Search results for: healthcare costs
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3728

Search results for: healthcare costs

728 The Non-Motor Symptoms of Filipino Patients with Parkinson’s Disease

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

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

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

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727 The Use of Solar Energy for Cold Production

Authors: Nadia Allouache, Mohamed Belmedani

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—It is imperative today to further explore alternatives to fossil fuels by promoting in particular renewable sources such as solar energy to produce cold. It is also important to carefully examine its current state as well as its future prospects in order to identify the best conditions to support its optimal development. Technologies linked to this alternative source fascinate their users because they seem magical in their ability to directly transform solar energy into cooling without resorting to polluting fuels such as those derived from hydrocarbons or other toxic substances. In addition, these not only allow significant savings in electricity, but can also help reduce the costs of electrical energy production when applied on a large scale. In this context, our study aims to analyze the performance of solar adsorption cooling systems by selecting the appropriate pair Adsorbent/Adsorbat. This paper presents a model describing the heat and mass transfer in tubular finned adsorber of solar adsorption refrigerating machine. The modelisation of the solar reactor take into account the heat and mass transfers phenomena. The reactor pressure is assumed to be uniform, the reactive reactor is characterized by an equivalent thermal conductivity and assumed to be at chemical and thermodynamic equilibrium. The numerical model is controlled by heat, mass and sorption equilibrium equations. Under the action of solar radiation, the mixture of adsorbent–adsorbate has a transitory behavior. Effect of key parameters on the adsorbed quantity and on the thermal and solar performances are analyzed and discussed. The results show that, The performances of the system that depends on the incident global irradiance during a whole day depends on the weather conditions. For the used working pairs, the increase of the fins number corresponds to the decreasing of the heat losses towards environmental and the increasing of heat transfer inside the adsorber. The system performances are sensitive to the evaporator and condenser temperatures. For the considered data measured for clear type days of may and july 2023 in Algeria and Tunisia, the performances of the cooling system are very significant in Algeria compared to Tunisia.

Keywords: adsorption, adsorbent-adsorbate pair, finned reactor, numerical modeling, solar energy

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726 Identifying Critical Links of a Transport Network When Affected by a Climatological Hazard

Authors: Beatriz Martinez-Pastor, Maria Nogal, Alan O'Connor

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During the last years, the number of extreme weather events has increased. A variety of extreme weather events, including river floods, rain-induced landslides, droughts, winter storms, wildfire, and hurricanes, have threatened and damaged many different regions worldwide. These events have a devastating impact on critical infrastructure systems resulting in high social, economical and environmental costs. These events have a huge impact in transport systems. Since, transport networks are completely exposed to every kind of climatological perturbations, and its performance is closely related with these events. When a traffic network is affected by a climatological hazard, the quality of its service is threatened, and the level of the traffic conditions usually decreases. With the aim of understanding this process, the concept of resilience has become most popular in the area of transport. Transport resilience analyses the behavior of a traffic network when a perturbation takes place. This holistic concept studies the complete process, from the beginning of the perturbation until the total recovery of the system, when the perturbation has finished. Many concepts are included in the definition of resilience, such as vulnerability, redundancy, adaptability, and safety. Once the resilience of a transport network can be evaluated, in this case, the methodology used is a dynamic equilibrium-restricted assignment model that allows the quantification of the concept, the next step is its improvement. Through the improvement of this concept, it will be possible to create transport networks that are able to withstand and have a better performance under the presence of climatological hazards. Analyzing the impact of a perturbation in a traffic network, it is observed that the response of the different links, which are part of the network, can be completely different from one to another. Consequently and due to this effect, many questions arise, as what makes a link more critical before an extreme weather event? or how is it possible to identify these critical links? With this aim, and knowing that most of the times the owners or managers of the transport systems have limited resources, the identification of the critical links of a transport network before extreme weather events, becomes a crucial objective. For that reason, using the available resources in the areas that will generate a higher improvement of the resilience, will contribute to the global development of the network. Therefore, this paper wants to analyze what kind of characteristic makes a link a critical one when an extreme weather event damages a transport network and finally identify them.

Keywords: critical links, extreme weather events, hazard, resilience, transport network

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725 Clinical Risk Score for Mortality and Predictors of Severe Disease in Adult Patients with Dengue

Authors: Siddharth Jain, Abhenil Mittal, Surendra Kumar Sharma

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Background: With its recent emergence and re-emergence, dengue has become a major international public health concern, imposing significant financial burden especially in developing countries. Despite aggressive control measures in place, India experienced one of its largest outbreaks in 2015 with Delhi being most severely affected. There is a lack of reliable predictors of disease severity and mortality in dengue. The present study was carried out to identify these predictors during the 2015 outbreak. Methods: This prospective observational study conducted at an apex tertiary care center in Delhi, India included confirmed adult dengue patients admitted between August-November 2015. Patient demographics, clinical details, and laboratory findings were recorded in a predesigned proforma. Appropriate statistical tests were used to summarize and compare the clinical and laboratory characteristics and derive predictors of mortality and severe disease, while developing a clinical risk score for mortality. Serotype analysis was also done for 75 representative samples to identify the dominant serotypes. Results: Data of 369 patients were analyzed (mean age 30.9 years; 67% males). Of these, 198 (54%) patients had dengue fever, 125 (34%) had dengue hemorrhagic fever (DHF Grade 1,2)and 46 (12%) developed dengue shock syndrome (DSS). Twenty two (6%) patients died. Late presentation to the hospital (≥5 days after onset) and dyspnoea at rest were identified as independent predictors of severe disease. Age ≥ 24 years, dyspnoea at rest and altered sensorium were identified as independent predictors of mortality. A clinical risk score was developed (12*age + 14*sensorium + 10*dyspnoea) which, if ≥ 22, predicted mortality with a high sensitivity (81.8%) and specificity (79.2%). The predominant serotypes in Delhi (2015) were DENV-2 and DENV-4. Conclusion: Age ≥ 24 years, dyspnoea at rest and altered sensorium were identified as independent predictors of mortality. Platelet counts did not determine the outcome in dengue patients. Timely referral/access to health care is important. Development and use of validated predictors of disease severity and simple clinical risk scores, which can be applied in all healthcare settings, can help minimize mortality and morbidity, especially in resource limited settings.

Keywords: dengue, mortality, predictors, severity

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724 Comparison of Hydrogen and Electrification Perspectives in Decarbonizing the Transport Sector

Authors: Matteo Nicoli, Gianvito Colucci, Valeria Di Cosmo, Daniele Lerede, Laura Savoldi

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The transport sector is currently responsible for approximately 1/3 of greenhouse gas emissions in Europe. In the wider context of achieving carbon neutrality of the global energy system, different alternatives are available to decarbonizethe transport sector. In particular, while electricity is already the most consumed energy commodity in rail transport, battery electric vehicles are one of the zero-emissions options on the market for road transportation. On the other hand, hydrogen-based fuel cell vehicles are available for road and non-road vehicles. The European Commission is strongly pushing toward the integration of hydrogen in the energy systems of European countries and its widespread adoption as an energy vector to achieve the Green Deal targets. Furthermore, the Italian government is defining hydrogen-related objectives with the publication of a dedicated Hydrogen Strategy. The adoption of energy system optimization models to study the possible penetration of alternative zero-emitting transport technologies gives the opportunity to perform an overall analysis of the effects that the development of innovative technologies has on the entire energy system and on the supply-side, devoted to the production of energy carriers such as hydrogen and electricity. Using an open-source modeling framework such as TEMOA, this work aims to compare the role of hydrogen and electric vehicles in the decarbonization of the transport sector. The analysis investigates the advantages and disadvantages of adopting the two options, from the economic point of view (costs associated with the two options) and the environmental one (looking at the emissions reduction perspectives). Moreover, an analysis on the profitability of the investments in hydrogen and electric vehicles will be performed. The study investigates the evolution of energy consumption and greenhouse gas emissions in different transportation modes (road, rail, navigation, and aviation) by detailed analysis of the full range of vehicles included in the techno-economic database used in the TEMOA model instance adopted for this work. The transparency of the analysis is guaranteed by the accessibility of the TEMOA models, based on an open-access source code and databases.

