Search results for: penetration rates

Authors: Saheed Shittu, Lolwa Alansari, Fahed Nattouf, Tawa Olukade, Naji Abdallah, Tamara Alshdafat, Sarra Amdouni

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Cesarean sections (CS), a highly regarded surgical intervention for improving fetal-maternal outcomes and serving as an integral part of emergency obstetric services, are not without complications. Although CS has many advantages, it poses significant risks to both mother and child and increases healthcare expenditures in the long run. The escalating global prevalence of CS, coupled with variations in rates among immigrant populations, has prompted an inquiry into the correlation between CS rates and the nationalities of women undergoing deliveries at Al-Wakra Hospital (AWH), Qatar's second-largest public maternity hospital. This inquiry is motivated by the notable CS rate of 36%, deemed high in comparison to the 34% recorded across other Hamad Medical Corporation (HMC) maternity divisions This is Qatar's first comprehensive investigation of Caesarean section rates and nationalities. A retrospective cross-sectional study was conducted, and data for all births delivered in 2019 were retrieved from the hospital's electronic medical records. The CS rate, the crude rate, and adjusted risks of Caesarean delivery for mothers from each nationality were determined. The common indications for CS were analysed based on nationality. The association between nationality and Caesarean rates was examined using binomial logistic regression analysis considering Qatari women as a standard reference group. The correlation between the CS rate in the country of nationality and the observed CS rate in Qatar was also examined using Pearson's correlation. This study included 4,816 births from 69 different nationalities. CS was performed in 1767 women, equating to 36.5%. The nationalities with the highest CS rates were Egyptian (49.6%), Lebanese (45.5%), Filipino and Indian (both 42.2%). Qatari women recorded a CS rate of 33.4%. The major indication for elective CS was previous multiple CS (39.9%) and one prior CS, where the patient declined vaginal birth after the cesarean (VBAC) option (26.8%). A distinct pattern was noticed: elective CS was predominantly performed on Arab women, whereas emergency CS was common among women of Asian and Sub-Saharan African nationalities. Moreover, a significant correlation was found between the CS rates in Qatar and the women's countries of origin. Also, a high CS rate was linked to instances of previous CS. As a result of these insights, strategic interventions were successfully implemented at the facility to mitigate unwarranted CS, resulting in a notable reduction in CS rate from 36.5% in 2019 to 34% in 2022. This proves the efficacy of the meticulously researched approach. The focus has now shifted to reducing primary CS rates and facilitating well-informed decisions regarding childbirth methods.

Keywords: maternal nationality, caesarean section rate variation, migrants, high-income country

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Authors: Lamia Bensissaid

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Goals: Endometriosis affects 6 to 10% of women of childbearing age. 17 to 44% of them have ovarian endometriomas. Medical and surgical treatments represent the two therapeutic axes with which PMA can be associated. Laparoscopic intraperitoneal ovarian cystectomy is described as the reference technique in the management of endometriomas by learned societies (CNGOF, ESHRE, NICE). However, it leads to a significant short-term reduction in the AMH level and the number of antral follicles, especially in cases of bilateral cystectomy, large cyst size or cystectomy after recurrence. Often, the disease is at an advanced stage with several surgical patients. Most have adhesions, which increase the risk of surgical complications and suboptimal resection and, therefore recurrence of the cyst. These results led to a change of opinion towards a conservative approach. Sclerotherapy is an old technique which acts by fibrinoid necrosis. It consists of injecting a sclerosing agent into the cyst cavity. Results : Recurrence was less than 15% for a 12-month follow-up; these rates are comparable to those of surgery. It does not seem to have a negative impact on ovarian reserve, but this is not sufficiently evaluated. It has an advantage in IVF pregnancy rates compared to cystectomy, particularly in cases of recurrent endometriomas. It has the advantages: · To be done on an outpatient basis. · To be inexpensive. · To avoid sometimes difficult and iterative surgery: · To allow an increase in pregnancy rates and the preservation of the ovarian reserve compared to iterative surgery. · of great interest in cases of bilateral endometriomas (kissing ovaries) or recurrent endometriomas. Conclusions: Ethanol sclerotherapy could be a good alternative to surgery.

Keywords: Endometrioma, Sclerotherapy, infertility, Ethanol

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Authors: J. M. Geyser

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Lamb is a popular meat throughout the world, particularly in Europe, the Middle East and Oceania. However, the conventional lamb industry faces challenges related to environmental sustainability, climate change, consumer health and dwindling profit margins. This has stimulated an increasing demand for organic lamb, as it is perceived to increase environmental sustainability, offer superior quality, taste, and nutritional value, which is appealing to farmers, including small-scale and female farmers, as it often commands a premium price. Despite its advantages, organic lamb production presents challenges, with a significant hurdle being the high production costs encompassing organic certification, lower stocking rates, higher mortality rates and marketing cost. These costs impact the profitability and competitiveness or organic lamb producers, particularly female and small-scale farmers, who often encounter additional obstacles, such as limited access to resources and markets. Therefore, this paper examines the cost of producing organic lambs and its impact on female farmers and raises the research question: “Is organic lamb production the saving grace for female and small-scale farmers?” Objectives include estimating and comparing production costs and profitability or organic lamb production with conventional lamb production, analyzing influencing factors, and assessing opportunities and challenges for female and small-scale farmers. The hypothesis states that organic lamb production can be a viable and beneficial option for female and small-scale farmers, provided that they can overcome high production costs and access premium markets. The study uses a mixed-method approach, combining qualitative and quantitative data. Qualitative data involves semi-structured interviews with ten female and small-scale farmers engaged in organic lamb production in South Africa. The interview covered topics such as farm characteristics, practices, cost components, mortality rates, income sources and empowerment indicators. Quantitative data used secondary published information and primary data from a female farmer. The research findings indicate that when a female farmer moves from conventional lamb production to organic lamb production, the cost in the first year of organic lamb production exceed those of conventional lamb production by over 100%. This is due to lower stocking rates and higher mortality rates in the organic system. However, costs start decreasing in the second year as stocking rates increase due to manure applications on grazing and lower mortality rates due to better worm resistance in the herd. In conclusion, this article sheds light on the economic dynamics of organic lamb production, particularly focusing on its impact on female farmers. To empower female farmers and to promote sustainable agricultural practices, it is imperative to understand the cost structures and profitability of organic lamb production.

