Search results for: human remains
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9868

Search results for: human remains

6358 Curbing Abuses of Legal Power in the Society

Authors: Tajudeen Ojo Ibraheem

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In a world characterized by greed and the lust for power and its attendant trappings, abuse of legal power is nothing new to most of us. Legal abuses of power abound in all fields of human endeavour. Accounts of such abuses dominate the mass media and for the average individual, no single day goes by without his getting to hear about at least one such occurrence. This paper briefly looks at the meaning of legal power, what legal abuse is all about, its causes, and some of its manifestations in the society. Its consequences will also be discussed and some suggestions for reform will be made. In the course of the paper, references will be made to various jurisdictions around the world.

Keywords: abuse, legal, power, society

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6357 Evaluation of Feasibility of Ecological Sanitation in Central Nepal

Authors: K. C. Sharda

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Introduction: In the world, almost half of the population are lacking proper access to improved sanitation services. In Nepal, large number of people are living without access to any sanitation facility. Ecological sanitation toilet which is defined as water conserving and nutrient recycling system for use of human urine and excreta in agriculture would count a lot to utilize locally available resources, to regenerate soil fertility, to save national currency and to achieve the goal of elimination open defecation in country like Nepal. The objectives of the research were to test the efficacy of human urine for improving crop performance and to evaluate the feasibility of ecological sanitation in rural area of Central Nepal. Materials and Methods: The field investigation was carried out at Palung Village Development Committee (VDC) of Makawanpur District, Nepal from March – August, 2016. Five eco-san toilets in two villages (Angare and Bhot Khoriya) were constructed and questionnaire survey was carried out. During the questionnaire survey, respondents were asked about socio-economic parameters, farming practices, awareness of ecological sanitation and fertilizer value of human urine and excreta in agriculture. In prior to a field experiment, soil was sampled for analysis of basic characteristics. In the field experiment, cauliflower was cultivated for a month in the two sites to compare the fertilizer value of urine with chemical fertilizer and no fertilizer with three replications. The harvested plant samples were analyzed to understand the nutrient content in plant with different treatments. Results and Discussion: Eighty three percent respondents were engaged in agriculture growing mainly vegetables, which may raise the feasibility of ecological sanitation. In the study area, water deficiencies in dry season, high demand of chemical fertilizer, lack of sanitation awareness were found to be solved. The soil at Angare has sandier texture and lower nitrogen content compared to that in Bhot Khoriya. While the field experiment in Angare showed that the aboveground biomass of cauliflower in the urine fertilized plot were similar with that in the chemically fertilized plot and higher than those in the non-fertilized plots, no significant difference among the treatments were found in Bhot Khoriya. The more distinctive response of crop growth to the three treatments in the former might be attributed to the poorer soil productivity, which in turn could be caused by the poorer inherent soil fertility and the poorer past management by the farmer in Angare. Thus, use of urine as fertilizer could help poor farmers with low quality soil. The significantly different content of nitrogen and potassium in the plant samples among three treatments in Bhot Khoriya would require further investigation. When urine is utilized as a fertilizer, the productivity could be increased and the money to buy chemical fertilizer would be utilized in other livelihood activities. Ecological sanitation is feasible in the area with similar socio-economic parameter.

Keywords: cauliflower, chemical fertilizer, ecological sanitation, Nepal, urine

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6356 Poliovirus Vaccine Immunity among Chronically Malnourished Pakistani Infants: A Randomized Controlled Trial from Developing Country

Authors: Ali Faisal Saleem, Farheen Quadri, Mach Ondrej, Anita Zaidi

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Purpose: Pakistan is the final frontier for a polio-free world. Chronic malnutrition is associated with lack of effective gut immunity, and possibly associated with poliomyelitis in children received multiple OPV. We evaluate IPV dose administered together with OPV results in higher immunogenicity and mucosal immunity compared to OPV alone in chronically malnourished infants. Methods AND Materials: A community-based, unblinded-randomized-trial, conducted in 5 peri-urban, low-middle-income households of Karachi, in infants 9-12 months. Two study groups were non-malnourished (HAZ= -2 or more) and chronic malnourished (HAZ <-2SD), with 2-arms each i) OPV and ii) OPV and IPV. Two blood specimens (2ml) at baseline and at day 28 and two stool specimens (6 gm.) at day 29 and after 7 days. All infants received a bOPV challenge dose after first stool specimen. Calculates sample size was 210 in each arm. Serological (baseline compared to 28 days post-vaccine) and mucosal immunity after one week of bOPV challenge dose were study outcomes. Results: Baseline seroprevalence in malnourished infants were low compared to non-malnourished (P1, P2 and P3 (p=<0.001). There is significant rise in antibody titer and P1 seroprevalence in Mal A and B after receiving study vaccine; much higher in Mal B. Infants randomized to bOPV + IPV study vaccine showed incremental immune response against P1 (Mal B, 92.2%; Nor B, 98.4%), P2 (Mal B, 90.4%; Nor B, 94.7%), and P3 (Mal B, 85.6% and Nor B, 93.5%) was observed. A significant proportion of infants in malnourished (P1, 13%; P2, 24%; P3, 26%) and normally nourished group (P1, 5%; P2, 11%; P3, 14%) were found to be seronegative at baseline. Infants who received BOPV + IPV as their study vaccine showed a very high seroconversion response after vaccine (p=<0.001 for P1, P2 and P3). Majority of the specimens were negative at baseline (Mal A, 2%, Mal B, 1%; Nor A, 2%; Nor B, 1%), and remains negative after bOPV challenge dose (Mal A, 8%, Mal B, 6%; Nor A, 11%; Nor B, 10%). Conclusion: Malnourished-infants have low poliovirus-seroprevalence that increased remarkably after IPV. There is less viral shedding after IPV in infants.

Keywords: chronic malnutrition, infants, IPV, OPV

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6355 Ribosomal Protein S4 Gene: Exploring the Presence in Syrian Strain of Leishmania Tropica Genome, Sequencing it and Evaluating Immune Response of pCI-S4 DNA Vaccine

Authors: Alyaa Abdlwahab

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Cutaneous leishmaniasis represents a serious health problem in Syria; this problem has become noticeably aggravated after the civil war in the country. Leishmania tropica parasite is the main cause of cutaneous leishmaniasis in Syria. In order to control the disease, we need an effective vaccine against leishmania parasite. DNA vaccination remains one of the favorable approaches that have been used to face cutaneous leishmaniasis. Ribosomal protein S4 is responsible for important roles in Leishmania parasite life. DNA vaccine based on S4 gene has been used against infections by many species of Leishmania parasite but leishmania tropica parasite, so this gene represents a good candidate for DNA vaccine construction. After proving the existence of ribosomal protein S4 gene in a Syrian strain of Leishmania tropica (LCED Syrian 01), sequencing it and cloning it into pCI plasmid, BALB/C mice were inoculated with pCI-S4 DNA vaccine. The immune response was determined by monitoring the lesion progression in inoculated BALB/C mice for six weeks after challenging mice with Leishmania tropica (LCED Syrian 01) parasites. IL-12, IFN-γ, and IL-4 were quantified in draining lymph nodes (DLNa) of the immunized BALB/C mice by using the RT-qPCR technique. The parasite burden was calculated in the final week for the footpad lesion and the DLNs of the mice. This study proved the existence and the expression of the ribosomal protein S4 gene in Leishmania tropica (LCED Syrian 01) promastigotes. The sequence of ribosomal protein cDNA S4 gene was determined and published in Genbank; the gene size was 822 bp. Expression was also demonstrated at the level of cDNA. Also, this study revealed that pCI-S4 DNA vaccine induces TH1\TH2 response in immunized mice; this response prevents partially developing a dermal lesion of Leishmania.

