Search results for: optimal setting
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4779

Search results for: optimal setting

1209 Neural Network-based Risk Detection for Dyslexia and Dysgraphia in Sinhala Language Speaking Children

Authors: Budhvin T. Withana, Sulochana Rupasinghe

Abstract:

The problem of Dyslexia and Dysgraphia, two learning disabilities that affect reading and writing abilities, respectively, is a major concern for the educational system. Due to the complexity and uniqueness of the Sinhala language, these conditions are especially difficult for children who speak it. The traditional risk detection methods for Dyslexia and Dysgraphia frequently rely on subjective assessments, making it difficult to cover a wide range of risk detection and time-consuming. As a result, diagnoses may be delayed and opportunities for early intervention may be lost. The project was approached by developing a hybrid model that utilized various deep learning techniques for detecting risk of Dyslexia and Dysgraphia. Specifically, Resnet50, VGG16 and YOLOv8 were integrated to detect the handwriting issues, and their outputs were fed into an MLP model along with several other input data. The hyperparameters of the MLP model were fine-tuned using Grid Search CV, which allowed for the optimal values to be identified for the model. This approach proved to be effective in accurately predicting the risk of Dyslexia and Dysgraphia, providing a valuable tool for early detection and intervention of these conditions. The Resnet50 model achieved an accuracy of 0.9804 on the training data and 0.9653 on the validation data. The VGG16 model achieved an accuracy of 0.9991 on the training data and 0.9891 on the validation data. The MLP model achieved an impressive training accuracy of 0.99918 and a testing accuracy of 0.99223, with a loss of 0.01371. These results demonstrate that the proposed hybrid model achieved a high level of accuracy in predicting the risk of Dyslexia and Dysgraphia.

Keywords: neural networks, risk detection system, Dyslexia, Dysgraphia, deep learning, learning disabilities, data science

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1208 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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1207 The Methanotrophic Activity in a Landfill Bio-Cover through a Subzero Winter

Authors: Parvin Berenjkar, Qiuyan Yuan, Richard Sparling, Stan Lozecznik

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Landfills highly contribute to anthropological global warming through CH₄ emissions. Landfills are usually capped by a conventional soil cover to control the migration of gases. Methane is consumed by CH₄-oxidizing microorganisms known as methanotrophs that naturally exist in the landfill soil cover. The growth of methanotrophs can be optimized in a bio-cover that typically consists of a gas distribution layer (GDL) to homogenize landfill gas fluxes and an overlying oxidation layer composed of suitable materials that support methanotrophic populations. Materials such as mature yard waste composts can provide an inexpensive and favourable porous support for the growth and activity of methanotrophs. In areas with seasonal cold climates, it is valuable to know if methanotrophs in a bio-cover can survive in winter until the next spring, and how deep they are active in the bio-cover to mitigate CH₄. In this study, a pilot bio-cover was constructed in a closed landfill cell in Winnipeg that has a very cold climate in Canada. The bio-cover has a surface area of 2.5 m x 3.5 m and 1.5 m of depth, filled with 50 cm of gravel as a GDL and 70 cm of biosolids compost amended with yard and leaf waste compost. The observed in situ potential of methanotrophs for CH₄ oxidation was investigated at a specific period of time from December 2016 to April 2017 as well as November 2017 to April 2018, when the transition to surface frost and thawing happens in the bio-cover. Compost samples taken from different depths of the bio-cover were incubated in the laboratory under standardized conditions; an optimal air: methane atmosphere, at 22ºC, but at in situ moisture content. Results showed that the methanotrophs were alive oxidizing methane without a lag, indicating that there was the potential for methanotrophic activity at some depths of the bio-cover.

Keywords: bio-cover, global warming, landfill, methanotrophic activity

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1206 Optimization of Digestive Conditions of Opuntia ficus-indica var. Saboten using Food-Grade Enzymes

Authors: Byung Wook Yang, Sae Kyul Kim, Seung Il Ahn, Jae Hee Choi, Heejung Jung, Yejin Choi, Byung Yong Kim, Young Tae Hahm

Abstract:

Opuntia ficus-indica is a member of the Cactaceae family that is widely grown in all the semiarid countries throughout the world. Opuntia ficus-indica var. Saboten (OFS), commonly known as prickly pear cactus, is commercially cultivated as a dietary foodstuffs and medicinal stuffs in Jeju Island, Korea. Owing to high viscosity of OFS’ pad, its application to the commercial field has been limited. When the low viscosity of OFS’s pad is obtained, it is useful for the manufacture of healthy food in the related field. This study was performed to obtain the optimal digestion conditions of food-grade enzymes (Pectinex, Viscozyme and Celluclast) with the powder of OFS stem. And also, the contents of water-soluble dietary fiber (WSDF) of the dried powder prepared by the extraction of OFS stem were monitored and optimized using the response surface methodology (RSM), which included 20 experimental points with 3 replicates for two independent variables (fermentation temperature and time). A central composite design was used to monitor the effect of fermentation temperature (30-90 °C, X1) and fermentation time (1-10h, X2) on dependent variables, such as viscosity (Y1), water-soluble dietary fiber (Y2) and dietary fiber yield (Y3). Estimated maximum values at predicted optimum conditions were in agreement with experimental values. Optimum temperature and duration were 50°C and 12 hours, respectively. Viscosity value reached 3.4 poise. Yield of water-soluble dietary fiber is determined in progress.

Keywords: Opuntia ficus-indica var. saboten, enzymatic fermentation, response surface methodology, water-soluble dietary fiber, viscosity

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1205 Ultrasound-Assisted Sol – Gel Synthesis of Nano-Boehmite for Biomedical Purposes

Authors: Olga Shapovalova, Vladimir Vinogradov

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Among many different sol – gel matrices only alumina can be successfully parenteral injected in the human body. And this is not surprising, because boehmite (aluminium oxyhydroxide) is the metal oxide approved by FDA and EMA for intravenous and intramuscular administrations, and also has been using for a longtime as adjuvant for producing of many modern vaccines. In our earlier study, it has been shown, that denaturation temperature of enzymes entrapped in sol-gel boehmite matrix increases for 30 – 60 °С with preserving of initial activity. It makes such matrices more attractive for long-term storage of non-stable drugs. In current work we present ultrasound-assisted sol-gel synthesis of nano-boehmite. This method provides bio-friendly, very stable, highly homogeneous alumina sol with using only water and aluminium isopropoxide as a precursor. Many parameters of the synthesis were studied in details: time of ultrasound treatment, US frequency, surface area, pore and nanoparticle size, zeta potential and others. Here we investigated the dependence of stability of colloidal sols and textural properties of the final composites as a function of the time of ultrasonic treatment. Chosen ultrasonic treatment time was between 30 and 180 minutes. Surface area, average pore diameter and total pore volume of the final composites were measured by surface and pore size analyzer Nova 1200 Quntachrome. It was shown that the matrices with ultrasonic treatment time equal to 90 minutes have the biggest surface area 431 ± 24 m2/g. On the other had such matrices have a smaller stability in comparison with the samples with ultrasonic treatment time equal to 120 minutes that have the surface area 390 ± 21 m2/g. It was shown that the stable sols could be formed only after 120 minutes of ultrasonic treatment, otherwise the white precipitate of boehmite is formed. We conclude that the optimal ultrasonic treatment time is 120 minutes.

