Search results for: outcomes that matter
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5056

Search results for: outcomes that matter

826 Influence of Moss Cover and Seasonality on Soil Microbial Biomass and Enzymatic Activity in Different Central Himalayan Temperate Forest Types

Authors: Anshu Siwach, Qianlai Zhuang, Ratul Baishya

Abstract:

Context: This study focuses on the influence of moss cover and seasonality on soil microbial biomass and enzymatic activity in different Central Himalayan temperate forest types. Soil microbial biomass and enzymes are key indicators of microbial communities in soil and provide information on soil properties, microbial status, and organic matter dynamics. The activity of microorganisms in the soil varies depending on the vegetation type and environmental conditions. Therefore, this study aims to assess the effects of moss cover, seasons, and different forest types on soil microbial biomass carbon (SMBC), soil microbial biomass nitrogen (SMBN), and soil enzymatic activity in the Central Himalayas, Uttarakhand, India. Research Aim: The aim of this study is to evaluate the levels of SMBC, SMBN, and soil enzymatic activity in different temperate forest types under the influence of two ground covers (soil with and without moss cover) during the rainy and winter seasons. Question Addressed: This study addresses the following questions: 1. How does the presence of moss cover and seasonality affect soil microbial biomass and enzymatic activity? 2. What is the influence of different forest types on SMBC, SMBN, and enzymatic activity? Methodology: Soil samples were collected from different forest types during the rainy and winter seasons. The study utilizes the chloroform-fumigation extraction method to determine SMBC and SMBN. Standard methodologies are followed to measure enzymatic activities, including dehydrogenase, acid phosphatase, aryl sulfatase, β-glucosidase, phenol oxidase, and urease. Findings: The study reveals significant variations in SMBC, SMBN, and enzymatic activity under different ground covers, within the rainy and winter seasons, and among the forest types. Moss cover positively influences SMBC and enzymatic activity during the rainy season, while soil without moss cover shows higher values during the winter season. Quercus-dominated forests, as well as Cupressus torulosa forests, exhibit higher levels of SMBC and enzymatic activity, while Pinus roxburghii forests show lower levels. Theoretical Importance: The findings highlight the importance of considering mosses in forest management plans to improve soil microbial diversity, enzymatic activity, soil quality, and health. Additionally, this research contributes to understanding the role of lower plants, such as mosses, in influencing ecosystem dynamics. Conclusion: The study concludes that moss cover during the rainy season significantly influences soil microbial biomass and enzymatic activity. Quercus and Cupressus torulosa dominated forests demonstrate higher levels of SMBC and enzymatic activity, indicating the importance of these forest types in sustaining soil microbial diversity and soil health. Including mosses in forest management plans can improve soil quality and overall ecosystem dynamics.

Keywords: moss cover, seasons, soil enzymes, soil microbial biomass, temperate forest types

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825 The Importance of Development Evaluation to Preterm Children in Remote Area

Authors: Chung-Yuan Wang, Min Hsu, Bo-Ya Juan, Hsiv Ching Lin, Hsveh Min Lin, Hsiu-Fang Yeh

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The success of Taiwan's National Health Insurance (NHI) system attracts widespread praise from the international society. However, the availability of medical care in a emote area is limited. Without the convenient public transportation system and mature social welfare policy, these people are difficult to regain their health and prevent disability. Preterm children have more risk to get development delay. Preterm children in a remote area have the human right to get rehabilitation resources as those in the city area. Therefore, the aim of this study was to show the importance of development screening to preterm children in a remote area and a tract the government to notice the issue. In Pingtung, children who are suspected development delay would be suggested to take a skillful screening evaluation in our hospital. Those preterm children (within 1-year-old) visited our pediatric clinic would also be referred to take the development evaluation. After the physiatrist’s systemic evaluation, the subjects would be scheduled to take the development evaluation. Gross motor, fine motor, speech comprehension/expression and mental study were included. The evaluation was in-charged by a physical therapist, occupational therapy, speech therapist and pediatric psychologist. The tools were Peabody developmental scale, Bayley Scales of Infant and Toddler Development (Bayley-III) and Wechsler Preschool & Primary Scale of Intelligence-Revised (WPPSI-R). In 2013, 459 children received the service in our hospital. Among these children, fifty-seven were noted with preterm baby history (gestation within 37 weeks). Thirty-six of these preterm children, who had never receive development evaluation, were included in this study. Thirty-six subjects (twenty-six male and ten female) were included. Nineteen subjects were found development delay. Six subjects were found suspected development delay. In gross motor, six subjects were development delay and eight were suspected development delay. In fine motor, five subjects were development delay and three were suspected development delay. In speech, sixteen subjects were development delay and six were suspected development delay. In our study, through the provision of development evaluation service, 72.2% preterm baby were found their development delay or suspected delay. They need further early intervention rehabilitation service. We made their parents realize that when development delay was recognized at the early stage, they are often reversible. No only the patients but also their families were improved their health status. The number of the subjects was limited in our study. Further study might be needed. Compared with 770 physical therapist (PT) and 370 occupational therapy (OT) in Taipei, there are only 108 PT and 54 OT in Pingtung. Further, there are much fewer therapists working on the field of pediatric rehabilitation. Living healthy is a human's right, no matter where does he live. For those development delay children in remote area, particularly preterm children, early detection, and early intervention rehabilitation service could play an important role in decreasing their disability and improving their quality of life. Through this study, we suggest the government to add more national resources on the development evaluation to preterm children in a remote area.

Keywords: development, early intervention, preterm children, rehabilitation

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824 Reconstruction of Performace-Based Budgeting in Indonesian Local Government: Application of Soft Systems Methodology in Producing Guideline for Policy Implementation

Authors: Deddi Nordiawan

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Effective public policy creation required a strong budget system, both in terms of design and implementation. Performance-based Budget is an evolutionary approach with two substantial characteristics; first, the strong integration between budgeting and planning, and second, its existence as guidance so that all activities and expenditures refer to measurable performance targets. There are four processes in the government that should be followed in order to make the budget become performance-based. These four processes consist of the preparation of a vision according to the bold aspiration, the formulation of outcome, the determination of output based on the analysis of organizational resources, and the formulation of Value Creation Map that contains a series of programs and activities. This is consistent with the concept of logic model which revealed that the budget performance should be placed within a relational framework of resources, activities, outputs, outcomes and impacts. Through the issuance of Law 17/2003 regarding State Finance, local governments in Indonesia have to implement performance-based budget. Central Government then issued Government Regulation 58/2005 which contains the detail guidelines how to prepare local governments budget. After a decade, implementation of performance budgeting in local government is still not fully meet expectations, though the guidance is completed, socialization routinely performed, and trainings have also been carried out at all levels. Accordingly, this study views the practice of performance-based budget at local governments as a problematic situation. This condition must be approached with a system approach that allows the solutions from many point of views. Based on the fact that the infrastructure of budgeting has already settled, the study then considering the situation as complexity. Therefore, the intervention needs to be done in the area of human activity system. Using Soft Systems Methodology, this research will reconstruct the process of performance-based budget at local governments is area of human activity system. Through conceptual models, this study will invite all actors (central government, local government, and the parliament) for dialogue and formulate interventions in human activity systems that systematically desirable and culturally feasible. The result will direct central government in revise the guidance to local government budgeting process as well as a reference to build the capacity building strategy.

Keywords: soft systems methodology, performance-based budgeting, Indonesia, public policy

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823 Experimental Field for the Study of Soil-Atmosphere Interaction in Soft Soils

Authors: Andres Mejia-Ortiz, Catalina Lozada, German R. Santos, Rafael Angulo-Jaramillo, Bernardo Caicedo

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The interaction between atmospheric variables and soil properties is a determining factor when evaluating the flow of water through the soil. This interaction situation directly determines the behavior of the soil and greatly influences the changes that occur in it. The atmospheric variations such as changes in the relative humidity, air temperature, wind velocity and precipitation, are the external variables that reflect a greater incidence in the changes that are generated in the subsoil, as a consequence of the water flow in descending and ascending conditions. These environmental variations have a major importance in the study of the soil because the conditions of humidity and temperature in the soil surface depend on them. In addition, these variations control the thickness of the unsaturated zone and the position of the water table with respect to the surface. However, understanding the relationship between the atmosphere and the soil is a somewhat complex aspect. This is mainly due to the difficulty involved in estimating the changes that occur in the soil from climate changes; since this is a coupled process where act processes of mass transfer and heat. In this research, an experimental field was implemented to study in-situ the interaction between the atmosphere and the soft soils of the city of Bogota, Colombia. The soil under study consists of a 60 cm layer composed of two silts of similar characteristics at the surface and a deep soft clay deposit located under the silky material. It should be noted that the vegetal layer and organic matter were removed to avoid the evapotranspiration phenomenon. Instrumentation was carried on in situ through a field disposal of many measuring devices such as soil moisture sensors, thermocouples, relative humidity sensors, wind velocity sensor, among others; which allow registering the variations of both the atmospheric variables and the properties of the soil. With the information collected through field monitoring, the water balances were made using the Hydrus-1D software to determine the flow conditions that developed in the soil during the study. Also, the moisture profile for different periods and time intervals was determined by the balance supplied by Hydrus 1D; this profile was validated by experimental measurements. As a boundary condition, the actual evaporation rate was included using the semi-empirical equations proposed by different authors. In this study, it was obtained for the rainy periods a descending flow that was governed by the infiltration capacity of the soil. On the other hand, during dry periods. An increase in the actual evaporation of the soil induces an upward flow of water, increasing suction due to the decrease in moisture content. Also, cracks were developed accelerating the evaporation process. This work concerns to the study of soil-atmosphere interaction through the experimental field and it is a very useful tool since it allows considering all the factors and parameters of the soil in its natural state and real values of the different environmental conditions.