Keywords: ribosomal protein S4, DNA vaccine, Leishmania tropica, BALB\c

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6354 Distribution and Historical Trends of PAHs Deposition in Recent Sediment Cores of the Imo River, SE Nigeria

Authors: Miranda I. Dosunmu, Orok E. Oyo-Ita, Inyang O. Oyo-Ita

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Polycyclic aromatic hydrocarbons (PAHs) are a class of priority listed organic pollutants due to their carcinogenicity, mutagenity, acute toxicity and persistency in the environment. The distribution and historical changes of PAHs contamination in recent sediment cores from the Imo River were investigated using gas chromatography coupled with mass spectrometer. The concentrations of total PAHs (TPAHs) ranging from 402.37 ng/g dry weight (dw) at the surface layer of the Estuary zone (ESC6; 0-5 cm) to 92,388.59 ng/g dw at the near surface layer of the Afam zone (ASC5; 5-10 cm) indicate that PAHs contamination was localized not only between sample sites but also within the same cores. Sediment-depth profiles for the four (Afam, Mangrove, Estuary and illegal Petroleum refinery) cores revealed irregular distribution patterns in the TPAH concentrations except the fact that these levels became maximized at the near surface layers (5-10 cm) corresponding to a geological time-frame of about 1996-2004. This time scale coincided with the period of intensive bunkering and oil pipeline vandalization by the Niger Delta militant groups. Also a general slight decline was found in the TPAHs levels from near the surface layers (5-10 cm) to the most recent top layers (0-5 cm) of the cores, attributable to the recent effort by the Nigerian government in clamping down the illegal activity of the economic saboteurs. Therefore, the recent amnesty period granted to the militant groups should be extended. Although mechanism of perylene formation still remains enigmatic, examination of its distributions down cores indicates natural biogenic, pyrogenic and petrogenic origins for the compound at different zones. Thus, the characteristic features of the Imo River environment provide a means of tracing diverse origins for perylene.

Keywords: perylene, historical trend, distribution, origin, Imo River

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6353 Influence of Climate Change on Landslides in Northeast India: A Case Study

Authors: G. Vishnu, T. V. Bharat

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Rainfall plays a major role in the stability of natural slopes in tropical and subtropical regions. These slopes usually have high slope angles and are stable during the dry season. The critical rainfall intensity that might trigger a landslide may not be the highest rainfall. In addition to geological discontinuities and anthropogenic factors, water content, suction, and hydraulic conductivity also play a role. A thorough geotechnical investigation with the principles of unsaturated soil mechanics is required to predict the failures in these cases. The study discusses three landslide events that had occurred in residual hills of Guwahati, India. Rainfall data analysis, history image analysis, land use, and slope maps of the region were analyzed and discussed. The landslide occurred on June (24, 26, and 28) 2020, on the respective sites, but the highest rainfall was on June (6 and 17) 2020. The factors that lead to the landslide occurrence is the combination of critical events initiated with rainfall, causing a reduction in suction. The sites consist of a mixture of rocks and soil. The slope failure occurs due to the saturation of the soil layer leading to loss of soil strength resulting in the flow of the entire soil rock mass. The land-use change, construction activities, other human and natural activities that lead to faster disintegration of rock mass may accelerate the landslide events. Landslides in these slopes are inevitable, and the development of an early warning system (EWS) to save human lives and resources is a feasible way. The actual time of failure of a slope can be better predicted by considering all these factors rather than depending solely on the rainfall intensities. An effective EWS is required with less false alarms in these regions by proper instrumentation of slope and appropriate climatic downscaling.

Keywords: early warning system, historic image analysis, slope instrumentation, unsaturated soil mechanics

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6352 Photocatalytic Degradation of Methylene Blue Dye Using Cuprous Oxide/Graphene Nanocomposite

Authors: Bekan Bogale, Tsegaye Girma Asere, Tilahun Yai, Fekadu Melak

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Aims: To study photocatalytic degradation of methylene blue dye on cuprous oxide/graphene nanocomposite. Background: Cuprous oxide (Cu2O) nanoparticles are among the metal oxides that demonstrated photocatalytic activity. However, the stability of Cu2O nanoparticles due to the fast recombination rate of electron/hole pairs remains a significant challenge in their photocatalytic applications. This, in turn, leads to mismatching of the effective bandgap separation, tending to reduce the photocatalytic activity of the desired organic waste (MB). To overcome these limitations, graphene has been combined with cuprous oxides, resulting in cuprous oxide/graphene nanocomposite as a promising photocatalyst. Objective: In this study, Cu2O/graphene nanocomposite was synthesized and evaluated for its photocatalytic performance of methylene blue (MB) dye degradation. Method: Cu2O/graphene nanocomposites were synthesized from graphite powder and copper nitrate using the facile sol-gel method. Batch experiments have been conducted to assess the applications of the nanocomposites for MB degradation. Parameters such as contact time, catalyst dosage, and pH of the solution were optimized for maximum MB degradation. The prepared nanocomposites were characterized by using UV-Vis, FTIR, XRD, and SEM. The photocatalytic performance of Cu2O/graphene nanocomposites was compared against Cu2O nanoparticles for cationic MB dye degradation. Results: Cu2O/graphene nanocomposite exhibits higher photocatalytic activity for MB degradation (with a degradation efficiency of 94%) than pure Cu2O nanoparticles (67%). This has been accomplished after 180 min of irradiation under visible light. The kinetics of MB degradation by Cu2O/graphene composites can be demonstrated by the second-order kinetic model. The synthesized nanocomposite can be used for more than three cycles of photocatalytic MB degradation. Conclusion: This work indicated new insights into Cu2O/graphene nanocomposite as high-performance in photocatalysis to degrade MB, playing a great role in environmental protection in relation to MB dye.

