Search results for: lack
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4424

Search results for: lack

1154 Effective Use of X-Box Kinect in Rehabilitation Centers of Riyadh

Authors: Reem Alshiha, Tanzila Saba

Abstract:

Physical rehabilitation is the process of helping people to recover and be able to go back to their former activities that have been delayed due to external factors such as car accidents, old age and victims of strokes (chronic diseases and accidents, and those related to sport activities).The cost of hiring a personal nurse or driving the patient to and from the hospital could be costly and time-consuming. Also, there are other factors to take into account such as forgetfulness, boredom and lack of motivation. In order to solve this dilemma, some experts came up with rehabilitation software to be used with Microsoft Kinect to help the patients and their families for in-home rehabilitation. In home rehabilitation software is becoming more and more popular, since it is more convenient for all parties affiliated with the patient. In contrast to the other costly market-based systems that have no portability, Microsoft’s Kinect is a portable motion sensor that reads body movements and interprets it. New software development has made rehabilitation games available to be used at home for the convenience of the patient. The game will benefit its users (rehabilitation patients) in saving time and money. There are many software's that are used with the Kinect for rehabilitation, but the software that is chosen in this research is Kinectotherapy. Kinectotherapy software is used for rehabilitation patients in Riyadh clinics to test its acceptance by patients and their physicians. In this study, we used Kinect because it was affordable, portable and easy to access in contrast to expensive market-based motion sensors. This paper explores the importance of in-home rehabilitation by using Kinect with Kinectotherapy software. The software targets both upper and lower limbs, but in this research, the main focus is on upper-limb functionality. However, the in-home rehabilitation is applicable to be used by all patients with motor disability, since the patient must have some self-reliance. The targeted subjects are patients with minor motor impairment that are somewhat independent in their mobility. The presented work is the first to consider the implementation of in-home rehabilitation with real-time feedback to the patient and physician. This research proposes the implementation of in-home rehabilitation in Riyadh, Saudi Arabia. The findings show that most of the patients are interested and motivated in using the in-home rehabilitation system in the future. The main value of the software application is due to these factors: improve patient engagement through stimulating rehabilitation, be a low cost rehabilitation tool and reduce the need for expensive one-to-one clinical contact. Rehabilitation is a crucial treatment that can improve the quality of life and confidence of the patient as well as their self-esteem.

Keywords: x-box, rehabilitation, physical therapy, rehabilitation software, kinect

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1153 Glycerol-Based Bio-Solvents for Organic Synthesis

Authors: Dorith Tavor, Adi Wolfson

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In the past two decades a variety of green solvents have been proposed, including water, ionic liquids, fluorous solvents, and supercritical fluids. However, their implementation in industrial processes is still limited due to their tedious and non-sustainable synthesis, lack of experimental data and familiarity, as well as operational restrictions and high cost. Several years ago we presented, for the first time, the use of glycerol-based solvents as alternative sustainable reaction mediums in both catalytic and non-catalytic organic synthesis. Glycerol is the main by-product from the conversion of oils and fats in oleochemical production. Moreover, in the past decade, its price has substantially decreased due to an increase in supply from the production and use of fatty acid derivatives in the food, cosmetics, and drugs industries and in biofuel synthesis, i.e., biodiesel. The renewable origin, beneficial physicochemical properties and reusability of glycerol-based solvents, enabled improved product yield and selectivity as well as easy product separation and catalyst recycling. Furthermore, their high boiling point and polarity make them perfect candidates for non-conventional heating and mixing techniques such as ultrasound- and microwave-assisted reactions. Finally, in some reactions, such as catalytic transfer-hydrogenation or transesterification, they can also be used simultaneously as both solvent and reactant. In our ongoing efforts to design a viable protocol that will facilitate the acceptance of glycerol and its derivatives as sustainable solvents, pure glycerol and glycerol triacetate (triacetin) as well as various glycerol-triacetin mixtures were tested as sustainable solvents in several representative organic reactions, such as nucleophilic substitution of benzyl chloride to benzyl acetate, Suzuki-Miyaura cross-coupling of iodobenzene and phenylboronic acid, baker’s yeast reduction of ketones, and transfer hydrogenation of olefins. It was found that reaction performance was affected by the glycerol to triacetin ratio, as the solubility of the substrates in the solvent determined product yield. Thereby, employing optimal glycerol to triacetin ratio resulted in maximum product yield. In addition, using glycerol-based solvents enabled easy and successful separation of the products and recycling of the catalysts.

Keywords: glycerol, green chemistry, sustainability, catalysis

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1152 Traditional and Commercially Prepared Medicine: Factors That Affect Preferences among Elderly Adults in Indigenous Community

Authors: Rhaetian Bern D. Azaula

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The Philippines' indigenous population, estimated to be 10%-20%, is protected by the Indigenous Peoples Rights Act (IPRA), passed in 1997. However, due to their isolation and limited access to basic services such as health education or needs for health assistance, the law's implementation remains a challenge. As traditional medicine continues to play a significant role in society as the prevention and treatment of some illnesses, it is still customary and widely used to use plants in both traditional and modern ways; however, commercially prepared drugs are progressively advanced as time goes by. Therefore, the purpose of this quantitative study is to investigate the indigenous community at Barangay Magsikap General Nakar, Quezon, and analyze the factors that affect the respondent’s preferences in an indigenous community and reasons for patronizing traditional and commercially prepared medicines and proposes updated health education strategies and instructional materials. Slovin's formula was utilized to reduce the total population representation, followed by stratified sampling for proportional allocation of respondents. The study selects respondents (1) from an Indigenous Community in Barangay Magsikap, General Nakar, Quezon, (2) aged 60 and above, and (3) who are willing to participate. The researcher utilized a checklist-based questionnaire with a Tagalog version, and a Likert Scale was utilized to assess the respondent's choices on selected items. The researcher obtained informed consent from the indigenous community's regional and local office, the chieftain of the tribe, and the respondents, ensuring confidentiality in the collection and retrieval of data. The study revealed that respondents aged 60-69, males with no formal education, are unemployed and have no income source. They prefer traditional medicines due to their affordability, availability, and cultural practices but lack safe preparation, dosages, and contraindications of used medicines. Commercially prepared medications are acknowledged, but respondents are not fully aware of proper administration instructions and dosage labels. Recommendations include disseminating approved herbal medicines and ensuring proper preparation, indications, and contraindications.

Keywords: traditional medicine, commercially prepared medicine, indigenous community, elderly adult

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1151 Exploring the Potential of Modular Housing Designs for the Emergency Housing Need in Türkiye after the February Earthquake in 2023

Authors: Hailemikael Negussie, Sebla Arın Ensarioğlu

Abstract:

In February 2023 Southeastern Türkiye and Northwestern Syria were hit by two consecutive earthquakes with high magnitude leaving thousands dead and thousands more homeless. The housing crisis in the affected areas has resulted in the need for a fast and qualified solution. There are a number of solutions, one of which is the use of modular designs to rebuild the cities that have been affected. Modular designs are prefabricated building components that can be quickly and efficiently assembled on-site, making them ideal to build structures with faster speed and higher quality. These structures are flexible, adaptable, and can be customized to meet the specific needs of the inhabitants, in addition to being more energy-efficient and sustainable. The prefabricated nature also assures that the quality of the products can be easily controlled. The reason for the collapse of most of the buildings during the earthquakes was found out to be the lack of quality during the construction stage. Using modular designs allows a higher control over the quality of the construction materials being used. The use of modular designs for a project of this scale presents some challenges, including the high upfront cost to design and manufacture components. However, if implemented correctly, modular designs can offer an effective and efficient solution to the urgent housing needs. The aim of this paper is to explore the potential of modular housing for mid- and long-term earthquake-resistant housing needs in the affected disaster zones after the earthquakes of February 2023. In the scope of this paper the adaptability of modular, prefabricated housing designs for the post-disaster environment, the advantages and disadvantages of this system will be examined. Elements such as; the current conditions of the region where the destruction happened, climatic data, topographic factors will be examined. Additionally, the paper will examine; examples of similar local and international modular post-earthquake housing projects. The region is projected to enter a rapid reconstruction phase in the following periods. Therefore, this paper will present a proposal for a system that can be used to produce safe and healthy urbanization policies without causing new aggrievements while meeting the housing needs of the people in the affected regions.