Keywords: boehmite matrix, stabilisation, ultrasound-assisted sol-gel synthesis

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1204 Engineering Topology of Construction Ecology in Urban Environments: Suez Canal Economic Zone

Authors: Moustafa Osman Mohammed

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Integration sustainability outcomes give attention to construction ecology in the design review of urban environments to comply with Earth’s System that is composed of integral parts of the (i.e., physical, chemical and biological components). Naturally, exchange patterns of industrial ecology have consistent and periodic cycles to preserve energy flows and materials in Earth’s System. When engineering topology is affecting internal and external processes in system networks, it postulated the valence of the first-level spatial outcome (i.e., project compatibility success). These instrumentalities are dependent on relating the second-level outcome (i.e., participant security satisfaction). Construction ecology approach feedback energy from resources flows between biotic and abiotic in the entire Earth’s ecosystems. These spatial outcomes are providing an innovation, as entails a wide range of interactions to state, regulate and feedback “topology” to flow as “interdisciplinary equilibrium” of ecosystems. The interrelation dynamics of ecosystems are performing a process in a certain location within an appropriate time for characterizing their unique structure in “equilibrium patterns”, such as biosphere and collecting a composite structure of many distributed feedback flows. These interdisciplinary systems regulate their dynamics within complex structures. These dynamic mechanisms of the ecosystem regulate physical and chemical properties to enable a gradual and prolonged incremental pattern to develop a stable structure. The engineering topology of construction ecology for integration sustainability outcomes offers an interesting tool for ecologists and engineers in the simulation paradigm as an initial form of development structure within compatible computer software. This approach argues from ecology, resource savings, static load design, financial other pragmatic reasons, while an artistic/architectural perspective, these are not decisive. The paper described an attempt to unify analytic and analogical spatial modeling in developing urban environments as a relational setting, using optimization software and applied as an example of integrated industrial ecology where the construction process is based on a topology optimization approach.

Keywords: construction ecology, industrial ecology, urban topology, environmental planning

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1203 Parameters Identification and Sensitivity Study for Abrasive WaterJet Milling Model

Authors: Didier Auroux, Vladimir Groza

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This work is part of STEEP Marie-Curie ITN project, and it focuses on the identification of unknown parameters of the proposed generic Abrasive WaterJet Milling (AWJM) PDE model, that appears as an ill-posed inverse problem. The necessity of studying this problem comes from the industrial milling applications where the possibility to predict and model the final surface with high accuracy is one of the primary tasks in the absence of any knowledge of the model parameters that should be used. In this framework, we propose the identification of model parameters by minimizing a cost function, measuring the difference between experimental and numerical solutions. The adjoint approach based on corresponding Lagrangian gives the opportunity to find out the unknowns of the AWJM model and their optimal values that could be used to reproduce the required trench profile. Due to the complexity of the nonlinear problem and a large number of model parameters, we use an automatic differentiation software tool (TAPENADE) for the adjoint computations. By adding noise to the artificial data, we show that in fact the parameter identification problem is highly unstable and strictly depends on input measurements. Regularization terms could be effectively used to deal with the presence of data noise and to improve the identification correctness. Based on this approach we present results in 2D and 3D of the identification of the model parameters and of the surface prediction both with self-generated data and measurements obtained from the real production. Considering different types of model and measurement errors allows us to obtain acceptable results for manufacturing and to expect the proper identification of unknowns. This approach also gives us the ability to distribute the research on more complex cases and consider different types of model and measurement errors as well as 3D time-dependent model with variations of the jet feed speed.

Keywords: Abrasive Waterjet Milling, inverse problem, model parameters identification, regularization

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1202 Search for APN Permutations in Rings ℤ_2×ℤ_2^k

Authors: Daniel Panario, Daniel Santana de Freitas, Brett Stevens

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Almost Perfect Nonlinear (APN) permutations with optimal resistance against differential cryptanalysis can be found in several domains. The permutation used in the standard for symmetric cryptography (the AES), for example, is based on a special kind of inversion in GF(28). Although very close to APN (2-uniform), this permutation still contains one number 4 in its differential spectrum, which means that, rigorously, it must be classified as 4-uniform. This fact motivates the search for fully APN permutations in other domains of definition. The extremely high complexity associated to this kind of problem precludes an exhaustive search for an APN permutation with 256 elements to be performed without the support of a suitable mathematical structure. On the other hand, in principle, there is nothing to indicate which mathematically structured domains can effectively help the search, and it is necessary to test several domains. In this work, the search for APN permutations in rings ℤ2×ℤ2k is investigated. After a full, exhaustive search with k=2 and k=3, all possible APN permutations in those rings were recorded, together with their differential profiles. Some very promising heuristics in these cases were collected so that, when used as a basis to prune backtracking for the same search in ℤ2×ℤ8 (search space with size 16! ≅244), just a few tenths of a second were enough to produce an APN permutation in a single CPU. Those heuristics were empirically extrapolated so that they could be applied to a backtracking search for APNs over ℤ2×ℤ16 (search space with size 32! ≅2117). The best permutations found in this search were further refined through Simulated Annealing, with a definition of neighbors suitable to this domain. The best result produced with this scheme was a 3-uniform permutation over ℤ2×ℤ16 with only 24 values equal to 3 in the differential spectrum (all the other 968 values were less than or equal 2, as it should be the case for an APN permutation). Although far from being fully APN, this result is technically better than a 4-uniform permutation and demanded only a few seconds in a single CPU. This is a strong indication that the use of mathematically structured domains, like the rings described in this work, together with heuristics based on smaller cases, can lead to dramatic cuts in the computational resources involved in the complexity of the search for APN permutations in extremely large domains.

Keywords: APN permutations, heuristic searches, symmetric cryptography, S-box design

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1201 Evaluating Radiation Dose for Interventional Radiologists Performing Spine Procedures