Keywords: field monitoring, soil-atmosphere, soft soils, soil-water balance

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822 The ‘Quartered Head Technique’: A Simple, Reliable Way of Maintaining Leg Length and Offset during Total Hip Arthroplasty

Authors: M. Haruna, O. O. Onafowokan, G. Holt, K. Anderson, R. G. Middleton

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Background: Requirements for satisfactory outcomes following total hip arthroplasty (THA) include restoration of femoral offset, version, and leg length. Various techniques have been described for restoring these biomechanical parameters, with leg length restoration being the most predominantly described. We describe a “quartered head technique” (QHT) which uses a stepwise series of femoral head osteotomies to identify and preserve the centre of rotation of the femoral head during THA in order to ensure reconstruction of leg length, offset and stem version, such that hip biomechanics are restored as near to normal as possible. This study aims to identify whether using the QHT during hip arthroplasty effectively restores leg length and femoral offset to within acceptable parameters. Methods: A retrospective review of 206 hips was carried out, leaving 124 hips in the final analysis. Power analysis indicated a minimum of 37 patients required. All operations were performed using an anterolateral approach by a single surgeon. All femoral implants were cemented, collarless, polished double taper CPT® stems (Zimmer, Swindon, UK). Both cemented, and uncemented acetabular components were used (Zimmer, Swindon, UK). Leg length, version, and offset were assessed intra-operatively and reproduced using the QHT. Post-operative leg length and femoral offset were determined and compared with the contralateral native hip, and the difference was then calculated. For the determination of leg length discrepancy (LLD), we used the method described by Williamson & Reckling, which has been shown to be reproducible with a measurement error of ±1mm. As a reference, the inferior margin of the acetabular teardrop and the most prominent point of the lesser trochanter were used. A discrepancy of less than 6mm LLD was chosen as acceptable. All peri-operative radiographs were assessed by two independent observers. Results: The mean absolute post-operative difference in leg length from the contralateral leg was +3.58mm. 84% of patients (104/124) had LLD within ±6mm of the contralateral limb. The mean absolute post-operative difference in offset from contralateral leg was +3.88mm (range -15 to +9mm, median 3mm). 90% of patients (112/124) were within ±6mm offset of the contralateral limb. There was no statistical difference noted between observer measurements. Conclusion: The QHT provides a simple, inexpensive yet effective method of maintaining femoral leg length and offset during total hip arthroplasty. Combining this technique with pre-operative templating or other techniques described may enable surgeons to reduce even further the discrepancies between pre-operative state and post-operative outcome.

Keywords: leg length discrepancy, technical tip, total hip arthroplasty, operative technique

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821 Importance of Macromineral Ratios and Products in Association with Vitamin D in Pediatric Obesity Including Metabolic Syndrome

Authors: Mustafa M. Donma, Orkide Donma

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Metabolisms of macrominerals, those of calcium, phosphorus and magnesium, are closely associated with the metabolism of vitamin D. Particularly magnesium, the second most abundant intracellular cation, is related to biochemical and metabolic processes in the body, such as those of carbohydrates, proteins and lipids. The status of each mineral was investigated in obesity to some extent. Their products and ratios may possibly give much more detailed information about the matter. The aim of this study is to investigate possible relations between each macromineral and some obesity-related parameters. This study was performed on 235 children, whose ages were between 06-18 years. Aside from anthropometric measurements, hematological analyses were performed. TANITA body composition monitor using bioelectrical impedance analysis technology was used to establish some obesity-related parameters including basal metabolic rate (BMR), total fat, mineral and muscle masses. World Health Organization body mass index (BMI) percentiles for age and sex were used to constitute the groups. The values above 99th percentile were defined as morbid obesity. Those between 95th and 99th percentiles were included into the obese group. The overweight group comprised of children whose percentiles were between 95 and 85. Children between the 85th and 15th percentiles were defined as normal. Metabolic syndrome (MetS) components (waist circumference, fasting blood glucose, triacylglycerol, high density lipoprotein cholesterol, systolic pressure, diastolic pressure) were determined. High performance liquid chromatography was used to determine Vitamin D status by measuring 25-hydroxy cholecalciferol (25-hydroxy vitamin D3, 25(OH)D). Vitamin D values above 30.0 ng/ml were accepted as sufficient. SPSS statistical package program was used for the evaluation of data. The statistical significance degree was accepted as p < 0.05. The important points were the correlations found between vitamin D and magnesium as well as phosphorus (p < 0.05) that existed in the group with normal BMI values. These correlations were lost in the other groups. The ratio of phosphorus to magnesium was even much more highly correlated with vitamin D (p < 0.001). The negative correlation between magnesium and total fat mass (p < 0.01) was confined to the MetS group showing the inverse relationship between magnesium levels and obesity degree. In this group, calcium*magnesium product exhibited the highest correlation with total fat mass (p < 0.001) among all groups. Only in the MetS group was a negative correlation found between BMR and calcium*magnesium product (p < 0.05). In conclusion, magnesium is located at the center of attraction concerning its relationships with vitamin D, fat mass and MetS. The ratios and products derived from macrominerals including magnesium have pointed out stronger associations other than each element alone. Final considerations have shown that unique correlations of magnesium as well as calcium*magnesium product with total fat mass have drawn attention particularly in the MetS group, possibly due to the derangements in some basic elements of carbohydrate as well as lipid metabolism.

Keywords: macrominerals, metabolic syndrome, pediatric obesity, vitamin D

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820 Corporate Governance and Disclosure Practices of Listed Companies in the ASEAN: A Conceptual Overview

Authors: Chen Shuwen, Nunthapin Chantachaimongkol

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Since the world has moved into a transitional period, known as globalization; the business environment is now more complicated than ever before. Corporate information has become a matter of great importance for stakeholders, in order to understand the current situation. As a result of this, the concept of corporate governance has been broadly introduced to manage and control the affairs of corporations while businesses are required to disclose both financial and non-financial information to public via various communication channels such as the annual report, the financial report, the company’s website, etc. However, currently there are several other issues related to asymmetric information such as moral hazard or adverse selection that still occur intensively in workplaces. To prevent such problems in the business, it is required to have an understanding of what factors strengthen their transparency, accountability, fairness, and responsibility. Under aforementioned arguments, this paper aims to propose a conceptual framework that enables an investigation on how corporate governance mechanism influences disclosure efficiency of listed companies in the Association of Southeast Asia Nations (ASEAN) and the factors that should be considered for further development of good behaviors, particularly in regards to voluntary disclosure practices. To achieve its purpose, extensive reviews of literature are applied as a research methodology. It is divided into three main steps. Firstly, the theories involved with both corporate governance and disclosure practices such as agency theory, contract theory, signaling theory, moral hazard theory, and information asymmetry theory are examined to provide theoretical backgrounds. Secondly, the relevant literatures based on multi- perspectives of corporate governance, its attributions and their roles on business processes, the influences of corporate governance mechanisms on business performance, and the factors determining corporate governance characteristics as well as capability are reviewed to outline the parameters that should be included in the proposed model. Thirdly, the well-known regulatory document OECD principles and previous empirical studies on the corporate disclosure procedures are evaluated to identify the similarities and differentiations with the disclosure patterns in the ASEAN. Following the processes and consequences of the literature review, abundant factors and variables are found. Further to the methodology, additional critical factors that also have an impact on the disclosure behaviors are addressed in two groups. In the first group, the factors which are linked to the national characteristics - the quality of national code, legal origin, culture, the level of economic development, and so forth. Whereas in the second group, the discoveries which refer to the firm’s characteristics - ownership concentration, ownership’s rights, controlling group, and so on. However, because of research limitations, only some literature are chosen and summarized to form part of the conceptual framework that explores the relationship between corporate governance and the disclosure practices of listed companies in ASEAN.