Keywords: battery electric vehicles, decarbonization, energy system optimization models, fuel cell vehicles, hydrogen, open-source modeling, TEMOA, transport

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723 Diagnostic Value of CT Scan in Acute Appendicitis

Authors: Maria Medeiros, Suren Surenthiran, Abitha Muralithar, Soushma Seeburuth, Mohammed Mohammed

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Introduction: Appendicitis is the most common surgical emergency globally and can have devastating consequences. Diagnostic imaging in acute appendicitis has become increasingly common in aiding the diagnosis of acute appendicitis. Computerized tomography (CT) and ultrasound (US) are the most commonly used imaging modalities for diagnosing acute appendicitis. Pre-operative imaging has contributed to a reduction of negative appendicectomy rates from between 10-29% to 5%. Literature report CT scan has a diagnostic sensitivity of 94% in acute appendicitis. This clinical audit was conducted to establish if the CT scan's diagnostic yield for acute appendicitis matches the literature. CT scan has a high sensitivity and specificity for diagnosing acute appendicitis and its use can result in a lower negative appendicectomy rate. The aim of this study is to compare the pre-operative imaging findings from CT scans to the histopathology results post-operatively and establish the accuracy of CT scans in aiding the diagnosis of acute appendicitis. Methods: This was a retrospective study focusing on adult presentations to the general surgery department in a district general hospital in central London with an impression of acute appendicitis. We analyzed all patients from July 2022 to December 2022 who underwent a CT scan preceding appendicectomy. Pre-operative CT findings and post-operative histopathology findings were compared to establish the efficacy of CT scans in diagnosing acute appendicitis. Our results were also cross-referenced with pre-existing literature. Data was collected and anonymized using CERNER and analyzed in Microsoft Excel. Exclusion criteria: Children, age <16. Results: 65 patients had CT scans in which the report stated acute appendicitis. Of those 65 patients, 62 patients underwent diagnostic laparoscopies. 100% of patients who underwent an appendicectomy with a pre-operative CT scan showing acute appendicitis had acute appendicitis in histopathology analysis. 3 of the 65 patients who had a CT scan showing appendicitis received conservative treatment. Conclusion: CT scans positive for acute appendicitis had 100% sensitivity and a positive predictive value, which matches published research studies (sensitivity of 94%). The use of CT scans in the diagnostic work-up for acute appendicitis can be extremely helpful in a) confirming the diagnosis and b) reducing the rates of negative appendicectomies and consequently reducing unnecessary operative-associated risks for patients, reducing costs and reducing pressure on emergency theatre lists.

Keywords: acute apendicitis, CT scan, general surgery, imaging

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722 Vibroacoustic Modulation of Wideband Vibrations and its Possible Application for Windmill Blade Diagnostics

Authors: Abdullah Alnutayfat, Alexander Sutin, Dong Liu

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Wind turbine has become one of the most popular energy productions. However, failure of blades and maintenance costs evolve into significant issues in the wind power industry, so it is essential to detect the initial blade defects to avoid the collapse of the blades and structure. This paper aims to apply modulation of high-frequency blade vibrations by low-frequency blade rotation, which is close to the known Vibro-Acoustic Modulation (VAM) method. The high-frequency wideband blade vibration is produced by the interaction of the surface blades with the environment air turbulence, and the low-frequency modulation is produced by alternating bending stress due to gravity. The low-frequency load of rotational wind turbine blades ranges between 0.2-0.4 Hz and can reach up to 2 Hz for strong wind. The main difference between this study and previous ones on VAM methods is the use of a wideband vibration signal from the blade's natural vibrations. Different features of the vibroacoustic modulation are considered using a simple model of breathing crack. This model considers the simple mechanical oscillator, where the parameters of the oscillator are varied due to low-frequency blade rotation. During the blade's operation, the internal stress caused by the weight of the blade modifies the crack's elasticity and damping. The laboratory experiment using steel samples demonstrates the possibility of VAM using a probe wideband noise signal. A cycle load with a small amplitude was used as a pump wave to damage the tested sample, and a small transducer generated a wideband probe wave. The received signal demodulation was conducted using the Detecting of Envelope Modulation on Noise (DEMON) approach. In addition, the experimental results were compared with the modulation index (MI) technique regarding the harmonic pump wave. The wideband and traditional VAM methods demonstrated similar sensitivity for earlier detection of invisible cracks. Importantly, employing a wideband probe signal with the DEMON approach speeds up and simplifies testing since it eliminates the need to conduct tests repeatedly for various harmonic probe frequencies and to adjust the probe frequency.

Keywords: vibro-acoustic modulation, detecting of envelope modulation on noise, damage, turbine blades

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721 Using Lean-Six Sigma Philosophy to Enhance Revenues and Improve Customer Satisfaction: Case Studies from Leading Telecommunications Service Providers in India

Authors: Senthil Kumar Anantharaman

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Providing telecommunications based network services in developing countries like India which has a population of 1.5 billion people, so that these services reach every individual, is one of the greatest challenges the country has been facing in its journey towards economic growth and development. With growing number of telecommunications service providers in the country, a constant challenge that has been faced by these providers is in providing not only quality but also delightful customer experience while simultaneously generating enhanced revenues and profits. Thus, the role played by process improvement methodologies like Six Sigma cannot be undermined and specifically in telecom service provider based operations, it has provided substantial benefits. Therefore, it advantages are quite comparable to its applications and advantages in other sectors like manufacturing, financial services, information technology-based services and Healthcare services. One of the key reasons that this methodology has been able to reap great benefits in telecommunications sector is that this methodology has been combined with many of its competing process improvement techniques like Theory of Constraints, Lean and Kaizen to give the maximum benefit to the service providers thereby creating a winning combination of organized process improvement methods for operational excellence thereby leading to business excellence. This paper discusses about some of the key projects and areas in the end to end ‘Quote to Cash’ process at big three Indian telecommunication companies that have been highly assisted by applying Six Sigma along with other process improvement techniques. While the telecommunication companies which we have considered, is primarily in India and run by both private operators and government based setups, the methodology can be applied equally well in any other part of developing countries around the world having similar context. This study also compares the enhanced revenues that can arise out of appropriate opportunities in emerging market scenarios, that Six Sigma as a philosophy and methodology can provide if applied with vigour and robustness. Finally, the paper also comes out with a winning framework in combining Six Sigma methodology with Kaizen, Lean and Theory of Constraints that will enhance both the top-line as well as the bottom-line while providing the customers a delightful experience.

