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Authors: Raeed Alanazi

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Introduction: Nursing students have a crucial role to play in the inhibition of infectious diseases and, therefore, must be trained in infection control and prevention modules prior to entering clinical settings. Simulations have been found to have a positive impact on infection control skills and the use of standard precautions. Aim: The purpose of this study was to use the four sources of self-efficacy in explaining the level of clinical self-efficacy and adherence to infection control practices in Saudi nursing students during simulation practice. Method: A cross-sectional design with convenience sampling was used. This study was conducted in all Saudi nursing schools, with a total number of 197 students participated in this study. Three scales were used simulation self- efficacy Scale (SSES), the four sources of self-efficacy scale (SSES), and Compliance with Standard Precautions Scale (CSPS). Multiple linear regression was used to test the use of the four sources of self-efficacy (SSES) in explaining level of clinical self-efficacy and adherence to infection control in nursing students. Results: The vicarious experience subscale (p =.044) was statistically significant. The regression model indicated that for every one unit increase in vicarious experience (observation and reflection in simulation), the participants’ adherence to infection control increased by .13 units (β =.22, t = 2.03, p =.044). In addition, the regression model indicated that for every one unit increase in education level, the participants’ adherence to infection control increased by 1.82 units (beta=.34= 3.64, p <.001). Also, the mastery experience subscale (p <.001) and vicarious experience subscale (p = .020) were shared significant associations with clinical self-efficacy. Conclusion: The findings of this research support the idea that simulation-based learning can be a valuable teaching-learning method to help nursing students develop clinical competence, which is essential in providing quality and safe nursing care.

Keywords: simulation-based learning, clinical self-efficacy, infection control, nursing students

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Authors: Andrea Palazzo, Daniel Macek, Veronika Malinova

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Contour processing is the new technology challenge for architects and construction companies. The many advantages it promises make it one of the most interesting solutions for construction in terms of automation of building processes. The technology for 3D printing houses offers many application possibilities, from low-cost construction, to being considered by NASA for visionary projects as a good solution for building settlements on other planets. Another very important point is that clients, as architects, will no longer have many limits in design concerning ideas and creativity. The prices for real estate are constantly increasing and the lack of availability of construction materials as well as the speculation that has been created around it in 2021 is bringing prices to such a level that in the future real estate developers risk not being able to find customers for these ultra-expensive homes. Hence, this paper starts with the introduction of 3D printing, which now has the potential to gain an important position in the market, becoming a valid alternative to the classic construction process. This technology is not only beneficial from an economic point of view but it is also a great opportunity to have an impact on the environment by reducing CO2 emissions. Further on in the article we will also understand if, after the COP 26 (2021 United Nations Climate Change Conference), world governments could also push towards building technologies that reduce the waste materials that are needed to be disposed of and at the same time reduce emissions with the contribution of governmental funds. This paper will give us insight on the multiple benefits of 3D printing and emphasise the importance of finding new solutions for materials that can be used by the printer. Therefore, based on the type of material, it will be possible to understand the compatibility with current regulations and how the authorities will be inclined to support this technology. This will help to enable the rise and development of this technology in Europe and in the rest of the world on actual housing projects and not only on prototypes.

Keywords: additive manufacturing, contour crafting, development, new regulation, printing material

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Authors: Tomas Premoli, Sareh Rowlands

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In this study, we investigate the impact of various convolutional neural network (CNN) architectures on the accuracy of diagnosing Alzheimer’s disease (AD) using patient MRI scans. Alzheimer’s disease is a debilitating neurodegenerative disorder that affects millions worldwide. Early, accurate, and non-invasive diagnostic methods are required for providing optimal care and symptom management. Deep learning techniques, particularly CNNs, have shown great promise in enhancing this diagnostic process. We aim to contribute to the ongoing research in this field by comparing the effectiveness of different CNN architectures and providing insights for future studies. Our methodology involved preprocessing MRI data, implementing multiple CNN architectures, and evaluating the performance of each model. We employed intensity normalization, linear registration, and skull stripping for our preprocessing. The selected architectures included VGG, ResNet, and DenseNet models, all implemented using the Keras library. We employed transfer learning and trained models from scratch to compare their effectiveness. Our findings demonstrated significant differences in performance among the tested architectures, with DenseNet201 achieving the highest accuracy of 86.4%. Transfer learning proved to be helpful in improving model performance. We also identified potential areas for future research, such as experimenting with other architectures, optimizing hyperparameters, and employing fine-tuning strategies. By providing a comprehensive analysis of the selected CNN architectures, we offer a solid foundation for future research in Alzheimer’s disease diagnosis using deep learning techniques. Our study highlights the potential of CNNs as a valuable diagnostic tool and emphasizes the importance of ongoing research to develop more accurate and effective models.

Keywords: Alzheimer’s disease, convolutional neural networks, deep learning, medical imaging, MRI

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Authors: Elena Mugarza, Stephanie Glendinning, Ross Stirling, Colin Davies

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The effects of climate change and increased rainfall events on UK-based infrastructure are observable, with an increasing number being reported on in the national press. The fatal derailment at Stonehaven in 2020 prompted a wider review of Network Rail-owned earthworks assets. The event was indicated by the Rail Accident Investigation Branch (RAIB) to be caused by mis-installed drainage on the adjacent cutting. The slope failure on Snake Pass (public highway A57) was reportedly caused by significant water ingress following numerous storm events and resulted in the road’s closure for several months. This problem is only projected to continue with greater intensity and more prolonged rainfall events forecasted in the future. Subsequently, this project is designed to evaluate effective drainage trench design within infrastructure embankments, considering the capillary barrier phenomenon that may govern their deterioration and resultant failure. Theoretically, the differential between grain sizes of the embankment clays and gravels, customarily used in drainage trenches, would have a limiting effect on infiltration. As such, it is anticipated that the inclusion of an additional material with an intermediate grain size should improve the hydraulic conductivity across the drainage boundary. Multiple drainage designs will be studied using instrumentation within the drain and surrounding clays. Data from the real-world installation at the BIONICS embankment will be collected and compared with laboratory and Finite Element (FE) simulations. This research aims to reduce the risk of infrastructure slope failures by improving the resilience of earthwork drainage and lessening the consequential impact on transportation networks.