Keywords: post-disaster housing, earthquake-resistant design, modular design, housing, Türkiye

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1150 The Relationship between Body Positioning and Badminton Smash Quality

Authors: Gongbing Shan, Shiming Li, Zhao Zhang, Bingjun Wan

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Badminton originated in ancient civilizations in Europe and Asia more than 2000 years ago. Presently, it is played almost everywhere with estimated 220 million people playing badminton regularly, ranging from professionals to recreational players; and it is the second most played sport in the world after soccer. In Asia, the popularity of badminton and involvement of people surpass soccer. Unfortunately, scientific researches on badminton skills are hardly proportional to badminton’s popularity. A search of literature has shown that the literature body of biomechanical investigations is relatively small. One of the dominant skills in badminton is the forehand overhead smash, which consists of 1/5 attacks during games. Empirical evidences show that one has to adjust the body position in relation to the coming shuttlecock to produce a powerful and accurate smash. Therefore, positioning is a fundamental aspect influencing smash quality. A search of literature has shown that there is a dearth/lack of study on this fundamental aspect. The goals of this study were to determine the influence of positioning and training experience on smash quality in order to discover information that could help learn/acquire the skill. Using a 10-camera, 3D motion capture system (VICON MX, 200 frames/s) and 15-segment, full-body biomechanical model, 14 skilled and 15 novice players were measured and analyzed. Results have revealed that the body positioning has direct influence on the quality of a smash, especially on shuttlecock release angle and clearance height (passing over the net) of offensive players. The results also suggest that, for training a proper positioning, one could conduct a self-selected comfort position towards a statically hanged shuttlecock and then step one foot back – a practical reference marker for learning. This perceptional marker could be applied in guiding the learning and training of beginners. As one gains experience through repetitive training, improved limbs’ coordination would increase smash quality further. The researchers hope that the findings will benefit practitioners for developing effective training programs for beginners.

Keywords: 3D motion analysis, biomechanical modeling, shuttlecock release speed, shuttlecock release angle, clearance height

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1149 Enhancing Critical Reflective Practice in Fieldwork Education: An Exploratory Study of the Role of Social Work Agencies in the Welfare Context of Hong Kong

Authors: Yee-May Chan

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In recent decades, it is observed that social work agencies have participated actively, and thus, have gradually been more influential in social work education in Hong Kong. The neo-liberal welfare ideologies and changing funding mode have transformed the landscape in social work practice and have also had a major influence on the fieldwork environment in Hong Kong. The aim of this research is to explore the educational role of social work agencies and examine in particular whether they are able to enhance or hinder critical reflective learning in fieldwork. In-depth interviews with 15 frontline social workers and managers in different social work agencies were conducted to collect their views and experience in helping social work students in fieldwork. The overall findings revealed that under the current social welfare context most social workers consider that the most important role of social work agencies in fieldwork is to help students prepare to fit-in the practice requirements and work within agencies’ boundary. The fit-for-purpose and down-to-earth view of fieldwork practice is seen as prevalent among most social workers. This narrow perception of agency’s role seems to be more favourable to competence-based approaches. In contrast, though critical reflection has been seen as important in addressing the changing needs of service users, the role of enhancing critical reflective learning has not been clearly expected or understood by most agency workers. The notion of critical reflection, if considered, has been narrowly perceived in fieldwork learning. The findings suggest that the importance of critical reflection is found to be subordinate to that of practice competence. The lack of critical reflection in the field is somehow embedded in the competence-based social work practice. In general, social work students’ critical reflection has not been adequately supported or enhanced in fieldwork agencies, nor critical reflective practice has been encouraged in fieldwork process. To address this situation, the role of social work agencies in fieldwork should be re-examined. To maximise critical reflective learning in the field, critical reflection as an avowed objective in fieldwork learning should be clearly stated. Concrete suggestions are made to help fieldwork agencies become more prepared to critical reflective learning. It is expected that the research can help social work communities to reflect upon the current realities of fieldwork context and to identify ways to strengthen agencies’ capacities to enhance critical reflective learning and practice of social work students.

Keywords: competence-based social work, critical reflective learning, fieldwork agencies, neo-liberal welfare

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1148 Update on Epithelial Ovarian Cancer (EOC), Types, Origin, Molecular Pathogenesis, and Biomarkers

Authors: Salina Yahya Saddick

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Ovarian cancer remains the most lethal gynecological malignancy due to the lack of highly sensitive and specific screening tools for detection of early-stage disease. The OSE provides the progenitor cells for 90% of human ovarian cancers. Recent morphologic, immunohistochemical and molecular genetic studies have led to the development of a new paradigm for the pathogenesis and origin of epithelial ovarian cancer (EOC) based on a ualistic model of carcinogenesis that divides EOC into two broad categories designated Types I and II which are characterized by specific mutations, including KRAS, BRAF, ERBB2, CTNNB1, PTEN PIK3CA, ARID1A, and PPPR1A, which target specific cell signaling pathways. Type 1 tumors rarely harbor TP53. type I tumors are relatively genetically stable and typically display a variety of somatic sequence mutations that include KRAS, BRAF, PTEN, PIK3CA CTNNB1 (the gene encoding beta catenin), ARID1A and PPP2R1A but very rarely TP53 . The cancer stem cell (CSC) hypothesis postulates that the tumorigenic potential of CSCs is confined to a very small subset of tumor cells and is defined by their ability to self-renew and differentiate leading to the formation of a tumor mass. Potential protein biomarker miRNA, are promising biomarkers as they are remarkably stable to allow isolation and analysis from tissues and from blood in which they can be found as free circulating nucleic acids and in mononuclear cells. Recently, genomic anaylsis have identified biomarkers and potential therapeutic targets for ovarian cancer namely, FGF18 which plays an active role in controlling migration, invasion, and tumorigenicity of ovarian cancer cells through NF-κB activation, which increased the production of oncogenic cytokines and chemokines. This review summarizes update information on epithelial ovarian cancers and point out to the most recent ongoing research.

Keywords: epithelial ovarian cancers, somatic sequence mutations, cancer stem cell (CSC), potential protein, biomarker, genomic analysis, FGF18 biomarker

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1147 Aromatic Medicinal Plant Classification Using Deep Learning

Authors: Tsega Asresa Mengistu, Getahun Tigistu

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Computer vision is an artificial intelligence subfield that allows computers and systems to retrieve meaning from digital images. It is applied in various fields of study self-driving cars, video surveillance, agriculture, Quality control, Health care, construction, military, and everyday life. Aromatic and medicinal plants are botanical raw materials used in cosmetics, medicines, health foods, and other natural health products for therapeutic and Aromatic culinary purposes. Herbal industries depend on these special plants. These plants and their products not only serve as a valuable source of income for farmers and entrepreneurs, and going to export not only industrial raw materials but also valuable foreign exchange. There is a lack of technologies for the classification and identification of Aromatic and medicinal plants in Ethiopia. The manual identification system of plants is a tedious, time-consuming, labor, and lengthy process. For farmers, industry personnel, academics, and pharmacists, it is still difficult to identify parts and usage of plants before ingredient extraction. In order to solve this problem, the researcher uses a deep learning approach for the efficient identification of aromatic and medicinal plants by using a convolutional neural network. The objective of the proposed study is to identify the aromatic and medicinal plant Parts and usages using computer vision technology. Therefore, this research initiated a model for the automatic classification of aromatic and medicinal plants by exploring computer vision technology. Morphological characteristics are still the most important tools for the identification of plants. Leaves are the most widely used parts of plants besides the root, flower and fruit, latex, and barks. The study was conducted on aromatic and medicinal plants available in the Ethiopian Institute of Agricultural Research center. An experimental research design is proposed for this study. This is conducted in Convolutional neural networks and Transfer learning. The Researcher employs sigmoid Activation as the last layer and Rectifier liner unit in the hidden layers. Finally, the researcher got a classification accuracy of 66.4 in convolutional neural networks and 67.3 in mobile networks, and 64 in the Visual Geometry Group.

