Search results for: concerns based adoption model
Commenced in January 2007
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Edition: International
Paper Count: 38853

Search results for: concerns based adoption model

3753 Self-Determination and Mental Disorders: Phenomenological Approach

Authors: Neringa Bagdonaite

Abstract:

Background: The main focus of this paper is to explore how self-determination interplays in suicidal and addictive context leading one to autonomously choose self-destructive addictive behaviour or suicidal intentions. Methods: Phenomenological descriptions of the experiential structure of self-determination in addiction and suicidal mental life are used. The phenomenological method describes structures of mental life from the first-person-perspective, with a focus on how an experienced object is given in a subject’s conscious experience. Results: A sense of self-determination in the context of suicidal and addictive behaviour is possibly impaired. In the context of suicide, it's proposed that suicide is always experienced at least minimally self-determined, as it's the last freely discovered self-efficient behaviour, in terms of radically changing one's desperate mental state. Suicide can never be experienced as fully self-determined because no future retrospective re-evaluation of behaviour is possible. Understanding self-determination in addiction is challenging because addicts perceive themselves and experience situations differently depending on: (I) their level of intoxication; (II) whether the situation is in the moment or in retrospect; and (III) the goals set out in that situation. Furthermore, within phenomenology addiction is described as an embodied custom, which‘s acquired and established while performing 'psychotropic technique'. The main goal of performing such a technique is to continue 'floating in an indifference state' or being 'comfortably numb'. Conclusions: Based on rich phenomenological descriptions of the studied phenomenon, this paper draws on the premise that to experience self-determination in both suicide and addiction, underlying desperate or negative emotional states are needed. Such underlying desperate or negative mental life experiences are required for one to pre-reflectively evaluate suicide or addictive behaviours as positive, relieving or effective in terms of changing one's emotional states. Such pre-reflective positive evaluations serve as the base for the continuation of behaviour and later are identified reflectively.

Keywords: addiction, phenomenology, self-determination, self-effectivity, suicide

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3752 Multi-Criteria Bid/No Bid Decision Support Framework for General Contractors: A Case of Pakistan

Authors: Nida Iftikhar, Jamaluddin Thaheem, Bilal Iftikhar

Abstract:

In the construction industry, adequate and effective decision-making can mean the difference between success and failure. Bidding is the most important element of the construction business since it is a mean by which contractors obtain work. This is probably the only option for any contractor firm to sustain in the market and achieve its objective of earning the profits by winning tenders. The capability to select most appropriate ventures not only defines the success and wellbeing of contractor firms but also their survival and sustainability in the industry. The construction practitioners are usually on their own when it comes to deciding on bidding for a project or not. Usually, experience-based solutions are offered where a lot of subjectivity is involved. This research has been opted considering the local construction industry of Pakistan in order to examine the critical success factors from contractors’ perspective while making bidding decisions, listing and evaluating critical factors in order of their importance, categorization of these factors into decision support & decision oppose groups and to develop a framework to help contractors in the decision-making process. Literature review, questionnaires, and structured interviews are used for identification and quantification of factors affecting bid/no bid decision-making. Statistical methods of ranking analysis and analytical hierarchy process of multi-criteria decision-making method are used for analysis. It is found that profitability, need for work and financial health of client are the most decisive factors in bid/no bid decision-making while project size, project type, fulfilling the tender conditions imposed by the client and relationship, identity & reputation of the client are least impact factors in bid/no bid decision-making. Further, to verify the developed framework, case studies have been conducted to evaluate the bid/no bid decision-making in building procurement. This is the first of its nature study in the context of the local construction industry and recommends using a holistic decision-making framework for such business-critical deliberations.

Keywords: bidding, bid decision-making, construction procurement, contractor

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3751 The Relationships between Physical Activity Levels, Enjoyment of Physical Activity, and Body Mass Index among Bruneian Secondary School Adolescents

Authors: David Xiaoqian Sun, Khairunnisa Binti Haji Sibah, Jr., Lejak Anak Ambol

Abstract:

The purpose of the study was to examine the relationships between objectively measured physical activity levels (PALs), enjoyment of physical activity (EPA), and body mass index (BMI) among adolescents. A total of 188 12-14-year-old Bruneian secondary school adolescents (88 boys and 100 girls) voluntarily took part in this study. Subjects wore the RT3 accelerometer for seven consecutive days in order to measure their PALs. Times of students’ engagement in total (TPA), light (LPA), moderate (MPV), and vigorous PA (VPA) were obtained from the accelerometer. Their BMIs were calculated from their body height and weight. Physical Activity Enjoyment Scale (PACES) was administrated to obtain their EPA levels. Four key enjoyment factors including fun factors, positive perceptions, unexciting in doing activities, and negative perceptions were identified. Subjects’ social economic status (SES) was provided by school administration. Results show that all the adolescents did not meet the recommended PA guidelines even though boys were engaged in more MVPA than girls. No relationships were found between BMI and all PALs in both boys and girls. BMI was significantly related to the PACES scores (r = -.22, p = 0.01), fun factors (r = -.20, p = 0.05) and positive perceptions (r =-.21, p < 0.05). The PACES scores were significantly related to LPA (r = .18, p = 0.01) but not related to MVPA (r = .04, p > 0.05). After controlling for age and SES, BMI was only significantly related to the PACES scores in girls (r = -.27, p < .01) but boys (r = -.06, p > 0.05). Fun factors were significantly related to LPA and MVPA (p < .01) in girls while negative perceptions were significantly related to LPA and MVPA (p < .01) in boys. This study provides evidence that enjoyment may be a trigger of LPA but MVPA and may be influenced by their BMI status particularly in girls. Based on these findings, physical and health educators are suggested to not only make PA more enjoyable, but also consider gender differences in promoting adolescents' participation in MVPA.

Keywords: accelerometer, body mass index, enjoyment of physical activity, moderate to vigorous physical activity

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3750 Democratising Rivers: Local River Conflicts in Rajasthan

Authors: Renu Sisodia

Abstract:

This paper attempted to explore and explain the local level river water conflicts in the larger context of state - society relations. This study also covered causes of local level river water conflicts in the catchment area of Bandi and Arvari river of Rajasthan. The focus of the study was on the emergence of community driven, decentralised management of river water bodies and strategies used by local communities to protect and manage river water conflicts. The research is conducted through the process of designing a framework based on essential theoretical and practical findings supported by primary and secondary data. Two in depth case study is conducted to understand the phenomenon in depth. The first field site is Bandi River of Pali district, which is about the struggle between textile industries, community and the State government in which water pollution is said to be one of the driving force of the conflict. Finding shows that the state is supporting textile industries in Pali district have not been adherent to the environmental ethics. Present legal infrastructure and local institutions fail to resolve the serious problem of water pollution in Bandi River and its adverse impact on the local community as a result local community resistance against the local administration and the state government. The second case illustrates the plight of Arvari River in Alwar district. Tussle for the ownership of fisheries between local community, the private fish contractor and State government has been the main bone of contestation. To resolve this conflict local community formed conflict management mechanism named as Arvari Parliament. Arvari Parliament has its own principle and rules to resolve water conflicts related to ownership of the river and use of the river water. The research findings also highlight the co-existence between conventional and modern practices in resolving conflicts.

