Search results for: cross border
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4313

Search results for: cross border

293 Spatial Analysis and Determinants of Number of Antenatal Health Care Visit Among Pregnant Women in Ethiopia: Application of Spatial Multilevel Count Regression Models

Authors: Muluwerk Ayele Derebe

Abstract:

Background: Antenatal care (ANC) is an essential element in the continuum of reproductive health care for preventing preventable pregnancy-related morbidity and mortality. Objective: The aim of this study is to assess the spatial pattern and predictors of ANC visits in Ethiopia. Method: This study was done using Ethiopian Demographic and Health Survey data of 2016 among 7,174 pregnant women aged 15-49 years which was a nationwide community-based cross-sectional survey. Spatial analysis was done using Getis-Ord Gi* statistics to identify hot and cold spot areas of ANC visits. Multilevel glmmTMB packages adjusted for spatial effects were used in R software. Spatial multilevel count regression was conducted to identify predictors of antenatal care visits for pregnant women, and proportional change in variance was done to uncover the effect of individual and community-level factors of ANC visits. Results: The distribution of ANC visits was spatially clustered Moran’s I = 0.271, p<.0.001, ICC = 0.497, p<0.001). The highest spatial outlier areas of ANC visit was found in Amhara (South Wollo, Weast Gojjam, North Shewa), Oromo (west Arsi and East Harariga), Tigray (Central Tigray) and Benishangul-Gumuz (Asosa and Metekel) regions. The data was found with excess zeros (34.6%) and over-dispersed. The expected ANC visit of pregnant women with pregnancy complications was higher at 0.7868 [ARR= 2.1964, 95% CI: 1.8605, 2.5928, p-value <0.0001] compared to pregnant women who had no pregnancy complications. The expected ANC visit of a pregnant woman who lived in a rural area was 1.2254 times higher [ARR=3.4057, 95% CI: 2.1462, 5.4041, p-value <0.0001] as compared to a pregnant woman who lived in an urban. The study found dissimilar clusters with a low number of zero counts for a mean number of ANC visits surrounded by clusters with a higher number of counts of an average number of ANC visits when other variables held constant. Conclusion: This study found that the number of ANC visits in Ethiopia had a spatial pattern associated with socioeconomic, demographic, and geographic risk factors. Spatial clustering of ANC visits exists in all regions of Ethiopia. The predictor age of the mother, religion, mother’s education, husband’s education, mother's occupation, husband's occupation, signs of pregnancy complication, wealth index and marital status had a strong association with the number of ANC visits by each individual. At the community level, place of residence, region, age of the mother, sex of the household head, signs of pregnancy complications and distance to health facility factors had a strong association with the number of ANC visits.

Keywords: Ethiopia, ANC, spatial, multilevel, zero inflated Poisson

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292 Healthcare Providers’ Perception Towards Utilization of Health Information Applications and Its Associated Factors in Healthcare Delivery in Health Facilities in Cape Coast Metropolis, Ghana

Authors: Richard Okyere Boadu, Godwin Adzakpah, Nathan Kumasenu Mensah, Kwame Adu Okyere Boadu, Jonathan Kissi, Christiana Dziyaba, Rosemary Bermaa Abrefa

Abstract:

Information and communication technology (ICT) has significantly advanced global healthcare, with electronic health (e-Health) applications improving health records and delivery. These innovations, including electronic health records, strengthen healthcare systems. The study investigates healthcare professionals' perceptions of health information applications and their associated factors in the Cape Coast Metropolis of Ghana's health facilities. Methods: We used a descriptive cross-sectional study design to collect data from 632 healthcare professionals (HCPs), in the three purposively selected health facilities in the Cape Coast municipality of Ghana in July 2022. Shapiro-Wilk test was used to check the normality of dependent variables. Descriptive statistics were used to report means with corresponding standard deviations for continuous variables. Proportions were also reported for categorical variables. Bivariate regression analysis was conducted to determine the factors influencing the Benefits of Information Technology (BoIT); Barriers to Information Technology Use (BITU); and Motives of Information Technology Use (MoITU) in healthcare delivery. Stata SE version 15 was used for the analysis. A p-value of less than 0.05 served as the basis for considering a statistically significant accepting hypothesis. Results: Healthcare professionals (HCPs) generally perceived moderate benefits (Mean score (M)=5.67) from information technology (IT) in healthcare. However, they slightly agreed that barriers like insufficient computers (M=5.11), frequent system downtime (M=5.09), low system performance (M=5.04), and inadequate staff training (M=4.88) hindered IT utilization. Respondents slightly agreed that training (M=5.56), technical support (M=5.46), and changes in work procedures (M=5.10) motivated their IT use. Bivariate regression analysis revealed significant influences of education, working experience, healthcare profession, and IT training on attitudes towards IT utilization in healthcare delivery (BoIT, BITU, and MoITU). Additionally, the age of healthcare providers, education, and working experience significantly influenced BITU. Ultimately, age, education, working experience, healthcare profession, and IT training significantly influenced MoITU in healthcare delivery. Conclusions: Healthcare professionals acknowledge moderate benefits of IT in healthcare but encounter barriers like inadequate resources and training. Motives for IT use include staff training and support. Bivariate regression analysis shows education, working experience, profession, and IT training significantly influence attitudes toward IT adoption. Targeted interventions and policies can enhance IT utilization in the Cape Coast Metropolis, Ghana.

Keywords: health information application, utilization of information application, information technology use, healthcare

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291 Design, Development and Testing of Polymer-Glass Microfluidic Chips for Electrophoretic Analysis of Biological Sample

Authors: Yana Posmitnaya, Galina Rudnitskaya, Tatyana Lukashenko, Anton Bukatin, Anatoly Evstrapov

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An important area of biological and medical research is the study of genetic mutations and polymorphisms that can alter gene function and cause inherited diseases and other diseases. The following methods to analyse DNA fragments are used: capillary electrophoresis and electrophoresis on microfluidic chip (MFC), mass spectrometry with electrophoresis on MFC, hybridization assay on microarray. Electrophoresis on MFC allows to analyse small volumes of samples with high speed and throughput. A soft lithography in polydimethylsiloxane (PDMS) was chosen for operative fabrication of MFCs. A master-form from silicon and photoresist SU-8 2025 (MicroChem Corp.) was created for the formation of micro-sized structures in PDMS. A universal topology which combines T-injector and simple cross was selected for the electrophoretic separation of the sample. Glass K8 and PDMS Sylgard® 184 (Dow Corning Corp.) were used for fabrication of MFCs. Electroosmotic flow (EOF) plays an important role in the electrophoretic separation of the sample. Therefore, the estimate of the quantity of EOF and the ways of its regulation are of interest for the development of the new methods of the electrophoretic separation of biomolecules. The following methods of surface modification were chosen to change EOF: high-frequency (13.56 MHz) plasma treatment in oxygen and argon at low pressure (1 mbar); 1% aqueous solution of polyvinyl alcohol; 3% aqueous solution of Kolliphor® P 188 (Sigma-Aldrich Corp.). The electroosmotic mobility was evaluated by the method of Huang X. et al., wherein the borate buffer was used. The influence of physical and chemical methods of treatment on the wetting properties of the PDMS surface was controlled by the sessile drop method. The most effective way of surface modification of MFCs, from the standpoint of obtaining the smallest value of the contact angle and the smallest value of the EOF, was the processing with aqueous solution of Kolliphor® P 188. This method of modification has been selected for the treatment of channels of MFCs, which are used for the separation of mixture of oligonucleotides fluorescently labeled with the length of chain with 10, 20, 30, 40 and 50 nucleotides. Electrophoresis was performed on the device MFAS-01 (IAI RAS, Russia) at the separation voltage of 1500 V. 6% solution of polydimethylacrylamide with the addition of 7M carbamide was used as the separation medium. The separation time of components of the mixture was determined from electropherograms. The time for untreated MFC was ~275 s, and for the ones treated with solution of Kolliphor® P 188 – ~ 220 s. Research of physical-chemical methods of surface modification of MFCs allowed to choose the most effective way for reducing EOF – the modification with aqueous solution of Kolliphor® P 188. In this case, the separation time of the mixture of oligonucleotides decreased about 20%. The further optimization of method of modification of channels of MFCs will allow decreasing the separation time of sample and increasing the throughput of analysis.

Keywords: electrophoresis, microfluidic chip, modification, nucleic acid, polydimethylsiloxane, soft lithography

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290 The Role of People in Continuing Airworthiness: A Case Study Based on the Royal Thai Air Force

Authors: B. Ratchaneepun, N.S. Bardell

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It is recognized that people are the main drivers in almost all the processes that affect airworthiness assurance. This is especially true in the area of aircraft maintenance, which is an essential part of continuing airworthiness. This work investigates what impact English language proficiency, the intersection of the military and Thai cultures, and the lack of initial and continuing human factors training have on the work performance of maintenance personnel in the Royal Thai Air Force (RTAF). A quantitative research method based on a cross-sectional survey was used to gather data about these three key aspects of “people” in a military airworthiness environment. 30 questions were developed addressing the crucial topics of English language proficiency, impact of culture, and human factors training. The officers and the non-commissioned officers (NCOs) who work for the Aeronautical Engineering Divisions in the RTAF comprised the survey participants. The survey data were analysed to support various hypotheses by using a t-test method. English competency in the RTAF is very important since all of the service manuals for Thai military aircraft are written in English. Without such competency, it is difficult for maintenance staff to perform tasks and correctly interpret the relevant maintenance manual instructions; any misunderstandings could lead to potential accidents. The survey results showed that the officers appreciated the importance of this more than the NCOs, who are the people actually doing the hands-on maintenance work. Military culture focuses on the success of a given mission, and leverages the power distance between the lower and higher ranks. In Thai society, a power distance also exists between younger and older citizens. In the RTAF, such a combination tends to inhibit a just reporting culture and hence hinders safety. The survey results confirmed this, showing that the older people and higher ranks involved with RTAF aircraft maintenance believe that the workplace has a positive safety culture and climate, whereas the younger people and lower ranks think the opposite. The final area of consideration concerned human factors training and non-technical skills training. The survey revealed that those participants who had previously attended such courses appreciated its value and were aware of its benefits in daily life. However, currently there is no regulation in the RTAF to mandate recurrent training to maintain such knowledge and skills. The findings from this work suggest that the people involved in assuring the continuing airworthiness of the RTAF would benefit from: (i) more rigorous requirements and standards in the recruitment, initial training and continuation training regarding English competence; (ii) the development of a strong safety culture that exploits the uniqueness of both the military culture and the Thai culture; and (iii) providing more initial and recurrent training in human factors and non-technical skills.

