Search results for: blood collection
Commenced in January 2007
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Edition: International
Paper Count: 5185

Search results for: blood collection

1345 Authorship Attribution Using Sociolinguistic Profiling When Considering Civil and Criminal Cases

Authors: Diana A. Sokolova

Abstract:

This article is devoted to one of the possibilities for identifying the author of an oral or written text - sociolinguistic profiling. Sociolinguistic profiling is utilized as a forensic linguistics technique to identify individuals through language patterns, particularly in criminal cases. It examines how social factors influence language use. This study aims to showcase the significance of linguistic profiling for attributing authorship in texts and emphasizes the necessity for its continuous enhancement while considering its strengths and weaknesses. The study employs semantic-syntactic, lexical-semantic, linguopragmatic, logical, presupposition, authorization, and content analysis methods to investigate linguistic profiling. The research highlights the relevance of sociolinguistic profiling in authorship attribution and underscores the importance of ongoing refinement of the technique, considering its limitations. This study emphasizes the practical application of linguistic profiling in legal settings and underscores the impact of social factors on language use, contributing to the field of forensic linguistics. Data collection involves collecting oral and written texts from criminal and civil court cases to analyze language patterns for authorship attribution. The collected data is analyzed using various linguistic analysis methods to identify individual characteristics and patterns that can aid in authorship attribution. The study addresses the effectiveness of sociolinguistic profiling in identifying authors of texts and explores the impact of social factors on language use in legal contexts. In spite of advantages challenges in linguistics profiling have spurred debates and controversies in academic circles, legal environments, and the public sphere. So, this research highlights the significance of sociolinguistic profiling in authorship attribution and emphasizes the need for further development of this method, considering its strengths and weaknesses.

Keywords: authorship attribution, detection of identifying, dialect, features, forensic linguistics, social influence, sociolinguistics, unique speech characteristics

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1344 Water Harvest and Recycling with Principles of Permaculture in Rural Buildings in Southeastern Anatolia Region, Turkey

Authors: Muhammed Gündoğan

Abstract:

Permaculture is an important source of science and experience that can ensure the integration of sustainable architecture with nature. Since the past, many applications have been applied in rural areas for generations with the principle of benefiting from the self-renewal potential of nature. This culture, which has been transferred from generation to generation with architectural disciplines, has the potential to significantly improve the sustainability of the rural area and is an important guide with its nature-based solution proposals. Şanlıurfa has arid and semi-arid climate characteristics. Although it has substantial agricultural potential, water is limited, especially in rural areas. In the region, rainwater harvesting practices such as artificial water canals and cisterns have been used for a long time. However, these solutions remained mostly at the urban scale, and their reflections at the building scale were restricted and inadequate solutions. Impermeable surfaces are required for water harvesting, but water harvesting is not possible as rural buildings are mostly surrounded by cultivated land. Therefore, existing structures are important in terms of applicability. In this context, considering the typology of Traditional Şanlıurfa Houses, the aim of the project was to create a proposal for limited potable and utility water, which is a serious problem, especially for rural buildings in Şanlıurfa. In the project proposal, roof systems that can work integrated with the structural shape of Traditional Şanlıurfa Houses, rainwater collection systems in the inner courtyard, and greywater recycling were provided. While the average precipitation amount was 453.7 kg/m3 between 1929 and 2012, this value was measured as 622.7 kg/m3 in 2012. Greywater was used to produce natural fertilizers and compost for small-scale fruit and vegetable gardens, and it was combined with the principles of Permaculture to make it a lifestyle. As a result, it has been estimated that a total of 976.4 m3 kg of water can be saved, with an annual average of 158.8 m3 of rainwater recycling and 817.6 m3 of greywater recycling within the scope of the project.

Keywords: rural, traditional residential building, permaculture, rainwater harvesting, greywater recycling

Procedia PDF Downloads 115
1343 Microfiber Release During Laundry Under Different Rinsing Parameters

Authors: Fulya Asena Uluç, Ehsan Tuzcuoğlu, Songül Bayraktar, Burak Koca, Alper Gürarslan

Abstract:

Microplastics are contaminants that are widely distributed in the environment with a detrimental ecological effect. Besides this, recent research has proved the existence of microplastics in human blood and organs. Microplastics in the environment can be divided into two main categories: primary and secondary microplastics. Primary microplastics are plastics that are released into the environment as microscopic particles. On the other hand, secondary microplastics are the smaller particles that are shed as a result of the consumption of synthetic materials in textile products as well as other products. Textiles are the main source of microplastic contamination in aquatic ecosystems. Laundry of synthetic textiles (34.8%) accounts for an average annual discharge of 3.2 million tons of primary microplastics into the environment. Recently, microfiber shedding from laundry research has gained traction. However, no comprehensive study was conducted from the standpoint of rinsing parameters during laundry to analyze microfiber shedding. The purpose of the present study is to quantify microfiber shedding from fabric under different rinsing conditions and determine the effective rinsing parameters on microfiber release in a laundry environment. In this regard, a parametric study is carried out to investigate the key factors affecting the microfiber release from a front-load washing machine. These parameters are the amount of water used during the rinsing step and the spinning speed at the end of the washing cycle. Minitab statistical program is used to create a design of the experiment (DOE) and analyze the experimental results. Tests are repeated twice and besides the controlled parameters, other washing parameters are kept constant in the washing algorithm. At the end of each cycle, released microfibers are collected via a custom-made filtration system and weighted with precision balance. The results showed that by increasing the water amount during the rinsing step, the amount of microplastic released from the washing machine increased drastically. Also, the parametric study revealed that increasing the spinning speed results in an increase in the microfiber release from textiles.

Keywords: front load, laundry, microfiber, microfiber release, microfiber shedding, microplastic, pollution, rinsing parameters, sustainability, washing parameters, washing machine

Procedia PDF Downloads 85
1342 Outcome of Emergency Response Team System in In-Hospital Cardiac Arrest

Authors: Jirapat Suriyachaisawat, Ekkit Surakarn

Abstract:

Introduction: To improve early detection and mortality rate of In- Hospital Cardiac arrest, Emergency Response Team (ERT) system was planned and implemented since June 2009 to detect pre-arrest conditions and for any concerns. The ERT consisted of on duty physicians and nurses from emergency department. ERT calling criteria consisted of acute change of HR < 40 or > 130 beats per minute, systolic blood pressure < 90mmHg, respiratory rate <8 or > 28 breaths per minute, O2 saturation < 90%, acute change in conscious state, acute chest pain or worried about the patients. From the data on ERT system implementation in our hospital in early phase (during June 2009-2011), there was no statistic significance in difference in In-Hospital cardiac arrest incidence and overall hospital mortality rate. Since the introduction of the ERT service in our hospital, we have conducted continuous educational campaign to improve awareness in an attempt to increase use of the service. Methods: To investigate outcome of ERT system in In-Hospital cardiac arrest and overall hospital mortality rate. We conducted a prospective, controlled before-and after examination of the long term effect of a ERT system on the incidence of cardiac arrest. We performed Chi -square analysis to find statistic significance. Results: Of a total 623 ERT cases from June 2009 until December 2012, there were 72 calls in 2009, 196 calls in 2010 ,139 calls in 2011 and 245 calls in 2012.The number of ERT calls per 1000 admissions in year 2009-10 was 7.69, 5.61 in 2011 and 9.38 in 2013. The number of Code blue calls per 1000 admissions decreased significantly from 2.28 to 0.99 per 1000 admissions (P value < 0.001). The incidence of cardiac arrest decreased progressively from 1.19 to 0.34 per 1000 admissions and significant in difference in year 2012 (P value < 0.001). The overall hospital mortality rate decreased by 8 % from 15.43 to 14.43 per 1000 admissions (P value 0.095). Conclusions: ERT system implementation was associated with progressive reduction in cardiac arrests over three year period, especially statistic significant in difference in 4th year after implementation. We also found an inverse association between number of ERT use and the risk of occurrence of cardiac arrests, But we have not found difference in overall hospital mortality rate.

