Search results for: therapeutic benefits
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4658

Search results for: therapeutic benefits

1628 An Interesting Case of Management of Life Threatening Calcium Disequilibrium in a Patient with Parathyroid Tumor

Authors: Rajish Shil, Mohammad Ali Houri, Mohammad Milad Ismail, Fatimah Al Kaabi

Abstract:

The clinical presentation of Primary hyperparathyroidism can vary from simple asymptomatic hypercalcemia to severe life-threatening hypercalcemic crisis with multi-organ dysfunction, which can be due to parathyroid adenoma or sometimes with malignant cancer. This cascade of clinical presentation can lead to a diagnostic and therapeutic challenge for treating the disease. We are presenting a case of severe hypercalcemic crisis due to parathyroid adenoma with an emphasis on early management, diagnosis, and interventions to prevent any lifelong complications and any permanent organ dysfunction. A 30 years old female with a history of primary Infertility, admitted to Al Ain Hospital critical care unit with Acute Severe Necrotizing Pancreatitis. She initially had a 1-month history of abdominal pain on and off, for which she was treated conservatively with no much improvement, and later on, she developed life-threatening severe pancreatitis, which required her to be admitted to the critical care unit. She was transferred from a private healthcare facility, where she was found to have a very high level of calcium up to 15mmol/L. She received systemic Zoledronic Acid, which lowered her calcium level transiently and later was increased again. She went on to develop multiple end-organ damages along with multiple electrolytes disturbances. She was found to have high levels of Parathyroid hormone, which was correlated with a parathyroid mass on the neck via radiological imaging. After a long course of medical treatment to lower the calcium to a near-normal level, parathyroidectomy was done, which showed parathyroid adenoma on histology. She developed hungry bone syndrome after the surgery and pancreatic pseudocyst after resolving of pancreatitis. She required aggressive treatment with Intravenous calcium for her hypocalcemia as she received zoledronic acid at the beginning of the disease. Later on, she was discharged on long term calcium and other electrolytes supplements. In patients presenting with hypercalcemia, it is prudent to investigate and start treatment early to prevent complications and end-organ damage from hypercalcemia and also to treat the primary cause of the hypercalcemia, with conscious follow up to prevent hypocalcemic complications after treatment. It is important to follow up patients with parathyroid adenomas for a long period in order to detect any recurrence of the tumor or to make sure if the primary tumor is either benign or malignant.

Keywords: hypercalcemia, pancreatitis, hypocalcemia, hyperparathyroidism

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1627 Control of Doxorubicin Release Rate from Magnetic PLGA Nanoparticles Using a Non-Permanent Magnetic Field

Authors: Inês N. Peça , A. Bicho, Rui Gardner, M. Margarida Cardoso

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Inorganic/organic nanocomplexes offer tremendous scope for future biomedical applications, including imaging, disease diagnosis and drug delivery. The combination of Fe3O4 with biocompatible polymers to produce smart drug delivery systems for use in pharmaceutical formulation present a powerful tool to target anti-cancer drugs to specific tumor sites through the application of an external magnetic field. In the present study, we focused on the evaluation of the effect of the magnetic field application time on the rate of drug release from iron oxide polymeric nanoparticles. Doxorubicin, an anticancer drug, was selected as the model drug loaded into the nanoparticles. Nanoparticles composed of poly(d-lactide-co-glycolide (PLGA), a biocompatible polymer already approved by FDA, containing iron oxide nanoparticles (MNP) for magnetic targeting and doxorubicin (DOX) were synthesized by the o/w solvent extraction/evaporation method and characterized by scanning electron microscopy (SEM), by dynamic light scattering (DLS), by inductively coupled plasma-atomic emission spectrometry and by Fourier transformed infrared spectroscopy. The produced particles yielded smooth surfaces and spherical shapes exhibiting a size between 400 and 600 nm. The effect of the magnetic doxorubicin loaded PLGA nanoparticles produced on cell viability was investigated in mammalian CHO cell cultures. The results showed that unloaded magnetic PLGA nanoparticles were nontoxic while the magnetic particles without polymeric coating show a high level of toxicity. Concerning the therapeutic activity doxorubicin loaded magnetic particles cause a remarkable enhancement of the cell inhibition rates compared to their non-magnetic counterpart. In vitro drug release studies performed under a non-permanent magnetic field show that the application time and the on/off cycle duration have a great influence with respect to the final amount and to the rate of drug release. In order to determine the mechanism of drug release, the data obtained from the release curves were fitted to the semi-empirical equation of the the Korsmeyer-Peppas model that may be used to describe the Fickian and non-Fickian release behaviour. Doxorubicin release mechanism has shown to be governed mainly by Fickian diffusion. The results obtained show that the rate of drug release from the produced magnetic nanoparticles can be modulated through the magnetic field time application.

Keywords: drug delivery, magnetic nanoparticles, PLGA nanoparticles, controlled release rate

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1626 Perception of Neighbourhood-Level Built Environment in Relation to Youth Physical Activity in Malaysia

Authors: A. Abdullah, N. Faghih Mirzaei, S. Hany Haron

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Neighbourhood environment walkability on reported physical activity (PA) levels of students of Universiti Sains Malaysia (USM) in Malaysia. Compared with previous generations, today’s young people spend less time playing outdoors and have lower participation rates in PA. Research suggests that negative perceptions of neighbourhood walkability may be a potential barrier to adolescents’ PA. The sample consisted of 200 USM students (to 24 years old) who live outside of the main campus and engage in PA in sport halls and sport fields of USM. The data were analysed using the t-test, binary logistic regression, and discriminant analysis techniques. The present study found that youth PA was affected by neighbourhood environment walkability factors, including neighbourhood infrastructures, neighbourhood safety (crime), and recreation facilities, as well as street characteristics and neighbourhood design variables such as facades of sidewalks, roadside trees, green spaces, and aesthetics. The finding also illustrated that active students were influenced by street connectivity, neighbourhood infrastructures, recreation facilities, facades of sidewalks, and aesthetics, whereas students in the less active group were affected by access to destinations, neighbourhood safety (crime), and roadside trees and green spaces for their PAs. These results report which factors of built environments have more effect on youth PA and they message to the public to create more awareness about the benefits of PA on youth health.