Authors: Kholood A. Baron

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While radiologist numbers specialized in spine interventional procedures are limited in Kuwait, the number of patients demanding these procedures is increasing rapidly. Due to this high demand, the workload of radiologists is increasing, which might represent a radiation exposure concern. During these procedures, the doctor’s hands are in very close proximity to the main radiation beam/ if not within it. The aim of this study is to measure the radiation dose for radiologists during several interventional procedures for the spine. Methods: Two doctors carrying different workloads were included. (DR1) was performing procedures in the morning and afternoon shifts, while (DR2) was performing procedures in the morning shift only. Comparing the radiation exposures that the hand of each doctor is receiving will assess radiation safety and help to set up workload regulations for radiologists carrying a heavy schedule of such procedures. Entrance Skin Dose (ESD) was measured via TLD (ThermoLuminescent Dosimetry) placed at the right wrist of the radiologists. DR1 was covering the morning shift in one hospital (Mubarak Al-Kabeer Hospital) and the afternoon shift in another hospital (Dar Alshifa Hospital). The TLD chip was placed in his gloves during the 2 shifts for a whole week. Since DR2 was covering the morning shift only in Al Razi Hospital, he wore the TLD during the morning shift for a week. It is worth mentioning that DR1 was performing 4-5 spine procedures/day in the morning and the same number in the afternoon and DR2 was performing 5-7 procedures/day. This procedure was repeated for 4 consecutive weeks in order to calculate the ESD value that a hand receives in a month. Results: In general, radiation doses that the hand received in a week ranged from 0.12 to 1.12 mSv. The ESD values for DR1 for the four consecutive weeks were 1.12, 0.32, 0.83, 0.22 mSv, thus for a month (4 weeks), this equals 2.49 mSv and calculated to be 27.39 per year (11 months-since each radiologist have 45 days of leave in each year). For DR2, the weekly ESD values are 0.43, 0.74, 0.12, 0.61 mSv, and thus, for a month, this equals 1.9 mSv, and for a year, this equals 20.9 mSv /year. These values are below the standard level and way below the maximum limit of 500 mSv per year (set by ICRP = International Council of Radiation Protection). However, it is worth mentioning that DR1 was a senior consultant and hence needed less fluoro-time during each procedure. This is evident from the low ESD values of the second week (0.32) and the fourth week (0.22), even though he was performing nearly 10-12 procedures in a day /5 days a week. These values were lower or in the same range as those for DR2 (who was a junior consultant). This highlighted the importance of increasing the radiologist's skills and awareness of fluoroscopy time effect. In conclusion, the radiation dose that radiologists received during spine interventional radiology in our setting was below standard dose limits.

Keywords: radiation protection, interventional radiology dosimetry, ESD measurements, radiologist radiation exposure

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1200 Topology Optimization of Heat and Mass Transfer for Two Fluids under Steady State Laminar Regime: Application on Heat Exchangers

Authors: Rony Tawk, Boutros Ghannam, Maroun Nemer

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Topology optimization technique presents a potential tool for the design and optimization of structures involved in mass and heat transfer. The method starts with an initial intermediate domain and should be able to progressively distribute the solid and the two fluids exchanging heat. The multi-objective function of the problem takes into account minimization of total pressure loss and maximization of heat transfer between solid and fluid subdomains. Existing methods account for the presence of only one fluid, while the actual work extends optimization distribution of solid and two different fluids. This requires to separate the channels of both fluids and to ensure a minimum solid thickness between them. This is done by adding a third objective function to the multi-objective optimization problem. This article uses density approach where each cell holds two local design parameters ranging from 0 to 1, where the combination of their extremums defines the presence of solid, cold fluid or hot fluid in this cell. Finite volume method is used for direct solver coupled with a discrete adjoint approach for sensitivity analysis and method of moving asymptotes for numerical optimization. Several examples are presented to show the ability of the method to find a trade-off between minimization of power dissipation and maximization of heat transfer while ensuring the separation and continuity of the channel of each fluid without crossing or mixing the fluids. The main conclusion is the possibility to find an optimal bi-fluid domain using topology optimization, defining a fluid to fluid heat exchanger device.

Keywords: topology optimization, density approach, bi-fluid domain, laminar steady state regime, fluid-to-fluid heat exchanger

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1199 Alcohol-Containing versus Aqueous-Based Solutions for Skin Preparation in Abdominal Surgery: A Systematic Review and Meta-Analysis

Authors: Dimitra V. Peristeri, Hussameldin M. Nour, Amiya Ahsan, Sameh Abogabal, Krishna K. Singh, Muhammad Shafique Sajid

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Introduction: The use of optimal skin antiseptic agents for the prevention of surgical site infection (SSI) is of critical importance, especially during abdominal surgical procedures. Alcohol-based chlorhexidine gluconate (CHG) and aqueous-based povidone-iodine (PVI) are the two most common skin antiseptics used nowadays. The objective of this article is to evaluate the effectiveness of alcohol-based CHG versus aqueous-based PVI used for skin preparation before abdominal surgery to reduce SSIs. Methods: Standard medical databases such as MEDLINE, Embase, Pubmed, and Cochrane Library were searched to find randomised, controlled trials (RCTs) comparing alcohol-based CHG skin preparation versus aqueous-based PVI in patients undergoing abdominal surgery. The combined outcomes of SSIs were calculated using an odds ratio (OR) with 95% confidence intervals (95% CI). All data were analysed using Review Manager (RevMan) Software 5.4, and the meta-analysis was performed with a random effect model analysis. Results: A total of 11 studies, all RCTs, were included (n= 12072 participants), recruiting adult patients undergoing abdominal surgery. In the random effect model analysis, the use of alcohol-based CHG in patients undergoing abdominal surgery was associated with a reduced risk of SSI compared to aqueous-based PVI (OR: 0.84; 95% CI [0.74, 0.96], z= 2.61, p= 0.009). Conclusion: Alcohol-based CHG may be more effective for preventing the risk of SSI compared to aqueous-based PVI agents in abdominal surgery. The conclusion of this meta-analysis may add a guiding value to reinforce current clinical practice guidelines.

Keywords: skin preparation, surgical site infection, chlorhexidine, skin antiseptics

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1198 Evolution of Rock-Cut Caves of Dhamnar at Dhamnar, MP

Authors: Abhishek Ranka

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Rock-cut Architecture is a manifestation of human endurance in constructing magnificent structures by sculpting and cutting entire hills. Cave Architecture in India form an important part of rock-cut development and is among the most prolific examples of rock-cut architecture in the world. There are more than 1500 rock-cut caves in various regions of India. Among them mostly are located in western India, more particularly in the state of Maharashtra. Some of the rock-cut caves are located in the central region of India, which is presently known as Malawa (Madhya Pradesh). The region is dominated by the vidhyachal hill ranges toward the west, dotted with the coarse laterite rock. Dhamnar Caves have been excavated in the central region of Mandsaur Dist. With a combination of shared sacred faiths. The earliest rock-cut activity began in the north, in Bihar, where caves were excavated in the Barabar and the Nagarjuni hills during the Mauryan period (3rd century BCE). The rock-cut activity then shifts to the central part of India in Madhya Pradesh, where the caves at Dhamnar, Bagh, Udayagiri, Poldungar, etc. excavated between 3rdto 9ᵗʰ CE. The rock-cut excavation continued to flourish in Madhya Pradesh till 10ᵗʰ century CE, simultaneously with monolithic Hindu temples. Dhamnar caves fall into four architectural typologies: the Lena caves, Chaitya caves, Viharas & Lena-Chaityagriha caves. The Buddhist rock-cutting activity in central India is divisible into two phases. In the first phase (2ndBCE-3rd CE), the Buddha image is conspicuously absent. After a lapse of about three centuries, activity begins again, and the Buddha images this time are carved. The former group belongs to the Hinayana (Lesser Vehicle) phase and the latter to the Mahayana (Greater Vehicle). Dhamnar caves has an elaborate facades, pillar capitals, and many more creative sculptures in various postures. These caves were excavated against the background of invigorating trade activities and varied socio-religious or Socio Cultural contexts. These caves also highlights the wealthy and varied patronage provided by the dynasties of the past. This paper speaks about the appraisal of the rock cut mechanisms, design strategies, and approaches while promoting a scope for further research in conservation practices. Rock-cut sites, with their physical setting and various functional spaces as a sustainable habitat for centuries, has a heritage footprint with a researchquotient.