Keywords: emergency response team, ERT, cardiac arrest, emergency medicine

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1341 River Habitat Modeling for the Entire Macroinvertebrate Community

Authors: Pinna Beatrice., Laini Alex, Negro Giovanni, Burgazzi Gemma, Viaroli Pierluigi, Vezza Paolo

Abstract:

Habitat models rarely consider macroinvertebrates as ecological targets in rivers. Available approaches mainly focus on single macroinvertebrate species, not addressing the ecological needs and functionality of the entire community. This research aimed to provide an approach to model the habitat of the macroinvertebrate community. The approach is based on the recently developed Flow-T index, together with a Random Forest (RF) regression, which is employed to apply the Flow-T index at the meso-habitat scale. Using different datasets gathered from both field data collection and 2D hydrodynamic simulations, the model has been calibrated in the Trebbia river (2019 campaign), and then validated in the Trebbia, Taro, and Enza rivers (2020 campaign). The three rivers are characterized by a braiding morphology, gravel riverbeds, and summer low flows. The RF model selected 12 mesohabitat descriptors as important for the macroinvertebrate community. These descriptors belong to different frequency classes of water depth, flow velocity, substrate grain size, and connectivity to the main river channel. The cross-validation R² coefficient (R²𝒸ᵥ) of the training dataset is 0.71 for the Trebbia River (2019), whereas the R² coefficient for the validation datasets (Trebbia, Taro, and Enza Rivers 2020) is 0.63. The agreement between the simulated results and the experimental data shows sufficient accuracy and reliability. The outcomes of the study reveal that the model can identify the ecological response of the macroinvertebrate community to possible flow regime alterations and to possible river morphological modifications. Lastly, the proposed approach allows extending the MesoHABSIM methodology, widely used for the fish habitat assessment, to a different ecological target community. Further applications of the approach can be related to flow design in both perennial and non-perennial rivers, including river reaches in which fish fauna is absent.

Keywords: ecological flows, macroinvertebrate community, mesohabitat, river habitat modeling

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1340 Study on Capability of the Octocopter Configurations in Finite Element Analysis Simulation Environment

Authors: Jeet Shende, Leonid Shpanin, Misko Abramiuk, Mattew Goodwin, Nicholas Pickett

Abstract:

Energy harvesting on board the Unmanned Ariel Vehicle (UAV) is one of the most rapidly growing emerging technologies and consists of the collection of small amounts of energy, for different applications, from unconventional sources that are incidental to the operation of the parent system or device. Different energy harvesting techniques have already been investigated in the multirotor drones, where the energy collected comes from the systems surrounding ambient environment and typically involves the conversion of solar, kinetic, or thermal energies into electrical energy. The energy harvesting from the vibrated propeller using the piezoelectric components inside the propeller has also been proven to be feasible. However, the impact on the UAV flight performance using this technology has not been investigated. In this contribution the impact on the multirotor drone operation has been investigated at different flight control configurations which support the efficient performance of the propeller vibration energy harvesting. The industrially made MANTIS X8-PRO octocopter frame kit was used to explore the octocopter operation which was modelled using SolidWorks 3D CAD package for simulation studies. The octocopter flight control strategy is developed through integration of the SolidWorks 3D CAD software and MATLAB/Simulink simulation environment for evaluation of the octocopter behaviour under different simulated flight modes and octocopter geometries. Analysis of the two modelled octocopter geometries and their flight performance is presented via graphical representation of simulated parameters. The possibility of not using the landing gear in octocopter geometry is demonstrated. The conducted study evaluates the octocopter’s flight control technique and its impact on the energy harvesting mechanism developed on board the octocopter. Finite Element Analysis (FEA) simulation results of the modelled octocopter in operation are presented exploring the performance of the octocopter flight control and structural configurations. Applications of both octocopter structures and their flight control strategy are discussed.

Keywords: energy harvesting, flight control modelling, object modeling, unmanned aerial vehicle

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1339 Epidemiology of Hepatitis B and Hepatitis C Viruses Among Pregnant Women at Queen Elizabeth Central Hospital, Malawi

Authors: Charles Bijjah Nkhata, Memory Nekati Mvula, Milton Masautso Kalongonda, Martha Masamba, Isaac Thom Shawa

Abstract:

Viral Hepatitis is a serious public health concern globally with deaths estimated at 1.4 million annually due to liver fibrosis, cirrhosis, and hepatocellular carcinoma. Hepatitis B and C are the most common viruses that cause liver damage. However, the majority of infected individuals are unaware of their serostatus. Viral Hepatitis has contributed to maternal and neonatal morbidity and mortality. There is no updated data on the Epidemiology of hepatitis B and C among pregnant mothers in Malawi. To assess the epidemiology of Hepatitis B and C viruses among pregnant women at Queen Elizabeth Central Hospital. Specific Objectives • To determine sero-prevalence of HBsAg and Anti-HCV in pregnant women at QECH. • To investigate risk factors associated with HBV and HCV infection in pregnant women. • To determine the distribution of HBsAg and Anti-HCV infection among pregnant women of different age group. A descriptive cross-sectional study was conducted among pregnant women at QECH in last quarter of 2021. Of the 114 pregnant women, 96 participants were consented and enrolled using a convenient sampling technique. 12 participants were dropped due to various reasons; therefore 84 completed the study. A semi-structured questionnaire was used to collect socio-demographic and behavior characteristics to assess the risk of exposure. Serum was processed from venous blood samples and tested for HBsAg and Anti-HCV markers utilizing Rapid screening assays for screening and Enzyme Linked Immunosorbent Assay for confirmatory. A total of 84 pregnant consenting pregnant women participated in the study, with 1.2% (n=1/84) testing positive for HBsAg and nobody had detectable anti-HCV antibodies. There was no significant link between HBV and HCV in any of the socio-demographic data or putative risk variables. The findings indicate a viral hepatitis prevalence lower than the set range by the WHO. This suggests that HBV and HCV are rare in pregnant women at QECH. Nevertheless, accessible screening for all pregnant women should be provided. The prevention of MTCT is key for reduction and prevention of the global burden of chronic viral Hepatitis.

