Search results for: global neurosurgery
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5316

Search results for: global neurosurgery

936 Barriers and Facilitators for Telehealth Use during Cervical Cancer Screening and Care: A Literature Review

Authors: Reuben Mugisha, Stella Bakibinga

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The cervical cancer burden is a global threat, but more so in low income settings where more than 85% of mortality cases occur due to lack of sufficient screening programs. There is consequently a lack of early detection of cancer and precancerous cells among women. Studies show that 3% to 35% of deaths could have been avoided through early screening depending on prognosis, disease progression, environmental and lifestyle factors. In this study, a systematic literature review is undertaken to understand potential barriers and facilitators as documented in previous studies that focus on the application of telehealth in cervical cancer screening programs for early detection of cancer and precancerous cells. The study informs future studies especially those from low income settings about lessons learned from previous studies and how to be best prepared while planning to implement telehealth for cervical cancer screening. It further identifies the knowledge gaps in the research area and makes recommendations. Using a specified selection criterion, 15 different articles are analyzed based on the study’s aim, theory or conceptual framework used, method applied, study findings and conclusion. Results are then tabulated and presented thematically to better inform readers about emerging facts on barriers and facilitators to telehealth implementation as documented in the reviewed articles, and how they consequently lead to evidence informed conclusions that are relevant to telehealth implementation for cervical cancer screening. Preliminary findings of this study underscore that use of low cost mobile colposcope is an appealing option in cervical cancer screening, particularly when coupled with onsite treatment of suspicious lesions. These tools relay cervical images to the online databases for storage and retrieval, they permit integration of connected devices at the point of care to rapidly collect clinical data for further analysis of the prevalence of cervical dysplasia and cervical cancer. Results however reveal the need for population sensitization prior to use of mobile colposcopies among patients, standardization of mobile colposcopy programs across screening partners, sufficient logistics and good connectivity, experienced experts to review image cases at the point-of-care as important facilitators to the implementation of mobile colposcope as a telehealth cervical cancer screening mechanism.

Keywords: cervical cancer screening, digital technology, hand-held colposcopy, knowledge-sharing

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935 Abatement of NO by CO on Pd Catalysts: Influence of the Support in Oxyfuel Combustion Conditions

Authors: Joudia Akil, Stephane Siffert, Laurence Pirault-Roy, Renaud Cousin, Christophe Poupin

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The CO2 emitted from anthropic activities is perceived as a constraint in industrial activity due to taxes, stringent environmental regulations, impact on global warming… To limit these CO2 emissions, reuse of CO2 represents a promising alternative, with important applications in chemical industry and for power generation. However, CO2 valorization process requires a gas as pure as possible Oxyfuel-combustion that enables obtaining a CO2 rich stream, with water vapor (10%) is then interesting. Nevertheless to decrease the amount of the by-products found with the CO2 (especially CO and NOx which are harmful to the environment) a catalytic treatment must be applied. Nowadays three-way catalysts are well-developed material for simultaneous conversion of unburned hydrocarbons, carbon monoxide (CO) and nitrogen oxides (NOx). The use of Pd attracted considerable attention on the basis of economic factors (the high cost and scarcity of Pt and Rh). This explains the large number of studies concerning the CO-NO reaction on Pd in the recent years. In the present study, we will compare a series of Pd materials supported on different oxides for CO2 purification from the oxyfuel combustion system, by reducing NO with CO in an oxidizing environment containing CO2 rich stream and presence of 8.2% of water. Al2O3, CeO2, MgO, SiO2 and TiO2 were used as support materials of the catalysts. 1wt% Pd/Support catalysts were obtained by wet impregnation on supports with a precursor of palladium [Pd(acac)2]. The obtained samples were subsequently characterized by H2 chemisorption, BET surface area and TEM. Finally, their catalytic performances were evaluated in CO2 purification which is carried out in a fixed-bed flow reactor containing 150 mg of catalyst at atmospheric pressure. The flow of the reactant gases is composed of: 20% CO2, 10% O2, 0.5% CO, 0.02% NO and 8.2% H2O (He as eluent gas) with a total flow of 200mL.min−1, in the same GHSV. The catalytic performance of the Pd catalysts for CO2 purification revealed that: -The support material has a strong influence on the catalytic activity of 1wt.% Pd supported catalysts. depending of the nature of support, the Pd-based catalysts activity changes. -The highest reduction of NO with CO is obtained in the following ranking: TiO2>CeO2>Al2O3. -The supports SiO2 and MgO should be avoided for this reaction, -Total oxidation of CO occurred over different materials, -CO2 purification can reach 97%, -The presence of H2O has a positive effect on the NO reduction due to the production of the reductant H2 from WGS reaction H2O+CO → H2+CO2

Keywords: carbon dioxide, environmental chemistry, heterogeneous catalysis, oxyfuel combustion

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934 Water Stress Response Profiling of Nigerian Bambara Groundnut (Vigna subterranea L. Verdc.) Germplasm and Genetic Diversity Studies of Some Selected Accessions Using SSR Markers

Authors: Dorcas Ropo Abejide, Olamide Ahmed Falusi, Oladipupo Abdulazeez Yusuf Daudu, Bolaji Zuluqurineen Salihu, Muhammad Liman Muhammad

Abstract:

This study evaluated the morpho-agronomic response of twenty-four (24) Nigerian Bambara groundnut landraces to water stress and genetic diversity of some selected accessions using SSR markers. The studies were carried out in the botanical garden of the Department of Plant Biology, Federal University of Technology, Minna, Niger State, Nigeria in a randomized complete block design using three replicates. Molecular analysis using SSR primers was carried out at the International Institute of Tropical Agriculture (IITA) Ibadan in order to characterize ten selected accessions comprising the seven most drought tolerant and three most susceptible accessions from the 24 accessions evaluated. Results revealed that water stress decreased morpho-agronomic traits such as plant height, leaf area, number of leaves per plant, seed yield, etc. A total of 22 alleles were detected by the SSR markers used with a mean number of 4 allelles. SSR markers MBamCO₃₃, Primer 65, and G358B2-D15 each detected 4 allelles, while Primer 3FR and 4FR detected 5 allelles each. The study revealed significantly high polymorphisms in 10 Loci. The mean value of polymorpic information content was 0.6997, implying the usefulness of the primers used in identifying genetic similarities and differences among the Bambara groundnut genotypes. The SSR analysis revealed a comparable pattern between genetic diversity and drought tolerance of the genotypes. The UPGMA dendrogram showed that at a genetic distance of 0.1, the accessions were grouped into three groups according to their level of tolerance to drought. The two most drought-tolerant accessions were grouped together, and the 5th and 6th most drought-tolerant accessions were also grouped together. This suggests that the genotypes grouped together may be genetically close, may possess similar genes, or have a common origin. The degree of genetic variants obtained from this profiling could be useful in Bambara groundnut breeding for drought tolerance. The identified drought tolerant Bambara groundnut landraces are important genetic resources for drought stress tolerance breeding programme of Bambara groundnut. The genotypes are also useful for germplasm conservation and global implications.

Keywords: Bambara groundnut, genetic diversity, germplasm, SSR markers, water stress

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933 Middle Ordovician (Llanvirnian) Relative Sea-Level Fluctuations

Authors: Ying Jia Teoh

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The Canning Basin is located between the Kimberley and Pilbara Precambrian cratonic blocks. It is a large but relatively poorly explored Paleozoic basin in remote Western Australia. During the early Ordovician period, the Australian continent was located near the equator. Middle Ordovician age Nita and Goldwyer Formations in Canning Basin are therefore warm water carbonates. The Nita Formation carbonates are a regressive sequence which conformably overlies the Goldwyer Formation. It contains numerous progradational cycles of limestone, vuggy dolomitized carbonate beds and shale deposited in subtidal to supratidal environments. The Goldwyer Formation contains transgressive shale sequences and regressive carbonates deposited in shallow subtidal conditions. The shales contain oil-prone Gloeocapsormorpha prisca-bearing source rocks. Llanvirnian relative sea-level fluctuations were reconstructed by using Fischer plots methodology for three key wells (wells McLarty 1, Looma 1 and Robert 1) in Broome Platform and compared with INPEFA data. The Goldwyer lower shale (interval Or1000P) shows increasing relative sea-level and this matches with a transgressive systems tract. Goldwyer middle carbonate (interval Or2000) shows relative sea-level drop and this matches with a regressive systems tract. Goldwyer upper shale (interval Or2000P) shows relative sea-level drop and this matches with a transgressive systems tract. Nita Formation Leo Member (interval Or3000) shows a relative sea level drop and this matches with a regressive systems tract. The Nita Formation Cudalgarra Member (intervals Or3000P and Or4000) with transgressive systems tract then this is followed by a regressive systems tract. This pattern matches with the relative sea-level curves in wells McLarty 1 and Robert 1. The correlation is weak for parts of well Looma 1. This is probably influenced by the fact that the thickness of this section is quite small. As a conclusion, Fischer plots for the Llanvirnian Goldwyer and Nita Formations show good agreement with the third order global sea level cycles of Haq and others. Fischer plots are generally correlated well with trend and cyclicity determined by INPEFA curves and as a method of cross-checking INPEFA data and sea-level change.