Keywords: rock-cut architecture, buddhism, hinduism, Iconography, and architectural typologies, Jainism

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1197 Optimization of Enzymatic Hydrolysis of Cooked Porcine Blood to Obtain Hydrolysates with Potential Biological Activities

Authors: Miguel Pereira, Lígia Pimentel, Manuela Pintado

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Animal blood is a major by-product of slaughterhouses and still represents a cost and environmental problem in some countries. To be eliminated, blood should be stabilised by cooking and afterwards the slaughterhouses must have to pay for its incineration. In order to reduce the elimination costs and valorise the high protein content the aim of this study was the optimization of hydrolysis conditions, in terms of enzyme ratio and time, in order to obtain hydrolysates with biological activity. Two enzymes were tested in this assay: pepsin and proteases from Cynara cardunculus (cardosins). The latter has the advantage to be largely used in the Portuguese Dairy Industry and has a low price. The screening assays were carried out in a range of time between 0 and 10 h and using a ratio of enzyme/reaction volume between 0 and 5%. The assays were performed at the optimal conditions of pH and temperature for each enzyme: 55 °C at pH 5.2 for cardosins and 37 °C at pH 2.0 for pepsin. After reaction, the hydrolysates were evaluated by FPLC (Fast Protein Liquid Chromatography) and tested for their antioxidant activity by ABTS method. FPLC chromatograms showed different profiles when comparing the enzymatic reactions with the control (no enzyme added). The chromatogram exhibited new peaks with lower MW that were not present in control samples, demonstrating the hydrolysis by both enzymes. Regarding to the antioxidant activity, the best results for both enzymes were obtained using a ratio enzyme/reactional volume of 5% during 5 h of hydrolysis. However, the extension of reaction did not affect significantly the antioxidant activity. This has an industrial relevant aspect in what concerns to the process cost. In conclusion, the enzymatic blood hydrolysis can be a better alternative to the current elimination process allowing to the industry the reuse of an ingredient with biological properties and economic value.

Keywords: antioxidant activity, blood, by-products, enzymatic hydrolysis

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1196 Italian Sign Language and Deafness in a North-Italian Border Region: Results of Research on the Linguistic Needs of Teachers and Students

Authors: Maria Tagarelli De Monte

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In 2021, the passage of the law recognizing Italian Sign Language (LIS) as the language of the Italian deaf minority was the input for including this visual-gestural language in the curricula of interpreters and translators choosing the academic setting for their training. Yet, a gap remains concerning LIS education of teachers and communication assistants as referring figures for people who are deaf or hard of hearing in mainstream education. As well documented in the related scientific literature, deaf children often experience severe difficulties with the languages spoken in the country where they grow up, manifesting in all levels of literacy competence. In the research introduced here, the experience of deaf students (and their teachers) attending schools is explored in areas that are characterized by strong native bilingualism, such as Friuli-Venezia Giulia (FVG), facing Italian Northeast borders. This region is peculiar as the native population may be bilingual Italian and Friulian (50% of the local population), German, and/or Slovenian. The research involved all schools of all levels in Friuli to understand the relationship between the language skills expressed by teachers and those shown by deaf learners with a background in sign language. In addition to collecting specific information on the degree of preparation of teachers in deaf-related matters and LIS, the research has allowed to highlight the role, often poorly considered, covered by the communication assistants who work alongside deaf students. On several occasions, teachers and assistants were unanimous in affirming the importance of mutual collaboration and adequate consideration of the educational-rehabilitative history of the deaf child and her family. The research was based on a mixed method of structured questionnaires and semi-structured interviews with the referring teachers. As a result, a varied and complex framework emerged, showing an asymmetry in preparing personnel dedicated to the deaf learner. Considering how Italian education has long invested in creating an inclusive and accessible school system (i.e. with the "Ten Theses for Democratic Language Education"), a constructive analysis will complete the discussion in an attempt to understand how linguistic (and modal) differences can become levers of inclusion.

Keywords: FVG, LIS, linguistic needs, deafness, teacher education, bilingual bimodal children, communication assistants, inclusion model

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1195 Enhancing Wire Electric Discharge Machining Efficiency through ANOVA-Based Process Optimization

Authors: Rahul R. Gurpude, Pallvita Yadav, Amrut Mulay

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In recent years, there has been a growing focus on advanced manufacturing processes, and one such emerging process is wire electric discharge machining (WEDM). WEDM is a precision machining process specifically designed for cutting electrically conductive materials with exceptional accuracy. It achieves material removal from the workpiece metal through spark erosion facilitated by electricity. Initially developed as a method for precision machining of hard materials, WEDM has witnessed significant advancements in recent times, with numerous studies and techniques based on electrical discharge phenomena being proposed. These research efforts and methods in the field of ED encompass a wide range of applications, including mirror-like finish machining, surface modification of mold dies, machining of insulating materials, and manufacturing of micro products. WEDM has particularly found extensive usage in the high-precision machining of complex workpieces that possess varying hardness and intricate shapes. During the cutting process, a wire with a diameter ranging from 0.18mm is employed. The evaluation of EDM performance typically revolves around two critical factors: material removal rate (MRR) and surface roughness (SR). To comprehensively assess the impact of machining parameters on the quality characteristics of EDM, an Analysis of Variance (ANOVA) was conducted. This statistical analysis aimed to determine the significance of various machining parameters and their relative contributions in controlling the response of the EDM process. By undertaking this analysis, optimal levels of machining parameters were identified to achieve desirable material removal rates and surface roughness.

Keywords: WEDM, MRR, optimization, surface roughness

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1194 A Deep Learning Model with Greedy Layer-Wise Pretraining Approach for Optimal Syngas Production by Dry Reforming of Methane

Authors: Maryam Zarabian, Hector Guzman, Pedro Pereira-Almao, Abraham Fapojuwo

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Dry reforming of methane (DRM) has sparked significant industrial and scientific interest not only as a viable alternative for addressing the environmental concerns of two main contributors of the greenhouse effect, i.e., carbon dioxide (CO₂) and methane (CH₄), but also produces syngas, i.e., a mixture of hydrogen (H₂) and carbon monoxide (CO) utilized by a wide range of downstream processes as a feedstock for other chemical productions. In this study, we develop an AI-enable syngas production model to tackle the problem of achieving an equivalent H₂/CO ratio [1:1] with respect to the most efficient conversion. Firstly, the unsupervised density-based spatial clustering of applications with noise (DBSAN) algorithm removes outlier data points from the original experimental dataset. Then, random forest (RF) and deep neural network (DNN) models employ the error-free dataset to predict the DRM results. DNN models inherently would not be able to obtain accurate predictions without a huge dataset. To cope with this limitation, we employ reusing pre-trained layers’ approaches such as transfer learning and greedy layer-wise pretraining. Compared to the other deep models (i.e., pure deep model and transferred deep model), the greedy layer-wise pre-trained deep model provides the most accurate prediction as well as similar accuracy to the RF model with R² values 1.00, 0.999, 0.999, 0.999, 0.999, and 0.999 for the total outlet flow, H₂/CO ratio, H₂ yield, CO yield, CH₄ conversion, and CO₂ conversion outputs, respectively.