Keywords: viral hepatitis, hepatitis B, hepatitis C, pregnancy, malawi, liver disease, mother to child transmission

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1338 Inelastic and Elastic Taping in Plantar Pressure of Runners Pronators: Clinical Trial

Authors: Liana Gomide, Juliana Rodrigues

Abstract:

The morphology of the foot defines its mode of operation and a biomechanical reform indispensable for a symmetrical distribution of plantar pressures in order not to overload some of its components in isolation. High plantar pressures at specific points in the foot may be a causal factor in several orthopedic disorders that affect the feet such as pain and stress fracture. With digital baro-podometry equipment one can observe an intensity of pressures along the entire foot and quantify some of the movements, such as a subtalar pronation present in the midfoot region. Although, they are involved in microtraumas. In clinical practice, excessive movement has been limited with the use of different taping techniques applied on the plantar arch. Thus, the objective of the present study was to analyze and compare the influence of the inelastic and elastic taping on the distribution of plantar pressure of runners pronators. This is a randomized clinical trial and blind-crossover. Twenty (20) male subjects, mean age 33 ± 7 years old, mean body mass of 71 ± 7 kg, mean height of 174 ± 6 cm, were included in the study. A data collection was carried out by a single research through barop-odometry equipment - Tekscan, model F-scan mobile. The tests were performed at three different times. In the first, an initial barop-odometric evaluation was performed, without a bandage application, with edges at a speed of 9.0 km/h. In the second and third moments, the inelastic or elastic taping was applied consecutively, according to the definition defined in the randomization. As results, it was observed that both as inelastic and elastic taping, provided significant reductions in contact pressure and peak pressure values when compared to the moment without a taping. However, an elastic taping was more effective in decreasing contact pressure (no bandage = 714 ± 201, elastic taping = 690 ± 210 and inelastic taping = 716 ± 180) and no peak pressure in the midfoot region (no bandage = 1490 ± 42, elastic taping = 1273 ± 323 and inelastic taping = 1487 ± 437). It is possible to conclude that it is an elastic taping provided by pressure in the middle region, thereby reducing the subtalar pronunciation event during the run.

Keywords: elastic taping, inelastic taping, running, subtalar pronation

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1337 The Use of Artificial Intelligence in Diagnosis of Mastitis in Cows

Authors: Djeddi Khaled, Houssou Hind, Miloudi Abdellatif, Rabah Siham

Abstract:

In the field of veterinary medicine, there is a growing application of artificial intelligence (AI) for diagnosing bovine mastitis, a prevalent inflammatory disease in dairy cattle. AI technologies, such as automated milking systems, have streamlined the assessment of key metrics crucial for managing cow health during milking and identifying prevalent diseases, including mastitis. These automated milking systems empower farmers to implement automatic mastitis detection by analyzing indicators like milk yield, electrical conductivity, fat, protein, lactose, blood content in the milk, and milk flow rate. Furthermore, reports highlight the integration of somatic cell count (SCC), thermal infrared thermography, and diverse systems utilizing statistical models and machine learning techniques, including artificial neural networks, to enhance the overall efficiency and accuracy of mastitis detection. According to a review of 15 publications, machine learning technology can predict the risk and detect mastitis in cattle with an accuracy ranging from 87.62% to 98.10% and sensitivity and specificity ranging from 84.62% to 99.4% and 81.25% to 98.8%, respectively. Additionally, machine learning algorithms and microarray meta-analysis are utilized to identify mastitis genes in dairy cattle, providing insights into the underlying functional modules of mastitis disease. Moreover, AI applications can assist in developing predictive models that anticipate the likelihood of mastitis outbreaks based on factors such as environmental conditions, herd management practices, and animal health history. This proactive approach supports farmers in implementing preventive measures and optimizing herd health. By harnessing the power of artificial intelligence, the diagnosis of bovine mastitis can be significantly improved, enabling more effective management strategies and ultimately enhancing the health and productivity of dairy cattle. The integration of artificial intelligence presents valuable opportunities for the precise and early detection of mastitis, providing substantial benefits to the dairy industry.

Keywords: artificial insemination, automatic milking system, cattle, machine learning, mastitis

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1336 Long-Term Outcome of Emergency Response Team System in In-Hospital Cardiac Arrest

Authors: Jirapat Suriyachaisawat, Ekkit Surakarn

Abstract:

Introduction: To improve early detection and mortality rate of in-hospital cardiac arrest, Emergency Response Team (ERT) system was planned and implemented since June 2009 to detect pre-arrest conditons and for any concerns. The ERT consisted of on duty physicians and nurses from emergency department. ERT calling criteria consisted of acute change of HR < 40 or > 130 beats per minute, systolic blood pressure < 90 mmHg, respiratory rate <8 or >28 breaths per minute, O2 saturation <90%, acute change in conscious state, acute chest pain or worry about the patients. From the data on ERT system implementation in our hospital in early phase (during June 2009-2011), there was no statistic significance in difference in in-hospital cardiac arrest incidence and overall hospital mortality rate. Since the introduction of the ERT service in our hospital, we have conducted continuous educational campaign to improve awareness in an attempt to increase use of the service. Methods: To investigate outcome of ERT system in in-hospital cardiac arrest and overall hospital mortality rate, we conducted a prospective, controlled before-and after examination of the long term effect of a ERT system on the incidence of cardiac arrest. We performed chi-square analysis to find statistic significance. Results: Of a total 623 ERT cases from June 2009 until December 2012, there were 72 calls in 2009, 196 calls in 2010, 139 calls in 2011 and 245 calls in 2012. The number of ERT calls per 1000 admissions in year 2009-10 was 7.69; 5.61 in 2011 and 9.38 in 2013. The number of code blue calls per 1000 admissions decreased significantly from 2.28 to 0.99 per 1000 admissions (P value < 0.001). The incidence of cardiac arrest decreased progressively from 1.19 to 0.34 per 1000 admissions and significant in difference in year 2012 (P value < 0.001 ). The overall hospital mortality rate decreased by 8 % from 15.43 to 14.43 per 1000 admissions (P value 0.095). Conclusions: ERT system implementation was associated with progressive reduction in cardiac arrests over three year period, especially statistic significant in difference in 4th year after implementation. We also found an inverse association between number of ERT use and the risk of occurrence of cardiac arrests, but we have not found difference in overall hospital mortality rate.

Keywords: cardiac arrest, outcome, in-hospital, ERT

Procedia PDF Downloads 193
1335 Effect of Resistance Training on BDNF and Inflammatory Markers in Healthy Older Adults

Authors: Obinna Afamefuna Echi

Abstract:

Background: The global increase in the elderly population is anticipated to reach significant levels by 2050, presenting extensive economic, social, and healthcare challenges. Age-related cognitive decline, alterations in brain anatomy, and systemic inflammation are profound concerns that diminish the quality of life and increase susceptibility to diseases like Alzheimer's and cardiovascular diseases. Resistance training is presently studied for its potential neuroprotective and anti-inflammatory benefits in older adults. Objectives: This study aimed to explore the effects of different resistance training modalities on neurotrophic factors, inflammatory markers, and cognitive functions in the elderly. Methods: A controlled trial was conducted with 60 male participants aged 60-75, assigned to either 12 weeks of high-intensity blood flow restriction training (BFRT), muscle damaging resistance training (MDRT), or a non-exercising control group. Cognitive function, neurotrophic factors such as BDNF, and inflammatory markers including IL-6 and TNF were measured before and after the intervention period. Setting: Participants were recruited from Kaunas, Lithuania, with sessions facilitated at the Lithuanian Sports University and health assessments conducted at the Lithuanian University of Health Sciences. Results: Preliminary data suggested did not show significant improvements in BDNF levels and cognitive functions in the BFRT and MDRT groups compared to controls. However, there was a notable reduction in inflammatory markers, indicating potential health benefits beyond cognitive enhancement. Conclusion: The incorporation of resistance training can be a strategic intervention to mitigate age-associated cognitive decline and systemic inflammation, thereby enhancing overall health and quality of life in older adults. The results advocate for wider adoption and further study of resistance training as a preventive measure in ageing populations. Funding: The Lithuanian Sports University, the Research Council of Lithuania and the Lithuanian University of Health Sciences.