Keywords: aromatic and medicinal plants, computer vision, deep convolutional neural network

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1146 Challenges and Practical Tips for Advance Care Planning and End-of-Life Communications With Cancer Patients in Global Pandemic

Authors: Poonam Goswami

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Background: The diagnosis of a serious illness like cancer can have an impact on a patient’s emotional well-being and may result in psychological symptoms, anxiety, depression, and loss of control. Advance care planning discussions ensure patients’ values and goals of care, including patients’ freedom to choose their place of death, are respected. Unfortunately, these discussions are often delayed and are not initiated early in patients’ cancer trajectory. As a result, patients’ wishes often remains unknown until the last phase of their life. Evidence suggests that many patients inappropriately receive aggressive treatment near the end of life, which does lead to higher resource utilization, decreased quality of life, and increased cost. Additionally, the novel coronavirus disease 2019 (COVID-19) pandemic challenged the health care systems worldwide and raised important ethical issues, especially regarding the potential need for rationing health care in the context of scarce resources and crisis capacity. The importance of goal concordant care is now even substantially important and is heightened in the context of this pandemic. Problem: Although there is growing evidence on the effects of the ACP on the completion of advanced directives, improved patient and family concordance for preferences for medical care, and receipt of care, there is still a lack of standardized ACP conversation strategies for patients with cancer. Methods: The Key concepts of ACP include (1) assessing patient and family readiness, (2) identifying a surrogate decision maker ( medical power of attorney), (3) exploring patient and family understanding of the disease and treatment options,(4) discussing the values and goals of care, and options for end-of-life care, (5) documenting patient preferences in the medical record, and (6) revisiting the discussions at every change in the treatment plan and /or change in clinical status, including at every hospitalization. Conclusion/Implication for practice: Advance Care Planning (ACP) and end-of-life (EOL) discussions are important for patients, families, and health care providers. Adopting the verbal and nonverbal communication strategies can help overcome the barriers to effective communication on these difficult discussions. ACP with goals of care discussions should not be delayed until the patient is hospitalized.

Keywords: advance care planning, end of life, cancer, global, pandemic

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1145 25 Years of the Neurolinguistic Approach: Origin, Outcomes, Expansion and Current Experiments

Authors: Steeve Mercier, Joan Netten, Olivier Massé

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The traditional lack of success of most Canadian students in the regular French program in attaining the ability to communicate spontaneously led to the conceptualization of a modified program. This program, called Intensive French, introduced and evaluated as an experiment in several school districts, formed the basis for the creation of a more effective approach for the development of skills in a second/foreign language and literacy: the Neurolinguistic Approach (NLA).The NLA expresses the major change in the understanding of how communication skills are developed: learning to communicate spontaneously in a second language depends on the reuse of structures in a variety of cognitive situations to express authentic messages rather than on knowledge of the way a language functions. Put differently, it prioritises the acquisition of implicit competence over the learning of grammatical knowledge. This is achieved by the adoption of a literacy-based approach and an increase in intensity of instruction.Besides having strong support empirically from numerous experiments, the NLA has sound theoretical foundation, as it conforms to research in neurolinguistics. The five pedagogical principles that define the approach will be explained, as well as the differences between the NLA and the paradigm on which most current resources and teaching strategies are based. It is now 25 years since the original research occurred. The use of the NLA, as it will be shown, has expanded widely. With some adaptations, it is used for other languages and in other milieus. In Canada, classes are offered in mandarin, Ukrainian, Spanish and Arabic, amongst others. It has also been used in several indigenous communities, such as to restore the use of Mohawk, Cri and Dene. Its use has expanded throughout the world, as in China, Japan, France, Germany, Belgium, Poland, Russia, as well as Mexico. The Intensive French program originally focussed on students in grades 5 or 6 (ages 10 -12); nowadays, the programs based on the approach include adults, particularly immigrants entering new countries. With the increasing interest in inclusion and cultural diversity, there is a demand for language learning amongst pre-school and primary children that can be successfully addressed by the NLA. Other current experiments target trilingual schools and work with Inuit communities of Nunavik in the province of Quebec.

Keywords: neuroeducation, neurolinguistic approach, literacy, second language acquisition, plurilingualism, foreign language teaching and learning

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1144 Application of Social Media for Promoting Library and Information Services: A Case Study of Library Science Professionals of India

Authors: Payel Saha

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Social media is playing an important role for dissemination of information in society. In 21st century most people have a smart phone and used different social media tools like Facebook, Twitter, Instagram, WhatsApp, Skype etc. in day to day life. It is rapidly growing web-based tool for everyone to share thoughts, ideas and knowledge globally using internet. The study highlights the current use of social media tools for promoting library and information services of Library and Information Professionals of India, which are working in Library. The study was conducted during November, 2017. A structured questionnaire was prepared using google docs and shared using different mailing list, sent to individual email IDs and sharing with other social media tools. Only 90 responses received from the different states of India and analyzed via MS-Excel. The data receive from 17 states and 3 union territories of India; however most of the respondents has come from the states Odisha 23, Himachal Pradesh 14 and Assam 10. The results revealed that out 90 respondents 37 Female and 53 male categories and also majority of respondents 71 have come from academic library followed by special library 15, Public library 3 and corporate library 1 respondent. The study indicates that, out of 90 respondent’s majority of 53 of respondents said that their Library have a social media account while 39 of respondents have not their Library social media account. The study also inform that Facebook, YouTube, Google+, LinkedIn, Twitter and Instagram are using by the LIS professional of India and Facebook 86 was popular social media tool among the other social media tools. Furthermore, respondent reported that they are using social media tools for sharing photos of events and programs of library 72, followed by tips for using different services 64, posting of new arrivals 56, tutorials of database 35 and send brief updates to patrons 32, announcement of library holidays 22. It was also reported by respondents that they are sharing information about scholarships training programs and marketing of library events etc. The study furthermore identify that lack of time is the major problem while using social media with 53 of respondents followed by low speed of internet 35, too many social media tools to learn 17 and some 3 respondents reported that there is no problem while using social media tools. The results also revealed that, majority of the respondents reported that they are using social media tools in daily basis 71 followed by weekly basis 16. It was followed by monthly 1 respondent and other 2 of the respondents. In summary, this study is expected to be useful in further promoting the social media for dissemination of library and information services to the general public.