Keywords: earthworks, slope drainage, transportation slopes, deterioration, capillary barriers, field study

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Authors: Joan Esper Kuhnly, Jess Holden, Lynn Shelley, Nicole Kuhnly

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Empathy serves as a foundational nursing principle inherent in the nurse’s ability to form those relationships from which to care for patients. Evidence supports, including empathy in nursing and healthcare education, but there is limited data on what methods are effective to do so. Building evidence supports experiential and interactive learning methods to be effective for students to gain insight and perspective from a personalized experience. The purpose of this project is to evaluate learning activities designed to promote the attainment of empathic behaviors across 5 levels of the nursing curriculum. Quantitative analysis will be conducted on data from pre and post-learning activities using the Toronto Empathy Questionnaire. The main hypothesis, that simulation learning activities will increase empathy, will be examined using a repeated measures Analysis of Variance (ANOVA) on Pre and Post Toronto Empathy Questionnaire scores for three simulation activities (Stroke, Poverty, Dementia). Pearson product-moment correlations will be conducted to examine the relationships between continuous demographic variables, such as age, credits earned, and years practicing, with the dependent variable of interest, Post Test Toronto Empathy Scores. Krippendorff’s method of content analysis will be conducted to identify the quantitative incidence of empathic responses. The researchers will use Colaizzi’s descriptive phenomenological method to describe the students’ simulation experience and understand its impact on caring and empathy behaviors employing bracketing to maintain objectivity. The results will be presented, answering multiple research questions. The discussion will be relevant to results and educational pedagogy in the nursing curriculum as they relate to the attainment of empathic behaviors.

Keywords: curriculum, empathy, nursing, simulation

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Authors: P. T. Ngan

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Purpose: The study aims to answer the question what are motivational conditions that have great influences on employees’ innovative work behaviors by investigating the case of SATAMANKULMA/ Anya Productions Ky in Kuopio, Finland. Design/methodology: The main methodology utilized was the qualitative single case study research, analysis was conducted with an adapted thematic content analysis procedure, created from empirical material that was collected through interviews, observation and document review. Findings: The paper highlights the significance of combining relevant synergistic extrinsic and intrinsic motivations into the organizational motivation system. The findings show that intrinsic drives are essential for the initiation phases while extrinsic drives are more important for the implementation phases of innovative work behaviors. The study also offers the IDEA motivation model-interpersonal relationships & networks, development opportunities, economic constituent and application supports as an ideal tool to optimize business performance. Practical limitations/ implications: The research was only conducted from the perspective of SATAMANKULMA/Anya Productions Ky, with five interviews, a few observations and with several reviewed documents. However, further research is required to include other stakeholders, such as the customers, partner companies etc. Also the study does not offer statistical validity of the findings; an extensive case study or a qualitative multiple case study is suggested to compare the findings and provide information as to whether IDEA model relevant in other types of firms. Originality/value: Neither the innovation nor the human resource management field provides a detailed overview of specific motivational conditions might use to stimulate innovative work behaviors of individual employees. This paper fills that void.

Keywords: employee innovative work behaviors, extrinsic motivation, intrinsic motivation, organizational innovativeness

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Authors: Isabelle Snyder

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Microgrid protection presents challenges to conventional protection techniques due to the low induced fault current. Protection relays present in microgrid applications require a combination of settings groups to adjust based on the architecture of the microgrid in islanded and grid-connected mode. In a radial system where the microgrid is at the other end of the feeder, directional elements can be used to identify the direction of the fault current and switch settings groups accordingly (grid connected or microgrid connected). However, with multiple microgrid connections, this concept becomes more challenging, and the direction of the current alone is not sufficient to identify the source of the fault current contribution. ORNL has previously developed adaptive relaying schemes through other DOE-funded research projects that will be evaluated and used as a baseline for this research. The four protection techniques in this study are the following: (1) Adaptive Current only Protection System (ACPS), Intentional (2) Unbalanced Control for Protection Control (IUCPC), (3) Adaptive Protection System with Communication Controller (APSCC) (4) Adaptive Model-Driven Protective Relay (AMDPR). The first two methods focus on identifying the islanded mode without communication by monitoring the current sequence component generated by the system (ACPS) or induced with inverter control during islanded mode (IUCPC) to identify the islanding condition without communication at the relay to adjust the settings. These two methods are used as a backup to the APSCC, which relies on a communication network to communicate the islanded configuration to the system components. The fourth method relies on a short circuit model inside the relay that is used in conjunction with communication to adjust the system configuration and computes the fault current and adjusts the settings accordingly.

Keywords: adaptive relaying, microgrid protection, sequence components, islanding detection, communication controlled protection, integrated short circuit model

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Authors: Ragi Poyyara, Vijaya Patnana, Mohammed Alam

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When acid is pumped into damaged reservoirs for damage removal/stimulation, distorted inflow of acid into the formation occurs caused by acid preferentially traveling into highly permeable regions over low permeable regions, or (in general) into the path of least resistance. This can lead to poor zonal coverage and hence warrants diversion to carry out an effective placement of acid. Diversion is desirably a reversible technique of temporarily reducing the permeability of high perm zones, thereby forcing the acid into lower perm zones. The uniqueness of each reservoir can pose several challenges to engineers attempting to devise optimum and effective diversion strategies. Diversion techniques include mechanical placement and/or chemical diversion of treatment fluids, further sub-classified into ball sealers, bridge plugs, packers, particulate diverters, viscous gels, crosslinked gels, relative permeability modifiers (RPMs), foams, and/or the use of placement techniques, such as coiled tubing (CT) and the maximum pressure difference and injection rate (MAPDIR) methodology. It is not always realized that the effectiveness of diverters greatly depends on reservoir properties, such as formation type, temperature, reservoir permeability, heterogeneity, and physical well characteristics (e.g., completion type, well deviation, length of treatment interval, multiple intervals, etc.). This paper reviews the mechanisms by which each variety of diverter functions and discusses the effect of various reservoir properties on the efficiency of diversion techniques. Guidelines are recommended to help enhance productivity from zones of interest by choosing the best methods of diversion while pumping an optimized amount of treatment fluid. The success of an overall acid treatment often depends on the effectiveness of the diverting agents.