Keywords: canning basin, Fischer plots, Llanvirnian, middle Ordovician, sea-level fluctuations, stratigraphy

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932 Domestic Violence against Women and the Nutritional Status of Their Under-5 Children: A Cross Sectional Survey in Urban Slums of Chittagong, Bangladesh

Authors: Mohiuddin Ahsanul Kabir Chowdhury, Ahmed Ehsanur Rahman, Nazia Binte Ali, Abdullah Nurus Salam Khan, Afrin Iqbal, Mohammad Mehedi Hasan, Salma Morium, Afsana Bhuiyan, Shams El Arifeen

Abstract:

Violence against women has been treated as a global epidemic which is as fatal as any serious disease or accidents. Like many other low-income countries it is also common in Bangladesh. In spite of existence of a few documented evidences in some other countries, in Bangladesh, domestic violence against women (DVAW) is not considered as a factor for malnutrition in children yet. Hence, the aim of the study was to investigate the association between DVAW and the nutritional status of their under-5 children in the context of slum areas of Chittagong, Bangladesh. A Cross-sectional survey was conducted among 87 women of reproductive age having at least one child under-5 years of age and staying with husband for at least last 1 year in selected slums under Chittagong City Corporation area. Data collection tools were structured questionnaire for the study participants and mid-upper arm circumference (MUAC) to measure the nutritional status of the under-5 children. The data underwent descriptive and regression analysis. Out of 87 respondents, 50 (57.5%) reported to suffer from domestic violence by their husband during last one year. Physical violence was found to be significantly associated with age (p=0.02), age at marriage (p=0.043), wealth score (p=0.000), and with knowledge regarding law (p=0.017). According to the measurement of mid-upper arm circumference (MUAC) 21% children were suffering from severe acute malnutrition (SAM) and the same percentage of children were suffering from moderate acute malnutrition (MAM). However, unadjusted odds ratio suggested that there was negative association with domestic violence and nutritional status. But, the logistic regression confounding for other variable showed significant association with total family income (p=0.006), wealth score (p=0.031), age at marriage (p=0.029) and number of child (p=0.006). Domestic violence against women and under nutrition of the children, both are highly prevalent in Bangladesh. More extensive research should be performed to identify the factors contributing to the high prevalence of domestic violence and malnutrition in urban slums of Bangladesh. Household-based intervention is needed to limit this burning problem. In a nutshell, effective community participation, education and counseling are essential to create awareness among the community.

Keywords: Bangladesh, cross sectional survey, domestic violence against women, nutritional status, under-5 children, urban slums

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931 Marketing and Pharmaceutical Analysis of Medical Cosmetics in Bulgaria and Japan

Authors: V. Petkova, V. Valchanova, D. Grekova, K. Andreevska, S. T. Geurguiev, V. Madgarov, D. Grekov

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Introduction: Production, distribution and sale of cosmetics is a global industry, which played a key role in the European Union (EU), the US and Japan. A major participant EU whose market cosmetics is greater than in the US and 2 times greater than that in Japan. The output value of the cosmetics industry in the EU is estimated at about € 35 billion in 2001. Nearly 5 billion cosmetic products (number of packages) are sold annually in the EU, and the main markets are France, Germany, Italy, Spain and the UK. The aim of the study is legal and marketing analysis of cosmetic products dispensed in a pharmacy. Materials and methodology: Historical legislative analysis - the method is applied in the analysis of changes in the legislative regulation of the activities of cosmetic products in Japan and Bulgaria Comparative legislative analysis - the method is applied when comparing the legislative requirements for cosmetic products in the already mentioned countries. Both methods are applied to the following regulations: 1) Japanese Pharmaceuticals Affairs Law, Tokyo, Japan, Ministry of Health, Labour and Welfare; 2) Law on Medicinal Products for Human Use; effective from 3.01.2014. Results: The legislative framework for cosmetic products in Bulgaria and Japan is close and generally includes general guidelines: Definition of a medicinal product; Categorization of drugs (with differences in sub-categories); Pre-registration and marketing approval of the competent authorities; Compulsory compliance with gmp (unlike cosmetics); Regulatory focus on product quality, efficacy and safety; Obligations for labeling of such products; Created systems Pharmacovigilance and commitment of all parties - industry and health professionals; The main similarities in the regulation of products classified as cosmetics are in the following segments: Full producer responsibility for product safety; Surveillance of market regulatory authorities; No need for pre-registration or pre-marketing approval (a basic requirement for notification); Without restrictions on sales channels; GMP manuals for cosmetics; Regulatory focus on product safety (than over efficiency); General requirements in labeling: The main differences in the regulation of products classified as cosmetics are in the following segments: Details in the regulation of cosmetic products; Future convergence of regulatory frameworks can contribute to the removal of barriers to trade, to encourage innovation, while simultaneously ensuring a high level of protection of consumer safety.

Keywords: cosmetics, legislation, comparative analysis, Bulgaria, Japan

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930 Fast Track to the Physical Internet: A Cross-Industry Project from Upper Austria

Authors: Laura Simmer, Maria Kalt, Oliver Schauer

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Freight transport is growing fast, but many vehicles are empty or just partially loaded. The vision and concepts of the Physical Internet (PI) proposes to eliminate these inefficiencies. Aiming for a radical sustainability improvement, the PI – inspired by the Digital Internet – is a hyperconnected global logistic system, enabling seamless asset sharing and flow consolidation. The implementation of a PI in its full expression will be a huge challenge: the industry needs innovation and implementation support including change management approaches, awareness creation and good practices diffusion, legislative actions to remove antitrust and international commerce barriers, standardization and public incentives policies. In order to take a step closer to this future the project ‘Atropine - Fast Track to the Physical Internet’ funded under the Strategic Economic and Research Program ‘Innovative Upper Austria 2020’ was set up. The two-year research project unites several research partners in this field, but also industrial partners and logistics service providers. With Atropine, the consortium wants to actively shape the mobility landscape in Upper Austria and make an innovative contribution to an energy-efficient, environmentally sound and sustainable development in the transport area. This paper should, on the one hand, clarify the questions what the project Atropine is about and, on the other hand, how a proof of concept will be reached. Awareness building plays an important role in the project as the PI requires a reorganization of the supply chain and the design of completely new forms of inter-company co-operation. New business models have to be developed and should be verified by simulation. After the simulation process one of these business models will be chosen and tested in real life with the partner companies. The developed results - simulation model and demonstrator - are used to determine how the concept of the PI can be applied in Upper Austria. Atropine shall pave the way for a full-scale development of the PI vision in the next few decades and provide the basis for pushing the industry toward a new level of co-operation with more shared resources and increased standardization.