Keywords: aircraft maintenance, continuing airworthiness, military culture, people, Royal Thai Air Force

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289 Music Genre Classification Based on Non-Negative Matrix Factorization Features

Authors: Soyon Kim, Edward Kim

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In order to retrieve information from the massive stream of songs in the music industry, music search by title, lyrics, artist, mood, and genre has become more important. Despite the subjectivity and controversy over the definition of music genres across different nations and cultures, automatic genre classification systems that facilitate the process of music categorization have been developed. Manual genre selection by music producers is being provided as statistical data for designing automatic genre classification systems. In this paper, an automatic music genre classification system utilizing non-negative matrix factorization (NMF) is proposed. Short-term characteristics of the music signal can be captured based on the timbre features such as mel-frequency cepstral coefficient (MFCC), decorrelated filter bank (DFB), octave-based spectral contrast (OSC), and octave band sum (OBS). Long-term time-varying characteristics of the music signal can be summarized with (1) the statistical features such as mean, variance, minimum, and maximum of the timbre features and (2) the modulation spectrum features such as spectral flatness measure, spectral crest measure, spectral peak, spectral valley, and spectral contrast of the timbre features. Not only these conventional basic long-term feature vectors, but also NMF based feature vectors are proposed to be used together for genre classification. In the training stage, NMF basis vectors were extracted for each genre class. The NMF features were calculated in the log spectral magnitude domain (NMF-LSM) as well as in the basic feature vector domain (NMF-BFV). For NMF-LSM, an entire full band spectrum was used. However, for NMF-BFV, only low band spectrum was used since high frequency modulation spectrum of the basic feature vectors did not contain important information for genre classification. In the test stage, using the set of pre-trained NMF basis vectors, the genre classification system extracted the NMF weighting values of each genre as the NMF feature vectors. A support vector machine (SVM) was used as a classifier. The GTZAN multi-genre music database was used for training and testing. It is composed of 10 genres and 100 songs for each genre. To increase the reliability of the experiments, 10-fold cross validation was used. For a given input song, an extracted NMF-LSM feature vector was composed of 10 weighting values that corresponded to the classification probabilities for 10 genres. An NMF-BFV feature vector also had a dimensionality of 10. Combined with the basic long-term features such as statistical features and modulation spectrum features, the NMF features provided the increased accuracy with a slight increase in feature dimensionality. The conventional basic features by themselves yielded 84.0% accuracy, but the basic features with NMF-LSM and NMF-BFV provided 85.1% and 84.2% accuracy, respectively. The basic features required dimensionality of 460, but NMF-LSM and NMF-BFV required dimensionalities of 10 and 10, respectively. Combining the basic features, NMF-LSM and NMF-BFV together with the SVM with a radial basis function (RBF) kernel produced the significantly higher classification accuracy of 88.3% with a feature dimensionality of 480.

Keywords: mel-frequency cepstral coefficient (MFCC), music genre classification, non-negative matrix factorization (NMF), support vector machine (SVM)

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288 Contribution of Word Decoding and Reading Fluency on Reading Comprehension in Young Typical Readers of Kannada Language

Authors: Vangmayee V. Subban, Suzan Deelan. Pinto, Somashekara Haralakatta Shivananjappa, Shwetha Prabhu, Jayashree S. Bhat

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Introduction and Need: During early years of schooling, the instruction in the schools mainly focus on children’s word decoding abilities. However, the skilled readers should master all the components of reading such as word decoding, reading fluency and comprehension. Nevertheless, the relationship between each component during the process of learning to read is less clear. The studies conducted in alphabetical languages have mixed opinion on relative contribution of word decoding and reading fluency on reading comprehension. However, the scenarios in alphasyllabary languages are unexplored. Aim and Objectives: The aim of the study was to explore the role of word decoding, reading fluency on reading comprehension abilities in children learning to read Kannada between the age ranges of 5.6 to 8.6 years. Method: In this cross sectional study, a total of 60 typically developing children, 20 each from Grade I, Grade II, Grade III maintaining equal gender ratio between the age range of 5.6 to 6.6 years, 6.7 to 7.6 years and 7.7 to 8.6 years respectively were selected from Kannada medium schools. The reading fluency and reading comprehension abilities of the children were assessed using Grade level passages selected from the Kannada text book of children core curriculum. All the passages consist of five questions to assess reading comprehension. The pseudoword decoding skills were assessed using 40 pseudowords with varying syllable length and their Akshara composition. Pseudowords are formed by interchanging the syllables within the meaningful word while maintaining the phonotactic constraints of Kannada language. The assessment material was subjected to content validation and reliability measures before collecting the data on the study samples. The data were collected individually, and reading fluency was assessed for words correctly read per minute. Pseudoword decoding was scored for the accuracy of reading. Results: The descriptive statistics indicated that the mean pseudoword reading, reading comprehension, words accurately read per minute increased with the Grades. The performance of Grade III children found to be higher, Grade I lower and Grade II remained intermediate of Grade III and Grade I. The trend indicated that reading skills gradually improve with the Grades. Pearson’s correlation co-efficient showed moderate and highly significant (p=0.00) positive co-relation between the variables, indicating the interdependency of all the three components required for reading. The hierarchical regression analysis revealed 37% variance in reading comprehension was explained by pseudoword decoding and was highly significant. Subsequent entry of reading fluency measure, there was no significant change in R-square and was only change 3%. Therefore, pseudoword-decoding evolved as a single most significant predictor of reading comprehension during early Grades of reading acquisition. Conclusion: The present study concludes that the pseudoword decoding skills contribute significantly to reading comprehension than reading fluency during initial years of schooling in children learning to read Kannada language.

Keywords: alphasyllabary, pseudo-word decoding, reading comprehension, reading fluency

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287 Exploring Nature and Pattern of Mentoring Practices: A Study on Mentees' Perspectives

Authors: Nahid Parween Anwar, Sadia Muzaffar Bhutta, Takbir Ali

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Mentoring is a structured activity which is designed to facilitate engagement between mentor and mentee to enhance mentee’s professional capability as an effective teacher. Both mentor and mentee are important elements of the ‘mentoring equation’ and play important roles in nourishing this dynamic, collaborative and reciprocal relationship. Cluster-Based Mentoring Programme (CBMP) provides an indigenous example of a project which focused on development of primary school teachers in selected clusters with a particular focus on their classroom practice. A study was designed to examine the efficacy of CBMP as part of Strengthening Teacher Education in Pakistan (STEP) project. This paper presents results of one of the components of this study. As part of the larger study, a cross-sectional survey was employed to explore nature and patterns of mentoring process from mentees’ perspectives in the selected districts of Sindh and Balochistan. This paper focuses on the results of the study related to the question: What are mentees’ perceptions of their mentors’ support for enhancing their classroom practice during mentoring process? Data were collected from mentees (n=1148) using a 5-point scale -‘Mentoring for Effective Primary Teaching’ (MEPT). MEPT focuses on seven factors of mentoring: personal attributes, pedagogical knowledge, modelling, feedback, system requirement, development and use of material, and gender equality. Data were analysed using SPSS 20. Mentees perceptions of mentoring practice of their mentors were summarized using mean and standard deviation. Results showed that mean scale scores on mentees’ perceptions of their mentors’ practices fell between 3.58 (system requirement) and 4.55 (personal attributes). Mentees’ perceives personal attribute of the mentor as the most significant factor (M=4.55) towards streamlining mentoring process by building good relationship between mentor and mentees. Furthermore, mentees have shared positive views about their mentors efforts towards promoting gender impartiality (M=4.54) during workshop and follow up visit. Contrary to this, mentees felt that more could have been done by their mentors in sharing knowledge about system requirement (e.g. school policies, national curriculum). Furthermore, some of the aspects in high scoring factors were highlighted by the mentees as areas for further improvement (e.g. assistance in timetabling, written feedback, encouragement to develop learning corners). Mentees’ perceptions of their mentors’ practices may assist in determining mentoring needs. The results may prove useful for the professional development programme for the mentors and mentees for specific mentoring programme in order to enhance practices in primary classrooms in Pakistan. Results would contribute into the body of much-needed knowledge from developing context.

Keywords: cluster-based mentoring programme, mentoring for effective primary teaching (MEPT), professional development, survey

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286 Enhancing the Effectiveness of Witness Examination through Deposition System in Korean Criminal Trials: Insights from the U.S. Evidence Discovery Process

Authors: Qi Wang

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With the expansion of trial-centered principles, the importance of witness examination in Korean criminal proceedings has been increasingly emphasized. However, several practical challenges have emerged in courtroom examinations, including concerns about witnesses’ memory deterioration due to prolonged trial periods, the possibility of inaccurate testimony due to courtroom anxiety and tension, risks of testimony retraction, and witnesses’ refusal to appear. These issues have led to a decline in the effective utilization of witness testimony. This study analyzes the deposition system, which is widely used in the U.S. evidence discovery process, and examines its potential implementation within the Korean criminal procedure framework. Furthermore, it explores the scope of application, procedural design, and measures to prevent potential abuse if the system were to be adopted. Under the adversarial litigation structure that has evolved through several amendments to the Criminal Procedure Act, the deposition system, although conducted pre-trial, serves as a preliminary procedure to facilitate efficient and effective witness examination during trial. This system not only aligns with the goal of discovering substantive truth but also upholds the practical ideals of trial-centered principles while promoting judicial economy. Furthermore, with the legal foundation established by Article 266 of the Criminal Procedure Act and related provisions, this study concludes that the implementation of the deposition system is both feasible and appropriate for the Korean criminal justice system. The specific functions of depositions include providing case-related information to refresh witnesses’ memory as a preliminary to courtroom examination, pre-reviewing existing statement documents to enhance trial efficiency, and conducting preliminary examinations on key issues and anticipated questions. The subsequent courtroom witness examination focuses on verifying testimony through public and cross-examination, identifying and analyzing contradictions in testimony, and conducting double verification of testimony credibility under judicial supervision. Regarding operational aspects, both prosecution and defense may request depositions, subject to court approval. The deposition process involves video or audio recording, complete documentation by court reporters, and the preparation of transcripts, with copies provided to all parties and the original included in court records. The admissibility of deposition transcripts is recognized under Article 311 of the Criminal Procedure Act. Given prosecutors’ advantageous position in evidence collection, which may lead to indifference or avoidance of depositions, the study emphasizes the need to reinforce prosecutors’ public interest status and objective duties. Additionally, it recommends strengthening pre-employment ethics education and post-violation disciplinary measures for prosecutors.

