Search results for: healthcare technologies
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4902

Search results for: healthcare technologies

492 Criminal Law and Internet of Things: Challenges and Threats

Authors: Celina Nowak

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The development of information and communication technologies (ICT) and a consequent growth of cyberspace have become a reality of modern societies. The newest addition to this complex structure has been Internet of Things which is due to the appearance of smart devices. IoT creates a new dimension of the network, as the communication is no longer the domain of just humans, but has also become possible between devices themselves. The possibility of communication between devices, devoid of human intervention and real-time supervision, generated new societal and legal challenges. Some of them may and certainly will eventually be connected to criminal law. Legislators both on national and international level have been struggling to cope with this technologically evolving environment in order to address new threats created by the ICT. There are legal instruments on cybercrime, however imperfect and not of universal scope, sometimes referring to specific types of prohibited behaviors undertaken by criminals, such as money laundering, sex offences. However, the criminal law seems largely not prepared to the challenges which may arise because of the development of IoT. This is largely due to the fact that criminal law, both on national and international level, is still based on the concept of perpetration of an offence by a human being. This is a traditional approach, historically and factually justified. Over time, some legal systems have developed or accepted the possibility of commission of an offence by a corporation, a legal person. This is in fact a legal fiction, as a legal person cannot commit an offence as such, it needs humans to actually behave in a certain way on its behalf. Yet, the legislators have come to understand that corporations have their own interests and may benefit from crime – and therefore need to be penalized. This realization however has not been welcome by all states and still give rise to doubts of ontological and theoretical nature in many legal systems. For this reason, in many legislations the liability of legal persons for commission of an offence has not been recognized as criminal responsibility. With the technological progress and the growing use of IoT the discussions referring to criminal responsibility of corporations seem rather inadequate. The world is now facing new challenges and new threats related to the ‘smart’ things. They will have to be eventually addressed by legislators if they want to, as they should, to keep up with the pace of technological and societal evolution. This will however require a reevaluation and possibly restructuring of the most fundamental notions of modern criminal law, such as perpetration, guilt, participation in crime. It remains unclear at this point what norms and legal concepts will be and may be established. The main goal of the research is to point out to the challenges ahead of the national and international legislators in the said context and to attempt to formulate some indications as to the directions of changes, having in mind serious threats related to privacy and security related to the use of IoT.

Keywords: criminal law, internet of things, privacy, security threats

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491 Virtual Team Performance: A Transactive Memory System Perspective

Authors: Belbaly Nassim

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Virtual teams (VT) initiatives, in which teams are geographically dispersed and communicate via modern computer-driven technologies, have attracted increasing attention from researchers and professionals. The growing need to examine how to balance and optimize VT is particularly important given the exposure experienced by companies when their employees encounter globalization and decentralization pressures to monitor VT performance. Hence, organization is regularly limited due to misalignment between the behavioral capabilities of the team’s dispersed competences and knowledge capabilities and how trust issues interplay and influence these VT dimensions and the effects of such exchanges. In fact, the future success of business depends on the extent to which VTs are managing efficiently their dispersed expertise, skills and knowledge to stimulate VT creativity. Transactive memory system (TMS) may enhance VT creativity using its three dimensons: knowledge specialization, credibility and knowledge coordination. TMS can be understood as a composition of both a structural component residing of individual knowledge and a set of communication processes among individuals. The individual knowledge is shared while being retrieved, applied and the learning is coordinated. TMS is driven by the central concept that the system is built on the distinction between internal and external memory encoding. A VT learns something new and catalogs it in memory for future retrieval and use. TMS uses the role of information technology to explain VT behaviors by offering VT members the possibility to encode, store, and retrieve information. TMS considers the members of a team as a processing system in which the location of expertise both enhances knowledge coordination and builds trust among members over time. We build on TMS dimensions to hypothesize the effects of specialization, coordination, and credibility on VT creativity. In fact, VTs consist of dispersed expertise, skills and knowledge that can positively enhance coordination and collaboration. Ultimately, this team composition may lead to recognition of both who has expertise and where that expertise is located; over time, the team composition may also build trust among VT members over time developing the ability to coordinate their knowledge which can stimulate creativity. We also assess the reciprocal relationship between TMS dimensions and VT creativity. We wish to use TMS to provide researchers with a theoretically driven model that is empirically validated through survey evidence. We propose that TMS provides a new way to enhance and balance VT creativity. This study also provides researchers insight into the use of TMS to influence positively VT creativity. In addition to our research contributions, we provide several managerial insights into how TMS components can be used to increase performance within dispersed VTs.