Keywords: application of social media, India, promoting library services, library professionals

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1143 An Adaptive Conversational AI Approach for Self-Learning

Authors: Airy Huang, Fuji Foo, Aries Prasetya Wibowo

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In recent years, the focus of Natural Language Processing (NLP) development has been gradually shifting from the semantics-based approach to deep learning one, which performs faster with fewer resources. Although it performs well in many applications, the deep learning approach, due to the lack of semantics understanding, has difficulties in noticing and expressing a novel business case with a pre-defined scope. In order to meet the requirements of specific robotic services, deep learning approach is very labor-intensive and time consuming. It is very difficult to improve the capabilities of conversational AI in a short time, and it is even more difficult to self-learn from experiences to deliver the same service in a better way. In this paper, we present an adaptive conversational AI algorithm that combines both semantic knowledge and deep learning to address this issue by learning new business cases through conversations. After self-learning from experience, the robot adapts to the business cases originally out of scope. The idea is to build new or extended robotic services in a systematic and fast-training manner with self-configured programs and constructed dialog flows. For every cycle in which a chat bot (conversational AI) delivers a given set of business cases, it is trapped to self-measure its performance and rethink every unknown dialog flows to improve the service by retraining with those new business cases. If the training process reaches a bottleneck and incurs some difficulties, human personnel will be informed of further instructions. He or she may retrain the chat bot with newly configured programs, or new dialog flows for new services. One approach employs semantics analysis to learn the dialogues for new business cases and then establish the necessary ontology for the new service. With the newly learned programs, it completes the understanding of the reaction behavior and finally uses dialog flows to connect all the understanding results and programs, achieving the goal of self-learning process. We have developed a chat bot service mounted on a kiosk, with a camera for facial recognition and a directional microphone array for voice capture. The chat bot serves as a concierge with polite conversation for visitors. As a proof of concept. We have demonstrated to complete 90% of reception services with limited self-learning capability.

Keywords: conversational AI, chatbot, dialog management, semantic analysis

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1142 Digital Immunity System for Healthcare Data Security

Authors: Nihar Bheda

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Protecting digital assets such as networks, systems, and data from advanced cyber threats is the aim of Digital Immunity Systems (DIS), which are a subset of cybersecurity. With features like continuous monitoring, coordinated reactions, and long-term adaptation, DIS seeks to mimic biological immunity. This minimizes downtime by automatically identifying and eliminating threats. Traditional security measures, such as firewalls and antivirus software, are insufficient for enterprises, such as healthcare providers, given the rapid evolution of cyber threats. The number of medical record breaches that have occurred in recent years is proof that attackers are finding healthcare data to be an increasingly valuable target. However, obstacles to enhancing security include outdated systems, financial limitations, and a lack of knowledge. DIS is an advancement in cyber defenses designed specifically for healthcare settings. Protection akin to an "immune system" is produced by core capabilities such as anomaly detection, access controls, and policy enforcement. Coordination of responses across IT infrastructure to contain attacks is made possible by automation and orchestration. Massive amounts of data are analyzed by AI and machine learning to find new threats. After an incident, self-healing enables services to resume quickly. The implementation of DIS is consistent with the healthcare industry's urgent requirement for resilient data security in light of evolving risks and strict guidelines. With resilient systems, it can help organizations lower business risk, minimize the effects of breaches, and preserve patient care continuity. DIS will be essential for protecting a variety of environments, including cloud computing and the Internet of medical devices, as healthcare providers quickly adopt new technologies. DIS lowers traditional security overhead for IT departments and offers automated protection, even though it requires an initial investment. In the near future, DIS may prove to be essential for small clinics, blood banks, imaging centers, large hospitals, and other healthcare organizations. Cyber resilience can become attainable for the whole healthcare ecosystem with customized DIS implementations.

Keywords: digital immunity system, cybersecurity, healthcare data, emerging technology

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1141 Research on Quality Assurance in African Higher Education: A Bibliometric Mapping from 1999 to 2019

Authors: Luís M. João, Patrício Langa

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The article reviews the literature on quality assurance (QA) in African higher education studies (HES) conducted through a bibliometric mapping of published papers between 1999 and 2019. Specifically, the article highlights the nuances of knowledge production in four scientific databases: Scopus, Web of Science (WoS), African Journal Online (AJOL), and Google Scholar. The analysis included 531 papers, of which 127 are from Scopus, 30 are from Web of Science, 85 are from African Journal Online, and 259 are from Google Scholar. In essence, 284 authors wrote these papers from 231 institutions and 69 different countries (i.e., Africa=54 and outside Africa=15). Results indicate the existing knowledge. This analysis allows the readers to understand the growth and development of the field during the two-decade period, identify key contributors, and observe potential trends or gaps in the research. The paper employs bibliometric mapping as its primary analytical lens. By utilizing this method, the study quantitatively assesses the publications related to QA in African HES, helping to identify patterns, collaboration networks, and disparities in research output. The bibliometric approach allows for a systematic and objective analysis of large datasets, offering a comprehensive view of the knowledge production in the field. Furthermore, the study highlights the lack of shared resources available to enhance quality in higher education institutions (HEIs) in Africa. This finding underscores the importance of promoting collaborative research efforts, knowledge exchange, and capacity building within the region to improve the overall quality of higher education. The paper argues that despite the growing quantity of QA research in African higher education, there are challenges related to citation impact and access to high-impact publication avenues for African researchers. It emphasises the need to promote collaborative research and resource-sharing to enhance the quality of HEIs in Africa. The analytical lenses of bibliometric mapping and the examination of publication players' scenarios contribute to a comprehensive understanding of the field and its implications for African higher education.

Keywords: Africa, bibliometric research, higher education studies, quality assurance, scientific database, systematic review

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1140 Comparison Serum Vitamin D by Geographic between the Highland and Lowland Schizophrenic Patient in the Sumatera Utara

Authors: Novita Linda Akbar, Elmeida Effendy, Mustafa M. Amin

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Background: The most common of psychotic disorders is schizophrenia. Vitamin D is made from sunlight, and in the skin from UVB radiation from sunlight. If people with Vitamin D deficiency is common severe mental illness such as schizophrenia.Schizophrenia is a chronic mental illness characterised by positive symptoms and negatives symptoms, such as hallucinations and delusions, flat affect and lack of motivation we can found. In patients with Schizophrenia maybe have several environmental risk factors for schizophrenia, such as season of birth, latitude, and climate has been linked to vitamin D deficiency. There is also relationship between the risk of schizophrenia and latitude, and with an increased incidence rate of schizophrenia seen at a higher latitude. Methods: This study was an analytical study, conducted in BLUD RS Jiwa Propinsi Sumatera Utara and RSUD Deli Serdang, the period in May 2016 and ended in June 2016 with a sample of the study 60 sample (20 patients live in the Highland and Lowland, 20 healthy controls). Inclusion criteria were schizophrenic patients both men and women, aged between 18 to 60 years old, acute phase no agitation or abstinence antipsychotic drugs for two weeks, live in the Highland and Lowland, and willing to participate this study. Exclusion criteria were history of other psychotic disorders, comorbidities with other common medical condition, a history of substance abuse. Sample inspection for serum vitamin D using ELFA method. Statistical analysis using numeric comparative T-independent test. Results: The results showed that average levels of vitamin D for a group of subjects living in areas of high land was 227.6 ng / mL with a standard deviation of 86.78 ng / mL, the lowest levels of vitamin D is 138 ng / mL and the highest 482 ng / mL. In the group of subjects who settled in the low lands seem mean vitamin D levels higher than the mountainous area with an average 237.8 ng / mL with a standard deviation of 100.16 ng / mL. Vitamin D levels are lowest and the highest 138-585 ng / mL. Conclusion and Suggestion: The results of the analysis using the Mann Whitney test showed that there were no significant differences between the mean for the levels of vitamin D based on residence subject with a value of p = 0.652.