Keywords: artificial intelligence, dry reforming of methane, artificial neural network, deep learning, machine learning, transfer learning, greedy layer-wise pretraining

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1193 Optimizing the Window Geometry Using Fractals

Authors: K. Geetha Ramesh, A. Ramachandraiah

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In an internal building space, daylight becomes a powerful source of illumination. The challenge therefore, is to develop means of utilizing both direct and diffuse natural light in buildings while maintaining and improving occupant's visual comfort, particularly at greater distances from the windows throwing daylight. The geometrical features of windows in a building have significant effect in providing daylight. The main goal of this research is to develop an innovative window geometry, which will effectively provide the daylight component adequately together with internal reflected component(IRC) and also the external reflected component(ERC), if any. This involves exploration of a light redirecting system using fractal geometry for windows, in order to penetrate and distribute daylight more uniformly to greater depths, minimizing heat gain and glare, and also to reduce building energy use substantially. Of late the creation of fractal geometrical window and the occurrence of daylight illuminance due to such windows is becoming an interesting study. The amount of daylight can change significantly based on the window geometry and sky conditions. This leads to the (i) exploration of various fractal patterns suitable for window designs, and (ii) quantification of the effect of chosen fractal window based on the relationship between the fractal pattern, size, orientation and glazing properties for optimizing daylighting. There are a lot of natural lighting applications able to predict the behaviour of a light in a room through a traditional opening - a regular window. The conventional prediction methodology involves the evaluation of the daylight factor, the internal reflected component and the external reflected component. Having evaluated the daylight illuminance level for a conventional window, the technical performance of a fractal window for an optimal daylighting is to be studied and compared with that of a regular window. The methodologies involved are highlighted in this paper.

Keywords: daylighting, fractal geometry, fractal window, optimization

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1192 Detecting Potential Geothermal Sites by Using Well Logging, Geophysical and Remote Sensing Data at Siwa Oasis, Western Desert, Egypt

Authors: Amr S. Fahil, Eman Ghoneim

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Egypt made significant efforts during the past few years to discover significant renewable energy sources. Regions in Egypt that have been identified for geothermal potential investigation include the Gulf of Suez and the Western Desert. One of the most promising sites for the development of Egypt's Northern Western Desert is Siwa Oasis. The geological setting of the oasis, a tectonically generated depression situated in the northernmost region of the Western desert, supports the potential for substantial geothermal resources. Field data obtained from 27 deep oil wells along the Western Desert included bottom-hole temperature (BHT) depth to basement measurements, and geological maps; data were utilized in this study. The major lithological units, elevation, surface gradient, lineaments density, and remote sensing multispectral and topographic were mapped together to generate the related physiographic variables. Eleven thematic layers were integrated in a geographic information system (GIS) to create geothermal maps to aid in the detection of significant potential geothermal spots along the Siwa Oasis and its vicinity. The contribution of total magnetic intensity data with reduction to the pole (RTP) to the first investigation of the geothermal potential in Siwa Oasis is applied in this work. The integration of geospatial data with magnetic field measurements showed a clear correlation between areas of high heat flow and magnetic anomalies. Such anomalies can be interpreted as related to the existence of high geothermal energy and dense rock, which also have high magnetic susceptibility. The outcomes indicated that the study area has a geothermal gradient ranging from 18 to 42 °C/km, a heat flow ranging from 24.7 to 111.3 m.W. k−1, a thermal conductivity of 1.3–2.65 W.m−1.k−1 and a measured amplitude temperature maximum of 100.7 °C. The southeastern part of the Siwa Oasis, and some sporadic locations on the eastern section of the oasis were found to have significant geothermal potential; consequently, this location is suitable for future geothermal investigation. The adopted method might be applied to identify significant prospective geothermal energy locations in other regions of Egypt and East Africa.

Keywords: magnetic data, SRTM, depth to basement, remote sensing, GIS, geothermal gradient, heat flow, thermal conductivity

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1191 The Acute Effects of Higher Versus Lower Load Duration and Intensity on Morphological and Mechanical Properties of the Healthy Achilles Tendon: A Randomized Crossover Trial

Authors: Eman Merza, Stephen Pearson, Glen Lichtwark, Peter Malliaras

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The Achilles tendon (AT) exhibits volume changes related to fluid flow under acute load which may be linked to changes in stiffness. Fluid flow provides a mechanical signal for cellular activity and may be one mechanism that facilitates tendon adaptation. This study aimed to investigate whether isometric intervention involving a high level of load duration and intensity could maximize the immediate reduction in AT volume and stiffness compared to interventions involving a lower level of load duration and intensity. Sixteen healthy participants (12 males, 4 females; age= 24.4 ± 9.4 years; body mass= 70.9 ± 16.1 kg; height= 1.7 ± 0.1 m) performed three isometric interventions of varying levels of load duration (2 s and 8 s) and intensity (35% and 75% maximal voluntary isometric contraction) over a 3 week period. Freehand 3D ultrasound was used to measure free AT volume (at rest) and length (at 35%, 55%, and 75% of maximum plantarflexion force) pre- and post-interventions. The slope of the force-elongation curve over these force levels represented individual stiffness (N/mm). Large reductions in free AT volume and stiffness resulted in response to long-duration high-intensity loading whilst less reduction was produced with a lower load intensity. In contrast, no change in free AT volume and a small increase in AT stiffness occurred with lower load duration. These findings suggest that the applied load on the AT must be heavy and sustained for a long duration to maximize immediate volume reduction, which might be an acute response that enables optimal long-term tendon adaptation via mechanotransduction pathways.

Keywords: Achilles tendon, volume, stiffness, free tendon, 3d ultrasound

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1190 Groundwater Influences Wellbeing of Farmers from Semi-Arid Areas of India: Assessment of Subjective Wellbeing

Authors: Seemabahen Dave, Maria Varua, Basant Maheshwari, Roger Packham

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The declining groundwater levels and quality are acknowledged to be affecting the well-being of farmers especially those located in the semi-arid regions where groundwater is the only source of water for domestic and agricultural use. Further, previous studies have identified the need to examine the quality of life of farmers beyond economic parameters and for a shift in setting rural development policy goals to the perspective of beneficiaries. To address these gaps, this paper attempts to ascertain the subjective wellbeing of farmers from two semi-arid regions of India. The study employs the integrated conceptual framework for the assessment of individual and regional subjective wellbeing developed by Larson in 2009 at Australia. The method integrates three domains i.e. society, natural environment and economic services consisting of 37 wellbeing factors. The original set of 27 revised wellbeing factors identified by John Ward is further revised in current study to make it more region specific. Generally, researchers in past studies select factors of wellbeing based on literature and assign the weights arbitrary. In contrast, the present methodology employs a unique approach by asking respondents to identify the factors most important to their wellbeing and assign weights of importance based on their responses. This method minimises the selection bias and assesses the wellbeing from farmers’ perspectives. The primary objectives of this study are to identify key wellbeing attributes and to assess the influence of groundwater on subjective wellbeing of farmers. Findings from 507 farmers from 11 villages of two watershed areas of Rajasthan and Gujarat, India chosen randomly and were surveyed using a structured face-to-face questionnaire are presented in this paper. The results indicate that significant differences exist in the ranking of wellbeing factors at individual, village and regional levels. The top five most important factors in the study areas include electricity, irrigation infrastructure, housing, land ownership, and income. However, respondents are also most dissatisfied with these factors and correspondingly perceive a high influence of groundwater on them. The results thus indicate that intervention related to improvement of groundwater availability and quality will greatly improve the satisfaction level of well-being factors identified by the farmers.