Keywords: virtual team creativity, transactive memory systems, specialization, credibility, coordination

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490 Study of Biofouling Wastewater Treatment Technology

Authors: Sangho Park, Mansoo Kim, Kyujung Chae, Junhyuk Yang

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The International Maritime Organization (IMO) recognized the problem of invasive species invasion and adopted the "International Convention for the Control and Management of Ships' Ballast Water and Sediments" in 2004, which came into force on September 8, 2017. In 2011, the IMO approved the "Guidelines for the Control and Management of Ships' Biofouling to Minimize the Transfer of Invasive Aquatic Species" to minimize the movement of invasive species by hull-attached organisms and required ships to manage the organisms attached to their hulls. Invasive species enter new environments through ships' ballast water and hull attachment. However, several obstacles to implementing these guidelines have been identified, including a lack of underwater cleaning equipment, regulations on underwater cleaning activities in ports, and difficulty accessing crevices in underwater areas. The shipping industry, which is the party responsible for understanding these guidelines, wants to implement them for fuel cost savings resulting from the removal of organisms attached to the hull, but they anticipate significant difficulties in implementing the guidelines due to the obstacles mentioned above. Robots or people remove the organisms attached to the hull underwater, and the resulting wastewater includes various species of organisms and particles of paint and other pollutants. Currently, there is no technology available to sterilize the organisms in the wastewater or stabilize the heavy metals in the paint particles. In this study, we aim to analyze the characteristics of the wastewater generated from the removal of hull-attached organisms and select the optimal treatment technology. The organisms in the wastewater generated from the removal of the attached organisms meet the biological treatment standard (D-2) using the sterilization technology applied in the ships' ballast water treatment system. The heavy metals and other pollutants in the paint particles generated during removal are treated using stabilization technologies such as thermal decomposition. The wastewater generated is treated using a two-step process: 1) development of sterilization technology through pretreatment filtration equipment and electrolytic sterilization treatment and 2) development of technology for removing particle pollutants such as heavy metals and dissolved inorganic substances. Through this study, we will develop a biological removal technology and an environmentally friendly processing system for the waste generated after removal that meets the requirements of the government and the shipping industry and lays the groundwork for future treatment standards.

Keywords: biofouling, ballast water treatment system, filtration, sterilization, wastewater

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489 Integration of Technology into Nursing Education: A Collaboration between College of Nursing and University Research Center

Authors: Lori Lioce, Gary Maddux, Norven Goddard, Ishella Fogle, Bernard Schroer

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This paper presents the integration of technologies into nursing education. The collaborative effort includes the College of Nursing (CoN) at the University of Alabama in Huntsville (UAH) and the UAH Systems Management and Production Center (SMAP). The faculty at the CoN conducts needs assessments to identify education and training requirements. A team of CoN faculty and SMAP engineers then prioritize these requirements and establish improvement/development teams. The development teams consist of nurses to evaluate the models and to provide feedback and of undergraduate engineering students and their senior staff mentors from SMAP. The SMAP engineering staff develops and creates the physical models using 3D printing, silicone molds and specialized molding mixtures and techniques. The collaboration has focused on developing teaching and training, or clinical, simulators. In addition, the onset of the Covid-19 pandemic has intensified this relationship, as 3D modeling shifted to supplied personal protection equipment (PPE) to local health care providers. A secondary collaboration has been introducing students to clinical benchmarking through the UAH Center for Management and Economic Research. As a result of these successful collaborations the Model Exchange & Development of Nursing & Engineering Technology (MEDNET) has been established. MEDNET seeks to extend and expand the linkage between engineering and nursing to K-12 schools, technical schools and medical facilities in the region to the resources available from the CoN and SMAP. As an example, stereolithography (STL) files of the 3D printed models, along with the specifications to fabricate models, are available on the MEDNET website. Ten 3D printed models have been developed and are currently in use by the CoN. The following additional training simulators are currently under development:1) suture pads, 2) gelatin wound models and 3) printed wound tattoos. Specification sheets have been written for these simulations that describe the use, fabrication procedures and parts list. These specifications are available for viewing and download on MEDNET. Included in this paper are 1) descriptions of CoN, SMAP and MEDNET, 2) collaborative process used in product improvement/development, 3) 3D printed models of training and teaching simulators, 4) training simulators under development with specification sheets, 5) family care practice benchmarking, 6) integrating the simulators into the nursing curriculum, 7) utilizing MEDNET as a pandemic response, and 8) conclusions and lessons learned.