Keywords: latitude, schizophrenia, Vitamin D, Sumatera Utara

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1139 Engineering a Tumor Extracellular Matrix Towards an in vivo Mimicking 3D Tumor Microenvironment

Authors: Anna Cameron, Chunxia Zhao, Haofei Wang, Yun Liu, Guang Ze Yang

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Since the first publication in 1775, cancer research has built a comprehensive understanding of how cellular components of the tumor niche promote disease development. However, only within the last decade has research begun to establish the impact of non-cellular components of the niche, particularly the extracellular matrix (ECM). The ECM, a three-dimensional scaffold that sustains the tumor microenvironment, plays a crucial role in disease progression. Cancer cells actively deregulate and remodel the ECM to establish a tumor-promoting environment. Recent work has highlighted the need to further our understanding of the complexity of this cancer-ECM relationship. In vitro models use hydrogels to mimic the ECM, as hydrogel matrices offer biological compatibility and stability needed for long term cell culture. However, natural hydrogels are being used in these models verbatim, without tuning their biophysical characteristics to achieve pathophysiological relevance, thus limiting their broad use within cancer research. The biophysical attributes of these gels dictate cancer cell proliferation, invasion, metastasis, and therapeutic response. Evaluating the three most widely used natural hydrogels, Matrigel, collagen, and agarose gel, the permeability, stiffness, and pore-size of each gel were measured and compared to the in vivo environment. The pore size of all three gels fell between 0.5-6 µm, which coincides with the 0.1-5 µm in vivo pore size found in the literature. However, the stiffness for hydrogels able to support cell culture ranged between 0.05 and 0.3 kPa, which falls outside the range of 0.3-20,000 kPa reported in the literature for an in vivo ECM. Permeability was ~100x greater than in vivo measurements, due in large part to the lack of cellular components which impede permeation. Though, these measurements prove important when assessing therapeutic particle delivery, as the ECM permeability decreased with increasing particle size, with 100 nm particles exhibiting a fifth of the permeability of 10 nm particles. This work explores ways of adjusting the biophysical characteristics of hydrogels by changing protein concentration and the trade-off, which occurs due to the interdependence of these factors. The global aim of this work is to produce a more pathophysiologically relevant model for each tumor type.

Keywords: cancer, extracellular matrix, hydrogel, microfluidic

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1138 Implementing Effective Strategies to Improve Teaching and Learning in Higher Education: Balancing the Engagement Acts between Lecturers And Students

Authors: Jeffrey Siphiwe Mkhize

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Twelve years of schooling for most South African children, particularly those children from disadvantaged past, are confronted with numerous and diverse challenges. These challenges range from infrastructural limitations, language of teaching, poor resources and varying family backgrounds. Likewise, schools are categorized to signify schools’ geographic location, poverty lines, societal class and type of students that the school are likely to enroll. Such categorization perpetuates particular lines of identities that are indirectly reinforced by the same system that seeks to redress. South African universities prefer point systems to determine students’ suitability to gain access to their programmes. Once students are admitted based on the qualifying points there is an assumed equity in the manner in which they receive tuition. They are assumed as equal; noting the widened access to South African universities as means to redress past inequalities. Given the challenges, inequalities, it is necessary to view higher education as a site for knowledge construction that is accessible to all students. Epistemological access is key to all students irrespective of their socio-economic status. This paper seeks to contribute to the discourse of student engagement using lecturer-student relationship as a lens to understand this phenomenon. Data were generated using South African Survey of Student Engagement, focus group interviews, semi-structured one-on-one-interviews as well as document analysis. The focus was on students registered for the first year of a Bachelor of Education degree as well as lecturers that teach high risk modules in this qualification at the same level. The findings suggest that lecturers are challenged by overcrowded classrooms and over-enrolled modules; this challenge hampers their good intentions to become more efficient and innovative in their teaching. Students lack confidence in approaching lecturers for assistance. Collaborative learning has stronger results and students believe in self-support to deal with their challenges based on their individual strengths. Collaborative learning is key to student academic performance.

Keywords: collaborative learning, consultations, student engagement, student performance

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1137 Prediction of Cardiovascular Markers Associated With Aromatase Inhibitors Side Effects Among Breast Cancer Women in Africa

Authors: Jean Paul M. Milambo

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Purpose: Aromatase inhibitors (AIs) are indicated in the treatment of hormone-receptive breast cancer in postmenopausal women in various settings. Studies have shown cardiovascular events in some developed countries. To date the data is sparce for evidence-based recommendations in African clinical settings due to lack of cancer registries, capacity building and surveillance systems. Therefore, this study was conducted to assess the feasibility of HyBeacon® probe genotyping adjunctive to standard care for timely prediction and diagnosis of Aromatase inhibitors (AIs) associated adverse events in breast cancer survivors in Africa. Methods: Cross sectional study was conducted to assess the knowledge of POCT among six African countries using online survey and telephonically contacted. Incremental cost effectiveness ratio (ICER) was calculated, using diagnostic accuracy study. This was based on mathematical modeling. Results: One hundred twenty-six participants were considered for analysis (mean age = 61 years; SD = 7.11 years; 95%CI: 60-62 years). Comparison of genotyping from HyBeacon® probe technology to Sanger sequencing showed that sensitivity was reported at 99% (95% CI: 94.55% to 99.97%), specificity at 89.44% (95% CI: 87.25 to 91.38%), PPV at 51% (95%: 43.77 to 58.26%), and NPV at 99.88% (95% CI: 99.31 to 100.00%). Based on the mathematical model, the assumptions revealed that ICER was R7 044.55. Conclusion: POCT using HyBeacon® probe genotyping for AI-associated adverse events maybe cost effective in many African clinical settings. Integration of preventive measures for early detection and prevention guided by different subtype of breast cancer diagnosis with specific clinical, biomedical and genetic screenings may improve cancer survivorship. Feasibility of POCT was demonstrated but the implementation could be achieved by improving the integration of POCT within primary health cares, referral cancer hospitals with capacity building activities at different level of health systems. This finding is pertinent for a future envisioned implementation and global scale-up of POCT-based initiative as part of risk communication strategies with clear management pathways.

Keywords: breast cancer, diagnosis, point of care, South Africa, aromatase inhibitors

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1136 Incidence and Predictors of Mortality Among HIV Positive Children on Art in Public Hospitals of Harer Town, Enrolled From 2011 to 2021

Authors: Getahun Nigusie

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Background; antiretroviral treatment reduce HIV-related morbidity, and prolonged survival of patients however, there is lack of up-to-date information concerning the treatment long term effect on the survival of HIV positive children especially in the study area. Objective: To assess incidence and predictors of mortality among HIV positive children on ART in public hospitals of Harer town who were enrolled from 2011 to 2021. Methodology: Institution based retrospective cohort study was conducted among 429 HIV positive children enrolled in ART clinic from January 1st 2011 to December30th 2021. Data were collected from medical cards by using a data extraction form, Descriptive analyses were used to Summarized the results, and life table was used to estimate survival probability at specific point of time after introduction of ART. Kaplan Meier survival curve together with log rank test was used to compare survival between different categories of covariates, and Multivariate Cox-proportional hazard regression model was used to estimate adjusted Hazard rate. Variables with p-values ≤0.25 in bivariable analysis were candidates to the multivariable analysis. Finally, variables with p-values < 0.05 were considered as significant variables. Results: The study participants had followed for a total of 2549.6 child-years (30596 child months) with an overall mortality rate of 1.5 (95% CI: 1.1, 2.04) per 100 child-years. Their median survival time was 112 months (95% CI: 101–117). There were 38 children with unknown outcome, 39 deaths, and 55 children transfer out to different facility. The overall survival at 6, 12, 24, 48 months were 98%, 96%, 95%, 94% respectively. being in WHO clinical Stage four (AHR=4.55, 95% CI:1.36, 15.24), having anemia(AHR=2.56, 95% CI:1.11, 5.93), baseline low absolute CD4 count (AHR=2.95, 95% CI: 1.22, 7.12), stunting (AHR=4.1, 95% CI: 1.11, 15.42), wasting (AHR=4.93, 95% CI: 1.31, 18.76), poor adherence to treatment (AHR=3.37, 95% CI: 1.25, 9.11), having TB infection at enrollment (AHR=3.26, 95% CI: 1.25, 8.49),and no history of change their regimen(AHR=7.1, 95% CI: 2.74, 18.24), were independent predictors of death. Conclusion: more than half of death occurs within 2 years. Prevalent tuberculosis, anemia, wasting, and stunting nutritional status, socioeconomic factors, and baseline opportunistic infection were independent predictors of death. Increasing early screening and managing those predictors are required.