Keywords: fear of crime, neighbourhood built environment, physical activities, street characteristics design

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1625 Robotic Assisted vs Traditional Laparoscopic Partial Nephrectomy Peri-Operative Outcomes: A Comparative Single Surgeon Study

Authors: Gerard Bray, Derek Mao, Arya Bahadori, Sachinka Ranasinghe

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The EAU currently recommends partial nephrectomy as the preferred management for localised cT1 renal tumours, irrespective of surgical approach. With the advent of robotic assisted partial nephrectomy, there is growing evidence that warm ischaemia time may be reduced compared to the traditional laparoscopic approach. There is still no clear differences between the two approaches with regards to other peri-operative and oncological outcomes. Current limitations in the field denote the lack of single surgeon series to compare the two approaches as other studies often include multiple operators of different experience levels. To the best of our knowledge, this study is the first single surgeon series comparing peri-operative outcomes of robotic assisted and laparoscopic PN. The current study aims to reduce intra-operator bias while maintaining an adequate sample size to assess the differences in outcomes between the two approaches. We retrospectively compared patient demographics, peri-operative outcomes, and renal function derangements of all partial nephrectomies undertaken by a single surgeon with experience in both laparoscopic and robotic surgery. Warm ischaemia time, length of stay, and acute renal function deterioration were all significantly reduced with robotic partial nephrectomy, compared to laparoscopic nephrectomy. This study highlights the benefits of robotic partial nephrectomy. Further prospective studies with larger sample sizes would be valuable additions to the current literature.

Keywords: partial nephrectomy, robotic assisted partial nephrectomy, warm ischaemia time, peri-operative outcomes

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1624 The Effectiveness of Exercise Therapy on Decreasing Pain in Women with Temporomandibular Disorders and How Their Brains Respond: A Pilot Randomized Controlled Trial

Authors: Zenah Gheblawi, Susan Armijo-Olivo, Elisa B. Pelai, Vaishali Sharma, Musa Tashfeen, Angela Fung, Francisca Claveria

Abstract:

Due to physiological differences between men and women, pain is experienced differently between the two sexes. Chronic pain disorders, notably temporomandibular disorders (TMDs), disproportionately affect women in diagnosis, and pain severity in opposition of their male counterparts. TMDs are a type of musculoskeletal disorder that target the masticatory muscles, temporalis muscle, and temporomandibular joints, causing considerable orofacial pain which can usually be referred to the neck and back. Therapeutic methods are scarce, and are not TMD-centered, with the latest research suggesting that subjects with chronic musculoskeletal pain disorders have abnormal alterations in the grey matter of their brains which can be remedied with exercise, and thus, decreasing the pain experienced. The aim of the study is to investigate the effects of exercise therapy in TMD female patients experiencing chronic jaw pain and to assess the consequential effects on brain activity. In a randomized controlled trial, the effectiveness of an exercise program to improve brain alterations and clinical outcomes in women with TMD pain will be tested. Women with chronic TMD pain will be randomized to either an intervention arm or a placebo control group. Women in the intervention arm will receive 8 weeks of progressive exercise of motor control training using visual feedback (MCTF) of the cervical muscles, twice per week. Women in the placebo arm will receive innocuous transcutaneous electrical nerve stimulation during 8 weeks as well. The primary outcomes will be changes in 1) pain, measured with the Visual Analogue Scale, 2) brain structure and networks, measured by fractional anisotropy (brain structure) and the blood-oxygen level dependent signal (brain networks). Outcomes will be measured at baseline, after 8 weeks of treatment, and 4 months after treatment ends and will determine effectiveness of MCTF in managing TMD, through improved clinical outcomes. Results will directly inform and guide clinicians in prescribing more effective interventions for women with TMD. This study is underway, and no results are available at this point. The results of this study will have substantial implications on the advancement in understanding the scope of plasticity the brain has in regards with pain, and how it can be used to improve the treatment and pain of women with TMD, and more generally, other musculoskeletal disorders.

Keywords: exercise therapy, musculoskeletal disorders, physical therapy, rehabilitation, tempomandibular disorders

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1623 Aging-Related Changes in Calf Muscle Function: Implications for Venous Hemodynamic and the Role of External Mechanical Activation

Authors: Bhavatharani S., Boopathy V., Kavin S., Naveethkumar R.

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Context: Resistance training with blood flow restriction (BFR) has increased in clinical rehabilitation due to the substantial benefits observed in augmenting muscle mass and strength using low loads. However, there is a great variability of training pressures for clinical populations as well as methods to estimate it. The aim of this study was to estimate the percentage of maximal BFR that could result by applying different methodologies based on arbitrary or individual occlusion levels using a cuff width between 9 and 13 cm. Design: A secondary analysis was performed on the combined databases of 2 previous larger studies using BFR training. Methods: To estimate these percentages, the occlusion values needed to reach complete BFR (100% limb occlusion pressure [LOP]) were estimated by Doppler ultrasound. Seventy-five participants (age 24.32 [4.86] y; weight: 78.51 [14.74] kg; height: 1.77 [0.09] m) were enrolled in the laboratory study for measuring LOP in the thigh, arm, or calf. Results: When arbitrary values of restriction are applied, a supra-occlusive LOP between 120% and 190% LOP may result. Furthermore, the application of 130% resting brachial systolic blood pressure creates a similar occlusive stimulus as 100% LOP. Conclusions: Methods using 100 mm Hg and the resting brachial systolic blood pressure could represent the safest application prescriptions as they resulted in applied pressures between 60% and 80% LOP. One hundred thirty percent of the resting brachial systolic blood pressure could be used to indirectly estimate 100% LOP at cuff widths between 9 and 13 cm. Finally, methodologies that use standard values of 200 and, 300 mm Hg far exceed LOP and may carry additional risk during BFR exercise.

Keywords: lower limb rehabilitation, ESP32, pneumatics for medical, programmed rehabilitation

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1622 Contextual Analysis of Spekboom (Portulacaria afra) on Air Quality: A Case of Durban, South Africa

Authors: C. Greenstone, R. Hansmann, K. Lawrence

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Portulacaria afra, commonly known as Spekboom is an indigenous South African plant. Spekboom is recognized for its medicinal, nutrient rich, easy to grow, drought tolerant and have climate change combating benefits. Durban’s air quality currently falls below the acceptable level. Urban greening absorbs air pollutants which can improve human health; however, urban planning often neglects the aspect of air quality on human health. It is therefore imperative that there is an investigation generating some quantification of the Spekboom plant on air quality. Though there are numerous advantages that Spekboom brings to ecosystems, the effect of Spekboom on air quality in context specific locales remains under researched. This study seeks to address this gap and bring forward the effect of Spekboom on air quality and improving human health overall using locations with specific characteristics ranging from industrial, commercial and residential. The study adopted a field sampling and spatial analysis approach through the collection of cuttings of Spekboom from various locations to measure the amount of toxins absorbed by the plant and thereafter using Geographic Information Systems (GIS) to spatially map the location of each sample. Through the results found, the implementation of Spekboom as an air purifier in areas that have poor air quality can be carried out. Spekboom could even be cultivated around cities forming a green belt to improve air quality on a much larger scale. Due to Spekboom's low maintenance characteristics, it makes the entire implementation process quite simple. Proposed Future research will be to collect yearly cuttings from the same plant in order to get a longitudinal, long-term assessment of air quality improvements in areas where Spekboom is implemented.