Keywords: groundwater, farmers, semi-arid regions, subjective wellbeing

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1189 The Reflexive Interaction in Group Formal Practices: The Question of Criteria and Instruments for the Character-Skills Evaluation

Authors: Sara Nosari

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In the research field on adult education, the learning development project followed different itineraries: recently it has promoted adult transformation by practices focused on the reflexive oriented interaction. This perspective, that connects life stories and life-based methods, characterizes a transformative space between formal and informal education. Within this framework, in the Nursing Degree Courses of Turin University, it has been discussed and realized a formal reflexive path on the care work professional identity through group practices. This path compared the future care professionals with possible experiences staged by texts used with the function of a pre-tests: these texts, setting up real or believable professional situations, had the task to start a reflection on the different 'elements' of care work professional life (relationship, educational character of relationship, relationship between different care roles; or even human identity, aims and ultimate aim of care, …). The learning transformative aspect of this kind of experience-test is that it is impossible to anticipate the process or the conclusion of reflexion because they depend on two main conditions: the personal sensitivity and the specific situation. The narrated experience is not a device, it does not include any tricks to understand the answering advance; the text is not aimed at deepening the knowledge, but at being an active and creative force which takes the group to compare with problematic figures. In fact, the experience-text does not have the purpose to explain but to problematize: it creates a space of suspension to live for questioning, for discussing, for researching, for deciding. It creates a space 'open' and 'in connection' where each one, in comparing with others, has the possibility to build his/her position. In this space, everyone has to possibility to expose his/her own argumentations and to be aware of the others emerged points of view, aiming to research and find the own personal position. However, to define his/her position, it is necessary to learn to exercise character skills (conscientiousness, motivation, creativity, critical thinking, …): if these not-cognitive skills have an undisputed evidence, less evident is how to value them. The paper will reflect on the epistemological limits and possibility to 'measure' character skills, suggesting some evaluation criteria.

Keywords: transformative learning, educational role, formal/informal education, character-skills

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1188 Multilingualism and the Creation of New Languages: The Case of Camfranglais Spoken in Italy and Germany

Authors: Jocelyne Kenne Kenne

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Previous works in the field of sociolinguistics have explored the various outcomes of linguistic pluralism. One of these outcomes is the creation of new languages. The presentation will focus on one of such languages, Camfranglais, a hybrid language spoken by Cameroonians. It appeared in the 1970s in the francophone area in Cameroon and developed as a result of interactions between French, English, Cameroonian Pidgin English and local Cameroonian languages, all languages spoken in Cameroon. With the migration of Cameroonians to Europe, researches have been conducted to analyze the sociolinguistic profile of Cameroonians in their new environment. The emphasis on this presentation will be on two recent studies that have been conducted to analyze the peculiarity of Camfranglais in two European countries: Germany and Italy. The research involved 59 Cameroonians living in Italy and 49 Cameroonians residing in Germany. The respondents were composed of participants from different linguistic background, students and workers, married and single. A combination of quantitative and qualitative research methods was employed. The field study was divided into three parts. The first part was focused on observing the Cameroonians interact in different places such as in canteens, in the university halls of residence, lecture theatres, at homes, at various Cameroonian meetings. Those observations were accompanied by audio-recordings of the various interactions. The aim was to study communication between Cameroonians to see whether they use Camfranglais or not; if yes, in which domains and what were the speakers’ linguistic profiles. Additionally, questionnaires of different lengths were used to collect biographical information concerning the participants and their sociolinguistic profile and finally, in-depth interviews with Cameroonians were conducted to inquire about the use, the functions and the importance of this language in the migratory context. The results of the research demonstrate how a widespread use of Camfranglais by Cameroonians in Germany and Italy reveal a longing for home on the one hand and a sign of belonging on the other. It also shows the differences that exist between the profiles of Camfranglais speakers in Europe and the speakers in Cameroon notably in terms of age and social class. Finally, it points out some differences in the use, the structure and the functions of this hybrid language in the migratory setting. This study is a contribution to existing research in the field of contact languages and can serve as a comparison for other situations of multilingualism and the creation of mixed languages. Furthermore, with globalization, the study of migrant languages and the contact of these languages with new languages are topics that might be productive for further research in the field of sociolinguistics.

Keywords: interaction, migrants language, multilingualism, mixed languages

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1187 Optimization of Process Parameters for Copper Extraction from Wastewater Treatment Sludge by Sulfuric Acid

Authors: Usarat Thawornchaisit, Kamalasiri Juthaisong, Kasama Parsongjeen, Phonsiri Phoengchan

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In this study, sludge samples that were collected from the wastewater treatment plant of a printed circuit board manufacturing industry in Thailand were subjected to acid extraction using sulfuric acid as the chemical extracting agent. The effects of sulfuric acid concentration (A), the ratio of a volume of acid to a quantity of sludge (B) and extraction time (C) on the efficiency of copper extraction were investigated with the aim of finding the optimal conditions for maximum removal of copper from the wastewater treatment sludge. Factorial experimental design was employed to model the copper extraction process. The results were analyzed statistically using analysis of variance to identify the process variables that were significantly affected the copper extraction efficiency. Results showed that all linear terms and an interaction term between volume of acid to quantity of sludge ratio and extraction time (BC), had statistically significant influence on the efficiency of copper extraction under tested conditions in which the most significant effect was ascribed to volume of acid to quantity of sludge ratio (B), followed by sulfuric acid concentration (A), extraction time (C) and interaction term of BC, respectively. The remaining two-way interaction terms, (AB, AC) and the three-way interaction term (ABC) is not statistically significant at the significance level of 0.05. The model equation was derived for the copper extraction process and the optimization of the process was performed using a multiple response method called desirability (D) function to optimize the extraction parameters by targeting maximum removal. The optimum extraction conditions of 99% of copper were found to be sulfuric acid concentration: 0.9 M, ratio of the volume of acid (mL) to the quantity of sludge (g) at 100:1 with an extraction time of 80 min. Experiments under the optimized conditions have been carried out to validate the accuracy of the Model.