Keywords: human immunodeficiency virus-positive children, anti-retroviral therapy, survival, Ethiopia

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1135 Climate Change Adaptation Strategy Recommended for the Conservation of Biodiversity in Western Ghats, India

Authors: Mukesh Lal Das, Muthukumar Muthuchamy

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Climate change Adaptation strategy (AS) is a scientific approach to dealing with the impacts of climate change (CC). Efforts are being made to contain the global emission of greenhouse gas within threshold limits, thereby limiting the rise of global temperature to an optimal level. Global Climate change is a spontaneous process; therefore, reversing the damage would take decades. The climate change adaptation strategy recommended by various stakeholders could be a key to resilience for biodiversity. The Indian Government has constituted the panel to synthesize the climate change action report at the federal and state levels. This review scavenged the published literature on the Western Ghats hotspots. And highlight the adaptation strategy recommended by diverse scientific actors to conserve biodiversity. It also reviews the grey literature adopted by state and federal governments and its effectiveness in mitigating the impacts on biodiversity. We have narrowed the scope of interest to the state action report by 6 Indian states such as Gujarat, Maharashtra, Goa, Karnataka, Kerala and Tamil Nadu, which host Western Ghats global biodiversity hotspot. Western Ghats(WGs) act as the water tower to the peninsular part of India, and its extensive watershed caters to the water demand of the Industry sector, Agriculture and urban community. Conservation of WGs is the key to the prosperity of Peninsular India. The global scientific community suggested more than 600+ Climate change adaptation strategies for the policymakers, stakeholders, and other state actors to take proactive actions. The preliminary analysis of the federal and the state action plan on climate change in the wake of CC indicate inadequacy in motion as per recommended scientific adaptation strategies. Tamil Nadu and Kerala state constitute nine effective adaptation strategies out of the 40+ recommended for Western Ghats conservation. And other four states' adaptation strategies are deficient, confusing and vague. Western Ghats' resilience capacity will soon or might have reached its threshold, and the frequency of severe drought and flash floods might upsurge manifold in the decades to come. The lack of a clear roadmap to climate change adaptation strategies in the federal and state action stirred us to identify the gap and address it by offering a holistic approach to WGs biodiversity conservation.

Keywords: adaptation strategy, biodiversity conservation, climate change, resilience, Western Ghats

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1134 Analysis on the Effectiveness of the "Three-Exemption" Policy Aimed at Promoting Unpaid Blood Donation in Zhejiang

Authors: Ni Tang, Jinping Zhang

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An effective and sustainable volunteer team is needed to create a more available blood supply system. In order to promote the sustainable development of blood donation in Zhejiang Province, China, a “three-exemption” policy was proposed in 2014: blood donors who received the National Award for unpaid blood donation may government-invested and funded parks, scenic spots and other places for free, visit non-profit medical institutions for free outpatient fees, and be exempted from urban public transportation fees. As the policy has been in place for seven years, this study evaluated the effectiveness of the policy by comparing the increasing rate of blood donation in Hangzhou (capital city of Zhejiang) before and after the policy using the intermittent time series analysis. The blood donation in Anhui, a Province near Zhejiang, was also compared as a negative control. Blood donation data from 2012 to 2018 were obtained from the donation center's official websites. The increasing rate of blood donation volume since 2012 in Hangzhou is 34.37 units/month, and after 2014, the increasing rate additionally increases 71.69 (p=0.1442), which indicating a statistically non-significant change after the policy. While as a negative control, in Anhui, the increasing rate of blood donation volume since 2012 is -163.3 unit/month, and the increasing rate additionally increases 167.2 (p=5.63e-07) after 2014. The result shows that the three-exemption policy had a certain level of impact on encouraging volunteers to donate blood, but the effect was not substantial. One possible reason for the ineffectiveness of the policy might be a lack of public awareness of the policy. On the other hand, this policy mainly waived unnecessary life expenses, such as fares and scenic entrance fees, and requires a certain number of blood donations, registration procedures, and blood donation certificates. Perhaps, reducing life-related expenses such as oil, water and electricity, could better attract people to participate in blood donation. This current study on the three-exemption policy provides a new direction for promoting people's blood donation. Incentive policies may require greater publicity and incentives. In order to better ensure the operation of the blood donation system, other policies, especially incentive policies, should be further explored.

Keywords: blood donation, policy, Zhejiang, unpaid blood donation, three-exemption policy

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1133 Towards a Vulnerability Model Assessment of The Alexandra Jukskei Catchment in South Africa

Authors: Vhuhwavho Gadisi, Rebecca Alowo, German Nkhonjera

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This article sets out to detail an investigation of groundwater management in the Juksei Catchment of South Africa through spatial mapping of key hydrological relationships, interactions, and parameters in catchments. The Department of Water Affairs (DWA) noted gaps in the implementation of the South African National Water Act 1998: article 16, including the lack of appropriate models for dealing with water quantity parameters. For this reason, this research conducted a drastic GIS-based groundwater assessment to improve groundwater monitoring system in the Juksei River basin catchment of South Africa. The methodology employed was a mixed-methods approach/design that involved the use of DRASTIC analysis, questionnaire, literature review and observations to gather information on how to help people who use the Juskei River. GIS (geographical information system) mapping was carried out using a three-parameter DRASTIC (Depth to water, Recharge, Aquifer media, Soil media, Topography, Impact of the vadose zone, Hydraulic conductivity) vulnerability methodology. In addition, the developed vulnerability map was subjected to sensitivity analysis as a validation method. This approach included single-parameter sensitivity, sensitivity to map deletion, and correlation analysis of DRASTIC parameters. The findings were that approximately 5.7% (45km2) of the area in the northern part of the Juksei watershed is highly vulnerable. Approximately 53.6% (428.8 km^2) of the basin is also at high risk of groundwater contamination. This area is mainly located in the central, north-eastern, and western areas of the sub-basin. The medium and low vulnerability classes cover approximately 18.1% (144.8 km2) and 21.7% (168 km2) of the Jukskei River, respectively. The shallow groundwater of the Jukskei River belongs to a very vulnerable area. Sensitivity analysis indicated that water depth, water recharge, aquifer environment, soil, and topography were the main factors contributing to the vulnerability assessment. The conclusion is that the final vulnerability map indicates that the Juksei catchment is highly susceptible to pollution, and therefore, protective measures are needed for sustainable management of groundwater resources in the study area.