Keywords: air quality, human health, portulacaria afra, spekboom

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1621 Designing of Food Products with Seasoned Plant Components Assigned for Obese and Diabetic Individuals

Authors: A. Gramza-Michałowska, J. Skręty, M. Antczak, J. Kobus-Cisowska, D. Kmiecik, J. Korczak, Kulczyński Bartosz

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Background: Modern consumer highly appreciates the correlation between eating habits and health. Intensified research showed many proofs confirming that food besides its basic nutritional function, possess also significant prophylactic and therapeutic potential. Preventive potential of selected food is commonly used as improvement factor of patients life standard. World Health Organization indicates that diabetes (Diabetes mellitus) and obesity are two of the most common and dangerous diseases. Diet therapy is an element of diabetes education program and a part of healing process, allowing maintaining and remaining the optimal metabolic state of the system. It must be remembered that diabetes treatment should be individualized to each patient. One of highly recommended vegetable for diabetes is asparagus (Asparagus officinalis L.), low calories common plant, growing in European countries. Objective: To propose the technology of unsweetened muesli production with addition of new components, we investigated the effects of selected vegetable addition on antioxidative capacity and consumer’s acceptance of muesli as representative of breakfast product. Methods: Muesli was formulated from a composition of oat flakes, flaxseed, bran, carrots, broccoli and asparagus. Basic composition of muesli was evaluated as content of protein, lipids, fatty acid composition, ash, selected minerals and caloricity. Antioxidant capacity of muesli was evaluated with use radical scavenging methods (DPPH, ABTS), ORAC value and PCL - photochemiluminescence antiradical potential. Proposed muesli as new product was also characterized with sensory analysis, which included color, scent, taste, consistency and overall acceptance of a product. Results: Results showed that addition of freeze-dried asparagus into muesli allowed to lower the fat content and caloricity of a product according to the base product. No significant loss in antioxidant potential was evaluated, also the sensory value of a product was not negative. Conclusion: Designed muesli would be an answer for obese people looking for healthy snack during the daytime. Results showed that product with asparagus addition would be accepted by the consumers and because of its antidiabetic potential could be a n important factor in prevention of diabetes or obesity. Financial support by the UE Project no PO IG 01.01.00.00-061/09

Keywords: muesli, vegetables, asparagus, antioxidant potential, lipids

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1620 Battery Energy Storage System Economic Benefits Assessment on a Network Frequency Control

Authors: Kréhi Serge Agbli, Samuel Portebos, Michaël Salomon

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Here a methodology is considered aiming at evaluating the economic benefit of the provision of a primary frequency control unit using a Battery Energy Storage System (BESS). In this methodology, two control types (basic and hysteresis) are implemented and the corresponding minimum energy storage system power allowing to maintain the frequency drop inside a given threshold under a given contingency is identified and compared using DigSilent’s PowerFactory software. Following this step, the corresponding energy storage capacity (in MWh) is calculated. As PowerFactory is dedicated to dynamic simulation for transient analysis, a first order model related to the IEEE 9 bus grid used for the analysis under PowerFactory is characterized and implemented on MATLAB-Simulink. Primary frequency control is simulated using the two control types over one-month grid's frequency deviation data on this Simulink model. This simulation results in the energy throughput both basic and hysteresis BESSs. It emerges that the 15 minutes operation band of the battery capacity allocated to frequency control is sufficient under the considered disturbances. A sensitivity analysis on the width of the control deadband is then performed for the two control types. The deadband width variation leads to an identical sizing with the hysteresis control showing a better frequency control at the cost of a higher delivered throughput compared to the basic control. An economic analysis comparing the cost of the sized BESS to the potential revenues is then performed.

Keywords: battery energy storage system, electrical network frequency stability, frequency control unit, PowerFactor

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1619 Strength Properties of Cement Mortar with Dark Glass Waste Powder as a Partial Sand Replacement

Authors: Ng Wei Yan, Lim Jee Hock, Lee Foo Wei, Mo Kim Hung, Yip Chun Chieh

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The burgeoning accumulation of glass waste in Malaysia, particularly from the food and beverage industry, has become a prominent environmental concern, with disposal sites reaching saturation. This study introduces a distinct approach to addressing the twin challenges of landfill scarcity and natural resource conservation by repurposing discarded glass bottle waste into a viable construction material. The research presents a comprehensive evaluation of the strength characteristics of cement mortar when dark glass waste powder is used as a partial sand replacement. The experimental investigation probes the density, flow spread diameter, and key strength parameters—including compressive, splitting tensile, and flexural strengths—of the modified cement mortar. Remarkably, results indicate that a full replacement of sand with glass waste powder significantly improves the material's strength attributes. A specific mixture with a cement/sand/water ratio of 1:5:1.24 was found to be optimal, yielding an impressive compressive strength of 7 MPa at the 28-day mark, accompanied by a favourable 200 mm spread diameter in flow table tests. The findings of this study underscore the dual benefits of utilizing glass waste powder in cement mortar: mitigating Malaysia's glass waste dilemma and enhancing the performance of construction materials such as bricks and concrete products. Consequently, the research validates the premise that increasing the incorporation of glass waste as a sand substitute promotes not only environmental sustainability but also material innovation in the construction industry.

Keywords: glass waste, strength properties, cement mortar, environmental friendly

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1618 Value Creation of Public Financial Management Reforms through Their Long-Term Impacts

Authors: Christoph Schuler, Oriana Ponta

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Public Financial Management (PFM) reforms are promoted by various international organizations such as the International Monetary Fund (IMF) or the World Bank, local development banks and the donor country community to strengthen governance and accountability in developing countries across the world. Reform efforts undertaken are often systematically measured against international best practice by the application of standardized analytical instruments such as the Public Expenditure and Financial Accountability Framework (PEFA) or the Poverty Reduction Action Plan (PARP). While those instruments analyze direct achievements of PFM reforms, the long-term benefits of such reforms for society remain untapped. This gives rise to the question why the concept of impact evaluation with its experimental or quasi-experimental settings in the form of randomized control trials has rarely been applied in the context of PFM reforms. To close this gap, this study provides examples where the concept of impact evaluation can be applied to PFM reforms and thereby shifting the focus from outcome towards a long-term impact. As it is a new approach, this study does not attempt to conduct a fully flagged impact evaluation of a certain PFM reform. However, it will outline, as a form of pre-test the applicability of the impact evaluation methodology in this context, for example, by more closely analyzing the commonly used indicators (for example within PEFA or PARP). This would mean to scrutinize these indicators as to how they were designed and how they are related to the long-term impact, they should be producing. The analysis of PFM reform indicators and their relation to long-term impacts should provide practitioners and scholars alike with new insights on how to strengthen the accountability of public service delivery through successful and sustainable PFM reforms.