Keywords: emerging markets, lean, process improvement, six sigma, telecommunications, theory of constraints

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720 Impact of Colors, Space Design and Artifacts on Cognitive Health in Government Hospitals of Uttarakhand

Authors: Ila Gupta

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The government hospitals in India by and large lack the necessary aesthetic therapeutic components, both in their interior and exterior space designs. These components especially in terms of color application are important to the emotional as well as physical well being of the patients and other participants of the space. The preliminary survey of few government hospitals in Uttarakhand, India, reveals that the government health care industry provides a wide scope for intervention. All most all of the spaces do not adhere to a proper therapeutic color scheme which directly helps the well-being of their patients and workers. The paper aims to conduct a survey and come up with recommendations in this regard. The government hospitals also lack a proper signage system which allows the space to be more user-friendly. The hospital spaces in totality also have scope for improvement in terms of space/landscape design which enhances the work environment in an efficient and positive way. This study will thus enable to come up with feasible recommendations for healthcare and built environment as well as retrofitting the existing spaces. The objective of the paper is mainly on few case studies. The present ambience in many government hospitals generally lacks a welcoming ambience. It is proposed to select one or two government hospitals and demonstrate application of appropriate and self-sustainable color schemes, placement of artifacts, changes in outdoor and indoor space design to bring about a change that is conducive for cognitive healing. Exterior changes to existing and old hospital buildings in depressed historic areas signify financial investment and change, and have the potential to play a significant role in both urban preservation and revitalization. Changes to exterior architectural colors are perhaps the most visible signifier of such revitalization, as the use of color changes as a tool in façade and interior improvement programs. The present project will provide its recommendations on the basis of case studies done in the Indian Public Health Care system. Furthermore, the recommendations will be in accordance with the extended study conducted in Indian Ayurvedic, Yogic texts as well as Vastu texts, which provides knowledge about built environments and healing properties of color.

Keywords: color, environment, facade, architectural color history, interior improvement programs, community development, district/government hospitals

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719 Social Business Model: Leveraging Business and Social Value of Social Enterprises

Authors: Miriam Borchardt, Agata M. Ritter, Macaliston G. da Silva, Mauricio N. de Carvalho, Giancarlo M. Pereira

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This paper aims to analyze the barriers faced by social enterprises and based on that to propose a social business model framework that helps them to leverage their businesses and the social value delivered. A business model for social enterprises should amplify the value perception including social value for the beneficiaries while generating enough profit to escalate the business. Most of the social value beneficiaries are people from the base of the economic pyramid (BOP) or the ones that have specific needs. Because of this, products and services should be affordable to consumers while solving social needs of the beneficiaries. Developing products and services with social value require tie relationship among the social enterprises and universities, public institutions, accelerators, and investors. Despite being focused on social value and contributing to the beneficiaries’ quality of life as well as contributing to the governments that cannot properly guarantee public services and infrastructure to the BOP, many barriers are faced by the social enterprises to escalate their businesses. This is a work in process and five micro- and small-sized social enterprises in Brazil have been studied: (i) one has developed a kit for cervical uterine cancer detection to allow the BOP women to collect their own material and deliver to a laboratory for U$1,00; (ii) other has developed special products without lactose and it is about 70% cheaper than the traditional brands in the market; (iii) the third has developed prosthesis and orthosis to surplus needs that health public system have not done efficiently; (iv) the fourth has produced and commercialized menstrual panties aiming to reduce the consumption of dischargeable ones while saving money to the consumers; (v) the fifth develops and commercializes clothes from fabric wastes in a partnership with BOP artisans. The preliminary results indicate that the main barriers are related to the public system to recognize these products as public money that could be saved if they bought products from these enterprises instead of the multinational pharmaceutical companies, to the traditional distribution system (e.g. pharmacies) that avoid these products because of the low or non-existing profit, to the difficulty buying raw material in small quantities, to leverage investment by the investors, to cultural barriers and taboos. Interesting strategies to reduce the costs have been observed: some enterprises have focused on simplifying products, others have invested in partnerships with local producers and have developed their machines focusing on process efficiency to leverage investment by the investors.

Keywords: base of the pyramid, business model, social business, social business model, social enterprises

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718 Modern Wars: States Responsibility

Authors: Lakshmi Chebolu

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'War’, the word itself, is so vibrant and handcuffs the entire society. Since the beginning of manhood, the world has been evident in constant struggles. However, along with the growth of communities, relations, on the one hand, and disputes, on the other hand, infinitely increased. When states cannot or will not settle their disputes or differences by means of peaceful agreements, weapons are suddenly made to speak. It does not mean states can engage in war whenever they desire. At an international level, there has been a vast development of the law of war in the 20th century. War, it may be internal or international, in all situations, belligerent actors should follow the principles of warfare. With the advent of technology, the shape of war has changed, and it violates fundamental principles without observing basic norms. Conversely, states' attitudes towards international relationships are also undermined to some extent as state parties are not prioritized the communal interest rather than political or individual interest. In spite of the persistent development of communities, still many people are innocent victims of modern wars. It costs a toll on many lives, liberties, and properties and remains a major obstacle to nations' development. Recent incidents in Afghan are a live example to World Nations. We know that the principles of international law cannot be implemented very strictly on perpetrators due to the lacuna in the international legal system. However, the rules of war are universal in nature. The Geneva Convention, 1949 which are the core element of IHL, has been ratified by all 196 States. In fact, very few international treaties received this much of big support from nations. State’s approach towards Modern International Law, places a heavy burden on States practice towards in implementation of law. Although United Nations Security Council possesses certain powers under ‘Pacific Settlement of Disputes’, (Chapter VI) of the United Nations Charter to prevent disputes in a peaceful manner, conversely, this practice has been overlooked for many years due to political interests, favor, etc. Despite international consensus on the prohibition of war and protection of fundamental freedoms and human dignity, still, often, law has been misused by states’. The recent tendencies trigger questions about states’ willingness towards the implementation of the law. In view of the existing practices of nations, this paper aims to elevate the legal obligations of the international community to save the succeeding generations from the scourge of modern war practices.

Keywords: modern wars, weapons, prohibition and suspension of war activities, states’ obligations

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717 Enhancing Social Well-Being in Older Adults Through Tailored Technology Interventions: A Future Systematic Review

Authors: Rui Lin, Jimmy Xiangji Huang, Gary Spraakman

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This forthcoming systematic review will underscore the imperative of leveraging technology to mitigate social isolation in older adults, particularly in the context of unprecedented global challenges such as the COVID-19 pandemic. With the continual evolution of technology, it becomes crucial to scrutinize the efficacy of interventions and discern how they can alleviate social isolation and augment social well-being among the elderly. This review will strive to clarify the best methods for older adults to utilize cost-effective and user-friendly technology and will investigate how the adaptation and execution of such interventions can be fine-tuned to maximize their positive outcomes. The study will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to filter pertinent studies. We foresee conducting an analysis of articles and executing a narrative analysis to discover themes and indicators related to quality of life and, technology use and well-being. The review will examine how involving older adults at the community level, applying top practices from community-based participatory research, can establish efficient strategies to implement technology-based interventions designed to diminish social isolation and boost digital use self-efficacy. Applications based on mobile technology and virtual platforms are set to assume a crucial role not only in enhancing connections within families but also in connecting older adults to vital healthcare resources, fostering both physical and mental well-being. The review will investigate how technological devices and platforms can address the cognitive, visual, and auditory requirements of older adults, thus strengthening their confidence and proficiency in digital use—a crucial factor during enforced social distancing or self-isolation periods during pandemics. This review will endeavor to provide insights into the multifaceted benefits of technology for older adults, focusing on how tailored technological interventions can be a beacon of social and mental wellness in times of social restrictions. It will contribute to the growing body of knowledge on the intersection of technology and elderly well-being, offering nuanced understandings and practical implications for developing user-centric, effective, and inclusive technological solutions for older populations.