Keywords: methylene blue, photocatalysis, cuprous oxide, graphene nanocomposite

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6351 Nabokov’s Lolita: Externalization of Contemporary Mind in the Configuration of Hedonistic Aesthetics

Authors: Saima Murtaza

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Ethics and aesthetics have invariably remained the two closely integrated artistic appurtenances for the production of any work of art. These artistic devices configure themselves into a complex synthesis in our contemporary literature. The labyrinthine integration of ethics and aesthetics, operating in the lives of human characters, to the extent of transcending all limits has resulted in an artistic puzzle for the readers. Art, no doubt, is an extrinsic expression of the intrinsic life of man. The use of aesthetics in literature pertaining to human existence; aesthetic solipsism, has resulted in the artistic objectification of these characters. The practice of the like aestheticism deprives the characters of their souls, rendering them as mere objects of aesthetic gaze at the hands of their artists-creators. Artists orchestrate their lives founding it on a plot which deviates from normal social and ethical standards. Their perverse attitude can be seen in dealing with characters, their feelings and the incidents of their lives. Morality is made to appear not as a religious construct but as an individual’s private affair. Furthermore, the idea of beauty incarnated, in other words hedonistic aesthetic does not placate a true aesthete. Ethics and aesthetics are the two most recurring motifs of our contemporary literature, especially of Nabokov’s world. The purpose of this study is to peruse these aforementioned motifs in Nabokov’s most enigmatic novel Lolita, a story of pedophilia, which is in fact reflective of our complex individual psychic and societal patterns. The narrative subverts all the traditional and hitherto known notions of aesthetics and ethics. When applied to literature, aesthetic does not simply mean ‘beautiful’ in the text. It refers to an intricate relationship between feelings and perception and also incorporates within its range wide-ranging emotional reactions to text. The term aesthetics in literature is connected with the readers whose critical responses to the text determine the merit of any work to be really a piece of art. Aestheticism is the child of ethics. Morality sets the grounds for the production of any work and the idea of aesthetics gives it transcendence.

Keywords: ethics, aesthetics and hedonistic aesthetic, nymphet syndrome, pedophilia

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6350 Acceptance of Health Information Application in Smart National Identity Card (SNIC) Using a New I-P Framework

Authors: Ismail Bile Hassan, Masrah Azrifah Azmi Murad

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This study discovers a novel framework of individual level technology adoption known as I-P (Individual- Privacy) towards Smart National Identity Card health information application. Many countries introduced smart national identity card (SNIC) with various applications such as health information application embedded inside it. However, the degree to which citizens accept and use some of the embedded applications in smart national identity remains unknown to many governments and application providers as well. Moreover, the previous studies revealed that the factors of trust, perceived risk, privacy concern and perceived credibility need to be incorporated into more comprehensive models such as extended Unified Theory of Acceptance and Use of Technology known as UTAUT2. UTAUT2 is a mainly widespread and leading theory existing in the information system literature up to now. This research identifies factors affecting the citizens’ behavioural intention to use health information application embedded in SNIC and extends better understanding on the relevant factors that the government and the application providers would need to consider in predicting citizens’ new technology acceptance in the future. We propose a conceptual framework by combining the UTAUT2 and Privacy Calculus Model constructs and also adding perceived credibility as a new variable. The proposed framework may provide assistance to any government planning, decision, and policy makers involving e-government projects. The empirical study may be conducted in the future to provide proof and empirically validate this I-P framework.

Keywords: unified theory of acceptance and use of technology (UTAUT) model, UTAUT2 model, smart national identity card (SNIC), health information application, privacy calculus model (PCM)

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6349 Preparedness and Control of Mosquito-Borne Diseases: Experiences from Northwestern Italy

Authors: Federica Verna, Alessandra Pautasso, Maria Caramelli, Cristiana Maurella, Walter Mignone, Cristina Casalone

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Mosquito-Borne Diseases (MBDs) are dangerously increasing in prevalence, geographical distribution and severity, representing an emerging threat for both humans and animals. Interaction between multiple disciplines is needed for an effective early warning, surveillance and control of MBDs, according to the One Health concept. This work reports the integrated surveillance system enforced by IZSPLV in Piedmont, Liguria and Valle d’Aosta regions (Northwestern Italy) in order to control MDBs spread. Veterinary services and local human health authority are involved in an information network, to connect the surveillance of human clinical cases with entomological surveillance and veterinary monitoring in order to implement control measures in case of outbreak. A systematic entomological surveillance is carried out during the vector season using mosquitoes traps located in sites selected according to risk factors. Collected mosquitoes are counted, identified to species level by morphological standard classification keys and pooled by collection site, date and species with a maximum of 100 individuals. Pools are analyzed, after RNA extraction, by Real Time RT-PCR distinctive for West Nile Virus (WNV) Lineage 1 and Lineage 2, Real Time RT-PCR USUTU virus (USUV) and a traditional flavivirus End-point RT-PCR. Positive pools are sequenced and the related sequences employed to perform a basic local alignment search tool (BLAST) in the GenBank library. Positive samples are sent to the National Reference Centre for Animal Exotic Diseases (CESME, Teramo) for confirmation. With particular reference to WNV, after the confirmation, as provided by national legislation, control measures involving both local veterinary and human health services are activated: equine sera are randomly sampled within a 4 km radius from the positive collection sites and tested with ELISA kit and WNV NAT screening of blood donors is introduced. This surveillance network allowed to detect since 2011 USUV circulation in this area of Italy. WNV was detected in Piedmont and Liguria for the first time in 2014 in mosquitoes. During the 2015 vector season, we observed the expansion of its activity in Piedmont. The virus was detected in almost all Provinces both in mosquitoes (6 pools) and animals (19 equine sera, 4 birds). No blood bag tested resulted infected. The first neuroinvasive human case occurred too. Competent authorities should be aware of a potentially increased risk of MBDs activity during the 2016 vector season. This work shows that this surveillance network allowed to early detect the presence of MBDs in humans and animals, and provided useful information to public authorities, in order to apply control measures. Finally, an additional value of our diagnostic protocol is the ability to detect all viruses belonging to the Flaviviridae family, considering the emergence caused by other Flaviviruses in humans such as the recent Zika virus infection in South America. Italy has climatic and environmental features conducive to Zika virus transmission, the competent vector and many travellers from Brazil reported every year.