Keywords: witness examination, deposition system, Korean criminal procedure, evidence discovery, trial-centered principle

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285 The Incidence of Inferior Alveolar Nerve Dysfunction Following Bilateral Sagittal Split Osteotomies: A Single Centre Retrospective Audit in the United Kingdom

Authors: Krupali Mukeshkumar, Jinesh Shah

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Background: Bilateral Sagittal Split Osteotomy (BSSO), used for the correction of mandibular deformities, is a common oral and maxillofacial surgical procedure. Inferior alveolar nerve dysfunction is commonly reported post-operatively by patients as paresthesia or anesthesia. The current literature lacks a consensus on the incidence of inferior alveolar nerve dysfunction as patients are not routinely assessed pre and post-operatively with an objective assessment. The range of incidence varies from 9% to 85% of patients, with some authors arguing that 100% of patients experience nerve dysfunction immediately post-surgery. Systematic reviews have shown a difference between incidence rates at different follow-up periods using objective and subjective methods. Aim: To identify the incidence of inferior alveolar nerve dysfunction following BSSO. Gold standard: Nerve dysfunction incidence rates similar or lower than current literature of 83% day one post-operatively and 18.4% at one year follow up. Setting: A retrospective cross-sectional audit of patients treated between 2017-2019 at the Royal Stoke University Hospital, Maxillofacial and Orthodontic departments. Sample: All patients who underwent a BSSO (with or without le fort one osteotomy) between 2017–2019 were identified from the database. Patients with pre-existing neurosensory disturbance, those who had a genioplasty at the same time and those with no follow-up were excluded. The sample consisted of 121 patients, 37 males and 84 females between the ages of 17-50 years at the time of surgery. Methods: Clinical records of 121 cases were reviewed to assess the age, sex, type of mandibular osteotomy, status of the nerve during the surgical procedure, type of bony split and incidence of nerve dysfunction at follow-up appointments. The surgical procedure was carried out by three Maxillo-facial surgeons and follow-up appointments were carried out in the Orthodontic and Oral and Maxillo-facial departments. Results: 120 patients were treated to correct the mandibular facial deformity and 1 patient was treated for sleep apnoea. Seventeen patients had a mandibular setback and 104 patients had mandibular advancement. 68 patients reported inferior alveolar nerve dysfunction at one week following their surgery. Seventy-six patients had temporary paresthesia present between 2 weeks and 12 months post-surgery. 13 patients had persistent nerve dysfunction at 12 months, of which 1 had a bad bony split during the BSSO. The incidence of nerve dysfunction postoperatively was 6.6% after 1 day, 56.1% at 1 week, 62.8% at 2 weeks, 59.5% between 3-6 weeks, 43.0% between 8-16 weeks and 10.7% at 1 year. Conclusions: The results of this audit show a similar incidence rate to the research gold standard at the one-year follow-up. Future Recommendations: No changes to surgical procedure or technique are indicated, but a need for improved documentation and a standardized approach for assessment of post-operative nerve dysfunction would be beneficial.

Keywords: bilateral sagittal split osteotomy, inferior alveolar nerve, mandible, nerve dysfunction

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284 Collaborative Procurement in the Pursuit of Net- Zero: A Converging Journey

Authors: Bagireanu Astrid, Bros-Williamson Julio, Duncheva Mila, Currie John

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The Architecture, Engineering, and Construction (AEC) sector plays a critical role in the global transition toward sustainable and net-zero built environments. However, the industry faces unique challenges in planning for net-zero while struggling with low productivity, cost overruns and overall resistance to change. Traditional practices fall short due to their inability to meet the requirements for systemic change, especially as governments increasingly demand transformative approaches. Working in silos and rigid hierarchies and a short-term, client-centric approach prioritising immediate gains over long-term benefit stands in stark contrast to the fundamental requirements for the realisation of net-zero objectives. These practices have limited capacity to effectively integrate AEC stakeholders and promote the essential knowledge sharing required to address the multifaceted challenges of achieving net-zero. In the context of built environment, procurement may be described as the method by which a project proceeds from inception to completion. Collaborative procurement methods under the Integrated Practices (IP) umbrella have the potential to align more closely with net-zero objectives. This paper explores the synergies between collaborative procurement principles and the pursuit of net zero in the AEC sector, drawing upon the shared values of cross-disciplinary collaboration, Early Supply Chain involvement (ESI), use of standards and frameworks, digital information management, strategic performance measurement, integrated decision-making principles and contractual alliancing. To investigate the role of collaborative procurement in advancing net-zero objectives, a structured research methodology was employed. First, the study focuses on a systematic review on the application of collaborative procurement principles in the AEC sphere. Next, a comprehensive analysis is conducted to identify common clusters of these principles across multiple procurement methods. An evaluative comparison between traditional procurement methods and collaborative procurement for achieving net-zero objectives is presented. Then, the study identifies the intersection between collaborative procurement principles and the net-zero requirements. Lastly, an exploration of key insights for AEC stakeholders focusing on the implications and practical applications of these findings is made. Directions for future development of this research are recommended. Adopting collaborative procurement principles can serve as a strategic framework for guiding the AEC sector towards realising net-zero. Synergising these approaches overcomes fragmentation, fosters knowledge sharing, and establishes a net-zero-centered ecosystem. In the context of the ongoing efforts to amplify project efficiency within the built environment, a critical realisation of their central role becomes imperative for AEC stakeholders. When effectively leveraged, collaborative procurement emerges as a powerful tool to surmount existing challenges in attaining net-zero objectives.

Keywords: collaborative procurement, net-zero, knowledge sharing, architecture, built environment

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283 Nursing Experience in the Intensive Care of a Lung Cancer Patient with Pulmonary Embolism on Extracorporeal Membrane Oxygenation

Authors: Huang Wei-Yi

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Objective: This article explores the intensive care nursing experience of a lung cancer patient with pulmonary embolism who was placed on ECMO. Following a sudden change in the patient’s condition and a consensus reached during a family meeting, the decision was made to withdraw life-sustaining equipment and collaborate with the palliative care team. Methods: The nursing period was from October 20 to October 27, 2023. The author monitored physiological data, observed, provided direct care, conducted interviews, performed physical assessments, and reviewed medical records. Together with the critical care team and bypass personnel, a comprehensive assessment was conducted using Gordon's Eleven Functional Health Patterns to identify the patient’s health issues, which included pain related to lung cancer and invasive devices, fear of death due to sudden deterioration, and altered tissue perfusion related to hemodynamic instability. Results: The patient was admitted with fever, back pain, and painful urination. During hospitalization, the patient experienced sudden discomfort followed by cardiac arrest, requiring multiple CPR attempts and ECMO placement. A subsequent CT angiogram revealed a pulmonary embolism. The patient's condition was further complicated by severe pain due to compression fractures, and a diagnosis of terminal lung cancer was unexpectedly confirmed, leading to emotional distress and uncertainty about future treatment. Throughout the critical care process, ECMO was removed on October 24, stabilizing the patient’s body temperature between 36.5-37°C and maintaining a mean arterial pressure of 60-80 mmHg. Pain management, including Morphine 8mg in 0.9% N/S 100ml IV drip q6h PRN and Ultracet 37.5 mg/325 mg 1# PO q6h, kept the pain level below 3. The patient was transferred to the ward on October 27 and discharged home on October 30. Conclusion: During the care period, collaboration with the medical team and palliative care professionals was crucial. Adjustments to pain medication, symptom management, and lung cancer-targeted therapy improved the patient’s physical discomfort and pain levels. By applying the unique functions of nursing and the four principles of palliative care, positive encouragement was provided. Family members, along with social workers, clergy, psychologists, and nutritionists, participated in cross-disciplinary care, alleviating anxiety and fear. The consensus to withdraw ECMO and life-sustaining equipment enabled the patient and family to receive high-quality care and maintain autonomy in decision-making. A follow-up call on November 1 confirmed that the patient was emotionally stable, pain-free, and continuing with targeted lung cancer therapy.