Keywords: Atropine, inter-company co-operation, Physical Internet, shared resources, sustainable logistics

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929 Factors in a Sustainability Assessment of New Types of Closed Cavity Facades

Authors: Zoran Veršić, Josip Galić, Marin Binički, Lucija Stepinac

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With the current increase in CO₂ emissions and global warming, the sustainability of both existing and new solutions must be assessed on a wide scale. As the implementation of closed cavity facades (CCF) is on the rise, a variety of factors must be included in the analysis of new types of CCF. This paper aims to cover the relevant factors included in the sustainability assessment of new types of CCF. Several mathematical models are being used to describe the physical behavior of CCF. Depending on the type of CCF, they cover the main factors which affect the durability of the façade: thermal behavior of various elements in the façade, stress, and deflection of the glass panels, pressure inside a cavity, exchange rate, and the moisture buildup in the cavity. CCF itself represents a complex system in which all mentioned factors must be considered mutually. Still, the façade is only an envelope of a more complex system, the building. Choice of the façade dictates the heat loss and the heat gain, thermal comfort of inner space, natural lighting, and ventilation. Annual consumption of energy for heating, cooling, lighting, and maintenance costs will present the operational advantages or disadvantages of the chosen façade system in both the economic and environmental aspects. Still, the only operational viewpoint is not all-inclusive. As the building codes constantly demand higher energy efficiency as well as transfer to renewable energy sources, the ratio of embodied and lifetime operational energy footprint of buildings is changing. With the drop in operational energy CO₂ emissions, embodied energy emissions present a larger and larger share in the lifecycle emissions of the building. Taken all into account, the sustainability assessment of a façade, as well as other major building elements, should include all mentioned factors during the lifecycle of an element. The challenge of such an approach is a timescale. Depending on the climatic conditions on the building site, the expected lifetime of CCF can exceed 25 years. In such a time span, some of the factors can be estimated more precisely than others. The ones depending on the socio-economic conditions are more likely to be harder to predict than the natural ones like the climatic load. This work recognizes and summarizes the relevant factors needed for the assessment of new types of CCF, considering the entire lifetime of a façade element and economic and environmental aspects.

Keywords: assessment, closed cavity façade, life cycle, sustainability

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928 Assessing In-Country Public Health Training Needs: Workforce Development to Meet Sustainable Development Goals

Authors: Leena Inamdar, David Allen, Sushma Acquilla, James Gore

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Health systems globally are facing increasingly complex challenges. Emerging health threats, changing population demographics and increasing health inequalities, globalisation, economic constraints on government spending are some of the most critical ones. These challenges demand not only innovative funding and cross-sectoral approaches, but also require a multidisciplinary public health workforce equipped with skills and expertise to meet the future challenges of the Sustainable Development Goals (SDGs). We aim to outline an approach to assessing the feasibility of establishing a competency-based public health training at a country level. Although the SDGs provide an enabling impetus for change and promote positive developments, public health training and education still lag behind. Large gaps are apparent in both the numbers of trained professionals and the options for high quality training. Public health training in most Low-Middle Income Countries is still largely characterized by a traditional and limited public health focus. There is a pressing need to review and develop core and emerging competences for a well-equipped workforce fit for the future. This includes the important role of national Health and Human Resource Ministries in determining these competences. Public health has long been recognised as a multidisciplinary field, with need for professionals from a wider range of disciplines such as management, health promotion, health economics, law. Leadership and communication skills are also critical to achieve the successes in meeting public health outcomes. Such skills and competences need to be translated into competency-based training and education, to prepare current public health professionals with the skills required in today’s competitive job market. Integration of academic and service based public-health training, flexible accredited programmes to support existing mid-career professionals, continuous professional development need to be explored. In the current global climate of austerity and increasing demands on health systems, the need for stepping up public health training and education is more important than ever. By using a case study, we demonstrate the process of assessing the in-county capacity to establish a competency based public health training programme that will help to develop a stronger, more versatile and much needed public health workforce to meet the SDGs.

Keywords: public health training, competency-based, assessment, SDGs

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927 The Effect of Technology on Hospitality, Tourism Marketing and Management

Authors: Reda Moussa Massoud Embark

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Tourism and hospitality graduate development is key to the future state of the tourism and hospitality industry. Meanwhile, Information and Communication Technology is increasingly becoming the engine for improving productivity and business opportunities in the travel and hospitality industry. Given the challenges and fierce global competition that have arisen in today's hospitality industry, it was important to shed light on strategic management. In addition, five-star hotels play a key role in supporting the tourism industry and investments in Egypt. Therefore, this study aims to examine the extent to which strategic management practices are implemented in five-star hotels in Egypt and to examine the differences between resort and inner-city hotels in terms of the implementation of strategic management processes. The influence of different hotel types on the implementation of the strategic management process is examined. A simple random sampling technique is used to select a sample of the target population, including hotels in the cities of Sharm el-Sheikh, Cairo and Hurghada. The data collection tool used in this study is an interviewer-administered questionnaire. Finally, combining the study results with the literature review allowed to present a set of recommendations to be addressed to hoteliers in the area of strategic management practices. Education and training in tourism and hospitality must take these changes into account in order to improve the ability of future managers to use a variety of tools and strategies to make their organizations more efficient and competitive. Therefore, this study aims to examine the types and effectiveness of training courses offered by tourism and hospitality departments in Egypt and to assess the importance of these training courses from the perspective of the graduate. The survey is aimed at graduates who have completed three different majors in the past decade: tourism and hospitality. Findings discussed the nature, level and effectiveness of the training provided at these faculties and the extent to which the training programs were valued by graduates working in different fields, and finally recommended specific practices to improve learning effectiveness increase and increase perceived employee benefits in the tourism and hospitality industry.

Keywords: marketing channels, crisis, hotel, international, tour, operators, online travel agencies, e-tourism, hotel websites, tourism, web-tourism, strategic-management, strategic tools, five-star hotels, resorts, downtown hotels, Egyptian Markets.

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926 System Transformation: Transitioning towards Low Carbon, Resource Efficient, and Circular Economy for Global Sustainability

Authors: Anthony Halog

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In the coming decades the world that we know today will be drastically transformed. Population and economic growth, particularly in developing countries, are radically changing the demand for food and natural resources. Due to the transformations caused by these megatrends, especially economic growth which is rapidly expanding the middle class and changing consumption patterns worldwide, it is expected that this will result to an increase of approximately 40 percent in the demand for food, water, energy and other resources in the next decades. To fulfill this demand in a sustainable and efficient manner while avoiding food and water scarcity as well as environmental catastrophes in the near future, some industries, particularly the ones involved in food and energy production, have to drastically change its current production systems towards circular and green economy. In Australia, the agri-food industry has played a very important role in the scenario described above. It is one of the major food exporters in the world, supplying fast growing international markets in Asia and the Middle East. Though the Australian food supply chains are economically and technologically developed, it has been facing enduring challenges about its international competitiveness and environmental burdens caused by its production processes. An integrated framework for sustainability assessment is needed to precisely identify inefficiencies and environmental impacts created during food production processes. This research proposes a combination of industrial ecology and systems science based methods and tools intending to develop a novel and useful methodological framework for life cycle sustainability analysis of the agri-food industry. The presentation highlights circular economy paradigm aiming to implement sustainable industrial processes to transform the current industrial model of agri-food supply chains. The results are expected to support government policy makers, business decision makers and other stakeholders involved in agri-food-energy production system in pursuit of green and circular economy. The framework will assist future life cycle and integrated sustainability analysis and eco-redesign of food and other industrial systems.

Keywords: circular economy, eco-efficiency, agri-food systems, green economy, life cycle sustainability assessment

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925 The Use of Venous Glucose, Serum Lactate and Base Deficit as Biochemical Predictors of Mortality in Polytraumatized Patients: Acomparative with Trauma and Injury Severity Score and Acute Physiology and Chronic Health Evalution IV

Authors: Osama Moustafa Zayed

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Aim of the work: To evaluate the effectiveness of venous glucose, levels of serum lactate and base deficit in polytraumatized patients as simple parameters to predict the mortality in these patients. Compared to the predictive value of Trauma and injury severity (TRISS) and Acute Physiology And Chronic Health Evaluation IV (APACHE IV). Introduction: Trauma is a serious global health problem, accounting for approximately one in 10 deaths worldwide. Trauma accounts for 5 million deaths per year. Prediction of mortality in trauma patients is an important part of trauma care. Several trauma scores have been devised to predict injury severity and risk of mortality. The trauma and injury severity score (TRISS) was most common used. Regardless of the accuracy of trauma scores, is based on an anatomical description of every injury and cannot be assigned to the patients until a full diagnostic procedure has been performed. So we hypothesized that alterations in admission glucose, lactate levels and base deficit would be an early and easy rapid predictor of mortality. Patient and Method: a comparative cross-sectional study. 282 Polytraumatized patients attended to the Emergency Department(ED) of the Suez Canal university Hospital constituted. The period from 1/1/2012 to 1/4/2013 was included. Results: We found that the best cut off value of TRISS probability of survival score for prediction of mortality among poly-traumatized patients is = 90, with 77% sensitivity and 89% specificity using area under the ROC curve (0.89) at (95%CI). APACHE IV demonstrated 67% sensitivity and 95% specificity at 95% CI at cut off point 99. The best cutoff value of Random Blood Sugar (RBS) for prediction of mortality was>140 mg/dl, with 89%, sensitivity, 49% specificity. The best cut off value of base deficit for prediction of mortality was less than -5.6 with 64% sensitivity, 93% specificity. The best cutoff point of lactate for prediction of mortality was > 2.6 mmol/L with 92%, sensitivity, 42% specificity. Conclusion: According to our results from all evaluated predictors of mortality (laboratory and scores) and mortality based on the estimated cutoff values using ROC curves analysis, the highest risk of mortality was found using a cutoff value of 90 in TRISS score while with laboratory parameters the highest risk of mortality was with serum lactate > 2.6 . Although that all of the three parameter are accurate in predicting mortality in poly-traumatized patients and near with each other, as in serum lactate the area under the curve 0.82, in BD 0.79 and 0.77 in RBS.