Keywords: older adults, health service delivery, digital health, social isolation, social well-being

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716 Estimation of Relative Subsidence of Collapsible Soils Using Electromagnetic Measurements

Authors: Henok Hailemariam, Frank Wuttke

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Collapsible soils are weak soils that appear to be stable in their natural state, normally dry condition, but rapidly deform under saturation (wetting), thus generating large and unexpected settlements which often yield disastrous consequences for structures unwittingly built on such deposits. In this study, a prediction model for the relative subsidence of stressed collapsible soils based on dielectric permittivity measurement is presented. Unlike most existing methods for soil subsidence prediction, this model does not require moisture content as an input parameter, thus providing the opportunity to obtain accurate estimation of the relative subsidence of collapsible soils using dielectric measurement only. The prediction model is developed based on an existing relative subsidence prediction model (which is dependent on soil moisture condition) and an advanced theoretical frequency and temperature-dependent electromagnetic mixing equation (which effectively removes the moisture content dependence of the original relative subsidence prediction model). For large scale sub-surface soil exploration purposes, the spatial sub-surface soil dielectric data over wide areas and high depths of weak (collapsible) soil deposits can be obtained using non-destructive high frequency electromagnetic (HF-EM) measurement techniques such as ground penetrating radar (GPR). For laboratory or small scale in-situ measurements, techniques such as an open-ended coaxial line with widely applicable time domain reflectometry (TDR) or vector network analysers (VNAs) are usually employed to obtain the soil dielectric data. By using soil dielectric data obtained from small or large scale non-destructive HF-EM investigations, the new model can effectively predict the relative subsidence of weak soils without the need to extract samples for moisture content measurement. Some of the resulting benefits are the preservation of the undisturbed nature of the soil as well as a reduction in the investigation costs and analysis time in the identification of weak (problematic) soils. The accuracy of prediction of the presented model is assessed by conducting relative subsidence tests on a collapsible soil at various initial soil conditions and a good match between the model prediction and experimental results is obtained.

Keywords: collapsible soil, dielectric permittivity, moisture content, relative subsidence

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715 Experiences of Community Midwives Receiving Helping Baby Breathe Training Through the Low Dose High-frequency Approach in Gujrat, Pakistan

Authors: Anila Naz, Arusa Lakhani, Kiran Mubeen, Yasmeen Amarsi

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Pakistan's neonatal mortality rate has the highest proportion in the South Asian region and it is higher in the rural areas as compared to the urban areas. Poor resuscitation techniques and lack of basic newborn resuscitation skills in birth attendants, are contributing factors towards neonatal deaths. Based on the significant outcomes of the Helping Baby Breath (HBB) training, a similar training was implemented for Community Midwives (CMWs) in a low resource setting in Gujrat, Pakistan, to improve their knowledge and skills. The training evaluation was conducted and participant feedback was obtained through both qualitative and quantitative methods. The findings of the quantitative assessment of the training evaluation will be published elsewhere. This paper presents the qualitative evaluation of the training. Objective: The objective of the study was to determine the perceptions of HBB trained CMWs about the effectiveness of the HBB training, and the challenges faced in the implementation of HBB skills for newborn resuscitation, at their work settings. The qualitative descriptive design was used in this study. The purposive sampling technique was chosen to recruit midwives and key informants as participants of the training. Interviews were conducted by using a semi-structured interview guide. The study included a total of five interviews: two focus group interviews for CMWs (10 in each group), and three individual interviews of key informants. The content analysis of the qualitative data yielded three themes: the effectiveness of training, challenges, and suggestions. The findings revealed that the HBB training was effective for the CMWs in terms of its usability, regarding improvement in newborn resuscitation knowledge and skills. Moreover, it enhanced confidence and satisfaction in CMWs. However, less volume of patients was a challenge for a few CMWs with regards to practicing their skills. Due to the inadequate number of patients and less opportunities of practice for several CMWs, they required such trainings frequently, in order to maintain their competency. The CMWs also recommended that HBB training should be part of the Midwifery program curriculum. Moreover, similar trainings were also recommended for other healthcare providers working in low resource settings, including doctors and nurses.

Keywords: neonatal resuscitation technique, helping baby breathe, community midwives, training evaluation

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714 The ‘Accompanying Spouse Dependent Visa Status’: Challenges and Constraints Faced by Zimbabwean Immigrant Women in Integration into South Africa’s Formal Labour Market

Authors: Rujeko Samanthia Chimukuche

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Introduction: Transboundary migration at both regional and continental levels has become the defining feature of the 21st century. The recent global migration crisis due to economic strife and war brings back to the fore an old age problem, but with fresh challenges. Migration and forced displacement are issues that require long-term solutions. In South Africa, for example, whilst much attention has been placed on xenophobic attacks and other issues at the nexus of immigrant and indigenous communities, the limited focus has been placed on the integration, specifically formal labour integration of immigrant communities and the gender inequalities that are prevalent. Despite noble efforts by South Africa, hosting several immigrants, several challenges arise in integrating the migrants into society as it is often difficult to harmonize the interests of indigenous communities and those of foreign nationals. This research study has aimed to fill in the gaps by analyzing how stringent immigration and visa regulations prevent skilled migrant women spouses from employment, which often results in several societal vices, including domestic abuse, minimum or no access to important services such as healthcare, education, social welfare among others. Methods: Using a qualitative approach, the study analyzed South Africa migration and labour policies in terms of mainstreaming the gender needs of skilled migrant women. Secondly, the study highlighted the migratory experiences and constraints of skilled Zimbabwean women migrant spouses in South Africa labour integration. The experiences of these women have shown the gender inequalities of the migratory policies. Thirdly, Zimbabwean women's opportunities and/or challenges in integration into the South African formal labour market were explored. Lastly, practical interventions to support the integration of skilled migrant women spouses into South Africa’s formal labour market were suggested. Findings: Key findings show that gender dynamics are pivotal in migration patterns and the mainstreaming of gender in migration policies. This study, therefore, contributed to the fields of gender and migration by examining ways in which gender rights of skilled migrant women spouses can be incorporated in labour integration policy making.

