiety, depression and stress, facilitating the connections between the cerebral hemispheres, thus also improving intellectual performances, self-confidence, motor skills and social interactions. Therefore it is necessary to design hospitals, rehabilitation centers, nursing homes, surrounded by gardens. Ecosystems of natural and urban parks and gardens create fascinating skyline and mosaics of landscapes rich in beauty and biodiversity. The MusGarPPhyD is useful for the health management promoting patient’s psychophysical activation, better mood/affective-tone and relastionships and contributing significantly to improving the life quality.

Keywords: musictherapy, gardentherapy, disability, life quality

Procedia PDF Downloads 37
191 Use of Proton Pump Inhibitors Medications during the First Years of Life and Late Complications

Authors: Kamelia Hamza

Abstract:

Background: Proton pump inhibitors (PPIs) are the most prescribed drug classes for pediatric gastroesophageal reflux disease (GERD).Many patients are treated with these drugs for atypical manifestations attributed to gastroesophageal reflux (GER), even in the absence of proved causal relationship. There is an impression of increase use of PPI's treatment for reflux in "clalit health services," the largest health organization in Israel. In the recent years, the medicine is given without restriction, it's not limited to pediatric gastroenterologists only, but pediatricians and family doctors. The objective of this study is to evaluate the hypothesis that exposure to PPIs during the first year of life is associated with an increased risk of developing late adverse diseases: pneumonia, asthma, AGE, IBD, celiac disease, allergic disorders, obesity, attention deficit hyperactivity disorders (ADHD), autism spectrum disorders (ASD). Methods: The study is a retrospective case-control cohort study based on a computerized database of Clalit Health Services (CHS). It includes 9844 children born between 2002-2018 and reported to complain of at least one of the symptoms (reflux/ spitting up, irritability, feeding difficulties, colics). The study population included the study group (n=4922) of children exposed to PPIs at any time prior to the first year of life and a control group (n=4922) child not exposed to PPIs who were matched to each case of the study group on age, race, socioeconomic status, and year of birth. The prevalence of late complications/diseases in the study group was compared with the prevalence of late complications/diseases diagnosis between 2002-2020 in the control group. Odds ratios and 95% confidence intervals were calculated by using logistic regression models. Results: We found that compared to the control group, children exposed to PPIs in the first year of life had an increased risk of developing several late complications/ disorders: pneumonia, asthma, various allergies (urticaria, allergic rhinitis, or allergic conjunctivitis) OR, inhalant allergies, and food allergies. In addition, they showed an increased risk of being diagnosed with ADHD or ASD, but children exposed to PPIs in the first year of life had decrease the risk of obesity by 17% (OR 0.825, 95%CI 0.697-0.976). Conclusions: We found significant associations between the use of PPIs during the first year of life and subsequent development of late complications/diseases such as respiratory diseases, allergy diseases, ADHD, and ASD. More studies are needed to prove causality and determine the mechanism behind the effect of PPIs and the development of late complications.

Keywords: acid suppressing medications, proton pump inhibitors, histamine 2 blocker, late complications, gastroesophageal reflux, gastroesophageal reflux disease, acute gastroenteritis, community acquired pneumonia, asthma, allergic diseases, obesity, inflammatory bowel diseases, ulcerative colitis, crohn disease, attention deficit hyperactivity disorders, autism spectrum disorders

Procedia PDF Downloads 77
190 Computational and Experimental Study of the Mechanics of Heart Tube Formation in the Chick Embryo

Authors: Hadi S. Hosseini, Larry A. Taber

Abstract:

In the embryo, heart is initially a simple tubular structure that undergoes complex morphological changes as it transforms into a four-chambered pump. This work focuses on mechanisms that create heart tube (HT). The early embryo is composed of three relatively flat primary germ layers called endoderm, mesoderm, and ectoderm. Precardiac cells located within bilateral regions of the mesoderm called heart fields (HFs) fold and fuse along the embryonic midline to create the HT. The right and left halves of this plate fold symmetrically to bring their upper edges into contact along the midline, where they fuse. In a region near the fusion line, these layers then separate to generate the primitive HT and foregut, which then extend vertically. The anterior intestinal portal (AIP) is the opening at the caudal end of the foregut, which descends as the HT lengthens. The biomechanical mechanisms that drive this folding are poorly understood. Our central hypothesis is that folding is caused by differences in growth between the endoderm and mesoderm while subsequent extension is driven by contraction along the AIP. The feasibility of this hypothesis is examined using experiments with chick embryos and finite-element modeling (FEM). Fertilized white Leghorn chicken eggs were incubated for approximately 22-33 hours until appropriate Hamburger and Hamilton stage (HH5 to HH9) was reached. To inhibit contraction, embryos were cultured in media containing blebbistatin (myosin II inhibitor) for 18h. Three-dimensional models were created using ABAQUS (D. S. Simulia). The initial geometry consists of a flat plate including two layers representing the mesoderm and endoderm. Tissue was considered as a nonlinear elastic material with growth and contraction (negative growth) simulated using a theory, in which the total deformation gradient is given by F=F^*.G, where G is growth tensor and F* is the elastic deformation gradient tensor. In embryos exposed to blebbistatin, initial folding and AIP descension occurred normally. However, after HFs partially fused to create the upper part of the HT, fusion, and AIP descension stopped, and the HT failed to grow longer. These results suggest that cytoskeletal contraction is required only for the later stages of HT formation. In the model, a larger biaxial growth rate in the mesoderm compared to the endoderm causes the bilayered plate to bend ventrally, as the upper edge moves toward the midline, where it 'fuses' with the other half . This folding creates the upper section of the HT, as well as the foregut pocket bordered by the AIP. After this phase completes by stage HH7, contraction along the arch-shaped AIP pulls the lower edge of the plate downward, stretching the two layers. Results given by model are in reasonable agreement with experimental data for the shape of HT, as well as patterns of stress and strain. In conclusion, results of our study support our hypothesis for the creation of the heart tube.

Keywords: heart tube formation, FEM, chick embryo, biomechanics

Procedia PDF Downloads 278
189 Home Garden: A Food-Based Strategy to Achieve Sustainable Impact on Household Nutrition of Resource-Poor Families in Nepal

Authors: Purushottam P. Khatiwada, Bikash Paudel, Ram B. Rana, Parshuram Biswakarma, Roshan Pudasaini

Abstract:

Nepal has been putting its efforts into securing food and nutrition security for its citizens adopting different models and approaches. Home Garden approach, that integrates vegetables, fruits, small livestock, poultry along with other components like fish, honeybee, mushroom, spices for the promotion of nutritional security of resource-poor and disadvantaged groups was implemented during March 2009 to July 2013 spreading over 16 districts of Nepal covering 115 farmers groups, directly working with 3500 households. Sustained long-term impact of development interventions targeted to the resource-poor and disadvantaged groups has been a recurrent issue for donors, policymakers and practitioners alike. Considering the issue, a post-project evaluation was carried out in a selected project group (Dangibari of Jhapa) after four years of project completion in 2017 in order to evaluate the impact and understand the factors associated with its success. Qualitative information was collected through focus group discussion with group members and associated local institutions. For quantitative information, a quick survey was carried out to the same group members only selecting few indicators. The results are compared with the data obtained from the baseline study conducted by the project in March 2009. The impact of project intervention was evident as compared to the benchmarks established during the baseline, even after four years of project completion. The area under home garden is increased to 729 m² from 386 m² and average food self-sufficiency months increased to 10.22 from 8.11. Seven to eleven fruit species are maintained in the home gardens. An average number of vegetable species grown increased to 15.85 from 9.86. It has resulted in an increase in vegetables self-sufficient month to 8.74 from 4.74 and a huge increase in cash income NPR 6142.8 (USD 59.6) from NPR 385.7 (USD 3.9) from the sale of surplus vegetables. Coaching and mentoring including nutrition sensitization by the project staff at the beginning, inputs and technical support during the project implementation phase and projects effort on the institutional building of disadvantaged farmers were the key drivers of home garden sustainability and expansion. Specifically, package of home garden management trainings provided by the project staff, availability of group funds for buying inputs even after the project, uniting home garden group members in a cooperative, resource leveraging by local institutions through group lobbying, farmers innovations for maintaining home garden diversity and continuous backstopping support by few active members as local resource persons to other members are some additional factors contributing to sustain and/or improve the home garden status by the resource-poor and disadvantaged group.

Keywords: food-based nutrition, home garden, resource-poor and disadvantaged group, sustained impact

Procedia PDF Downloads 113
188 Comparison between Bernardi’s Equation and Heat Flux Sensor Measurement as Battery Heat Generation Estimation Method

Authors: Marlon Gallo, Eduardo Miguel, Laura Oca, Eneko Gonzalez, Unai Iraola

Abstract:

The heat generation of an energy storage system is an essential topic when designing a battery pack and its cooling system. Heat generation estimation is used together with thermal models to predict battery temperature in operation and adapt the design of the battery pack and the cooling system to these thermal needs guaranteeing its safety and correct operation. In the present work, a comparison between the use of a heat flux sensor (HFS) for indirect measurement of heat losses in a cell and the widely used and simplified version of Bernardi’s equation for estimation is presented. First, a Li-ion cell is thermally characterized with an HFS to measure the thermal parameters that are used in a first-order lumped thermal model. These parameters are the equivalent thermal capacity and the thermal equivalent resistance of a single Li-ion cell. Static (when no current is flowing through the cell) and dynamic (making current flow through the cell) tests are conducted in which HFS is used to measure heat between the cell and the ambient, so thermal capacity and resistances respectively can be calculated. An experimental platform records current, voltage, ambient temperature, surface temperature, and HFS output voltage. Second, an equivalent circuit model is built in a Matlab-Simulink environment. This allows the comparison between the generated heat predicted by Bernardi’s equation and the HFS measurements. Data post-processing is required to extrapolate the heat generation from the HFS measurements, as the sensor records the heat released to the ambient and not the one generated within the cell. Finally, the cell temperature evolution is estimated with the lumped thermal model (using both HFS and Bernardi’s equation total heat generation) and compared towards experimental temperature data (measured with a T-type thermocouple). At the end of this work, a critical review of the results obtained and the possible mismatch reasons are reported. The results show that indirectly measuring the heat generation with HFS gives a more precise estimation than Bernardi’s simplified equation. On the one hand, when using Bernardi’s simplified equation, estimated heat generation differs from cell temperature measurements during charges at high current rates. Additionally, for low capacity cells where a small change in capacity has a great influence on the terminal voltage, the estimated heat generation shows high dependency on the State of Charge (SoC) estimation, and therefore open circuit voltage calculation (as it is SoC dependent). On the other hand, with indirect measuring the heat generation with HFS, the resulting error is a maximum of 0.28ºC in the temperature prediction, in contrast with 1.38ºC with Bernardi’s simplified equation. This illustrates the limitations of Bernardi’s simplified equation for applications where precise heat monitoring is required. For higher current rates, Bernardi’s equation estimates more heat generation and consequently, a higher predicted temperature. Bernardi´s equation accounts for no losses after cutting the charging or discharging current. However, HFS measurement shows that after cutting the current the cell continues generating heat for some time, increasing the error of Bernardi´s equation.

Keywords: lithium-ion battery, heat flux sensor, heat generation, thermal characterization

Procedia PDF Downloads 337
187 Cultural Knowledge Transfer of the Inherited Karen Backstrap Weaving for the 4th Generation of a Pwo Karen Community

Authors: Suphitcha Charoen-Amornkitt, Chokeanand Bussracumpakorn

Abstract:

The tendency of the Karen backstrap weaving succession has gradually decreased due to the difficulty of weaving techniques and the relocation of the young generation. The Yang Nam Klat Nuea community, Nong Ya Plong District, Phetchaburi, is a Pwo Karen community that is seriously confronted with a lack of cultural heritage. Thus, a group of weavers was formed to revive the knowledge of weaving. However, they have been gradually confronted with culture assimilation to mainstream culture from the desire for marketing acceptance and imperative and forced the extinction of culture due to the disappearance of weaving details and techniques. Although there are practical solutions, i.e., product development, community improvement, knowledge improvement, and knowledge transfer, to inherit the Karen weaving culture, people in the community cannot fulfill their deep intention about the weaving inheritance as most solutions have focused on developing the commercial products and making the income instead of inheriting their knowledge. This research employed qualitative user research with an in-depth user interview to study communal knowledge transfer succession based on the internal involved parties, i.e., four expert weavers, three young weavers, and three 4th generation villagers. The purpose is to explore the correlation and mindset of villagers towards the culture with specific issues, including the psychology of culture, core knowledge and learning methods, cultural inheritance, and cultural engagement. As a result, the existing models of knowledge management mostly focused on tangible strategies, which can notice progress in short terms, such as direct teaching and consistent practicing. At the same time, the motivation and passion of inheritors were abolished while the research found that the young generation who profoundly connected with the textile culture will have a more significant intention to continue the culture. Therefore, this research suggests both internal and external solutions to treat the community. Regarding the internal solutions, family, weaving group, and school have an important role to participate with young villagers by encouraging activities to support the cultivating of Karen’s history, understanding their identities, and adapting the culture as a part of daily life. At the same time, collecting all of the knowledge in the archives, e.g., recorded video, instruction, and books, can crucially prevent the culture from extinction. Regarding the external solutions, this study suggests that working with social media will enhance the intimacy of textile culture, while the community should relieve the roles in marketing competition and start to drive cultural experiences to create a new market position. In conclusion, this research intends to explore the causes and motivation to support the transfer of the culture to the 4th generation villagers and to raise awareness of the diversity of culture in society. With these suggestions and the desire to improve pride and confidence in culture, the community agrees that strengthening the relationships between the young villagers and the weaving culture can bring attention and interest back to the weaving culture.