Keywords: diversion, reservoir, zonal coverage, carbonate, sandstone

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Authors: Husham Bayazed

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Purpose of Presentation: The eye is one of a few sites in the body with immune privilege (IP). However, this IP is relatively easily bypassed in the face of sufficient strong local or systemic immunological responses. As immune responses are crucial elements of the repair response, the eye has developed distinct mechanisms to deliver immune responses to injury in the avascular regions of the eye. This presentation may cover and provide an overview of the mechanisms that dictate immune cell trafficking to the local ocular microenvironment in response to different autoimmune and inflammatory-mediated diseases. Recent Findings: Literature reviews declare that immune responses and inflammation play a key role in a diverse range of eye diseases. In recent years, our understanding of ocular immune responses has widely spread in ocular surface inflammation, uveitis, age-related macular degeneration (AMD), glaucoma, transplantation rejection, and other ocular diseases. It is becoming increasingly clear that multiple seemingly unrelated diseases involve immune responses with common themes in their ocular pathogenesis. Recent studies are focusing on elucidating the pathogenesis of ocular inflammatory disease to identify new targets for immunotherapy that will not only improve efficacy but also minimize adverse effects from traditional therapy. Summary: While IP was believed to protect the eye from day-to-day inflammatory insults, however, it is relatively easily breached in the face of different strong local or systemic immunological and inflammatory responses. Therefore, the ocular immune response encapsulates the full range of classical and non-classical immune responses and demonstrates many features which are reflected in other tissues, but eye tissues, by modifying these responses, may reveal unexpected and novel findings which are relevant to immune responses generally. This may have therapeutic potential for new targeting immunotherapy, restoring immune tolerance in ocular autoimmune and inflammatory diseases, and preventing rejection such as stem cells, currently being considered for treatment of worldwide blinding diseases such as AMD.

Keywords: ocular diseases, immunology, immune privilege, immunotherapy

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Authors: Sara D. Garduno-Diaz, Ramona Milcheva, Chanyu Xu

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Women’s reproductive stages (pre-pregnancy, pregnancy, and lactation) represent a time of higher micronutrient needs. With a healthy food selection as the first path of choice to cover these increased needs, tandem micronutrient supplementation is often required. Because pregnancy and lactation should be treated with care, all supplements consumed should be of quality ingredients and manufactured through controlled processes. This work describes the process followed for the development of plant-based multiple micronutrient supplements aimed at addressing the growing demand for natural ingredients of non-animal origin. A list of key nutrients for inclusion was prioritized, followed by the identification and selection of qualified raw ingredient providers. Nutrient absorption into the food matrix was carried out through natural processes. The outcome is a new line of products meeting the set criteria of being gluten and lactose-free, suitable for vegans/vegetarians, and without artificial conservatives. In addition, each product provides the consumer with 10 vitamins, 6 inorganic nutrients, 1 source of essential fatty acids, and 1 source of phytonutrients each (maca, moringa, and chlorella). Each raw material, as well as the final product, was submitted to microbiological control three-fold (in-house and external). The final micronutrient mix was then tested for human factor contamination, pesticides, total aerobic microbial count, total yeast count, and total mold count. The product was created with the aim of meeting product standards for the European Union, as well as specific requirements for the German market in the food and pharma fields. The results presented here reach the point of introduction of the newly developed product to the market, with acceptability and effectiveness results to be published at a later date.

Keywords: fertility, lactation, organic, pregnancy, vegetarian

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Authors: A. R. Shakura, A. B. Elistina, M. S. Aini, S. Norhasmah, A. Fakhru’l-Razi

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Tsunami 2004 was an unforeseeable event that caught Malaysia of guard resulting with 68 losses of lives and with an estimated economic loss of about 55.15billion US dollar. Scientists predict that if the earthquake epicentre originates from the Andaman-Nicobar region, the coastal population of Penang will have about 30 minutes to evacuate to safety. Thus, a study was conducted to enhance resiliency of Penang community as the area was the worst affected region during 2004 tsunami disaster. This paper is intended to examine the factors that influence intention to prepare for future tsunami among the coastal residence in Penang. The differences in the level of intention to prepare were also examined between those who experience and did not experience the 2004 tsunami. This study utilized a cross-sectional research design using a survey method. A total of 503 respondents were chosen systematically and data gathered were analysed using SPSS. Both genders, male and female were equally represented with a mean age of 44 years. Data indicated that the level of intention to prepare for tsunami disaster was moderate (M=3.72) with no significant difference in intention to prepare between those who had experienced or had not experienced the 2004 tsunami. Subsequently, results from a multiple regression analysis found that sense of community to be the most influential factor followed by subjective norm, trust, positive outcome expectancy and risk perception, explaining the 57% variance in intention to prepare. These factors reflect the influence of the collectivistic culture in Malaysia whereby households plus communities have a central role in encouraging each other. Therefore, the findings highlights the potential of adopting a community based disaster risk management as recommended by the United Nations International Strategy Disaster Reduction (UNISDR) which encompasses the cooperation between the local community and relevant stakeholders in preparing for future tsunami disaster.

Keywords: disaster management, experience, intention to prepare, tsunami

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Authors: M. Umar Dahot, G. S. Mangrio

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In this study Agro-industrial waste was used as a carbon source, which is a low cost substrate. Along with this, various sugars and molasses of 2.5% and 5% were investigated as substrate/carbon source for the growth of A.niger and Pectinase production. Different nitrogen sources were also used. An overview of results obtained show that 5% sucrose, 5% molasses and 0.4% (NH4)2SO4 were found the best carbon and nitrogen sources for the production of pectinase by A. niger. The maximum production of pectinase (26.87units/ml) was observed at pH 6.0 after 72 hrs incubation. The optimum temperature for the maximum production of pectinase was achieved at 35ºC when maximum production of pectinase was obtained as 28.25Units/ml.Pectinase enzyme was purified with ammonium sulphate precipitation and dialyzed sample was finally applied on gel filtration chromatography (Sephadex G-100) and Ion Exchange DEAE A-50. The enzyme was purified 2.5 fold by gel chromatography on Sephadex G-100 and Four fractions were obtained, Fraction 1, 2, 4 showed single band while Fraction -3 showed multiple bands on SDS Page electrophoresis. Fraction -3 was pooled, dialyzed and separated on Sephdex A-50 and two fractions 3a and 3b showed single band. The molecular weights of the purified fractions were detected in the range of 33000 ± 2000 and 38000± 2000 Daltons. The purified enzyme was specifically most active with pure pectin, while pectin, Lemon pectin and orange peel given lower activity as compared to (control). The optimum pH and temperature for pectinase activity was found between pH 5.0 and 6.0 and 40°- 50°C, respectively. The enzyme was stable over the pH range 3.0-8.0. The thermostability of was determined and it was observed that the pectinase activity is heat stable and retains activity more than 40% when incubated at 90°C for 10 minutes. The pectinase activity of F3a and F3b was increased with different metal ions. The Pectinase activity was stimulated in the presence of CaCl2 up to 10-30%. ZnSO4, MnSO4 and Mg SO4 showed higher activity in fractions F3a and F3b, which indicates that the pectinase belongs to metalo-enzymes. It is concluded that A. niger is capable to produce pH stable and thermostable pectinase, which can be used for industrial purposes.