Keywords: water, water pollution, water conflicts, water scarcity, conflict resolution, local community

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3749 Upcoming Fight Simulation with Smart Shadow

Authors: Ramiz Kuliev, Fuad Kuliev-Smirnov

Abstract:

The 'Shadow Sparring' training exercise is widely used in the training of boxers and martial artists. The main disadvantage of the usual shadow sparring is that the trainer cannot fully control such training and evaluate its results. During the competition, the athlete, preparing for the upcoming fight, imagines the Shadow (upcoming opponent) in accordance with his own imagination. A ‘Smart-Shadow Sparring’ (SSS) is an innovative version of the ‘Shadow Sparring’. During SSS, the fighter will see the Shadow (virtual opponent that moves, defends, and punches) and understand when he misses the punches from the Shadow. The task of a real athlete is to spar with a virtual one, move around, punch in the direction of unprotected areas of the Shadow and dodge his punches. Moves and punches of Shadow are set up before each training. The system will give the coach full information about virtual sparring: (i) how many and what type of punches has the fighter landed, (ii) accuracy of these punches, (iii) how many and what type of virtual punches (punches of Smart-Shadow) has the fighter missed, etc. SSS will be recorded as animated fighting of two fighters and will help the coach to analyze past training. SSS can be configured to fit the physical and technical characteristics of the next real opponent (size, techniques, speed, missed and landed punches, etc.). This will allow to simulate and rehearse the upcoming fight and improve readiness for the next opponent. For amateur fighters, SSS will be reconfigured several times during a tournament, when the real opponent becomes known. SSS can be used in three versions: (1) Digital Shadow: the athlete will see a Shadow on a monitor (2) VR-Shadow: the athlete will see a Shadow in a VR-glasses (3) Smart Shadow: a Shadow will be controlled by artificial intelligence. These technologies are based on the ‘semi-real simulation’ method. The technology allows coaches to train athletes remotely. Simulation of different opponents will help the athletes better prepare for competition. Repeat rehearsals of the upcoming fight will help improve results. SSS can improve results in Boxing, Taekwondo, Karate, and Fencing. 41 sets of medals will be awarded in these sports at the 2020 Olympic Games.

Keywords: boxing, combat sports, fight simulation, shadow sparring

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3748 The Influence of Bacteriocins Producing Lactic Acid Bacteria Multiplied in an Alternative Substrate on Calves Blood Parameters

Authors: E. Bartkiene, V. Krungleviciute, J. Kucinskiene, R. Antanaitis, A. Kucinskas

Abstract:

In calves less than 10-day-old, infection commonly cause severe diarrhoea and high mortality. To prevention of calves diseases a common practice is to treat calves with prophylactic antibiotics, in this case the use of lactic acid bacteria (LAB) is promising. Often LAB strains are incubated in comercial de Man-Rogosa-Sharpe (MRS) medium, the culture are centrifuged, the cells are washing with sterile water, and this suspension is used as a starter culture for animal health care. Juice of potatoe tubers is industrial wastes, wich may constitute a source of digestible nutrients for microorganisms. In our study the ability of LAB to utilize potatoe tubers juice in cell synthesis without external nutrient supplement was investigated, and the influence of multiplied LAB on calves blood parameters was evaluated. Calves were selected based on the analogy principle (treatment group (n=6), control group (n=8)). For the treatment group 14 days was given a 50 ml of fermented potatoe tubers juice containing 9.6 log10 cfu/ml of LAB. Blood parameters (gas and biochemical) were assessed by use of an auto-analyzers (Hitachi 705 and EPOC). Before the experiment, blood pH of treatment group calves was 7.33, control – 7.36, whereas, after 14 days, 7.28 and 7.36, respectively. Calves blood pH in the treatment group remained stable over the all experiment period. Concentration of PCO2 in control calves group blood increased from 63.95 to 70.93, whereas, in the treatment group decreased from 63.08 to 60.71. Concentration of lactate in the treatment group decreased from 3.20 mmol/l to 2.64 mmol/l, whereas, in control - increased from 3.95 mmol/l to 4.29 mmol/l. Concentration of AST in the control calves group increased from 50.18 IU/L to 58.9 IU/L, whereas, in treatment group decreased from 49.82 IU/L to 33.1 IU/L. We conclude that the 50 ml of fermented potatoe tubers juice containing 9.6 log10 cfu/ml of LAB per day, by using 14 days, reduced risk of developing acidosis (stabilizes blood pH (p < 0.05)), reduces lactates and PCO2 concentration (p < 0.05) and risk of liver lesions (reduces AST concentration (p < 0.005)) in blood of calves.

Keywords: alternative substrate, blood parameters, calves, lactic acid bacteria

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3747 Expression Level of Dehydration-Responsive Element Binding/DREB Gene of Some Local Corn Cultivars from Kisar Island-Maluku Indonesia Using Quantitative Real-Time PCR

Authors: Hermalina Sinay, Estri L. Arumingtyas

Abstract:

The research objective was to determine the expression level of dehydration responsive element binding/DREB gene of local corn cultivars from Kisar Island Maluku. The study design was a randomized block design with single factor consist of six local corn cultivars obtained from farmers in Kisar Island and one reference varieties wich has been released by the government as a drought-tolerant varieties and obtained from Cereal Crops Research Institute (ICERI) Maros South Sulawesi. Leaf samples were taken is the second leaf after the flag leaf at the 65 days after planting. Isolation of total RNA from leaf samples was carried out according to the protocols of the R & A-BlueTM Total RNA Extraction Kit and was used as a template for cDNA synthesis. The making of cDNA from total RNA was carried out according to the protocol of One-Step Reverse Transcriptase PCR Premix Kit. Real Time-PCR was performed on cDNA from reverse transcription followed the procedures of Real MODTM Green Real-Time PCR Master Mix Kit. Data obtained from the real time-PCR results were analyzed using relative quantification method based on the critical point / Cycle Threshold (CP / CT). The results of gene expression analysis of DREB gene showed that the expression level of the gene was highest obtained at Deep Yellow local corn cultivar, and the lowest one was obtained at the Rubby Brown Cob cultivar. It can be concluded that the expression level of DREB gene of Deep Yellow local corn cultivar was highest than other local corn cultivars and Srikandi variety as a reference variety.

Keywords: expression, level, DREB gene, local corn cultivars, Kisar Island, Maluku

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3746 Taking What Each Needs - The Basic Logic of Everyday Practice in State-backed Cultural Infrastructure in China

Authors: Yiling Shao, Megan Dai

Abstract:

This paper attempts to explore whether the cultural infrastructure supported by the Chinese government is still subject to a logic of “strict regulation”.Previous studies have pointed out that the "paternalism" tendency of China's cultural policy always leads to excessive government intervention in cultural development, while Chinese cultural practitioners can only seek cultural autonomy in the cracks of supervision. This can also explain why Chinese cultural policies sometimes have different effects than the official expectations.But this only reflects one aspect of China's cultural policy. In fact, the welfare cultural infrastructure funded by the government seems to highlight the principles of "safeguarding citizens' cultural rights" and "citizens' voluntary" rather than "indoctrination" and "enlightenment", What new features of China's cultural policy are reflected behind this policy orientation that is completely different from the logic of "regulation", which has also become an important issue in this paper. Based on the field survey of a cultural infrastructure (Gao ming District Cultural Center) in Gao ming District, Fo shan City, Guangdong Province, China, for nearly one year, the authors have obtained many text and picture materials.The paper discusses the dual role of cultural centers in China's cultural policy -both as a formal commitment by the state to protect citizens' basic cultural rights and as a social space for citizens to use preferential policies to obtain cultural capital. All in all, the author have conclued three operational logics of the cultural infrastructure currently supported by the Chinese government (at least in developed areas): first, the cultural center has become a versatile cultural space; second, grass-roots cultural cadres can be described as "policy entrepreneurs"; third, ordinary citizens will use the officially supported cultural infrastructure to increase cultural capital. This paper argues that, in comparison to the common “regulatory hand” in the field of cultural industries, in cultural infrastructure supported by state, the authorities and citizens are not in conflict. On the contrary, authorities must adopt a de-regulatory "pleasing" strategy to gain the support of citizens.