Keywords: contamination, DRASTIC, groundwater, vulnerability, model

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1132 Sound Source Localisation and Augmented Reality for On-Site Inspection of Prefabricated Building Components

Authors: Jacques Cuenca, Claudio Colangeli, Agnieszka Mroz, Karl Janssens, Gunther Riexinger, Antonio D'Antuono, Giuseppe Pandarese, Milena Martarelli, Gian Marco Revel, Carlos Barcena Martin

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This study presents an on-site acoustic inspection methodology for quality and performance evaluation of building components. The work focuses on global and detailed sound source localisation, by successively performing acoustic beamforming and sound intensity measurements. A portable experimental setup is developed, consisting of an omnidirectional broadband acoustic source and a microphone array and sound intensity probe. Three main acoustic indicators are of interest, namely the sound pressure distribution on the surface of components such as walls, windows and junctions, the three-dimensional sound intensity field in the vicinity of junctions, and the sound transmission loss of partitions. The measurement data is post-processed and converted into a three-dimensional numerical model of the acoustic indicators with the help of the simultaneously acquired geolocation information. The three-dimensional acoustic indicators are then integrated into an augmented reality platform superimposing them onto a real-time visualisation of the spatial environment. The methodology thus enables a measurement-supported inspection process of buildings and the correction of errors during construction and refurbishment. Two experimental validation cases are shown. The first consists of a laboratory measurement on a full-scale mockup of a room, featuring a prefabricated panel. The latter is installed with controlled defects such as lack of insulation and joint sealing material. It is demonstrated that the combined acoustic and augmented reality tool is capable of identifying acoustic leakages from the building defects and assist in correcting them. The second validation case is performed on a prefabricated room at a near-completion stage in the factory. With the help of the measurements and visualisation tools, the homogeneity of the partition installation is evaluated and leakages from junctions and doors are identified. Furthermore, the integration of acoustic indicators together with thermal and geometrical indicators via the augmented reality platform is shown.

Keywords: acoustic inspection, prefabricated building components, augmented reality, sound source localization

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1131 Object-Scene: Deep Convolutional Representation for Scene Classification

Authors: Yanjun Chen, Chuanping Hu, Jie Shao, Lin Mei, Chongyang Zhang

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Traditional image classification is based on encoding scheme (e.g. Fisher Vector, Vector of Locally Aggregated Descriptor) with low-level image features (e.g. SIFT, HoG). Compared to these low-level local features, deep convolutional features obtained at the mid-level layer of convolutional neural networks (CNN) have richer information but lack of geometric invariance. For scene classification, there are scattered objects with different size, category, layout, number and so on. It is crucial to find the distinctive objects in scene as well as their co-occurrence relationship. In this paper, we propose a method to take advantage of both deep convolutional features and the traditional encoding scheme while taking object-centric and scene-centric information into consideration. First, to exploit the object-centric and scene-centric information, two CNNs that trained on ImageNet and Places dataset separately are used as the pre-trained models to extract deep convolutional features at multiple scales. This produces dense local activations. By analyzing the performance of different CNNs at multiple scales, it is found that each CNN works better in different scale ranges. A scale-wise CNN adaption is reasonable since objects in scene are at its own specific scale. Second, a fisher kernel is applied to aggregate a global representation at each scale and then to merge into a single vector by using a post-processing method called scale-wise normalization. The essence of Fisher Vector lies on the accumulation of the first and second order differences. Hence, the scale-wise normalization followed by average pooling would balance the influence of each scale since different amount of features are extracted. Third, the Fisher vector representation based on the deep convolutional features is followed by a linear Supported Vector Machine, which is a simple yet efficient way to classify the scene categories. Experimental results show that the scale-specific feature extraction and normalization with CNNs trained on object-centric and scene-centric datasets can boost the results from 74.03% up to 79.43% on MIT Indoor67 when only two scales are used (compared to results at single scale). The result is comparable to state-of-art performance which proves that the representation can be applied to other visual recognition tasks.

Keywords: deep convolutional features, Fisher Vector, multiple scales, scale-specific normalization

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1130 Development of Alternative Fuels Technologies: Compressed Natural Gas Home Refueling Station

Authors: Szymon Kuczynski, Krystian Liszka, Mariusz Laciak, Andrii Oliinyk, Adam Szurlej

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Compressed natural gas (CNG) represents an excellent compromise between the availability of a technology that is proven and relatively easy to use in many areas of the automotive industry and incurred costs. This fuel causes a lower corrosion effect due to the lower content of products causing the potential difference on the walls of the engine system. Natural gas powered vehicles (NGVs) do not emit any substances that can contaminate water or land. The absence of carcinogenic substances in gaseous fuel extends the life of the engine. In the longer term, it contributes positively to waste management as well as waste disposal. Popularization of propulsion systems powered by natural gas CNG positively affects the reduction of heavy duty transport. For these reasons, CNG as a fuel stimulates considerable interest around the world. Over the last few years, technologies related to use of natural gas as an engine fuel have been developed and improved. These solutions have evolved from the prototype phase to the industrial scale implementation. The widespread availability of gaseous fuels has led to the development of a technology that allows the CNG fuel to be refueled directly from the urban gas network to the vehicle tank (ie. HYGEN - CNGHRS). Home refueling installations, although they have been known for many years, are becoming increasingly important in the present day. The major obstacle in the sale of this technology was, until recently, quite high capital expenditure compared to the later benefits. Home refueling systems allow refueling vehicle tank, with full control of fuel costs and refueling time. CNG Home Refueling Stations (such as HYGEN) allow gas value chain to overcome the dogma that there is a lack of refueling infrastructure allowing companies in gas value chain to participate in transportation market. Technology is based on one stage hydraulic compressor (instead of multistage mechanical compressor technology) which provides the possibility to compress low pressure gas from distribution gas network to 200 bar for its further usage as a fuel for NGVs. This boosts revenues and profits of gas companies by expanding its presence in higher margin of energy sector.

Keywords: alternative fuels, CNG (compressed natural gas), CNG stations, NGVs (natural gas vehicles), gas value chain

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1129 Nursing-Related Barriers to Children’s Pain Management at Selected Hospitals in Ghana: A Descriptive Qualitative Study

Authors: Abigail Kusi Amponsah, Evans Frimpong Kyei, John Bright Agyemang, Hanson Boakye, Joana Kyei-Dompim, Collins Kwadwo Ahoto, Evans Oduro

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Staff shortages, deficient knowledge, inappropriate attitudes, demanding workloads, analgesic shortages, and low prioritization of pain management have been identified in earlier studies as the nursing-related barriers to optimal children’s pain management. These studies have mainly been undertaken in developed countries, which have different healthcare dynamics than those in developing countries. The current study, therefore, sought to identify and understand the nursing-related barriers to children’s pain management in the Ghanaian context. A descriptive qualitative study was conducted among 28 purposively sampled nurses working in the pediatric units of five hospitals in the Ashanti region of Ghana. Over the course of three months, participants were interviewed on the barriers which prevented them from optimally managing children’s pain in practice. Recorded interviews were transcribed verbatim and deductively analysed based on a conceptual interest in pain assessment and management-related barriers. NVivo 12 plus software guided data management and analyses. The mean age of participating nurses was 30 years, with majority being females (n =24). Participants had worked in the nursing profession for an average of five years and in the pediatric care settings for an average of two years. The nursing-related barriers identified in the present study included communication difficulties in assessing and evaluating pain management interventions with children who have nonfunctional speech, insufficient training, misconceptions on the experience of pain in children, lack of assessment tools, and insufficient number of nurses to manage the workload and nurses’ inability to prescribe analgesics. The present study revealed some barriers which prevented Ghanaian nurses from optimally managing children’s pain. Nurses should be educated, empowered, and supported with the requisite material resources to effectively manage children’s pain and improve outcomes for families, healthcare systems, and the nation. Future studies should explore the facilitators and barriers from other stakeholders involved in pediatric pain management

Keywords: Nursing-Related Barriers, Children, Pain Management, Ghana

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1128 Impact of Land-Use and Climate Change on the Population Structure and Distribution Range of the Rare and Endangered Dracaena ombet and Dobera glabra in Northern Ethiopia