Keywords: APACHE IV, emergency department, polytraumatized patients, serum lactate

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924 Kinetic Studies on CO₂ Gasification of Low and High Ash Indian Coals in Context of Underground Coal Gasification

Authors: Geeta Kumari, Prabu Vairakannu

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Underground coal gasification (UCG) technology is an efficient and an economic in-situ clean coal technology, which converts unmineable coals into calorific valuable gases. This technology avoids ash disposal, coal mining, and storage problems. CO₂ gas can be a potential gasifying medium for UCG. CO₂ is a greenhouse gas and, the liberation of this gas to the atmosphere from thermal power plant industries leads to global warming. Hence, the capture and reutilization of CO₂ gas are crucial for clean energy production. However, the reactivity of high ash Indian coals with CO₂ needs to be assessed. In the present study, two varieties of Indian coals (low ash and high ash) are used for thermogravimetric analyses (TGA). Two low ash north east Indian coals (LAC) and a typical high ash Indian coal (HAC) are procured from the coal mines of India. Low ash coal with 9% ash (LAC-1) and 4% ash (LAC-2) and high ash coal (HAC) with 42% ash are used for the study. TGA studies are carried out to evaluate the activation energy for pyrolysis and gasification of coal under N₂ and CO₂ atmosphere. Coats and Redfern method is used to estimate the activation energy of coal under different temperature regimes. Volumetric model is assumed for the estimation of the activation energy. The activation energy estimated under different temperature range. The inherent properties of coals play a major role in their reactivity. The results show that the activation energy decreases with the decrease in the inherent percentage of coal ash due to the ash layer hindrance. A reverse trend was observed with volatile matter. High volatile matter of coal leads to the estimation of low activation energy. It was observed that the activation energy under CO₂ atmosphere at 400-600°C is less as compared to N₂ inert atmosphere. At this temperature range, it is estimated that 15-23% reduction in the activation energy under CO₂ atmosphere. This shows the reactivity of CO₂ gas with higher hydrocarbons of the coal volatile matters. The reactivity of CO₂ with the volatile matter of coal might occur through dry reforming reaction in which CO₂ reacts with higher hydrocarbon, aromatics of the tar content. The observed trend of Ea in the temperature range of 150-200˚C and 400-600˚C is HAC > LAC-1 >LAC-2 in both N₂ and CO₂ atmosphere. At the temperature range of 850-1000˚C, higher activation energy is estimated when compared to those values in the temperature range of 400-600°C. Above 800°C, char gasification through Boudouard reaction progressed under CO₂ atmosphere. It was observed that 8-20 kJ/mol of activation energy is increased during char gasification above 800°C compared to volatile matter pyrolysis between the temperature ranges of 400-600°C. The overall activation energy of the coals in the temperature range of 30-1000˚C is higher in N₂ atmosphere than CO₂ atmosphere. It can be concluded that higher hydrocarbons such as tar effectively undergoes cracking and reforming reactions in presence of CO₂. Thus, CO₂ gas is beneficial for the production of high calorific value syngas using high ash Indian coals.

Keywords: clean coal technology, CO₂ gasification, activation energy, underground coal gasification

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923 Using Collaborative Planning to Develop a Guideline for Integrating Biodiversity into Land Use Schemes

Authors: Sagwata A. Manyike, Hulisani Magada

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The South African National Biodiversity Institute is in the process of developing a guideline which sets out how biodiversity can be incorporated into land use (zoning) schemes. South Africa promulgated its Spatial Planning and Land Use Management Act in 2015 and the act seeks, amongst other things, to bridge the gap between spatial planning and land use management within the country. In addition, the act requires local governments to develop wall-to-wall land use schemes for their entire jurisdictions as they had previously only developed them for their urban areas. At the same time, South Africa has a rich history of systematic conservation planning whereby Critical Biodiversity Areas and Ecological Support Areas have been spatially delineated at a scale appropriate for spatial planning and land use management at the scale of local government. South Africa is also in the process of spatially delineating ecological infrastructure which is defined as naturally occurring ecosystems which provide valuable services to people such as water and climate regulation, soil formation, disaster risk reduction, etc. The Biodiversity and Land Use Project, which is funded by the Global Environmental Facility through the United Nations Development Programme is seeking to explore ways in which biodiversity information and ecological infrastructure can be incorporated into the spatial planning and land use management systems of local governments. Towards this end, the Biodiversity and Land Use Project have developed a guideline which sets out how local governments can integrate biodiversity into their land-use schemes as a way of not only ensuring sustainable development but also as a way helping them prepare for climate change. In addition, by incorporating biodiversity into land-use schemes, the project is exploring new ways of protecting biodiversity through land use schemes. The Guideline for Incorporating Biodiversity into Land Use Schemes was developed as a response to the fact that the National Land Use Scheme Guidelines only indicates that local governments needed to incorporate biodiversity without explaining how this could be achieved. The Natioanl Guideline also failed to specify which biodiversity-related layers are compatible with which land uses or what the benefits of incorporating biodiversity into the schemes will be for that local government. The guideline, therefore, sets out an argument for why biodiversity is important in land management processes and proceeds to provide a step by step guideline for how schemes can integrate priority biodiversity layers. This guideline will further be added as an addendum to the National Land Use Guidelines. Although the planning act calls for local government to have wall to wall schemes within 5 years of its enactment, many municipalities will not meet this deadline and so this guideline will support them in the development of their new schemes.

Keywords: biodiversity, climate change, land use schemes, local government

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922 Evaluation of Microbial Accumulation of Household Wastewater Purified by Advanced Oxidation Process

Authors: Nazlı Çetindağ, Pelin Yılmaz Çetiner, Metin Mert İlgün, Emine Birci, Gizemnur Yıldız Uysal, Özcan Hatipoğlu, Ehsan Tuzcuoğlu, Gökhan Sır

Abstract:

Water scarcity is an unavoidable issue impacting an increasing number of individuals daily, representing a global crisis stemming from swift population growth, urbanization, and excessive resource exploitation. Consequently, solutions that involve the reclamation of wastewater are considered essential. In this context, household wastewater, categorized as greywater, plays a significant role in freshwater used for residential purposes and is attributed to washing. This type of wastewater comprises diverse elements, including organic substances, soaps, detergents, solvents, biological components, and inorganic elements such as certain metal ions and particles. The physical characteristics of wastewater vary depending on its source, whether commercial, domestic, or from a hospital setting. Consequently, the treatment strategy for this wastewater type necessitates comprehensive investigation and appropriate handling. The advanced oxidation process (AOP) emerges as a promising technique associated with the generation of reactive hydroxyl radicals highly effective in oxidizing organic pollutants. This method takes precedence over others like coagulation, flocculation, sedimentation, and filtration due to its avoidance of undesirable by-products. In the current study, the focus was on exploring the feasibility of the AOP for treating actual household wastewater. To achieve this, a laboratory-scale device was designed to effectively target the formed radicals toward organic pollutants, resulting in lower organic compounds in wastewater. Then, the number of microorganisms present in treated wastewater, in addition to the chemical content of the water, was analyzed to determine whether the lab-scale device eliminates microbial accumulation with AOP. This was also an important parameter since microbes can indirectly affect human health and machine hygiene. To do this, water samples were taken from treated and untreated conditions and then inoculated on general purpose agar to track down the total plate count. Analysis showed that AOP might be an option to treat household wastewater and lower microorganism growth.