Keywords: integrated surveillance, mosquito borne disease, West Nile virus, Zika virus

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6348 Bionaut™: A Microrobotic Drug-Device Platform for the Local Treatment of Brainstem Gliomas

Authors: Alex Kiselyov, Suehyun Cho, Darrell Harrington; Florent Cros, Olin Palmer, John Caputo, Michael Kardosh, Eran Oren, William Loudon, Michael Shpigelmacher

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Despite the most aggressive surgical and adjuvant therapeutic strategies, treatment of both pediatric and adult brainstem tumors remains problematic. Novel strategies, including targeted biologics, immunotherapy, and specialized delivery systems such as convection-enhanced delivery (CED), have been proposed. While some of these novel treatments are entering phase I trials, the field is still in need of treatment(s) that exhibits dramatically enhanced potency with optimal therapeutic ratio. Bionaut Labs has developed a modular microrobotic platform for performing localized delivery of diverse therapeutics in vivo. Our biocompatible particles (Bionauts™) are externally propelled and visualized in real-time. Bionauts™ are specifically designed to enhance the effect of radiation therapy via anatomically precise delivery of a radiosensitizing agent, as exemplified by temozolomide (TMZ) and Avastin™ to the brainstem gliomas of diverse origin. The treatment protocol is designed to furnish a better therapeutic outcome due to the localized (vs systemic) delivery of the drug to the neoplastic lesion(s) for use as a synergistic combination of radiation and radiosensitizing agent. In addition, the procedure is minimally invasive and is expected to be appropriate for both adult and pediatric patients. Current progress, including platform optimization, selection of the lead radiosensitizer as well as in vivo safety studies of the Bionauts™ in large animals, specifically the spine and the brain of porcine and ovine models, will be discussed.

Keywords: Bionaut, brainstem, glioma, local delivery, micro-robot, radiosensitizer

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6347 An Approach to Building a Recommendation Engine for Travel Applications Using Genetic Algorithms and Neural Networks

Authors: Adrian Ionita, Ana-Maria Ghimes

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The lack of features, design and the lack of promoting an integrated booking application are some of the reasons why most online travel platforms only offer automation of old booking processes, being limited to the integration of a smaller number of services without addressing the user experience. This paper represents a practical study on how to improve travel applications creating user-profiles through data-mining based on neural networks and genetic algorithms. Choices made by users and their ‘friends’ in the ‘social’ network context can be considered input data for a recommendation engine. The purpose of using these algorithms and this design is to improve user experience and to deliver more features to the users. The paper aims to highlight a broader range of improvements that could be applied to travel applications in terms of design and service integration, while the main scientific approach remains the technical implementation of the neural network solution. The motivation of the technologies used is also related to the initiative of some online booking providers that have made the fact that they use some ‘neural network’ related designs public. These companies use similar Big-Data technologies to provide recommendations for hotels, restaurants, and cinemas with a neural network based recommendation engine for building a user ‘DNA profile’. This implementation of the ‘profile’ a collection of neural networks trained from previous user choices, can improve the usability and design of any type of application.

Keywords: artificial intelligence, big data, cloud computing, DNA profile, genetic algorithms, machine learning, neural networks, optimization, recommendation system, user profiling

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6346 Review of Strategies for Hybrid Energy Storage Management System in Electric Vehicle Application

Authors: Kayode A. Olaniyi, Adeola A. Ogunleye, Tola M. Osifeko

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Electric Vehicles (EV) appear to be gaining increasing patronage as a feasible alternative to Internal Combustion Engine Vehicles (ICEVs) for having low emission and high operation efficiency. The EV energy storage systems are required to handle high energy and power density capacity constrained by limited space, operating temperature, weight and cost. The choice of strategies for energy storage evaluation, monitoring and control remains a challenging task. This paper presents review of various energy storage technologies and recent researches in battery evaluation techniques used in EV applications. It also underscores strategies for the hybrid energy storage management and control schemes for the improvement of EV stability and reliability. The study reveals that despite the advances recorded in battery technologies there is still no cell which possess both the optimum power and energy densities among other requirements, for EV application. However combination of two or more energy storages as hybrid and allowing the advantageous attributes from each device to be utilized is a promising solution. The review also reveals that State-of-Charge (SoC) is the most crucial method for battery estimation. The conventional method of SoC measurement is however questioned in the literature and adaptive algorithms that include all model of disturbances are being proposed. The review further suggests that heuristic-based approach is commonly adopted in the development of strategies for hybrid energy storage system management. The alternative approach which is optimization-based is found to be more accurate but is memory and computational intensive and as such not recommended in most real-time applications.

Keywords: battery state estimation, hybrid electric vehicle, hybrid energy storage, state of charge, state of health

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6345 An Approximation Technique to Automate Tron

Authors: P. Jayashree, S. Rajkumar

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With the trend of virtual and augmented reality environments booming to provide a life like experience, gaming is a major tool in supporting such learning environments. In this work, a variant of Voronoi heuristics, employing supervised learning for the TRON game is proposed. The paper discusses the features that would be really useful when a machine learning bot is to be used as an opponent against a human player. Various game scenarios, nature of the bot and the experimental results are provided for the proposed variant to prove that the approach is better than those that are currently followed.

Keywords: artificial Intelligence, automation, machine learning, TRON game, Voronoi heuristics

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6344 Pulmonary Embolism Indicative of Myxoma of the Right Atrium

Authors: A. Kherraf, M. Bouziane, A. Drighil, L. Azzouzi, R. Habbal

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Objective: Myxomas are rare heart tumors most commonly found in the left atrium. The purpose of this observation is to report a rare case of myxoma of the right atrium revealed by pulmonary embolism. Observation: A 34-year-old patient with no history presented to the emergency room with sudden onset dyspnea. Clinical examination showed arterial pressure at 110/70mmHg, tachycardia at 110bpm, and 90% oxygen saturation. The ECG enrolled in incomplete right bundle branch block. The radio-thorax was normal. Echocardiography revealed the presence of a large homogeneous intra-OD mass, contiguous to the inter-atrial septum, prolapsing through the tricuspid valve, and causing mild tricuspid insufficiency, with dilation of the right ventricle and retained systolic function with PAPs estimated at 45mmHg. A chest scan was performed, revealing the presence of right segmental pulmonary embolism. The patient was put under anticoagulant and underwent surgical resection of the mass; its pathological examination concluded to a myxoma. The post-operative consequences were simple, without recurrence of the mass after one year follow-up. Discussion: Myxomas represent 50% of heart tumors. Most often, they originate in the left atrium, and more rarely in the right atrium or the ventricles. Myxoma of the right atrium can be responsible for life-threatening pulmonary embolism. The most predictive factor for embolization remains the morphology of the myxomas; papillary or villous myxomas are the most friable. Surgery is the standard treatment, with regular postoperative follow-up to detect recurrence. Conclusion: Myxomas of the right atrium are a rare location for these tumors. Pulmonary embolism is the main complication and should routinely involve careful study of the right chambers on echocardiography.