Keywords: cultural infrastructure, cultural capital, deregulation, policy entrepreneur

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3745 Scoping Review of Biological Age Measurement Composed of Biomarkers

Authors: Diego Alejandro Espíndola-Fernández, Ana María Posada-Cano, Dagnóvar Aristizábal-Ocampo, Jaime Alberto Gallo-Villegas

Abstract:

Background: With the increase in life expectancy, aging has been subject of frequent research, and therefore multiple strategies have been proposed to quantify the advance of the years based on the known physiology of human senescence. For several decades, attempts have been made to characterize these changes through the concept of biological age, which aims to integrate, in a measure of time, structural or functional variation through biomarkers in comparison with simple chronological age. The objective of this scoping review is to deepen the updated concept of measuring biological age composed of biomarkers in the general population and to summarize recent evidence to identify gaps and priorities for future research. Methods: A scoping review was conducted according to the five-phase methodology developed by Arksey and O'Malley through a search of five bibliographic databases to February 2021. Original articles were included with no time or language limit that described the biological age composed of at least two biomarkers in those over 18 years of age. Results: 674 articles were identified, of which 105 were evaluated for eligibility and 65 were included with information on the measurement of biological age composed of biomarkers. Articles from 1974 of 15 nationalities were found, most observational studies, in which clinical or paraclinical biomarkers were used, and 11 different methods described for the calculation of the composite biological age were informed. The outcomes reported were the relationship with the same measured biomarkers, specified risk factors, comorbidities, physical or cognitive functionality, and mortality. Conclusions: The concept of biological age composed of biomarkers has evolved since the 1970s and multiple methods of its quantification have been described through the combination of different clinical and paraclinical variables from observational studies. Future research should consider the population characteristics, and the choice of biomarkers against the proposed outcomes to improve the understanding of aging variables to direct effective strategies for a proper approach.

Keywords: biological age, biological aging, aging, senescence, biomarker

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3744 Nanoprofiling of GaAs Surface in a Combined Low-Temperature Plasma for Microwave Devices

Authors: Victor S. Klimin, Alexey A. Rezvan, Maxim S. Solodovnik, Oleg A. Ageev

Abstract:

In this paper, the problems of existing methods of profiling and surface modification of nanoscale arsenide-gallium structures are analyzed. The use of a combination of methods of local anodic oxidation and plasma chemical etching to solve this problem is considered. The main features that make this technology one of the promising areas of modification and profiling of near-surface layers of solids are demonstrated. In this paper, we studied the effect of formation stress and etching time on the geometrical parameters of the etched layer and the roughness of the etched surface. Experimental dependences of the thickness of the etched layer on the time and stress of formation were obtained. The surface analysis was carried out using atomic force microscopy methods, the corresponding profilograms were constructed from the obtained images, and the roughness of the etched surface was studied accordingly. It was shown that at high formation voltage, the depth of the etched surface increased, this is due to an increase in the number of active particles (oxygen ions and hydroxyl groups) formed as a result of the decomposition of water molecules in an electric field, during the formation of oxide nanostructures on the surface of gallium arsenide. Oxide layers were used as negative masks for subsequent plasma chemical etching by the STE ICPe68 unit. BCl₃ was chosen as the chlorine-containing gas, which differs from analogs in some parameters for the effect of etching of nanostructures based on gallium arsenide in the low-temperature plasma. The gas mixture of reaction chamber consisted of a buffer gas NAr = 100 cm³/min and a chlorine-containing gas NBCl₃ = 15 cm³/min at a pressure P = 2 Pa. The influence of these methods modes, which are formation voltage and etching time, on the roughness and geometric parameters, and corresponding dependences are demonstrated. Probe nanotechnology was used for surface analysis.

Keywords: nanostructures, GaAs, plasma chemical etching, modification structures

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3743 An Exploratory Research on Awareness towards Human Rights among Public Representatives of Bihar, India

Authors: Saba Farheen, Uday Shankar

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Background- Attaining equality among all humans and eliminating all forms of discrimination against them are fundamental human rights. These rights are based on the belief that all human beings are born free with equal dignity, esteem, and honour. In India, more than 30 percent politicians are having criminal background. They are also illiterate, which obstacle them in governing the system. They do not know the basic human rights. Because of this, they cannot decide what to do for the sake of the nation. Bihar is the third largest populated state of India and is characterized by corrupt politicians and poor literacy rate. If the politicians can aware about the human rights, then they will show positive attitude towards these. Aim- The main goal of the present research was to study the subjects’ knowledge or awareness towards their human rights. It was an attempt to identify social-psychological conditions that inhibit or facilitate awareness among public representatives towards their human rights in the special context of Bihar, India. Thus the main variable awareness towards human rights has been treated as the main dependent variable. The other two variables-socio economic status and Educational status, have been treated as independent variables. Method- The subjects were 400 public representatives in the age group of 35 to 50 years. They were from High socio economic status (N=150), Middle socio economic status (N=150), and Low socio economic status (N=100). The subjects were either educated (N=200) or Uneducated (N=200). The subjects were selected randomly from the different districts of Bihar, India. “Human Rights Awareness Scale” by Dr. Iftekhar Hossain, Dr. Saba Farheen, and Dr. Uday Shankar was applied in this study. Results- Results have shown that the public representatives have very low level of awareness towards the human rights. Also, the subjects from Middle SES have highest awareness in comparison with subjects of High and Low SES. Uneducated public representatives have less awareness than the educated one about human rights. Conclusion- Conclusively, it can be stated that human rights awareness among the public representatives of India is very low, and it is being affected by their Socio economic status and literacy level.

Keywords: human rights, awareness, public representatives, bihar, India

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3742 Regulation, Evaluation and Incentives: An Analysis of Management Characteristics of Nonprofit Organizations in China

Authors: Wuqi Yang, Sufeng Li, Linda Zhai, Zhizhong Yuan, Shengli Wang

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How to assess and evaluate a not-for-profit (NFP) organisation’s performance should be of concern to all stakeholders because, amongst other things, without correctly evaluating its performance might affect an NFP being not able to continue to meet its service objectives. Given the growing importance of this sector in China, more and more existing and potential donors, governments and others are starting to take an increased interest in the financial conditions and performance of NFPs. However, when these various groups look for ways (methods) to assess the performance of NFPs, they find there has been relatively little research conducted into methods for assessing the performance of NFPs in China. Furthermore, there does not appear to have been any research to date into the performance evaluation of Chinese NFPs. The focus of this paper is to investigate how the Chinese government manages and evaluates not-for-profit (NFP) organisations' performances in China. Through examining and evaluating the NFPs in China from different aspects such as business development, mission fulfillment, financial position and other status, this paper finds some institutional constraints currently facing by the NFPs in China. At the end of this paper, a new regulatory framework is proposed for regulators’ considerations. The research methods are based on a combination of a literature review; using Balanced Scorecard to assess NFPs in China; Case Study method is employed to analyse a charity foundation’s performance in Hebei Province and proposing solutions to resolve the current issues and challenges facing by the NFPs. These solutions include: formulating laws and regulations on NFPs; simplifying management procedures, introducing tax incentives, providing financial support and other incentives to support the development of non-profit organizations in China. This study provides the first step towards a greater understanding of the NFP performance evaluation in China. It is expected that the findings and solutions from this study will be useful to anyone involved with the China NFP sector; particularly CEOs, managers, bankers, independent auditors and government agencies.