Keywords: accountability, impact evaluation, PFM reforms, public financial management

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1617 Implications of Industry 4.0 to Supply Chain Management and Human Resources Management: The State of the Art

Authors: Ayse Begum Kilic, Sevgi Ozkan

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Industry 4.0 (I4.0) is a significant and promising research topic that is expected to gain more importance due to its effects on important concepts like cost, resource management, and accessibility. Instead of focusing those effects in only one area, combining different departments, and see the big picture helps to make more realistic predictions about the future. The aim of this paper is to identify the implications of Industry 4.0 for both supply chain management and human resources management by finding out the topics that take place at the intersection of them. Another objective is helping the readers to realize the expected changes in these two areas due to I4.0 in order to take the necessary steps in advance and make recommendations to catch up the latest trends. The expected changes are concluded from the industry reports and related journal papers in the literature. As found in the literature, this study is the first to combine the Industry 4.0, supply chain management and human resources management and urges to lead future works by finding out the intersections of those three areas. Benefits of I4.0 and the amount, research areas and the publication years of papers on I4.0 in the academic journals are mentioned in this paper. One of the main findings of this research is that a change in the labor force qualifications is expected with the advancements in the technology. There will be a need for higher level of skills from the workers. This will directly affect the human resources management in a way of recruiting and managing those people. Another main finding is, as it is explained with an example in the article, the advancements in the technology will change the place of production. For instance, 'dark factories', a popular topic of I4.0, will enable manufacturers to produce in places that close to their marketplace. The supply chains are expected to be influenced by that change.

Keywords: human resources management, industry 4.0, logistics, supply chain management

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1616 Sustainable Agriculture of Tribal Farmers: An Analysis in Koraput and Malkangiri Districts of Odisha, India

Authors: Amrita Mishra, Tushar Kanti Das

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Agriculture is the backbone of the economy of Odisha. Sustainability of agriculture holds the key for the development of Odisha. The Sustainable Development Goals are a framework of 17 goals and 169 targets across social, economical and environmental areas of sustainable development. Among all the seventeen goals the second goal is focusing on the promotion of Sustainable Agriculture. In this research our main aim is also to contribute an understanding of effectiveness of sustainable agriculture as a tool for rural development in the selected tribal district (i.e. Koraput and Malkangiri) of Odisha. These two districts are comes under KBK districts of Odisha which are identified as most backward districts of Odisha. The objectives of our study are to investigate the effect of sustainable agriculture on the lives of tribal farmers, to study whether the farmers are empowered by their participation in sustainable agriculture initiatives to move towards their own vision of development and to study the investment and profit ratio in sustainable agriculture. This research will help in filling the major gaps in sociological studies of sustainable agriculture. This information will helpful for farmers, development organisations, donors and policy makers in formulating the development of effective initiatives and policies to support the development of sustainable agriculture. In this study, we have taken 210 respondents and used various statistical techniques like chi-square test, one-way ANOVA and percentage analysis. This research shows that sustainable agriculture is an effective development strategy that benefits the tribal farmers to move towards their own vision of Good Fortune. The poor farmers who struggle to feed their families and maintain viable livelihoods on shrinking land for them sustainable agriculture are really benefited. The farmers are using homemade pesticides, manure and also getting the seeds from different development organisations and Government. So the investment in Sustainable Agriculture is very less. All farmers said their lives are now better than before. The creation of farmers groups for training and marketing for the produces was shown to be very important for empowerment.

Keywords: sustainable, agriculture, tribal farmers, development, empowerment

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1615 Promoting Open Educational Resources (OER) in Theological/Religious Education in Nigeria

Authors: Miracle Ajah

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One of the biggest challenges facing Theological/Religious Education in Nigeria is access to quality learning materials. For instance at the Trinity (Union) Theological College, Umuahia, it was difficult for lecturers to access suitable and qualitative materials for instruction especially the ones that would suit the African context and stimulate a deep rooted interest among the students. Some textbooks written by foreign authors were readily available in the School Library, but were lacking in the College bookshops for students to own copies. Even when the College was able to order some of the books from abroad, it did not usher in the needed enthusiasm expected from the students because they were either very expensive or very difficult to understand during private studies. So it became necessary to develop contextual materials which were affordable and understandable, though with little success. The National Open University of Nigeria (NOUN)’s innovation in the development and sharing of learning resources through its Open Course ware is a welcome development and of great assistance to students. Apart from NOUN students who could easily access the materials, many others from various theological/religious institutes across the nation have benefited immensely. So, the thesis of this paper is that the promotion of open educational resources in theological/religious education in Nigeria would facilitate a better informed/equipped religious leadership, which would in turn impact its adherents for a healthier society and national development. Adopting a narrative and historical approach within the context of Nigeria’s educational system, the paper discusses: educational traditions in Nigeria; challenges facing theological/religious education in Nigeria; and benefits of open educational resources. The study goes further to making recommendations on how OER could positively influence theological/religious education in Nigeria. It is expected that theologians, religious educators, and ODL practitioners would find this work very useful.

Keywords: OER, theological education, religious education, Nigeria

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1614 Multicenter Baseline Survey to Outline Antimicrobial Prescribing Practices at Six Public Sectortertiary Care Hospitals in a Low Middle Income Country

Authors: N. Khursheed, M. Fatima, S. Jamal, A. Raza, S. Rattani, Q. Ahsan, A. Rasheed, M. Jawed

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Introduction: Antibiotics are among the commonly prescribed medicines to treat bacterial infections. Their misuse intensifies resistance, and overuse incurs heavy losses to the healthcare system in terms of increased treatment costs and enhanced disease burden. Studies show that 40% of empirically used antibiotics are irrationally utilized. The objective of this study was to evaluate prescribing pattern of antibiotics at six public sector tertiary care hospitals across Pakistan. Methods: A multicenter cross-sectional point prevalence survey (PPS) was conducted in selected wards of six public sector tertiary care hospitals in Pakistan as part of the Clinical Engagement program by Fleming Fund Country Grant Pakistan in collaboration with Indus Hospital & Health Network (IHHN) from February to March 2021, these included Jinnah Postgraduate Medical Center and Dr. Ruth K. M. Pfau Civil Hospital from Karachi, Sheikh Zayed Hospital Lahore, Nishtar Medical University Hospital Multan, Medical Teaching Institute Hayatabad Medical Complex Peshawar, and Provincial Headquarters Hospital Gilgit. WHO PPS methodology was used for data collection (Hospital, ward, and patient level data was collected). Data was entered into the open-source Kobo Collect application and was analyzed using SPSS (version 22.0). Findings: Medical records of 837 in-patients were surveyed, of which the prevalence of antibiotics use was 78.5%. The most commonly prescribed antimicrobial was Ceftriaxone (21.7%) which is categorized in the Watch group of WHO AWaRe Classification, followed by Metronidazole (17.3%), Cefoperazone/Sulbactam (8.4%), Co-Amoxiclav (6.3%) and Piperacillin/Tazobactam (5.9%). The antibiotics were prescribed largely for surgical prophylaxis (36.7%), followed by community-acquired infections (24.7%). One antibiotic was prescribed to 46.7%, two to 39.9%, and three or more to 12.5 %. Two of six (30%) hospitals had functional drug and therapeutic committees, three (50%) had infection prevention and control committees, and one facility had an antibiotic formulary. Conclusion: Findings demonstrate high consumption of broad-spectrum antimicrobials and emphasizes the importance of expanding the antimicrobial stewardship program. Mentoring clinical teams will help to rationalize antimicrobial use.