Keywords: pulmonary embolism, myxoma, right atrium, heart tumors

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6343 High Temperature and High Pressure Purification of Hydrogen from Syngas Using Metal Organic Framework Adsorbent

Authors: Samira Rostom, Robert Symonds, Robin W. Hughes

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Hydrogen is considered as one of the most important clean and renewable energy carriers for a sustainable energy future. However, its efficient and cost-effective purification remains challenging. This paper presents the potential of using metal–organic frameworks (MOFs) in combination with pressure swing adsorption (PSA) technology for syngas based H2 purification. PSA process analysis is done considering high pressure and elevated temperature process conditions, it reduces the demand for off-gas recycle to the fuel reactor and simultaneously permits higher desorption pressure, thereby reducing the parasitic load on the hydrogen compressor. The elevated pressure and temperature adsorption we present here is beneficial to minimizing overall process heating and cooling demand compared to existing processes. Here, we report the comparative performance of zeolite-5A, Cu-BTC, and the mix of zeolite-5A/Cu-BTC for H2 purification from syngas typical of those exiting water-gas-shift reactors. The MOFs were synthesized hydrothermally and then mixed systematically at different weight ratios to find the optimum composition based on the adsorption performance. The formation of different compounds were characterized by XRD, N2 adsorption and desorption, SEM, FT-IR, TG, and water vapor adsorption technologies. Single-component adsorption isotherms of CO2, CO, CH4, N2, and H2 over single materials and composites were measured at elevated pressures and different temperatures to determine their equilibrium adsorption capacity. The examination of the stability and regeneration performance of metal–organic frameworks was carried out using a gravimetric system at temperature ranges of 25-150℃ for a pressure range of 0-30 bar. The studies of adsorption/desorption on the MOFs showed selective adsorption of CO2, CH4, CO, and N2 over H2. Overall, the findings of this study suggest that the Ni-MOF-74/Cu-BTC composites are promising candidates for industrial H2 purification processes.

Keywords: MOF, H2 purification, high T, PSA

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6342 Disaster Management Supported by Unmanned Aerial Systems

Authors: Agoston Restas

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Introduction: This paper describes many initiatives and shows also practical examples which happened recently using Unmanned Aerial Systems (UAS) to support disaster management. Since the operation of manned aircraft at disasters is usually not only expensive but often impossible to use as well, in many cases managers fail to use the aerial activity. UAS can be an alternative moreover cost-effective solution for supporting disaster management. Methods: This article uses thematic division of UAS applications; it is based on two key elements, one of them is the time flow of managing disasters, other is its tactical requirements. Logically UAS can be used like pre-disaster activity, activity immediately after the occurrence of a disaster and the activity after the primary disaster elimination. Paper faces different disasters, like dangerous material releases, floods, earthquakes, forest fires and human-induced disasters. Research used function analysis, practical experiments, mathematical formulas, economic analysis and also expert estimation. Author gathered international examples and used own experiences in this field as well. Results and discussion: An earthquake is a rapid escalating disaster, where, many times, there is no other way for a rapid damage assessment than aerial reconnaissance. For special rescue teams, the UAS application can help much in a rapid location selection, where enough place remained to survive for victims. Floods are typical for a slow onset disaster. In contrast, managing floods is a very complex and difficult task. It requires continuous monitoring of dykes, flooded and threatened areas. UAS can help managers largely keeping an area under observation. Forest fires are disasters, where the tactical application of UAS is already well developed. It can be used for fire detection, intervention monitoring and also for post-fire monitoring. In case of nuclear accident or hazardous material leakage, UAS is also a very effective or can be the only one tool for supporting disaster management. Paper shows some efforts using UAS to avoid human-induced disasters in low-income countries as part of health cooperation.

Keywords: disaster management, floods, forest fires, Unmanned Aerial Systems

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6341 Unraveling the Complexity of Postpartum Distress: Examining the Influence of Alexithymia, Social Support, Partners' Support, and Birth Satisfaction on Postpartum Distress among Bulgarian Mothers

Authors: Stela Doncheva

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Postpartum distress, encompassing depressive symptoms, obsessions, and anxiety, remains a subject of significant scientific interest due to its prevalence among individuals giving birth. This critical and transformative period presents a multitude of factors that impact women's health. On the one hand, variables such as social support, satisfaction in romantic relationships, shared newborn care, and birth satisfaction directly affect the mental well-being of new mothers. On the other hand, the interplay of hormonal changes, personality characteristics, emotional difficulties, and the profound life adjustments experienced by mothers can profoundly influence their self-esteem and overall physical and emotional well-being. This paper extensively explores the factors of alexithymia, social support, partners' support, and birth satisfaction to gain deeper insights into their impact on postpartum distress. Utilizing a qualitative survey consisting of six self-reflective questionnaires, this study collects valuable data regarding the individual postpartum experiences of Bulgarian mothers. The primary objective is to enrich our understanding of the complex factors involved in the development of postpartum distress during this crucial period. The results shed light on the intricate nature of the problem and highlight the significant influence of bio-psycho-social elements. By contributing to the existing knowledge in the field, this research provides valuable implications for the development of interventions and support systems tailored to the unique needs of mothers in the postpartum period. Ultimately, this study aims to improve the overall well-being of new mothers and promote optimal maternal health during the postpartum journey.

Keywords: maternal mental health, postpartum distress, postpartum depression, postnatal mothers

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6340 Europe's War on Refugees: The Increased Need for International Protection and Promotion of Migrant Rights

Authors: Rai Friedman

Abstract:

The recent migrant crisis has revealed an unmet demand for increased international protection and promotion of migrant rights. Europe has found itself at the centre of the migration crisis, being the recipient to the largest number of asylum-seekers since the conclusion of the second World War. Rather than impart a unified humanitarian lens of offering legal protections, the Schengen territory is devising new, preventative measures to confront the influx of asylum-seekers. This paper will focus on the refugee crisis in Europe as it relates to the Central Mediterranean route. To do so, it will outline the increased need for international protection for migrant rights through analyzing historic human rights treaties and conventions; the formation of the current composition of the Schengen area; the evolutionary changes in policies and legal landscapes throughout Europe and the Central Mediterranean route; the vernacular transformation surrounding refugees, migrants, and asylum-seekers; and expose the gaps in international protection. It will also discuss Europe’s critical position, both geographically and conceptually, critiquing the notion of European victimization. Lastly, it will discuss the increased harm of preventative border measures and argue for tangible sustainability solutions through economic programming models in highly vulnerable countries. To do so, this paper will observe a case study in Algeria that has conceded to an economic programming model for forced migrants. In 2017 amid worker shortages, Algeria announced it would grant African migrants’ legal status to become agriculturalists and construction workers. Algeria is one of the few countries along the Central Mediterranean route that has adopted a law to govern foreign nationals’ conditions of entry, stay and circulation. Thereafter, it will provide recommendations for solutions for forced migration along the Central Mediterranean route and advocate for strengthened protections under international law.