Keywords: corporate governance, disclosure practice, ASEAN, listed company

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819 Effect of Preoperative Single Dose Dexamethasone and Lignocaine on Post-Operative Quality of Recovery and Pain Relief after Laparoscopic Cholecystectomy

Authors: Gurjeet Khurana, Surender Singh, Poonam Arora, Praveendra K. Sachan

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Introduction: Post-operative quality of recovery is the key outcome in the perspective of anesthesiologist. It is directly related to patient satisfaction. This is unsurprising, considering most aspects of a poor quality recovery after surgery will impair satisfaction with care. This study was thus undertaken to evaluate effects of Dexamethasone and Lignocaine on Quality of Recovery using QoR- 40 questionnaire and compare their effects. Material and methods: After obtaining the ethical committee approval and written informed consent, 67 patients of 18-60 years, ASA grade I and II scheduled for elective laparoscopic cholecystectomy were randomly allocated into two groups. Group I of 34 patients received 2mg/kg lignocaine diluted to 10ml with normal saline. Group 2 of 33 patients received 0.1 mg/kg I/V Dexamethasone diluted to 10ml with normal saline. QoR-40 was assessed on pre-operative day, and again QoR-40 was assessed at 24 hr post-operative day-1. Postoperative pain scores, nausea and vomiting and shoulder pain were secondary outcomes. Results: The Global QoR-40 was more than 180 at 24 hr in both the groups. The Dexamethasone group had higher Global QoR-40 than lignocaine group 187.94 v/s 182.85. Amongst dimensions of QoR-40 Dexamethasone had statistically better physical comfort, physical independence, and pain relief as compared to Lignocaine. Positive items had excellent responses in Dexamethasone group. Headache, backache and sore throat were also less severe in Dexamethasone group as compared to Lignocaine group. Dexamethasone group had lower VAS compared to lignocaine group. Similarly, there was less fentanyl consumption in dexamethasone group (364.08 ± 127.31) in postoperative period when compared to the lignocaine group (412.31 ± 147.8). Group receiving dexamethasone had 36% increase in appetite compared to lignocaine group (17.6%), which facilitated early oral feeding. Frequency of PONV was less in group-2 at different time interval as compared to group 1. Total episode of PONV were 18 in group 1 and 7 in group 2. Statistically significant difference was seen among two groups (p value= 0.007). Use of antiemetic was more in group 1 as compared to group 2 at all the times, though it was not statistically significant at different time intervals. Antiemetics were administered to 18 patients in group 1 as compared to 5 patients in group 2 postoperatively. Statistically significant difference (p value= 0.011) was seen in total antiemetic consumption. Conclusion: Our study demonstrated that pre-operative administration of a single dose of dexamethasone enhanced the quality of recovery after laparoscopic cholecystectomy as compared to Lignocaine bolus dose.

Keywords: dexamethasone, lignocaine, QoR-40 questionnaire, quality of recovery

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818 Being an English Language Teaching Assistant in China: Understanding the Identity Evolution of Early-Career English Teacher in Private Tutoring Schools

Authors: Zhou Congling

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The integration of private tutoring has emerged as an indispensable facet in the acquisition of language proficiency beyond formal educational settings. Notably, there has been a discernible surge in the demand for private English tutoring, specifically geared towards the preparation for internationally recognized gatekeeping examinations, such as IELTS, TOEFL, GMAT, and GRE. This trajectory has engendered an escalating need for English Language Teaching Assistants (ELTAs) operating within the realm of Private Tutoring Schools (PTSs). The objective of this study is to unravel the intricate process by which these ELTAs formulate their professional identities in the nascent stages of their careers as English educators, as well as to delineate their perceptions regarding their professional trajectories. The construct of language teacher identity is inherently multifaceted, shaped by an amalgamation of individual, societal, and cultural determinants, exerting a profound influence on how language educators navigate their professional responsibilities. This investigation seeks to scrutinize the experiential and influential factors that mold the identities of ELTAs in PTSs, particularly post the culmination of their language-oriented academic programs. Employing a qualitative narrative inquiry approach, this study aims to delve into the nuanced understanding of how ELTAs conceptualize their professional identities and envision their future roles. The research methodology involves purposeful sampling and the conduct of in-depth, semi-structured interviews with ten participants. Data analysis will be conducted utilizing Barkhuizen’s Short Story Analysis, a method designed to explore a three-dimensional narrative space, elucidating the intricate interplay of personal experiences and societal contexts in shaping the identities of ELTAs. The anticipated outcomes of this study are poised to contribute substantively to a holistic comprehension of ELTA identity formation, holding practical implications for diverse stakeholders within the private tutoring sector. This research endeavors to furnish insights into strategies for the retention of ELTAs and the enhancement of overall service quality within PTSs.

Keywords: China, English language teacher, narrative inquiry, private tutoring school, teacher identity

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817 Postoperative Wound Infections Following Caesarean Section in Obese Patients

Authors: S. Yeo, M. Mathur

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Introduction: Obesity, defined as a Body Mass Index (BMI) of more than or equal to 30kg/m, is associated with an increased risk of complications during pregnancy and delivery. During labour, obese mothers often require greater intervention and have higher rates of caesarean section. Despite a low overall rate of serious complications following caesarean section, a high BMI predisposes to a higher risk of postoperative complications. Our study, therefore, aimed to investigate the impact of antenatal obesity on adverse outcomes following caesarean section, particularly wound-related infections. Materials and Methods: A retrospective cohort study of all caesarean deliveries during the first quarter of a chosen year was undertaken in our hospital, which is a tertiary referral centre with > 12,000 deliveries per year. Patients’ health records and data from our hospital’s electronic labour and delivery database were reviewed. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS), and odds ratios plus adjusted odd ratios were calculated with 95% confidence intervals (CI). Results: A total of 1829 deliveries were reviewed during our study period. Of these, 180 (9.8%) patients were obese. The rate of caesarean delivery was 48.9% in obese patients versus 28.1% in non-obese patients. Post-operatively, 17% of obese patients experienced wound infection versus 0.2% of non-obese patients. Obese patients were also more likely to experience major postpartum haemorrhage (4.6% vs. 0.2%) and postpartum pyrexia (18.2% vs. 5.0%) in comparison to non-obese patients. Conclusions: Obesity is a significant risk factor in the development of postoperative complications following caesarean section. Wound infection remains a major concern for obese patients undergoing major surgery and results in extensive morbidity during the postnatal period. Postpartum infection can prolong recovery and affect maternal mental health, leading to reduced perinatal bonding with long-term implications on breastfeeding and parenting confidence. This study supports the need for the development of standardized protocols specifically for obese patients undergoing caesarean section. Multidisciplinary team care, in conjunction with anaesthesia, family physicians, and plastic surgery counterparts, early on in the antenatal journey, may be beneficial where wound complications are anticipated and to minimize the burden of postoperative infection in obese mothers.

Keywords: pregnancy, obesity, caesarean, infection

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816 Improving Rural Access to Specialist Emergency Mental Health Care: Using a Time and Motion Study in the Evaluation of a Telepsychiatry Program

Authors: Emily Saurman, David Lyle

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In Australia, a well serviced rural town might have a psychiatrist visit once-a-month with more frequent visits from a psychiatric nurse, but many have no resident access to mental health specialists. Access to specialist care, would not only reduce patient distress and benefit outcomes, but facilitate the effective use of limited resources. The Mental Health Emergency Care-Rural Access Program (MHEC-RAP) was developed to improve access to specialist emergency mental health care in rural and remote communities using telehealth technologies. However, there has been no current benchmark to gauge program efficiency or capacity; to determine whether the program activity is justifiably sufficient. The evaluation of MHEC-RAP used multiple methods and applied a modified theory of access to assess the program and its aim of improved access to emergency mental health care. This was the first evaluation of a telepsychiatry service to include a time and motion study design examining program time expenditure, efficiency, and capacity. The time and motion study analysis was combined with an observational study of the program structure and function to assess the balance between program responsiveness and efficiency. Previous program studies have demonstrated that MHEC-RAP has improved access and is used and effective. The findings from the time and motion study suggest that MHEC-RAP has the capacity to manage increased activity within the current model structure without loss to responsiveness or efficiency in the provision of care. Enhancing program responsiveness and efficiency will also support a claim of the program’s value for money. MHEC-RAP is a practical telehealth solution for improving access to specialist emergency mental health care. The findings from this evaluation have already attracted the attention of other regions in Australia interested in implementing emergency telepsychiatry programs and are now informing the progressive establishment of mental health resource centres in rural New South Wales. Like MHEC-RAP, these centres will provide rapid, safe, and contextually relevant assessments and advice to support local health professionals to manage mental health emergencies in the smaller rural emergency departments. Sharing the application of this methodology and research activity may help to improve access to and future evaluations of telehealth and telepsychiatry services for others around the globe.