Keywords: ageing, resistance training, BDNF, cognitive function

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1334 Design of Traffic Counting Android Application with Database Management System and Its Comparative Analysis with Traditional Counting Methods

Authors: Muhammad Nouman, Fahad Tiwana, Muhammad Irfan, Mohsin Tiwana

Abstract:

Traffic congestion has been increasing significantly in major metropolitan areas as a result of increased motorization, urbanization, population growth and changes in the urban density. Traffic congestion compromises efficiency of transport infrastructure and causes multiple traffic concerns; including but not limited to increase of travel time, safety hazards, air pollution, and fuel consumption. Traffic management has become a serious challenge for federal and provincial governments, as well as exasperated commuters. Effective, flexible, efficient and user-friendly traffic information/database management systems characterize traffic conditions by making use of traffic counts for storage, processing, and visualization. While, the emerging data collection technologies continue to proliferate, its accuracy can be guaranteed through the comparison of observed data with the manual handheld counters. This paper presents the design of tablet based manual traffic counting application and framework for development of traffic database management system for Pakistan. The database management system comprises of three components including traffic counting android application; establishing online database and its visualization using Google maps. Oracle relational database was chosen to develop the data structure whereas structured query language (SQL) was adopted to program the system architecture. The GIS application links the data from the database and projects it onto a dynamic map for traffic conditions visualization. The traffic counting device and example of a database application in the real-world problem provided a creative outlet to visualize the uses and advantages of a database management system in real time. Also, traffic data counts by means of handheld tablet/ mobile application can be used for transportation planning and forecasting.

Keywords: manual count, emerging data sources, traffic information quality, traffic surveillance, traffic counting device, android; data visualization, traffic management

Procedia PDF Downloads 182
1333 A Comparative Understanding of Critical Problems Faced by Pakistani and Indian Transportation Industry

Authors: Fawad Hussain, Saleh Abdullah Saleh, Mohammad Basir B Saud, Mohd Azwardi Md. Isa

Abstract:

It is very important for a developing nation to develop their infrastursture on the prime priority because their infrastursture particularly their roads and transporation functions as a blood in the system. Almost 1.1 billion populations share the travel and transportation industry in India. On the other hand, the Pakistan transportation industry is also extensive and elevating about 170 million users of transportation. Indian and Pakistani specifically within bus industry have good interconnectivity within and between the urban and rural areas as well as connectivity between the two countries, which is dramatically helping the economic alleviation of both countries. Due to high economic instability, unemployment and poverty rate are among the reasons why both the governments are very committed and seriously taken further action to help boost their economy. They believe that any form of transportation development would play a vital role in the development of land, infrastructure which could indirectly support many other industries’ development, such as tourism, freighting and shipping businesses, just to mention a few. However, it seems that their previous transportation planning in the due course has failed to meet the fast growing demand. As with the spin of time, both the countries are looking forward for a reasonable, safe and economical long term solutions, which is from time to time keep appreciating and reacting according to other key economic drivers. Content analysis method and case study approach is used in this paper and secondary data from the bureau of statistic is used for case analysis. The paper centered on the mobility concerns of the lower and middle income people in India and Pakistan. The paper is aimed to highlight the weaknesses, opportunities and limitations resulting from low priority industry for government, which is making the either country's public suffer. The paper has concluded that the main issue is identified as the slow, inappropriate and unfavorable decisions which are not in favor of long term country’s economic development and public welfare as well as interest. The paper also recommends to future market sense public and private transportation, which has failed to meet the public expectations.

Keywords: bus transportation industries, transportation demand, government parallel initiatives, road and traffic congestions

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1332 An Exploration of German Tourists’ Market Demand Towards Ethiopian Tourist Destinations

Authors: Dagnew Dessie Mengie

Abstract:

The purpose of this study was to investigate German tourists' demand for Ethiopian tourism destinations. The author has made every effort to identify the differences in the preferences of German visitors’ demand in Ethiopia comparing with Egypt, Kenya, Tanzania, and South African tourism sectors if they are invited to visit at the same time. However, the demand for international tourism for Ethiopia currently lags behind these African countries. Therefore, to offer demand-driven tourism products, the Ethiopian government and tour and travel operators need to understand the important factors that affect international tourists’ decision to visit Ethiopian tourist destinations. The aim of this study was to analyze German Tourists’ Demand for Ethiopian destinations. The researcher aimed to identify the demand for German tourists’ preference for Ethiopian tourist destinations compared to the above-mentioned African countries. For collecting and analysing data for this study, both quantitative and qualitative methods of research are being used in this study. The most significant data are collected by using the primary data collection method i.e. survey and interviews which are the most and large number of potential responses and feedback from nine German active tourists,12 Ethiopian tourism officials, four African embassies, and four well functioning private tour companies and secondary data collected from books, journals, previous research and electronic websites. Based on the data analysis of the information gathered from interviews and questionnaires, the study disclosed that the majority of German tourists do have not that high demand for Ethiopian Tourist destinations due to the following reasons: (1) Many Germans are fascinated by adventures and safari and simply want to lie on the beach and relax. These interests have leaded them to look for other African countries which have these accesses. (2) Uncomfortable infrastructure and transport problems are attributed to the decreasing number of German tourists in the country. (3) Inadequate marketing operation of the Ethiopian Tourism Authority and its delegates in advertising and clarifying the above irregularities which are raised by the tourists.

Keywords: environmental benefits of tourism, social benefits of tourism, economic benefits of tourism, political factors on tourism

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1331 Serum Zinc Level in Patients with Multidrug Resistant Tuberculosis

Authors: Nilima Barman, M. Atiqul Haque, Debabrata Ghosh

Abstract:

Background: Zinc, one of the vital micronutrients, has an incredible role in the immune system. Hypozincemia affects host defense by reducing the number of circulating T cells and phagocytosis activity of other cells which ultimately impair cell-mediated immunity 1, 2. The immune system is detrimentally suppressed in multidrug-resistant tuberculosis (MDR-TB) 3, 4, a major threat of TB control worldwide5. As zinc deficiency causes immune suppression, we assume that it might have a role in the development of MDR-TB. Objectives: To estimate the serum zinc level in newly diagnosed multidrug resistant tuberculosis (MDR-TB) in comparison with that of newly diagnosed pulmonary TB (NdPTB) and healthy individuals. Materials and Methods: This study was carried out in the department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka in collaboration with National Institute of Diseases of the Chest Hospital (NIDCH), Bangladesh from March’ 2012 to February 2013. A total of 337 respondents, of them 107 were MDR TB patients enrolled from NIDCH, 69 were NdPTB and 161 were healthy adults. All NdPTB patients and healthy adults were randomly selected from Sirajdikhan subdistrict of Munshiganj District. It is a rural community 22 kilometer south from capital city Dhaka. Serum zinc level was estimated by atomic absorption spectrophotometry method from early morning fasting blood sample. The evaluation of serum zinc level was done according to normal range from 70 to120 µgm/dL6. Results: Males were predominant in study groups (p>0.05). Mean (sd) serum zinc levels in MDR-TB, NdPTB and healthy adult group were 65.14 (12.52), 75.22(15.89), and 87.98 (21.80) μgm/dL respectively and differences were statistically significant (F=52.08, P value<0.001). After multiple comparison test (Bonferroni test) significantly lower level of serum zinc was found in MDRTB group than NdPTB and healthy adults (p<.001). Point biserial correlation showed a negative association of having MDR TB and serum zinc level (r= -.578; p value <0.001). Conclusion: The significant low level of serum zinc in MDR-TB patients suggested impaired immune status. We recommended for further exploration of low level of serum zinc as risk factor of MDR TB.