Keywords: refugees, migrants, human rights, middle east, Africa, mediterranean, international humanitarian law, policy

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6339 The Effect of Vitamin D Supplementation on Prostate Cancer: A Systematic Review and Meta-Analysis of Clinical Trials

Authors: Simin Shahvazi, Sepideh Soltani, Seyed Mehdi Ahmadi, Russell J. De Souza, Amin Salehi-Abargouei

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Background and Objectives: Vitamin D has received attention for its potential to disrupt cancer processes such as attenuating cell proliferation and exacerbating differentiation and apoptosis. However, whether there exists a role for vitamin D in the treatment of prostate cancer specifically remains controversial. We systematically review the literature to assess whether supplementation with vitamin D influences PSA response and overall survival in patients with prostate cancer. Methods: We searched PubMed, Scopus, ISI Web of Science and Google scholar from inception through up to 10 September 2017 for both before-and-after and randomized trials that evaluated the effect of vitamin D supplementation on the prostate specific antigen (PSA) response rate in participants with prostate cancer. The DerSimonian and Laird, inverse-weighted random-effects model was used to pool effect estimates from the studies. Heterogeneity and potential publication bias were evaluated. Subgroup analyses were also performed. Results: Twenty-two studies (16 before-after and 6 randomized controlled trials) were found and included in meta-analysis. The analysis on controlled clinical trials revealed that PSA change from baseline [weighted mean difference (WMD) = -1.66 ng/ml, 95%CI: -0.69, 0.36, P= 0.543)], PSA response (RR=1.18, 95%CI: 0.97, 1.45, P=0.104) and mortality rate (risk ratio (RR) = 1.05, 95% CI: 0.81-1.36; P=0.713) was not significantly different between vitamin D supplementation and placebo groups. Single arm trials revealed that vitamin D supplementation had had a modest effect on PSA response rate: 19% of those enrolled had at least a 50% reduction in PSA by the end of treatment (95% CI: 7% to 31%; p=0.002). Conclusion: We found that vitamin D modestly increases the PSA response rate in single arm studies. No effect on serum PSA levels, PSA response and mortality was seen in randomized controlled clinical trials. It does not seem patients with prostate cancer benefit from vitamin D supplementation.

Keywords: mortality, prostatic neoplasms, PSA response, vitamin D

Procedia PDF Downloads 186
6338 A Retrospective Cross-Sectional Study on the Prevalence and Factors Associated with Virological Non-Suppression among HIV-Positive Adult Patients on Antiretroviral Therapy in Woliso Town, Oromia, Ethiopia

Authors: Teka Haile, Behailu Hawulte, Solomon Alemayehu

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Background: HIV virological failure still remains a problem in HV/AIDS treatment and care. This study aimed to describe the prevalence and identify the factors associated with viral non-suppression among HIV-positive adult patients on antiretroviral therapy in Woliso Town, Oromia, Ethiopia. Methods: A retrospective cross-sectional study was conducted among 424 HIV-positive patient’s attending antiretroviral therapy (ART) in Woliso Town during the period from August 25, 2020 to August 30, 2020. Data collected from patient medical records were entered into Epi Info version 2.3.2.1 and exported to SPSS version 21.0 for analysis. Logistic regression analysis was done to identify factors associated with viral load non-suppression, and statistical significance of odds ratios were declared using 95% confidence interval and p-value < 0.05. Results: A total of 424 patients were included in this study. The mean age (± SD) of the study participants was 39.88 (± 9.995) years. The prevalence of HIV viral load non-suppression was 55 (13.0%) with 95% CI (9.9-16.5). Second-line ART treatment regimen (Adjusted Odds Ratio (AOR) = 8.98, 95% Confidence Interval (CI): 2.64, 30.58) and routine viral load testing (AOR = 0.01, 95% CI: 0.001, 0.02) were significantly associated with virological non-suppression. Conclusion: Virological non-suppression was high, which hinders the achievement of the third global 95 target. The second-line regimen and routine viral load testing were significantly associated with virological non-suppression. It suggests the need to assess the effectiveness of antiretroviral drugs for epidemic control. It also clearly shows the need to decentralize third-line ART treatment for those patients in need.

Keywords: virological non-suppression, HIV-positive, ART, Woliso town, Ethiopia

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6337 Profiling of the Cell-Cycle Related Genes in Response to Efavirenz, a Non-Nucleoside Reverse Transcriptase Inhibitor in Human Lung Cancer

Authors: Rahaba Marima, Clement Penny

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The Health-related quality of life (HRQoL) for HIV positive patients has improved since the introduction of the highly active antiretroviral treatment (HAART). However, in the present HAART era, HIV co-morbidities such as lung cancer, a non-AIDS (NAIDS) defining cancer have been documented to be on the rise. Under normal physiological conditions, cells grow, repair and proliferate through the cell-cycle as cellular homeostasis is important in the maintenance and proper regulation of tissues and organs. Contrarily, the deregulation of the cell-cycle is a hallmark of cancer, including lung cancer. The association between lung cancer and the use of HAART components such as Efavirenz (EFV) is poorly understood. This study aimed at elucidating the effects of EFV on the cell-cycle genes’ expression in lung cancer. For this purpose, the human cell-cycle gene array composed of 84 genes was evaluated on both normal lung fibroblasts (MRC-5) cells and adenocarcinoma (A549) lung cells, in response to 13µM EFV or 0.01% vehicle. The ±2 up or down fold change was used as a basis of target selection, with p < 0.05. Additionally, RT-qPCR was done to validate the gene array results. Next, In-silico bio-informatics tools, Search Tool for the Retrieval of Interacting Genes/Proteins (STRING), Reactome, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway and Ingenuity Pathway Analysis (IPA) were used for gene/gene interaction studies as well as to map the molecular and biological pathways influenced by the identified targets. Interestingly, the DNA damage response (DDR) pathway genes such as p53, Ataxia telangiectasia mutated and Rad3 related (ATR), Growth arrest and DNA damage inducible alpha (GADD45A), HUS1 checkpoint homolog (HUS1) and Role of radiation (RAD) genes were shown to be upregulated following EFV treatment, as revealed by STRING analysis. Additionally, functional enrichment analysis by the KEGG pathway revealed that most of the differentially expressed gene targets function at the cell-cycle checkpoint such as p21, Aurora kinase B (AURKB) and Mitotic Arrest Deficient-Like 2 (MAD2L2). Core analysis by IPA revealed that p53 downstream targets such as survivin, Bcl2, and cyclin/cyclin dependent kinases (CDKs) complexes are down-regulated, following exposure to EFV. Furthermore, Reactome analysis showed a significant increase in cellular response to stress genes, DNA repair genes, and apoptosis genes, as observed in both normal and cancerous cells. These findings implicate the genotoxic effects of EFV on lung cells, provoking the DDR pathway. Notably, the constitutive expression of this pathway (DDR) often leads to uncontrolled cell proliferation and eventually tumourigenesis, which could be the attribute of HAART components’ (such as EFV) effect on human cancers. Targeting the cell-cycle and its regulation holds a promising therapeutic intervention to the potential HAART associated carcinogenesis, particularly lung cancer.