Keywords: cost analysis, empowerment, female farmers, organic lamb production

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Authors: Kurudzirayi Robson Musikavanhu

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Nanophase particles exhibit quantum behavior by virtue of their small size, being particles of gamma to x-ray wavelength [atomic range]. Such particles exhibit high frequencies, high energy/photon, high penetration power, high ionization power [atomic behavior] and are stable at low energy levels as opposed to bulk phase matter [macro particles] which exhibit higher wavelength [radio wave end] properties, hence lower frequency, lower energy/photon, lower penetration power, lower ionizing power and are less stable at low temperatures. The ‘unique’ behavioral motion of Nano systems will remain a mystery as long as quantum theory remains a mystery, and for pharmacology, pharmacovigilance profiling of Nano systems becomes virtually impossible. Quantum theory is the 4 – 3 – 5 electromagnetic law of life and life motion systems on planet earth. Electromagnetic [wave-particle] properties of all particulate matter changes as mass [bulkiness] changes from one phase to the next [Nano-phase to micro-phase to milli-phase to meter-phase to kilometer phase etc.] and the subsequent electromagnetic effect of one phase particle on bulk matter [different phase] changes from one phase to another. All matter exhibit electromagnetic properties [wave-particle duality] in behavior and the lower the wavelength [and the lesser the bulkiness] the higher the gamma ray end properties exhibited and the higher the wavelength [and the greater the bulkiness], the more the radio-wave end properties are exhibited. Quantum theory is the 4 [moon] – 3[sun] – [earth] 5 law of the Electromagnetic spectrum [solar system]. 4 + 3 = 7; 4 + 3 + 5 = 12; 4 * 3 * 5 = 60; 42 + 32 = 52; 43 + 33 + 53 = 63. Quantum age is overdue.

Keywords: electromagnetic solar system, nano-material, nano pharmacology, pharmacovigilance, quantum theory

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Authors: Grace Rachid, Mutasem El Fadel, Mahmoud Al Hindi, Ibrahim Jamali, Daniel Abdel Nour

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This study examines the feasibility of indirect solar desalination in oil producing countries in the Middle East and North Africa (MENA) region. It relies on value engineering (VE) and cost-benefit with sensitivity analyses to identify optimal coupling configurations of desalination and solar energy technologies. A comparative return on investment was assessed as a function of water costs for varied plant capacities (25,000 to 75,000 m3/day), project lifetimes (15 to 25 years), and discount rates (5 to 15%) taking into consideration water and energy subsidies, land cost as well as environmental externalities in the form of carbon credit related to greenhouse gas (GHG) emissions reduction. The results showed reverse osmosis (RO) coupled with photovoltaic technologies (PVs) as the most promising configuration, robust across different prices for Brent oil, discount rates, as well as different project lifetimes. Environmental externalities and subsidies analysis revealed that a 16% reduction in existing subsidy on water tariffs would ensure economic viability. Additionally, while land costs affect investment attractiveness, the viability of RO coupled with PV remains possible for a land purchase cost < $ 80/m2 or a lease rate < $1/m2/yr. Beyond those rates, further subsidy lifting is required.

Keywords: solar energy, desalination, value engineering, CBA, carbon credit, subsidies

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Authors: Binod C. Agrawal

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In modern history, industrial and media merchandising in South Asia from East Asia, Europe, United States and other countries of the West is over 200 years old. Hence, continued external technology and media exposure is not a new experience in multi-lingual and multi religious South Asia which evolved cultural means to withstand structural change. In the post-World War II phase, media exposure especially of telecommunication, film, Internet, radio, print media and television have increased manifold. South Asia did not lose any time in acquiring and adopting digital media accelerated by chip revolution, computer and satellite communication. The penetration of digital media and utilization are exceptionally high though the spread has an unequal intensity, use and effects. The author argues that industrial and media products are “cultural products” apart from being “technological products”; hence their influences are most felt in the cultural domain which may lead to blunting of unique cultural specifics in the multi-cultural, multi-lingual and multi religious South Asia. Social scientists, political leaders and parents have voiced concern of “Cultural domination”, “Digital media colonization” and “Westernization”. Increased digital media access has also opened up doors of pornography and other harmful information that have sparked fresh debates and discussions about serious negative, harmful, and undesirable social effects especially among youth. Within ‘techno-social’ perspective, based on recent research studies, the paper aims to describe and analyse possible socio-economic change due to digital media penetration. Further, analysis supports the view that the ancient multi-lingual and multi-religious cultures of South Asia due to inner cultural strength may sustain without setting in a process of irreversible structural changes in South Asia.

Keywords: cultural sustainability, digital media effects, digital media impact in South Asia, social change in South Asia

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Authors: Ndeye Tiguida Sarr, Onur Akpinar

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The tourism industry, being the sector that includes all the activities related to the organization and satisfaction of tourists during their trip, also has a very important role in the national economy of the host country. In order to measure the stakes of tourism on the economy, microeconomic and macroeconomic factors are elements of analysis. While microeconomics is limited to an individual perspective, macroeconomics extends to a global perspective and treats the economy as a whole by focusing on social and economic actors in general. It is in this context that this study focuses on macroeconomic variables in order to determine the factors that influence the financial performance of tourism firms in Turkey, which is one of the world's major destinations. The aim of the study is to demonstrate the relationship between macroeconomic variables and the financial performance of tourism firms. Data from 2011 to 2020 are collected, from a sample of 16 companies that represent the tourism sector in Borsa Istanbul. Tobin’s Q ratio, Market to Book ratio, Return on Invested Capital, and Return on Assets as the financial performance indicators were dependent variables of the study. Gross Domestic Products, Inflation, Interest Rates, and Unemployment as macroeconomic indicators were independent variables. Again, Size, Liquidity, Leverage, and Age were control variables of the study. According to the results, value indicators, which are Tobin’s Q ratio and Market to Book ratio, have a statistically significant relationship with Inflation, Interest Rates, and Unemployment. A negative relationship is found between value indicators and Interest rates and a positive relationship between value indicators and Unemployment and Inflation. On the other hand, there is no significant relationship between profit indicators (Return on Invested Capital and Return on Assets) and macroeconomic variables. Accordingly, Interest rates negatively affect the financial performance of tourism firms and stand out as a factor that decreases the value.