Keywords: Chinese non-profit organizations, evaluation, management, supervision

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3741 Coagulation-flocculation Process with Metal Salts, Synthetic Polymers and Biopolymers for the Removal of Trace Metals (Cu, Pb, Ni, Zn) from Wastewater

Authors: Andrew Hargreaves, Peter Vale, Jonathan Whelan, Carlos Constantino, Gabriela Dotro, Pablo Campo

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As a consequence of their potential to cause harm, there are strong regulatory drivers that require metals to be removed as part of the wastewater treatment process. Bioavailability-based standards have recently been specified for copper (Cu), lead (Pb), nickel (Ni) and zinc (Zn) and are expected to reduce acceptable metal concentrations. In order to comply with these standards, wastewater treatment works may require new treatment types to enhance metal removal and it is, therefore, important to examine potential treatment options. A substantial proportion of Cu, Pb, Ni and Zn in effluent is adsorbed to and/or complexed with macromolecules (eg. proteins, polysaccharides, aminosugars etc.) that are present in the colloidal size fraction. Therefore, technologies such as coagulation-flocculation (CF) that are capable of removing colloidal particles have good potential to enhance metals removal from wastewater. The present study investigated the effectiveness of CF at removing trace metals from humus effluent using the following coagulants; ferric chloride (FeCl3), the synthetic polymer polyethyleneimine (PEI), and the biopolymers chitosan and Tanfloc. Effluent samples were collected from a trickling filter treatment works operating in the UK. Using jar tests, the influence of coagulant dosage and the velocity and time of the slow mixing stage were studied. Chitosan and PEI had a limited effect on the removal of trace metals (<35%). FeCl3 removed 48% Cu, 56% Pb and 41% Zn at the recommended dose of 0.10 mg/L. At the recommended dose of 0.25 mg/L Tanfloc removed 77% Cu, 68% Pb, 18% Ni and 42% Zn. The dominant mechanism for particle removal by FeCl3 was enmeshment in the precipitates (i.e. sweep flocculation) whereas, for Tanfloc, inter-particle bridging was the dominant removal mechanism. Overall, FeCl3 and Tanfloc were found to be most effective at removing trace metals from wastewater.

Keywords: coagulation-flocculation, jar test, trace metals, wastewater

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3740 Clinical Audit of Selected Nephrology Nursing Procedures Performed in Nephrology Unit of AIIMS with a View to Develop Nephrology Nursing Procedure Protocol

Authors: Mamta Thakur, Dr. Shashi Mawar, Ms. Levis Murry, Dr. D.k.sharma

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Aim: The aim of this study is to develop nephrology nursing procedure protocol after clinical audit of current nephrology nursing practices. Materials and methods: This descriptive observational study was conducted on 40 nurses who were working in Nephrology Department of AIIMS, New Delhi to observe their current practices to assess the existing gaps in the practice. The nurses were enrolled through total enumerative sampling. Sociodemographic profile of nurses and clinical profile for site of procedure was collected. Observation checklist was formed on the basis of standard nursing practices, which included 7 dimensions for hemodialysis procedure and 3 dimensions for procedure of assisting renal biopsy. Based on the gaps identified, nephrology nursing procedure protocol will be developed. Nurses were observed during two shifts, and each nurse was observed once. Scoring of items were done in each dimension, and for acceptable practices, nurses have to score ≥80% in each dimension. Results: Data was analyzed using descriptive statistics. Majority of nurses (73.7%) in nephrology ward and (80.9%) in hemodialysis unit have not undergone any special training in nephrology. Most of nurses (80.9%) followed the acceptable nursing practices for procedure of connection for hemodialysis. None of nurses followed the acceptable level (≥80%) of nursing practices for the procedure of predialysis assessment, the procedure for site preparation, during dialysis assessment and post dialysis assessment. None (100%) showed the acceptable level of nursing practices for all the dimensions of assisting renal biopsy procedure. Nephrology nursing procedure protocol was developed by researcher following a rigorous process, and this will reduce the gaps in the nursing practice. Conclusion: Clinical audit found that there were gaps in the existing nursing practices compared to the standardised nursing practices for procedure of hemodialysis and assisting renal biopsy, and these gaps have been addressed by the development of the protocol.

Keywords: nursing practice, nephrology nursing procedure, nursing protocol, renal biopsy, hemodialysis

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3739 Towards Sustainable Construction in the United Arab Emirates: Challenges and Opportunities

Authors: Yousef Alqaryouti, Mariam Al Suwaidi, Raed Mohmood AlKhuwaildi, Hind Kolthoum, Issa Youssef, Mohammed Al Imam

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The UAE has experienced rapid economic growth due to its mature oil production industry, leading to a surge in urbanization and infrastructure development in the construction sector. Sustainable development practices are becoming increasingly important, and the UAE government has taken proactive measures to promote them, including the introduction of sustainable building codes, energy-efficient technologies, and renewable energy sources. Initiatives such as the Masdar City project and the Emirates Green Building Council further demonstrate the government's commitment to a cleaner and healthier environment. By adopting sustainable practices, the UAE can reduce its carbon footprint, lessen its reliance on fossil fuels, and achieve cost savings in the long run. The purpose of this paper is to conduct a thorough review of the current state of sustainability in the construction industry of the UAE. Our research methodology includes a local market survey and qualitative observational analysis of executed housing construction projects by the Mohammed Bin Rashid Housing Establishment. The market survey assesses eleven different challenging factors that affect sustainable construction project delivery. The qualitative observational research is based on data collected from three projects, including construction progress, bill of quantity, and construction program. The study concludes that addressing these challenges requires a collaborative team approach, incentivized contracts, traditional project management practices, an integrated project team, and an increase in sustainability awareness among stakeholders. The recommendations proposed in this study aim to promote and improve the application of sustainability in the UAE's construction industry for the future.

Keywords: sustainability, construction, challenges, opportunities, case study, market survey

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3738 The Korean Neo-Confucian Ideal of Pluralism and Han

Authors: Hyeon Sop Baek

Abstract:

This paper will investigate the Korean concept of han and suggest that the feeling of han is essentially inseparable from the central project of the Korean neo-Confucian philosophical tradition. Han is a complex sentiment, but one may characterize it as an internally directed complex of sentiments of frustration, sadness, and anger. In particular, this paper aims to demonstrate that the Korean neo-Confucian project's ultimate objective was to build a pluralistic world – where different people can coexist together in harmony and participate in building the ideal world. Nevertheless, the confrontation between the neo-Confucian idea – that every person has the intrinsic potential to be moral – and the bleakness of reality that made their objective virtually impossible to achieve led to the formation and development of the feeling of han. The paper will first examine the concept of han and what it entails and then investigate the core elements of Korean neo-Confucianism, examining the works of Korean neo-Confucians, including Toegye, Yulgok, and Jeong Dojeon. Furthermore, the concept of plurality will be drawn from the political theory of Hannah Arendt. While the Arendtian and Korean neo-Confucian philosophies are ultimately different, this paper will contend that the two philosophies' broader aims share many resonating points. Specifically, within both philosophies, the human plurality – that all humans are equal but not the same – underlies the foundation of an ideal political realm. From there, an argument that the difficulty faced by the neo-Confucians in Korea in constructing a polity based on the ideal of respect and human moral capacity ultimately contributed to the emergence of the sentiment han will be presented. In conclusion, this paper will demonstrate that the ultimate objectives of Korean Confucianism lie in closing the gap between the ideal and reality in moral cultivation as well as its political project of building an ideal, pluralistic world, and han emerges from the realization of the difficulty of achieving that goal. Finally, this paper will contest that han needs not be perceived negatively, and han can be a driving force for political participation in the contemporary democratic, pluralistic society.