Keywords: pectinase, a. niger, production, purification, characterization

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Authors: Afroditi Zamanidou, Dionysios Giannakopoulos, Konstantinos Manolitsis

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A notable amount of electrical energy demand in many countries worldwide is used to cover public energy demand for road, square and other public spaces’ lighting. Renewable energy can contribute in a significant way to the electrical energy demand coverage for public lighting. This paper focuses on the sizing and design of a hybrid energy system (HES) exploiting the solar-wind energy potential to meet the electrical energy needs of lighting roads, squares and other public spaces. Moreover, the proposed HES provides coverage of the electrical energy demand for a Wi-Fi hotspot and a charging hotspot for the end-users. Alongside the sizing of the energy production system of the proposed HES, in order to ensure a reliable supply without interruptions, a storage system is added and sized. Multiple scenarios of energy consumption are assumed and applied in order to optimize the sizing of the energy production system and the energy storage system. A database with meteorological prediction data for 51 areas in Greece is developed in order to assess the possible deployment of the proposed HES. Since there are detailed meteorological prediction data for all 51 areas under investigation, the use of these data is evaluated, comparing them to real meteorological data. The meteorological prediction data are exploited to form three hourly production profiles for each area for every month of the year; minimum, average and maximum energy production. The energy production profiles are combined with the energy consumption scenarios and the sizing results of the energy production system and the energy storage system are extracted and presented for every area. Finally, the economic performance of the proposed HES in terms of Levelized cost of energy is estimated by calculating and assessing construction, operation and maintenance costs.

Keywords: energy production system sizing, Greece’s deployment potential, meteorological prediction data, wind-solar hybrid energy system, levelized cost of energy

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Authors: E. S. Umdu, Ilker Kahraman, Nurdan Yildirim, Levent Bilir

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Algae-culture offers new applications in sustainable architecture with its continuous productive cycle, and a potential for high carbon dioxide capture. Microalgae itself has multiple functions such as carbon dioxide fixation, biomass production, oxygen generation and waste water treatment. Incorporating microalgae cultivation processes and systems to building design to utilize this potential is promising. Microalgae cultivation systems, especially closed photo bioreactors can be implemented as components in buildings. And these systems be accommodated in the façade of a building, or in other urban infrastructure in the future. Application microalgae bio-reactors of on building’s façade has the added benefit of acting as an effective insulation system, keeping out the heat of the summer and the chill of the winter. Furthermore, microalgae can give a dynamic appearance with a liquid façade that also works as an adaptive sunshade. Recently, potential of microalgae to use as a building component to reduce net energy demand in buildings becomes a popular topic and innovative design proposals and a handful of pilot applications appeared. Yet there is only a handful of examples in application and even less information on how these systems affect building energy behavior. Further studies on microalgae mostly focused on single application approach targeting either carbon dioxide utilization through biomass production or biofuel production. The main objective of this study is to investigate effects of design parameters of microalgae panel bio-reactors on light transmission characteristics and CO2 capture potential during growth of Nannochloropsis occulata sp. A maximum reduction of 18 ppm in CO2 levels of input air during the experiments with a % light transmission of 14.10, was achieved in 6 day growth cycles. Heat transfer behavior during these cycles was also inspected for possible façade applications.

Keywords: building façade, CO2 capture, light transmittance, microalgae

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Authors: Sunghyoun Lee, Byeongkee Yu, Chanjung Lee, Yeongtaek Lim

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Oyster mushrooms are one of the ingredients that Koreans prefer. The oyster mushroom cultivation house has multiple layers in order to increase the mushroom production per unit area. However, the growing shelves in the house act as obstacles and hinder the circulation of the interior air, which leads to the difference of cultivation environment between the upper part and lower part of the growing shelves. Due to this difference of environments, growth distinction occurs according to the area of the growing shelves. It is known that minute air circulation around the mushroom cap facilitates the metabolism of mushrooms and improves its quality. This study has utilized the computational fluid dynamics (CFD) program, that is, FLUENT R16, in order to analyze the improvement of the internal environment uniformity of the oyster mushroom cultivation house. The analyzed factors are velocity distribution, temperature distribution, and humidity distribution. In order to maintain the internal environment uniformity of the oyster mushroom cultivation house, it appeared that installing circulation fan at the upper part of the working passage towards the ceiling is effective. When all the environmental control equipment – unit cooler, inlet fan, outlet fan, air circulation fan, and humidifier - operated simultaneously, the RMS figure on the growing shelves appeared as follows: velocity 28.23%, temperature 30.47%, humidity 7.88%. However, when only unit cooler and air circulation fan operated, the RMS figure on the growing shelves appeared as follows: velocity 22.28%, temperature 0.87%, humidity 0.82%. Therefore, in order to maintain the internal environment uniformity of the mushroom cultivation house, reducing the overall operating time of inlet fan, outlet fan, and humidifier is needed, and managing the internal environment with unit cooler and air circulation fan appropriately is essential.