Keywords: usage of household water, advanced oxidation process, water reuse, modelling

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921 Environmental Accounting: A Conceptual Study of Indian Context

Authors: Pradip Kumar Das

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As the entire world continues its rapid move towards industrialization, it has seriously threatened mankind’s ability to maintain an ecological balance. Geographical and natural forces have a significant influence on the location of industries. Industrialization is the foundation stone of the development of any country, while the unplanned industrialization and discharge of waste by industries is the cause of environmental pollution. There is growing degree of awareness and concern globally among nations about environmental degradation or pollution. Environmental resources endowed by the gift of nature and not manmade are invaluable natural resources of a country like India. Any developmental activity is directly related to natural and environmental resources. Economic development without environmental considerations brings about environmental crises and damages the quality of life of present, as well as future generation. As corporate sectors in the global market, especially in India, are becoming anxious about environmental degradation, naturally more and more emphasis will be ascribed to how environment-friendly the outcomes are. Maintaining accounts of such environmental and natural resources in the country has become more urgent. Moreover, international awareness and acceptance of the importance of environmental issues has motivated the development of a branch of accounting called “Environmental Accounting”. Environmental accounting attempts to detect and focus the resources consumed and the costs rendered by an industrial unit to the environment. For the sustainable development of mankind, a healthy environment is indispensable. Gradually, therefore, in many countries including India, environment matters are being given top most priority. Accounting and disclosure of environmental matters have been increasingly manifesting as an important dimension of corporate accounting and reporting practices. But, as conventional accounting deals with mainly non-living things, the formulation of valuation, and measurement and accounting techniques for incorporating environment-related matters in the corporate financial statement sometimes creates problems for the accountant. In the light of this situation, the conceptual analysis of the study is concerned with the rationale of environmental accounting on the economy and society as a whole, and focuses the failures of the traditional accounting system. A modest attempt has been made to throw light on the environmental awareness in developing nations like India and discuss the problems associated with the implementation of environmental accounting. The conceptual study also reflects that despite different anomalies, environmental accounting is becoming an increasing important aspect of the accounting agenda within the corporate sector in India. Lastly, a conclusion, along with recommendations, has been given to overcome the situation.

Keywords: environmental accounting, environmental degradation, environmental management, environmental resources

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920 The Effects of Molecular and Climatic Variability on the Occurrence of Aspergillus Species and Aflatoxin Production in Commercial Maize from Different Agro-climatic Regions in South Africa

Authors: Nji Queenta Ngum, Mwanza Mulunda

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Introduction Most African research reports on the frequent aflatoxin contamination of various foodstuffs, with researchers rarely specifying which of the Aspergillus species are present in these commodities. Numerous research works provide evidence of the ability of fungi to grow, thrive, and interact with other crop species and focus on the fact that these processes are largely affected by climatic variables. South Africa is a water-stressed country with high spatio-temporal rainfall variability; moreover, temperatures have been projected to rise at a rate twice the global rate. This weather pattern change may lead to crop stress encouraging mold contamination with subsequent mycotoxin production. In this study, the biodiversity and distribution of Aspergillus species with their corresponding toxins in maize from six distinct maize producing regions with different weather patterns in South Africa were investigated. Materials And Methods By applying cultural and molecular methods, a total of 1028 maize samples from six distinct agro-climatic regions were examined for contamination by the Aspergillus species while the high performance liquid chromatography (HPLC) method was applied to analyse the level of contamination by aflatoxins. Results About 30% of the overall maize samples were contaminated by at least one Aspergillus species. Less than 30% (28.95%) of the 228 isolates subjected to the aflatoxigenic test was found to possess at least one of the aflatoxin biosynthetic genes. Furthermore, almost 20% were found to be contaminated with aflatoxins, with mean total aflatoxin concentration levels of 64.17 ppb. Amongst the contaminated samples, 59.02% had mean total aflatoxin concentration levels above the SA regulatory limit of 20ppb for animals and 10 for human consumption. Conclusion In this study, climate variables (rainfall reduction) were found to significantly (p<0.001) influence the occurrence of the Aspergillus species (especially Aspergillus fumigatus) and the production of aflatoxin in South Africa commercial maize by maize variety, year of cultivation as well as the agro-climatic region in which the maize is cultivated. This included, amongst others, a reduction in the average annual rainfall of the preceding year to about 21.27 mm, and, as opposed to other regions whose average maximum rainfall ranged between 37.24 – 44.1 mm, resulted in a significant increase in the aflatoxin contamination of maize.

Keywords: aspergillus species, aflatoxins, diversity, drought, food safety, HPLC and PCR techniques

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919 Durability of Functionally Graded Concrete

Authors: Prasanna Kumar Acharya, Mausam Kumari Yadav

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Cement concrete has emerged as the most consumed construction material. It has also dominated all other construction materials because of its versatility. Apart from numerous advantages it has a disadvantage concerning durability. The large structures constructed with cement concrete involving the consumption of huge natural materials remain in serviceable condition for 5 – 7 decades only while structures made with stones stand for many centuries. The short life span of structures not only affects the economy but also affects the ecology greatly. As such, the improvement of durability of cement concrete is a global concern and scientists around the globe are trying for this purpose. Functionally graded concrete (FGC) is an exciting development. In contrast to conventional concrete, FGC demonstrates different characteristics depending on its thickness, which enables it to conform to particular structural specifications. The purpose of FGC is to improve the performance and longevity of conventional concrete structures with cutting-edge building materials. By carefully distributing various kinds and amounts of reinforcements, additives, mix designs and/or aggregates throughout the concrete matrix, this variety is produced. A key component of functionally graded concrete's performance is its durability, which affects the material's capacity to tolerate aggressive environmental influences and load-bearing circumstances. This paper reports the durability of FGC made using Portland slag cement (PSC). For this purpose, control concretes (CC) of M20, M30 and M40 grades were designed. Single-layered samples were prepared using each grade of concrete. Further using combinations of M20 + M30, M30 + M40 and M40 + M20, doubled layered concrete samples in a depth ratio of 1:1 was prepared those are herein called FGC samples. The efficiency of FGC samples was compared with that of the higher-grade concrete of parent materials in terms of compressive strength, water absorption, sorptivity, acid resistance, sulphate resistance, chloride resistance and abrasion resistance. The properties were checked at the age of 28 and 91 days. Apart from strength and durability parameters, the microstructure of CC and FGC were studied in terms of X-ray diffraction, scanning electron microscopy and energy-dispersive X-ray. The result of the study revealed that there is an increase in the efficiency of concrete evaluated in terms of strength and durability when it is made functionally graded using a layered technology having different grades of concrete in layers. The results may help to enhance the efficiency of structural concrete and its durability.

Keywords: fresh on compacted, functionally graded concrete, acid, chloride, sulphate test, sorptivity, abrasion, water absorption test

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918 Six Years Antimicrobial Resistance Trends among Bacterial Isolates in Amhara National Regional State, Ethiopia

Authors: Asrat Agalu Abejew

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Background: Antimicrobial resistance (AMR) is a silent tsunami and one of the top global threats to health care and public health. It is one of the common agendas globally and in Ethiopia. Emerging AMR will be a double burden to Ethiopia, which is facing a series of problems from infectious disease morbidity and mortality. In Ethiopia, although there are attempts to document AMR in healthcare institutions, comprehensive and all-inclusive analysis is still lacking. Thus, this study is aimed to determine trends in AMR from 2016-2021. Methods: A retrospective analysis of secondary data recorded in the Amhara Public Health Institute (APHI) from 2016 to 2021 G.C was conducted. Blood, Urine, Stool, Swabs, Discharge, body effusions, and other Microbiological specimens were collected from each study participants, and Bacteria identification and Resistance tests were done using the standard microbiologic procedure. Data was extracted from excel in August 2022, Trends in AMR were analyzed, and the results were described. In addition, the chi-square (X2) test and binary logistic regression were used, and a P. value < 0.05 was used to determine a significant association. Results: During 6 years period, there were 25143 culture and susceptibility tests. Overall, 265 (46.2%) bacteria were resistant to 2-4 antibiotics, 253 (44.2%) to 5-7 antibiotics, and 56 (9.7%) to >=8 antibiotics. The gram-negative bacteria were 166 (43.9%), 155 (41.5%), and 55 (14.6%) resistant to 2-4, 5-7, and ≥8 antibiotics, respectively, whereas 99(50.8%), 96(49.2% and 1 (0.5%) of gram-positive bacteria were resistant to 2-4, 5-7 and ≥8 antibiotics respectively. K. pneumonia 3783 (15.67%) and E. coli 3199 (13.25%) were the most commonly isolated bacteria, and the overall prevalence of AMR was 2605 (59.9%), where K. pneumonia 743 (80.24%), E. cloacae 196 (74.81%), A. baumannii 213 (66.56%) being the most common resistant bacteria for antibiotics tested. Except for a slight decline during 2020 (6469 (25.4%)), the overall trend of AMR is rising from year to year, with a peak in 2019 (8480 (33.7%)) and in 2021 (7508 (29.9%). If left un-intervened, the trend in AMR will increase by 78% of variation from the study period, as explained by the differences in years (R2=0.7799). Ampicillin, Augmentin, ciprofloxacin, cotrimoxazole, tetracycline, and Tobramycin were almost resistant to common bacteria they were tested. Conclusion: AMR is linearly increasing during the last 6 years. If left as it is without appropriate intervention after 15 years (2030 E.C), AMR will increase by 338.7%. A growing number of multi-drug resistant bacteria is an alarm to awake policymakers and those who do have the concern to intervene before it is too late. This calls for a periodic, integrated, and continuous system to determine the prevalence of AMR in commonly used antibiotics.