Keywords: 3D printing, nursing education, simulation, trainers

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488 Diabetic Screening in Rural Lesotho, Southern Africa

Authors: Marie-Helena Docherty, Sion Edryd Williams

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The prevalence of diabetes mellitus is increasing worldwide. In Sub-Saharan Africa, type 2 diabetes represents over 90% of all types of diabetes with the number of diabetic patients expected to rise. This represents a huge economic burden in an area already contending with high rates of other significant diseases, including the highest worldwide prevalence of HIV. Diabetic complications considerably impact on morbidity and mortality. The epidemiological data for the region quotes high rates of retinopathy (7-63%), neuropathy (27-66%) and microalbuminuria (10-83%). It is therefore imperative that diabetic screening programmes are established. It is recognised that in many parts of the developing world the implementation and management of such programmes is limited by a lack of available resources. The International Diabetes Federation produced guidelines in 2012 taking these limitations into account suggesting that all diabetic patients should have access to basic screening. These guidelines are consistent with the national diabetic guidelines produced by the Lesotho Medical Council. However, diabetic care in Lesotho is delivered at the local level, with variable levels of quality. A cross sectional study was performed in the outpatient department of Maluti Hospital in Mapoteng, Lesotho, a busy rural hospital in the Berea district. Demographic data on gender, age and modality of treatment were collected over a six-week time period. Information regarding 3 basic screening parameters was obtained. These parameters included eye screening (defined as a documented ophthalmology review within the last 12 months), foot screening (defined as a documented foot health assessment by any health care professional within the last 12 months) and secondary prevention (defined as a documented blood pressure and lipid profile reading within the last 12 months). These parameters were selected on the basis of the absolute minimum level of resources in Maluti Hospital. Renal screening was excluded, as the hospital does not have access to reliable renal profile checks or urinalysis. There is however a fully functioning on-site ophthalmology department run by a senior ophthalmologist with the ability to provide retinal photography, retinal surgery and photocoagulation therapy. Data was collected on 183 type 2 diabetics. 112 patients were male and 71 were female. The average age was 43 years. 4 patients were diet controlled, 140 patients were on oral hypoglycaemic agents (metformin and/or glibenclamide), and 39 patients were on a combination of insulin and oral hypoglycaemics. In the preceding 12 months, 5 patients had undergone eye screening (3%), 24 patients had undergone foot screening (13%), and 31 patients had lipid profile testing (17%). All patients had a documented blood pressure reading (100%). Our results show that screening is poorly performed in the basic indicators suggested by the IDF and the Lesotho Medical Council. On the basis of these results, a screening programme was developed using the mnemonic SaFE; secondary prevention, foot and eye care. This is simple, memorable and transferable between healthcare professionals. In the future, the expectation would be to expand upon this current programme to include renal screening, and to further develop screening pertaining to secondary prevention.

Keywords: Africa, complications, rural, screening

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487 Experimental Recovery of Gold, Silver and Palladium from Electronic Wastes Using Ionic Liquids BmimHSO4 and BmimCl as Solvents