Keywords: accompanying spouse visa, gender-migration, labour-integration, Zimbabwean women

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713 Towards a Doughnut Economy: The Role of Institutional Failure

Authors: Ghada El-Husseiny, Dina Yousri, Christian Richter

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Social services are often characterized by market failures, which justifies government intervention in the provision of these services. It is widely acknowledged that government intervention breeds corruption since resources are being transferred from one party to another. However, what is still being extensively studied is the magnitude of the negative impact of corruption on publicly provided services and development outcomes. Corruption has the power to hinder development and cripple our march towards the Sustainable Development Goals. Corruption diminishes the efficiency and effectiveness of public health and education spending and directly impacts the outcomes of these sectors. This paper empirically examines the impact of Institutional Failure on public sector services provision, with the sole purpose of studying the impact of corruption on SDG3 and 4; Good health and wellbeing and Quality education, respectively. The paper explores the effect of corruption on these goals from various perspectives and extends the analysis by examining if the impact of corruption on these goals differed when it accounted for the current corruption state. Using Pooled OLS(Ordinary Least Square) and Fixed effects panel estimation on 22 corrupt and 22 clean countries between 2000 and 2017. Results show that corruption in both corrupt and clean countries has a more severe impact on Health than the Education sector. In almost all specifications, corruption has an insignificant effect on School Enrollment rates but a significant effect on Infant Mortality rates. Results further indicate that, on average, a 1 point increase in the CPI(Consumer Price Index) can increase health expenditures by 0.116% in corrupt and clean countries. However, the fixed effects model indicates that the way Health and Education expenditures are determined in clean and corrupt countries are completely country-specific, in which corruption plays a minimal role. Moreover, the findings show that School Enrollment rates and Infant Mortality rates depend, to a large extent, on public spending. The most astounding results-driven is that corrupt countries, on average, have more effective and efficient healthcare expenditures. While some insights are provided as to why these results prevail, they should be further researched. All in all, corruption impedes development outcomes, and any Anti-corrupt policies taken will bring forth immense improvements and speed up the march towards sustainability.

Keywords: corruption, education, health, public spending, sustainable development

Procedia PDF Downloads 171
712 Numerical Analysis of Charge Exchange in an Opposed-Piston Engine

Authors: Zbigniew Czyż, Adam Majczak, Lukasz Grabowski

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The paper presents a description of geometric models, computational algorithms, and results of numerical analyses of charge exchange in a two-stroke opposed-piston engine. The research engine was a newly designed internal Diesel engine. The unit is characterized by three cylinders in which three pairs of opposed-pistons operate. The engine will generate a power output equal to 100 kW at a crankshaft rotation speed of 3800-4000 rpm. The numerical investigations were carried out using ANSYS FLUENT solver. Numerical research, in contrast to experimental research, allows us to validate project assumptions and avoid costly prototype preparation for experimental tests. This makes it possible to optimize the geometrical model in countless variants with no production costs. The geometrical model includes an intake manifold, a cylinder, and an outlet manifold. The study was conducted for a series of modifications of manifolds and intake and exhaust ports to optimize the charge exchange process in the engine. The calculations specified a swirl coefficient obtained under stationary conditions for a full opening of intake and exhaust ports as well as a CA value of 280° for all cylinders. In addition, mass flow rates were identified separately in all of the intake and exhaust ports to achieve the best possible uniformity of flow in the individual cylinders. For the models under consideration, velocity, pressure and streamline contours were generated in important cross sections. The developed models are designed primarily to minimize the flow drag through the intake and exhaust ports while the mass flow rate increases. Firstly, in order to calculate the swirl ratio [-], tangential velocity v [m/s] and then angular velocity ω [rad / s] with respect to the charge as the mean of each element were calculated. The paper contains comparative analyses of all the intake and exhaust manifolds of the designed engine. Acknowledgement: This work has been realized in the cooperation with The Construction Office of WSK "PZL-KALISZ" S.A." and is part of Grant Agreement No. POIR.01.02.00-00-0002/15 financed by the Polish National Centre for Research and Development.

Keywords: computational fluid dynamics, engine swirl, fluid mechanics, mass flow rates, numerical analysis, opposed-piston engine

Procedia PDF Downloads 199
711 Sustainable Valorization of Wine Production Waste: Unlocking the Potential of Grape Pomace and Lees in the Vinho Verde Region

Authors: Zlatina Genisheva, Pedro Ferreira-Santos, Margarida Soares, Cândida Vilarinho, Joana Carvalho

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The wine industry produces significant quantities of waste, much of which remains underutilized as a potential raw material. Typically, this waste is either discarded in the fields or incinerated, leading to environmental concerns. By-products of wine production, like lees and grape pomace, are readily available at relatively low costs and hold promise as raw materials for biochemical conversion into valuable products. Reusing these waste materials is crucial, not only for reducing environmental impact but also for enhancing profitability. The Vinhos Verdes demarcated region, the largest wine-producing area in Portugal, has remained relatively stagnant over time. This project aims to offer an alternative income source for producers in the region while also expanding the limited existing research on this area. The main objective of this project is the study of the sustainable valorization of grape pomace and lees from the production of DOC Vinho Verde. Extraction tests were performed to obtain high-value compounds, targeting phenolic compounds from grape pomace and protein-rich extracts from lees. An environmentally friendly technique, microwave extraction, was used for this process. This method is not only efficient but also aligns with the principles of green chemistry, reducing the use of harmful solvents and minimizing energy consumption. The findings from this study have the potential to open new revenue streams for the region’s wine producers while promoting environmental sustainability. The optimal conditions for extracting proteins from lees involve the use of NaOH at 150ºC. Regardless of the solvent employed, the ideal temperature for obtaining extracts rich in polyphenol compounds and exhibiting strong antioxidant activity is also 150ºC. For grape pomace, extracts with a high concentration of polyphenols and significant antioxidant properties were obtained at 210ºC. However, the highest total tannin concentrations were achieved at 150ºC, while the maximum total flavonoid content was obtained at 170ºC.

Keywords: antioxidants, circular economy, polyphenol compounds, waste valorization

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710 Pathway to Sustainable Shipping: Electric Ships

Authors: Wei Wang, Yannick Liu, Lu Zhen, H. Wang

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Maritime transport plays an important role in global economic development but also inevitably faces increasing pressures from all sides, such as ship operating cost reduction and environmental protection. An ideal innovation to address these pressures is electric ships. The electric ship is in the early stage. Considering the special characteristics of electric ships, i.e., travel range limit, to guarantee the efficient operation of electric ships, the service network needs to be re-designed carefully. This research designs a cost-efficient and environmentally friendly service network for electric ships, including the location of charging stations, charging plan, route planning, ship scheduling, and ship deployment. The problem is formulated as a mixed-integer linear programming model with the objective of minimizing total cost comprised of charging cost, the construction cost of charging stations, and fixed cost of ships. A case study using data of the shipping network along the Yangtze River is conducted to evaluate the performance of the model. Two operating scenarios are used: an electric ship scenario where all the transportation tasks are fulfilled by electric ships and a conventional ship scenario where all the transportation tasks are fulfilled by fuel oil ships. Results unveil that the total cost of using electric ships is only 42.8% of using conventional ships. Using electric ships can reduce 80% SOx, 93.47% NOx, 89.47% PM, and 42.62% CO2, but will consume 2.78% more time to fulfill all the transportation tasks. Extensive sensitivity analyses are also conducted for key operating factors, including battery capacity, charging speed, volume capacity, and a service time limit of transportation task. Implications from the results are as follows: 1) it is necessary to equip the ship with a large capacity battery when the number of charging stations is low; 2) battery capacity will influence the number of ships deployed on each route; 3) increasing battery capacity will make the electric ship more cost-effective; 4) charging speed does not affect charging amount and location of charging station, but will influence the schedule of ships on each route; 5) there exists an optimal volume capacity, at which all costs and total delivery time are lowest; 6) service time limit will influence ship schedule and ship cost.