Keywords: antimicrobial resistance, antimicrobial stewardship, point prevalence survey, antibiotics

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1613 Behavioural Studies on Multidirectional Reinforced 4-D Orthogonal Composites on Various Preform Configurations

Authors: Sriram Venkatesh, V. Murali Mohan, T. V. Karthikeyan

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The main advantage of multi-directionally reinforced composites is the freedom to orient selected fibre types and hence derives the benefits of varying fibre volume fractions and there by accommodate the design loads of the final structure of composites. This technology provides the means to produce tailored composites with desired properties. Due to the high level of fibre integrity with through thickness reinforcement those composites are expected to exhibit superior load bearing characteristics with capability to carry load even after noticeable and apparent fracture. However a survey of published literature indicates inadequacy in the design and test data base for the complete characterization of the multidirectional composites. In this paper the research objective is focused on the development and testing of 4-D orthogonal composites with different preform configurations and resin systems. A preform is the skeleton 4D reinforced composite other than the matrix. In 4-D preforms fibre bundles are oriented in three directions at 1200 with respect to each other and they are on orthogonal plane with the fibre in 4th direction. This paper addresses the various types of 4-D composite manufacturing processes and the mechanical test methods followed for the material characterization. A composite analysis is also made, experiments on course and fine woven preforms are conducted and the findings of test results are discussed in this paper. The interpretations of the test results reveal several useful and interesting features. This should pave the way for more widespread use of the perform configurations for allied applications.

Keywords: multi-directionally reinforced composites, 4-D orthogonal preform, course weave, fine weave, fibre bundle spools, unit cell, fibre architecture, fibre volume fraction, fibre distribution

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1612 Migrant Labour in Kerala: A Study on Inter-State Migrant Workers

Authors: Arun Perumbilavil Anand

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In the recent years, Kerala is witnessing a large inflow of migrants from different parts of the country. Though initially, the migrants were largely from the districts of Tamil Nadu and mostly of seasonal nature, but at a later period, the state started getting migrants from the far-off states like UP, Assam, Bengal, etc. Higher wages for unskilled labour, large opportunities for employment, the reluctance on the part of Kerala workers to do menial and hard physical work, and the shortage of local labour, paradoxically despite the high unemployment rate in the state, led to the massive influx of migrant labourers. This study takes a multi-dimensional overview of migrant labour in Kerala by encompassing factors such as channels of migration, nature of employment contracts entered into and the corresponding wages and benefits obtained by them. The study also analysed the circumstances that led to the large influx of migrants from different states of India. It further makes an attempt to examine the varying dimensions of living and working environment, and also the health conditions of migrants. The study is based on the empirical findings obtained as a result of the primary interviews conducted with migrants in the districts of Palakkad, Malappuram, and Ernakulam. The study concludes by noting that Kerala will inevitably have to depend on migrant labour and is likely to experience heavy in-migration of labour in future, provided that if the existing socioeconomic and demographic situations persist. Since, this is inevitable, the best way before the state is to prepare well in advance to receive and accommodate such migrant labour to lead a comfortable life in a hassle free environment, so that it would definitely play a vital role in further strengthening and sustaining the growth trajectory of not only Kerala’s economy but also the states of origin.

Keywords: Kerala, labour, migration, migrant workers

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1611 Visual Representation and the De-Racialization of Public Spaces

Authors: Donna Banks

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In 1998 Winston James called for more research on the Caribbean diaspora and this ethnographic study, incorporating participant observation, interviews, and archival research, adds to the scholarship in this area. The research is grounded in the discipline of cultural studies but is cross-disciplinary in nature, engaging anthropology, psychology, and urban planning. This paper centers on community murals and their contribution to a more culturally diverse and representative community. While many museums are in the process of reassessing their collection, acquiring works, and developing programming to be more inclusive, and public art programs are investing millions of dollars in trying to fashion an identity in which all residents can feel included, local artists in neighborhoods in many countries have been using community murals to tell their stories. Community murals serve a historical, political, and social purpose and are an instrumental strategy in creative placemaking projects. Community murals add to the livability of an area. Even though official measurements of livability do not include race, ethnicity, and gender - which are egregious omissions - murals are a way to integrate historically underrepresented people into the wider history of a country. This paper draws attention to a creative placemaking project in the port city of Bristol, England. A city, like many others, with a history of spacializing race and racializing space. For this reason, Bristol’s Seven Saints of St. Pauls® Art & Heritage Trail, which memorializes seven Caribbean-born social and political change agents, is examined. The Seven Saints of St. Pauls® Art & Heritage Trail is crucial to the city, as well as the country, in its contribution to the de-racialization of public spaces. Within British art history, with few exceptions, portraits of non-White people who are not depicted in a subordinate role have been absent. The artist of the mural project, Michelle Curtis, has changed this long-lasting racist and hegemonic narrative. By creating seven large-scale portraits of individuals not typically represented visually, the artist has added them into Britain’s story. In these murals, however, we see more than just the likeness of a person; we are presented with a visual commentary that reflects each Saint’s hybrid identity of being both Black Caribbean and British, as well as their social and political involvement. Additionally, because the mural project is part of a heritage trail, the murals' are therapeutic and contribute to improving the well-being of residents and strengthening their sense of belonging.

Keywords: belonging, murals, placemaking, representation

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1610 Designing an MTB-MLE for Linguistically Heterogenous Contexts: A Practitioner’s Perspective

Authors: Ajay Pinjani, Minha Khan, Ayesha Mehkeri, Anum Iftikhar

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There is much research available on the benefits of adopting mother tongue-based multilingual education (MTB MLE) in primary school classrooms, but there is limited guidance available on how to design such programs for low-resource and linguistically diverse contexts. This paper is an effort to bridge the gap between theory and practice by offering a practitioner’s perspective on designing an MTB MLE program for linguistically heterogeneous contexts. The research compounds findings from current academic literature on MTB MLE, the study of global MTB MLE programs, interviews with practitioners, policy-makers, and academics worldwide, and a socio-linguistic survey carried out in parts of Tharparkar, Pakistan, the area selected for envisioned pilot implementation. These findings enabled the creation of ‘guiding principles’ which provide structure for the development of a contextualized and holistic MTB-MLE program. The guiding principles direct the creation of teaching and learning materials, creating effective teaching and learning environment, community engagement, and program evaluation. Additionally, the paper demonstrates the development of a context-specific language ladder framework which outlines the language journey of a child’s education, beginning with the mother tongue/ most familiar language in the early years and then gradually transitioning into other languages. Both the guiding principles and language ladder can be adapted to any multilingual context. Thus, this research provides MTB MLE practitioners with assistance in developing an MTB MLE model, which is best suited for their context.