Keywords: intensive care, lung cancer, pulmonary embolism, ECMO

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282 The Relationship between Wasting and Stunting in Young Children: A Systematic Review

Authors: Susan Thurstans, Natalie Sessions, Carmel Dolan, Kate Sadler, Bernardette Cichon, Shelia Isanaka, Dominique Roberfroid, Heather Stobagh, Patrick Webb, Tanya Khara

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For many years, wasting and stunting have been viewed as separate conditions without clear evidence supporting this distinction. In 2014, the Emergency Nutrition Network (ENN) examined the relationship between wasting and stunting and published a report highlighting the evidence for linkages between the two forms of undernutrition. This systematic review aimed to update the evidence generated since this 2014 report to better understand the implications for improving child nutrition, health and survival. Following PRISMA guidelines, this review was conducted using search terms to describe the relationship between wasting and stunting. Studies related to children under five from low- and middle-income countries that assessed both ponderal growth/wasting and linear growth/stunting, as well as the association between the two, were included. Risk of bias was assessed in all included studies using SIGN checklists. 45 studies met the inclusion criteria- 39 peer reviewed studies, 1 manual chapter, 3 pre-print publications and 2 published reports. The review found that there is a strong association between the two conditions whereby episodes of wasting contribute to stunting and, to a lesser extent, stunting leads to wasting. Possible interconnected physiological processes and common risk factors drive an accumulation of vulnerabilities. Peak incidence of both wasting and stunting was found to be between birth and three months. A significant proportion of children experience concurrent wasting and stunting- Country level data suggests that up to 8% of children under 5 may be both wasted and stunted at the same time, global estimates translate to around 16 million children. Children with concurrent wasting and stunting have an elevated risk of mortality when compared to children with one deficit alone. These children should therefore be considered a high-risk group in the targeting of treatment. Wasting, stunting and concurrent wasting and stunting appear to be more prevalent in boys than girls and it appears that concurrent wasting and stunting peaks between 12- 30 months of age with younger children being the most affected. Seasonal patterns in prevalence of both wasting and stunting are seen in longitudinal and cross sectional data and in particular season of birth has been shown to have an impact on a child’s subsequent experience of wasting and stunting. Evidence suggests that the use of mid-upper-arm circumference combined with weight-for-age Z-score might effectively identify children most at risk of near-term mortality, including those concurrently wasted and stunted. Wasting and stunting frequently occur in the same child, either simultaneously or at different moments through their life course. Evidence suggests there is a process of accumulation of nutritional deficits and therefore risk over the life course of a child demonstrates the need for a more integrated approach to prevention and treatment strategies to interrupt this process. To achieve this, undernutrition policies, programmes, financing and research must become more unified.

Keywords: Concurrent wasting and stunting, Review, Risk factors, Undernutrition

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281 The Impact of Social Support on Anxiety and Depression under the Context of COVID-19 Pandemic: A Scoping Review and Meta-Analysis

Authors: Meng Wu, Atif Rahman, Eng Gee, Lim, Jeong Jin Yu, Rong Yan

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Context: The COVID-19 pandemic has had a profound impact on mental health, with increased rates of anxiety and depression observed. Social support, a critical factor in mental well-being, has also undergone significant changes during the pandemic. This study aims to explore the relationship between social support, anxiety, and depression during COVID-19, taking into account various demographic and contextual factors. Research Aim: The main objective of this study is to conduct a comprehensive systematic review and meta-analysis to examine the impact of social support on anxiety and depression during the COVID-19 pandemic. The study aims to determine the consistency of these relationships across different age groups, occupations, regions, and research paradigms. Methodology: A scoping review and meta-analytic approach were employed in this study. A search was conducted across six databases from 2020 to 2022 to identify relevant studies. The selected studies were then subjected to random effects models, with pooled correlations (r and ρ) estimated. Homogeneity was assessed using Q and I² tests. Subgroup analyses were conducted to explore variations across different demographic and contextual factors. Findings: The meta-analysis of both cross-sectional and longitudinal studies revealed significant correlations between social support, anxiety, and depression during COVID-19. The pooled correlations (ρ) indicated a negative relationship between social support and anxiety (ρ = -0.30, 95% CI = [-0.333, -0.255]) as well as depression (ρ = -0.27, 95% CI = [-0.370, -0.281]). However, further investigation is required to validate these results across different age groups, occupations, and regions. Theoretical Importance: This study emphasizes the multifaceted role of social support in mental health during the COVID-19 pandemic. It highlights the need to reevaluate and expand our understanding of social support's impact on anxiety and depression. The findings contribute to the existing literature by shedding light on the associations and complexities involved in these relationships. Data Collection and Analysis Procedures: The data collection involved an extensive search across six databases to identify relevant studies. The selected studies were then subjected to rigorous analysis using random effects models and subgroup analyses. Pooled correlations were estimated, and homogeneity was assessed using Q and I² tests. Question Addressed: This study aimed to address the question of the impact of social support on anxiety and depression during the COVID-19 pandemic. It sought to determine the consistency of these relationships across different demographic and contextual factors. Conclusion: The findings of this study highlight the significant association between social support, anxiety, and depression during the COVID-19 pandemic. However, further research is needed to validate these findings across different age groups, occupations, and regions. The study emphasizes the need for a comprehensive understanding of social support's multifaceted role in mental health and the importance of considering various contextual and demographic factors in future investigations.

Keywords: social support, anxiety, depression, COVID-19, meta-analysis

Procedia PDF Downloads 63
280 Impact Location From Instrumented Mouthguard Kinematic Data In Rugby

Authors: Jazim Sohail, Filipe Teixeira-Dias

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Mild traumatic brain injury (mTBI) within non-helmeted contact sports is a growing concern due to the serious risk of potential injury. Extensive research is being conducted looking into head kinematics in non-helmeted contact sports utilizing instrumented mouthguards that allow researchers to record accelerations and velocities of the head during and after an impact. This does not, however, allow the location of the impact on the head, and its magnitude and orientation, to be determined. This research proposes and validates two methods to quantify impact locations from instrumented mouthguard kinematic data, one using rigid body dynamics, the other utilizing machine learning. The rigid body dynamics technique focuses on establishing and matching moments from Euler’s and torque equations in order to find the impact location on the head. The methodology is validated with impact data collected from a lab test with the dummy head fitted with an instrumented mouthguard. Additionally, a Hybrid III Dummy head finite element model was utilized to create synthetic kinematic data sets for impacts from varying locations to validate the impact location algorithm. The algorithm calculates accurate impact locations; however, it will require preprocessing of live data, which is currently being done by cross-referencing data timestamps to video footage. The machine learning technique focuses on eliminating the preprocessing aspect by establishing trends within time-series signals from instrumented mouthguards to determine the impact location on the head. An unsupervised learning technique is used to cluster together impacts within similar regions from an entire time-series signal. The kinematic signals established from mouthguards are converted to the frequency domain before using a clustering algorithm to cluster together similar signals within a time series that may span the length of a game. Impacts are clustered within predetermined location bins. The same Hybrid III Dummy finite element model is used to create impacts that closely replicate on-field impacts in order to create synthetic time-series datasets consisting of impacts in varying locations. These time-series data sets are used to validate the machine learning technique. The rigid body dynamics technique provides a good method to establish accurate impact location of impact signals that have already been labeled as true impacts and filtered out of the entire time series. However, the machine learning technique provides a method that can be implemented with long time series signal data but will provide impact location within predetermined regions on the head. Additionally, the machine learning technique can be used to eliminate false impacts captured by sensors saving additional time for data scientists using instrumented mouthguard kinematic data as validating true impacts with video footage would not be required.

Keywords: head impacts, impact location, instrumented mouthguard, machine learning, mTBI

Procedia PDF Downloads 217
279 Greener Minds: Understanding Students' Perceptions of Environmental Sustainability in Higher Education, Sultan Qaboos University

Authors: Aisha Alshdefat, Lina Shakman

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Objective: With environmental sustainability (ES) emerging as a critical concern due to its global impact, higher education institutions play a vital role in promoting ES through curricula and campus operations. This study examines the perceptions, attitudes, and behaviors related to ES among students at Sultan Qaboos University, aiming to identify areas for improved integration of sustainability practices in higher education. Design: A descriptive cross-sectional study, conducted via an online questionnaire, examines perceptions and attitudes toward environmental sustainability among students at Sultan Qaboos University, Muscat, Oman. The survey instrument employs a 5-point Likert scale to assess six key areas: awareness, concern, attitude, willingness to participate, current behaviors, and recommendations for enhancing campus sustainability initiatives. A convenience sample of 200 students was initially targeted, with 157 students ultimately responding between September and November 2024. Eligible participants included Undergraduate and graduate students who consented after being fully informed of the study objectives and design were included, while those who withdrew or refused participation were excluded. Following ethical approval, data collection was carried out through Google Forms. SPSS Version 23 was used for descriptive and inferential analyses, including Pearson’s correlation, chi-square, and Fisher's exact test, to explore associations among key variables. Findings: Preliminary analysis indicates that 68% of participants are familiar with core environmental sustainability (ES) concepts, including the Sustainable Development Goals (SDGs), and express high concern regarding environmental issues. However, only 47% report active involvement in campus-led ES initiatives, underscoring an engagement gap. Over 70% of respondents believe that sustainability should be prioritized as a university policy, and 62% expressed willingness to participate in additional ES-related programs. Despite this interest, 58% advocated for more sustainability-focused courses in their curriculum, suggesting current offerings are insufficient. Statistical analysis revealed a significant positive correlation between ES awareness and willingness to engage in sustainable practices (p < 0.05). These findings highlight the need for expanded institutional efforts, including targeted programs and curriculum integration, to cultivate a more sustainability-centered culture among students. Conclusion: The results emphasize that while students demonstrate a strong foundational awareness of ES, greater institutional support is essential to transform this awareness into active engagement. More comprehensive integration of sustainability within academic programs and campus life could substantially enhance students’ involvement and commitment to environmental stewardship.

Keywords: environmental sustainability, higher education, students, perceptions, Sultan Qaboos University.

Procedia PDF Downloads 16
278 3D Classification Optimization of Low-Density Airborne Light Detection and Ranging Point Cloud by Parameters Selection

Authors: Baha Eddine Aissou, Aichouche Belhadj Aissa

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Light detection and ranging (LiDAR) is an active remote sensing technology used for several applications. Airborne LiDAR is becoming an important technology for the acquisition of a highly accurate dense point cloud. A classification of airborne laser scanning (ALS) point cloud is a very important task that still remains a real challenge for many scientists. Support vector machine (SVM) is one of the most used statistical learning algorithms based on kernels. SVM is a non-parametric method, and it is recommended to be used in cases where the data distribution cannot be well modeled by a standard parametric probability density function. Using a kernel, it performs a robust non-linear classification of samples. Often, the data are rarely linearly separable. SVMs are able to map the data into a higher-dimensional space to become linearly separable, which allows performing all the computations in the original space. This is one of the main reasons that SVMs are well suited for high-dimensional classification problems. Only a few training samples, called support vectors, are required. SVM has also shown its potential to cope with uncertainty in data caused by noise and fluctuation, and it is computationally efficient as compared to several other methods. Such properties are particularly suited for remote sensing classification problems and explain their recent adoption. In this poster, the SVM classification of ALS LiDAR data is proposed. Firstly, connected component analysis is applied for clustering the point cloud. Secondly, the resulting clusters are incorporated in the SVM classifier. Radial basic function (RFB) kernel is used due to the few numbers of parameters (C and γ) that needs to be chosen, which decreases the computation time. In order to optimize the classification rates, the parameters selection is explored. It consists to find the parameters (C and γ) leading to the best overall accuracy using grid search and 5-fold cross-validation. The exploited LiDAR point cloud is provided by the German Society for Photogrammetry, Remote Sensing, and Geoinformation. The ALS data used is characterized by a low density (4-6 points/m²) and is covering an urban area located in residential parts of the city Vaihingen in southern Germany. The class ground and three other classes belonging to roof superstructures are considered, i.e., a total of 4 classes. The training and test sets are selected randomly several times. The obtained results demonstrated that a parameters selection can orient the selection in a restricted interval of (C and γ) that can be further explored but does not systematically lead to the optimal rates. The SVM classifier with hyper-parameters is compared with the most used classifiers in literature for LiDAR data, random forest, AdaBoost, and decision tree. The comparison showed the superiority of the SVM classifier using parameters selection for LiDAR data compared to other classifiers.