Keywords: acid treatment, chemical extraction, sludge, waste management

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1186 Qualitative Analysis of User Experiences and Needs for Educational Chatbots in Higher Education

Authors: Felix Golla

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In an era where technology increasingly intersects with education, the potential of chatbots and ChatGPT agents in enhancing student learning experiences in higher education is both significant and timely. This study explores the integration of these AI-driven tools in educational settings, emphasizing their design and functionality to meet the specific needs of students. Recognizing the gap in literature concerning student-centered AI applications in education, this research offers valuable insights into the role and efficacy of chatbots and ChatGPT agents as educational tools. Employing qualitative research methodologies, the study involved conducting semi-structured interviews with university students. These interviews were designed to gather in-depth insights into the students' experiences and expectations regarding the use of AI in learning environments. The High-Performance Cycle Model, renowned for its focus on goal setting and motivation, served as the theoretical framework guiding the analysis. This model helped in systematically categorizing and interpreting the data, revealing the nuanced perceptions and preferences of students regarding AI tools in education. The major findings of the study indicate a strong preference among students for chatbots and ChatGPT agents that offer personalized interaction, adaptive learning support, and regular, constructive feedback. These features were deemed essential for enhancing student engagement, motivation, and overall learning outcomes. Furthermore, the study revealed that students perceive these AI tools not just as passive sources of information but as active facilitators in the learning process, capable of adapting to individual learning styles and needs. In conclusion, this study underscores the transformative potential of chatbots and ChatGPT agents in higher education. It highlights the need for these AI tools to be designed with a student-centered approach, ensuring their alignment with educational objectives and student preferences. The findings contribute to the evolving discourse on AI in education, suggesting a paradigm shift towards more interactive, responsive, and personalized learning experiences. This research not only informs educators and technologists about the desirable features of educational chatbots but also opens avenues for future studies to explore the long-term impact of AI integration in academic curricula.

Keywords: chatbot design in education, high-performance cycle model application, qualitative research in AI, student-centered learning technologies

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1185 Impact of Non-Parental Early Childhood Education on Digital Friendship Tendency

Authors: Sheel Chakraborty

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Modern society in developed countries has distanced itself from the earlier norm of joint family living, and with the increase of economic pressure, parents' availability for their children during their infant years has been consistently decreasing over the past three decades. During the same time, the pre-primary education system - built mainly on the developmental psychology theory framework of Jean Piaget and Lev Vygotsky, has been promoted in the US through the legislature and funding. Early care and education may have a positive impact on young minds, but a growing number of kids facing social challenges in making friendships in their teenage years raises serious concerns about its effectiveness. The survey-based primary research presented here shows a statistically significant number of millennials between the ages of 10 and 25 prefer to build friendships virtually than face-to-face interactions. Moreover, many teenagers depend more on their virtual friends whom they never met. Contrary to the belief that early social interactions in a non-home setup make the kids confident and more prepared for the real world, many shy-natured kids seem to develop a sense of shakiness in forming social relationships, resulting in loneliness by the time they are young adults. Reflecting on George Mead’s theory of self that is made up of “I” and “Me”, most functioning homes provide the required freedom and forgivable, congenial environment for building the "I" of a toddler; however, daycare or preschools can barely match that. It seems social images created from the expectations perceived by preschoolers “Me" in a non-home setting may interfere and greatly overpower the formation of a confident "I" thus creating a crisis around the inability to form friendships face to face when they grow older. Though the pervasive nature of social media can’t be ignored, the non-parental early care and education practices adopted largely by the urban population have created a favorable platform of teen psychology on which social media popularity thrived, especially providing refuge to shy Gen-Z teenagers. This can explain why young adults today perceive social media as their preferred outlet of expression and a place to form dependable friendships, despite the risk of being cyberbullied.

Keywords: digital socialization, shyness, developmental psychology, friendship, early education

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1184 Thoughts Regarding Interprofessional Work between Nurses and Speech-Language-Hearing Therapists in Cancer Rehabilitation: An Approach for Dysphagia

Authors: Akemi Nasu, Keiko Matsumoto

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Rehabilitation for cancer requires setting up individual goals for each patient and an approach that properly fits the stage of cancer when putting into practice. In order to cope with the daily changes in the patients' condition, the establishment of a good cooperative relationship between the nurses and the physiotherapists, occupational therapists, and speech-language-hearing therapists (therapists) becomes essential. This study will focus on the present situation of the cooperation between nurses and therapists, especially the speech-language-hearing therapists, and aim to elucidate what develops there. A semi-structured interview was conducted targeted at a physical therapist having practical experience in working in collaboration with nurses. The contents of the interview were transcribed and converted to data, and the data was encoded and categorized with sequentially increasing degrees of abstraction to conduct a qualitative explorative factor analysis of the data. When providing ethical explanations, particular care was taken to ensure that participants would not be subjected to any disadvantages as a result of participating in the study. In addition, they were also informed that their privacy would be ensured and that they have the right to decline to participate in the study. In addition, they were also informed that the results of the study would be announced publicly at an applicable nursing academic conference. This study has been approved following application to the ethical committee of the university with which the researchers are affiliated. The survey participant is a female speech-language-hearing therapist in her forties. As a result of the analysis, 6 categories were extracted consisting of 'measures to address appetite and aspiration pneumonia prevention', 'limitation of the care a therapist alone could provide', 'the all-inclusive patient- supportive care provided by nurses', 'expand the beneficial cooperation with nurses', 'providing education for nurses on the swallowing function utilizing videofluoroscopic examination of swallowing', 'enhancement of communication including conferences'. In order to improve the team performance, and for the teamwork competency necessary for the provision of safer care, mutual support is essential. As for the cooperation between nurses and therapists, this survey indicates that the maturing of the cooperation between professionals in order to improve nursing professionals' knowledge and enhance communication will lead to an improvement in the quality of the rehabilitation for cancer.

Keywords: cancer rehabilitation, nurses, speech-language-hearing therapists, interprofessional work

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1183 Carbapenem Usage in Medical Wards: An Antibiotic Stewardship Feedback Project

Authors: Choon Seong Ng, P. Petrick, C. L. Lau

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Background: Carbapenem-resistant isolates have been increasingly reported recently. Carbapenem stewardship is designed to optimize its usage particularly among medical wards with high prevalence of carbapenem prescriptions to combat such emerging resistance. Carbapenem stewardship programmes (CSP) can reduce antibiotic use but clinical outcome of such measures needs further evaluation. We examined this in a prospective manner using feedback mechanism. Methods: Our single-center prospective cohort study involved all carbapenem prescriptions across the medical wards (including medical patients admitted to intensive care unit) in a tertiary university hospital setting. The impact of such stewardship was analysed according to the accepted and the rejected groups. The primary endpoint was safety. Safety measure applied in this study was the death at 1 month. Secondary endpoints included length of hospitalisation and readmission. Results: Over the 19 months’ period, input from 144 carbapenem prescriptions was analysed on the basis of acceptance of our CSP recommendations on the use of carbapenems. Recommendations made were as follows : de-escalation of carbapenem; stopping the carbapenem; use for a short duration of 5-7 days; required prolonged duration in the case of carbapenem-sensitive Extended Spectrum Beta-Lactamases bacteremia; dose adjustment; and surgical intervention for removal of septic foci. De-escalation, shorten duration of carbapenem and carbapenem cessation comprised 79% of the recommendations. Acceptance rate was 57%. Those who accepted CSP recommendations had no increase in mortality (p = 0.92), had a shorter length of hospital stay (LOS) and had cost-saving. Infection-related deaths were found to be higher among those in the rejected group. Moreover, three rejected cases (6%) among all non-indicated cases (n = 50) were found to have developed carbapenem-resistant isolates. Lastly, Pitt’s bacteremia score appeared to be a key element affecting the carbapenem prescription’s behaviour in this trial. Conclusions: Carbapenem stewardship program in the medical wards not only saves money, but most importantly it is safe and does not harm the patients with added benefits of reducing the length of hospital stay. However, more time is needed to engage the primary clinical teams by formal clinical presentation and immediate personal feedback by senior Infectious Disease (ID) personnel to increase its acceptance.