Keywords: financial performance, macroeconomic variables, panel data, Tobin Q

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Authors: John Kosmeh

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Introduction – For years, senior health care and skilled nursing facilities have been plagued with the dilemma of not having the necessary tools and equipment to adequately care for senior residents in their communities. This has led to high transport rates to emergency departments and high 30-day readmission rates, costing billions of unnecessary dollars each year, as well as quality assurance issues. Our Senior care telemedicine program is designed to solve this issue. Methods – We conducted a 1-year pilot program using our technology coupled with our 24/7 telemedicine program with skilled nursing facilities in different parts of the United States. We then compared transports rates and 30-day readmission rates to previous years before the use of our program, as well as transport rates of other communities of similar size not using our program. This data was able to give us a clear and concise look at the success rate of reducing unnecessary transport and readmissions as well as cost savings. Results – A 94% reduction nationally of unnecessary out-of-facility transports, and to date, complete elimination of 30-day readmissions. Our virtual platform allowed us to instruct facility staff on the utilization of our tools and system as well as deliver treatment by our ER-trained providers. Delay waiting for PCP callbacks was eliminated. We were able to obtain lung, heart, and abdominal ultrasound imaging, 12 lead EKG, blood labs, auscultate lung and heart sounds, and collect other diagnostic tests at the bedside within minutes, providing immediate care and allowing us to treat residents within the SNF. Are virtual capabilities allowed for loved ones, family members, and others who had medical power of attorney to virtually connect with us at the time of visit, to speak directly with the medical provider, providing increased confidence in the decision to treat the resident in-house. The decline in transports and readmissions will greatly reduce governmental cost burdens, as well as fines imposed on SNF for high 30-day readmissions, reduce the cost of Medicare A readmissions, and significantly impact the number of patients visiting overcrowded ERs. Discussion – By utilizing our program, SNF can effectively reduce the number of unnecessary transports of residents, as well as create significant savings from loss of day rates, transportation costs, and high CMS fines. The cost saving is in the thousands monthly, but more importantly, these facilities can create a higher quality of life and medical care for residents by providing definitive care instantly with ER-trained personnel.

Keywords: senior care, long term care, telemedicine, technology, senior care communities

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Authors: Maha Jazouli

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Suicide is one of the most important causes of death in the prison environment, both in Canada and internationally. Rates of attempts of suicide and self-harm have been on the rise in recent years, with hangings being the most frequent method resorted to. The objective of this article is to propose a method to automatically detect in real time suicidal behaviors. We present a gesture recognition system that consists of three modules: model-based movement tracking, feature extraction, and gesture recognition using machine learning algorithms (MLA). Our proposed system gives us satisfactory results. This smart video surveillance system can help assist staff responsible for the safety and health of inmates by alerting them when suicidal behavior is detected, which helps reduce mortality rates and save lives.

Keywords: suicide detection, Kinect azure, RGB-D camera, SVM, machine learning, gesture recognition

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Authors: Zak Maas, Daniel Carson, Rachel McIntyre, Mark Omundsen, Teresa Holm

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Aim: After hemicolectomy a period of obligatory bowel dysfunction is expected, termed postoperative ileus (POI). Prolonged postoperative ileus (PPOI), typically four or more days, is associated with higher morbidity and extended inpatient stay. This leads to significant financial and resource-related burdens on healthcare systems. Several studies including a meta-analysis have compared rates of PPOI in left vs right hemicolectomy, which suggest that right-sided resections may be more likely to result in PPOI. Our study aims to further investigate whether significant differences in PPOI and obligatory POI exist between right versus extended right hemicolectomy. Methods: This is a retrospective review assessing rates of PPOI in patients who underwent right vs extended right hemicolectomy at Tauranga Hospital. Patients were divided and compared depending on approach (open versus laparoscopic) and acuity (acute versus elective). Exclusion criteria included synchronous major operations and patients preoperatively on parenteral nutrition. Primary outcome was PPOI as pre-defined in contemporary literature. Secondary outcomes were time to passage of flatus, passage of stool, toleration of oral diet and rate of complications. Results: There were 669 patients identified for analysis (507 laparoscopic vs 162 open; 194 acute vs 475 elective). Early analysis indicates rates of PPOI was significantly increased in patients undergoing extended right hemicolectomy. Factors including age, gender, ethnicity, preoperative haemaglobin, preoperative albumin and diagnosis of inflammatory bowel disease were examined by multivariate analysis to determine correlation with PPOI. Conclusion: PPOI is a common complication of hemicolectomy surgery. Higher rates of PPOI in extended right vs right hemicolectomy warrants further research into determining the cause. This study examines some other factors which may contribute to PPOI.

Keywords: hemicolectomy, colorectal, complications, postoperative ileus

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Authors: Maria L. G. Lourenço, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, João C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

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Orphaned is a risk factor for mortality in newborns since it is a condition with total or partial absence of maternal care that is essential for neonatal survival, including nursing (nutrition, the transference of passive immunity and hydration), warmth, urination, and defecation stimuli, and protection. The most common causes of mortality in orphans are related to lack of assistance, handling mistakes and infections. This study aims to describe the orphans rates in neonatal puppies, the main causes, and the mortality rates. The study included 735 neonates admitted to the Sao Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil, between January 2018 and November 2019. The orphans rate was 43.4% (319/735) of all neonates included, and the main causes for orphaned were related to maternal agalactia/hypogalactia (23.5%, 75/319); numerous litter (15.7%, 50/319), toxic milk syndrome due to maternal mastitis (14.4%, 46/319), absence of suction/weak neonate (12.2%, 39/319), maternal disease (9.4%, 30/319), cleft palate/lip (6.3%, 20/319), maternal death (5.9%, 19/319), prematurity (5.3%, 17/319), rejection/failure in maternal instinct (3.8%, 12/319) and abandonment by the owner/separation of mother and neonate (3.5%, 11/319). The main consequences of orphaned observed in the admitted neonates were hypoglycemia, hypothermia, dehydration, aspiration pneumonia, wasting syndrome, failure in the transference of passive immunity, infections and sepsis, which happened due to failure of identifying the problem early, lack of adequate assistance, negligence and handling mistakes by the owner. The total neonatal mortality rate was 8% (59/735) and the neonatal mortality rate among orphans was 18.5% (59/319). The orphaned and mortality rates were considered high, but even higher rates may be observed in locations without adequate neonatal assistance and owner orientation. The survival of these patients is related to constant monitoring of the litter, early diagnosis and assistance, and the implementation of effective handling for orphans. Understanding the correct handling for neonates and instructing the owners regarding proper handling are essential to minimize the consequences of orphaned and the mortality rates.