Keywords: Bangladesh, immune status, multidrug-resistant tuberculosis, serum zinc

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1330 Archaeological Study of Statues of King Thutmosis III from Luxor

Authors: Ahmed Mamdouh

Abstract:

Introduction: The era of Thutmosis III represents a transitional period between the art of the Thutmoside art and the Amarna period, so we intend to declare that it serves as the cradle of Amarna art. The study will examine the Statues of king Thutmose III that was discovered in Luxor by an Egyptian mission. These Statues have been transferred to the Conservation Center of the Grand Egyptian Museum (GEM) to be conserved and made ready to bedisplayed at the new museum (the project of the century). We focus upon three Statues (GEM numbers 45863, 45864, 45865), chosen because they relate to different years of the king's reign. These Statues were all made of granite. The first one is a Kneeling statue representing the god Amun showing king Thutmose III offering to the goddess Hathor. The second is decorated with king Thutmose III with the red crown, between the goddess Hathor and the royal wife, Nefertari. The third shows the king offering NW vessels and bread to the god Seker. Each Statue is divided into registers containing a description and decorated with scenes of the king presenting offerings to gods. Methodology: The proposed study will focus on the development which happened sequentially according to differences that occur in each Statue. We will use comparative research to determine the workshops of these statues, whether one or several, and what are the distinguishing features of each one. We will examine what innovations the artisans added to royal art. The description and the texts will be translated with linguistic comments. This research focuses on text analyses and technology. Paleographic information found on these objects includes the names and titles of the king. Conclusion: This research focuses on text analyses and technology. The study aims to create a manual that may help in dating the artwork of Thutmosis III. This research will be beneficial and useful for heritage and ancient civilizations, particularly when we talk about opening museums like the Grand Egyptian museum, which will exhibit a collection of statues. Indeed this kind of study will open a new destination in order to know how to identify these collections and how to exhibit them commensurate with the nature of ancient Egyptian history and heritage.

Keywords: archaeological study, Giza, new kingdom, statues, royal art

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1329 Optimizing Pavement Construction Procedures in the Southern Desert of Libya

Authors: Khlifa El Atrash, Gabriel Assaf

Abstract:

Libya uses a volumetric analysis in designing asphalt mixtures, which can also be upgraded in hot, arid weather. However, in order to be effective, it should include many important aspects which are materials, environment, and method of construction. However, the quality of some roads was below a satisfactory level. This paper examines the factors that contribute to low quality of road performance in Libya. To evaluate these factors, a questionnaire survey and a laboratory comparative study were performed for a few mixes under-represented of temperature and traffic load. In laboratory, rutting test conducted on two different asphalt mixture, these mixes included, an asphalt concrete mix using local aggregate and asphalt binder B(60/70) at the optimum Marshall asphalt content, another mixes designed using Superpave design procedure with the same materials and performance asphalt binder grade PG (70-10). In the survey, the questionnaire was distributed to 55 engineers and specialists in this field. The interview was conducted to a few others, and the factors that were leading to poor performance of asphalt roads were listed as; 1) Owner Experience and technical staff 2) Asphalt characteristics 3) Updating and development of Asphalt Mix Design methods 4) Lack of data collection by authorization Agency 5) Construction and compaction process 6) Mentoring and controlling mixing procedure. Considering and improving these factors will play an important role to improve the pavement performances, longer service life, and lower maintenance costs. This research summarized some recommendations for making asphalt mixtures used in hot, dry areas. Such asphalt mixtures should use asphalt binder which is less affected by pavement temperature change and traffic load. The properties of the mixture, such as durability, deformation, air voids, and performance, largely depend on the type of materials, environment, and mixing method. These properties, in turn, affect the pavement performance.

Keywords: volumetric analysis, pavement performances, hot climate, traffic load, pavement temperature, asphalt mixture, environment, design and construction

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1328 Data Protection and Regulation Compliance on Handling Physical Child Abuse Scenarios- A Scoping Review

Authors: Ana Mafalda Silva, Rebeca Fontes, Ana Paula Vaz, Carla Carreira, Ana Corte-Real

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Decades of research on the topic of interpersonal violence against minors highlight five main conclusions: 1) it causes harmful effects on children's development and health; 2) it is prevalent; 3) it violates children's rights; 4) it can be prevented and 5) parents are the main aggressors. The child abuse scenario is identified through clinical observation, administrative data and self-reports. The most used instruments are self-reports; however, there are no valid and reliable self-report instruments for minors, which consist of a retrospective interpretation of the situation by the victim already in her adult phase and/or by her parents. Clinical observation and collection of information, namely from the orofacial region, are essential in the early identification of these situations. The management of medical data, such as personal data, must comply with the General Data Protection Regulation (GDPR), in Europe, and with the General Law of Data Protection (LGPD), in Brazil. This review aims to answer the question: In a situation of medical assistance to minors, in the suspicion of interpersonal violence, due to mistreatment, is it necessary for the guardians to provide consent in the registration and sharing of personal data, namely medical ones. A scoping review was carried out based on a search by the Web of Science and Pubmed search engines. Four papers and two documents from the grey literature were selected. As found, the process of identifying and signaling child abuse by the health professional, and the necessary early intervention in defense of the minor as a victim of abuse, comply with the guidelines expressed in the GDPR and LGPD. This way, the notification in maltreatment scenarios by health professionals should be a priority and there shouldn’t be the fear or anxiety of legal repercussions that stands in the way of collecting and treating the data necessary for the signaling procedure that safeguards and promotes the welfare of children living with abuse.

Keywords: child abuse, disease notifications, ethics, healthcare assistance

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1327 The Effect of Different Concentrations of Extracting Solvent on the Polyphenolic Content and Antioxidant Activity of Gynura procumbens Leaves

Authors: Kam Wen Hang, Tan Kee Teng, Huang Poh Ching, Chia Kai Xiang, H. V. Annegowda, H. S. Naveen Kumar

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Gynura procumbens (G. procumbens) leaves, commonly known as ‘sambung nyawa’ in Malaysia is a well-known medicinal plant commonly used as folk medicines in controlling blood glucose, cholesterol level as well as treating cancer. These medicinal properties were believed to be related to the polyphenolic content present in G. procumbens extract, therefore optimization of its extraction process is vital to obtain highest possible antioxidant activities. The current study was conducted to investigate the effect of different concentrations of extracting solvent (ethanol) on the amount of polyphenolic content and antioxidant activities of G. procumbens leaf extract. The concentrations of ethanol used were 30-70%, with the temperature and time kept constant at 50°C and 30 minutes, respectively using ultrasound-assisted extraction. The polyphenolic content of these extracts were quantified by Folin-Ciocalteu colorimetric method and results were expressed as milligram gallic acid equivalent (mg GAE)/g. Phosphomolybdenum method and 1, 1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging assays were used to investigate the antioxidant properties of the extract and the results were expressed as milligram ascorbic acid equivalent (mg AAE)/g and effective concentration (EC50) respectively. Among the three different (30%, 50% and 70%) concentrations of ethanol studied, the 50% ethanolic extract showed total phenolic content of 31.565 ± 0.344 mg GAE/g and total antioxidant activity of 78.839 ± 0.199 mg AAE/g while 30% ethanolic extract showed 29.214 ± 0.645 mg GAE/g and 70.701 ± 1.394 mg AAE/g, respectively. With respect to DPPH radical scavenging assay, 50% ethanolic extract had exhibited slightly lower EC50 (314.3 ± 4.0 μg/ml) values compared to 30% ethanol extract (340.4 ± 5.3 μg/ml). Out of all the tested extracts, 70% ethanolic extract exhibited significantly (p< 0.05) highest total phenolic content (38.000 ± 1.009 mg GAE/g), total antioxidant capacity (95.874 ± 2.422 mg AAE/g) and demonstrated the lowest EC50 in DPPH assay (244.2 ± 5.9 μg/ml). An excellent correlations were drawn between total phenolic content, total antioxidant capacity and DPPH radical scavenging activity (R2 = 0.949 and R2 = 0.978, respectively). It was concluded from this study that, 70% ethanol should be used as the optimal polarity solvent to obtain G. procumbens leaf extract with maximum polyphenolic content with antioxidant properties.