Keywords: mother tongue based multilingual education, education design, language ladder, language issues, heterogeneous contexts

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1609 DPAGT1 Inhibitors: Discovery of Anti-Metastatic Drugs

Authors: Michio Kurosu

Abstract:

Alterations in glycosylation not only directly impact cell growth and survival but also facilitate tumor-induced immunomodulation and eventual metastasis. Identification of cell type-specific glycoconjugates (tumor markers) has led to the discovery of new assay systems for certain cancers via immunodetection reagents. N- and O-linked glycans are the most abundant forms of glycoproteins. Recent studies of cancer immunotherapy are based on the immunogenicity of truncated O-glycan chains (e.g., Tn, sTn, T, and sLea/x). The prevalence of N-linked glycan changes in the development of tumor cells is known; however, therapeutic antibodies against N-glycans have not yet been developed. This is due to the lack of specificity of N-linked glycans between normal/healthy and cancer cells. Abnormal branching of N-linked glycans has been observed, particularly in solid cancer cells. While the discovery of drug-like glycosyltransferase inhibitors that block the biosynthesis of specific branching has a very low likelihood of success, altered glycosylation levels can be exploited by suppressing N-glycan biosynthesis through the inhibition of dolichyl-phosphate N-acetylglucosaminephosphotransferase1 (DPAGT1) activity. Inhibition of DPAGT1 function leads to changes of O-glycosylation on proteins associated with mitochondria and zinc finger binding proteins (indirect effects). On the basis of dynamic crosstalk between DPAGT1 and Snail/Slung/ZEB1 (a family of transcription factors that promote the repression of the adhesion molecules), we have developed pharmacologically acceptable selective DPAGT1 inhibitors. Tunicamycin kills a wide range of cancer and healthy cells in a non-selective manner. In sharp contrast, our DPAGT1 inhibitors display strong cytostatic effects against 16 solid cancers, which require the overexpression of DPAGT1 in their progression but do not affect the cell viability of healthy cells. The identified DPAGT1 inhibitors possess impressive anti-metastatic ability in various solid cancer cell lines and induce their mitochondrial structural changes, resulting in apoptosis. A prototype DPAGT1 inhibitor, APPB has already been proven to shrink solid tumors (e.g., pancreatic cancers, triple-negative breast cancers) in vivo while suppressing metastases and has strong synergistic effects when combined with current cytotoxic drugs (e.g., paclitaxel). At this conference, our discovery of selective DPAGT1 inhibitors with drug-like properties and proof-of-pharmaceutical concept studies of a novel DPAGT1 inhibitor are presented.

Keywords: DPAGT1 inhibitors, anti-metastatic drugs, natural product based drug designs, cytostatic effects

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1608 Comparisons of Depressive Symptoms and Cognitive Appraisals in Different Age Groups under Abusive Leadership

Authors: Shao-Ying Wang, Shin-I Shih, Chi-Cheng Wu

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Background: By following to the maturity theory about age, the manifestation of depression in different age groups under occupational stressors still remains unclear. Therefore, the aim of this study was to examine the depression within four main symptoms clusters: cognition, affect, physical complaints and interpersonal difficulty among the different age groups. Additionally, this study also used the stress appraisal theory, through the examination of challenge and hindrance appraisals, the effects of cognitive factors were expected to give therapeutic indication for the future treatment of depression under abusive leadership. Methods (Participants and Procedure): The data were collected in two waves from employees of local companies in Taiwan. The participants (58 males and 167 females) were native Chinese speakers, ranging in age from 20 to 59 years (M= 36.51). Up to 80% educational level of participants were above senior high. The married population was approximately at 43%. Measures; 1. Abusive Leadership: To measure abusive leadership, we used 15-item scale of abusive supervision which anchored on a 7-point Likert-type scale. (α= .96) 2. Depression: We used Taiwanese Depression Scale to measure the 4 clusters (cognition, affect, physical complaints and interpersonal difficulty) of symptoms. Participants responded for depression anchored on a 7-point Likert-type scale (α= .96). 3. Stress Appraisal Scale: To measure challenge and hindrance types of appraisal, participants responded to 33-item measure anchored on a 7-point Likert-type scale. (Challenge appraisal; α= .90; hindrance appraisal α= .87). Results: The results of correlation showed that there was a significant and negative correlation between abusive leadership and age (r = - .21, p < .01). Abusive leadership was positive correlated significantly with hindrance appraisal (r = .52, p < .01) and depression (r = .20, p < .01). The results also showed that hindrance appraisal was correlated to depression positively (r = .36, p < .01). A one-way ANOVA was conducted to compare the effect of lower/middle/order age groups on each cluster of depressive symptoms. The results showed that the effect of age groups on cognition was significant F (2, 157) =3.66, P < .05. Older age group (M=13.43 SD=6.84) reported less cognitive symptoms of depression than the middle (M=16.77 SD=7.49) and lower age (M=16.91 SD=6.97) groups. Besides, the effect of age groups on affect was also significant F (2,157)= 4.09 P < .05. Older age group (M=18.68 SD=8.98) reported less affective symptoms of depression than the middle (M=22.01 SD=7.96) and lower age (M=23.56 SD=7.67) groups. Moreover, the main effect of hindrance appraisal was found F (2, 157) =3.81, P < .05. Older age group (M=9.44 SD=2.89) reported fewer score on hindrance appraisals than the middle (M=11.06 SD=4.02) and lower age (M=9.62 SD=3.17) groups. To conclude, the severity of depression symptoms varies across different age groups. Maturity seems to be the protective factor to depression, accompanying with lower hindrance appraisals.

Keywords: abusive leadership, affective commitment, depression symptoms, psychological well-being

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1607 Diselenide-Linked Redox Stimuli-Responsive Methoxy Poly(Ethylene Glycol)-b-Poly(Lactide-Co-Glycolide) Micelles for the Delivery of Doxorubicin in Cancer Cells