Keywords: Korea, Confucianism, neo-Confucianism, philosophy, han, Korean philosophy

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3737 Assessing the Indicators Influencing Port Resilience: A Comprehensive Literature Review

Authors: Guo Rui, Cao Xinhu

Abstract:

In recent decades, the world has endured severe challenges in light of climate change, epidemics, geopolitics, terrorism, economic uncertainties, as well as regional conflicts and rivalries. The appropriate use of critical infrastructures (Cis) is confronted. Ports, as typical Cis cover more than 80% of the global freight movement. Within this context, even the minimal disruption of port operations could cause malfunction of the holistic supply chain network and substantial economic losses. Hence, it is crucial to evaluate port performance from the perspective of resilience. Research on resilience and risk/safety management has been increasing, however, it needs more attention, as it could prevent potential socio-economic losses and inspire decision-makers to make resilience-based decisions to answer the challenges, such as COVID-19. To facilitate better moves from decision-makers, ports need to identify proper factors influencing port resilience. Inappropriately influenced factor selection could have a cascading effect on undesirable port performances. Thus, a systematic evaluation of factors is essential to stimulate the improvement process of port resilience investigation. This study zooms into container ports considering their critical role in international trade and global supply chains. 440 articles are selected after relevance ranking, and consequently, 62 articles are scrutinized after the title and abstract screening. Forty-one articles are included for bibliographic analysis in the end. It is found that there is no standardized index system to measure port resilience. And most studies evaluate port resilience merely in the recovery phase. Only two articles cover absorption, adaption and recovery state. However, no literature involves the prevention state. Hence, a uniform resilience index system is expected with a clear resilience definition. And port safety and security should also be considered while evaluating port resilience.

Keywords: port resilience, port safety and security, literature review, index system, port performance

Procedia PDF Downloads 118
3736 Chemical Kinetics and Computational Fluid-Dynamics Analysis of H2/CO/CO2/CH4 Syngas Combustion and NOx Formation in a Micro-Pilot-Ignited Supercharged Dual Fuel Engine

Authors: Ulugbek Azimov, Nearchos Stylianidis, Nobuyuki Kawahara, Eiji Tomita

Abstract:

A chemical kinetics and computational fluid-dynamics (CFD) analysis was performed to evaluate the combustion of syngas derived from biomass and coke-oven solid feedstock in a micro-pilot ignited supercharged dual-fuel engine under lean conditions. For this analysis, a new reduced syngas chemical kinetics mechanism was constructed and validated by comparing the ignition delay and laminar flame speed data with those obtained from experiments and other detail chemical kinetics mechanisms available in the literature. The reaction sensitivity analysis was conducted for ignition delay at elevated pressures in order to identify important chemical reactions that govern the combustion process. The chemical kinetics of NOx formation was analyzed for H2/CO/CO2/CH4 syngas mixtures by using counter flow burner and premixed laminar flame speed reactor models. The new mechanism showed a very good agreement with experimental measurements and accurately reproduced the effect of pressure, temperature and equivalence ratio on NOx formation. In order to identify the species important for NOx formation, a sensitivity analysis was conducted for pressures 4 bar, 10 bar and 16 bar and preheat temperature 300 K. The results show that the NOx formation is driven mostly by hydrogen based species while other species, such as N2, CO2 and CH4, have also important effects on combustion. Finally, the new mechanism was used in a multidimensional CFD simulation to predict the combustion of syngas in a micro-pilot-ignited supercharged dual-fuel engine and results were compared with experiments. The mechanism showed the closest prediction of the in-cylinder pressure and the rate of heat release (ROHR).

Keywords: syngas, chemical kinetics mechanism, internal combustion engine, NOx formation

Procedia PDF Downloads 398
3735 An Empirical Exploration of Factors Influencing Lecturers' Acceptance of Open Educational Resources for Enhanced Knowledge Sharing in North-East Nigerian Universities

Authors: Bello, A., Muhammed Ibrahim Abba., Abdullahi, M., Dauda, Sabo, & Shittu, A. T.

Abstract:

This study investigated the Predictors of Lecturers Knowledge Sharing Acceptance on Open Educational Resources (OER) in North-East Nigerian in Universities. The study population comprised of 632 lecturers of Federal Universities in North-east Nigeria. The study sample covered 338 lecturers who were selected purposively from Adamawa, Bauchi and Borno State Federal Universities in Nigeria. The study adopted a prediction correlational research design. The instruments used for data collection was the questionnaire. Experts in the field of educational technology validated the instrument and tested it for reliability checks using Cronbach’s alpha. The constructs on lecturers’ acceptance to share OER yielded a reliability coefficient of; α = .956 for Performance Expectancy, α = .925; for Effort Expectancy, α = .955; for Social Influence, α = .879; for Facilitating Conditions and α = .948 for acceptance to share OER. the researchers contacted the Deanery of faculties of education and enlisted local coordinators to facilitate the data collection process at each university. The data was analysed using multiple sequential regression statistic at a significance level of 0.05 using SPSS version 23.0. The findings of the study revealed that performance expectancy (β = 0.658; t = 16.001; p = 0.000), effort expectancy (β = 0.194; t = 3.802; p = 0.000), social influence (β = 0.306; t = 5.246; p = 0.000), collectively indicated that the variables have a predictive capacity to stimulate lecturer’s acceptance to share their resources on OER repository. However, the finding revealed that facilitating conditions (β = .053; t = .899; p = 0.369), does not have a predictive capacity to stimulate lecturer’s acceptance to share their resources on OER repository. Based on these findings, the study recommends among others that the university management should consider adjusting OER policy to be centered around actualizing lecturers career progression.

Keywords: acceptance, lecturers, open educational resources, knowledge sharing

Procedia PDF Downloads 53
3734 Integrated Life Skill Training and Executive Function Strategies in Children with Autism Spectrum Disorder in Qatar: A Study Protocol for a Randomized Controlled Trial

Authors: Bara M Yousef, Naresh B Raj, Nadiah W Arfah, Brightlin N Dhas

Abstract:

Background: Executive function (EF) impairment is common in children with autism spectrum disorder (ASD). EF strategies are considered effective in improving the therapeutic outcomes of children with ASD. Aims: This study primarily aims to explore whether integrating EF strategies combined with regular occupational therapy intervention is more effective in improving daily life skills (DLS) and sensory integration/processing (SI/SP) skills than regular occupational therapy alone in children with ASD and secondarily aims to assess treatment outcomes on improving visual motor integration (VMI) skills. Procedures: A total of 92 children with ASD will be recruited and, following baseline assessments, randomly assigned to the treatment group (45-min once weekly individual occupational therapy plus EF strategies) and control group (45-min once weekly individual therapy sessions alone). Results and Outcomes: All children will be evaluated systematically by assessing SI/SP, DLS, and VMI, skills at baseline, 7 weeks, and 14 weeks of treatment. Data will be analyzed using ANCOVA and T-test. Conclusions and Implications: This single-blind, randomized controlled trial will provide empirical evidence for the effectiveness of EF strategies when combined with regular occupational therapy programs. Based on trial results, EF strategies could be recommended in multidisciplinary programs for children with ASD. Trial Registration: The trial has been registered in the clinicaltrail.gov for a registry, protocol ID: MRC-01-22-509 ClinicalTrials.gov Identifier: NCT05829577, registered 25th April 2023