Keywords: AMR, trend, pattern, MDR

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917 Comparative Analysis of the Impact of Urbanization on Land Surface Temperature in the United Arab Emirates

Authors: A. O. Abulibdeh

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The aim of this study is to investigate and compare the changes in the Land Surface Temperature (LST) as a function of urbanization, particularly land use/land cover changes, in three cities in the UAE, mainly Abu Dhabi, Dubai, and Al Ain. The scale of this assessment will be at the macro- and micro-levels. At the macro-level, a comparative assessment will take place to compare between the four cities in the UAE. At the micro-level, the study will compare between the effects of different land use/land cover on the LST. This will provide a clear and quantitative city-specific information related to the relationship between urbanization and local spatial intra-urban LST variation in three cities in the UAE. The main objectives of this study are 1) to investigate the development of LST on the macro- and micro-level between and in three cities in the UAE over two decades time period, 2) to examine the impact of different types of land use/land cover on the spatial distribution of LST. Because these three cities are facing harsh arid climate, it is hypothesized that (1) urbanization is affecting and connected to the spatial changes in LST; (2) different land use/land cover have different impact on the LST; and (3) changes in spatial configuration of land use and vegetation concentration over time would control urban microclimate on a city scale and control macroclimate on the country scale. This study will be carried out over a 20-year period (1996-2016) and throughout the whole year. The study will compare between two distinct periods with different thermal characteristics which are the cool/cold period from November to March and warm/hot period between April and October. The best practice research method for this topic is to use remote sensing data to target different aspects of natural and anthropogenic systems impacts. The project will follow classical remote sensing and mapping techniques to investigate the impact of urbanization, mainly changes in land use/land cover, on LST. The investigation in this study will be performed in two stages. Stage one remote sensing data will be used to investigate the impact of urbanization on LST on a macroclimate level where the LST and Urban Heat Island (UHI) will be compared in the three cities using data from the past two decades. Stage two will investigate the impact on microclimate scale by investigating the LST and UHI using a particular land use/land cover type. In both stages, an LST and urban land cover maps will be generated over the study area. The outcome of this study should represent an important contribution to recent urban climate studies, particularly in the UAE. Based on the aim and objectives of this study, the expected outcomes are as follow: i) to determine the increase or decrease of LST as a result of urbanization in these four cities, ii) to determine the effect of different land uses/land covers on increasing or decreasing the LST.

Keywords: land use/land cover, global warming, land surface temperature, remote sensing

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916 Integrated Human Resources and Work Environment Management System

Authors: Loreta Kaklauskiene, Arturas Kaklauskas

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The Integrated Human Resources and Work Environment Management (HOWE) System optimises employee productivity, improves the work environment, and, at the same time, meets the employer’s strategic goals. The HOWE system has been designed to ensure an organisation can successfully compete in the global market, thanks to the high performance of its employees. The HOWE system focuses on raising workforce productivity and improving work conditions to boost employee performance and motivation. The methods used in our research are linear correlation, INVAR multiple criteria analysis, digital twin, and affective computing. The HOWE system is based on two patents issued in Lithuania (LT 6866, LT 6841) and one European Patent application (No: EP 4 020 134 A1). Our research analyses ways to make human resource management more efficient and boost labour productivity by improving and adapting a personalised work environment. The efficiency of human capital and labour productivity can be increased by applying personalised workplace improvement systems that can optimise lighting colours and intensity, scents, data, information, knowledge, activities, media, games, videos, music, air pollution, humidity, temperature, vibrations, and other workplace aspects. HOWE generates and maintains a personalised workspace for an employee, taking into account the person’s affective, physiological and emotional (APSE) states. The purpose of this project was to create a HOWE for the customisation of quality control in smart workspaces taking into account the user’s APSE states in an integrated manner as a single unit. This customised management of quality control covers the levels of lighting and colour intensities, scents, media, information, activities, learning materials, games, music, videos, temperature, energy efficiency, the carbon footprint of a workspace, humidity, air pollution, vibrations and other aspects of smart spaces. The system is based on Digital Twins technology, seen as a logical extension of BIM.

Keywords: human resource management, health economics, work environment, organizational behaviour and employee productivity, prosperity in work, smart system

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915 Uncertainty Quantification of Fuel Compositions on Premixed Bio-Syngas Combustion at High-Pressure

Authors: Kai Zhang, Xi Jiang

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Effect of fuel variabilities on premixed combustion of bio-syngas mixtures is of great importance in bio-syngas utilisation. The uncertainties of concentrations of fuel constituents such as H2, CO and CH4 may lead to unpredictable combustion performances, combustion instabilities and hot spots which may deteriorate and damage the combustion hardware. Numerical modelling and simulations can assist in understanding the behaviour of bio-syngas combustion with pre-defined species concentrations, while the evaluation of variabilities of concentrations is expensive. To be more specific, questions such as ‘what is the burning velocity of bio-syngas at specific equivalence ratio?’ have been answered either experimentally or numerically, while questions such as ‘what is the likelihood of burning velocity when precise concentrations of bio-syngas compositions are unknown, but the concentration ranges are pre-described?’ have not yet been answered. Uncertainty quantification (UQ) methods can be used to tackle such questions and assess the effects of fuel compositions. An efficient probabilistic UQ method based on Polynomial Chaos Expansion (PCE) techniques is employed in this study. The method relies on representing random variables (combustion performances) with orthogonal polynomials such as Legendre or Gaussian polynomials. The constructed PCE via Galerkin Projection provides easy access to global sensitivities such as main, joint and total Sobol indices. In this study, impacts of fuel compositions on combustion (adiabatic flame temperature and laminar flame speed) of bio-syngas fuel mixtures are presented invoking this PCE technique at several equivalence ratios. High-pressure effects on bio-syngas combustion instability are obtained using detailed chemical mechanism - the San Diego Mechanism. Guidance on reducing combustion instability from upstream biomass gasification process is provided by quantifying the significant contributions of composition variations to variance of physicochemical properties of bio-syngas combustion. It was found that flame speed is very sensitive to hydrogen variability in bio-syngas, and reducing hydrogen uncertainty from upstream biomass gasification processes can greatly reduce bio-syngas combustion instability. Variation of methane concentration, although thought to be important, has limited impacts on laminar flame instabilities especially for lean combustion. Further studies on the UQ of percentage concentration of hydrogen in bio-syngas can be conducted to guide the safer use of bio-syngas.