Keywords: air circulation fan, computational fluid dynamics, multi-layered shelves cultivation, oyster mushroom cultivation house

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Authors: M. A. Munteanu, A. M. Lungu, A. I. Chivescu, V. Teodorescu, E. Tufanoiu, C. Nicolae, T. I. Nanea

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Introduction: Sodium-glucose co-transporter 2 inhibitors (SGLT2i), which were first developed as antidiabetic medications, have demonstrated numerous positive benefits on the cardiovascular system, especially in the prevention of heart failure (HF). HF is a challenging, multifaceted disease that needs all-encompassing therapy. It should not be viewed as a limited form of heart illness but rather as a systemic disease that leads to multiple organ failure and death. SGLT2i is an extremely effective tool for treating HF by using its pleiotropic effects. In addition to its use in patients with diabetes mellitus who are at high cardiovascular risk or who have already experienced a cardiovascular event, SGLT2i administration has been shown to have positive effects on a variety of HF manifestations and stages, regardless of the patient's presence of diabetes mellitus. Material and Methods: According to the guide, 110 patients (83 males and 27 females) with heart failure with mildly reduced ejection fraction (HFmrEF), with T2D and neoplasia, were enrolled in the prospective study. The structural and functional state of the left ventricle myocardium and ejection fraction was assessed through echocardiography. Patients were randomized to receive once-daily dapagliflozin 10 mg. Results: Patients with HFmrEF were divided into 3 subgroups according to age. 7% (8) patients aged < 45 years, 35% (28) patients aged between 46-59 years, and 58% (74) patients aged> 60 years. The most prevalent comorbidities were hypertension (43.1%), coronary heart disease (40%), and obesity (33.2%). Study drug discontinuation and serious adverse events were not frequent in the subgroups, in either men or women, until now. Conclusions: SGLT-2 inhibitors are a novel class of antidiabetic agents that have demonstrated positive efficacy and safety outcomes in the setting of HFmrEF. Until now, in our study, dapagliflozin was safe and well-tolerated irrespective of sex.

Keywords: diabetes mellitus type 2, Sodium-glucose co-transporters-2 inhibitors, heart failure, neoplasia

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Authors: Igor Vishnevskyi

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Introduction: The urinary bladder undergoes repeated strain during its working cycle, suggesting the presence of an efficient support system, force transmission, and mechanical amplification. The concept of a "hydrostatic skeleton" (HS) could contribute to our understanding of the functional relationships among bladder constituents. Methods: A multidisciplinary literature review was conducted to identify key features of the HS and to gather evidence supporting its applicability in urinary bladder biomechanics. The collected evidence was synthesized to propose a framework for understanding the potential hydrostatic properties of the urinary bladder based on existing knowledge and HS principles. Results: Our analysis revealed similarities in biomechanical features between living fluid-filled structures and the urinary bladder. These similarities include the geodesic arrangement of fibres, the role of enclosed fluid (urine) in force transmission, prestress as a determinant of stiffness, and the ability to maintain shape integrity during various activities. From a biomechanical perspective, urine may be considered an essential component of the bladder. The hydrostatic skeleton, with its autonomy and flexibility, may provide insights for researchers involved in bladder engineering. Discussion: The concept of a hydrostatic skeleton offers a holistic perspective for understanding bladder function by considering multiple mechanical factors as a single structure with emergent properties. Incorporating viewpoints from various fields on HS can help identify how this concept applies to live fluid-filled structures or organs and reveal its broader relevance to biological systems, both natural and artificial. Conclusion: The hydrostatic skeleton (HS) design principle can be applied to the urinary bladder. Understanding the bladder as a structure with HS can be instrumental in biomechanical modelling and engineering. Further research is required to fully elucidate the cellular and molecular mechanisms underlying HS in the bladder.

Keywords: hydrostatic skeleton, urinary bladder morphology, shape integrity, prestress, biomechanical modelling

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Authors: Edwina Owusu Panin, Kwame Baah Owusu Panin

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This abstract intends to demonstrate multiple strategies of autism management in Ghana by exploring the possibilities. The advantages of adopting creative art forms as a therapeutic method. Autism is a developmental disorder that includes social interaction, communication, and repetitive behaviours. In Ghana, as in many other countries, there is a rising demand for effective intervention and support for people with autism and their families. Creative arts such as music, dance, drama and visual arts have shown promise in promoting communication, social interaction and inclusion of people with autism. These art forms provide alternative channels for self-expression and can be powerful tools for autistic people to interact with the world, their friends and families around them. Creative art forms interventions have been found to improve social skills, improve emotion regulation, promote creativity and increase self-confidence in people with autism. This study examines existing programs and interventions in Ghana involving creative art forms for people with autism through a comparative analysis. It explores the different approaches, methods and results of these interventions. By comparing and evaluating these programs, the study aims to identify best practices, challenges and areas for development in managing autism through the creative arts in Ghana. Although many schools and rehabilitation centres employ various forms in therapeutic approaches for autism. There is no comparative analysis of which type of autism and which creative art forms is suitable. The results of this study will contribute to the development of evidence-based practices for the management of autism in Ghana. It provides valuable information about the effectiveness of creative arts interventions and helps inform policy makers, educators, therapists and other stakeholders involved in autism support. Ultimately, the goal is to improve the well-being and quality of life of people with autism in Ghana and their families by promoting inclusive and accessible interventions that harness the power of creative art forms.

Keywords: autism, therapeutic, creative art, art form

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Authors: Andriy Fedorenko

Abstract:

Background Early closure of the open abdomen is a priority after damage control laparotomy to prevent retraction of fascial layers and prevent hernia formation that requires definitive repair at a later stage. This substantially reduces the complications associated with ventral hernia formation for up to a year after initial surgery. TopClosure® is an innovative method that employs stress-relaxation and mechanical creep for skin stretching. Its use enables the primary closure of large abdominal wall defects and mitigates large ventral hernia formation. Materials and Methods A 7-year-old girl presented with severe blast injury. She underwent initial laparotomy in a facility within the conflict zone and was transferred in a state of septic shock to our facility for further care. Her abdominal injuries included liver lacerations, multiple perforations of the transverse colon and ileum, and a 8x16cm oblique abdominal wall defect. Further damage control laparotomy was performed with primary suture of the colon and ileum and temporary closure of the abdomen using a Bagota bag. Twelve hours later, negative pressure wound therapy (NPWT) was applied to the abdominal wound after relook laparotomy. Five days later, TopClosure® was applied to the lower part of the wound incorporating NPWT to the upper wound. Results The patient suffered leak from the colonic suture line and required relaparotomy. TopClosure® abdominal closure was achieved after every laparotomy. Conclusion TopClosure® utilizes the viscoelastic properties of the skin achieving full closure of the abdominal wall (including the fascia and skin),eliminating the need for prolonged NPWT, skin graft, and delayed ventral hernia repair surgery.