Keywords: autism spectrum disorder, executive function strategies, daily life skills, sensory integration/processing, visual motor integration, occupational therapy, effectiveness

Procedia PDF Downloads 102
3733 Stimulating the Social Emotional Development of Children through Play Activities: The Role of Teachers and Parents Support

Authors: Mahani Razali, Nordin Mamat

Abstract:

The purpose of this research is to identify the teacher’s role and parent’s participation to develop children`s socio emotion through play activities. This research is based on three main objectives which are to identify children`s socio emotion during play activities, teacher’s role and parent’s participation to develop children`s socio emotion. This qualitative study was carried out among 25 pre-school children, three teachers and three parents as the research sample. On the other hand, parent’s support was obtained from their discussions, supervisions and communication at home. The data collection procedures involved structured observation which was to identify socio emotional development element among pre-school children through play activities; as for semi-structured interviews, it was done to study the perception of the teachers and parents on the acquired socio emotional development among the children. Besides, documentation analysis method was used as to triangulate acquired information with observations and interviews. In this study, the qualitative data analysis was tabulated in descriptive manner with frequency and percentage format. This study primarily focused on five main socio emotional elements among the pre-school children: 1) Cooperation, 2) Confidence and Courage, 3) Ability to communicate, 4) patience, and 5) Tolerance. The findings of this study were presented in the form of case to case manner from the researches sample. Findings revealed that the children showed positive outcomes on the socio emotional development during their play. Both teachers and parents showed positive perceptions towards the acquired socio emotional development during their play activities. In conclusion, this research summarizes that teacher’s role and parent’s support can improve children`s socio emotional development through play activities. As a whole, this research highlighted the significance of play activities as to stimulate socio emotional development among the pre-school children.

Keywords: social emotional, children, play activities, stimulating

Procedia PDF Downloads 397
3732 Entrepreneurial Orientation and Business Performance: The Case of Micro Scale Food Processors Operating in a War-Recovery Environment

Authors: V. Suganya, V. Balasuriya

Abstract:

The functioning of Micro and Small Scale (MSS) businesses in the northern part of Sri Lanka was vulnerable due to three decades of internal conflict and the subsequent post-war economic openings has resulted new market prospects for MSS businesses. MSS businesses survive and operate with limited resources and struggle to access finance, raw material, markets, and technology. This study attempts to identify the manner in which entrepreneurial orientation puts into practice by the business operators to overcome these business challenges. Business operators in the traditional food processing sector are taken for this study as this sub-sector of the food industry is developing at a rapid pace. A review of the literature was done to recognize the concepts of entrepreneurial orientation, defining MMS businesses and the manner in which business performance is measured. Direct interview method supported by a structured questionnaire is used to collect data from 80 respondents; based on a fixed interval random sampling technique. This study reveals that more than half of the business operators have opted to commence their business ventures as a result of identifying a market opportunity. 41 per cent of the business operators are highly entrepreneurial oriented in a scale of 1 to 5. Entrepreneurial orientation shows significant relationship and strongly correlated with business performance. Pro-activeness, innovativeness and competitive aggressiveness shows a significant relationship with business performance while risk taking is negative and autonomy is not significantly related to business performance. It is evident that entrepreneurial oriented business practices contribute to better business performance even though 70 per cent prefer the ideas/views of the support agencies than the stakeholders when making business decisions. It is recommended that appropriate training should be introduced to develop entrepreneurial skills focusing to improve business networks so that new business opportunities and innovative business practices are identified.

Keywords: Micro and Small Scale (MMS) businesses, entrepreneurial orientation (EO), food processing, business operators

Procedia PDF Downloads 483
3731 The Effects of the Interaction between Prenatal Stress and Diet on Maternal Insulin Resistance and Inflammatory Profile

Authors: Karen L. Lindsay, Sonja Entringer, Claudia Buss, Pathik D. Wadhwa

Abstract:

Maternal nutrition and stress are independently recognized as among the most important factors that influence prenatal biology, with implications for fetal development and poor pregnancy outcomes. While there is substantial evidence from non-pregnancy human and animal studies that a complex, bi-directional relationship exists between nutrition and stress, to the author’s best knowledge, their interaction in the context of pregnancy has been significantly understudied. The aim of this study is to assess the interaction between maternal psychological stress and diet quality across pregnancy and its effects on biomarkers of prenatal insulin resistance and inflammation. This is a prospective longitudinal study of N=235 women carrying a healthy, singleton pregnancy, recruited from prenatal clinics of the University of California, Irvine Medical Center. Participants completed a 4-day ambulatory assessment in early, middle and late pregnancy, which included multiple daily electronic diary entries using Ecological Momentary Assessment (EMA) technology on a dedicated study smartphone. The EMA diaries gathered moment-level data on maternal perceived stress, negative mood, positive mood and quality of social interactions. The numerical scores for these variables were averaged across each study time-point and converted to Z-scores. A single composite variable for 'STRESS' was computed as follows: (Negative mood+Perceived stress)–(Positive mood+Social interaction quality). Dietary intakes were assessed by three 24-hour dietary recalls conducted within two weeks of each 4-day assessment. Daily nutrient and food group intakes were averaged across each study time-point. The Alternative Healthy Eating Index adapted for pregnancy (AHEI-P) was computed for early, middle and late pregnancy as a validated summary measure of diet quality. At the end of each 4-day ambulatory assessment, women provided a fasting blood sample, which was assayed for levels of glucose, insulin, Interleukin (IL)-6 and Tumor Necrosis Factor (TNF)-α. Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) was computed. Pearson’s correlation was used to explore the relationship between maternal STRESS and AHEI-P within and between each study time-point. Linear regression was employed to test the association of the stress-diet interaction (STRESS*AHEI-P) with the biological markers HOMA-IR, IL-6 and TNF-α at each study time-point, adjusting for key covariates (pre-pregnancy body mass index, maternal education level, race/ethnicity). Maternal STRESS and AHEI-P were significantly inversely correlated in early (r=-0.164, p=0.018) and mid-pregnancy (-0.160, p=0.019), and AHEI-P from earlier gestational time-points correlated with later STRESS (early AHEI-P x mid STRESS: r=-0.168, p=0.017; mid AHEI-P x late STRESS: r=-0.142, p=0.041). In regression models, the interaction term was not associated with HOMA-IR or IL-6 at any gestational time-point. The stress-diet interaction term was significantly associated with TNF-α according to the following patterns: early AHEI-P*early STRESS vs early TNF-α (p=0.005); early AHEI-P*early STRESS vs mid TNF-α (p=0.002); early AHEI-P*mid STRESS vs mid TNF-α (p=0.005); mid AHEI-P*mid STRESS vs mid TNF-α (p=0.070); mid AHEI-P*late STRESS vs late TNF-α (p=0.011). Poor diet quality is significantly related to higher psychosocial stress levels in pregnant women across gestation, which may promote inflammation via TNF-α. Future prenatal studies should consider the combined effects of maternal stress and diet when evaluating either one of these factors on pregnancy or infant outcomes.