Keywords: antioxidant activity, DPPH assay, Gynura procumbens, phenolic compounds

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1326 Clinical Advice Services: Using Lean Chassis to Optimize Nurse-Driven Telephonic Triage of After-Hour Calls from Patients

Authors: Eric Lee G. Escobedo-Wu, Nidhi Rohatgi, Fouzel Dhebar

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It is challenging for patients to navigate through healthcare systems after-hours. This leads to delays in care, patient/provider dissatisfaction, inappropriate resource utilization, readmissions, and higher costs. It is important to provide patients and providers with effective clinical decision-making tools to allow seamless connectivity and coordinated care. In August 2015, patient-centric Stanford Health Care established Clinical Advice Services (CAS) to provide clinical decision support after-hours. CAS is founded on key Lean principles: Value stream mapping, empathy mapping, waste walk, takt time calculations, standard work, plan-do-check-act cycles, and active daily management. At CAS, Clinical Assistants take the initial call and manage all non-clinical calls (e.g., appointments, directions, general information). If the patient has a clinical symptom, the CAS nurses take the call and utilize standardized clinical algorithms to triage the patient to home, clinic, urgent care, emergency department, or 911. Nurses may also contact the on-call physician based on the clinical algorithm for further direction and consultation. Since August 2015, CAS has managed 228,990 calls from 26 clinical specialties. Reporting is built into the electronic health record for analysis and data collection. 65.3% of the after-hours calls are clinically related. Average clinical algorithm adherence rate has been 92%. An average of 9% of calls was escalated by CAS nurses to the physician on call. An average of 5% of patients was triaged to the Emergency Department by CAS. Key learnings indicate that a seamless connectivity vision, cascading, multidisciplinary ownership of the problem, and synergistic enterprise improvements have contributed to this success while striving for continuous improvement.

Keywords: after hours phone calls, clinical advice services, nurse triage, Stanford Health Care

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1325 Factors Associated with Seroconversion of Oral Polio Vaccine among the Children under 5 Year in District Mirpurkhas, Pakistan 2015

Authors: Muhammad Asif Syed, Mirza Amir Baig

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Background: Pakistan is one of the two remaining polio-endemic countries, posing a significant public health challenge for global polio eradication due to failure to interrupt polio transmission. Country specific seroprevalence studies help in the evaluation of immunization program performance, the susceptibility of population against polio virus and identification of existing level of immunity with factors that affect seroconversion of the oral polio vaccine (OPV). The objective of the study was to find out factors associated with seroconversion of the OPV among children 6-59 months in Pakistan. Methods: A Hospital based cross-sectional serosurvey was undertaken in May-June 2015 at District Mirpurkhas, Sindh-Pakistan. Total 180 children aged 6–59 months were selected by using systematic random sampling from Muhammad Medical College Hospital, Mirpurkhas. Demographic, vaccination history and risk factors information were collected from the parents/guardian. Blood sample was collected and tested for the detection of poliovirus IgG antibodies by using ELISA Kit. The IgG titer <10 IU/ml, 50 to <150 IU/ml and >150 IU/ml was defined as negative, weak positive and positive immunity respectively. Pearson Chi-square test was used to determine the difference in seroprevalence in univariate analysis. Results: A total of 180 subjects were enrolled mean age was 23 months (7 -59 months). Off these 160 (89%) children were well and 18 (10%) partially protected against polio virus. Two (1.1%) children had no protection against polio virus as they had <10 IU/ml poliovirus IgG antibodies titer. Both negative cases belong from the female gender, age group 12-23 months, urban area and BMI <50 percentile. There was a difference between normal and the wasting children; it did attain statistical significance (χ2= 35.5, p=0.00). The difference in seroconversion was also observed in relation to the gender (χ2=6.23, p=0.04), duration of breast feeding (χ2=18.6, p=0.04), history of diarrheal disease before polio vaccine administration (χ2=7.7, p=0.02), and stunting (χ2= 114, p=0.00). Conclusion: This study demonstrated that near 90% children achieve seroconversion of OPV and well protected against polio virus. There is an urgent need to focus on factors like duration of breast feeding, diarrheal diseases and malnutrition (acute and chronic) among the children as an immunization strategy.

Keywords: seroconversion, oral polio vaccine, Polio, Pakistan

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1324 Development of an Optimised, Automated Multidimensional Model for Supply Chains

Authors: Safaa H. Sindi, Michael Roe

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This project divides supply chain (SC) models into seven Eras, according to the evolution of the market’s needs throughout time. The five earliest Eras describe the emergence of supply chains, while the last two Eras are to be created. Research objectives: The aim is to generate the two latest Eras with their respective models that focus on the consumable goods. Era Six contains the Optimal Multidimensional Matrix (OMM) that incorporates most characteristics of the SC and allocates them into four quarters (Agile, Lean, Leagile, and Basic SC). This will help companies, especially (SMEs) plan their optimal SC route. Era Seven creates an Automated Multidimensional Model (AMM) which upgrades the matrix of Era six, as it accounts for all the supply chain factors (i.e. Offshoring, sourcing, risk) into an interactive system with Heuristic Learning that helps larger companies and industries to select the best SC model for their market. Methodologies: The data collection is based on a Fuzzy-Delphi study that analyses statements using Fuzzy Logic. The first round of Delphi study will contain statements (fuzzy rules) about the matrix of Era six. The second round of Delphi contains the feedback given from the first round and so on. Preliminary findings: both models are applicable, Matrix of Era six reduces the complexity of choosing the best SC model for SMEs by helping them identify the best strategy of Basic SC, Lean, Agile and Leagile SC; that’s tailored to their needs. The interactive heuristic learning in the AMM of Era seven will help mitigate error and aid large companies to identify and re-strategize the best SC model and distribution system for their market and commodity, hence increasing efficiency. Potential contributions to the literature: The problematic issue facing many companies is to decide which SC model or strategy to incorporate, due to the many models and definitions developed over the years. This research simplifies this by putting most definition in a template and most models in the Matrix of era six. This research is original as the division of SC into Eras, the Matrix of Era six (OMM) with Fuzzy-Delphi and Heuristic Learning in the AMM of Era seven provides a synergy of tools that were not combined before in the area of SC. Additionally the OMM of Era six is unique as it combines most characteristics of the SC, which is an original concept in itself.