Keywords: bio-syngas combustion, clean energy utilisation, fuel variability, PCE, targeted uncertainty reduction, uncertainty quantification

Procedia PDF Downloads 277
914 Institutional Legitimacy and Professional Boundary: Western Medicine-Trained Doctors' Attitudes and Behaviors toward Traditional Chinese Medicine

Authors: Xiaoli Tian

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The recent growing interest in and use of complementary and alternative medicine is a global phenomenon. In many regions, traditional Chinese medicine (TCM), an important type of complementary and alternative medicine, has been formally integrated into the healthcare system. Consequently, today’s doctors face increasing requests and questions from patients regarding TCM. However, studies of TCM focus either on patients’ approaches to TCM and Western medicine (WM) or on the politics involved in the institutionalization of TCM. To our knowledge, sociological studies on doctors’ attitudes toward TCM are rare. This paper compares the receptivity of WM-trained Chinese doctors to TCM in Hong Kong and mainland China, in order to evaluate the interplay between professional training and dominant medical paradigms, on the one hand, and institutional legitimacy and government and client pressures to accept TCM, on the other. Based on survey and in-depth interviews with Western-medicine doctors in Hong Kong and mainland China, this research finds that: there is major difference between Western-medicine doctors’ attitude toward traditional Chinese medicine (TCM) in Hong Kong and mainland China. Doctors in Hong Kong are still suspicious toward TCM, no matter if they have exposure to TCM or not. Even some doctors who have much knowledge about TCM, such as got a diploma or certificate in TCM or tried TCM themselves, are still suspicious. This is because they hold up to the ideal of 'evidence-based medicine' and emphasize the kind of evidence based on randomized controlled trial (RCT). To Western medicine doctors in Hong Kong, this is the most reliable type of evidence for any medical practice, but it is lacking in TCM. This is the major reason why they do not trust TCM and would not refer patients to TCM in clinical practices. In contrast, western medicine doctors in mainland China also know about randomized controlled trial (RCT) and believe that’s the most reliable evidence, but they tend to think experience-based evidence is also reliable. On this basis, they think TCM also has clinical effectiveness. Research findings reveal that legitimacy based on institutional arrangements is a relevant factor, but how doctors understand their professional boundaries also play an important role. Doctors in Hong Kong are more serious about a strict professional boundary between Western medicine and TCM because they benefited from it, such as a very prestigious status and high income. Doctors in mainland China tend to be flexible about professional boundaries because they never benefited from a well-defined strict professional boundary. This is related to a long history of the lack of professionalism in China but is also aggravated by the increasing state support of TCM.

Keywords: evidence-based decision-making, institutional legitimacy, professional behavior, traditional Chinese medicine

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913 Construction Noise Control: Hong Kong Reviews International Best Practices

Authors: Morgan Cheng, Wilson Ho, Max Yiu, Dragon Tsui, Wylog Wong, Richard Kwan, K. C. Lam, Hannah Lo, C. L. Wong

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Hong Kong has been known worldwide for its ability to thrive under trying circumstances. The 7.5 million residents of this mature and busy metropolis are living in a primarily high-rise city whereby development and renewal of the cityscape are taking place unceasingly. Hong Kong residents are therefore affected by the virtually continuous and numerous construction activities. In 2020, the Hong Kong environmental protection department (EPD) completed a feasibility study on managing construction noise, including those associated with the renovation of domestic premises. Part of the study was the review of management and control of construction noise in other metropolitan cities globally. As far as the authors are aware of, such worldwide and extensive review of best practices on construction noise control has not been conducted for over 20 years. In order to benefit from international best practices, the extensive review is to identify possible areas for improvement in Hong Kong. The consultant of the study first referred to the United Nations Report ‘The World’s Cities in 2016’ and examined the top 100 cities therein. The 20 most suitable cities were then chosen for further review. Upon screening of each of these 20 cities, 12 cities with the more relevant management practices were selected for further scrutiny. These 12 cities were: Asia – Tokyo, Seoul, Taipei, Guangzhou, Singapore; Europe – City of Westminster (London), Berlin; North America – Toronto, New York City, San Francisco; Oceania – Sydney, Melbourne. Afterwards, three cities, namely Sydney, City of Westminster, and New York City, were selected for in-depth review. These cities were chosen primarily because of the maturity, success, and effectiveness of their construction noise management and control measures, as well as their similarity to Hong Kong in key and selected aspects. One of the more important findings of the review is the usefulness of early focus, with the aim of designing the noise issues away wherever practicable. The consultant examined the similar yet different construction noise early focus mechanisms of the three cities. This paper describes this landmark worldwide and extensive review of international best practices on construction noise management and control. The methodology, approach, and key findings are presented to give readers a succinct yet comprehensive view. The authors shared the findings with the acoustics professionals worldwide with the hope of global advancement of more mature construction noise management while welcoming sustainable development and construction.

Keywords: construction noise, international best practices, noise control, noise management

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912 Souk Waqif in Old Doha, Qatar: Cultural Heritage, Urban Regeneration, and Sustainability

Authors: Djamel Boussaa

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Cultural heritage and tourism have become during the last two decades dynamic areas of development in the world. The idea of heritage is crucial to the critical decision-making process as to how irreplaceable resources are to be utilized by people of the present or conserved for future generations in a fast changing world. In view of the importance of ‘heritage’ to the development of a tourist destination the emphasis on developing appropriate adaptive reuse strategies cannot be overemphasized. In October 1999, the 12th general assembly of the ICOMOS in Mexico stated, that in the context of sustainable development, two interrelated issues need urgent attention, cultural tourism and historic towns and cities. These two issues underscore the fact that historic resources are non-renewable, belonging to all of humanity. Without adequate adaptive reuse actions to ensure a sustainable future for these historic resources, may lead to their complete vanishing. The growth of tourism and its role in dispersing cultural heritage to everyone is developing rapidly. According to the World Tourism Organization, natural and cultural heritage resources are and will remain motivating factors for travel in the foreseeable future. According to the experts, people choose travel destinations where they can learn about traditional and distinct cultures in their historic context. The Qatar rich urban heritage is now being recognized as a valuable resource for future development. This paper discusses the role of cultural heritage and tourism in regenerating Souk Waqif, and consequently the city of Doha. Therefore, in order to use cultural heritage wisely, it will be necessary to position heritage as an essential element of sustainable development, giving particular attention to cultural heritage and tourism. The research methodology is based on an empirical survey of the situation, based on several visits, meetings and interviews with the local heritage players. The rehabilitation project initiated since 2004 will be examined and assessed. Therefore, there is potential to assess the situation and propose directions for a sustainable future to this historic landmark. Conservation for the sake of conservation appears to be an outdated concept. Many irreplaceable natural and cultural sites are being compromised because local authorities are not giving economic consideration to the value of rehabilitating such sites. The question to be raised here is 'How can cultural heritage be used wisely for tourism without compromising its social sustainability within the emerging global world?'

Keywords: cultural heritage, tourism, regeneration, economy, social sustainability

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911 Management of Urinary Tract Infections by Nurse Practitioners in a Canadian Pediatric Emergency Department: A Rretrospective Cohort Study

Authors: T. Mcgraw, F. N. Morin, N. Desai

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Background: Antimicrobial resistance is a critical issue in global health care and a significant contributor to increased patient morbidity and mortality. Suspected urinary tract infection (UTI) is a key area of inappropriate antibiotic prescription in pediatrics. Management patterns of infectious diseases have been shown to vary by provider type within a single setting. The aim of this study was to assess compliance with national UTI management guidelines by nurse practitioners in a pediatric emergency department (ED). Methods: This was a post-hoc analysis of a retrospective cohort study to review and evaluate visits to a tertiary care freestanding pediatric emergency department. Patients were included if they were 60 days to 36 months old and discharged with a diagnosis of UTI or ‘rule-out UTI’ between July 2015 and July 2020. Primary outcome measure was proportion of visits seen by Nurse Practitioners (NP) which were associated with national guideline compliance in the diagnosis and treatment of suspected UTI. We performed descriptive statistics and comparative analyses to determine differences in practice patterns between NPs, and physicians. Results: A total of 636 charts were reviewed, of which 402 patients met inclusion criteria. 17 patients were treated by NPs, 385 were treated by either Pediatric Emergency Medicine physicians (PEM) or non-PEM physicians. Overall, the proportion of infants receiving guideline-compliant care was 25.9% (21.8-30.4%). Of those who were prescribed antibiotics, 79.6% (74.7-83.8%) received first line guideline recommended therapy and 58.9% (53.8-63.8%) received fully compliant therapy with respect to age, dose, duration, and frequency. In patients treated by NPs, 16/17 (94%(95% CI:73.0-99.0)) required antibiotics, 15/16 (93%(95% CI: 71.7-98.9)) were treated with first line agent (cephalexin), 8/16 (50%(95% CI:28-72)) were guideline compliant of dose and duration. 5/8 (63%(95% CI:30.6-86.3)) were noncompliant for dose being too high. There was no difference in receiving guideline compliant empiric antibiotic therapy between physicians and nurse practitioners (OR: 0.837 CI: 0.302-2.69). Conclusion: In this post-hoc analysis, guideline noncompliance by nurse practitioners is common in children tested and treated for UTIs in a pediatric emergency department. Care by a Nurse Practitioner was not associated with greater rate of noncompliance than care by a Pediatric Emergency Medicine physician. Future appropriately powered studies may focus on confirming these results.