Keywords: diet quality, inflammation, insulin resistance, nutrition, pregnancy, stress, tumor necrosis factor-alpha

Procedia PDF Downloads 193
3730 Factors Affecting Women's Participation in Social, Political and Economic Decision-Making Positions at Kelemwollega Zone, Western Ethiopia

Authors: T. Aragaw, P. Gari

Abstract:

In spite of social, political, and economic marginalization, women are still considered as the backbone of Ethiopia, one of the least developed countries in the world. The general purpose of this study was to assess factors that affect participation of women in politics, social and economic decisions at Kelem-Wollega Administrative Zone of Oromia Regional State, Ethiopia. Data used in this paper is mainly primary, and a few secondary data were incorporated. Respondents were selected using a systematic random sampling method and were placed questionnaires containing open-ended and closed-ended. Focus group discussion was also used for the study subjects in two offices. According to the information collected from the KWAZ Development and Social Service Office, a total of 18,473 tax-paying employees are present in the Zone, which is 14% of the total population of the Zone. Among the total number of employees in the Zone, 2,617 have been recruited for this study based on the criteria stated. This showed 1.8% of them were comprised of several churches and religious owned integrated development projects in the KWAZ. The 2,103 (80.34%) study participants responded personally, and they completed and returned the questionnaire to the researchers. The study revealed that in public institutions existed in KWAZ, the majority of women were having an educational status of diploma and lower, practicing lower non-decision making and leadership positions. Conclusion: Major barriers hindering women include: Socio-cultural attitudes, lack of necessary experience, education, the burden of domestic responsibilities, and lack of role models of women leaders in the Zone. Empowerment of women via social organizations, critical involvement of the government, and Affirmative action for women is critical. Further research is needed on the scope and challenges in implementing the strategies.

Keywords: women, affirmative action, leadership, empowerment, Ethiopia

Procedia PDF Downloads 181
3729 From Homogeneous to Phase Separated UV-Cured Interpenetrating Polymer Networks: Influence of the System Composition on Properties and Microstructure

Authors: Caroline Rocco, Feyza Karasu, Céline Croutxé-Barghorn, Xavier Allonas, Maxime Lecompère, Gérard Riess, Yujing Zhang, Catarina Esteves, Leendert van der Ven, Rolf van Benthem Gijsbertus de With

Abstract:

Acrylates are widely used in UV-curing technology. Their high reactivity can, however, limit their conversion due to early vitrification. In addition, the free radical photopolymerization is known to be sensitive to oxygen inhibition leading to tacky surfaces. Although epoxides can lead to full polymerization, they are sensitive to humidity and exhibit low polymerization rate. To overcome the intrinsic limitations of both classes of monomers, Interpenetrating Polymer Networks (IPNs) can be synthesized. They consist of at least two cross linked polymers which are permanently entangled. They can be achieved under thermal and/or light induced polymerization in one or two steps approach. IPNs can display homogeneous to heterogeneous morphologies with various degrees of phase separation strongly linked to the monomer miscibility and also synthesis parameters. In this presentation, we synthesize UV-cured methacrylate - epoxide based IPNs with different chemical compositions in order to get a better understanding of their formation and phase separation. Miscibility before and during the photopolymerization, reaction kinetics, as well as mechanical properties and morphology have been investigated. The key parameters controlling the morphology and the phase separation, namely monomer miscibility and synthesis parameters have been identified. By monitoring the stiffness changes on the film surface, atomic force acoustic microscopy (AFAM) gave, in conjunction with polymerization kinetic profiles and thermomechanical properties, explanations and corroborated the miscibility predictions. When varying the methacrylate / epoxide ratio, it was possible to move from a miscible and highly-interpenetrated IPN to a totally immiscible and phase-separated one.

Keywords: investigation of properties and morphology, kinetics, phase separation, UV-cured IPNs

Procedia PDF Downloads 357
3728 Evaluating the Learning Outcomes of Physical Therapy Clinical Fieldwork Course

Authors: Hui-Yi Wang, Shu-Mei Chen, Mei-Fang Liu

Abstract:

Background and purpose: Providing clinical experience in medical education is an important discipline method where students can gradually apply their academic knowledge to clinical situations. The purpose of this study was to establish self-assessment questionnaires for students to assess their learning outcomes for two fields of physical therapy, orthopedic physical therapy, and pediatric physical therapy, in a clinical fieldwork course. Methods: The questionnaires were developed based on the core competence dimensions of the course. The content validity of the questionnaires was evaluated and established by expert meetings. Among the third-year undergraduate students who took the clinical fieldwork course, there were 49 students participated in this study. Teachers arranged for the students to study two professional fields, and each professional field conducted a three-week clinical lesson. The students filled out the self-assessment questionnaires before and after each three-week lesson. Results: The self-assessment questionnaires were established by expert meetings that there were six core competency dimensions in each of the two fields, with 20 and 21 item-questions, respectively. After each three-week clinical fieldwork, the self-rating scores in each core competency dimension were higher when compared to those before the course, indicating having better clinical abilities after the lessons. The best self-rating scores were the dimension of attitude and humanistic literacy, and the two lower scores were the dimensions of professional knowledge and skills and problem-solving critical thinking. Conclusions: This study developed questionnaires for clinical fieldwork courses to reflect students' learning outcomes, including the performance of professional knowledge, practice skills, and professional attitudes. The use of self-assessment of learning performance can help students build up their reflective competencies. Teachers can guide students to pay attention to the performance of abilities in each core dimension to enhance the effectiveness of learning through self-reflection and improvement.

Keywords: physical therapy, clinical fieldwork course, learning outcomes assessment, medical education, self-reflection ability

Procedia PDF Downloads 107
3727 Different Types of Amyloidosis Revealed with Positive Cardiac Scintigraphy with Tc-99M DPD-SPECT

Authors: Ioannis Panagiotopoulos, Efstathios Kastritis, Anastasia Katinioti, Georgios Efthymiadis, Argyrios Doumas, Maria Koutelou

Abstract:

Introduction: Transthyretin amyloidosis (ATTR) is a rare but serious infiltrative disease. Myocardial scintigraphy with DPD has emerged as the most effective, non-invasive, highly sensitive, and highly specific diagnostic method for cardiac ATTR amyloidosis. However, there are cases in which additional laboratory investigations reveal AL amyloidosis or other diseases despite a positive DPD scintigraphy. We describe the experience from the Onassis Cardiac Surgery Center and the monitoring center for infiltrative myocardial diseases of the cardiology clinic at AHEPA. Materials and Methods: All patients with clinical suspicion of cardiac or extracardiac amyloidosis undergo a myocardial scintigraphy scan with Tc-99m DPD. In this way, over 500 patients have been examined. Further diagnostic approach based on clinical and imaging findings includes laboratory investigation and invasive techniques (e.g., biopsy). Results: Out of 76 patients in total with positive myocardial scintigraphy Grade 2 or 3 according to the Perugini scale, 8 were proven to suffer from AL Amyloidosis during the investigation of paraproteinemia. Among these patients, 3 showed Grade 3 uptake, while the rest were graded as Grade 2, or 2 to 3. Additionally, one patient presented diffuse and unusual radiopharmaceutical uptake in soft tissues throughout the body without cardiac involvement. These findings raised suspicions, leading to the analysis of κ and λ light chains in the serum, as well as immunostaining of proteins in the serum and urine of these specific patients. The final diagnosis was AL amyloidosis. Conclusion: The value of DPD scintigraphy in the diagnosis of cardiac amyloidosis from transthyretin is undisputed. However, positive myocardial scintigraphy with DPD should not automatically lead to the diagnosis of ATTR amyloidosis. Laboratory differentiation between ATTR and AL amyloidosis is crucial, as both prognosis and therapeutic strategy are dramatically altered. Laboratory exclusion of paraproteinemia is a necessary and essential step in the diagnostic algorithm of ATTR amyloidosis for all positive myocardial scintigraphy with diphosphonate tracers since >20% of patients with Grade 3 and 2 uptake may conceal AL amyloidosis.