Keywords: topclosure, abdominal wall defect, hernia, damage control

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Authors: Aikaterini Amanatidou

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We describe the case of a 20-year-old female patient diagnosed with Ehlers-Danlos Syndrome (EDS) who was scheduled to undergo a wisdom teeth extraction in outpatient surgery. EDS is a hereditary connective tissue disorder characterized by joint hypermobility, skin hyper-extensibility, and vascular and soft tissue fragility. There are six subtypes of Ehlers-Danlos, and in our case, the patient had EDS hyper-mobility (HT) type disorder. One important clinical feature of this syndrome is chronic pain, which is often poorly understood and treated. Our patient had a long history of articular and lumbar pain when she was diagnosed. She was prescribed analgesic treatment for acute and neuropathic pain and had multiple sessions of psychotherapy and physiotherapy to ease the pain. Unfortunately, her extensive medical history was underrated by our anesthetic team, and no further measures were taken for the operation. Despite an uneventful intra-operative phase, the patient experienced several episodes of hyperalgesia during the immediate post-operative care. Management of pain was challenging for the anesthetic team: initial opioid treatment had only a temporary effect and a paradoxical reaction after a while. Final pain relief was eventually obtained with psycho-physiologic treatment, high doses of ketamine, and patient-controlled analgesia infusion of morphine-ketamine-dehydrobenzperidol. We suspected an episode of Opioid-Induced hyperalgesia. This case report supports the hypothesis that anti-hyperalgesics such as ketamine as well as lidocaine, and dexmedetomidine should be considered intra-operatively to avoid opioid-induced hyperalgesia and may be an alternative solution to manage complex chronic pain like others in neuropathic pain syndromes.

Keywords: Ehlers-Danlos, post-operative management, hyperalgesia, opioid-induced hyperalgesia, rare disease

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Authors: Nirmala Lama

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The construction of high dams has led to significant challenges in managing flow rates discharging over spillways, resulting in cavitation damages on hydraulic surfaces. To address this, aerator devices were designed and installed to promote fore aeration, thereby controlling and mitigating damages caused by cavitation. Consequently, these aerator types, three-dimensional aerators (3DAEs), have demonstrated superior efficiency in introducing forced air into the flow.This research focuses on the installation and evaluation of three-dimensional aerator devices at the high discharge spillway surface. In the laboratory, the air concentration downstream of the hydraulic structures was extensively measured, and the data were analyzed in details.Multiple flow scenarios and structural arrangements of the aerators were adopted for the study. The outcomes of these experiments are listed as In terms of air concentration value, the comparison between 3 DAE (three-dimensional aerator) with offset only and offset with ramp reveals significant differences. The concentration value on the side wall was justified. The side cavity length was found to increase with higher approach Froude numbers and lateral enlargement widths. Furthermore, 3DAE exhibited shorter side cavity lengths compared to three-dimensional aerator devices without ramps (3DAD), a beneficial features for controlling water fins. An empirical formula to express the side cavity length was derived from the measured data. Also, the comparison were made on the basis of water fin formation between the different arrangements of 3D aerators. In conclusion, this research provides valuable insights into the performance of three-dimensional aerators in mitigating cavitation damages and controlling water fins in high dam spillways. The findings offer practical implications for designers and engineers seeking to enhance the efficiency and safety of hydraulic structures subjected to high flow rates.

Keywords: three-dimension aerator, cavity, water fin, air entrainment

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Authors: Jacob T. Liberty, Wilfred I. Okonkwo

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The present study designed and constructed a post-harvest passive solar tomato dryer of dimension 176 x 152 x 54cm for drying tomato. Quality of the dried crop was evaluated and compared with the fresh ones. The solar dryer consist of solar collector (air heater), 110 x 61 x 10 x 10cm, the drying chamber, 102 x54cm, removal heat storage unit, 40 x 35 x 13cm and drying trays, 43 x 42cm. The physicochemical properties of this crop were evaluated before and after drying. Physicochemical properties evaluated includes moisture, protein, fat, fibre, ash, carbohydrate and vitamin C, contents. The fresh, open and solar dried samples were analysed for their proximate composition using the recommended method of AOAC. Also, statistical analysis of the data was conducted using analysis of variance (ANOVA) using completely Randomize Design (CRD) and means were separated by Duncan’s New Multiple Range test (DNMRT). Proximate analysis showed that solar dried tomato had significantly (P < 0.05) higher protein, fibre, ash, carbohydrate and vitamin C except for the fat content that was significantly (P < 0.05) higher for all the open sun dried samples than the solar dried and fresh product. The nutrient which is highly affected by sun drying is vitamin C. Result indicates that moisture loss in solar dried tomato was faster and lower than the open dried samples and as such makes the solar dried products of lesser tendency to mould and bacterial growth. Also, the open sun dried samples had to be carried into the sheltered place each time it rained. The solar dried produce is of high quality. Further processing of the dried crops will involve packaging for commercial purposes. This will also help in making these agricultural product available in a relatively cheap price in off season and also avert micronutrient deficiencies in diet especially among the low-income groups in Nigeria.

Keywords: tomato, passive solar dryer, physicochemical properties, removal heat storage

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Authors: Yasaman Samie

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The ever-increasing rate of textile and clothing (T&C) waste generation and the common ineffective waste management practices have been for long a challenge for civic waste management. This challenge stems from not only the complexity in the T&C material components but also the heterogeneous nature of the T&C waste management sector and the disconnection between the stakeholders. To date, there is little research that investigates the importance of a governmental structure and its role in T&C waste managerial practices and decision makings. This paper reflects on the impacts and involvement of governments, the Acts, and legislation on the effectiveness of T&C waste management practices, which are carried out by multiple players in a city context. In doing so, this study first develops a methodical framework for holistically analyzing a city’s T&C waste ecosystem. Central to this framework are six dimensions: social, environmental, economic, political, cultural, and educational, as well as the connection between these dimensions such as Socio-Political and Cultural-Political. Second, it delves into the political dimension and its interconnections with varying aspects of T&C waste. In this manner, this case-study takes metropolitan Melbourne as a case and draws on social theories of Actor-Network Theory and the principals of supply chain design and planning. Data collection was through two rounds of semi-structured interviews with 18 key players of T&C waste ecosystem (including charities, city councils, private sector providers and producers) mainly within metropolitan Melbourne and also other Australian and European cities. Research findings expand on the role of the politics of waste in facilitating a proactive approach to T&C waste management in the cities. That is achieved through a revised definition for T&C waste and its characteristics, discussing the varying perceptions of value in waste, prioritizing waste types in civic waste management practices and how all these aspects shall be reflected in the in-placed acts and legislations.