Keywords: classification, airborne LiDAR, parameters selection, support vector machine

Procedia PDF Downloads 148
277 Optimization of Structures with Mixed Integer Non-linear Programming (MINLP)

Authors: Stojan Kravanja, Andrej Ivanič, Tomaž Žula

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This contribution focuses on structural optimization in civil engineering using mixed integer non-linear programming (MINLP). MINLP is characterized as a versatile method that can handle both continuous and discrete optimization variables simultaneously. Continuous variables are used to optimize parameters such as dimensions, stresses, masses, or costs, while discrete variables represent binary decisions to determine the presence or absence of structural elements within a structure while also calculating discrete materials and standard sections. The optimization process is divided into three main steps. First, a mechanical superstructure with a variety of different topology-, material- and dimensional alternatives. Next, a MINLP model is formulated to encapsulate the optimization problem. Finally, an optimal solution is searched in the direction of the defined objective function while respecting the structural constraints. The economic or mass objective function of the material and labor costs of a structure is subjected to the constraints known from structural analysis. These constraints include equations for the calculation of internal forces and deflections, as well as equations for the dimensioning of structural components (in accordance with the Eurocode standards). Given the complex, non-convex and highly non-linear nature of optimization problems in civil engineering, the Modified Outer-Approximation/Equality-Relaxation (OA/ER) algorithm is applied. This algorithm alternately solves subproblems of non-linear programming (NLP) and main problems of mixed-integer linear programming (MILP), in this way gradually refines the solution space up to the optimal solution. The NLP corresponds to the continuous optimization of parameters (with fixed topology, discrete materials and standard dimensions, all determined in the previous MILP), while the MILP involves a global approximation to the superstructure of alternatives, where a new topology, materials, standard dimensions are determined. The optimization of a convex problem is stopped when the MILP solution becomes better than the best NLP solution. Otherwise, it is terminated when the NLP solution can no longer be improved. While the OA/ER algorithm, like all other algorithms, does not guarantee global optimality due to the presence of non-convex functions, various modifications, including convexity tests, are implemented in OA/ER to mitigate these difficulties. The effectiveness of the proposed MINLP approach is demonstrated by its application to various structural optimization tasks, such as mass optimization of steel buildings, cost optimization of timber halls, composite floor systems, etc. Special optimization models have been developed for the optimization of these structures. The MINLP optimizations, facilitated by the user-friendly software package MIPSYN, provide insights into a mass or cost-optimal solutions, optimal structural topologies, optimal material and standard cross-section choices, confirming MINLP as a valuable method for the optimization of structures in civil engineering.

Keywords: MINLP, mixed-integer non-linear programming, optimization, structures

Procedia PDF Downloads 47
276 Are Oral Health Conditions Associated with Children’s School Performance and School Attendance in the Kingdom of Bahrain - A Life Course Approach

Authors: Seham A. S. Mohamed, Sarah R. Baker, Christopher Deery, Mario V. Vettore

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Background: The link between oral health conditions and school performance and attendance remain unclear among Middle Eastern children. The association has been studied extensively in the Western region; however, several concerns have been raised regarding the reliability and validity of measures, low quality of studies, inadequate inclusion of potential confounders, and the lack of a conceptual framework. These limitations have meant that, to date, there has been no detailed understanding of the association or of the key social, clinical, behavioural and parental factors which may impact the association. Aim: To examine the association between oral health conditions and children’s school performance and attendance at Grade 2 in Muharraq city in the Kingdom of Bahrain using Heilmann et al.’s (2015) life course framework for oral health. Objectives: To (1) describe the prevalence of oral health conditions among 7-8 years old schoolchildren in the city of Muharraq; (2) analyse the social, biological, behavioural, and parental pathways that link early and current life exposures with children’s current oral health status; (3) examine the association between oral health conditions and school performance and attendance among schoolchildren; (4) explore the early and current life course social, biological, behavioural and parental factors associated with children’s school outcomes. Design: A time-ordered-cross-sectional study was conducted with 466 schoolchildren aged 7-8 years and their parents from Muharraq city in KoB. Data were collected through parents’ self-administered questionnaires, children’s face-face interviews, and dental clinical examinations. Outcome variables, including school performance and school attendance data, were obtained from the parents and school records. The data were analysed using structural equation modelling (SEM). Results: Dental caries, the consequence of dental caries (PUFA/pufa), and enamel developmental defects (EDD) prevalence were 93.4%, 25.7%, and 17.2%, respectively. The findings from the SEM showed that children born in families with high SES were less likely to suffer from dentine dental caries (β= -0.248) and more likely to earn high school performance (β= 0.136) at 7-8 years of age in Muharraq. From the current life course of children, the dental plaque was associated significantly and directly with enamel caries (β= 0.094), dentine caries (β= 0.364), treated teeth (filled or extracted because of dental caries) (β= 0.121), and indirectly associated with dental pain (β= 0.057). Further, dentine dental caries was associated significantly and directly with low school performance (β= -0.155). At the same time, the dental plaque was indirectly associated with low school performance via dental caries (β = −0.044). Conversely, treated teeth were associated directly with high school performance (β= 0.100). Notably, none of the OHCs, biological, SES, behavioural, or parental conditions was related to school attendance in children. Conclusion: The life course approach was adequate to examine the role of OHCs on children’s school performance and attendance. Birth and current (7-8-year-olds) social factors were significant predictors of poor OH and poor school performance.

Keywords: dental caries, life course, Bahrain, school outcomes

Procedia PDF Downloads 109
275 Mental Well-Being and Quality of Life: A Comparative Study of Male Leather Tannery and Non-Tannery Workers of Kanpur City, India

Authors: Gyan Kashyap, Shri Kant Singh

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Improved mental health can be articulated as a good physical health and quality of life. Mental health plays an important role in survival of any one’s life. In today’s time people living with stress in life due to their personal matters, health problems, unemployment, work environment, living environment, substance use, life style and many more important reasons. Many studies confirmed that the significant proportion of mental health people increasing in India. This study is focused on mental well-being of male leather tannery workers in Kanpur city, India. Environment at work place as well as living environment plays an important health risk factors among leather tannery workers. Leather tannery workers are more susceptible to many chemicals and physical hazards, just because they are liable to be affected by their exposure to lots of hazardous materials and processes during tanning work in very hazardous work environment. The aim of this study to determine the level of mental health disorder and quality of life among male leather tannery and non-tannery workers in Kanpur city, India. This study utilized the primary data from the cross- sectional household study which was conducted from January to June, 2015 on tannery and non-tannery workers as a part of PhD program from the Jajmau area of Kanpur city, India. The sample of 286 tannery and 295 non-tannery workers has been collected from the study area. We have collected information from the workers of age group 15-70 those who were working at the time of survey for at least one year. This study utilized the general health questionnaire (GHQ-12) and work related stress scale to test the mental wellbeing of male tannery and non-tannery workers. By using GHQ-12 and work related stress scale, Polychoric factor analysis method has been used for best threshold and scoring. Some of important question like ‘How would you rate your overall quality of life’ on Likert scale to measure the quality of life, their earnings, education, family size, living condition, household assets, media exposure, health expenditure, treatment seeking behavior and food habits etc. Results from the study revealed that around one third of tannery workers had severe mental health problems then non-tannery workers. Mental health problem shown the statistically significant association with wealth quintile, 56 percent tannery workers had severe mental health problem those belong to medium wealth quintile. And 42 percent tannery workers had moderate mental health problem among those from the low wealth quintile. Work related stress scale found the statistically significant results for tannery workers. Large proportion of tannery and non-tannery workers reported they are unable to meet their basic needs from their earnings and living in worst condition. Important result from the study, tannery workers who were involved in beam house work in tannery (58%) had severe mental health problem. This study found the statistically significant association with tannery work and mental health problem among tannery workers.