Keywords: Leagile, automation, heuristic learning, supply chain models

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1323 Demographic Profile, Risk Factors and In-hospital Outcomes of Acute Coronary Syndrome (ACS) in Young Population, in Pakistan-Single Center Real World Experience

Authors: Asma Qudrat, Abid Ullah, Rafi Ullah, Ali Raza, Shah Zeb, Syed Ali Shan Ul-Haq, Shahkar Ahmed Shah, Attiya Hameed Khan, Saad Zaheer, Umama Qasim, Kiran Jamal, Zahoor khan

Abstract:

Objectives: Coronary artery disease (CAD) is the major public health issue associated with high mortality and morbidity rate worldwide. Young patients with ACS have unique characteristics with different demographic profiles and risk factors. The precise diagnosis and early risk stratification is important in guiding treatment and predicting the prognosis of young patients with ACS. To evaluate the associated demographics, risk factors, and outcomes profile of ACS in young age patients. Methods: The research follow a retrospective design, the single centre study of patients diagnosis with the first event of ACS in young age (>18 and <40) were included. Data collection included demographic profiles, risk factors, and in-hospital outcomes of young ACS patients. The patient’s data was retrieved through Electronic Medical Records (EMR) of Peshawar Institute of Cardiology (PIC), and all characteristic were assessed. Results: In this study, 77% were male, and 23% were female patients. The risk factors were assessed with CAD and shown significant results (P < 0.01). The most common presentation was STEMI, with (45%) most in ACS young patients. The angiographic pattern showed single vessel disease (SVD) in 49%, double vessel disease (DVD) in 17% and triple vessel disease (TVD) was found in 10%, and Left Artery Disease (LAD) (54%) was present to be the most common involved artery. Conclusion: It is concluded that the male sex was predominant in ACS young age patients. SVD was the common coronary angiographic finding. Risk factors showed significant results towards CAD and common presentations.

Keywords: coronary artery disease, Non-ST elevation myocardial infarction, ST elevation myocardial infarction, unstable angina, acute coronary syndrome

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1322 Expert-Based Validated Measures for Improving Quality Healthcare Services Utilization among Elderly Persons: A Cross-Section Survey

Authors: Uchenna Cosmas Ugwu, Osmond Chukwuemeka Ene

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Globally, older adults are considered the most vulnerable groups to age-related diseases including diabetes mellitus, obesity, cardiovascular diseases, cancer and osteoporosis. With improved access to quality healthcare services, these complications can be prevented and the incidence rates reduced to the least occurrence. The aim of this study is to validate appropriate measures for improving quality healthcare services utilization among elderly persons in Nigeria and also to determine the significant association within demographic variables. A cross-sectional survey research design was adopted. Using a convenient sampling technique, a total of 400 experts (150 registered nurses and 250 public health professionals) with minimum of doctoral degree qualification were sampled and studied. A structured instrument titled “Expert-Based Healthcare Services Utilization Questionnaire (EBHSUQ) with .83 reliability index was used for data collection. All the statistical data analysis was completed using frequency counts, percentage scores and chi-square statistics. The results were significant at p≤0.05. It was found that quality healthcare services utilization by elderly persons in Nigeria would be improved if the services are: available (83%), affordable (82%), accessible (79%), suitable (77%), acceptable (77%), continuous (75%) and stress-free (75%). Statistically, significant association existed on quality healthcare services utilization with gender (p=.03<.05) and age (p=.01<.05) while none was observed on work experience (p=.23>.05), marital status (p=.11>.05) and employment category (p=.09>.05). To improve quality healthcare services utilization for elderly persons in Nigeria, the adoption of appropriate measures by Nigerian government and professionals in healthcare sectors are paramount. Therefore, there is need for collaborative efforts by the Nigerian government and healthcare professionals geared towards educating the general public through mass sensitization, awareness campaign, conferences, seminars and workshops for the importance of accessing healthcare services.

Keywords: elderly persons, healthcare services, cross-sectional survey research design, utilization.

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1321 Job Satisfaction and Associated factors of Urban Health Extension Professionals in Addis Ababa City, Ethiopia

Authors: Metkel Gebremedhin, Biruk Kebede, Guash Abay

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Job satisfaction largely determines the productivity and efficiency of human resources for health. There is scanty evidence on factors influencing the job satisfaction of health extension professionals (HEPs) in Addis Ababa. The objective of this study was to determine the level of and factors influencing job satisfaction among extension health workers in Addis Ababa city. This was a cross-sectional study conducted in Addis Ababa, Ethiopia. Among all public health centers found in the Addis Ababa city administration health bureau that would be included in the study, a multistage sampling technique was employed. Then we selected the study health centers randomly and urban health extension professionals from the selected health centers. In-depth interview data collection methods were carried out for a comprehensive understanding of factors affecting job satisfaction among Health extension professionals (HEPs) in Addis Ababa. HEPs working in Addis Ababa areas are the primary study population. Multivariate logistic regression with 95% CI at P ≤ 0.05 was used to assess associated factors to job satisfaction. The overall satisfaction rate was 10.7% only, while 89.3%% were dissatisfied with their jobs. The findings revealed that variables such as marital status, staff relations, community support, supervision, and rewards have a significant influence on the level of job satisfaction. For those who were not satisfied, the working environment, job description, low salary, poor leadership and training opportunities were the major causes. Other factors influencing the level of satisfaction were lack of medical equipment, lack of transport facilities, lack of training opportunities, and poor support from woreda experts. Our study documented a very low level of overall satisfaction among health extension professionals in Addis Ababa city public health centers. Considering the factors responsible for this state of affairs, urgent and concrete strategies must be developed to address the concerns of extension health professionals as they represent a sensitive domain of the health system of Addis Ababa city. Improving the overall work environment, review of job descriptions and better salaries might bring about a positive change.

Keywords: job satisfaction, extension health professionals, Addis Ababa

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1320 The Importance of Reflection and Collegial Support for Clinical Instructors When Evaluating Failing Students in a Clinical Nursing Course

Authors: Maria Pratt, Lynn Martin

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Context: In nursing education, clinical instructors are crucial in assessing and evaluating students' performance in clinical courses. However, instructors often struggle when assigning failing grades to students at risk of failing. Research Aim: This qualitative study aims to understand clinical instructors' experiences evaluating students with unsatisfactory performance, including how reflection and collegial support impact this evaluation process. Methodology, Data Collection, and Analysis Procedures: This study employs Gadamer's Hermeneutic Inquiry as the research methodology. A purposive maximum variation sampling technique was used to recruit eight clinical instructors from a collaborative undergraduate nursing program in Southwestern Ontario. Semi-structured, open-ended, and audio-taped interviews were conducted with the participants. The hermeneutic analysis was applied to interpret the interview data to allow for a thorough exploration and interpretation of the instructors' experiences evaluating failing students. Findings: The main findings of this qualitative research indicate that evaluating failing students was emotionally draining for the clinical instructors who experienced multiple challenges, uncertainties, and negative feelings associated with assigning failing grades. However, the analysis revealed that ongoing reflection and collegial support played a crucial role in mitigating the challenges they experienced. Conclusion: This study contributes to the theoretical understanding of nursing education by shedding light on clinical instructors' challenges in evaluating failing students. It emphasizes the emotional toll associated with this process and the role that reflection and collegial support play in alleviating those challenges. The findings underscore the need for ongoing professional development and support for instructors in nursing education. By understanding and addressing clinical instructors' experiences, nursing education programs can better equip them to effectively evaluate struggling students and provide the necessary support for their professional growth.