Keywords: Pwo Karen textile culture, backstrap weaving succession, cultural inheritance, knowledge transfer, knowledge management

Procedia PDF Downloads 62
186 Shocks and Flows - Employing a Difference-In-Difference Setup to Assess How Conflicts and Other Grievances Affect the Gender and Age Composition of Refugee Flows towards Europe

Authors: Christian Bruss, Simona Gamba, Davide Azzolini, Federico Podestà

Abstract:

In this paper, the authors assess the impact of different political and environmental shocks on the size and on the age and gender composition of asylum-related migration flows to Europe. With this paper, the authors contribute to the literature by looking at the impact of different political and environmental shocks on the gender and age composition of migration flows in addition to the size of these flows. Conflicting theories predict different outcomes concerning the relationship between political and environmental shocks and the migration flows composition. Analyzing the relationship between the causes of migration and the composition of migration flows could yield more insights into the mechanisms behind migration decisions. In addition, this research may contribute to better informing national authorities in charge of receiving these migrant, as women and children/the elderly require different assistance than young men. To be prepared to offer the correct services, the relevant institutions have to be aware of changes in composition based on the shock in question. The authors analyze the effect of different types of shocks on the number, the gender and age composition of first time asylum seekers originating from 154 sending countries. Among the political shocks, the authors consider: violence between combatants, violence against civilians, infringement of political rights and civil liberties, and state terror. Concerning environmental shocks, natural disasters (such as droughts, floods, epidemics, etc.) have been included. The data on asylum seekers applying to any of the 32 Schengen Area countries between 2008 and 2015 is on a monthly basis. Data on asylum applications come from Eurostat, data on shocks are retrieved from various sources: georeferenced conflict data come from the Uppsala Conflict Data Program (UCDP), data on natural disasters from the Centre for Research on the Epidemiology of Disasters (CRED), data on civil liberties and political rights from Freedom House, data on state terror from the Political Terror Scale (PTS), GDP and population data from the World Bank, and georeferenced population data from the Socioeconomic Data and Applications Center (SEDAC). The authors adopt a Difference-in-Differences identification strategy, exploiting the different timing of several kinds of shocks across countries. The highly skewed distribution of the dependent variable is taken into account by using count data models. In particular, a Zero Inflated Negative Binomial model is adopted. Preliminary results show that different shocks - such as armed conflict and epidemics - exert weak immediate effects on asylum-related migration flows and almost non-existent effects on the gender and age composition. However, this result is certainly affected by the fact that no time lags have been introduced so far. Finding the correct time lags depends on a great many variables not limited to distance alone. Therefore, finding the appropriate time lags is still a work in progress. Considering the ongoing refugee crisis, this topic is more important than ever. The authors hope that this research contributes to a less emotionally led debate.

Keywords: age, asylum, Europe, forced migration, gender

Procedia PDF Downloads 235
185 Policy Views of Sustainable Integrated Solution for Increased Synergy between Light Railways and Electrical Distribution Network

Authors: Mansoureh Zangiabadi, Shamil Velji, Rajendra Kelkar, Neal Wade, Volker Pickert

Abstract:

The EU has set itself a long-term goal of reducing greenhouse gas emissions by 80-95% of the 1990 levels by 2050 as set in the Energy Roadmap 2050. This paper reports on the European Union H2020 funded E-Lobster project which demonstrates tools and technologies, software and hardware in integrating the grid distribution, and the railway power systems with power electronics technologies (Smart Soft Open Point - sSOP) and local energy storage. In this context this paper describes the existing policies and regulatory frameworks of the energy market at European level with a special focus then at National level, on the countries where the members of the consortium are located, and where the demonstration activities will be implemented. By taking into account the disciplinary approach of E-Lobster, the main policy areas investigated includes electricity, energy market, energy efficiency, transport and smart cities. Energy storage will play a key role in enabling the EU to develop a low-carbon electricity system. In recent years, Energy Storage System (ESSs) are gaining importance due to emerging applications, especially electrification of the transportation sector and grid integration of volatile renewables. The need for storage systems led to ESS technologies performance improvements and significant price decline. This allows for opening a new market where ESSs can be a reliable and economical solution. One such emerging market for ESS is R+G management which will be investigated and demonstrated within E-Lobster project. The surplus of energy in one type of power system (e.g., due to metro braking) might be directly transferred to the other power system (or vice versa). However, it would usually happen at unfavourable instances when the recipient does not need additional power. Thus, the role of ESS is to enhance advantages coming from interconnection of the railway power systems and distribution grids by offering additional energy buffer. Consequently, the surplus/deficit of energy in, e.g. railway power systems, is not to be immediately transferred to/from the distribution grid but it could be stored and used when it is really needed. This will assure better energy management exchange between the railway power systems and distribution grids and lead to more efficient loss reduction. In this framework, to identify the existing policies and regulatory frameworks is crucial for the project activities and for the future development of business models for the E-Lobster solutions. The projections carried out by the European Commission, the Member States and stakeholders and their analysis indicated some trends, challenges, opportunities and structural changes needed to design the policy measures to provide the appropriate framework for investors. This study will be used as reference for the discussion in the envisaged workshops with stakeholders (DSOs and Transport Managers) in the E-Lobster project.

Keywords: light railway, electrical distribution network, Electrical Energy Storage, policy

Procedia PDF Downloads 109
184 Beyond Personal Evidence: Using Learning Analytics and Student Feedback to Improve Learning Experiences

Authors: Shawndra Bowers, Allie Brandriet, Betsy Gilbertson

Abstract:

This paper will highlight how Auburn Online’s instructional designers leveraged student and faculty data to update and improve online course design and instructional materials. When designing and revising online courses, it can be difficult for faculty to know what strategies are most likely to engage learners and improve educational outcomes in a specific discipline. It can also be difficult to identify which metrics are most useful for understanding and improving teaching, learning, and course design. At Auburn Online, the instructional designers use a suite of data based student’s performance, participation, satisfaction, and engagement, as well as faculty perceptions, to inform sound learning and design principles that guide growth-mindset consultations with faculty. The consultations allow the instructional designer, along with the faculty member, to co-create an actionable course improvement plan. Auburn Online gathers learning analytics from a variety of sources that any instructor or instructional design team may have access to at their own institutions. Participation and performance data, such as page: views, assignment submissions, and aggregate grade distributions, are collected from the learning management system. Engagement data is pulled from the video hosting platform, which includes unique viewers, views and downloads, the minutes delivered, and the average duration each video is viewed. Student satisfaction is also obtained through a short survey that is embedded at the end of each instructional module. This survey is included in each course every time it is taught. The survey data is then analyzed by an instructional designer for trends and pain points in order to identify areas that can be modified, such as course content and instructional strategies, to better support student learning. This analysis, along with the instructional designer’s recommendations, is presented in a comprehensive report to instructors in an hour-long consultation where instructional designers collaborate with the faculty member on how and when to implement improvements. Auburn Online has developed a triage strategy of priority 1 or 2 level changes that will be implemented in future course iterations. This data-informed decision-making process helps instructors focus on what will best work in their teaching environment while addressing which areas need additional attention. As a student-centered process, it has created improved learning environments for students and has been well received by faculty. It has also shown to be effective in addressing the need for improvement while removing the feeling the faculty’s teaching is being personally attacked. The process that Auburn Online uses is laid out, along with the three-tier maintenance and revision guide that will be used over a three-year implementation plan. This information can help others determine what components of the maintenance and revision plan they want to utilize, as well as guide them on how to create a similar approach. The data will be used to analyze, revise, and improve courses by providing recommendations and models of good practices through determining and disseminating best practices that demonstrate an impact on student success.