Keywords: cost reduction, electric ship, environmental protection, sustainable shipping

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709 Accurate Mass Segmentation Using U-Net Deep Learning Architecture for Improved Cancer Detection

Authors: Ali Hamza

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Accurate segmentation of breast ultrasound images is of paramount importance in enhancing the diagnostic capabilities of breast cancer detection. This study presents an approach utilizing the U-Net architecture for segmenting breast ultrasound images aimed at improving the accuracy and reliability of mass identification within the breast tissue. The proposed method encompasses a multi-stage process. Initially, preprocessing techniques are employed to refine image quality and diminish noise interference. Subsequently, the U-Net architecture, a deep learning convolutional neural network (CNN), is employed for pixel-wise segmentation of regions of interest corresponding to potential breast masses. The U-Net's distinctive architecture, characterized by a contracting and expansive pathway, enables accurate boundary delineation and detailed feature extraction. To evaluate the effectiveness of the proposed approach, an extensive dataset of breast ultrasound images is employed, encompassing diverse cases. Quantitative performance metrics such as the Dice coefficient, Jaccard index, sensitivity, specificity, and Hausdorff distance are employed to comprehensively assess the segmentation accuracy. Comparative analyses against traditional segmentation methods showcase the superiority of the U-Net architecture in capturing intricate details and accurately segmenting breast masses. The outcomes of this study emphasize the potential of the U-Net-based segmentation approach in bolstering breast ultrasound image analysis. The method's ability to reliably pinpoint mass boundaries holds promise for aiding radiologists in precise diagnosis and treatment planning. However, further validation and integration within clinical workflows are necessary to ascertain their practical clinical utility and facilitate seamless adoption by healthcare professionals. In conclusion, leveraging the U-Net architecture for breast ultrasound image segmentation showcases a robust framework that can significantly enhance diagnostic accuracy and advance the field of breast cancer detection. This approach represents a pivotal step towards empowering medical professionals with a more potent tool for early and accurate breast cancer diagnosis.

Keywords: mage segmentation, U-Net, deep learning, breast cancer detection, diagnostic accuracy, mass identification, convolutional neural network

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708 Health Seeking Manners of Road Traffic Accident Victims: A Qualitative Study

Authors: Mohammad Mahbub Alam Talukder, Shahnewaz, Hasanat-E-Rabbi, Mohammed Nazrul Islam

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Road traffic accident is a global problem which is severe in the developing countries like Bangladesh. In consequence, in developing countries road trauma has now been recognized as an increasing public health hazards and economic burning issue. And after road traffic accidents the lack of management and economic costs related with health seeking behavior have a disproportionate impact on lower income groups, thus contributing to the persistence of poverty in conjunction with disability. This cross sectional study, carried out during July 2012 to June 2013, aimed to explore health seeking decision and culture of handling the road traffic accident related victims, as taken from experiences of the poor disabled people of slum dwellers of Dhaka city. The present study has been designed based on qualitative techniques such as in-depth interview and case studies. Additionally, a survey questionnaire was used to collect the demographic characteristics of the study population (n=150) and to select participants purposely for in-depth interview (n=50) and case study (n=30). Content analysis of qualitative data was done through theme coding and matrix analysis of case study was done to use relevant verbatim. Most of the time the health seeking decision totally depended on the surrounded people of the accidental place, their knowledge, awareness and remaining facility and capacity regarding proper management of the victims. However, most of the cases the victims did not get any early treatment and it took 2-12 hours to get even the first aid because of distance, shortage of money, lack of availability of getting the aid, lack of mass awareness etc. Under the reality of discriminated and unaffordable health service provision better treatment could not turn out due to economic inability of the poor victims. To avoid the severe trauma, treatment delay must be reduced by providing first aid within very short time and to do so, mass awareness campaign is necessary for handing the victims. Moreover, necessary measures should be taken to ensure cost free health service provision to treat the chronic disabled condition of the road traffic accident related poor victims.

Keywords: accident, injury, disabled, qualitative, slum

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707 Solar Photovoltaic Foundation Design

Authors: Daniel John Avutia

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Solar Photovoltaic (PV) development is reliant on the sunlight hours available in a particular region to generate electricity. A potential area is assessed through its inherent solar radiation intensity measured in watts per square meter. Solar energy development involves the feasibility, design, construction, operation and maintenance of the relevant infrastructure, but this paper will focus on the design and construction aspects. Africa and Australasia have the longest sunlight hours per day and the highest solar radiation per square meter, 7 sunlight hours/day and 5 kWh/day respectively. Solar PV support configurations consist of fixed-tilt support and tracker system structures, the differentiation being that the latter was introduced to improve the power generation efficiency of the former due to the sun tracking movement capabilities. The installation of Solar PV foundations involves rammed piles, drilling/grout piles and shallow raft reinforced concrete structures. This paper presents a case study of 2 solar PV projects in Africa and Australia, discussing the foundation design consideration and associated construction cost implications of the selected foundations systems. Solar PV foundations represent up to one fifth of the civil works costs in a project. Therefore, the selection of the most structurally sound and feasible foundation for the prevailing ground conditions is critical towards solar PV development. The design wind speed measured by anemometers govern the pile embedment depth for rammed and drill/grout foundation systems. The lateral pile deflection and vertical pull out resistance of piles increase proportionally with the embedment depth for uniform pile geometry and geology. The pile driving rate may also be used to anticipate the lateral resistance and skin friction restraining the pile. Rammed pile foundations are the most structurally suitable due to the pile skin friction and ease of installation in various geological conditions. The competitiveness of solar PV projects within the renewable energy mix is governed by lowering capital expenditure, improving power generation efficiency and power storage technological advances. The power generation reliability and efficiency are areas for further research within the renewable energy niche.

Keywords: design, foundations, piles, solar

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706 Storage Assignment Strategies to Reduce Manual Picking Errors with an Emphasis on an Ageing Workforce

Authors: Heiko Diefenbach, Christoph H. Glock

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Order picking, i.e., the order-based retrieval of items in a warehouse, is an important time- and cost-intensive process for many logistic systems. Despite the ongoing trend of automation, most order picking systems are still manual picker-to-parts systems, where human pickers walk through the warehouse to collect ordered items. Human work in warehouses is not free from errors, and order pickers may at times pick the wrong or the incorrect number of items. Errors can cause additional costs and significant correction efforts. Moreover, age might increase a person’s likelihood to make mistakes. Hence, the negative impact of picking errors might increase for an aging workforce currently witnessed in many regions globally. A significant amount of research has focused on making order picking systems more efficient. Among other factors, storage assignment, i.e., the assignment of items to storage locations (e.g., shelves) within the warehouse, has been subject to optimization. Usually, the objective is to assign items to storage locations such that order picking times are minimized. Surprisingly, there is a lack of research concerned with picking errors and respective prevention approaches. This paper hypothesize that the storage assignment of items can affect the probability of pick errors. For example, storing similar-looking items apart from one other might reduce confusion. Moreover, storing items that are hard to count or require a lot of counting at easy-to-access and easy-to-comprehend self heights might reduce the probability to pick the wrong number of items. Based on this hypothesis, the paper discusses how to incorporate error-prevention measures into mathematical models for storage assignment optimization. Various approaches with respective benefits and shortcomings are presented and mathematically modeled. To investigate the newly developed models further, they are compared to conventional storage assignment strategies in a computational study. The study specifically investigates how the importance of error prevention increases with pickers being more prone to errors due to age, for example. The results suggest that considering error-prevention measures for storage assignment can reduce error probabilities with only minor decreases in picking efficiency. The results might be especially relevant for an aging workforce.