Keywords: access, emergency, mental health, rural, time and motion

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815 Evaluating the Efficacy of Tasquinimod in Covid-19

Authors: Raphael Udeh, Luis García De Guadiana Romualdo, Xenia Dolje-Gore

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Background: Quite disturbing is the huge public health impact of COVID-19: As at today [25th March 2021, the COVID-19 global burden shows over 123 million cases and over 2.7 million deaths worldwide. Rationale: Recent evidence shows calprotectin’s potential as a therapeutic target, stating that tasquinimod, from the Quinoline-3-Carboxamide family is capable of blocking the interaction between calprotectin and TLR4. Hence preventing the cytokine release syndrome, that heralds the functional exhaustion in COVID-19. Early preclinical studies showed that tasquinimod inhibit tumor growth and prevent angiogenesis/cytokine storm. Phase I – III clinical studies in prostate cancer showed it has a good safety profile with good radiologic progression free survival but no effect on overall survival. Rationale/hypothesis: Strategic endeavors have been amplified globally to assess new therapeutic interventions for COVID-19 management – thus the clinical and antiviral efficacy of tasquinimod in COVID-19 remains to be explored. Hence the primary objective of this trial will be to evaluate the efficacy of tasquinimod in the treatment of adult patients with severe COVID-19 infections. Therefore, I hypothesise that among adults with COVID19 infection, tasquinimod will reduce the severe respiratory distress associated with COVID-19 compared to placebo, over a 28-day study period. Method: The setting is in Europe. Design – a randomized, placebo-controlled, phase II double-blinded trial. Trial lasts for 28 days from randomization, Tasquinimod capsule given as 0.5mg daily 1st fortnight, then 1mg daily 2nd fortnight. I0 outcome - assessed using six-point ordinal scale alongside eight 20 outcomes. 125 participants to be enrolled, data collection at baseline and subsequent data points, and safety reporting monitored via serological profile. Significance: This work could potentially establish tasquinimod as an effective and safe therapeutic agent for COVID-19 by reducing the severe respiratory distress, related time to recovery, time on oxygen/admission. It will also drive future research – as in larger multi-centre RCT.

Keywords: Calprotectin, COVID-19, Phase II Trial, Tasquinimod

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814 Exploring the Applicability of a Rapid Health Assessment in India

Authors: Claudia Carbajal, Jija Dutt, Smriti Pahwa, Sumukhi Vaid, Karishma Vats

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ASER Centre, the research and assessment arm of Pratham Education Foundation sees measurement as the first stage of action. ASER uses primary research to push and give empirical foundations to policy discussions at a multitude of levels. At a household level, common citizens use a simple assessment (a floor-level test) to measure learning across rural India. This paper presents the evidence on the applicability of an ASER approach to the health sector. A citizen-led assessment was designed and executed that collected information from young mothers with children up to a year of age. The pilot assessments were rolled-out in two different models: Paid surveyors and student volunteers. The survey covered three geographic areas: 1,239 children in the Jaipur District of Rajasthan, 2,086 in the Rae Bareli District of Uttar Pradesh, and 593 children in the Bhuj Block in Gujarat. The survey tool was designed to study knowledge of health-related issues, daily practices followed by young mothers and access to relevant services and programs. It provides insights on behaviors related to infant and young child feeding practices, child and maternal nutrition and supplementation, water and sanitation, and health services. Moreover, the survey studies the reasons behind behaviors giving policy-makers actionable pathways to improve implementation of social sector programs. Although data on health outcomes are available, this approach could provide a rapid annual assessment of health issues with indicators that are easy to understand and act upon so that measurements do not become an exclusive domain of experts. The results give many insights into early childhood health behaviors and challenges. Around 98% of children are breastfed, and approximately half are not exclusively breastfed (for the first 6 months). Government established diet diversity guidelines are met for less than 1 out of 10 children. Although most households are satisfied with the quality of drinking water, most tested households had contaminated water.

Keywords: citizen-led assessment, rapid health assessment, Infant and Young Children Feeding, water and sanitation, maternal nutrition, supplementation

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813 The Preceptorship Experience and Clinical Competence of Final Year Nursing Students

Authors: Susan Ka Yee Chow

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Effective clinical preceptorship is affecting students’ competence and fostering their growth in applying theoretical knowledge and skills in clinical settings. Any difference between the expected and actual learning experience will reduce nursing students’ interest in clinical practices and having a negative consequence with their clinical performance. This cross-sectional study is an attempt to compare the differences between preferred and actual preceptorship experience of final year nursing students, and to examine the relationship between the actual preceptorship experience and perceived clinical competence of the students in a tertiary institution. Participants of the study were final year bachelor nursing students of a self-financing tertiary institution in Hong Kong. The instruments used to measure the effectiveness of clinical preceptorship was developed by the participating institution. The scale consisted of five items in a 5-point likert scale. The questions including goals development, critical thinking, learning objectives, asking questions and providing feedback to students. The “Clinical Competence Questionnaire” by Liou & Cheng (2014) was used to examine students’ perceived clinical competences. The scale consisted of 47 items categorized into four domains, namely nursing professional behaviours; skill competence: general performance; skill competence: core nursing skills and skill competence: advanced nursing skills. There were 193 questionnaires returned with a response rate of 89%. The paired t-test was used to compare the differences between preferred and actual preceptorship experiences of students. The results showed significant differences (p<0.001) for the five questions. The mean for the preferred scores is higher than the actual scores resulting statistically significance. The maximum mean difference was accepted goal and the highest mean different was giving feedback. The Pearson Correlation Coefficient was used to examine the relationship. The results showed moderate correlations between nursing professional behaviours with asking questions and providing feedback. Providing useful feedback to students is having moderate correlations with all domains of the Clinical Competence Questionnaire (r=0.269 – 0.345). It is concluded that nursing students do not have a positive perception of the clinical preceptorship. Their perceptions are significantly different from their expected preceptorship. If students were given more opportunities to ask questions in a pedagogical atmosphere, their perceived clinical competence and learning outcomes could be improved as a result.

Keywords: clinical preceptor, clinical competence, clinical practicum, nursing students

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812 Using Scilab® as New Introductory Method in Numerical Calculations and Programming for Computational Fluid Dynamics (CFD)

Authors: Nicoly Coelho, Eduardo Vieira Vilas Boas, Paulo Orestes Formigoni

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Faced with the remarkable developments in the various segments of modern engineering, provided by the increasing technological development, professionals of all educational areas need to overcome the difficulties generated due to the good understanding of those who are starting their academic journey. Aiming to overcome these difficulties, this article aims at an introduction to the basic study of numerical methods applied to fluid mechanics and thermodynamics, demonstrating the modeling and simulations with its substance, and a detailed explanation of the fundamental numerical solution for the use of finite difference method, using SCILAB, a free software easily accessible as it is free and can be used for any research center or university, anywhere, both in developed and developing countries. It is known that the Computational Fluid Dynamics (CFD) is a necessary tool for engineers and professionals who study fluid mechanics, however, the teaching of this area of knowledge in undergraduate programs faced some difficulties due to software costs and the degree of difficulty of mathematical problems involved in this way the matter is treated only in postgraduate courses. This work aims to bring the use of DFC low cost in teaching Transport Phenomena for graduation analyzing a small classic case of fundamental thermodynamics with Scilab® program. The study starts from the basic theory involving the equation the partial differential equation governing heat transfer problem, implies the need for mastery of students, discretization processes that include the basic principles of series expansion Taylor responsible for generating a system capable of convergence check equations using the concepts of Sassenfeld, finally coming to be solved by Gauss-Seidel method. In this work we demonstrated processes involving both simple problems solved manually, as well as the complex problems that required computer implementation, for which we use a small algorithm with less than 200 lines in Scilab® in heat transfer study of a heated plate in rectangular shape on four sides with different temperatures on either side, producing a two-dimensional transport with colored graphic simulation. With the spread of computer technology, numerous programs have emerged requiring great researcher programming skills. Thinking that this ability to program DFC is the main problem to be overcome, both by students and by researchers, we present in this article a hint of use of programs with less complex interface, thus enabling less difficulty in producing graphical modeling and simulation for DFC with an extension of the programming area of experience for undergraduates.