Keywords: orphans, neonatal care, puppies, newborn dogs

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Authors: A. T. Zaki

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The flipped classroom approach as a mode of blended learning was formally introduced to students of the English language modules at the British University in Egypt (BUE) at the start of the academic year 2015/2016. This paper aims to study the impact of the flipped classroom approach after three semesters of implementation. It will restrict itself to the examination of students’ achievement rates, student satisfaction, and how different student cohorts have benefited differently from the flipped practice. The paper concludes with recommendations of how the experience can be further developed.

Keywords: achievement rates, developmental experience, Egypt, flipped classroom, higher education, student cohorts, student satisfaction

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Authors: Viktor R. Stoynov, Zlatka V. Valkova-Jarvis

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The intelligent management and optimisation of radio resource technologies will lead to a considerable improvement in the overall performance in Next Generation Networks (NGNs). Carrier Aggregation (CA) technology, also known as Spectrum Aggregation, enables more efficient use of the available spectrum by combining multiple Component Carriers (CCs) in a virtual wideband channel. LTE-A (Long Term Evolution–Advanced) CA technology can combine multiple adjacent or separate CCs in the same band or in different bands. In this way, increased data rates and dynamic load balancing can be achieved, resulting in a more reliable and efficient operation of mobile networks and the enabling of high bandwidth mobile services. In this paper, several distinct CA deployment strategies for the utilisation of spectrum bands are compared in indoor-outdoor scenarios, simulated via the recently-developed Realistic Indoor Environment Generator (RIEG). We analyse the performance of the User Equipment (UE) by integrating the average throughput, the level of fairness of radio resource allocation, and other parameters, into one summative assessment termed a Comparative Factor (CF). In addition, comparison of non-CA and CA indoor mobile networks is carried out under different load conditions: varying numbers and positions of UEs. The experimental results demonstrate that the CA technology can improve network performance, especially in the case of indoor scenarios. Additionally, we show that an increase of carrier frequency does not necessarily lead to improved CF values, due to high wall-penetration losses. The performance of users under bad-channel conditions, often located in the periphery of the cells, can be improved by intelligent CA location. Furthermore, a combination of such a deployment and effective radio resource allocation management with respect to user-fairness plays a crucial role in improving the performance of LTE-A networks.

Keywords: comparative factor, carrier aggregation, indoor mobile network, resource allocation

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Authors: Alain Villemeur

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The relationships between the profit share in income on the one hand and the growth rates of output and employment on the other hand have been studied for 17 advanced economies since 1961. The vast majority (98%) of annual values for the profit share fall between 20% and 40%, with an average value of 33.9%. For the 17 advanced economies, Gross Domestic Product and productivity growth rates tend to fall as the profit share in income rises. For the employment growth rates, the relationships are complex; nevertheless, over long periods (1961-2000), it appears that the more job-creating economies are Australia, Canada, and the United States; they have experienced a profit share close to 1/3. This raises a number of questions, not least the value of 1/3 for the profit share and its role in macroeconomic fundamentals. To explain these facts, an endogenous growth model is developed. This growth and distribution model reconciles the great ideas of Kaldor (economic growth as a chain reaction), of Keynes (effective demand and marginal efficiency of capital) and of Ricardo (importance of the wage-profit distribution) in an economy facing creative destruction. A production function is obtained, depending mainly on the growth of employment, the rate of net investment and the profit share in income. In theory, we show the existence of incentives: an incentive for job creation when the profit share is less than 1/3 and another incentive for job destruction in the opposite case. Thus, increasing the profit share can boost the employment growth rate until it reaches the value of 1/3; otherwise lowers the employment growth rate. Three key findings can be drawn from these considerations. The first reveals that the best GDP and productivity growth rates are obtained with a profit share of less than 1/3. The second is that maximum job growth is associated with a 1/3 profit share, given the existence of incentives to create more jobs when the profit share is less than 1/3 or to destroy more jobs otherwise. The third is the decline in performance (GDP growth rate and productivity growth rate) when the profit share increases. In conclusion, increasing the profit share in income weakens GDP growth or productivity growth as a long-term trend, contrary to the trickle-down hypothesis. The employment growth rate is maximum for a profit share in income of 1/3. All these lessons suggest macroeconomic policies considering the profit share in income.

Keywords: advanced countries, GDP growth, employment growth, profit share, economic policies

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Authors: Man Young Kim, Gyo Woo Lee

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In this numerical study, we want to present the design of highly efficient extruded-type heat sink. The symmetrically arranged extruded-type heat sinks are used instead of a single extruded or swaged-type heat sink. In this parametric study, the maximum temperatures, the base temperatures between heaters, and the heat release rates were investigated with respect to the arrangements of heat sources, air flow rates, and amounts of heat input. Based on the results we believe that the use of both side of heat sink is to be much better for release the heat than the use of single side. Also from the results, it is believed that the symmetric arrangement of heat sources is recommended to achieve a higher heat transfer from the heat sink.