Keywords: antibiotic stewardship, infectious disease, nurse practitioner, urinary tract infection

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910 Shoreline Variation with Construction of a Pair of Training Walls, Ponnani Inlet, Kerala, India

Authors: Jhoga Parth, T. Nasar, K. V. Anand

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An idealized definition of shoreline is that it is the zone of coincidence of three spheres such as atmosphere, lithosphere, and hydrosphere. Despite its apparent simplicity, this definition in practice a challenge to apply. In reality, the shoreline location deviates continually through time, because of various dynamic factors such as wave characteristics, currents, coastal orientation and the bathymetry, which makes the shoreline volatile. This necessitates us to monitor the shoreline in a temporal basis. If shoreline’s nature is understood at particular coastal stretch, it need not be the same trend at the other location, though belonging to the same sea front. Shoreline change is hence a local phenomenon and has to be studied with great intensity considering as many factors involved as possible. Erosion and accretion of sediment are such natures of a shoreline, which needs to be quantified by comparing with its predeceasing variations and understood before implementing any coastal projects. In recent years, advent of Global Positioning System (GPS) and Geographic Information System (GIS) acts as an emerging tool to quantify the intra and inter annual sediment rate getting accreted or deposited compared to other conventional methods in regards with time was taken and man power. Remote sensing data, on the other hand, paves way to acquire historical sets of data where field data is unavailable with a higher resolution. Short term and long term period shoreline change can be accurately tracked and monitored using a software residing in GIS - Digital Shoreline Analysis System (DSAS) developed by United States Geological Survey (USGS). In the present study, using DSAS, End Point Rate (EPR) is calculated analyze the intra-annual changes, and Linear Rate Regression (LRR) is adopted to study inter annual changes of shoreline. The shoreline changes are quantified for the scenario during the construction of breakwater in Ponnani river inlet along Kerala coast, India. Ponnani is a major fishing and landing center located 10°47’12.81”N and 75°54’38.62”E in Malappuram district of Kerala, India. The rate of erosion and accretion is explored using satellite and field data. The full paper contains the rate of change of shoreline, and its analysis would provide us understanding the behavior of the inlet at the study area during the construction of the training walls.

Keywords: DSAS, end point rate, field measurements, geo-informatics, shoreline variation

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909 Ethnic Xenophobia as Symbolic Politics: An Explanation of Anti-Migrant Activity from Brussels to Beirut

Authors: Annamarie Rannou, Horace Bartilow

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Global concerns about xenophobic activity are on the rise across developed and developing countries. And yet, social science scholarship has almost exclusively examined xenophobia as a prejudice of advanced western nations. This research argues that the fields of study related to xenophobia must be re-conceptualized within a framework of ethnicity in order to level the playing field for cross-regional inquiry. This study develops a new concept of ethnic xenophobia and integrates existing explanations of anti-migrant expression into theories of ethnic threat. We argue specifically that political elites convert economic, political, and social threats at the national level into ethnic xenophobic activity in order to gain or maintain political advantage among their native selectorate. We expand on Stuart Kaufman’s theory of symbolic politics to underscore the methods of mobilization used against migrants and the power of elite discourse in moments of national crises. An original dataset is used to examine over 35,000 cases of ethnic xenophobic activity targeting refugees. Wordscores software is used to develop a unique measure of anti-migrant elite rhetoric which captures the symbolic discourse of elites in their mobilization of ethnic xenophobic activism. We use a Structural Equation Model (SEM) to test the causal pathways of the theory across seventy-two developed and developing countries from 1990 to 2016. A framework of Most Different Systems Design (MDSD) is also applied to two pairs of developed-developing country cases, including Kenya and the Netherlands and Lebanon and the United States. This study sheds tremendous light on an underrepresented area of comparative research in migration studies. It shows that the causal elements of anti-migrant activity are far more similar than existing research suggests which has major implications for policy makers, practitioners, and academics in fields of migration protection and advocacy. It speaks directly to the mobilization of myths surrounding refugees, in particular, and the nationalization of narratives of migration that may be neutralized by the development of deeper associational relationships between natives and migrants.

Keywords: refugees, ethnicity, symbolic politics, elites, migration, comparative politics

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908 Assessing Building Rooftop Potential for Solar Photovoltaic Energy and Rainwater Harvesting: A Sustainable Urban Plan for Atlantis, Western Cape

Authors: Adedayo Adeleke, Dineo Pule

Abstract:

The ongoing load-shedding in most parts of South Africa, combined with climate change causing severe drought conditions in Cape Town, has left electricity consumers seeking alternative sources of power and water. Solar energy, which is abundant in most parts of South Africa and is regarded as a clean and renewable source of energy, allows for the generation of electricity via solar photovoltaic systems. Rainwater harvesting is the collection and storage of rainwater from building rooftops, allowing people without access to water to collect it. The lack of dependable energy and water source must be addressed by shifting to solar energy via solar photovoltaic systems and rainwater harvesting. Before this can be done, the potential of building rooftops must be assessed to determine whether solar energy and rainwater harvesting will be able to meet or significantly contribute to Atlantis industrial areas' electricity and water demands. This research project presents methods and approaches for automatically extracting building rooftops in Atlantis industrial areas and evaluating their potential for solar photovoltaics and rainwater harvesting systems using Light Detection and Ranging (LiDAR) data and aerial imagery. The four objectives were to: (1) identify an optimal method of extracting building rooftops from aerial imagery and LiDAR data; (2) identify a suitable solar radiation model that can provide a global solar radiation estimate of the study area; (3) estimate solar photovoltaic potential overbuilding rooftop; and (4) estimate the amount of rainwater that can be harvested from the building rooftop in the study area. Mapflow, a plugin found in Quantum Geographic Information System(GIS) was used to automatically extract building rooftops using aerial imagery. The mean annual rainfall in Cape Town was obtained from a 29-year rainfall period (1991- 2020) and used to calculate the amount of rainwater that can be harvested from building rooftops. The potential for rainwater harvesting and solar photovoltaic systems was assessed, and it can be concluded that there is potential for these systems but only to supplement the existing resource supply and offer relief in times of drought and load-shedding.

Keywords: roof potential, rainwater harvesting, urban plan, roof extraction

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907 Estimates of Freshwater Content from ICESat-2 Derived Dynamic Ocean Topography

Authors: Adan Valdez, Shawn Gallaher, James Morison, Jordan Aragon

Abstract:

Global climate change has impacted atmospheric temperatures contributing to rising sea levels, decreasing sea ice, and increased freshening of high latitude oceans. This freshening has contributed to increased stratification inhibiting local mixing and nutrient transport and modifying regional circulations in polar oceans. In recent years, the Western Arctic has seen an increase in freshwater volume at an average rate of 397+-116 km3/year. The majority of the freshwater volume resides in the Beaufort Gyre surface lens driven by anticyclonic wind forcing, sea ice melt, and Arctic river runoff. The total climatological freshwater content is typically defined as water fresher than 34.8. The near-isothermal nature of Arctic seawater and non-linearities in the equation of state for near-freezing waters result in a salinity driven pycnocline as opposed to the temperature driven density structure seen in the lower latitudes. In this study, we investigate the relationship between freshwater content and remotely sensed dynamic ocean topography (DOT). In-situ measurements of freshwater content are useful in providing information on the freshening rate of the Beaufort Gyre; however, their collection is costly and time consuming. NASA’s Advanced Topographic Laser Altimeter System (ATLAS) derived dynamic ocean topography (DOT), and Air Expendable CTD (AXCTD) derived Freshwater Content are used to develop a linear regression model. In-situ data for the regression model is collected across the 150° West meridian, which typically defines the centerline of the Beaufort Gyre. Two freshwater content models are determined by integrating the freshwater volume between the surface and an isopycnal corresponding to reference salinities of 28.7 and 34.8. These salinities correspond to those of the winter pycnocline and total climatological freshwater content, respectively. Using each model, we determine the strength of the linear relationship between freshwater content and satellite derived DOT. The result of this modeling study could provide a future predictive capability of freshwater volume changes in the Beaufort-Chukchi Sea using non in-situ methods. Successful employment of the ICESat-2’s DOT approximation of freshwater content could potentially reduce reliance on field deployment platforms to characterize physical ocean properties.

Keywords: ICESat-2, dynamic ocean topography, freshwater content, beaufort gyre

Procedia PDF Downloads 88