Keywords: GHQ-12, mental well-being, factor analysis, quality of life, tannery workers

Procedia PDF Downloads 388
274 Modification of a Commercial Ultrafiltration Membrane by Electrospray Deposition for Performance Adjustment

Authors: Elizaveta Korzhova, Sebastien Deon, Patrick Fievet, Dmitry Lopatin, Oleg Baranov

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Filtration with nanoporous ultrafiltration membranes is an attractive option to remove ionic pollutants from contaminated effluents. Unfortunately, commercial membranes are not necessarily suitable for specific applications, and their modification by polymer deposition is a fruitful way to adapt their performances accordingly. Many methods are usually used for surface modification, but a novel technique based on electrospray is proposed here. Various quantities of polymers were deposited on a commercial membrane, and the impact of the deposit is investigated on filtration performances and discussed in terms of charge and hydrophobicity. The electrospray deposition is a technique which has not been used for membrane modification up to now. It consists of spraying small drops of polymer solution under a high voltage between the needle containing the solution and the metallic support on which membrane is stuck. The advantage of this process lies in the small quantities of polymer that can be coated on the membrane surface compared with immersion technique. In this study, various quantities (from 2 to 40 μL/cm²) of solutions containing two charged polymers (13 mmol/L of monomer unit), namely polyethyleneimine (PEI) and polystyrene sulfonate (PSS), were sprayed on a negatively charged polyethersulfone membrane (PLEIADE, Orelis Environment). The efficacy of the polymer deposition was then investigated by estimating ion rejection, permeation flux, zeta-potential and contact angle before and after the polymer deposition. Firstly, contact angle (θ) measurements show that the surface hydrophilicity is notably improved by coating both PEI and PSS. Moreover, it was highlighted that the contact angle decreases monotonously with the amount of sprayed solution. Additionally, hydrophilicity enhancement was proved to be better with PSS (from 62 to 35°) than PEI (from 62 to 53°). Values of zeta-potential (ζ were estimated by measuring the streaming current generated by a pressure difference on both sides of a channel made by clamping two membranes. The ζ-values demonstrate that the deposits of PSS (negative at pH=5.5) allow an increase of the negative membrane charge, whereas the deposits of PEI (positive) lead to a positive surface charge. Zeta-potentials measurements also emphasize that the sprayed quantity has little impact on the membrane charge, except for very low quantities (2 μL/m²). The cross-flow filtration of salt solutions containing mono and divalent ions demonstrate that polymer deposition allows a strong enhancement of ion rejection. For instance, it is shown that rejection of a salt containing a divalent cation can be increased from 1 to 20 % and even to 35% by deposing 2 and 4 μL/cm² of PEI solution, respectively. This observation is coherent with the reversal of the membrane charge induced by PEI deposition. Similarly, the increase of negative charge induced by PSS deposition leads to an increase of NaCl rejection from 5 to 45 % due to electrostatic repulsion of the Cl- ion by the negative surface charge. Finally, a notable fall in the permeation flux due to the polymer layer coated at the surface was observed and the best polymer concentration in the sprayed solution remains to be determined to optimize performances.

Keywords: ultrafiltration, electrospray deposition, ion rejection, permeation flux, zeta-potential, hydrophobicity

Procedia PDF Downloads 187
273 Assessment of Occupational Health and Safety Conditions of Health Care Workers in Barangay Health Centers in a Selected City in Metro Manila

Authors: Deinzel R. Uezono, Vivien Fe F. Fadrilan-Camacho, Bianca Margarita L. Medina, Antonio Domingo R. Reario, Trisha M. Salcedo, Luke Wesley P. Borromeo

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The environment of health care workers is considered one of the most hazardous settings due to the nature of their work. In developing countries especially, the Philippines, this continues to be overlooked in terms of programs and services on occupational health and safety (OHS). One possible reason for this is the existing information gap on OHS which limits data comparability and impairs effective monitoring and assessment of interventions. To address this gap, there is a need to determine the current conditions of Filipino health care workers in their workplace. This descriptive cross-sectional study assessed the occupational health and safety conditions of health care workers in barangay health centers in a selected city in Metro Manila, Philippines by: (1) determining the hazards present in the workplace; (2) determining the most common self-reported medical problems; and (3) describing the elements of an OHS system based on the six building blocks of health system. Assessment was done through walkthrough survey, self-administered questionnaire, and key informant interview. Data analysis was done using Epi Info 7 and NVivo 11. Results revealed different health hazards present in the workplace particularly biological hazards (exposure to sick patients and infectious specimens), physical hazards (inadequate space and/or lighting), chemical hazards (toxic reagents and flammable chemicals), and ergonomic hazards (activities requiring repetitive motion and awkward posture). Additionally, safety hazards (improper capping of syringe and lack of fire safety provisions) were also observed. Meanwhile, the most commonly self-reported chronic diseases among health care workers (N=336) were hypertension (20.24%, n=68) and diabetes (12.50%, n=42). Top commonly self-reported symptoms were colds (66.07%, n=222), coughs (63.10%, n=212), headache (55.65%, n=187), and muscle pain (50.60%, n=170) while other diseases were influenza (16.96%, n=57) and UTI (15.48%, n=52). In terms of the elements of the OHS system, a general policy on occupational health and safety was found to be lacking and in effect, an absence of health and safety committee overseeing the implementing and monitoring of the policy. No separate budget specific for OHS programs and services was also found to be a limitation. As a result, no OHS personnel and trainings/seminar were identified. No established information system for OHS was in place. In conclusion, health and safety hazards were observed to be present across the barangay health centers visited in a selected city in Metro Manila. Medical conditions identified as most commonly self-reported were hypertension and diabetes for chronic diseases; colds, coughs, headache, and muscle pain for medical symptoms; and influenza and UTI for other diseases. As for the elements of the occupational health and safety system, there was a lack in the general components of the six building blocks of the health system.

Keywords: health hazards, occupational health and safety, occupational health and safety system, safety hazards

Procedia PDF Downloads 187
272 Analysis of the Effects of Institutions on the Sub-National Distribution of Aid Using Geo-Referenced AidData

Authors: Savas Yildiz

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The article assesses the performance of international aid donors to determine the sub-national distribution of their aid projects dependent on recipient countries’ governance. The present paper extends the scope from a cross-country perspective to a more detailed analysis by looking at the effects of institutional qualities on the sub-national distribution of foreign aid. The analysis examines geo-referenced aid project in 37 countries and 404 regions at the first administrative division level in Sub-Saharan Africa from the World Bank (WB) and the African Development Bank (ADB) that were approved between the years 2000 and 2011. To measure the influence of institutional qualities on the distribution of aid the following measures are used: control of corruption, government effectiveness, regulatory quality and rule of law from the World Governance Indicators (WGI) and the corruption perception index from Transparency International. Furthermore, to assess the importance of ethnic heterogeneity on the sub-national distribution of aid projects, the study also includes interaction terms measuring ethnic fragmentation. The regression results indicate a general skew of aid projects towards regions which hold capital cities, however, being incumbent presidents’ birth region does not increase the allocation of aid projects significantly. Nevertheless, with increasing quality of institutions aid projects are less skewed towards capital regions and the previously estimated coefficients loose significance in most cases. Higher ethnic fragmentation also seems to impede the possibility to allocate aid projects mainly in capital city regions and presidents’ birth places. Additionally, to assess the performance of the WB based on its own proclaimed goal to aim the poor in a country, the study also includes sub-national wealth data from the Demographic and Health Surveys (DSH), and finds that, even with better institutional qualities, regions with a larger share from the richest quintile receive significantly more aid than regions with a larger share of poor people. With increasing ethnic diversity, the allocation of aid projects towards regions where the richest citizens reside diminishes, but still remains high and significant. However, regions with a larger share of poor people still do not receive significantly more aid. This might imply that the sub-national distribution of aid projects increases in general with higher ethnic fragmentation, independent of the diverse regional needs. The results provide evidence that institutional qualities matter to undermine the influence of incumbent presidents on the allocation of aid projects towards their birth regions and capital regions. Moreover, even for countries with better institutional qualities the WB and the ADB do not seem to be able to aim the poor in a country with their aid projects. Even, if one considers need-based variables, such as infant mortality and child mortality rates, aid projects do not seem to be allocated in districts with a larger share of people in need. Therefore, the study provides further evidence using more detailed information on the sub-national distribution of aid projects that aid is not being allocated effectively towards regions with a larger share of poor people to alleviate poverty in recipient countries directly. Institutions do not have any significant influence on the sub-national distribution of aid towards the poor.

Keywords: aid allocation, georeferenced data, institutions, spatial analysis

Procedia PDF Downloads 119
271 Wrestling with Religion: A Theodramatic Exploration of Morality in Popular Culture

Authors: Nicholas Fieseler

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The nature of religion implicit in popular culture is relevant both in and out of the university. The traditional rules-based conception of religion and the ethical systems that emerge from them do not necessarily convey the behavior of daily life as it exists apart from spaces deemed sacred. This paper proposes to examine the religion implicit in the popular culture phenomenon of professional wrestling and how that affects the understanding of popular religion. Pro wrestling, while frequently dismissed, offers a unique manner through which to re-examine religion in popular culture. A global phenomenon, pro wrestling occupies a distinct space in numerous countries and presents a legitimate reflection of human behavior cross-culturally on a scale few other phenomena can equal. Given its global viewership of millions, it should be recognized as a significant means of interpreting the human attraction to violence and its association with religion in general. Hans Urs von Balthasar’s theory of Theodrama will be used to interrogate the inchoate religion within pro wrestling. While Balthasar developed theodrama within the confines of Christian theology; theodrama contains remarkable versatility in its potential utility. Since theodrama re-envisions reality as drama, the actions of every human actor on the stage contributes to the play’s development, and all action contains some transcendent value. It is in this sense that even the “low brow” activity of pro wrestling may be understood in religious terms. Moreover, a pro wrestling storyline acts as a play within a play: the struggles in a pro wrestling match reflect the human attitudes toward life as it exists in the sacred and profane realms. The indistinct lines separating traditionally good (face) from traditionally bad (heel)wrestlers mirror the moral ambiguity in which many people interpret life. This blurred distinction between good and bad, and large segments of an audience’s embrace of the heel wrestlers, reveal ethical constraints that guide the everyday values of pro wrestling spectators, a moral ambivalence that is often overlooked by traditional religious systems, and which has hitherto been neglected in the academic literature on pro wrestling. The significance of interpreting the religion implicit in pro wrestling through a the dramatic lens extends beyond pro wrestling specifically and can examine the religion implicit in popular culture in general. The use of theodrama mitigates the rigid separation often ascribed to areas deemed sacred/ profane, ortranscendent / immanent, enabling a re-evaluation of religion and ethical systems as practiced in popular culture. The use of theodrama will be expressed by utilizing the pro wrestling match as a literary text that reflects the society from which it emerges. This analysis will also reveal the complex nature of religion in popular culture and provides new directions for the academic study of religion. This project consciously bridges the academic and popular realms. The goal of the research is not to add only to the academic literature on implicit religion in popular culture but to publish it in a form which speaks to those outside the standard academic audiences for such work.