Keywords: heat sink, forced convection, heat transfer, performance evaluation, symmetrical arrangement

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Authors: Wisam Ismail, Chole Wright, Elizabeth Baker, Cathy Tait, Mohamed Salhab, Richard Linforth

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Background: Post-mastectomy breast reconstruction is an important treatment option for women with breast cancer with psychosocial, emotional and quality of life benefits. Despite this, Asian patients are one-fifth as likely as Caucasian patients to undergo reconstruction after mastectomy. Aim: This study aimed to assess the difference in breast reconstruction rates between Asian and Caucasian patients treated at Bradford Teaching Hospitals between May 2011 – December 2015.The long-term goal is to equip healthcare professionals to improve breast cancer treatment outcome by increasing breast reconstruction rates in this sub-population. Methods: All patients undergoing mastectomy were identified using a prospectively collected departmental database. Further data was obtained via retrospective electronic case note review. Bradford city population is about 530.000 by the end of 2015, with 67.44% of the city's population was White ethnic groups and 26.83% Asian Ethnic Groups (UK population consensus). The majority of Asian population speaks Urdu, hence an Urdu speaking breast care nurse was appointed to facilitate communications and deliver a better understanding of the reconstruction options and pathways. Statistical analysis was undertaken using the SAS program. Patients were stratified by age, self-reported ethnicity, axillary surgery and reconstruction. Relative odds were calculated using univariate and multivariate logistic regression analyses with adjustment for known confounders. An Urdu speaking breast care nurse was employed throughout this period to facilitate communication and patient decision making. Results: 506 patients underwent Mastectomy over 5 years. 72 (14%) Asian v. 434 (85%) Caucasian. Overall median age is 64 years (SD1.1). Asian median age is 62 (SD0.9), versus Caucasian 65 (SD1.2). Total axillary clearance rate was 30% (42% Asian v.30% Caucasian). Overall reconstruction rate was 126 patients (28.9%).Only 6 of 72 Asian patients (<1%) underwent breast reconstruction versus 121of 434 Caucasian (28%) (p < 0.04), Odds ratio 0.68, (95% confidence interval 0.57-0.79). Conclusions: There is a significant difference in post-mastectomy reconstruction rates between Asian and Caucasian patients. This difference is likely to be multi-factorial. Higher rates of axillary clearance in Asian patients might suggest later disease presentation and/or higher rates of subsequent adjuvant therapy, both of which, can impact on the suitability of breast reconstruction. Strategies aimed at reducing racial disparities in breast reconstruction should include symptom awareness to enable earlier presentation and facilitated communication to ensure informed decision-making.

Keywords: aesthetic, Asian, breast, reconstruction

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Authors: Aneta Nitsch-Osuch, Sylwia Dyk, Izabela Gołebiak

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Background. Since 2014 the pertussis vaccine is recommended to Polish health care workers who have close contacts with infants. Although this recommendation is implemented into the National Immunization Programme, its realization has remained unknown. The Purpose: The aim of the study, conducted at the department of Social Medicine and Public Health (Medical University of Warsaw, Poland), was to describe a perception, knowledge and coverage rates regarding pertussis vaccination among nursing staff. According to the authors' knowledge, it was the first study related to this topic in our country. Material and Methods: A total number of 543 nurses who work at pediatric or neonatal wards was included into the study (501 women and 42 men), average age was 47 years. All nurses were asked to fulfill the anonymous survey, previously validated. Results: 1. Coverage rates: The analysis of results revealed that only 4% of responders reported they were vaccinated with Tdpa within past 10 years, while 8% declared they would plan the vaccine in the future. 35% of responders would consider the Tdpa vaccine whether there is some kind of the reimbursement. 2. Perception and knowledge of the disease and vaccination: The majority (82%) of nurses did not recognize pertussis as a re-emerging infectious disease. 54% of them believed that obligatory vaccinations in the childhood protect against the disease and the protection is a life-long one. Only 15% of nurses considered pertussis as a possible nosocomial infection. The current epidemiology of the disease was known to 6% of responders, while 24% of them were familiar with pertussis vaccination schedules for infants, children and adolescents, but only 9% of responders knew that adults older than 19 years are recommended to be vaccinated with Tdpa every 10 years. Many nurses (82%) would expect more educational activities related to pertussis and methods of its prophylaxis. Conclusions: The pertussis vaccine coverage rate among Polish nurses is extremely low. This is a result of not enough knowledge about the disease and its prevention. Educational activities addressed to health care workers and reimbursement of the pertussis vaccine are required to improve awareness and increase of vaccine coverage rates in the future.

Keywords: coverage, nurse, pertussis, vaccine

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Authors: Eric Hawkinson

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After designing and implementing several iterations of implementations of augmented reality (AR) in tourism, this paper takes a deep look into design principles and implementation strategies of using AR at destination tourism settings. The study looks to define augmented tourism from past implementations as well as several cases, uses designed and implemented for tourism. The discussion leads to formation of frameworks and best practices for AR as well as virtual reality( VR) to be used in tourism settings. Some main affordances include guest autonomy, customized experiences, visitor data collection and increased electronic word-of-mouth generation for promotion purposes. Some challenges found include the need for high levels of technology infrastructure, low adoption rates or ‘buy-in’ rates, high levels of calibration and customization, and the need for maintenance and support services. Some suggestions are given as to how to leverage the affordances and meet the challenges of implementing AR for tourism.

Keywords: augmented tourism, augmented reality, eTourism, virtual tourism, tourism design

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Authors: Emed Krekshi, Walid Ben Husein

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The Bahr Essalam gas-condensate field is located off the Libyan coast and is currently being produced by Mellitah Oil and Gas (MOG). Gas and condensate are produced from the Bahr Essalam reservoir through a mixture of platform and subsea wells, with the subsea wells being gathered at the western manifolds and delivered to the Sabratha platform via a 22-inch pipeline. Gas is gathered and dehydrated on the Sabratha platform and then delivered to the Mellitah gas plant via an existing 36-inch gas export pipeline. The condensate separated on the Sabratha platform will be delivered to the Mellitah gas plant via an existing 10-inch export pipeline. The Bahr Essalam Phase II project includes 2 production wells (CC16 & CC17) at C-Central A connected to the Sabratha platform via a new 10.9 km long 10”/14” production pipeline. Production rates from CC16 and CC17 have exceeded the maximum planned rate of 40 MMSCFD per well. A hydrothermal analysis was conducted to review and Verify input data, focusing on the variation of flowing well head as a function of flowrate.as well as Review available input data against the previous design input data to determine the extent of change. The steady-state and transient simulations performed with Olga yielded coherent results and confirmed the possibility of achieving flow rates of up to 60MMSCFD per well without exceeding the design temperatures, pressures, and velocities.