Authors: Emiru Birhane, Tesfay Gidey, Haftu Abrha, Abrha Brhan, Amanuel Zenebe, Girmay Gebresamuel, Florent Noulèkoun

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Dracaena ombet and Dobera glabra are two of the most rare and endangered tree species in dryland areas. Unfortunately, their sustainability is being compromised by different anthropogenic and natural factors. However, the impacts of ongoing land use and climate change on the population structure and distribution of the species are less explored. This study was carried out in the grazing lands and hillside areas of the Desa'a dry Afromontane forest, northern Ethiopia, to characterize the population structure of the species and predict the impact of climate change on their potential distributions. In each land-use type, abundance, diameter at breast height, and height of the trees were collected using 70 sampling plots distributed over seven transects spaced one km apart. The geographic coordinates of each individual tree were also recorded. The results showed that the species populations were characterized by low abundance and unstable population structure. The latter was evinced by a lack of seedlings and mature trees. The study also revealed that the total abundance and dendrometric traits of the trees were significantly different between the two land uses. The hillside areas had a denser abundance of bigger and taller trees than the grazing lands. Climate change predictions using the MaxEnt model highlighted that future temperature increases coupled with reduced precipitation would lead to significant reductions in the suitable habitats of the species in northern Ethiopia. The species' suitable habitats were predicted to decline by 48–83% for D. ombet and 35–87% for D. glabra. Hence, to sustain the species populations, different strategies should be adopted, namely the introduction of alternative livelihoods (e.g., gathering NTFP) to reduce the overexploitation of the species for subsistence income and the protection of the current habitats that will remain suitable in the future using community-based exclosures. Additionally, the preservation of the species' seeds in gene banks is crucial to ensure their long-term conservation.

Keywords: grazing lands, hillside areas, land-use change, MaxEnt, range limitation, rare and endangered tree species

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1127 Using Action Based Research to Examine the Effects of Co-Teaching on Middle School and High School Student Achievement in Math and Language Arts

Authors: Kathleen L. Seifert

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Students with special needs are expected to achieve the same academic standards as their general education peers, yet many students with special needs are pulled-out of general content instruction. Because of this, many students with special needs are denied content knowledge from a content expert and instead receive content instruction in a more restrictive setting. Collaborative teaching, where a general education and special education teacher work alongside each other in the same classroom, has become increasingly popular as a means to meet the diverse needs of students in America’s public schools. The idea behind co-teaching is noble; to ensure students with special needs receive content area instruction from a content expert while also receiving the necessary supports to be successful. However, in spite of this noble effort, the effects of co-teaching are not always positive. The reasons why have produced several hypotheses, one of which has to do with lack of proper training and implementation of effective evidence-based co-teaching practices. In order to examine the effects of co-teacher training, eleven teaching pairs from a small mid-western school district in the United States participated in a study. The purpose of the study was to examine the effects of co-teacher training on middle and high school student achievement in Math and Language Arts. A local university instructor provided teachers with training in co-teaching via a three-day workshop. In addition, co-teaching pairs were given the opportunity for direct observation and feedback using the Co-teaching Core Competencies Observation Checklist throughout the academic year. Data are in the process of being collected on both the students enrolled in the co-taught classes as well as on the teachers themselves. Student data compared achievement on standardized assessments and classroom performance across three domains: 1. General education students compared to students with special needs in co-taught classrooms, 2. Students with special needs in classrooms with and without co-teaching, 3. Students in classrooms where teachers were given observation and feedback compared to teachers who refused the observation and feedback. Teacher data compared the perceptions of the co-teaching initiative between teacher pairs who received direct observation and feedback from those who did not. The findings from the study will be shared with the school district and used for program improvement.

Keywords: collabortive teaching, collaboration, co-teaching, professional development

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1126 Split Health System for Diabetes Care in Urban Area: Experience from an Action Research Project in an Urban Poor Neighborhood in Bengaluru

Authors: T. S. Beerenahally, S. Amruthavalli, C. M. Munegowda, Leelavathi, Nagarathna

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Introduction: In majority of urban India, the health system is split between different authorities being responsible for the health care of urban population. We believe that, apart from poor awareness and financial barriers to care, there are other health system barriers which affect quality and access to care for people with diabetes. In this paper, we attempted to identify health system complexity that determines access to public health system for diabetes care in KG Halli, a poor urban neighborhood in Bengaluru. The KG Halli has been a locus of a health systems research from 2009 to 2015. Methodology: The source of data is from the observational field-notes written by research team as part of urban health action research project (UHARP). Field notes included data from the community and the public primary care center. The data was generated by the community health assistants and the other research team members during regular home visits and interaction with individuals who self-reported to be diabetic over four years as part of UHARP. Results: It emerged during data analysis that the patients were not keen on utilizing primary public health center for many reasons. Patient has felt that the service provided at the center was not integrated. There was lack of availability of medicines, with a regular stock out of medicines in a year and laboratory service for investigation was limited. Many of them said that the time given by the providers was not sufficient and there was also a feeling of providers not listening to them attentively. The power dynamics played a huge role in communication. Only the consultation was available for free of cost at the public primary care center. The patient had to spend for the investigations and the major portion for medicine. Conclusion: Diabetes is a chronic disease that poses an important emerging public health concern. Most of the financial burden is borne by the family as the public facilities have failed to provide free care in India. Our study indicated various factors including individual beliefs, stigma and financial constraints affecting compliance to diabetes care.

Keywords: diabetes care, disintegrated health system, quality of care, urban health

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1125 Self-Care and Risk Behaviors in Primary Caregiver of Cancer Patients

Authors: Ivonne N. Pérez-Sánchez. María L. Rascón- Gasca, Angélica Riveros-Rosas, Rebeca Robles García

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Introduction: Primary caregivers of cancer patients have health problems related to their lack of time, stress, and fiscal strain. Their health problems could affect their patients’ health and also increase the expenses in public health. Aim: To describe self-care and risk behaviors in a sample of Mexican primary caregiver and the relation of these behaviors with emotional distress (caregiver burden, anxiety and depression symptoms), coping and sociodemographic variables. Method: Participated in this study 173 caregivers of a third level reference medical facility (age: M=49.4, SD=13.5) females 78%, males 22%, 57.5% were caregivers of patients with terminal cancer (CPTC), and 40.5% were caregivers of patients on oncology treatment (CPOT). Results: The 75.7% of caregivers reported to have had health problem in last six months as well as several symptoms which were related to emotional distress, these symptoms were more frequently between CPTC and female caregivers. A half (47.3%) of sample reported have had difficulties in caring their health; these difficulties were related to emotional distress and lower coping, more affected caregivers were who attend male patients and CPTC. The 76.8% of caregivers had health problems in last six months, but 26.5% of them waited to search medical care until they were very sick, and 11% didn't do it. Also, more than a half of sample (56.1%) admitted to have risk behaviors as drink alcohol, smoke or overeating for feeling well, these caregivers showed high emotional distress and lower coping. About caregivers healthy behaviors, 80% of them had a hobby; 27.2% do exercise usually and between 12% to 60% did medical checkups (glucose tests, blood pressure and cholesterol tests, eye exams and watched their weight), these caregivers had lower emotional distress and high coping, some variables related health behaviors were: care only one patient or a female patient and be a CPOT, social support, high educational level and experience as a caregiver in past. The half of caregivers were worrying to develop cancer in the future; this idea was 2.5 times more frequent in caregiver with problems to care their health. Conclusions: The results showed a big proportion of caregivers with medical problems. High emotional distress and low coping were related to physical symptoms, risk behaviors, and low self-care; poor self-care was frequently even in caregiver who have chronic illness.

Keywords: cancer, primary caregiver, risk behaviors, self-care

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