Keywords: numerical methods, finite difference method, heat transfer, Scilab

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811 Functional Ingredients from Potato By-Products: Innovative Biocatalytic Processes

Authors: Salwa Karboune, Amanda Waglay

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Recent studies indicate that health-promoting functional ingredients and nutraceuticals can help support and improve the overall public health, which is timely given the aging of the population and the increasing cost of health care. The development of novel ‘natural’ functional ingredients is increasingly challenging. Biocatalysis offers powerful approaches to achieve this goal. Our recent research has been focusing on the development of innovative biocatalytic approaches towards the isolation of protein isolates from potato by-products and the generation of peptides. Potato is a vegetable whose high-quality proteins are underestimated. In addition to their high proportion in the essential amino acids, potato proteins possess angiotensin-converting enzyme-inhibitory potency, an ability to reduce plasma triglycerides associated with a reduced risk of atherosclerosis, and stimulate the release of the appetite regulating hormone CCK. Potato proteins have long been considered not economically feasible due to the low protein content (27% dry matter) found in tuber (Solanum tuberosum). However, potatoes rank the second largest protein supplying crop grown per hectare following wheat. Potato proteins include patatin (40-45 kDa), protease inhibitors (5-25 kDa), and various high MW proteins. Non-destructive techniques for the extraction of proteins from potato pulp and for the generation of peptides are needed in order to minimize functional losses and enhance quality. A promising approach for isolating the potato proteins was developed, which involves the use of multi-enzymatic systems containing selected glycosyl hydrolase enzymes that synergistically work to open the plant cell wall network. This enzymatic approach is advantageous due to: (1) the use of milder reaction conditions, (2) the high selectivity and specificity of enzymes, (3) the low cost and (4) the ability to market natural ingredients. Another major benefit to this enzymatic approach is the elimination of a costly purification step; indeed, these multi-enzymatic systems have the ability to isolate proteins, while fractionating them due to their specificity and selectivity with minimal proteolytic activities. The isolated proteins were used for the enzymatic generation of active peptides. In addition, they were applied into a reduced gluten cookie formulation as consumers are putting a high demand for easy ready to eat snack foods, with high nutritional quality and limited to no gluten incorporation. The addition of potato protein significantly improved the textural hardness of reduced gluten cookies, more comparable to wheat flour alone. The presentation will focus on our recent ‘proof-of principle’ results illustrating the feasibility and the efficiency of new biocatalytic processes for the production of innovative functional food ingredients, from potato by-products, whose potential health benefits are increasingly being recognized.

Keywords: biocatalytic approaches, functional ingredients, potato proteins, peptides

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810 The Neuroscience Dimension of Juvenile Law Effectuates a Comprehensive Treatment of Youth in the Criminal System

Authors: Khushboo Shah

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Categorical bans on the death penalty and life-without-parole sentences for juvenile offenders in a growing number of countries have established a new era in juvenile jurisprudence. This has been brought about by integration of the growing knowledge in cognitive neuroscience and appreciation of the inherent differences between adults and adolescents over the last ten years. This evolving understanding of being a child in the criminal system can be aptly reflected through policies that incorporate the mitigating traits of youth. First, the presentation will delineate the structures in cognitive neuroscience and in particular, focus on the prefrontal cortex, the amygdala, and the basal ganglia. These key anatomical structures in the brain are linked to three mitigating adolescent traits—an underdeveloped sense of responsibility, an increased vulnerability to negative influences, and transitory personality traits—that establish why juveniles have a lessened culpability. The discussion will delve into the details depicting how an underdeveloped prefrontal cortex results in the heightened emotional angst, high-energy and risky behavior characteristic of the adolescent time period or how the amygdala, the emotional center of the brain, governs different emotional expression resulting in why teens are susceptible to negative influences. Based on this greater understanding, it is incumbent that policies adequately reflect the adolescent physiology and psychology in the criminal system. However, it is important to ensure that these views are appropriately weighted while considering the jurisprudence for the treatment of children in the law. To ensure this balance is appropriately stricken, policies must incorporate the distinctive traits of youth in sentencing and legal considerations and yet refrain from the potential fallacies of absolving a juvenile offender of guilt and culpability. Accordingly, three policies will demonstrate how these results can be achieved: (1) eliminate housing of juvenile offenders in the adult prison system, (2) mandate fitness hearings for all transfers of juveniles to adult criminal court, and (3) use the post-disposition review as a type of rehabilitation method for juvenile offenders. Ultimately, this interdisciplinary approach of science and law allows for a better understanding of adolescent psychological and social functioning and can effectuate better legal outcomes for juveniles tried as adults.

Keywords: criminal law, Juvenile Justice, interdisciplinary, neuroscience

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809 Evidence of a Negativity Bias in the Keywords of Scientific Papers

Authors: Kseniia Zviagintseva, Brett Buttliere

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Science is fundamentally a problem-solving enterprise, and scientists pay more attention to the negative things, that cause them dissonance and negative affective state of uncertainty or contradiction. While this is agreed upon by philosophers of science, there are few empirical demonstrations. Here we examine the keywords from those papers published by PLoS in 2014 and show with several sentiment analyzers that negative keywords are studied more than positive keywords. Our dataset is the 927,406 keywords of 32,870 scientific articles in all fields published in 2014 by the journal PLOS ONE (collected from Altmetric.com). Counting how often the 47,415 unique keywords are used, we can examine whether those negative topics are studied more than positive. In order to find the sentiment of the keywords, we utilized two sentiment analysis tools, Hu and Liu (2004) and SentiStrength (2014). The results below are for Hu and Liu as these are the less convincing results. The average keyword was utilized 19.56 times, with half of the keywords being utilized only 1 time and the maximum number of uses being 18,589 times. The keywords identified as negative were utilized 37.39 times, on average, with the positive keywords being utilized 14.72 times and the neutral keywords - 19.29, on average. This difference is only marginally significant, with an F value of 2.82, with a p of .05, but one must keep in mind that more than half of the keywords are utilized only 1 time, artificially increasing the variance and driving the effect size down. To examine more closely, we looked at those top 25 most utilized keywords that have a sentiment. Among the top 25, there are only two positive words, ‘care’ and ‘dynamics’, in position numbers 5 and 13 respectively, with all the rest being identified as negative. ‘Diseases’ is the most studied keyword with 8,790 uses, with ‘cancer’ and ‘infectious’ being the second and fourth most utilized sentiment-laden keywords. The sentiment analysis is not perfect though, as the words ‘diseases’ and ‘disease’ are split by taking 1st and 3rd positions. Combining them, they remain as the most common sentiment-laden keyword, being utilized 13,236 times. More than just splitting the words, the sentiment analyzer logs ‘regression’ and ‘rat’ as negative, and these should probably be considered false positives. Despite these potential problems, the effect is apparent, as even the positive keywords like ‘care’ could or should be considered negative, since this word is most commonly utilized as a part of ‘health care’, ‘critical care’ or ‘quality of care’ and generally associated with how to improve it. All in all, the results suggest that negative concepts are studied more, also providing support for the notion that science is most generally a problem-solving enterprise. The results also provide evidence that negativity and contradiction are related to greater productivity and positive outcomes.

Keywords: bibliometrics, keywords analysis, negativity bias, positive and negative words, scientific papers, scientometrics

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808 Facilitated Massive Open Online Course (MOOC) Based Teacher Professional Development in Kazakhstan: Connectivism-Oriented Practices

Authors: A. Kalizhanova, T. Shelestova

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Teacher professional development (TPD) in Kazakhstan has followed a fairly standard format for centuries, with teachers learning new information from a lecturer and being tested using multiple-choice questions. In the online world, self-access courses have become increasingly popular. Due to their extensive multimedia content, peer-reviewed assignments, adaptable class times, and instruction from top university faculty from across the world, massive open online courses (MOOCs) have found a home in Kazakhstan's system for lifelong learning. Recent studies indicate the limited use of connectivism-based tools such as discussion forums by Kazakhstani pre-service and in-service English teachers, whose professional interests are limited to obtaining certificates rather than enhancing their teaching abilities and exchanging knowledge with colleagues. This paper highlights the significance of connectivism-based tools and instruments, such as MOOCs, for the continuous professional development of pre- and in-service English teachers, facilitators' roles, and their strategies for enhancing trainees' conceptual knowledge within the MOOCs' curriculum and online learning skills. Reviewing the most pertinent papers on Connectivism Theory, facilitators' function in TPD, and connectivism-based tools, such as MOOCs, a code extraction method was utilized. Three experts, former active participants in a series of projects initiated across Kazakhstan to improve the efficacy of MOOCs, evaluated the excerpts and selected the most appropriate ones to propose the matrix of teacher professional competencies that can be acquired through MOOCs. In this paper, we'll look at some of the strategies employed by course instructors to boost their students' English skills and knowledge of course material, both inside and outside of the MOOC platform. Participants' interactive learning contributed to their language and subject conceptual knowledge and prepared them for peer-reviewed assignments in the MOOCs, and this approach of small group interaction was given to highlight the outcomes of participants' interactive learning. Both formal and informal continuing education institutions can use the findings of this study to support teachers in gaining experience with MOOCs and creating their own online courses.