Keywords: AL amyloidosis, amyloidosis, ATTR, myocardial scintigraphy, Tc-99m DPD

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3726 Traumatic Brain Injury Neurosurgical Care Continuum Delays in Mulago Hospital in Kampala Uganda

Authors: Silvia D. Vaca, Benjamin J. Kuo, Joao Ricardo Nickenig Vissoci, Catherine A. Staton, Linda W. Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Henry E. Rice, Gerald A. Grant, Michael M. Haglund

Abstract:

Background: Patients with traumatic brain injury (TBI) can develop rapid neurological deterioration from swelling and intracranial hematomas, which can result in focal tissue ischemia, brain compression, and herniation. Moreover, delays in management increase the risk of secondary brain injury from hypoxemia and hypotension. Therefore, in TBI patients with subdural hematomas (SDHs) and epidural hematomas (EDHs), surgical intervention is both necessary and time sensitive. Significant delays are seen along the care continuum in low- and middle-income countries (LMICs) largely due to limited healthcare capacity to address the disproportional rates of TBI in Sub Saharan Africa (SSA). While many LMICs have subsidized systems to offset surgical costs, the burden of securing funds by the patients for medications, supplies, and CT diagnostics poses a significant challenge to timely surgical interventions. In Kampala Uganda, the challenge of obtaining timely CT scans is twofold: logistical and financial barriers. These bottlenecks contribute significantly to the care continuum delays and are associated with poor TBI outcomes. Objective: The objectives of this study are to 1) describe the temporal delays through a modified three delays model that fits the context of neurosurgical interventions for TBI patients in Kampala and 2) investigate the association between delays and mortality. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Four time intervals were constructed along five time points: injury, hospital arrival, neurosurgical evaluation, CT results, and definitive surgery. Time interval differences among mild, moderate and severe TBI and their association with mortality were analyzed. Results: The mortality rate of all TBI patients presenting to MNRH was 9.6%, which ranged from 4.7% for mild and moderate TBI patients receiving surgery to 81.8% for severe TBI patients who failed to receive surgery. The duration from injury to surgery varied considerably across TBI severity with the largest gap seen between mild TBI (174 hours) and severe TBI (69 hours) patients. Further analysis revealed care continuum differences for interval 3 (neurosurgical evaluation to CT result) and 4 (CT result to surgery) between severe TBI patients (7 hours for interval 3 and 24 hours for interval 4) and mild TBI patients (19 hours for interval 3, and 96 hours for interval 4). These post-arrival delays were associated with mortality for mild (p=0.05) and moderate TBI (p=0.03) patients. Conclusions: To our knowledge, this is the first analysis using a modified 'three delays' framework to analyze the care continuum of TBI patients in Uganda from injury to surgery. We found significant associations between delays and mortality for mild and moderate TBI patients. As it currently stands, poorer outcomes were observed for these mild and moderate TBI patients who were managed non-operatively or failed to receive surgery while surgical services were shunted to more severely ill patients. While well intentioned, high mortality rates were still observed for the severe TBI patients managed surgically. These results suggest the need for future research to optimize triage practices, understand delay contributors, and improve pre-hospital logistical referral systems.

Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, traumatic brain injury

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3725 Hypothesis on Annual Sea Level Variation and Increased Volume Transport in Korea Strait

Authors: Young-Taeg Kim, Gwang Ho Seo, Hyungju Oh, Ho Kyung Ha, Kuk Jin Kim

Abstract:

Kim et al., hypothesized an increase in volume transport in the Korea Strait based on the concurrent increase in water temperature and mean sea level observed by the Korea Hydrographic and Oceanographic Agency (KHOA) in the vicinity of the Korea Strait from 2000 to 2009. Since then, to our best knowledge, no definitive studies have been reported on the increase in volume transport through the Korea Strait, but the observed water temperature (2000-2021) and sea level (1989-2021) in the Korea Strait and East Sea have been found to be increasing. In particular, the rapid increase rate in the mean sea level rise (2.55~3.53 mm/y) in these areas cannot be explained by only steric effect due to the increased water temperature. It is more reasonable interpretation that the sea level rise is due to an increase in the volume transport of warm and salty currents. If the increase in the volume transport is explained by the geostrophic equation without considering the sea level rise in the Korea Strait, the current velocity should increase. However, up to now, there are no reports of an increase in current velocity from direct observations using ADCP (e.g., observations of Camellia) or from various numerical models. Therefore, the increase in volume transport cannot be explained by the geostrophic equation. Another possible explanation for the increase in the volume transport is the effect of wind. Although Korea is dominated by monsoon, it is affected by winds according to El Niño and La Niña, which have a cycle of about 3 to 4 years. During El Niño (La Niña), northerly winds (southerly winds) prevail in Korea. Consequently, it is inferred that the transported volume in the Korea Strait slowly increases interannually. However, in this study, it was difficult to find a clear correlation between annually-averaged mean sea level and El Niño (or La Niña) during 1989-2021. This is probably due to the interactions of the PDO (Pacific Decadal Oscillation) and AO (Arctic Oscillation) along with the ENSO (El niño-Southern Oscillation). However, it is clear that the interannual variability of winds is affecting the volume transport in the Korean Strait. On the other hand, the effect of global sea level rise on the volume transport in the Korea Strait is small compared to the interannual variability of the volume transport, but it seems to play a constant role.

Keywords: mean sea level, volume transport, El nino, La nina

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3724 Analysis of Human Toxicity Potential of Major Building Material Production Stage Using Life Cycle Assessment

Authors: Rakhyun Kim, Sungho Tae

Abstract:

Global environmental issues such as abnormal weathers due to global warming, resource depletion, and ecosystem distortions have been escalating due to rapid increase of population growth, and expansion of industrial and economic development. Accordingly, initiatives have been implemented by many countries to protect the environment through indirect regulation methods such as Environmental Product Declaration (EPD), in addition to direct regulations such as various emission standards. Following this trend, life cycle assessment (LCA) techniques that provide quantitative environmental information, such as Human Toxicity Potential (HTP), for buildings are being developed in the construction industry. However, at present, the studies on the environmental database of building materials are not sufficient to provide this support adequately. The purpose of this study is to analysis human toxicity potential of major building material production stage using life cycle assessment. For this purpose, the theoretical consideration of the life cycle assessment and environmental impact category was performed and the direction of the study was set up. That is, the major material in the global warming potential view was drawn against the building and life cycle inventory database was selected. The classification was performed about 17 kinds of substance and impact index, such as human toxicity potential, that it specifies in CML2001. The environmental impact of analysis human toxicity potential for the building material production stage was calculated through the characterization. Meanwhile, the environmental impact of building material in the same category was analyze based on the characterization impact which was calculated in this study. In this study, establishment of environmental impact coefficients of major building material by complying with ISO 14040. Through this, it is believed to effectively support the decisions of stakeholders to improve the environmental performance of buildings and provide a basis for voluntary participation of architects in environment consideration activities.

Keywords: human toxicity potential, major building material, life cycle assessment, production stage

Procedia PDF Downloads 126