Keywords: Bahr Essalam, Mellitah Oil and Gas, production flow rates, steady and transient

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Authors: Victor Birikorang Danquah

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Ghana's primary energy supply is heavily reliant on petroleum, biomass, and hydropower. Currently, Ghana gets its energy from hydropower (Akosombo and Bui), thermal power plants powered by crude oil, natural gas, and diesel, solar power, and imports from La Cote d'Ivoire. Until the early 2000s, large hydroelectric dams dominated Ghana's electricity generation. Due to unreliable weather patterns, Ghana increased its reliance on thermal power. However, thermal power contributes the highest percentage in terms of electricity generation in Ghana and is predominantly supplied by Independent Power Producers (IPPs). Ghana's electricity industry operates the corporate utility model as its business model. This model is typically' vertically integrated,' with a single corporation selling the majority of power generated by its generation assets to its retail business, which then sells the electricity to retail market consumers. The corporate utility model has a straightforward value proposition that is based on increasing the number of energy units sold. The unit volume business model drives the entire energy value chain to increase throughput, locking system users into unsustainable practices. This report uses the qualitative research approach to explore the electricity industry in Ghana. There is a need for increasing renewable energy, such as wind and solar, in electricity generation. The research recommends two critical business models for the penetration of renewable energy in Ghana's power sector. The first model is the peer-to-peer electricity trading model, which relies on a software platform to connect consumers and generators in order for them to trade energy directly with one another. The second model is about encouraging local energy generation, incentivizing optimal time-of-use behaviour, and allowing any financial gains to be shared among the community members.

Keywords: business model innovation, electricity generation, renewable energy, solar energy, sustainability, wind energy

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Authors: Kaycee Bills

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Past studies have indicated students who have disabilities are at a higher risk of experiencing bullying victimization in comparison to other student groups. Extracurricular activity participation has been shown to establish better social outcomes for students. These positive social outcomes indirectly decrease the number of times a student is bullied. The following study uses the National Crime Victimization Survey – School Crime Supplement (NCVS/SCS) to analyze the bullying concurrences experienced among students, with disabilities being a focal variable. To explore the relationship between extracurricular involvement and bullying occurrence rates, this study employs a binary logistic regression to determine if athletic and non-athletic extracurricular activities have an impact on the number of times a student with disabilities experiences bullying. Implications for future social welfare practice and research are discussed.

Keywords: disability, bullying, extracurricular activities, athletics

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Authors: Ákos Wolf, Richard P. Ray

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Due to the introduction of Eurocode 8, the structural design for seismic and dynamic effects has become more significant in Hungary. This has emphasized the need for more effort to describe the behavior of structures under these conditions. Soil conditions have a significant effect on the response of structures by modifying the stiffness and damping of the soil-structural system and by modifying the seismic action as it reaches the ground surface. Shear modulus (G) and shear wave velocity (v_s), which are often measured in the field, are the fundamental dynamic soil properties for foundation vibration problems, liquefaction potential and earthquake site response analysis. There are several laboratory and in-situ measurement techniques to evaluate dynamic soil properties, but unfortunately, they are often too expensive for general design practice. However, a significant number of correlations have been proposed to determine shear wave velocity or shear modulus from Cone Penetration Tests (CPT), which are used more and more in geotechnical design practice in Hungary. This allows the designer to analyze and compare CPT and seismic test result in order to select the best correlation equations for Hungarian soils and to improve the recommendations for the Hungarian geologic conditions. Based on a literature review, as well as research experience in Hungary, the influence of various parameters on the accuracy of results will be shown. This study can serve as a basis for selecting and modifying correlation equations for Hungarian soils. Test data are taken from seven locations in Hungary with similar geologic conditions. The shear wave velocity values were measured by seismic CPT. Several factors are analyzed including soil type, behavior index, measurement depth, geologic age etc. for their effect on the accuracy of predictions. The final results show an improved prediction method for Hungarian soils

Keywords: CPT correlation, dynamic soil properties, seismic CPT, shear wave velocity

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Authors: M. Zasada, A. Markiewicz, A. Erkiert-Polguj, E. Budzisz

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The epidermis is a keratinized stratified squamous epithelium covered by the hydro-lipid barrier. Therefore, active substances should be able to penetrate through this hydro-lipid coating. L-ascorbic acid is one of the vitamins which plays an important role in stimulation fibroblast to produce collagen type I and in hyperpigmentation lightening. Vitamin C is a water-soluble antioxidant, which protects skin from oxidation damage and rejuvenates photoaged skin. No-needle mesotherapy is a non-invasive rejuvenation technique depending on electric pulses, electroporation, and ultrasounds. These physicals factors result in deeper penetration of cosmetics. It is important to increase the penetration of L-ascorbic acid, thereby increasing the spectrum of its activity. The aim of the work was to assess the effectiveness of pure L-ascorbic acid activity in anti-aging therapy using a needle-free and micro-needling mesotherapy. The study was performed on a group of 35 healthy volunteers in accordance with the Declaration of Helsinki of 1964 and agreement of the Ethics Commissions no RNN/281/16/KE 2017. Women were randomized to mesotherapy or control group. Control group applied topically 2,5 ml serum containing 20% L-ascorbic acid with hydrate from strawberries, every 10 days for a period of 9 weeks. No-needle mesotherapy, on the left half of the face and micro-needling on the right with the same serum, was done in mesotherapy group. The pH of serum was 3.5-4, and the serum was prepared directly prior to the facial treatment. The skin parameters were measured at the beginning and before each treatment. The measurement of the forehead skin was done using Cutometer® (measurement of skin elasticity and firmness), Corneometer® (skin hydration measurement), Mexameter® (skin tone measurement). Also, the photographs were taken by Fotomedicus system. Additionally, the volunteers fulfilled the questionnaire. Serum was tested for microbiological purity and stability after the opening of the cosmetic. During the study, all of the volunteers were taken care of a dermatologist. The regular application of the serum has caused improvement of the skin parameters. Respectively, after 4 and 8 weeks improvement in hydration and elasticity has been seen (Corneometer®, Cutometer® results). Moreover, the number of hyper-pigmentated spots has decreased (Mexameter®). After 8 weeks the volunteers has claimed that the tested product has smoothing and moisturizing features. Subjective opinions indicted significant improvement of skin color and elasticity. The product containing the L-ascorbic acid used with intercellular penetration promoters demonstrates higher anti-aging efficiency than control. In vivo studies confirmed the effectiveness of serum and the impact of the active substance on skin firmness and elasticity, the degree of hydration and skin tone. Mesotherapy with pure L-ascorbic acid provides better diffusion of active substances through the skin.