Keywords: connectivism-based tools, teacher professional development, massive open online courses, facilitators, Kazakhstani context

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807 Analysis of Sickle Cell Disease and Maternal Mortality in United Kingdom

Authors: Basma Hassabo, Sarah Ahmed, Aisha Hameed

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Aims and Objectives: To determine the incidence of maternal mortality amongst pregnant women with sickle cell disease (SCD) in the United Kingdom and to determine exact cause of death in these women. Background: SCD is caused by the ‘sickle’ gene and is characterized by episodes of severe bone pain and other complications like acute chest syndrome, chronic pulmonary hypertension, stroke, retinopathy, chronic renal failure, hepato-splenic crises, avascular bone necrosis, sepsis and leg ulcers. SCD is a continual cause of maternal mortality and fetal complications, and it comprises 1.5% of all Direct and Indirect deaths in the UK. Sepsis following premature rupture of membranes with ascending infection, post-partum infection and pre-labour overwhelming septic shock is one of its leading causes of death. Over the last fifty years of maternal mortality reports in UK, between 1 to 4 pregnant women died in each triennium. Material and Method: This is a retrospective study that involves pregnant women who died from SCD complications in the UK between 1952-2012. Data were collected from the UK Confidential Enquiries into Maternal Death and its causes between 1952–2012. Prior to 1985, exact cause of death in this cohort was not recorded. Results: 33 deaths reported between 1964 and 1984. 17 deaths were reported due to sickle cell disease between 1985 and 2012. Five women in this group died of sickle cell crisis, one woman had liver sequestration crisis, two women died of venous thromboembolism, two had myocardial fibrosis and three died of sepsis. Remaining women died of amniotic fluid embolism, SUDEP, myocardial ischemia and intracranial haemorrhage. Conclusion: The leading causes of death in sickle cell sick pregnant women are sickle cell crises, sepsis, venous thrombosis and thromboembolism. Prenatal care for women with SCD should be managed by a multidisciplinary team that includes an obstetrician, nutritionist, primary care physician, and haematologist. In every sick Sickle Cell woman Sickle Cell crises should be on the top of the list of differential diagnosis. Aggressive treatment of complications with low threshold to commence broad-spectrum antibiotics and LMWH contribute to better outcomes.

Keywords: incidence, maternal mortality, sickle cell disease (SCD), uk

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806 Thermo-Hydro-Mechanical-Chemical Coupling in Enhanced Geothermal Systems: Challenges and Opportunities

Authors: Esmael Makarian, Ayub Elyasi, Fatemeh Saberi, Olusegun Stanley Tomomewo

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Geothermal reservoirs (GTRs) have garnered global recognition as a sustainable energy source. The Thermo-Hydro-Mechanical-Chemical (THMC) integration coupling proves to be a practical and effective method for optimizing production in GTRs. The study outcomes demonstrate that THMC coupling serves as a versatile and valuable tool, offering in-depth insights into GTRs and enhancing their operational efficiency. This is achieved through temperature analysis and pressure changes and their impacts on mechanical properties, structural integrity, fracture aperture, permeability, and heat extraction efficiency. Moreover, THMC coupling facilitates potential benefits assessment and risks associated with different geothermal technologies, considering the complex thermal, hydraulic, mechanical, and chemical interactions within the reservoirs. However, THMC-coupling utilization in GTRs presents a multitude of challenges. These challenges include accurately modeling and predicting behavior due to the interconnected nature of processes, limited data availability leading to uncertainties, induced seismic events risks to nearby communities, scaling and mineral deposition reducing operational efficiency, and reservoirs' long-term sustainability. In addition, material degradation, environmental impacts, technical challenges in monitoring and control, accurate assessment of resource potential, and regulatory and social acceptance further complicate geothermal projects. Addressing these multifaceted challenges is crucial for successful geothermal energy resources sustainable utilization. This paper aims to illuminate the challenges and opportunities associated with THMC coupling in enhanced geothermal systems. Practical solutions and strategies for mitigating these challenges are discussed, emphasizing the need for interdisciplinary approaches, improved data collection and modeling techniques, and advanced monitoring and control systems. Overcoming these challenges is imperative for unlocking the full potential of geothermal energy making a substantial contribution to the global energy transition and sustainable development.

Keywords: geothermal reservoirs, THMC coupling, interdisciplinary approaches, challenges and opportunities, sustainable utilization

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805 Randomized Trial of Tian Jiu Therapy in San Fu Days for Patients with Chronic Asthma

Authors: Libing Zhu, Waichung Chen, Kwaicing Lo, Lei Li

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Background: Tian Jiu Therapy (a medicinal vesiculation therapy according to traditional Chinese medicine theory) in San Fu Days (the three hottest days in a year is calculated by the Chinese ancient calendar) is widely used by patients with chronic asthma in China although from modern medicine perspective there is insufficient evidence of its effectiveness and safety issues. We investigated the efficacy and safety of Tian Jiu Therapy compared with placebo in patients with chronic asthma. Methods: Patients with chronic asthma were randomly assigned to Tian Jiu treatment group (n=165), placebo control group (n=158). Registered Chinese Medicine practitioners, in Orthopedics-Traumatology, Acupuncture, and Tui-na Clinical Centre for Teaching and Research, School of Chinese Medicine, The University of Hong Kong, administered Tian Jiu Therapy and placebo treatment in 3 times over 2 months. Patients completed questionnaires and lung function test before treatment and after treatment, 3, 6, 9, and 11 months, respectively. The primary outcome was the no of asthma-related sub-healthy symptoms and the percentage of patients with twenty-three symptoms. Results: 451 patients were recruited totally, 111 patients refused or did not participate according the appointment time and 17 did not meet the inclusion criteria. Consequently, 323 of eligible patients were enrolled. There was nothing difference between Tian Jiu Therapy group and placebo control group at the end of all treatments neither primary nor secondary outcomes. While Tian Jiu Therapy as compared with placebo significantly reduced the percentage of participants who are susceptible waken up by asthma symptoms from 27% to 14% at 2nd follow-up (P < 0.05). Similarly, Tian Jiu Therapy significantly reduced the proportion of participants who had the symptom of running nose and sneezing before onset from 18% to 8% at 2nd follow-up (P < 0.05). Additionally, Tian Jiu Therapy significantly reduced the level of asthma, the proportion of participants who don’t need to processed during asthma attack increased from 6% to 15% at 1st follow-up and 0% to 7% at 3rd follow-up (P < 0.05). Improvements also occurred with Tian Jiu Therapy group, it reduced the proportion of participants who were spontaneously sweating at 3rd follow up and diarrhea after intake of oily food at 4th follow-up (P < 0.05). Conclusion: When added to a regimen of foundational therapy for chronic asthma participants, Tian Jiu Therapy further reduced the need for medications to control asthma, improved the quality of participants’ life, and significantly reduced the level of asthma. What is more, this benefit seems to have an accumulative effect over time was in accordance with the TCM theory of 'winter disease is being cured in summer'.