Keywords: an aging workforce, error prevention, order picking, storage assignment

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705 Management in Health Education Process among Spa Resorts in Poland

Authors: J. Wozniak-Holecka, T. Holecki, P. Romaniuk

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Spa facilities are being perceived as the ways of healing treatment in Poland and are guaranteed within the public financing. The universal health insurance (National Health Fund, NFZ), and the disability prevention programme held by Social Insurance Institution (ZUS) are the main sources of financing spa facilities. The dominant public payer of spa services is the NFZ. The Social Insurance Institution covers the cost of health treatment realized in spa facilities as medical rehabilitation, in the field of disability prevention. Health services delivered in the spa resorts are characterized by complexity, and the combination of various methods, typical for health prevention, education, balneotherapy, and physiotherapy. Healing with natural methods, believed to enhance the therapeutic effect, is also involved in health spa treatment. Regardless of the type of facility, each form of spa treatment includes health promotion, health education, prevention at all levels, including rehabilitation. The aim of the study was to determine the optimal organization of health education process. Its efficiency strongly depends on the type of service provider and the funding institution (NFZ vs ZUS). It results from the use of different measures of the effectiveness, the quality and the evaluation of the process being assessed by funding institutions. The methods of the study include a comparative and descriptive quantitative and qualitative analysis. In the empirical part, a questionnaire had been developed. It was then distributed among spa personnel, responsible directly for the health promotion, and among patients who are beneficiaries of health services in spa centers. The quantitative part of the study was based on interviews carried with the use of the online survey (CAWI: Computer-Assisted Web Interview), telephone survey (CATI: Computer-Assisted Telephone Interview) and a conventional questionnaire (PAPI: Paper over Pencil Interview). As a result of the conducted research, it was found that the effectiveness of health education activities in spa resort facilities in Poland is higher when the services are organized using structured tools for managerial control. This applies to formalized procedures implemented by one of the dominant payers covering costs of services (ZUS) and involves the application of health education as one of the mandatory elements of treatment, subjected to the process of control during the course of spa therapy and evaluation after it is completed.

Keywords: effectiveness, health education, public health system, spa treatment

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704 The Investment Decision-Making Principles in Regional Tourism

Authors: Evgeni Baratashvili, Giorgi Sulashvili, Malkhaz Sulashvili, Bela Khotenashvili, Irma Makharashvili

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The most investment decision-making principle of regional travel firm's management and its partner is the formulation of the aims of investment programs. The investments can be targeted in order to reduce the firm's production costs and to purchase good transport equipment. In attractive region, in order to develop firm’s activities, the investment program can be targeted for increasing of provided services. That is the case where the sales already have been used in the market. The investment can be directed to establish the affiliate firms, branches, to construct new hotels, to create food and trade enterprises, to develop entertainment enterprises, etc. Economic development is of great importance to regional development. International experience shows that inclusive economic growth largely depends on not only the national, but also regional development planning and implementation of a strong and competitive regions. Regional development is considered as the key factor in achieving national success. Establishing a modern institute separate entities if the pilot centers will constitute a promotion, international best practice-based public-private partnership to encourage the use of models. Regional policy directions and strategies adopted in accordance with the successful implementation of major importance in the near future specific action plans for inclusive development and implementation, which will be provided in accordance with the effective monitoring and evaluation tools and measurable indicators combined. All of these above-mentioned investments are characterized by different levels, which are related to the following fact: How successful tourism marketing service is, whether it is able to determine the proper market's reaction according to the particular firm's actions. In the sphere of regional tourism industry and in the investment decision possible variants it can be developed the some specter of models. Each of the models can be modified and specified according to the situation, and characteristic skills of the existing problem that must be solved. Besides, while choosing the proper model, the process is affected by the regulation system of economic processes. Also, it is influenced by liberalization quality and by the level of state participation.

Keywords: net income of travel firm, economic growth, Investment profitability, regional development, tourist product, tourism development

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703 Improving the Detection of Depression in Sri Lanka: Cross-Sectional Study Evaluating the Efficacy of a 2-Question Screen for Depression

Authors: Prasad Urvashi, Wynn Yezarni, Williams Shehan, Ravindran Arun

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Introduction: Primary health services are often the first point of contact that patients with mental illness have with the healthcare system. A number of tools have been developed to increase detection of depression in the context of primary care. However, one challenge amongst many includes utilizing these tools within the limited primary care consultation timeframe. Therefore, short questionnaires that screen for depression that are just as effective as more comprehensive diagnostic tools may be beneficial in improving detection rates of patients visiting a primary care setting. Objective: To develop and determine the sensitivity and specificity of a 2-Question Questionnaire (2-QQ) to screen for depression in in a suburban primary care clinic in Ragama, Sri Lanka. The purpose is to develop a short screening tool for depression that is culturally adapted in order to increase the detection of depression in the Sri Lankan patient population. Methods: This was a cross-sectional study involving two steps. Step one: verbal administration of 2-QQ to patients by their primary care physician. Step two: completion of the Peradeniya Depression Scale, a validated diagnostic tool for depression, the patient after their consultation with the primary care physician. The results from the PDS were then correlated to the results from the 2-QQ for each patient to determine sensitivity and specificity of the 2-QQ. Results: A score of 1/+ on the 2-QQ was most sensitive but least specific. Thus, setting the threshold at this level is effective for correctly identifying depressed patients, but also inaccurately captures patients who are not depressed. A score of 6 on the 2-QQ was most specific but least sensitive. Setting the threshold at this level is effective for correctly identifying patients without depression, but not very effective at capturing patients with depression. Discussion: In the context of primary care, it may be worthwhile setting the 2-QQ screen at a lower threshold for positivity (such as a score of 1 or above). This would generate a high test sensitivity and thus capture the majority of patients that have depression. On the other hand, by setting a low threshold for positivity, patients who do not have depression but score higher than 1 on the 2-QQ will also be falsely identified as testing positive for depression. However, the benefits of identifying patients who present with depression may outweigh the harms of falsely identifying a non-depressed patient. It is our hope that the 2-QQ will serve as a quick primary screen for depression in the primary care setting and serve as a catalyst to identify and treat individuals with depression.

Keywords: depression, primary care, screening tool, Sri Lanka

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702 Novel Adomet Analogs as Tools for Nucleic Acids Labeling

Authors: Milda Nainyte, Viktoras Masevicius

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Biological methylation is a methyl group transfer from S-adenosyl-L-methionine (AdoMet) onto N-, C-, O- or S-nucleophiles in DNA, RNA, proteins or small biomolecules. The reaction is catalyzed by enzymes called AdoMet-dependent methyltransferases (MTases), which represent more than 3 % of the proteins in the cell. As a general mechanism, the methyl group from AdoMet replaces a hydrogen atom of nucleophilic center producing methylated DNA and S-adenosyl-L-homocysteine (AdoHcy). Recently, DNA methyltransferases have been used for the sequence-specific, covalent labeling of biopolymers. Two types of MTase catalyzed labeling of biopolymers are known, referred as two-step and one-step. During two-step labeling, an alkylating fragment is transferred onto DNA in a sequence-specific manner and then the reporter group, such as biotin, is attached for selective visualization using suitable chemistries of coupling. This approach of labeling is quite difficult and the chemical hitching does not always proceed at 100 %, but in the second step the variety of reporter groups can be selected and that gives the flexibility for this labeling method. In the one-step labeling, AdoMet analog is designed with the reporter group already attached to the functional group. Thus, the one-step labeling method would be more comfortable tool for labeling of biopolymers in order to prevent additional chemical reactions and selection of reaction conditions. Also, time costs would be reduced. However, effective AdoMet analog appropriate for one-step labeling of biopolymers and containing cleavable bond, required for reduction of PCR interferation, is still not known. To expand the practical utility of this important enzymatic reaction, cofactors with activated sulfonium-bound side-chains have been produced and can serve as surrogate cofactors for a variety of wild-type and mutant DNA and RNA MTases enabling covalent attachment of these chains to their target sites in DNA, RNA or proteins (the approach named methyltransferase-directed Transfer of Activated Groups, mTAG). Compounds containing hex-2-yn-1-yl moiety has proved to be efficient alkylating agents for labeling of DNA. Herein we describe synthetic procedures for the preparation of N-biotinoyl-N’-(pent-4-ynoyl)cystamine starting from the coupling of cystamine with pentynoic acid and finally attaching the biotin as a reporter group. The synthesis of the first AdoMet based cofactor containing a cleavable reporter group and appropriate for one-step labeling was developed.