Keywords: ethics, popular religion, professional wrestling, theodrama

Procedia PDF Downloads 142
270 Relationship between Thumb Length and Pointing Performance on Portable Terminal with Touch-Sensitive Screen

Authors: Takahiro Nishimura, Kouki Doi, Hiroshi Fujimoto

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Touch-sensitive screens that serve as displays and input devices have been adopted in many portable terminals such as smartphones and personal media players, and the market of touch-sensitive screens has expanded greatly. One of the advantages of touch-sensitive screen is the flexibility in the graphical user interface (GUI) design, and it is imperative to design an appropriate GUI to realize an easy-to-use interface. Moreover, it is important to evaluate the relationship between pointing performance and GUI design. There is much knowledge regarding easy-to-use GUI designs for portable terminals with touch-sensitive screens, and most have focused on GUI design approaches for women or children with small hands. In contrast, GUI design approaches for users with large hands have not received sufficient attention. In this study, to obtain knowledge that contributes to the establishment of individualized easy-to-use GUI design guidelines, we conducted experiments to investigate the relationship between thumb length and pointing performance on portable terminals with touch-sensitive screens. In this study, fourteen college students who participated in the experiment were divided into two groups based on the length of their thumbs. Specifically, we categorized the participants into two groups, thumbs longer than 64.2 mm into L (Long) group, and thumbs longer than 57.4 mm but shorter than 64.2 mm into A (Average) group, based on Japanese anthropometric database. They took part in this study under the authorization of Waseda University’s ‘Ethics Review Committee on Research with Human Subjects’. We created an application for the experimental task and implemented it on the projected capacitive touch-sensitive screen portable terminal (iPod touch (4th generation)). The display size was 3.5 inch and 960 × 640 - pixel resolution at 326 ppi (pixels per inch). This terminal was selected as the experimental device, because of its wide use and market share. The operational procedure of the application is as follows. First, the participants placed their thumb on the start position. Then, one cross-shaped target in a 10 × 7 array of 70 positions appeared at random. The participants pointed the target with their thumb as accurately and as fast as possible. Then, they returned their thumb to the start position and waited. The operation ended when this procedure had been repeated until all 70 targets had each been pointed at once by the participants. We adopted the evaluation indices for absolute error, variable error, and pointing time to investigate pointing performance when using the portable terminal. The results showed that pointing performance varied with thumb length. In particular, on the lower right side of the screen, the performance of L group with long thumb was low. Further, we presented an approach for designing easy-to- use button GUI for users with long thumbs. The contributions of this study include revelation of the relationship between pointing performance and user’s thumb length when using a portable terminal in terms of accuracy, precision, and speed of pointing. We hope that these findings contribute to an easy-to-use GUI design for users with large hands.

Keywords: pointing performance, portable terminal, thumb length, touch-sensitive screen

Procedia PDF Downloads 164
269 Fear of Falling and Subjective Cognitive Decline Are Predictors of Fall Risk in Community-dwelling Older Adults Living in Low-income Settings

Authors: Ladda Thiamwong, Renata Komalasari

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Falls are the leading cause of disability and hospitalization in low-income older adults. Fear of falling is present in 20% to 85 % of older adults and has been identified as an independent risk factor of fall risk, activity restriction, and loss of independence. About 12% of American older adults have subjective cognitive decline. Cognitive impairment is also an established factor of fall risk. However, it is unclear whether measures of fear of falling and subjective cognitive decline have the greatest association with fall risk in low-income older adults. The aim of this study was to evaluate the association between fear of falling, subjective cognitive decline-functional performance (SCD-FP), and fall risk using simple screening tools. In this cross-section study, we collected data from community-dwelling older adults 60 years or older in low-income settings in Central Florida, and 86 participants were included in the data analysis. Fear of falling was assessed by the Short Fall Efficacy Scale- International (Short FES-I) with seven items. Subjective cognitive decline-functional performance (SCD-FP) was assessed by a self-reported experience of worsening or more frequent confusion or memory loss in the past 12 months and its functional implications. Fall risk was evaluated by the Centers for Disease Control and Prevention (CDC)'s Stay Independent checklist with 12 items. The majority of participants were female, and more than half of the participants were African American. More than half of the participants had a higher school degree or higher, and less than 20% had no financial problems. Less than 30% of the participants perceived their general health as very good- excellent. More than half of the participants lived alone, and less than 15% lived with a partner or spouse. About 60% of the participants had hypertension, 40% had diabetes, 16% had cancer, and 50% had arthritis. About 30% of the participants had difficulty walking up ten steps without resting, more than 40% felt unsteady when walking, and 30% had been advised to use a cane or walker to get around safely. Regression analysis showed that fall risk was associated with fear of falling ( = .524, p <.001) and subjective cognitive decline-functional performance ( = .465, p =.027). The structure coefficient showed that fear of falling (rs2 = .922) was a stronger predictor of fall risk than subjective cognitive decline-functional performance (rs2= .200). Fear of falling and subjective cognitive decline-functional performance are growing public health issues, and addressing those issues is a public priority. Proactive screening for fear of falling and subjective cognitive decline-functional performance is critical in fall prevention. A combination of all three self-reported tools (Short FES-I, SCD-FP, and CDC's Stay Independent checklist) takes less than 5 minutes to complete. Primary care providers or public health professionals should consider including these tools to screen fear of falling and subjective cognitive decline-functional performance as part of fall risk assessment, especially in low-income settings. Thus, encouraging older adults and healthcare professionals to discuss fear of falling, subjective cognitive decline, and fall risk during routine medical office visits.

Keywords: falls, fall risk, fear of falling, cognition, subjective cognitive decline, low-income, older adults, community, screening, nursing, primary care

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268 Dietary Diversity of Pregnant Mothers in a Semi-Urban Setting: Sri Lanka

Authors: R. B. B. Samantha Ramachandra, L. D. J. Upul Senarath, S. H. Padmal De Silva

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Dietary pattern largely differs over countries and even within a country, it shows cultural differences. The dietary pattern changes the energy consumption and micronutrient intake, directly affects the pregnancy outcome. The dietary diversity was used as an indirect measure to assess micronutrient adequacy for pregnant mothers in this study. The study was conducted as a baseline survey with the objective of designing an intervention to improve the dietary diversity of pregnant mothers in Sri Lanka. The survey was conducted in Kalutara district of Sri Lanka in 2015 among 769 pregnant mothers at different gestational ages. Dietary diversity questionnaire developed by Food and Agricultural Organization’s (FAO) Food and Nutrition technical Assistance (FANTA) II project, recommended for cross-country use with adaptations was used for data collection. Trained data collectors met pregnant mothers at field ante-natal clinic and questioned on last 24hr dietary recall with portion size and coded food items to identify the diversity. Pregnant mothers were identified from randomly selected 21 clusters of public health midwife areas. 81.5% mothers (n=627) in the sample had been registered at Public Health Midwife (PHM) before 8 weeks of gestation. 24.4% of mothers were with low starting BMI and 22.7% mothers were with high starting BMI. 47.6% (n=388) mothers had abstained from at least one food item during the pregnancy. The food group with the highest consumption was rice (98.4%) followed by sugar (89.9%). 76.1% mothers had consumed milk, 73% consumed fish and sea foods. Consumption of green leaves was 52% and Vit A rich foods consumed only by 49% mothers. Animal organs, flesh meat and egg all showed low prevalence as 4.7%, 21.6% and 20% respectively. Consumption of locally grown roots, nut, legumes all showed very low prevalence. Consumption of 6 or more food groups was considered as good dietary diversity (DD), 4 to 5 food groups as moderate diversity and 3 or less food groups as poor diversity by FAO FANTA II project. 42.1% mothers demonstrated good DD while another 42.1% recorded moderate diversity. Working mothers showed better DD (51.6%, n=82/159) compared to housewives in the sample (chi = 10.656a,. df=2, p=0.005). The good DD showed gradual improvement from 43.1% to 55.5% along the poorest to richest wealth index (Chi=48.045, df=8 and p=0.000). DD showed significant association with the ethnicity and Moors showed the lowest DD. DD showed no association with the home gardening even though where better diversity expected among those who have home gardening (p=0.548). Sri Lanka is a country where many food items can be grown in the garden and semi-urban setting have adequate space for gardening. Many Sri Lankan mothers do not add homegrown items in their meal. At the same time, their consumption of animal food shows low prevalence. The DD of most of the mothers being either moderate or low (58%) may result from inadequate micro nutrient intake during pregnancy. It is recommended that adding green leaves, locally grown vegetables, roots, nuts and legumes can help increasing the DD of Sri Lankan mothers at low cost.

Keywords: dietary diversity, pregnant mothers, micro-nutrient, food groups

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267 The Lived Experiences and Coping Strategies of Women with Attention Deficit and Hyperactivity Disorder (ADHD)

Authors: Oli Sophie Meredith, Jacquelyn Osborne, Sarah Verdon, Jane Frawley

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PROJECT OVERVIEW AND BACKGROUND: Over one million Australians are affected by ADHD at an economic and social cost of over $20 billion per annum. Despite health outcomes being significantly worse compared with men, women have historically been overlooked in ADHD diagnosis and treatment. While research suggests physical activity and other non-prescription options can help with ADHD symptoms, the frontline response to ADHD remains expensive stimulant medications that can have adverse side effects. By interviewing women with ADHD, this research will examine women’s self-directed approaches to managing symptoms, including alternatives to prescription medications. It will investigate barriers and affordances to potentially helpful approaches and identify any concerning strategies pursued in lieu of diagnosis. SIGNIFICANCE AND INNOVATION: Despite the economic and societal impact of ADHD on women, research investigating how women manage their symptoms is scant. This project is significant because although women’s ADHD symptoms are markedly different to those of men, mainstream treatment has been based on the experiences of men. Further, it is thought that in developing nuanced coping strategies, women may have masked their symptoms. Thus, this project will highlight strategies which women deem effective in ‘thriving’ rather than just ‘hiding’. By investigating the health service use, self-care and physical activity of women with ADHD, this research aligns with a priority research areas as identified by the November 2023 senate ADHD inquiry report. APPROACH AND METHODS: Semi-structured interviews will be conducted with up to 20 women with ADHD. Interviews will be conducted in person and online to capture experience across rural and metropolitan Australia. Participants will be recruited in partnership with the peak representative body, ADHD Australia. The research will use an intersectional framework, and data will be analysed thematically. This project is led by an interdisciplinary and cross-institutional team of women with ADHD. Reflexive interviewing skills will be employed to help interviewees feel more comfortable disclosing their experiences, especially where they share common ground ENGAGEMENT, IMPACT AND BENEFIT: This research will benefit women with ADHD by increasing knowledge of strategies and alternative treatments to prescription medications, reducing the social and economic burden of ADHD on Australia and on individuals. It will also benefit women by identifying risks involved with some self-directed approaches in lieu of medical advice. The project has an accessible impact plan to directly benefit end-users, which includes the development of a podcast and a PDF resource translating findings. The resources will reach a wide audience through ADHD Australia’s extensive national networks. We will collaborate with Charles Sturt’s Accessibility and Inclusion Division of Safety, Security and Well-being to create a targeted resource for students with ADHD.