Keywords: asthma, Tian Jiu Therapy, San Fu Days, triaditional Chinese medicine, clinical trial

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804 Comparison of a Capacitive Sensor Functionalized with Natural or Synthetic Receptors Selective towards Benzo(a)Pyrene

Authors: Natalia V. Beloglazova, Pieterjan Lenain, Martin Hedstrom, Dietmar Knopp, Sarah De Saeger

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In recent years polycyclic aromatic hydrocarbons (PAHs), which represent a hazard to humans and entire ecosystem, have been receiving an increased interest due to their mutagenic, carcinogenic and endocrine disrupting properties. They are formed in all incomplete combustion processes of organic matter and, as a consequence, ubiquitous in the environment. Benzo(a)pyrene (BaP) is on the priority list published by the Environmental Agency (US EPA) as the first PAH to be identified as a carcinogen and has often been used as a marker for PAHs contamination in general. It can be found in different types of water samples, therefore, the European Commission set up a limit value of 10 ng L–1 (10 ppt) for BAP in water intended for human consumption. Generally, different chromatographic techniques are used for PAHs determination, but these assays require pre-concentration of analyte, create large amounts of solvent waste, and are relatively time consuming and difficult to perform on-site. An alternative robust, stand-alone, and preferably cheap solution is needed. For example, a sensing unit which can be submerged in a river to monitor and continuously sample BaP. An affinity sensor based on capacitive transduction was developed. Natural antibodies or their synthetic analogues can be used as ligands. Ideally the sensor should operate independently over a longer period of time, e.g. several weeks or months, therefore the use of molecularly imprinted polymers (MIPs) was discussed. MIPs are synthetic antibodies which are selective for a chosen target molecule. Their robustness allows application in environments for which biological recognition elements are unsuitable or denature. They can be reused multiple times, which is essential to meet the stand-alone requirement. BaP is a highly lipophilic compound and does not contain any functional groups in its structure, thus excluding non-covalent imprinting methods based on ionic interactions. Instead, the MIPs syntheses were based on non-covalent hydrophobic and π-π interactions. Different polymerization strategies were compared and the best results were demonstrated by the MIPs produced using electropolymerization. 4-vinylpyridin (VP) and divinylbenzene (DVB) were used as monomer and cross-linker in the polymerization reaction. The selectivity and recovery of the MIP were compared to a non-imprinted polymer (NIP). Electrodes were functionalized with natural receptor (monoclonal anti-BaP antibody) and with MIPs selective towards BaP. Different sets of electrodes were evaluated and their properties such as sensitivity, selectivity and linear range were determined and compared. It was found that both receptor can reach the cut-off level comparable to the established ML, and despite the fact that the antibody showed the better cross-reactivity and affinity, MIPs were more convenient receptor due to their ability to regenerate and stability in river till 7 days.

Keywords: antibody, benzo(a)pyrene, capacitive sensor, MIPs, river water

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803 A Concept Study to Assist Non-Profit Organizations to Better Target Developing Countries

Authors: Malek Makki

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The main purpose of this research study is to assist non-profit organizations (NPOs) to better segment a group of least developing countries and to optimally target the most needier areas, so that the provided aids make positive and lasting differences. We applied international marketing and strategy approaches to segment a sub-group of candidates among a group of 151 countries identified by the UN-G77 list, and furthermore, we point out the areas of priorities. We use reliable and well known criteria on the basis of economics, geography, demography and behavioral. These criteria can be objectively estimated and updated so that a follow-up can be performed to measure the outcomes of any program. We selected 12 socio-economic criteria that complement each other: GDP per capita, GDP growth, industry value added, export per capita, fragile state index, corruption perceived index, environment protection index, ease of doing business index, global competitiveness index, Internet use, public spending on education, and employment rate. A weight was attributed to each variable to highlight the relative importance of each criterion within the country. Care was taken to collect the most recent available data from trusted well-known international organizations (IMF, WB, WEF, and WTO). Construct of equivalence was carried out to compare the same variables across countries. The combination of all these weighted estimated criteria provides us with a global index that represents the level of development per country. An absolute index that combines wars and risks was introduced to exclude or include a country on the basis of conflicts and a collapsing state. The final step applied to the included countries consists of a benchmarking method to select the segment of countries and the percentile of each criterion. The results of this study allowed us to exclude 16 countries for risks and security. We also excluded four countries because they lack reliable and complete data. The other countries were classified per percentile thru their global index, and we identified the needier and the areas where aids are highly required to help any NPO to prioritize the area of implementation. This new concept is based on defined, actionable, accessible and accurate variables by which NPO can implement their program and it can be extended to profit companies to perform their corporate social responsibility acts.

Keywords: developing countries, international marketing, non-profit organization, segmentation

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802 Alternative Islamic Finance Channels and Instruments: An Evaluation of the Potential and Considerations in Light of Sharia Principles

Authors: Tanvir A. Uddin, Blake Goud

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Emerging trends in FinTech-enabled alternative finance, which includes channels and instruments emerging outside the traditional financial system, heralds unprecedented opportunities to improve financial intermediation and increase access to finance. With widespread criticism of the mainstream Islamic banking and finance sector as either mimicking the conventional system, failing to achieve inclusive growth or both, industry stakeholders are turning to technology to show that finance can be done differently. This paper will outline the critical elements for successful deployment of technology to maximize benefit and minimize potential for harm from introduction of Islamic FinTech and propose recommendations for Islamic financial institutions, FinTech companies, regulators and other stakeholders who are integrating or who are considering introducing FinTech solutions. The paper will present an overview of literature, present relevant case studies and summarize the lessons from interviews conducted with Islamic FinTech founders from around the world. With growing central bank concerns about leveraged loans and ballooning private credit markets globally (estimated at $1.4 trillion), current and future Islamic FinTech operators are at risk of contributing to the problems they aim to solve by operating in a 'shadow banking' system. The paper will show that by systematising a robust theory of change linked to positive outcomes, utilising objective impact frameworks (e.g., the Impact Measurement Project) and instilling a risk management culture that is proactive about potential social harm (e.g., irresponsible lending), FinTech can enable the Islamic finance industry to support positive social impact and minimize harm in support of the maqasid. The adoption of FinTech within the Islamic finance context is still at a nascent stage and the recommendations we provide based on the limited experience to date will help address some of the major cross-cutting issues related to FinTech. Further research will be needed to elucidate in more detail issues relating to individual sectors and countries within the broader global Islamic finance industry.

Keywords: alternative finance, FinTech, Islamic finance, maqasid, theory of change

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801 Interplay of Physical Activity, Hypoglycemia, and Psychological Factors: A Longitudinal Analysis in Diabetic Youth

Authors: Georges Jabbour

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Background and aims: This two-year follow-up study explores the long-term sustainability of physical activity (PA) levels in young people with type 1 diabetes, focusing on the relationship between PA, hypoglycemia, and behavioral scores. The literature highlights the importance of PA and its health benefits, as well as the barriers to engaging in PA practices. Studies have shown that individuals with high levels of vigorous physical activity have higher fear of hypoglycemia (FOH) scores and more hypoglycemia episodes. Considering that hypoglycemia episodes are a major barrier to physical activity, and many studies reported a negative association between PA and high FOH scores, it cannot be guaranteed that those experiencing hypoglycemia over a long period will remain active. Building on that, the present work assesses whether high PA levels, despite elevated hypoglycemia risk, can be maintained over time. The study tracks PA levels at one and two years, correlating them with hypoglycemia instances and Fear of Hypoglycemia (FOH) scores. Materials and methods: A self-administered questionnaire was completed by 61 youth with T1D, and their PA was assessed. Hypoglycemia episodes, fear of hypoglycemia scores and HbA1C levels were collected. All assessments were realized at baseline (visit 0: V0), one year (V1) and two years later (V2). For the purpose of the present work, we explore the relationships between PA levels, hypoglycemia episodes, and FOH scores at each time point. We used multiple linear regression to model the mean outcomes for each exposure of interest. Results: Findings indicate no changes in total moderate to vigorous PA (MVPA) and VPA levels among visits, and HbA1c (%) was negatively correlated with the total amount of VPA per day in minutes (β= -0.44; p=0.01, β= -0.37; p=0.04, and β= -0.66; p=0.01 for V0, V1, and V2, respectively). Our linear regression model reported a significant negative correlation between VPA and FOH across the visits (β=-0.59, p=0.01; β= -0.44, p=0.01; and β= -0.34, p=0.03 for V0, V1, and V2, respectively), and HbA1c (%) was influenced by both the number of hypoglycemic episodes and FOH score at V2 (β=0.48; p=0.02 and β=0.38; p=0.03, respectively). Conclusion: The sustainability of PA levels and HbA1c (%) in young individuals with type 1 diabetes is influenced by various factors, including fear of hypoglycemia. Understanding these complex interactions is essential for developing effective interventions to promote sustained PA levels in this population. Our results underline the necessity of a multi-strategic approach to promoting active lifestyles among diabetic youths. This approach should synergize PA enhancement with vigilant glucose monitoring and effective FOH management.