Keywords: audit and feedback, carbapenem stewardship, medical wards, university hospital

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1182 Attitudes Towards Homosexuality, Bisexuality and Transgenderism among Medical Students of a Sri Lankan University

Authors: Rajapaksha J. S. R. L., Rajapaksha R. G. D. T., Ranawaka A. U. R., Rangalla R. D. M. P., Ranwala R. D. E. B., Chandratilake M. N.

Abstract:

Introduction: Lesbian, gay, bisexual, and transgender (LGBT) patients experience discrimination, insensitivity, and ignorance about LGBT-specific health needs among healthcare providers. Developing the correct attitudes among medical students towards LGBT may help provide them with optimal healthcare. Objectives: This study aimed at assessing the attitudes of medical students towards the LBGT community. Methodology: A cross-sectional descriptive study was among all the medical students in the Faculty of Medicine, University of Kelaniya, Sri Lanka, using a validated online questionnaire. The questionnaire focused on eight areas. The data were descriptively analyzed, and the demographic groups were compared. Results: 358 students completed the survey. The response rate was 34.26%. Their attitudes on traditional gender roles and comfortability in interacting with LGBT people were moderate, and they disagreed with negative LGBT social beliefs. They knew less about the origin of sexuality/gender of LGBT. Although they accepted LGBT as a part of diversity, they discouraged normalizing the social practices of LGBT people. Their acceptance and association of LGBT were moderately positive. A minority has encountered LGBT in close social circles, and the majority of them were batch-mates. Although males’ knowledge about the origin of LGBT was higher, they favoured traditional gender roles more. The religious groups showed no differences. The favourability of attitudes towards LGBT reflected respondents’ political ideology. Conclusion: Although medical students’ knowledge on the sexuality/gender basis of LGBT is poor, they have moderately favourable attitudes towards them. They accept LGBT as a part of social diversity but not their social practices. Poor knowledge, lack of encounters, cultural influences, and political ideology may have influenced their attitudes.

Keywords: medical students, attitude, LGBT, diversity

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1181 Organized Crime-A Social Challenge for Kosovo towards European Union Integration

Authors: Samedin Mehmeti

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Very tens political and economic situation, in particular armed conflicts that followed at the time of the destruction of the former Yugoslavia, influenced migrations and displacement of population. Especially setting international sanctions and embargo influenced the creation of organized criminal groups. A lot of members of the former Yugoslav security apparatus in collaboration with ordinary criminal groups engaged in: smuggling of goods, petroleum and arms, sale and transport of drugs, payable murder, damage to public property, kidnappings, extortion, racketeering, etc. This tradition of criminality, of course in other forms and with other methods, has continued after conflicts and continues with a high intensity even in nowadays. One of the most delicate problems of organized crime activity is the impact on the economic sphere, where organized crime opposes and severely damages national security and economy to criminalize it in certain sectors and directions. Organized crime groups including who find Kosovo as a place to develop their criminal activities are characterized by: loyalty of many people especially through family connections and kinship in carrying out criminal activities and the existence of powerful hierarchy of leadership which in many cases include the corrupt officials of state apparatus. Groups have clear hierarchy and flexible structure of command, each member within the criminal group knows his duties concrete. According to statistics presented in police reports its notable that Kosovo has a large number of cases of organized crime, cultivation, trafficking and possession of narcotics. As already is very well known that one of the primary conditions that must be fulfilled on track toward integration in the European Union is precisely to prevent and combat organized crime. Kosovo has serious problems with prosecutorial and judicial system. But the misuse of public funds, even those coming directly from EU budget or the budget of the European Union member states, have a negative impact on this process. The economic crisis that has gripped some of the EU countries has led to the creation of an environment in which there are far fewer resources and opportunities to invest in preventing and combating organized crime within member states. This automatically reduces the level of financial support for other countries in the fight against organized crime. Kosovo as a poor country, now has less likely benefiting from the support tools that will be eventually offered by Europe set of in this area.

Keywords: police, european integration, organized crime, narcotics

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1180 Management Tools for Assessment of Adverse Reactions Caused by Contrast Media at the Hospital

Authors: Pranee Suecharoen, Ratchadaporn Soontornpas, Jaturat Kanpittaya

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Background: Contrast media has an important role for disease diagnosis through detection of pathologies. Contrast media can, however, cause adverse reactions after administration of its agents. Although non-ionic contrast media are commonly used, the incidence of adverse events is relatively low. The most common reactions found (10.5%) were mild and manageable and/or preventable. Pharmacists can play an important role in evaluating adverse reactions, including awareness of the specific preparation and the type of adverse reaction. As most common types of adverse reactions are idiosyncratic or pseudo-allergic reactions, common standards need to be established to prevent and control adverse reactions promptly and effectively. Objective: To measure the effect of using tools for symptom evaluation in order to reduce the severity, or prevent the occurrence, of adverse reactions from contrast media. Methods: Retrospective review descriptive research with data collected on adverse reactions assessment and Naranjo’s algorithm between June 2015 and May 2016. Results: 158 patients (10.53%) had adverse reactions. Of the 1,500 participants with an adverse event evaluation, 137 (9.13%) had a mild adverse reaction, including hives, nausea, vomiting, dizziness, and headache. These types of symptoms can be treated (i.e., with antihistamines, anti-emetics) and the patient recovers completely within one day. The group with moderate adverse reactions, numbering 18 cases (1.2%), had hypertension or hypotension, and shortness of breath. Severe adverse reactions numbered 3 cases (0.2%) and included swelling of the larynx, cardiac arrest, and loss of consciousness, requiring immediate treatment. No other complications under close medical supervision were recorded (i.e., corticosteroids use, epinephrine, dopamine, atropine, or life-saving devices). Using the guideline, therapies are divided into general and specific and are performed according to the severity, risk factors and ingestion of contrast media agents. Patients who have high-risk factors were screened and treated (i.e., prophylactic premedication) for prevention of severe adverse reactions, especially those with renal failure. Thus, awareness for the need for prescreening of different risk factors is necessary for early recognition and prompt treatment. Conclusion: Studying adverse reactions can be used to develop a model for reducing the level of severity and setting a guideline for a standardized, multidisciplinary approach to adverse reactions.

Keywords: role of pharmacist, management of adverse reactions, guideline for contrast media, non-ionic contrast media

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