Keywords: data-driven, improvement, online courses, faculty development, analytics, course design

Procedia PDF Downloads 34
183 Design of Smart Catheter for Vascular Applications Using Optical Fiber Sensor

Authors: Lamiek Abraham, Xinli Du, Yohan Noh, Polin Hsu, Tingting Wu, Tom Logan, Ifan Yen

Abstract:

In the field of minimally invasive, smart medical instruments such as catheters and guidewires are typically used at a remote distance to gain access to the diseased artery, often negotiating tortuous, complex, and diseased vessels in the process. Three optical fiber sensors with a diameter of 1.5mm each that are 120° apart from each other is proposed to be mounted into a catheter-based pump device with a diameter of 10mm. These sensors are configured to solve the challenges surgeons face during insertion through curvy major vessels such as the aortic arch. Moreover, these sensors deal with providing information on rubbing the walls and shape sensing. This study presents an experimental and mathematical models of the optical fiber sensors with 2 degrees of freedom. There are two eight gear-shaped tubes made up of 3D printed thermoplastic Polyurethane (TPU) material that are connected. The optical fiber sensors are mounted inside the first tube for protection from external light and used TPU material as a prototype for a catheter. The second tube is used as a flat reflection for the light intensity modulation-based optical fiber sensors. The first tube is attached to the linear guide for insertion and withdrawal purposes and can manually turn it 45° by manipulating the tube gear. A 3D hard material phantom was developed that mimics the aortic arch anatomy structure in which the test was carried out. During the insertion of the sensors into the 3D phantom, datasets are obtained in terms of voltage, distance, and position of the sensors. These datasets reflect the characteristics of light intensity modulation of the optical fiber sensors with a plane project of the aortic arch structure shape. Mathematical modeling of the light intensity was carried out based on the projection plane and experiment set-up. The performance of the system was evaluated in terms of its accuracy in navigating through the curvature and information on the position of the sensors by investigating 40 single insertions of the sensors into the 3D phantom. The experiment demonstrated that the sensors were effectively steered through the 3D phantom curvature and to desired target references in all 2 degrees of freedom. The performance of the sensors echoes the reflectance of light theory, where the smaller the radius of curvature, the more of the shining LED lights are reflected and received by the photodiode. A mathematical model results are in good agreement with the experiment result and the operation principle of the light intensity modulation of the optical fiber sensors. A prototype of a catheter using TPU material with three optical fiber sensors mounted inside has been developed that is capable of navigating through the different radius of curvature with 2 degrees of freedom. The proposed system supports operators with pre-scan data to make maneuverability and bendability through curvy major vessels easier, accurate, and safe. The mathematical modelling accurately fits the experiment result.

Keywords: Intensity modulated optical fiber sensor, mathematical model, plane projection, shape sensing.

Procedia PDF Downloads 210
182 Analytical and Numerical Modeling of Strongly Rotating Rarefied Gas Flows

Authors: S. Pradhan, V. Kumaran

Abstract:

Centrifugal gas separation processes effect separation by utilizing the difference in the mole fraction in a high speed rotating cylinder caused by the difference in molecular mass, and consequently the centrifugal force density. These have been widely used in isotope separation because chemical separation methods cannot be used to separate isotopes of the same chemical species. More recently, centrifugal separation has also been explored for the separation of gases such as carbon dioxide and methane. The efficiency of separation is critically dependent on the secondary flow generated due to temperature gradients at the cylinder wall or due to inserts, and it is important to formulate accurate models for this secondary flow. The widely used Onsager model for secondary flow is restricted to very long cylinders where the length is large compared to the diameter, the limit of high stratification parameter, where the gas is restricted to a thin layer near the wall of the cylinder, and it assumes that there is no mass difference in the two species while calculating the secondary flow. There are two objectives of the present analysis of the rarefied gas flow in a rotating cylinder. The first is to remove the restriction of high stratification parameter, and to generalize the solutions to low rotation speeds where the stratification parameter may be O (1), and to apply for dissimilar gases considering the difference in molecular mass of the two species. Secondly, we would like to compare the predictions with molecular simulations based on the direct simulation Monte Carlo (DSMC) method for rarefied gas flows, in order to quantify the errors resulting from the approximations at different aspect ratios, Reynolds number and stratification parameter. In this study, we have obtained analytical and numerical solutions for the secondary flows generated at the cylinder curved surface and at the end-caps due to linear wall temperature gradient and external gas inflow/outflow at the axis of the cylinder. The effect of sources of mass, momentum and energy within the flow domain are also analyzed. The results of the analytical solutions are compared with the results of DSMC simulations for three types of forcing, a wall temperature gradient, inflow/outflow of gas along the axis, and mass/momentum input due to inserts within the flow. The comparison reveals that the boundary conditions in the simulations and analysis have to be matched with care. The commonly used diffuse reflection boundary conditions at solid walls in DSMC simulations result in a non-zero slip velocity as well as a temperature slip (gas temperature at the wall is different from wall temperature). These have to be incorporated in the analysis in order to make quantitative predictions. In the case of mass/momentum/energy sources within the flow, it is necessary to ensure that the homogeneous boundary conditions are accurately satisfied in the simulations. When these precautions are taken, there is excellent agreement between analysis and simulations, to within 10 %, even when the stratification parameter is as low as 0.707, the Reynolds number is as low as 100 and the aspect ratio (length/diameter) of the cylinder is as low as 2, and the secondary flow velocity is as high as 0.2 times the maximum base flow velocity.

Keywords: rotating flows, generalized onsager and carrier-Maslen model, DSMC simulations, rarefied gas flow

Procedia PDF Downloads 372
181 Applying Napoleoni's 'Shell-State' Concept to Jihadist Organisations's Rise in Mali, Nigeria and Syria/Iraq, 2011-2015

Authors: Francesco Saverio Angiò

Abstract:

The Islamic State of Iraq and the Levant / Syria (ISIL/S), Al-Qaeda in the Islamic Maghreb (AQIM) and People Committed to the Propagation of the Prophet's Teachings and Jihad, also known as ‘Boko Haram’ (BH), have fought successfully against Syria and Iraq, Mali, Nigeria’s government, respectively. According to Napoleoni, the ‘shell-state’ concept can explain the economic dimension and the financing model of the ISIL insurgency. However, she argues that AQIM and BH did not properly plan their financial model. Consequently, her idea would not be suitable to these groups. Nevertheless, AQIM and BH’s economic performances and their (short) territorialisation suggest that their financing models respond to a well-defined strategy, which they were able to adapt to new circumstances. Therefore, Napoleoni’s idea of ‘shell-state’ can be applied to the three jihadist armed groups. In the last five years, together with other similar entities, ISIL/S, AQIM and BH have been fighting against governments with insurgent tactics and terrorism acts, conquering and ruling a quasi-state; a physical space they presented as legitimate territorial entity, thanks to a puritan version of the Islamic law. In these territories, they have exploited the traditional local economic networks. In addition, they have contributed to the development of legal and illegal transnational business activities. They have also established a justice system and created an administrative structure to supply services. Napoleoni’s ‘shell-state’ can describe the evolution of ISIL/S, AQIM and BH, which has switched from an insurgency to a proto or a quasi-state entity, enjoying a significant share of power over territories and populations. Napoleoni first developed and applied the ‘Shell-state’ concept to describe the nature of groups such as the Palestine Liberation Organisation (PLO), before using it to explain the expansion of ISIL. However, her original conceptualisation emphasises on the economic dimension of the rise of the insurgency, focusing on the ‘business’ model and the insurgents’ financing management skills, which permits them to turn into an organisation. However, the idea of groups which use, coordinate and grab some territorial economic activities (at the same time, encouraging new criminal ones), can also be applied to administrative, social, infrastructural, legal and military levels of their insurgency, since they contribute to transform the insurgency to the same extent the economic dimension does. In addition, according to Napoleoni’s view, the ‘shell-state’ prism is valid to understand the ISIL/S phenomenon, because the group has carefully planned their financial steps. Napoleoni affirmed that ISIL/S carries out activities in order to promote their conversion from a group relying on external sponsors to an entity that can penetrate and condition local economies. On the contrary, ‘shell-state’ could not be applied to AQIM or BH, which are acting more like smugglers. Nevertheless, despite its failure to control territories, as ISIL has been able to do, AQIM and BH have responded strategically to their economic circumstances and have defined specific dynamics to ensure a flow of stable funds. Therefore, Napoleoni’s theory is applicable.

Keywords: shell-state, jihadist insurgency, proto or quasi-state entity economic planning, strategic financing

Procedia PDF Downloads 322
180 Drivers of the Performance of Members of a Social Incubator Considering the Values of Work: A Qualitative Study with Social Entrepreneurs

Authors: Leticia Lengler, Vania Estivalete, Vivian Flores Costa, Tais De Andrade, Lisiane Fellini Faller

Abstract:

Social entrepreneurship has emerged and driven a new development perspective, and as the literature mentions, it is based on innovation, and mainly, on the creation of social value, rather than personal wealth and shareholders. In this field of study, one of the focuses of discussion refers to the distinct characteristics of the individuals responsible for socially directed initiatives, named as social entrepreneurs. To contribute to this perspective, the present study aims to identify the values related to work that guide the performance of social entrepreneurs, members of enterprises that have developed themselves within a social incubator at a federal institution of higher education in Brazil. Each person's value system is present in different facets of his life, manifesting himself in his choices and in the way he conducts the relationship with other people in society. Especially the values of work, the focus of this research, play a significant role in organizational studies, since they are considered one of the important guiding principles of the behavior of individuals in the work environment. Regarding the method of the study, a descriptive and qualitative research was carried out. In the data collection, 24 entrepreneurs, members of five different enterprises belonging to the social incubator, were interviewed. The research instrument consisted of three open questions, which could be answered with the support of a "disc of values", an artifact organized to clearly demonstrate the values of the work to the respondents. The analysis of the interviews took into account the categories defined a priori, based on the model proposed by previous authors who validated these constructs within their research contexts, contemplating the following dimensions: Self-determination and stimulation; Safety; Conformity; Universalism and benevolence; Achievement; and Power. It should be noted that, in order to provide a better understanding of the interviewees, in the "disc of values" used in the research, these dimensions were represented by the objectives that define them, being respectively: Challenge; Financial independence; Commitment; Welfare of others; Personal success; And Power. Some preliminary results show that, as guiding principles of the investigation, priority is given to work values related to Self-determination and stimulation, Conformity and Universalism and benevolence. Such findings point to the importance given by these individuals to independent thinking and acting, as well as to novelty and constant challenge. Still, they demonstrate the appreciation of commitment to their enterprise, the people who make it and the quality of their work. They also point to the relevance of the possibility of contributing to the greater social good, that is, of the search for the well-being of close people and of society, as it is implied in models of social entrepreneurship coming from literature. With a lower degree of priority, the values denominated Safety and Realization, as the financial question at work and the search for satisfaction and personal success, through the use of socially recognized skills were mentioned aspects with little emphasis by social entrepreneurs. The Power value was not considered as guiding principle of the work for the respondents.

Keywords: qualitative study, social entrepreneur, social incubator, values of work

Procedia PDF Downloads 234
179 Online Monitoring and Control of Continuous Mechanosynthesis by UV-Vis Spectrophotometry

Authors: Darren A. Whitaker, Dan Palmer, Jens Wesholowski, James Flaherty, John Mack, Ahmad B. Albadarin, Gavin Walker

Abstract:

Traditional mechanosynthesis has been performed by either ball milling or manual grinding. However, neither of these techniques allow the easy application of process control. The temperature may change unpredictably due to friction in the process. Hence the amount of energy transferred to the reactants is intrinsically non-uniform. Recently, it has been shown that the use of Twin-Screw extrusion (TSE) can overcome these limitations. Additionally, TSE enables a platform for continuous synthesis or manufacturing as it is an open-ended process, with feedstocks at one end and product at the other. Several materials including metal-organic frameworks (MOFs), co-crystals and small organic molecules have been produced mechanochemically using TSE. The described advantages of TSE are offset by drawbacks such as increased process complexity (a large number of process parameters) and variation in feedstock flow impacting on product quality. To handle the above-mentioned drawbacks, this study utilizes UV-Vis spectrophotometry (InSpectroX, ColVisTec) as an online tool to gain real-time information about the quality of the product. Additionally, this is combined with real-time process information in an Advanced Process Control system (PharmaMV, Perceptive Engineering) allowing full supervision and control of the TSE process. Further, by characterizing the dynamic behavior of the TSE, a model predictive controller (MPC) can be employed to ensure the process remains under control when perturbed by external disturbances. Two reactions were studied; a Knoevenagel condensation reaction of barbituric acid and vanillin and, the direct amidation of hydroquinone by ammonium acetate to form N-Acetyl-para-aminophenol (APAP) commonly known as paracetamol. Both reactions could be carried out continuously using TSE, nuclear magnetic resonance (NMR) spectroscopy was used to confirm the percentage conversion of starting materials to product. This information was used to construct partial least squares (PLS) calibration models within the PharmaMV development system, which relates the percent conversion to product to the acquired UV-Vis spectrum. Once this was complete, the model was deployed within the PharmaMV Real-Time System to carry out automated optimization experiments to maximize the percentage conversion based on a set of process parameters in a design of experiments (DoE) style methodology. With the optimum set of process parameters established, a series of PRBS process response tests (i.e. Pseudo-Random Binary Sequences) around the optimum were conducted. The resultant dataset was used to build a statistical model and associated MPC. The controller maximizes product quality whilst ensuring the process remains at the optimum even as disturbances such as raw material variability are introduced into the system. To summarize, a combination of online spectral monitoring and advanced process control was used to develop a robust system for optimization and control of two TSE based mechanosynthetic processes.