Authors: Yihenew Simegniew Birhan, Hsieh Chih Tsai

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The recent advancements in synthetic chemistry and nanotechnology fostered the development of different nanocarriers for enhanced intracellular delivery of pharmaceutical agents to tumor cells. Polymeric micelles (PMs), characterized by small size, appreciable drug loading capacity (DLC), better accumulation in tumor tissue via enhanced permeability and retention (EPR) effect, and the ability to avoid detection and subsequent clearance by the mononuclear phagocyte (MNP) system, are convenient to improve the poor solubility, slow absorption and non-selective biodistribution of payloads embedded in their hydrophobic cores and hence, enhance the therapeutic efficacy of chemotherapeutic agents. Recently, redox-responsive polymeric micelles have gained significant attention for the delivery and controlled release of anticancer drugs in tumor cells. In this study, we synthesized redox-responsive diselenide bond containing amphiphilic polymer, Bi(mPEG-PLGA)-Se₂ from mPEG-PLGA, and 3,3'-diselanediyldipropanoic acid (DSeDPA) using DCC/DMAP as coupling agents. The successful synthesis of the copolymers was verified by different spectroscopic techniques. Above the critical micelle concentration, the amphiphilic copolymer, Bi(mPEG-PLGA)-Se₂, self-assembled into stable micelles. The DLS data indicated that the hydrodynamic diameter of the micelles (123.9 ± 0.85 nm) was suitable for extravasation into the tumor cells through the EPR effect. The drug loading content (DLC) and encapsulation efficiency (EE) of DOX-loaded micelles were found to be 6.61 wt% and 54.9%, respectively. The DOX-loaded micelles showed initial burst release accompanied by sustained release trend where 73.94% and 69.54% of encapsulated DOX was released upon treatment with 6mM GSH and 0.1% H₂O₂, respectively. The biocompatible nature of Bi(mPEG-PLGA)-Se₂ copolymer was confirmed by the cell viability study. In addition, the DOX-loaded micelles exhibited significant inhibition against HeLa cells (44.46%), at a maximum dose of 7.5 µg/mL. The fluorescent microscope images of HeLa cells treated with 3 µg/mL (equivalent DOX concentration) revealed efficient internalization and accumulation of DOX-loaded Bi(mPEG-PLGA)-Se₂ micelles in the cytosol of cancer cells. In conclusion, the intelligent, biocompatible, and the redox stimuli-responsive behavior of Bi(mPEG-PLGA)-Se₂ copolymer marked the potential applications of diselenide-linked mPEG-PLGA micelles for the delivery and on-demand release of chemotherapeutic agents in cancer cells.

Keywords: anticancer drug delivery, diselenide bond, polymeric micelles, redox-responsive

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1606 Development of a Web-Based Application for Intelligent Fertilizer Management in Rice Cultivation

Authors: Hao-Wei Fu, Chung-Feng Kao

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In the era of rapid technological advancement, information technology (IT) has become integral to modern life, exerting significant influence across diverse sectors and serving as a catalyst for development in various industries. Within agriculture, the integration of IT offers substantial benefits, notably enhancing operational efficiency. Real-time monitoring systems, for instance, have been widely embraced in agriculture, effectively improving crop management practices. This study specifically addresses the management of rice panicle fertilizer, presenting the development of a web application tailored to handle data associated with rice panicle fertilizer management. Leveraging the normalized difference red edge index, this application optimizes the quantity of rice panicle fertilizer used, providing recommendations to agricultural stakeholders and service providers in the agricultural information sector. The overarching objective is to minimize costs while maximizing yields. Furthermore, a robust database system has been established to store and manage relevant data for future reference in rice cultivation management. Additionally, the study utilizes the Representational State Transfer software architectural style to construct an application programming interface (API), facilitating data creation, retrieval, updating, and deletion for users via the HyperText Transfer Protocol methods. Future plans involve integrating this API with third-party services to incorporate it into larger frameworks, thus catering to the diverse requirements of various third-party services.

Keywords: application programming interface, HyperText Transfer Protocol, nitrogen fertilizer intelligent management, web-based application

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1605 Ethical Implications of Gaps in the Implementation Process of the Circular Economy: Special Focus on Underdeveloped Countries

Authors: Sujith Gunawardhana

Abstract:

The circular economy is a system in which resources and energy are derived from renewable sources, utilized efficiently, recycled, and reused to reduce waste, reduce nonrenewable resource consumption, and mitigate negative environmental impacts. However, it poses moral questions about sustainability, the environment, and societal issues. Many societies face challenges when implementing the circular economy, as the concept is still young. The equitable distribution of the advantages and costs of circularity should be ensured during implementation, as some communities, particularly disadvantaged or marginalized ones, may suffer unfairly disproportionately from the harmful effects of production and recycling facilities. Prioritizing the health and safety of workers, communities, and the environment is essential, and strict rules must be implemented to guard against harm. However, most underdeveloped countries need a legal safeguard for this situation. The ultimate objective of the circular economy is to improve social, environmental, and economic performance, but its implementation also requires consideration of the ethics of care and non-epistemic values. Those are often hindered in underdeveloped countries, as the availability of infrastructure and technology, affordability, and legislative framework are poor. To achieve long-term success in the circular economy, evaluating implementation steps and considering health, safety, environmental, and social risks is crucial. To implement the circular economy, respect ethics of care and non-epistemic values. Adopt Kantian Ethics and control technology design to ensure equal benefits for all involved. Ethical gaps may lead underdeveloped countries to generate social pressure against the circular economy.

Keywords: circular economy, ethics, values, sustainability

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1604 Study and Analysis of Permeable Articulated Concrete Blocks Pavement: With Reference to Indian Context

Authors: Shrikant Charhate, Gayatri Deshpande

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Permeable pavements have significant benefits like managing runoff, infiltration, and carrying traffic over conventional pavements in terms of sustainability and environmental impact. Some of the countries are using this technique, especially at locations where durability and other parameters are of importance in nature; however, sparse work has been done on this concept. In India, this is yet to be adopted. In this work, the progress in the characterization and development of Permeable Articulated Concrete Blocks (PACB) pavement design is described and discussed with reference to Indian conditions. The experimentation and in-depth analysis was carried out considering conditions like soil erosion, water logging, and dust which are significant challenges caused due to impermeability of pavement. Concrete blocks with size 16.5’’x 6.5’’x 7’’ consisting of arch shape (4’’) at beneath and ½” PVC holes for articulation were casted. These blocks were tested for flexural strength. The articulation process was done with nylon ropes forming series of concrete block system. The total spacing between the blocks was kept about 8 to 10% of total area. The hydraulic testing was carried out by placing the articulated blocks with the combination of layers of soil, geotextile, clean angular aggregate. This was done to see the percentage of seepage through the entire system. The experimental results showed that with the shape of concrete block the flexural strength achieved was beyond the permissible limit. Such blocks with the combination could be very useful innovation in Indian conditions and useful at various locations compared to the traditional blocks as an alternative for long term sustainability.

Keywords: connections, geotextile, permeable ACB, pavements, stone base

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1603 Nutritional Importance and Functional Properties of Baobab Leaves

Authors: Khadijat Ayanpeju Abdulsalam, Bolanle Mary Olawoye, Paul Babatunde Ayoola

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The potential of Baobab leaves is understudied and not yet fully documented. The purpose of this work is to highlight the important nutritional value and practical qualities of baobab leaves. In this research, proximate analysis was studied to determine the macronutrient quantitative analysis in baobab leaves. Studies were also conducted on other characteristics, such as moisture content, which is significant to the food business since it affects food quality, preservation, and resistance to deterioration. Dietary fiber, which was also studied, has important health benefits, such as lowering blood cholesterol levels by lowering low-density lipoprotein or "bad" cholesterol. It functions as an anti-obesity and anti-diabetic agent, lowering the likelihood of haemorrhoids developing. Additionally, increasing face bulk and short-chain fatty acid synthesis improves gastrointestinal health and overall wellness. Baobab leaves had a moisture content of 6.4%, fat of 16.1%, ash of 3.2%, protein of 18.7%, carbohydrate 57.2% and crude fiber of 4.1%. The minerals determined in the sample of baobab leaves are Ca, Fe, Mg, K, Na, P, and Zn with Potassium (347.6±0.70) as the most abundant mineral while Zn (9.31±0.60) is the least abundant. The functional properties studied include pH, gelation temperature, bulk density, water absorption capacity, oil absorption capacity, foaming property, emulsifying property, and stability and swelling capacity, which are 8.72, 29, 0.39, 138, 98.20, 0.80, 72.80, and 73.50 respectively. The Fourier Transform InfraRed absorption spectra show bands like C=O, C-Cl and N-H. Baobab leaves are edible, nutritious, and non-toxic, as the mineral contents are within the required range.