Keywords: ADHD, women's health, self-directed strategies, health service use, physical activity, public health

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266 Multilevel Regression Model - Evaluate Relationship Between Early Years’ Activities of Daily Living and Alzheimer’s Disease Onset Accounting for Influence of Key Sociodemographic Factors Using a Longitudinal Household Survey Data

Authors: Linyi Fan, C.J. Schumaker

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Background: Biomedical efforts to treat Alzheimer’s disease (AD) have typically produced mixed to poor results, while more lifestyle-focused treatments such as exercise may fare better than existing biomedical treatments. A few promising studies have indicated that activities of daily life (ADL) may be a useful way of predicting AD. However, the existing cross-sectional studies fail to show how functional-related issues such as ADL in early years predict AD and how social factors influence health either in addition to or in interaction with individual risk factors. This study would helpbetterscreening and early treatments for the elderly population and healthcare practice. The findings have significance academically and practically in terms of creating positive social change. Methodology: The purpose of this quantitative historical, correlational study was to examine the relationship between early years’ ADL and the development of AD in later years. The studyincluded 4,526participantsderived fromRAND HRS dataset. The Health and Retirement Study (HRS) is a longitudinal household survey data set that is available forresearchof retirement and health among the elderly in the United States. The sample was selected by the completion of survey questionnaire about AD and dementia. The variablethat indicates whether the participant has been diagnosed with AD was the dependent variable. The ADL indices and changes in ADL were the independent variables. A four-step multilevel regression model approach was utilized to address the research questions. Results: Amongst 4,526 patients who completed the AD and dementia questionnaire, 144 (3.1%) were diagnosed with AD. Of the 4,526 participants, 3,465 (76.6%) have high school and upper education degrees,4,074 (90.0%) were above poverty threshold. The model evaluatedthe effect of ADL and change in ADL on onset of AD in late years while allowing the intercept of the model to vary by level of education. The results suggested that the only significant predictor of the onset of AD was changes in early years’ ADL (b = 20.253, z = 2.761, p < .05). However, the result of the sensitivity analysis (b = 7.562, z = 1.900, p =.058), which included more control variables and increased the observation period of ADL, are not supported this finding. The model also estimated whether the variances of random effect vary by Level-2 variables. The results suggested that the variances associated with random slopes were approximately zero, suggesting that the relationship between early years’ ADL were not influenced bysociodemographic factors. Conclusion: The finding indicated that an increase in changes in ADL leads to an increase in the probability of onset AD in the future. However, this finding is not support in a broad observation period model. The study also failed to reject the hypothesis that the sociodemographic factors explained significant amounts of variance in random effect. Recommendations were then made for future research and practice based on these limitations and the significance of the findings.

Keywords: alzheimer’s disease, epidemiology, moderation, multilevel modeling

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265 Correlation between the Levels of Some Inflammatory Cytokines/Haematological Parameters and Khorana Scores of Newly Diagnosed Ambulatory Cancer Patients

Authors: Angela O. Ugwu, Sunday Ocheni

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Background: Cancer-associated thrombosis (CAT) is a cause of morbidity and mortality among cancer patients. Several risk factors for developing venous thromboembolism (VTE) also coexist with cancer patients, such as chemotherapy and immobilization, thus contributing to the higher risk of VTE in cancer patients when compared to non-cancer patients. This study aimed to determine if there is any correlation between levels of some inflammatory cytokines/haematological parameters and Khorana scores of newly diagnosed chemotherapy naïve ambulatory cancer patients (CNACP). Methods: This was a cross-sectional analytical study carried out from June 2021 to May 2022. Eligible newly diagnosed cancer patients 18 years and above (case group) were enrolled consecutively from the adult Oncology Clinics of the University of Nigeria Teaching Hospital, Ituku/Ozalla (UNTH). The control group was blood donors at UNTH Ituku/Ozalla, Enugu blood bank, and healthy members of the Medical and Dental Consultants Association of Nigeria (MDCAN), UNTH Chapter. Blood samples collected from the participants were assayed for IL-6, TNF-Alpha, and haematological parameters such as haemoglobin, white blood cell count (WBC), and platelet count. Data were entered into an Excel worksheet and were then analyzed using Statistical Package for Social Sciences (SPSS) computer software version 21.0 for windows. A P value of < 0.05 was considered statistically significant. Results: A total of 200 participants (100 cases and 100 controls) were included in the study. The overall mean age of the participants was 47.42 ±15.1 (range 20-76). The sociodemographic characteristics of the two groups, including age, sex, educational level, body mass index (BMI), and occupation, were similar (P > 0.05). Following One Way ANOVA, there were significant differences between the mean levels of interleukin-6 (IL-6) (p = 0.036) and tumor necrotic factor-α (TNF-α) (p = 0.001) in the three Khorana score groups of the case group. Pearson’s correlation analysis showed a significant positive correlation between the Khorana scores and IL-6 (r=0.28, p = 0.031), TNF-α (r= 0.254, p= 0.011), and PLR (r= 0.240, p=0.016). The mean serum levels of IL-6 were significantly higher in CNACP than in the healthy controls [8.98 (8-12) pg/ml vs. 8.43 (2-10) pg/ml, P=0.0005]. There were also significant differences in the mean levels of the haemoglobin (Hb) level (P < 0.001)); white blood cell (WBC) count ((P < 0.001), and platelet (PL) count (P = 0.005) between the two groups of participants. Conclusion: There is a significant positive correlation between the serum levels of IL-6, TNF-α, and PLR and the Khorana scores of CNACP. The mean serum levels of IL-6, TNF-α, PLR, WBC, and PL count were significantly higher in CNACP than in the healthy controls. Ambulatory cancer patients with high-risk Khorana scores may benefit from anti-inflammatory drugs because of the positive correlation with inflammatory cytokines. Recommendations: Ambulatory cancer patients with 2 Khorana scores may benefit from thromboprophylaxis since they have higher Khorana scores. A multicenter study with a heterogeneous population and larger sample size is recommended in the future to further elucidate the relationship between IL-6, TNF-α, PLR, and the Khorana scores among cancer patients in the Nigerian population.

Keywords: thromboprophylaxis, cancer, Khorana scores, inflammatory cytokines, haematological parameters

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264 Treatment with Triton-X 100: An Enhancement Approach for Cardboard Bioprocessing

Authors: Ahlam Said Al Azkawi, Nallusamy Sivakumar, Saif Nasser Al Bahri

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Diverse approaches and pathways are under development with the determination to develop cellulosic biofuels and other bio-products eventually at commercial scale in “bio-refineries”; however, the key challenge is mainly the high level of complexity in processing the feedstock which is complicated and energy consuming. To overcome the complications in utilizing the naturally occurring lignocellulose biomass, using waste paper as a feedstock for bio-production may solve the problem. Besides being abundant and cheap, bioprocessing of waste paper has evolved in response to the public concern from rising landfill cost from shrinking landfill capacity. Cardboard (CB) is one of the major components of municipal solid waste and one of the most important items to recycle. Although 50-70% of cardboard constitute is known to be cellulose and hemicellulose, the presence of lignin around them cause hydrophobic cross-link which physically obstructs the hydrolysis by rendering it resistant to enzymatic cleavage. Therefore, pretreatment is required to disrupt this resistance and to enhance the exposure of the targeted carbohydrates to the hydrolytic enzymes. Several pretreatment approaches have been explored, and the best ones would be those can influence cellulose conversion rates and hydrolytic enzyme performance with minimal or less cost and downstream processes. One of the promising strategies in this field is the application of surfactants, especially non-ionic surfactants. In this study, triton-X 100 was used as surfactants to treat cardboard prior enzymatic hydrolysis and compare it with acid treatment using 0.1% H2SO4. The effect of the surfactant enhancement was evaluated through its effect on hydrolysis rate in respect to time in addition to evaluating the structural changes and modification by scanning electron microscope (SEM) and X-ray diffraction (XRD) and through compositional analysis. Further work was performed to produce ethanol from CB treated with triton-X 100 via separate hydrolysis and fermentation (SHF) and simultaneous saccharification and fermentation (SSF). The hydrolysis studies have demonstrated enhancement in saccharification by 35%. After 72 h of hydrolysis, a saccharification rate of 98% was achieved from CB enhanced with triton-X 100, while only 89 of saccharification achieved from acid pre-treated CB. At 120 h, the saccharification % exceeded 100 as reducing sugars continued to increase with time. This enhancement was not supported by any significant changes in the cardboard content as the cellulose, hemicellulose and lignin content remained same after treatment, but obvious structural changes were observed through SEM images. The cellulose fibers were clearly exposed with very less debris and deposits compared to cardboard without triton-X 100. The XRD pattern has also revealed the ability of the surfactant in removing calcium carbonate, a filler found in waste paper known to have negative effect on enzymatic hydrolysis. The cellulose crystallinity without surfactant was 73.18% and reduced to 66.68% rendering it more amorphous and susceptible to enzymatic attack. Triton-X 100 has proved to effectively enhance CB hydrolysis and eventually had positive effect on the ethanol yield via SSF. Treating cardboard with only triton-X 100 was a sufficient treatment to enhance the enzymatic hydrolysis and ethanol production.

Keywords: cardboard, enhancement, ethanol, hydrolysis, treatment, Triton-X 100

Procedia PDF Downloads 153