Keywords: adoMet analogs, DNA alkylation, cofactor, methyltransferases

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701 Application of Artificial Intelligence in Market and Sales Network Management: Opportunities, Benefits, and Challenges

Authors: Mohamad Mahdi Namdari

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In today's rapidly changing and evolving business competition, companies and organizations require advanced and efficient tools to manage their markets and sales networks. Big data analysis, quick response in competitive markets, process and operations optimization, and forecasting customer behavior are among the concerns of executive managers. Artificial intelligence, as one of the emerging technologies, has provided extensive capabilities in this regard. The use of artificial intelligence in market and sales network management can lead to improved efficiency, increased decision-making accuracy, and enhanced customer satisfaction. Specifically, AI algorithms can analyze vast amounts of data, identify complex patterns, and offer strategic suggestions to improve sales performance. However, many companies are still distant from effectively leveraging this technology, and those that do face challenges in fully exploiting AI's potential in market and sales network management. It appears that the general public's and even the managerial and academic communities' lack of knowledge of this technology has caused the managerial structure to lag behind the progress and development of artificial intelligence. Additionally, high costs, fear of change and employee resistance, lack of quality data production processes, the need for updating structures and processes, implementation issues, the need for specialized skills and technical equipment, and ethical and privacy concerns are among the factors preventing widespread use of this technology in organizations. Clarifying and explaining this technology, especially to the academic, managerial, and elite communities, can pave the way for a transformative beginning. The aim of this research is to elucidate the capacities of artificial intelligence in market and sales network management, identify its opportunities and benefits, and examine the existing challenges and obstacles. This research aims to leverage AI capabilities to provide a framework for enhancing market and sales network performance for managers. The results of this research can help managers and decision-makers adopt more effective strategies for business growth and development by better understanding the capabilities and limitations of artificial intelligence.

Keywords: artificial intelligence, market management, sales network, big data analysis, decision-making, digital marketing

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700 The Impact of Dog-Assisted Wellbeing Intervention on Student Motivation and Affective Engagement in the Primary and Secondary School Setting

Authors: Yvonne Howard

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This project currently under development is centered around current learning processes, including a thorough literature review and ongoing practical experiences gained as a deputy head in a school. These daily experiences with students engaging in animal-assisted interventions and the school therapy dog form a strong base for this research. The primary objective of this research is to comprehensively explore the impact of dog-assisted well-being interventions on student motivation and affective engagement within primary and secondary school settings. The educational domain currently encounters a significant challenge due to the lack of substantial research in this area. Despite the perceived positive outcomes of such interventions being acknowledged and shared in various settings, the evidence supporting their effectiveness in an educational context remains limited. This study aims to bridge the gap in the research and shed light on the potential benefits of dog-assisted well-being interventions in promoting student motivation and affective engagement. The significance of this topic recognizes that education is not solely confined to academic achievement but encompasses the overall well-being and emotional development of students. Over recent years, there has been a growing interest in animal-assisted interventions, particularly in healthcare settings. This interest has extended to the educational context. While the effectiveness of these interventions in these areas has been explored in other fields, the educational sector lacks comprehensive research in this regard. Through a systematic and thorough research methodology, this study seeks to contribute valuable empirical data to the field, providing evidence to support informed decision-making regarding the implementation of dog-assisted well-being interventions in schools. This research will utilize a mixed-methods design, combining qualitative and quantitative measures to assess the research objectives. The quantitative phase will include surveys and standardized scales to measure student motivation and affective engagement, while the qualitative phase will involve interviews and observations to gain in-depth insights from students, teachers, and other stakeholders. The findings will contribute evidence-based insights, best practices, and practical guidelines for schools seeking to incorporate dog-assisted interventions, ultimately enhancing student well-being and improving educational outcomes.

Keywords: therapy dog, wellbeing, engagement, motivation, AAI, intervention, school

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699 Gabriel Marcel and Friedrich Nietzsche: Existence and Death of God

Authors: Paolo Scolari

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Nietzschean thought flows like a current throughout Marcel’s philosophy. Marcel is in constant dialogue with him. He wants to give homage to him, making him one of the most eminent representatives of existential thought. His enthusiasm is triggered by Nietzsche’s phrase: ‘God is dead,’ the fil rouge that ties all of the Nietzschean references scattered through marcelian texts. The death of God is the theme which emphasises both the greatness and simultaneously the tragedy of Nietzsche. Marcel wants to substitute the idea ‘God is dead’ with its original meaning: a tragic existential characteristic that imitators of Nietzsche seemed to have blurred. An interpretation that Marcel achieves aiming at double target. On the one hand he removes the heavy metaphysical suit from Nietzsche’s aphorisms on the death of God, that his interpreters have made them wear – Heidegger especially. On the other hand, he removes a stratus of trivialisation which takes the aphorisms out of context and transforms them into advertising slogans – here Sartre becomes the target. In the lecture: Nietzsche: l'homme devant la mort de dieu, Marcel hurls himself against the metaphysical Heidegger interpretation of the death of God. A hermeneutical proposal definitely original, but also a bit too abstract. An interpretation without bite, that does not grasp the tragic existential weight of the original Nietzschean idea. ‘We are probably on the wrong road,’ announces, ‘when at all costs, like Heidegger, we want to make a metaphysic out of Nietzsche.’ Marcel also criticizes Sartre. He lands in Geneva and reacts to the journalists, by saying: ‘Gentlemen, God is dead’. Marcel only needs this impromptu exclamation to understand how Sartre misinterprets the meaning of the death of God. Sartre mistakes and loses the existential sense of this idea in favour of the sensational and trivialisation of it. Marcel then wipes the slate clean from these two limited interpretations of the declaration of the death of God. This is much more than a metaphysical quarrel and not at all comparable to any advertising slogan. Behind the cry ‘God is dead’ there is the existence of an anguished man who experiences in his solitude the actual death of God. A man who has killed God with his own hands, haunted by the chill that from now on he will have to live in a completely different way. The death of God, however, is not the end. Marcel spots a new beginning at the point in which nihilism is overcome and the Übermensch is born. Dialoguing with Nietzsche he notices to being in the presence of a great spirit that has contributed to the renewal of a spiritual horizon. He descends to the most profound depths of his thought, aware that the way out is really far below, in the remotest areas of existence. The ambivalence of Nietzsche does not scare him. Rather such a thought, characterised by contradiction, will simultaneously be infinitely dangerous and infinitely healthy.

Keywords: Nietzsche's Death of God, Gabriel Marcel, Heidegger, Sartre

Procedia PDF Downloads 239