Keywords: physical activity, hypoglycemia, fear of hypoglycemia, youth

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800 Transformation in Palliative Care Delivery in Surgery

Authors: W. L. Tsang, H. Y. Li, S. L. Wong, T. Y. Kwok, S. C. Yuen, S. S. Kwok, P. S. Ko, S. Y. Lau

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Introduction: Palliative care is no doubt necessary in surgery. When one looks at studies of what patients with life-threatening illness want and compares to what they experience in surgical units, the gap is huge. Surgical nurses, being patient advocates, should engage with patients and families sooner rather than later in their illness trajectories to consider how to manage the illness, not just their capacity to survive. Objective: This clinical practice guide aims to fill the service gap of palliative care in surgery by producing a quality-driven, evidence-based yet straightforward clinical practice guide based on a focus strategy. Methodology: In line with Guide to Good Nursing Practice: End-of-Life Care recommended by Nursing Council of Hong Kong and the strategic goal of improving quality of palliative care proposed in HA Strategic Plan 2017-2022, multiple phases of work were undertaken from July 2015 to December 2017. A pragmatic clinical practice guide for surgical patients facing life-threatening conditions was developed based on assessments on knowledge of and attitudes towards end-of-life care of surgical nurses. Key domains, including preparation for bereavement, nursing care for imminently dying patients and at the dying scene were crystallized according to the results of the assessments and the palliative care checklist formulated by UCH Palliative Care Team. After a year of rollout, its content was refined through analyses of implementation in routine practice and consensus opinions from frontline nurses. Results and Outcomes: This clinical practice guide inspires surgical nurses with the art of care to provide for patients’ comfort, function, and longevity. It provides practical directions and assists nurses to master the skills on advance care planning and learn how to be clear with patients, families and themselves about the realities of the disease pictures. Through the implementation, patients and families are included in the decision process, and their wishes are honored. The delivery of explicit and high-quality palliative care maintains good nurse-to-patient relations and enhances satisfaction of hospital care of patients and families. Conclusion: Surgical nursing has always been up to the unique challenges of the era. This clinical practice guide has become an island of credibility for our nurses as they traverse the often stormy waters of life-limiting illness.

Keywords: palliative care delivery, palliative care in surgery, hospice care, end-of-life care

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799 The Interventions to Parents Caring Children with Attention Deficit/Hyperactivity Disorder in Hong Kong

Authors: Wing Chi Wong

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Globally, studying parents caring for children with attention deficit/ hyperactivity disorder (ADHD) is valuable in order to design measures in supporting those parents by health care providers and government. Such parents in Hong Kong seem to encounter detrimental stress and enormous difficulties which are exacerbated by the traditional Chinese culture, exclusion from social members and fiercely competitive educational system. However, seldom studies scrutinize this issue in Hong Kong. This article aims to review the literature regarding parents caring offsprings with ADHD in Hong Kong. Criteria were set for searching among published studies listed in various databases, including MEDLINE, CINCAHL, PsycINFO, ProQuest, Embase, Cochrane Library and Springer Link. Articles with words 'Attention Deficit Hyperactivity Disorder', 'parenting', 'parent', 'family', 'father', 'mother', 'care' in titles and abstracts were identified. Articles with all types of research designs and methods, regardless in English or Chinese, were included. They were limited to years between January 2008 and September 2018. Four relevant studies have resulted. Of them, two were exploratory studies, one was a qualitative study, and one was a survey. Samples were recruited from child psychiatric clinic, Child and Adolescent Mental Health Unit, or multiple family group therapy centres. Authors proclaimed that quality of life of those parents was usually low; particularly mothers perceived a higher stress than fathers; parenting barriers existed; conflicts were commonly raised in parent-child relationship resulting in probable maltreatment to children. Previous studies generally suggested the potential negative outcomes of parents caring children with ADHD. The types and effectiveness of interventions to those parents on relieving their tortures under Hong Kong context had not been explored and systematically evaluated. The scanty studies and existing understanding could not give a promising conclusion pertaining to the appropriate family intervention to parents living with children with ADHD. A stringent research design is necessary to establish evidence on the effectiveness of interventions for those families.

Keywords: attention deficit/ hyperactivity disorder, Hong Kong, parents, interventions

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798 The Right to Water in the Lancang-Mekong River Basin Disputes

Authors: Heping Dang, Raymond Yu Wang

Abstract:

The Langcang-Mekong River is the most important international watercourse in mainland Southeast Asia. In recent years, the six riparian states, China, Myanmar, Laos, Thailand, Cambodia and Vietnam, have confronted increasing disputes over the use of the trans-boundary water. To settle these disputes and protect the fundamental right to water, quite a few inter-state mechanisms have been established, such as the Mekong River Commission, the economic cooperation program of the Greater Mekong Subregion, the ‘Belt and Road Initiative’ and the ‘Lancang-Mekong Cooperation Mechanism’ and the ‘Lower Mekong Initiative’. Non-Governmental Organizations (NGOs) have also been an important and constructive institutional entrepreneur in trans-boundary water governance. Although the status and extent of the right to water are yet to be clearly defined, this paper aims to 1) unpack how the right to water is interpreted and exercised in the Lancang-Mekong River Basin Dispute; and 2) to evaluate the roles of the right to water in settling international water disputes. To achieve these objectives, Secondary data such as archival documents of international law and relevant stakeholders will be compiled for analysis. First-hand information about the organizational structure, accountability, values and strategies of the international mechanisms and NGOs in question will also be collected through fieldwork in the Mekong river basin. Semi-structural interviews, group discussions and participatory observation will be conducted to collect data. The authors have access to the fieldwork because they have abundant experience of collaborating with Mekong-based international NGOs in previous research projects. This research will display how the concepts and principles of international law and the UN guidelines are interpreted in practice. These principles include the definition and extent of the right to water, the practical use of ‘vital human need’, the indicators of ‘adequacy of water’ including ‘availability, quality and accessibility’, and how the right to water is related to the progressive realization of the right to life. This down-to earth research will enrich the theoretical discussion of international law, particularly international human rights law, within the UN framework. Moreover, the outcomes of this research will provide new insights into the roles that the right to water might play in consensus-building and dispute settlement in a rapidly changing context, where water is pivotal for poverty alleviation, biodiversity conservation and the promotion of sustainable livelihoods.

Keywords: international water dispute, Lancang-Mekong River, right to water, state and non-state actors

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797 Wood Energy, Trees outside Forests and Agroforestry Wood Harvesting and Conversion Residues Preparing and Storing

Authors: Adeiza Matthew, Oluwadamilola Abubakar

Abstract:

Wood energy, also known as wood fuel, is a renewable energy source that is derived from woody biomass, which is organic matter that is harvested from forests, woodlands, and other lands. Woody biomass includes trees, branches, twigs, and other woody debris that can be used as fuel. Wood energy can be classified based on its sources, such as trees outside forests, residues from wood harvesting and conversion, and energy plantations. There are several policy frameworks that support the use of wood energy, including participatory forest management and agroforestry. These policies aim to promote the sustainable use of woody biomass as a source of energy while also protecting forests and wildlife habitats. There are several options for using wood as a fuel, including central heating systems, pellet-based systems, wood chip-based systems, log boilers, fireplaces, and stoves. Each of these options has its own benefits and drawbacks, and the most appropriate option will depend on factors such as the availability of woody biomass, the heating needs of the household or facility, and the local climate. In order to use wood as a fuel, it must be harvested and stored properly. Hardwood or softwood can be used as fuel, and the heating value of firewood depends on the species of tree and the degree of moisture content. Proper harvesting and storage of wood can help to minimize environmental impacts and improve wildlife habitats. The use of wood energy has several environmental impacts, including the release of greenhouse gases during combustion and the potential for air pollution from combustion by-products. However, wood energy can also have positive environmental impacts, such as the sequestration of carbon in trees and the reduction of reliance on fossil fuels. The regulation and legislation of wood energy vary by country and region, and there is an ongoing debate about the potential use of wood energy in renewable energy technologies. Wood energy is a renewable energy source that can be used to generate electricity, heat, and transportation fuels. Woody biomass is abundant and widely available, making it a potentially significant source of energy for many countries. The use of wood energy can create local economic and employment opportunities, particularly in rural areas. Wood energy can be used to reduce reliance on fossil fuels and reduce greenhouse gas emissions. Properly managed forests can provide a sustained supply of woody biomass for energy, helping to reduce the risk of deforestation and habitat loss. Wood energy can be produced using a variety of technologies, including direct combustion, co-firing with fossil fuels, and the production of biofuels. The environmental impacts of wood energy can be minimized through the use of best practices in harvesting, transportation, and processing. Wood energy is regulated and legislated at the national and international levels, and there are various standards and certification systems in place to promote sustainable practices. Wood energy has the potential to play a significant role in the transition to a low-carbon economy and the achievement of climate change mitigation goals.

Keywords: biomass, timber, charcoal, firewood

Procedia PDF Downloads 95