Keywords: civic waste management, multi-stakeholder ecosystem, textile and clothing waste, waste and governments

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Authors: Huang Wei-Chi, Li Wei, Yu Tien-Chieh

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Medication adherence is crucial for treatment success. Adherence problem is common in patients with polypharmacy, especially in the geriatric population who are vulnerable to multiple chronic conditions but averagely less knowledgeable about diseases and medications. In order to help patients take medications appropriately and enhance the understanding of diseases or medications, a Line official account named e-Pharmacist was designed. The line is a popular freeware app with the highest penetration rate (95.7%) in Taiwan. The interface of e-Pharmacist is user-friendly for easy-to-read and convenient operating. Differ from other medication adherence apps, users just added e-Pharmacist as a LINE friend without installing any more apps and the drug lists were automatically downloaded from the personal electronic medical records with security permission. Over and above medication reminder, several additional capabilities were set up and engaged in the platform of e-Pharmacist including prescription refill reservation, laboratory examination consultation, medical appointment registration, and “Daily Health Log” where patients can record and track data of blood pressure/blood sugar and daily meals for self-health management as well as can share the important information to clinical professionals when seeking medical help. Additionally, a Line chatbot was utilized to provide tailored medicine information for the individual user. From July 2020 to March 2022, around 3000 patients added e-pharmacist as Line friends. Every day more than 1500 patients receive messages from e-pharmacist to notify them to take medicine. Thanks to the e-pharmacist alert system and Chatbot, the low-compliance patients (defined by Program on Adherence to Medication, PAM) significantly dropped from 36% to 6%, whereas the high-compliance patients dramatically increased from 13% to 77%. The user satisfaction is 98%. In brief, an e-pharmacist is not only a medication reminder but also a tailored personal assistant with value-added service for health management.

Keywords: e-pharmacist, self-health management, medication reminder, value-added service

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Authors: Vassilis Argyropoulos, Magda Nikolaraizi, Maria Papazafiri

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This study describes a series of learning workshops, which took place within CUIDAR project. The workshops aimed to empower children to share their experiences and views in relation to natural hazards and disasters. The participants in the workshops were ten primary school students who had severe visual impairments or multiple disabilities and visual impairments (MDVI). The main objectives of the workshops were: a) to promote access of the children through the use of appropriate educational material such as texts in braille, enlarged text, tactile maps and the implementation of differentiated instruction, b) to make children aware regarding their rights to have access to information and to participate in planning and decision-making especially in relation to disaster education programs, and c) to encourage children to have an active role during the workshops through child-led and experiential learning activities. The children expressed their views regarding the meaning of hazards and disasters. Following, they discussed their experiences and emotions regarding natural hazards and disasters, and they chose to place the emphasis on a hazard, which was more pertinent to them, their community and their region, namely fires. Therefore, they recalled fires that have caused major disasters, and they discussed about the impact that these fires had on their community or on their country. Furthermore, they were encouraged to become aware regarding their own role and responsibility to prevent a fire or get prepared and know how to behave if a fire occurs. They realized that prevention and preparation are a matter of personal responsibility. They also felt the responsibility to inform their own families. Finally, they met important people involved in fire protection such as rescuers and firefighters and had the opportunity to carry dialogues. In conclusion, through child led workshops, experiential and accessible activities, the students had the opportunity to share their own experiences, to express their views and their questions, to broaden their knowledge and to realize their personal responsibility in disaster risk reduction, specifically in relation to fires.

Keywords: accessibility, children, disasters, visual impairment

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Authors: Ülle Parm, Kata Pedamäe, Jaak Jürimäe, Evelin Lätt, Aivar Orav, Anna-Liisa Tamm

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Vegetarianism has gained popularity across the world. It`s being chosen for multiple reasons, but among Estonians, these have remained unknown. Previously, attention to bone health and probable nutrient deficiency of vegetarians has been paid and in vegetarians lower body mass index (BMI) and blood cholesterol level has been found but the results are inconclusive. The goal was to explain reasons for choosing vegetarian diet in Estonia and impact of vegetarianism to body composition – BMI, fat percentage (fat%), fat mass (FM), and fat free mass (FFM). The study group comprised of 68 vegetarians and 103 omnivorous. The determining body composition with DXA (Hologic) was concluded in 2013. Body mass (medical electronic scale, A&D Instruments, Abingdon, UK) and height (Martin metal anthropometer to the nearest 0.1 cm) were measured and BMI calculated (kg/m2). General data (physical activity level included) was collected with questionnaires. The main reasons why vegetarianism was chosen were the healthiness of the vegetarian diet (59%) and the wish to fight for animal rights (72%) Food additives were consumed by less than half of vegetarians, more often by men. Vegetarians had lower BMI than omnivores, especially amongst men. Based on BMI classification, vegetarians were less obese than omnivores. However, there were no differences in the FM, FFM and fat percentage figures of the two groups. Higher BMI might be the cause of higher physical activity level among omnivores compared with vegetarians. For classifying people as underweight, normal weight, overweight and obese both BMI and fat% criteria were used. By BMI classification in comparison with fat%, more people in the normal weight group were considered; by using fat% in comparison with BMI classification, however, more people categorized as overweight. It can be concluded that the main reasons for vegetarianism chosen in Estonia are healthiness of the vegetarian diet and the wish to fight for animal rights and vegetarian diet has no effect on body fat percentage, FM and FFM.

Keywords: body composition, body fat percentage, body mass index, vegetarianism

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Authors: P. Jost, L. Muckova, M. Matula, J. Pejchal, D. Jun, R. Stetina

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Sulfur mustard (bis(2-chlorethyl) sulfide) is highly toxic, chemical warfare agent that has been used in the past in several armed conflicts. Except for the skin, respiratory tract is one of the important routes of exposure. The elucidation and understanding of the mechanism of toxicity of SM have been effort intensive research. The multiple targets character of SM caused cellular damage resulted in activation of many different mechanisms which contribute to cellular response and participate in the final cytopathology effect. In our present work, we compared time-dependent changes in sulfur mustard exposed adult human lung fibroblasts NHLF and lung epithelial alveolar cell line A-549. Cell viability (MTT assay, Calcein-AM assay, and xCELLigence - real-time cell analysis), apoptosis (flow cytometry), mitochondrial membrane potential (Δψm, flow cytometry), reactive oxygen species induction (DC and cell cycle distribution (flow cytometry) were studied. We observed significantly decreased mitochondrial membrane potential and subsequent induction of apoptosis correlating with decreased cellular viability in the sulfur mustard exposed cells. In low concentrations, sulfur mustard-induced S-phase cell cycle arrest, on the other hand, high concentrations, cell cycle phase distribution of sulfur mustard exposed cells resembled cell cycle phase distribution of control group, which implies nonspecific cell cycle inhibition. Epithelial cells A-549 was found as more sensible to sulfur mustard toxicity. Acknowledgements: This work was supported by a long-term organization development plan Medical Aspects of Weapons of Mass Destruction of the Faculty of Military Health Sciences, University of Defence.