Keywords: continuous synthesis, pharmaceutical, spectroscopy, advanced process control

Procedia PDF Downloads 144
178 Amifostine Analogue, Drde-30, Attenuates Radiation-Induced Lung Injury in Mice

Authors: Aastha Arora, Vikas Bhuria, Saurabh Singh, Uma Pathak, Shweta Mathur, Puja P. Hazari, Rajat Sandhir, Ravi Soni, Anant N. Bhatt, Bilikere S. Dwarakanath

Abstract:

Radiotherapy is an effective curative and palliative option for patients with thoracic malignancies. However, lung injury, comprising of pneumonitis and fibrosis, remains a significant clin¬ical complication of thoracic radiation, thus making it a dose-limiting factor. Also, injury to the lung is often reported as part of multi-organ failure in victims of accidental radiation exposures. Radiation induced inflammatory response in the lung, characterized by leukocyte infiltration and vascular changes, is an important contributing factor for the injury. Therefore, countermeasure agents to attenuate radiation induced inflammatory response are considered as an important approach to prevent chronic lung damage. Although Amifostine, the widely used, FDA approved radio-protector, has been found to reduce the radiation induced pneumonitis during radiation therapy of non-small cell lung carcinoma, its application during mass and field exposure is limited due to associated toxicity and ineffectiveness with the oral administration. The amifostine analogue (DRDE-30) overcomes this limitation as it is orally effective in reducing the mortality of whole body irradiated mice. The current study was undertaken to investigate the potential of DRDE-30 to ameliorate radiation induced lung damage. DRDE-30 was administered intra-peritoneally, 30 minutes prior to 13.5 Gy thoracic (60Co-gamma) radiation in C57BL/6 mice. Broncheo- alveolar lavage fluid (BALF) and lung tissues were harvested at 12 and 24 weeks post irradiation for studying inflammatory and fibrotic markers. Lactate dehydrogenase (LDH) leakage, leukocyte count and protein content in BALF were used as parameters to evaluate lung vascular permeability. Inflammatory cell signaling (p38 phosphorylation) and anti-oxidant status (MnSOD and Catalase level) was assessed by Western blot, while X-ray CT scan, H & E staining and trichrome staining were done to study the lung architecture and collagen deposition. Irradiation of the lung increased the total protein content, LDH leakage and total leukocyte count in the BALF, reflecting endothelial barrier dysfunction. These disruptive effects were significantly abolished by DRDE-30, which appear to be linked to the DRDE-30 mediated abrogation of activation of the redox-sensitive pro- inflammatory signaling cascade, the MAPK pathway. Concurrent administration of DRDE-30 with radiation inhibited radiation-induced oxidative stress by strengthening the anti-oxidant defense system and abrogated p38 mitogen-activated protein kinase activation, which was associated with reduced vascular leak and macrophage recruitment to the lungs. Histopathological examination (by H & E staining) of the lung showed radiation-induced inflammation of the lungs, characterized by cellular infiltration, interstitial oedema, alveolar wall thickening, perivascular fibrosis and obstruction of alveolar spaces, which were all reduced by pre-administration of DRDE-30. Structural analysis with X-ray CT indicated lung architecture (linked to the degree of opacity) comparable to un-irradiated mice that correlated well with the lung morphology and reduced collagen deposition. Reduction in the radiation-induced inflammation and fibrosis brought about by DRDE-30 resulted in a profound increase in animal survival (72 % in the combination vs 24% with radiation) observed at the end of 24 weeks following irradiation. These findings establish the potential of the Amifostine analogue, DRDE-30, in reducing radiation induced pulmonary injury by attenuating the inflammatory and fibrotic responses.

Keywords: amifostine, fibrosis, inflammation, lung injury radiation

Procedia PDF Downloads 486
177 Participatory Action Research with Social Workers: The World Café Method to Share Critical Reflections and Possible Solutions on Working Practices in Migration Contexts

Authors: Ilaria Coppola, Davide Lacqua, Nadia Ranìa

Abstract:

Over the past two decades, migration has gained central importance in the global landscape. Europe hosts the largest number of migrants, totaling 92.9 million people, approximately 37.4 million of whom are regular residents within the European Union's borders. Reception services and different modes of management have received increasing attention precisely because of the complexity of the phenomenon, which necessarily impacts the wider community. Indeed, opening a reception center in an area entails major challenges for that context, for the community that inhabits it, and for the people who use that service. Questioning the strategies needed to offer a functional reception service means listening to the different actors involved who daily face the difficulties involved in working in the field. Recognizing the importance of the professional figures who work closely with migrant people, each with their own specific experiences has led researchers to study and analyze the different types of reception centers and their management. This has led to the development of intervention models and best practices in various countries. However, research from this perspective is still limited, especially in Italy. From this theoretical framework, this study aims to bring out an innovative qualitative tool, such as the world café, the work experiences of 29 social workers working in shelters in the Italian context. Most of the participants were female and lived in the Northwest regions of Italy. Through this tool, the aim was to bring out and share reflections on the critical issues encountered in working in reception centers, with a view to identifying possible solutions for better management of services. The World café represents a tool used in participatory action research that promotes dialogue among participants through the sharing of reflections and ideas. In fact, from critical reflections, participants are invited to identify and share possible solutions to provide a more functional service with benefits to the entire community. Therefore, this research, through the innovative technique of the World café, aims to promote critical thinking processes that can help participants find solutions that can be introduced into their work contexts or proposed to decision-makers. Specifically, the findings shed light on several issues, including complex bureaucratic procedures, insufficient project planning, and inefficiencies in the services provided to migrants. These concerns collectively contribute to what participants perceive as a disorganized and uncoordinated system. In addition, the study explores potential solutions that promote more efficient networking practices, coordinated project management, and a more positive approach to cultural diversity. The main results obtained will be discussed with a focus on critical reflections and possible solutions identified.

Keywords: participatory action research, world café method, reception services, migration contexts, social workers, Italy

Procedia PDF Downloads 32
176 Preventative Programs for At-Risk Families of Child Maltreatment: Using Home Visiting and Intergenerational Relationships

Authors: Kristina Gordon

Abstract:

One in three children in the United States is a victim of a maltreatment investigation, and about one in nine children has a substantiated investigation. Home visiting is one of several preventative strategies rooted in an early childhood approach that fosters maternal, infant, and early childhood health, protection, and growth. In the United States, 88% of states report administering home visiting programs or state-designed models. The purpose of this study was to conduct a systematic review on home visiting programs in the United States focused on the prevention of child abuse and neglect. This systematic review included 17 articles which found that most of the studies reported optimistic results. Common across studies was program content related to (1) typical child development, (2) parenting education, and (3) child physical health. Although several factors common to home visiting and parenting interventions have been identified, no research has examined the common components of manualized home visiting programs to prevent child maltreatment. Child maltreatment can be addressed with home visiting programs with evidence-based components and cultural adaptations that increase prevention by assisting families in tackling the risk factors they face. An innovative approach to child maltreatment prevention is bringing together at-risk families with the aging community. This innovative approach was prompted due to existing home visitation programs only focusing on improving skillsets and providing temporary relationships. This innovative approach can provide the opportunity for families to build a relationship with an aging individual who can share their wisdom, skills, compassion, love, and guidance, to support families in their well-being and decrease child maltreatment occurrence. Families would be identified if they experience any of the risk factors, including parental substance abuse, parental mental illness, domestic violence, and poverty. Families would also be identified as at risk if they lack supportive relationships such as grandparents or relatives. Families would be referred by local agencies such as medical clinics, hospitals, schools, etc., that have interactions with families regularly. The aging community would be recruited at local housing communities and community centers. An aging individual would be identified by the elderly community when there is a need or interest in a relationship by or for the individual. Cultural considerations would be made when assessing for compatibility between the families and aging individuals. The pilot program will consist of a small group of participants to allow manageable results to evaluate the efficacy of the program. The pilot will include pre-and post-surveys to evaluate the impact of the program. From the results, data would be created to determine the efficacy as well as the sufficiency of the details of the pilot. The pilot would also be evaluated on whether families were referred to Child Protective Services during the pilot as it relates to the goal of decreasing child maltreatment. The ideal findings will display a decrease in child maltreatment and an increase in family well-being for participants.