Keywords: anti-aging, l-ascorbic acid, mesotherapy, promoters

Procedia PDF Downloads 238

Authors: Tzu-Jung Tseng, Pei-Hsuen Han, Tsung-Hsueh Lu

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Background: Choropleth mortality map is commonly used to identify areas with higher mortality risk. However, the use of choropleth map alone might result in the misinterpretation of differences in mortality rates between areas. Two areas with different color shades might not actually have a significant difference in mortality rates. The mortality rates estimated for an area with a small population would be less stable. We suggest of bringing the 95% confidence intervals (CI) into the choropleth mortality map to help users interpret the areal mortality rate difference more properly. Method: In the first choropleth mortality map, we used only three color to indicate standardized mortality ratio (SMR) for each district in Tainan, Taiwan. The red color denotes that the SMR of that district was significantly higher than the Tainan average; on the contrary, the green color suggests that the SMR of that district was significantly lower than the Tainan average. The yellow color indicates that the SMR of that district was not statistically significantly different from the Tainan average. In the second choropleth mortality map, we used traditional sequential color scheme (color ramp) for different SMR in 37 districts in Tainan City with bar chart of each SMR with 95% CI in which the users could examine if the line of 95% CI of SMR of two districts overlapped (nonsignificant difference). Results: The all-causes SMR of each district in Tainan for 2008 to 2013 ranged from 0.77 (95% CI 0.75 to 0.80) in East District to 1.39 Beimen (95% CI 1.25 to 1.52). In the first choropleth mortality map, only 16 of 37 districts had red color and 8 districts had green color. For different causes of death, the number of districts with red color differed. In the first choropleth mortality map we added a bar chart with line of 95% CI of SMR in each district, in which the users could visualize the SMR differences between districts. Conclusion: Through the use of 95% CI the users could interpret the aral mortality differences more properly.

Keywords: choropleth map, small area variation, standardized mortality ratio (SMR), Taiwan

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Authors: Chun-Yu Chen, Kua-Rong Wu, Yu-Cheng Chen, Perng-Jy Tsai

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Cooking fumes are known containing polycyclic aromatic hydrocarbons (PAHs) and aldehydes, and some of them have been proven carcinogenic or possibly carcinogenic to humans. Considering their chronic health effects, long-term exposure data is required for assessing cooking workers’ lifetime health risks. Previous exposure assessment studies, due to both time and cost constraints, mostly were based on the cross-sectional data. Therefore, establishing a long-term exposure data has become an important issue for conducting health risk assessment for cooking workers. An approach was proposed in this study. Here, the generation rates of both PAHs and aldehydes from a cooking process were determined by placing a sampling train exactly under the under the exhaust fan under the both the total enclosure condition and normal operating condition, respectively. Subtracting the concentration collected by the former (representing the total emitted concentration) from that of the latter (representing the hood collected concentration), the fugitive emitted concentration was determined. The above data was further converted to determine the generation rates based on the flow rates specified for the exhaust fan. The determinations of the above generation rates were conducted in a testing chamber with a selected cooking process (deep-frying chicken nuggets under 3 L peanut oil at 200°C). The sampling train installed under the exhaust fan consisted respectively an IOM inhalable sampler with a glass fiber filter for collecting particle-phase PAHs, followed by a XAD-2 tube for gas-phase PAHs. The above was also used to sample aldehydes, however, installed with a filter pre-coated with DNPH, and followed by a 2,4-DNPH-cartridge for collecting particle-phase and gas-phase aldehydes, respectively. PAHs and aldehydes samples were analyzed by GC/MS-MS (Agilent 7890B), and HPLC-UV (HITACHI L-7100), respectively. The obtained generation rates of both PAHs and aldehydes were applied to the near-field/ far-field exposure model to estimate the exposures of cooks (the estimated near-field concentration), and helpers (the estimated far-field concentration). For validating purposes, both PAHs and aldehydes samplings were conducted simultaneously using the same sampling train at both near-field and far-field sites of the testing chamber. The sampling results, together with the use of the mixed-effect model, were used to calibrate the estimated near-field/ far-field exposures. In the present study, the obtained emission rates were further converted to emission factor of both PAHs and aldehydes according to the amount of food oil consumed. Applying the long-term food oil consumption records, the emission rates for both PAHs and aldehydes were determined, and the long-term exposure databanks for cooks (the estimated near-field concentration), and helpers (the estimated far-field concentration) were then determined. Results show that the proposed approach was adequate to determine the generation rates of both PAHs and aldehydes under various fan exhaust flow rate conditions. The estimated near-field/ far-field exposures, though were significantly different from that obtained from the field, can be calibrated using the mixed effect model. Finally, the established long-term data bank could provide a useful basis for conducting long-term exposure assessments for cooking workers exposed to PAHs and aldehydes.

Keywords: aldehydes, cooking oil fumes, long-term exposure assessment, modeling, polycyclic aromatic hydrocarbons (PAHs)

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Authors: Mohammad Ghavami, Reza S. Dilmaghani

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This paper presents an adaptive framework for modelling financial markets using equity risk premiums, risk free rates and volatilities. The recorded economic factors are initially used to train four adaptive filters for a certain limited period of time in the past. Once the systems are trained, the adjusted coefficients are used for modelling and prediction of an important financial market index. Two different approaches based on least mean squares (LMS) and recursive least squares (RLS) algorithms are investigated. Performance analysis of each method in terms of the mean squared error (MSE) is presented and the results are discussed. Computer simulations carried out using recorded data show MSEs of 4% and 3.4% for the next month prediction using LMS and RLS adaptive algorithms, respectively. In terms of twelve months prediction, RLS method shows a better tendency estimation compared to the LMS algorithm.