Keywords: apoptosis, cell cycle, cytotoxicity, sulfur mustard

Procedia PDF Downloads 192

Authors: Sofia Serra-Dawa

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Adult relationships accrue on a variety of past social experiences, intentions, and emotions that might predispose and influence the approach to and construction of subsequent relationships. The Adult Attachment Theory (AAT) proposes four types of adult attachment, where attachment is built over two dimensions of anxiety and avoidance: secure, anxious-preoccupied, dismissive-avoidant, and fearful-avoidant. The AAT has been studied in multiple settings such as personal and therapeutic relationships, educational settings, sexual orientation, health, and religion. In music scholarship, the AAT has been used to frame class learning of student singers and study the relational behavior between voice teachers and students. Building on this study, the present inquiry studies how attachment types might characterize learning relationships of music students (in the Western Conservatory tradition), and whether particular instrumental experiences might correlate to given attachment styles. Given certain behavioral cohesive features of established traditions of instrumental playing and performance modes, it is hypothesized that student musicians will display specific characteristics correlated to instrumental traditions, demonstrating clear tendency of attachment style, which in turn has implications on subsequent professional interactions. This study is informed by the methodological framework of Adult Attachment Scale-R (Collins and Read, 1990), which was particularly chosen given its non-invasive questions and classificatory validation. It is further hypothesized that the analytical comparison of musicians’ profiles has the potential to serve as the baseline for other comparative behavioral observation studies [this component is expected to be verified and completed well before the conference meeting]. This research may have implications for practitioners concerned with matching and improving musical teaching and learning relationships and in (professional and amateur) long-term musical settings.

Keywords: adult attachment, music education, musicians attachment profile, musicians relationships

Procedia PDF Downloads 157

Authors: Brahmanage S. Rangika, Dinithi C. Peiris

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Boiled Aqueous Flower Extract (AFE) of Nyctanthes arbor-tristis L. (Family: Oleaceae) is used in traditional Sri Lankan medicinal system to treat diabetes. However, this is not scientifically proven and the mechanisms by which the flowers reduce diabetes have not been investigated. The present study was carried out to examine the hypoglycemic potential and toxicity effects of aqueous flower extract of N. arbor-tristis. AFE was prepared and mice were treated orally either with 250, 500, and 750 mg/kg of AFE or distilled water (Control). Fasting and random blood glucose levels were determined. In addition, the toxicity of AFE was determined using chronic oral administration. In normoglycemic mice, mid dose (500mg/kg) of AFE significantly (p < 0.01) reduced fasting blood glucose levels by 49% at 4h post treatment. Further, 500mg/kg of AFE significantly (p < 0.01) lowered random blood glucose level of non-fasted normoglycemic mice. AFE significantly lowered total cholesterol and triglyceride levels while increasing the HDL levels in the serum. Further, AFE significantly inhibited the glucose absorption from the lumen of the intestine and it increases the diaphragm uptake of glucose. Alpha-amylase inhibitory activity was also evident. However, AFE did not induce any overt signs of toxicity or hepatotoxicity. There were no adverse effects on food and water intake and body weight of mice during the experimental period. It can be concluded that AFE of N. arbor-tristis posses safe oral anti diabetic potentials mediated via multiple mechanisms. Results of the present study scientifically proved the claims made about the uses of N. arbor-tristis in the treatment of diabetes mellitus in traditional Sri Lankan medicinal system. Further, flowers can also be used for as a remedy to improve blood lipid profile.

Keywords: aqueous extract, hypoglycemic hypolipidemic, Nyctanthes arbor-tristis flowers, hepatotoxicity

Procedia PDF Downloads 370

Authors: Harshita Raj, Joydeep Ghosh, Rakesh L. Tanna, Prabal K. Chattopadhyay, K. A. Jadeja, Sharvil Patel, Kaushal M. Patel, Narendra C. Patel, S. B. Bhatt, V. K. Panchal, Chhaya Chavda, C. N. Gupta, D. Raju, S. K. Jha, J. Raval, S. Joisa, S. Purohit, C. V. S. Rao, P. K. Atrey, Umesh Nagora, R. Manchanda, M. B. Chowdhuri, Nilam Ramaiya, S. Banerjee, Y. C. Saxena

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Efficient gas fueling is a critical aspect that needs to be mastered in order to maintain plasma density, to carry out fusion. This requires a fair understanding of fuel recycling in order to optimize the gas fueling. In Aditya tokamak, multiple gas puffs are used in a precise and controlled manner, for hydrogen fueling during the flat top of plasma discharge which has been instrumental in achieving discharges with enhanced density as well as energy confinement time. Following each gas puff, we observe peaks in temporal profile of Hα emission, Soft X-ray (SXR) and chord averaged electron density in a number of discharges, indicating efficient gas fueling. Interestingly, Hα temporal profile exhibited an additional peak following the peak corresponding to each gas puff. These additional peak Hα appeared in between the two gas puffs, indicating the presence of a secondary hydrogen source apart from the gas puffs. A thorough investigation revealed that these secondary Hα peaks coincide with Hard X- ray bursts which come from the interaction of runaway electrons with vessel limiters. This leads to consider that the runaway electrons (REs), which hit the wall, in turn, bring out the absorbed hydrogen and oxygen from the wall and makes the interaction of REs with limiter a secondary hydrogen source. These observations suggest that runaway electron induced recycling should also be included in recycling particle source in the particle balance calculations in tokamaks. Observation of two Hα peaks associated with one gas puff and their roles in enhancing and maintaining plasma density in Aditya tokamak will be discussed in this paper.

Keywords: fusion, gas fueling, recycling, Tokamak, Aditya

Procedia PDF Downloads 402