Keywords: clinical instructor, student evaluation, nursing, reflection, support

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1319 Acute Myeloid Leukemia Relapse in an a Rare form After Treating his Tuberculosis TB

Authors: Sheikha Turki Alketbi

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Objectives: 1. Documenting the spontaneous resolution of AML following the initiation of anti-TB therapy. 2. Presenting an uncommon type of relapse in Acute Myeloid Leukemia. 3. Highlighting the role of immune markers in the diagnosis of Leukemia cutis. 4. Exploring and highlighting the possibility of skin relapse as the exclusive manifestation, even when skin involvement is known secondary manifestation in AML. Background: Spontaneous remission of Acute Myeloid Leukemia (AML) is a rare phenomenon that has only been reported in some case reports, usually following severe infections. Some studies have described the occurrence of tuberculosis (TB) infection with AML, usually after starting chemotherapy. Spontaneous resolution of AML after starting anti TB therapy (ATT), without starting chemotherapy has never been described in the literature. Moreover, Leukemia cutis is another rare skin manifestation of Acute Myeloid Leukemia as a result of infiltration of the skin or subcutaneous tissue by leukemic cells, in which can present during, precedes, after or independently of systemic leukemia. Methods: Here, we present a case of a 13-year-old male who presented with fever, weight loss, lethargy, epistaxis, bruising and dry cough and was later diagnosed with AML. Before initiating leukemia treatment, the patient was tested for TB and was found to have active TB infection. His leukemia treatment was postponed to clear the TB infection and he was commenced on ATT. Two months later, repeat blood film and bone marrow biopsy showed resolution of his AML. The patient remained in remission for 1 month, after which he presented with symmetrical blue purple well-defined round indurated plaques on the chest and thighs. Our differentials were leukemia cutis and Kaposi sarcoma. Results: Skin Biopsy with immune markers done, showed a picture of Acute Myeloid Leukemia. Immunohistochemistry (IHC) showed neoplastic cells diffusely and strongly positive for LCA, CD2, CD31, MPO, CD117, Lysozymes and TDT, and moderately positive for CD34, CD99, CD43 and CD6 And patchy for CD68. Ki67 showed 60% proliferation index. They were negative for the remaining markers. This suggested acute myeloid leukemia (AML). Conclusion: In summary, we present a rare case of TB with AML that resolved after treatment of TB with ATT but relapsed later as leukemia cutis. While skin involvement might occur as a secondary manifestation of AML, Skin relapse could be the only one.

Keywords: Leukemia cutis, Leukemia relapse, Acute Myeloid Leukemia, spontaneous resolution of AML

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1318 Assessing Carbon Stock and Sequestration of Reforestation Species on Old Mining Sites in Morocco Using the DNDC Model

Authors: Nabil Elkhatri, Mohamed Louay Metougui, Ngonidzashe Chirinda

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Mining activities have left a legacy of degraded landscapes, prompting urgent efforts for ecological restoration. Reforestation holds promise as a potent tool to rehabilitate these old mining sites, with the potential to sequester carbon and contribute to climate change mitigation. This study focuses on evaluating the carbon stock and sequestration potential of reforestation species in the context of Morocco's mining areas, employing the DeNitrification-DeComposition (DNDC) model. The research is grounded in recognizing the need to connect theoretical models with practical implementation, ensuring that reforestation efforts are informed by accurate and context-specific data. Field data collection encompasses growth patterns, biomass accumulation, and carbon sequestration rates, establishing an empirical foundation for the study's analyses. By integrating the collected data with the DNDC model, the study aims to provide a comprehensive understanding of carbon dynamics within reforested ecosystems on old mining sites. The major findings reveal varying sequestration rates among different reforestation species, indicating the potential for species-specific optimization of reforestation strategies to enhance carbon capture. This research's significance lies in its potential to contribute to sustainable land management practices and climate change mitigation strategies. By quantifying the carbon stock and sequestration potential of reforestation species, the study serves as a valuable resource for policymakers, land managers, and practitioners involved in ecological restoration and carbon management. Ultimately, the study aligns with global objectives to rejuvenate degraded landscapes while addressing pressing climate challenges.

Keywords: carbon stock, carbon sequestration, DNDC model, ecological restoration, mining sites, Morocco, reforestation, sustainable land management.

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1317 Evaluation of the Gasification Process for the Generation of Syngas Using Solid Waste at the Autónoma de Colombia University

Authors: Yeraldin Galindo, Soraida Mora

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Solid urban waste represents one of the largest sources of global environmental pollution due to the large quantities of these that are produced every day; thus, the elimination of such waste is a major problem for the environmental authorities who must look for alternatives to reduce the volume of waste with the possibility of obtaining an energy recovery. At the Autónoma de Colombia University, approximately 423.27 kg/d of solid waste are generated mainly paper, cardboard, and plastic. A large amount of these solid wastes has as final disposition the sanitary landfill of the city, wasting the energy potential that these could have, this, added to the emissions generated by the collection and transport of the same, has as consequence the increase of atmospheric pollutants. One of the alternative process used in the last years to generate electrical energy from solid waste such as paper, cardboard, plastic and, mainly, organic waste or biomass to replace the use of fossil fuels is the gasification. This is a thermal conversion process of biomass. The objective of it is to generate a combustible gas as the result of a series of chemical reactions propitiated by the addition of heat and the reaction agents. This project was developed with the intention of giving an energetic use to the waste (paper, cardboard, and plastic) produced inside the university, using them to generate a synthesis gas with a gasifier prototype. The gas produced was evaluated to determine their benefits in terms of electricity generation or raw material for the chemical industry. In this process, air was used as gasifying agent. The characterization of the synthesis gas was carried out by a gas chromatography carried out by the Chemical Engineering Laboratory of the National University of Colombia. Taking into account the results obtained, it was concluded that the gas generated is of acceptable quality in terms of the concentration of its components, but it is a gas of low calorific value. For this reason, the syngas generated in this project is not viable for the production of electrical energy but for the production of methanol transformed by the Fischer-Tropsch cycle.

Keywords: alternative energies, gasification, gasifying agent, solid urban waste, syngas

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1316 The Role of Women in Criminal Organizations

Authors: Rossella Marzullo

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Family plays a central role in the Calabrian criminal organization, which draws its strength from blood ties and gender stereotypes that still impose a strong verticalization of intra-family relationships for the benefit of men. However, female figures are of great importance in the organizational structure of the 'Ndrangheta families, despite the fact that they appear to be formally suffocated by the culture of gender subordination still strongly present in the archaic world of criminal organizations. And this is so much true that over time, the women of the 'Ndrangheta have added to the function of ‘internal containment’, the increasingly explicit function of intermediaries in the ‘external’ activities of the clan. But what happens in the 'Ndrangheta if women break the bond and decide to speak? The results are shocking. When a woman starts talking to ask the institutions for help, the system ‘goes crazy’, because the woman is considered the means of consolidating and transmitting family codes: she educates, forges, holds the structure together. If a woman from the 'Ndrangheta decides to speak out and get out of the family bottlenecks of the clan, she does not exclusively destroy the family; she destroys the system. This happens because, while not playing the same roles as men within organizations, women carry out support activities as intermediaries for the circulation of communications, thus ensuring the operability of the gang in practice and on a daily basis. Crossing the border means breaking the bonds of belonging, thus questioning one's own identity and reconstructing it according to other points of reference. How much these disruptive choices are feared by the men of the 'Ndrangheta has been seen in the dramatic stories of Lea Garofalo and Maria Concetta Cacciola: the fear of the breaking of the family pact, of the earthquake that arises from within, has marked their fate of death, useful both to stop the judicial action and to recompose the organization's estate under the aegis of terror. With physical, psychological violence, underhanded torture, and moral blackmail, the men of the mafia family tried to heal the shock caused by the voices of women, relying on violence and yet another attempt to subordinate them. This proves that the 'Ndrangheta is really afraid of them. The female voices of the 'Ndrangheta, who have shaken a consolidated and considered intangible system, represent the anti-'ndrangheta par excellence; in their choices, there is an even stronger desire to break with the mafia world.

Keywords: families, gender, ‘Ndrangheta, stereotypes

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