Keywords: cell-cycle, DNA damage response, Efavirenz, lung cancer

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6336 ICAM1 Expression is Enhanced by TNFa through Histone Methylation in Human Brain Microvessel Cells

Authors: Ji-Young Choi, Jungjin Kim, Sang-Sun Yun, Sangmee Ahn Jo

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Intracellular adhesion molecule1 (ICAM1) is a mediator of inflammation and involved in adhesion and transmigration of leukocytes to endothelial cells, resulting in enhancement of brain inflammation. We hypothesized that increase of ICAM1 expression in endothelial cells is an early step in the pathogenesis of brain diseases such as Alzheimer’s disease. Here, we report that ICAM1 expression is regulated by pro-inflammatory cytokine TNFa in human microvascular endothelial cell (HBMVEC). TNFa significantly increased ICAM1 mRNA and protein levels at the concentrations showing no cell toxicity. This increase was also shown in micro vessels of mouse brain 24 hours after treatment with TNFa (8 mg/kg, i.v). We then investigated the epigenetic mechanism involved in the induction of ICAM1 expression. Chromatin immunoprecipitation assay revealed that TNFa reduced methylation of histone3K9 (H3K9-2me) and histone3K27 (H3K27-3me), well-known modification as gene suppression, with in the ICAM1 promoter region. However, acetylation of H3K9 and H3K14, well-known modification as gene activation, was not changed by TNFa. Treatment of BIX01294, a specific inhibitor of histone methyltransferase G9a responsible for H3K9-2me, dramatically increased in ICAM1 mRNA and protein levels and overexpression of G9a gene suppressed TNFa-induced ICAM1 expression. In contrast, GSK126, an inhibitor of histone methyltransferase EZH2 responsible for H3K27-3me and valproic acid, an inhibitor of histone deacetylase (HDAC) did not affect ICAM1 expression. These results suggested that histone3 methylation is involved in ICAM1 repression. Moreover, TNFa or BIX01294-induced ICAM induction resulted in both enhancements in adhesion and transmigration of leukocyte on endothelial cell. This study demonstrates that TNFa upregulates ICAM1 expression through H3K9-2me and H3K27-3me within the ICAM1 promoter region, in which G9a is likely to play a pivotal role in ICAM1 transcription. Our study provides a novel mechanism for ICAM1 transcription regulation in HBMVEC.

Keywords: ICAM1, TNFa, HBMVEC, H3K9-2me

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6335 Value of Unilateral Spinal Anaesthesia For Hip Fracture Surgery In The Elderly (75 Cases)

Authors: Fedili Benamar, Beloulou Mohamed Lamine, Ouahes Hassane, Ghattas Samir

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Background and aims: While in Western countries, unilateral spinal anesthesia has been widely practiced for a long time, it remains little known in the local anesthesia community, and has not been the object of many studies. However, it is a simple, practical and effective technique. Our objective was to evaluate this practice in emergency anesthesia management in frail patients and to compare it with conventional spinal anesthesia. Methods: This is a prospective, observational, comparative study between hypobaric unilateral and conventional spinal anaesthesia for hip fracture surgery carried out in the operating room of the university military hospital of Staoueli. The work was spread over of 12-month period from 2019 to 2020. The parameters analyzed were hemodynamic variations, vasopressor use, block efficiency, postoperative adverse events, and postoperative morphine consumption. Results: -75 cases (mean age 72±14 years) -Group1= 41 patients (54.6%) divided into (ASA1=14.6% ASA2=60.98% ASA3=24.39%) single shoot spinal anaesthesia -Group2= 34 patients (45.3%) divided into (ASA1=2.9%, ASA2=26.4% ASA3=61.7%, ASA4=8.8%) unilateral hypobaric spinal anesthesia. -Hemodynamic variations were more severe in group 1 (51% hypotension) compared to 30% in group 2 RR=1.69 and odds ratio=2.4 -these variations were more marked in the ASA3 subgroup (group 1=70% hypotension versus group 2=30%) with an RR=2.33 and an odds ratio=5.44 -39% of group 1 required vasoactive drugs (15mg +/- 11) versus 32% of group 2 (8mg+/- 6.49) - no difference in the use of morphine in post-op. Conclusions: Within the limits of the population studied, this work demonstrates the clinical value of unilateral spinal anesthesia in ortho-trauma surgery in the frail patient.

Keywords: spinal anaesthesia, vasopressor, morphine, hypobaric unilateral spinal anesthesia, ropivacaine, hip surgery, eldery, hemodynamic

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6334 Free Secondary Education in Tanzania: Prospects, Challenges, and Proposals

Authors: Yazidu Saidi Mbalamula

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Free Basic Education (FBE) policy implementation in Secondary Schools has been one of thrilled undertaking both to the government and household in Tanzania. On the one hand, the government has achieved citizenry acceptance to responsibility and accountability, and on the other hand, the household has been relieved from social costs that were unbearable and deprived many Tanzanians access to basic education and secondary education in particular. Specifically, this study presents a descriptive survey conducted in two districts of Kagera region located at the northern part of Tanzania. Three objectives were pursued to identify achievements realized and challenges in the FBE implementation, and also stakeholders’ proposals were explored on how to improve FBE implementation. A sample of 91 respondents, including school managers, teachers, students, and parents, were involved in the study. Both questionnaires and interviews were used whereby the quantitative data were analyzed using Statistical Package for Social Sciences (SPSS), and content analysis was used to analyze the qualitative data. The results show that implementation of free education policy in secondary schools had far positive impact on the improvement of school management, school attendance, reduced school drop-out, reduced parents-school managers conflicts, and increased enrollment rates. Notwithstanding that, the political machinery remains instrumental to instigate policy reforms in education sector. Nevertheless, the alienating interests of politibureau, often top-down and blanketed by superficial government redness, can hardly be feasible to wield such huge programme given staggering stakeholders’ awareness of the actual requirements and unlatching resources to back up policy implementation. The study recommends that further studies on stakeholders’ conceptions on the FBE and equity of financing of basic education in Tanzania.