Keywords: child maltreatment, home visiting, neglect, preventative, abuse

Procedia PDF Downloads 90
175 Women's Entrepreneurship in Mena Region: Gem Key Learnings

Authors: Fatima Boutaleb

Abstract:

Entrepreneurship proves to be crucial for the economic growth and development, since it contributes to job creation and the improvement of the overall productivity thus generating a positive impact upon society at various levels. Promoting entrepreneurship stimulates therefore economic diversity that is key to the betterment and/or maintaining of the standard of living. In fact, recent research suggests that entrepreneurship contributes to development by creating businesses and jobs, stimulating innovation, creating social capital across borders, and channeling political and financial capital. However, different research studies indicate that among the main factors impeding the entrepreneurship are politico-economic as socio-cultural problems, with an intensity for those related to young people and to women. In the MENA region, discrimination inherent in gender is alarming: Only one woman in eight runs her own business against 1 in 3 men. In most countries, young women and young men are facing problems involving access to finance, inadequate infrastructure, lack of support and, in general, an ecosystem that is rather unfavorable. According to the International Labor Organization, North Africa and the Middle East has the highest unemployment rate in all other regions of the world. In other hand, nearly a quarter of the population under 30 is unemployed and youth unemployment costs more than $40 billion each year to the region. In the current context, the situations in the Middle East and North Africa region are singular, both in terms of demographic trends and socio-economic issues around the employment of a large and better trained youth, but still strongly affected by unemployment and under-employment. According to a study published in 2015 by McKinsey, the world gain 26% of additional GDP (47% in the MENA region), more than 28 trillion dollars by 2025, if women came to participate, as well as men, to the economy. Promoting entrepreneurship represents an excellent alternative for the countries whose productive fabric fails to integrate the contingent of young people entering the job market each year. The MENA region, presenting entrepreneurial activity rates below those of other regions in terms of comparable development, has undoubtedly leeway at this level, even though the region displays large national heterogeneity, namely in the priority given to the promotion of entrepreneurship. The objective of this article is therefore to examine the women entrepreneurial vocation in the MENA region, to see to what extent research on the determinant of gender can provide information on the trend of the emerging entrepreneurial activity whether driven by necessity or by opportunity and, on this basis, to submit public policy proposals for the improvement of the mechanisms of inclusion among the youth women people. The objective is not to analyze the causality models but rather to identify the entrepreneurial construct specific to the MENA region via the analysis of GEM data from 2017 to 2019 among adults belonging to 10 countries of the MENA region. Notably, the study shows that inclusion of young women may be enhanced. These disadvantaged segments frequently intend to become entrepreneurs, but they tend not to enact their vocational intentions.

Keywords: economic development, entrepreneurial activity, GEM, gender, informal sector

Procedia PDF Downloads 72
174 The Academic Experience of Vocational Training Teachers

Authors: Andréanne Gagné, Jo Anni Joncas, Éric Tendon

Abstract:

Teaching in vocational training requires an excellent mastery of the trade being taught, but also solid professional skills in pedagogy. Teachers are typically recruited on the basis of their trade expertise, and they do not necessarily have training or experience in pedagogy. In order to counter this lack, the Ministry of Education (Québec, Canada) requires them to complete a 120-credit university program to obtain their teaching certificate. They must complete this training in addition to their teaching duties. This training was rarely planned in the teacher’s life course, and each teacher approaches it differently: some are enthusiastic, but many feel reluctant discouragement and even frustration at the idea of committing to a training program lasting an average of 10 years to completion. However, Quebec is experiencing an unprecedented shortage of teachers, and the perseverance of vocational teachers in their careers requires special attention because of the conditions of their specific integration conditions. Our research examines the perceptions that vocational teachers in training have of their academic experience in pre-service teaching. It differs from previous research in that it focuses on the influence of the academic experience on the teaching employment experience. The goal is that by better understanding the university experience of teachers in vocational education, we can identify support strategies to support their school experience and their teaching. To do this, the research is based on the theoretical framework of the sociology of experience, which allows us to study the way in which these “teachers-students” give meaning to their university program in articulation with their jobs according to three logics of action. The logic of integration is based on the process of socialization, where the action is preceded by the internalization of values, norms, and cultural models associated with the training context. The logic of strategy refers to the usefulness of this experience where the individual constructs a form of rationality according to his objectives, resources, social position, and situational constraints. The logic of subjectivation refers to reflexivity activities aimed at solving problems and making choices. These logics served as a framework for the development of an online questionnaire. Three hundred respondents, newly enrolled in an undergraduate teaching program (bachelor's degree in vocational education), expressed themselves about their academic experience. This paper relates qualitative data (open-ended questions) subjected to an interpretive repertory analysis approach to descriptive data (closed-ended questions) that emerged. The results shed light on how the respondents perceive themselves as teachers and students, their perceptions of university training and the support offered, and the place that training occupies in their professional path. Indeed, their professional and academic paths are inextricably linked, and it seems essential to take them into account simultaneously to better meet their needs and foster the development of their expertise in pedagogy. The discussion focuses on the strengths and limitations of university training from the perspective of the logic of action. The results also suggest support strategies that can be implemented to better support the integration and retention of student teachers in professional education.

Keywords: teacher, vocational training, pre-service training, academic experience

Procedia PDF Downloads 79
173 Developing Thai-UK Double Degree Programmes: An Exploratory Study Identifying Challenges, Competing Interests and Risks

Authors: Joy Tweed, Jon Pike

Abstract:

In Thailand, a 4.0 policy has been initiated that is designed to prepare and train an appropriate workforce to support the move to a value-based economy. One aspect of support for this policy is a project to encourage the creation of double degree programmes, specifically between Thai and UK universities. This research into the project, conducted with its key players, explores the factors that can either enable or hinder the development of such programmes. It is an area that has received little research attention to date. Key findings focus on differences in quality assurance requirements, attitudes to benefits, risks, and committed levels of institutional support, thus providing valuable input into future policy making. The Transnational Education (TNE) Development Project was initiated in 2015 by the British Council, in conjunction with the Office for Higher Education Commission (OHEC), Thailand. The purpose of the project was to facilitate opportunities for Thai Universities to partner with UK Universities so as to develop double degree programme models. In this arrangement, the student gains both a UK and a Thai qualification, spending time studying in both countries. Twenty-two partnerships were initiated via the project. Utilizing a qualitative approach, data sources included participation in TNE project workshops, peer reviews, and over 20 semi-structured interviews conducted with key informants within the participating UK and Thai universities. Interviews were recorded, transcribed, and analysed for key themes. The research has revealed that the strength of the relationship between the two partner institutions is critical. Successful partnerships are often built on previous personal contact, have senior-level involvement and are strengthened by partnership on different levels, such as research, student exchange, and other forms of mobility. The support of the British Council was regarded as a key enabler in developing these types of projects for those universities that had not been involved in TNE previously. The involvement of industry is apparent in programmes that have high scientific content but not well developed in other subject areas. Factors that hinder the development of partnership programmes include the approval processes and quality requirements of each institution. Significant differences in fee levels between Thai and UK universities provide a challenge and attempts to bridge them require goodwill on the part of the latter that may be difficult to realise. This research indicates the key factors to which attention needs to be given when developing a TNE programme. Early attention to these factors can reduce the likelihood that the partnership will fail to develop. Representatives in both partner universities need to understand their respective processes of development and approval. The research has important practical implications for policy-makers and planners involved with TNE, not only in relation to the specific TNE project but also more widely in relation to the development of TNE programmes in other countries and other subject areas. Future research will focus on assessing the success of the double degree programmes generated by the TNE Development Project from the perspective of universities, policy makers, and industry partners.

Keywords: double-degree, internationalization, partnerships, Thai-UK

Procedia PDF Downloads 83
172 Clinically-Based Improvement Project Focused on Reducing Risks Associated with Diabetes Insipidus, Syndrome of Inappropriate ADH, and Cerebral Salt Wasting in Paediatric Post-Neurosurgical and Traumatic Brain Injury Patients

Authors: Shreya Saxena, Felix Miller-Molloy, Phillipa Bowen, Greg Fellows, Elizabeth Bowen

Abstract:

Background: Complex fluid balance abnormalities are well-established post-neurosurgery and traumatic brain injury (TBI). The triple-phase response requires fluid management strategies reactive to urine output and sodium homeostasis as patients shift between Diabetes Insipidus (DI) and Syndrome of Inappropriate ADH (SIADH). It was observed, at a tertiary paediatric center, a relatively high prevalence of the above complications within a cohort of paediatric post-neurosurgical and TBI patients. An audit of the clinical practice against set institutional guidelines was undertaken and analyzed to understand why this was occurring. Based on those results, new guidelines were developed with structured educational packages for the specialist teams involved. This was then reaudited, and the findings were compared. Methods: Two independent audits were conducted across two time periods, pre and post guideline change. Primary data was collected retrospectively, including both qualitative and quantitative data sets from the CQUIN neurosurgical database and electronic medical records. All paediatric patients post posterior fossa (PFT) or supratentorial surgery or with a TBI were included. A literature review of evidence-based practice, initial audit data, and stakeholder feedback was used to develop new clinical guidelines and nursing standard operation procedures. Compliance against these newly developed guidelines was re-assessed and a thematic, trend-based analysis of the two sets of results was conducted. Results: Audit-1 January2017-June2018, n=80; Audit-2 January2020-June2021, n=30 (reduced operative capacity due to COVID-19 pandemic). Overall, improvements in the monitoring of both fluid balance and electrolyte trends were demonstrated; 51% vs. 77% and 78% vs. 94%, respectively. The number of clear fluid management plans documented postoperatively also increased (odds ratio of 4), leading to earlier recognition and management of evolving fluid-balance abnormalities. The local paediatric endocrine team was involved in the care of all complex cases and notified sooner for those considered to be developing DI or SIADH (14% to 35%). However, significant Na fluctuations (>12mmol in 24 hours) remained similar – 5 vs six patients – found to be due to complex pituitary hypothalamic pathology – and the recommended adaptive fluid management strategy was still not always used. Qualitative data regarding useability and understanding of fluid-balance abnormalities and the revised guidelines were obtained from health professionals via surveys and discussion in the specialist teams providing care. The feedback highlighted the new guidelines provided a more consistent approach to the post-operative care of these patients and was a better platform for communication amongst the different specialist teams involved. The potential limitation to our study would be the small sample size on which to conduct formal analyses; however, this reflects the population that we were investigating, which we cannot control. Conclusion: The revised clinical guidelines, based on audited data, evidence-based literature review and stakeholder consultations, have demonstrated an improvement in understanding of the neuro-endocrine complications that are possible, as well as increased compliance to post-operative monitoring of fluid balance and electrolytes in this cohort of patients. Emphasis has been placed on preventative rather than treatment of DI and SIADH. Consequently, this has positively impacted patient safety for the center and highlighted the importance of educational awareness and multi-disciplinary team working.

Keywords: post-operative, fluid-balance management, neuro-endocrine complications, paediatric

Procedia PDF Downloads 70
171 Enhancing Financial Security: Real-Time Anomaly Detection in Financial Transactions Using Machine Learning

Authors: Ali Kazemi

Abstract:

The digital evolution of financial services, while offering unprecedented convenience and accessibility, has also escalated the vulnerabilities to fraudulent activities. In this study, we introduce a distinct approach to real-time anomaly detection in financial transactions, aiming to fortify the defenses of banking and financial institutions against such threats. Utilizing unsupervised machine learning algorithms, specifically autoencoders and isolation forests, our research focuses on identifying irregular patterns indicative of fraud within transactional data, thus enabling immediate action to prevent financial loss. The data we used in this study included the monetary value of each transaction. This is a crucial feature as fraudulent transactions may have distributions of different amounts than legitimate ones, such as timestamps indicating when transactions occurred. Analyzing transactions' temporal patterns can reveal anomalies (e.g., unusual activity in the middle of the night). Also, the sector or category of the merchant where the transaction occurred, such as retail, groceries, online services, etc. Specific categories may be more prone to fraud. Moreover, the type of payment used (e.g., credit, debit, online payment systems). Different payment methods have varying risk levels associated with fraud. This dataset, anonymized to ensure privacy, reflects a wide array of transactions typical of a global banking institution, ranging from small-scale retail purchases to large wire transfers, embodying the diverse nature of potentially fraudulent activities. By engineering features that capture the essence of transactions, including normalized amounts and encoded categorical variables, we tailor our data to enhance model sensitivity to anomalies. The autoencoder model leverages its reconstruction error mechanism to flag transactions that deviate significantly from the learned normal pattern, while the isolation forest identifies anomalies based on their susceptibility to isolation from the dataset's majority. Our experimental results, validated through techniques such as k-fold cross-validation, are evaluated using precision, recall, and the F1 score alongside the area under the receiver operating characteristic (ROC) curve. Our models achieved an F1 score of 0.85 and a ROC AUC of 0.93, indicating high accuracy in detecting fraudulent transactions without excessive false positives. This study contributes to the academic discourse on financial fraud detection and provides a practical framework for banking institutions seeking to implement real-time anomaly detection systems. By demonstrating the effectiveness of unsupervised learning techniques in a real-world context, our research offers a pathway to significantly reduce the incidence of financial fraud, thereby enhancing the security and trustworthiness of digital financial services.

Keywords: anomaly detection, financial fraud, machine learning, autoencoders, isolation forest, transactional data analysis

Procedia PDF Downloads 22