Keywords: adaptive methods, LSE, MSE, prediction of financial Markets

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Authors: Natalia Sypion-Dutkowska

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Abstract — The main research objective of the paper is to discover the relationship between the age groups of residents and crime in particular districts of a large city. The basic analytical tool is specific crime rates, calculated not in relation to the total population, but for age groups in a different social situation - property, housing, work, and representing different generations with different behavior patterns. They are the communities from which criminals and victims of crimes come. The analysis of literature and national police reports gives rise to hypotheses about the ability of a given age group to generate crime as a source of offenders and as a group of victims. These specific indicators are spatially differentiated, which makes it possible to detect socio-demographic determinants of spatial patterns of urban crime. A multi-feature classification of districts was also carried out, in which specific crime rates are the diagnostic features. In this way, areas with a similar structure of socio-demographic determinants of spatial patterns on urban crime were designated. The case study is the city of Szczecin in Poland. It has about 400,000 inhabitants and its area is about 300 sq km. Szczecin is located in the immediate vicinity of Germany and is the economic, academic and cultural capital of the region. It also has a seaport and an airport. Moreover, according to ESPON 2007, Szczecin is the Transnational and National Functional Urban Area. Szczecin is divided into 37 districts - auxiliary administrative units of the municipal government. The population of each of them in 2015-17 was divided into 8 age groups: babes (0-2 yrs.), children (3-11 yrs.), teens (12-17 yrs.), younger adults (18-30 yrs.), middle-age adults (31-45 yrs.), older adults (46-65 yrs.), early older (66-80) and late older (from 81 yrs.). The crimes reported in 2015-17 in each of the districts were divided into 10 groups: fights and beatings, other theft, car theft, robbery offenses, burglary into an apartment, break-in into a commercial facility, car break-in, break-in into other facilities, drug offenses, property damage. In total, 80 specific crime rates have been calculated for each of the districts. The analysis was carried out on an intra-city scale, this is a novel approach as this type of analysis is usually carried out at the national or regional level. Another innovative research approach is the use of specific crime rates in relation to age groups instead of standard crime rates. Acknowledgments: This research was funded by the National Science Centre, Poland, registration number 2019/35/D/HS4/02942.

Keywords: age groups, determinants of crime, spatial crime pattern, urban crime

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Authors: Neritan Shkodrani

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On November 26, 2019, an earthquake hit the central western part of Albania. It was assessed as Mw 6.4. Its epicenter was located offshore north western Durrës, about 7 km north of the city. In this paper, the consequences of settlements of very soft soils have been discussed for the case of a residential building, mentioned as “K Building”, which was suffering a significant tilting after the earthquake. “KBuilding” is an RC framed building having 12+1 (basement) storiesand a floor area of 21000 m2. The construction of the building was completed in 2012. “KBuilding”, located in Durres city, suffered severe non-structural damage during November 26, 2019, Durrës Earthquake sequences. During the in-site inspections immediately after the earthquake, the general condition of the buildings, the presence of observable settlements on the ground, and the crack situation in the structure were determined, and damage inspection were performed. It was significant to note that the “K Building” presented tilting that might be attributed, as it was believed at the beginning, partially to the failure of the columns of the ground floor and partially to liquefaction phenomena, but it did not collapse. At the first moment was not clear if the foundation had a bearing capacity failure or the foundation failed because of the soil liquefaction. Geotechnical soil investigations by using CPTU test were executed, and their data are usedto evaluatebearing capacity, consolidation settlement of the mat foundation, and soil liquefaction since they were believed to be the main reasons of this building tilting.Geotechnical soil investigation consist in 5 (five) Static Cone Penetration tests with pore pressure measurement (piezocone test). They reached a penetration depth of 20.0 m to 30.0 mand, clearly shown the presence of very soft and organic soils in the soil profile of the site. Geotechnical CPT based analysis of bearing capacity, consolidation, and secondary settlement are applied, and results are reported for each test. These results shown very small values of allowable bearing capacity and very high values of consolidation and secondary settlements. Liquefaction analysis based on the data of CPTU tests and the characteristics of ground shaking of the mentioned earthquake has shown the possibility of liquefaction for some layers of the considered soil profile, but the estimated vertical settlements are at a small range and clearly shown that the main reason of the building tilting was not related to the consequences of liquefaction, but was an existing settlement caused from the applied bearing pressure of this building. All the CPTU tests were carried out on August 2021, almost two years after the November 26, 2019, Durrës Earthquake and when the building itself was demolished. After removing the mat foundation on September 2021, it was possible to carry out CPTU tests even on the footprint of the existing building, which made possible to observe the effects of long time applied of foundation bearing pressure to the consolidation on the considered soil profile.

Keywords: bearing capacity, cone penetration test, consolidation settlement, secondary settlement, soil liquefaction, etc

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Authors: Hayder Raad Hafuze, Munqith Saleem Dawood, Jamal Abdul Jabbar

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The effect of using both ultrasounds with laser in medical imaging of the biological tissue has been studied in this paper. Different wave lengths of incident laser light (405 nm, 532 nm, 650 nm, 808 nm and 1064 nm) were used with different ultrasound frequencies (1MHz and 3.3MHz). The results showed that, the change of acoustic intensity enhance the laser penetration of the tissue for different thickness. The existence of the ideal Raman-Nath diffraction pattern were investigated in terms of phase delay and incident angle.

Keywords: tissue, laser, ultrasound, effect, imaging

Procedia PDF Downloads 391

Authors: O. A. Babalola, A. F Adekunle, F. Oladeji, A. T. Osungbade, O. A. Akinlaja

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Optimizing microbiological activities in an organic crop production system is crucial to the realization of optimum growth and development of the crops. Field and pot experiments were conducted to assess soil microbial activities, growth and yield of tomato varieties in response to 4 rates of composted plant and animal residues. The compost rates were 0, 5, 10 and 20 t ha-1, and improved Ibadan and Ibadan local constituted the varieties. Fungi population, microbial biomass nitrogen, cellulase and proteinase activities were significantly higher (P≤ 0.05) at the rhizosphere of the local variety than that of improved variety. This led to a significantly higher number of branches, plant height, leaf area, number of fruits and less days to maturity in the local variety. Furthermore, compost-amended soil had significantly higher microbial populations, microbial biomass N, P and C, enzyme activities, soil N, P and organic carbon than control, but amendment of 20 t ha-1 gave significantly higher values than other compost rates. Consequently, growth parameters and tissue N significantly increased in all compost treatments while dry matter yield and weight of fruits were significantly higher in soil amended with 20 t ha-1. Correlation analysis showed that microbial activities at 6 weeks after transplanting (6 WAT) were more consistently and highly correlated with growth and yield parameters. It was concluded that microbial activities could be optimized to improve the yield of the two tomato varieties in an organic production system, through the application of compost, particularly at 20 t ha-1.

Keywords: compost, microbial activities, microbial contribution, tomato growth and yield

Procedia PDF Downloads 229