Keywords: capitation grant, CCM, free basic education, kagera, education policy

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6333 Requests and Responses to Requests in Jordanian Arabic

Authors: Raghad Abu Salma, Beatrice Szczepek Reed

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Politeness is one of the most researched areas in pragmatics as it is key to interpersonal interactional phenomena. Many studies, particularly in linguistics, have focused on developing politeness theories and exploring linguistic devices used in communication to construct and establish social norms. However, the question of what constitutes polite language remains a point of ongoing debate. Prior research primarily examined politeness in English and its native speaking communities, oversimplifying the notion of politeness and associating it with surface-level language use. There is also a dearth of literature on politeness in Arabic, particularly in the context of Jordanian Arabic. Prior research investigating politeness in Arabic make generalized claims about politeness in Arabic without taking the linguistic variations into account or providing empirical evidence. This proposed research aims to explore how Jordanian Arabic influences its first language users in making and responding to requests, exploring participants' perceptions of politeness and the linguistic choices they make in their interactions. The study focuses on Jordanian expats living in London, UK providing an intercultural perspective that prior research does not consider. This study employs a mixed-methods approach combining discourse completion tasks (DCTs) with semi-structured interviews. While DCTs provide insight into participants’ linguistic choices, semi-structured interviews glean insight into participants' perceptions of politeness and their linguistic choices impacted by cultural norms and diverse experiences. This paper discusses previous research on politeness in Arabic, identifies research gaps, and discusses different methods for data collection. This paper also presents preliminary findings from the ongoing study.

Keywords: politeness, pragmatics, jordanian arabic, intercultural politeness

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6332 Network Analysis and Sex Prediction based on a full Human Brain Connectome

Authors: Oleg Vlasovets, Fabian Schaipp, Christian L. Mueller

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we conduct a network analysis and predict the sex of 1000 participants based on ”connectome” - pairwise Pearson’s correlation across 436 brain parcels. We solve the non-smooth convex optimization problem, known under the name of Graphical Lasso, where the solution includes a low-rank component. With this solution and machine learning model for a sex prediction, we explain the brain parcels-sex connectivity patterns.

Keywords: network analysis, neuroscience, machine learning, optimization

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6331 Evaluating the Management of Febrile Infants (Less than 90 Days) Presenting to Tallaght Ed- Completed Audit Cycle

Authors: Amel Osman, Stewart McKenna

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Aim: Fever may present as the sole sign of a serious underlying infection in young infants. Febrile Infants aged less than 90 days are at an elevated susceptibility to invasive bacterial infections, thus presenting a challenge in ensuring the appropriate management of these cases. This study aims to ensure strict adherence to NICE guidelines for the management of fever in infants between 0 and 90 days presenting to Tallaght Hospital ED. A comprehensive audit, followed by a re-audit, was conducted to enhance the quality of care delivered to these patients. In accordance with NICE guidelines, all febrile infants should undergo blood tests. Additionally, LP should be performed in all neonates under 28 days, infants displaying signs of illness, and those with WCC below 5 or above 15. Method: A retrospective case review was performed, encompassing all patients aged between 0 to 90 days who presented with fever at Tallaght ED. Data retrieval was conducted from electronic records on two separate occasions, six months apart. The evaluation encompassed the assessment of body temperature as well as both partial and full septic workups. Results: Over the study period, 150 infants presented to the ED with fever in the initial audit, and 120 in the re-audit. In the first study, 81 patients warranted a full septic workup as per NICE, but only 48 received it. Conversely, 40 patients met criteria for a partial septic workup, with 12 undergoing blood tests. In the second study, 73 patients qualified for a full septic workup, of which 52 were completed. Additionally, 27 patients were indicated for a partial workup, with 20 undergoing blood tests. Conclusion: Managing febrile infants under three months of age presenting to Tallaght ED remains a persistent challenge, underscoring the need for continuous educational initiatives to guarantee that these patients receive the requisite assessments and treatments.

Keywords: infants, fever, septic workup, tallaght

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6330 Pricing and Economic Benefits of Commercial Insurance Incorporated into Home-based Hospice Care

Authors: Lie-Fen Lin, Tzu-Hsuan Lin, Ching-Heng Lin

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Hospice care for terminally ill patients provides not only a better quality of life but also cost-saving benefits. However, the utilization of home-based hospice care (HBH care) remains low even for countries covered by National Health Insurance (NHI) programs in Taiwan. In the current commercial insurance policy, only hospital-based hospice benefits were covered. It may have an influence on the insureds chosen to receive end-of-life care in a hospitalized manner. Thus, how to propose a feasible method to advocate HBH care utilization rate of public health policies is an important issue. A total of 130,219 cancer decedents in the year 2011-2013 from the National Health Insurance Research Database (NHIRD) in Taiwan were included in this study. By adding a day volume pays benefits of HBH care as a commercial insurance rider, will provide alternative benefits for the insureds. A multiple-state Markov chain model was incorporated to estimate the transition intensities of patients in different states at the end of their lives (Non-hospice, HBH, hospital-based hospice), and the premiums were estimated. HBH care insurance benefits provide financial support and reduce the burden of care for patients. The rate-making of this product is very sensitive while the utilization rate is rising, especially for high ages. The proposed HBH care insurance is a feasible way to reduce the financial burden, enhance the care quality and family satisfaction of insureds. Meanwhile, insurance companies can participate in advocating a good medical policy to enhance the social image. In addition, the medical costs of NHI can reduce effectively.

Keywords: home-based hospice care, commercial insurance, Markov chain model, the day volume pays

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6329 A Two Arm Double Parallel Randomized Controlled Trail of the Effects of Health Education Intervention on Insecticide Treated Nets Use and Its Practices among Pregnant Women Attending Antenatal Clinic: Study Protocol

Authors: Opara Monica, Suriani Ismail, Ahmad Iqmer Nashriq Mohd Nazan

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The true magnitude of the mortality and morbidity attributable to malaria worldwide is, at best, a scientific guess, although it is not disputable that the greatest burden is in sub-Saharan Africa. Those at highest risk are children younger than 5 years and pregnant women, particularly primigravidae. Nationally, malaria remains the third leading cause of death and is still considered a major public health problem. Therefore, this study is aimed to assess the effectiveness of health education intervention on insecticide-treated net use and its practices among pregnant women attending antenatal clinics. Materials and Methods: This study will be an intervention study with two arms double parallel randomized controlled trial (blinded) to be conducted in 3 stages. The first stage will develop health belief model (HBM) program, while in the second stage, pregnant women will be recruited, assessed (baseline data), randomized into two arms of the study, and follow-up for six months. The third stage will evaluate the impact of the intervention on HBM and disseminate the findings. Data will be collected with the use of a structured questionnaire which will contain validated tools. The main outcome measurement will be the treatment effect using HBM, while data will be analysed using SPSS, version 22. Discussion: The study will contribute to the existing knowledge on hospital-based care programs for pregnant women in developing countries where the literature is scanty. It will generally give insight into the importance of HBM measurement in interventional studies on malaria and other related infectious diseases in this setting.

Keywords: malaria, health education, insecticide-treated nets, sub-Saharan Africa

Procedia PDF Downloads 106