Keywords: dietary fibre, proximate analysis, macronutrients, minerals, baobab leaves, frequency range

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1602 The Performance of Natural Light by Roof Systems in Cultural Buildings

Authors: Ana Paula Esteves, Diego S. Caetano, Louise L. B. Lomardo

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This paper presents an approach to the performance of the natural lighting, when the use of appropriated solar lighting systems on the roof is applied in cultural buildings such as museums and foundations. The roofs, as a part of contact between the building and the external environment, require special attention in projects that aim at energy efficiency, being an important element for the capture of natural light in greater quantity, but also for being the most important point of generation of photovoltaic solar energy, even semitransparent, allowing the partial passage of light. Transparent elements in roofs, as well as superior protection of the building, can also play other roles, such as: meeting the needs of natural light for the accomplishment of the internal tasks, attending to the visual comfort; to bring benefits to the human perception and about the interior experience in a building. When these resources are well dimensioned, they also contribute to the energy efficiency and consequent character of sustainability of the building. Therefore, when properly designed and executed, a roof light system can bring higher quality natural light to the interior of the building, which is related to the human health and well-being dimension. Furthermore, it can meet the technologic, economic and environmental yearnings, making possible the more efficient use of that primordial resource, which is the light of the Sun. The article presents the analysis of buildings that used zenith light systems in search of better lighting performance in museums and foundations: the Solomon R. Guggenheim Museum in the United States, the Iberê Camargo Foundation in Brazil, the Museum of Fine Arts in Castellón in Spain and the Pinacoteca of São Paulo.

Keywords: natural lighting, roof lighting systems, natural lighting in museums, comfort lighting

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1601 Cybersecurity Assessment of Decentralized Autonomous Organizations in Smart Cities

Authors: Claire Biasco, Thaier Hayajneh

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A smart city is the integration of digital technologies in urban environments to enhance the quality of life. Smart cities capture real-time information from devices, sensors, and network data to analyze and improve city functions such as traffic analysis, public safety, and environmental impacts. Current smart cities face controversy due to their reliance on real-time data tracking and surveillance. Internet of Things (IoT) devices and blockchain technology are converging to reshape smart city infrastructure away from its centralized model. Connecting IoT data to blockchain applications would create a peer-to-peer, decentralized model. Furthermore, blockchain technology powers the ability for IoT device data to shift from the ownership and control of centralized entities to individuals or communities with Decentralized Autonomous Organizations (DAOs). In the context of smart cities, DAOs can govern cyber-physical systems to have a greater influence over how urban services are being provided. This paper will explore how the core components of a smart city now apply to DAOs. We will also analyze different definitions of DAOs to determine their most important aspects in relation to smart cities. Both categorizations will provide a solid foundation to conduct a cybersecurity assessment of DAOs in smart cities. It will identify the benefits and risks of adopting DAOs as they currently operate. The paper will then provide several mitigation methods to combat cybersecurity risks of DAO integrations. Finally, we will give several insights into what challenges will be faced by DAO and blockchain spaces in the coming years before achieving a higher level of maturity.

Keywords: blockchain, IoT, smart city, DAO

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1600 The Reality of E-Commerce in Egypt and Its Role in Enhancing Companies' Competitiveness

Authors: Esam El Gohary

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— The companies’ ability to survive and compete in the fierce competition is determined by its competitiveness level. With the spread of information technology use and appearance of online shopping, it became crucial for companies to adopt e-commerce system to increase its competitiveness. This paper was conducted with the purpose of determine how increasing the service value through e-commerce factors (competitive strategy, ICT infrastructures, logistics, security, human resources and innovation) can enhance companies' competitiveness. The problem of this paper is summarized in the absence of the thorough awareness of e-commerce benefits for business owners and customers, as well as how to reduce the intangibility attributes of e-commerce. For this purpose this paper describes the e-commerce in Egypt and its success factors (infrastructures, legal and regulatory environment, human resources and innovation), as well as displays the barriers of such factor, to investigate the significant of these factors on increasing service value and enhance companies' competitiveness. This paper revealed that e-commerce companies have many opportunities to enhance its competitiveness in Egypt, which is enhanced by several factors. The most important factors are “strong ICT infrastructure, qualified and skilled human resources, in addition to the distinctive logistics that distinguish Egypt due to its location, strong legal and regulatory environment and Innovation, as well as the competitive strategy. As well as, companies encounter several threats such as; the lack of infrastructures and logistics in rural areas, the absence of the inclusive understanding and awareness of e-commerce, fear from e-payment transactions and fraud, the ambiguity and burdensome of customs. Through the research findings several recommendations were introduced to both government and companies to overcome threats and exploit opportunities to improve performance and enhance companies' competitiveness.

Keywords: e-commerce competitiveness, e-commerce factors, e-commerce in Egypt, information technology

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1599 Don't Just Guess and Slip: Estimating Bayesian Knowledge Tracing Parameters When Observations Are Scant

Authors: Michael Smalenberger

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Intelligent tutoring systems (ITS) are computer-based platforms which can incorporate artificial intelligence to provide step-by-step guidance as students practice problem-solving skills. ITS can replicate and even exceed some benefits of one-on-one tutoring, foster transactivity in collaborative environments, and lead to substantial learning gains when used to supplement the instruction of a teacher or when used as the sole method of instruction. A common facet of many ITS is their use of Bayesian Knowledge Tracing (BKT) to estimate parameters necessary for the implementation of the artificial intelligence component, and for the probability of mastery of a knowledge component relevant to the ITS. While various techniques exist to estimate these parameters and probability of mastery, none directly and reliably ask the user to self-assess these. In this study, 111 undergraduate students used an ITS in a college-level introductory statistics course for which detailed transaction-level observations were recorded, and users were also routinely asked direct questions that would lead to such a self-assessment. Comparisons were made between these self-assessed values and those obtained using commonly used estimation techniques. Our findings show that such self-assessments are particularly relevant at the early stages of ITS usage while transaction level data are scant. Once a user’s transaction level data become available after sufficient ITS usage, these can replace the self-assessments in order to eliminate the identifiability problem in BKT. We discuss how these findings are relevant to the number of exercises necessary to lead to mastery of a knowledge component, the associated implications on learning curves, and its relevance to instruction time.

Keywords: Bayesian Knowledge Tracing, Intelligent Tutoring System, in vivo study, parameter estimation

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