Authors: Lisa Shambare, Jean Mulopo, Sehliselo Ndlovu

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One of the major challenges of sustainable development is promoting an industry which is both ecologically durable and economically viable. This requires processes that are material and energy efficient whilst also being able to limit the production of waste and toxic effluents through effective methods of process synthesis and intensification. In South Africa and globally, both miniaturisation and technological advances have substantially increased the amount of electronic wastes (e-waste) generated annually. Vast amounts of e-waste are being generated yearly with only a minute quantity being recycled officially. The passion for electronic devices cannot ignore the scarcity and cost of mining the noble metal resources which contribute significantly to the efficiency of most electronic devices. It has hence become imperative especially in an African context that sustainable strategies which are environmentally friendly be developed for recycling of the noble metals from e-waste. This paper investigates the recovery of gold, silver and palladium from electronic wastes, which consists of a vast array of metals, using ionic liquids which have the potential of reducing the gaseous and aqueous emissions associated with existing hydrometallurgical and pyrometallurgical technologies while also maintaining the economy of the overall recycling scheme through solvent recovery. The ionic liquids 1-butyl-3-methyl imidazolium hydrogen sulphate (BmimHSO4) which behaves like a protic acid and was used in the present research for the selective leaching of gold and silver from e-waste. Different concentrations of the aqueous ionic liquid were used in the experiments ranging from 10% to 50%. Thiourea was used as the complexing agent in the investigation with Fe3+ as the oxidant. The pH of the reaction was maintained in the range of 0.8 to 1.5. The preliminary investigations conducted were successful in the leaching of silver and palladium at room temperature with optimum results being at 48hrs. The leaching results could not be explained because of the leaching of palladium with the absence of gold. Hence a conclusion could not be drawn and there was the need for further experiments to be run. The leaching of palladium was carried out with hydrogen peroxide as oxidant and 1-butyl-3-methyl imidazolium chloride (BmimCl) as the solvent. The experiments at carried out at a temperature of 60 degrees celsius and a very low pH. The chloride ion was used to complex with palladium metal. From the preliminary results, it could be concluded that pretreatment of the treatment e-waste was necessary to improve the efficiency of the metal recovery process. A conclusion could not be drawn for the leaching experiments.

Keywords: BmimCl, BmimHSO4, gold, palladium, silver

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486 Technological Affordances of a Mobile Fitness Application- A Role of Escapism and Social Outcome Expectation

Authors: Inje Cho

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The leading health risks threatening the world today are associated with a modern lifestyle characterized by sedentary behavior, stress, anxiety, and an obesogenic food environment. To counter this alarming trend, the Centers for Disease Control and Prevention have proffered Physical Activity guidelines to bolster physical engagement. Concurrently, the burgeon of smartphones and mobile applications has witnessed a proliferation of fitness applications aimed at invigorating exercise adherence and real-time activity monitoring. Grounded in the Uses and gratification theory, this study delves into the technological affordances of mobile fitness applications, discerning the mediating influences of escapism and social outcome expectations on attitudes and exercise intention. The theory explains how individuals employ distinct communication mediums to satiate their exigencies and desires. Technological affordances manifest as attributes of emerging technologies that galvanize personal engagement in physical activities. Several features of mobile fitness applications include affordances for goal setting, virtual rewards, peer support, and exercise information. Escapism, denoting the inclination to disengage from normal routines, has emerged as a salient motivator for the consumption of new media. This study postulates that individual’s perceptions technological affordances within mobile fitness applications, can affect escapism and social outcome expectations, potentially influencing attitude, and behavior formation. Thus, the integrated model has been developed to empirically examine the interrelationships between technological affordances, escapism, social outcome expectations, and exercise intention. Structural Equation Modelling serves as the methodological tool, and a cohort of 400 Fitbit users shall be enlisted from the Prolific, data collection platform. A sequence of multivariate data analyses will scrutinize both the measurement and hypothesized structural models. By delving into the effects of mobile fitness applications, this study contributes to the growing of new media studies in sport management. Moreover, the novel integration of the uses and gratification theory, technological affordances, via the prism of escapism, illustrates the dynamics that underlies mobile fitness user’s attitudes and behavioral intentions. Therefore, the findings from this study contribute to theoretical understanding and provide pragmatic insights to developers and practitioners in optimizing the impact of mobile fitness applications.

Keywords: technological affordances, uses and gratification, mobile fitness apps, escapism, physical activity

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485 The Impact of Professional Development in the Area of Technology Enhanced Learning on Higher Education Teaching Practices Across Atlantic Technological University - Research Methodology and Preliminary Findings

Authors: Annette Cosgrove, Carina Ginty, Tony Hall, Cornelia Connolly

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The objectives of this research study is to examine the impact of professional development in Technology Enhanced Learning (TEL) and the digitization of learning in teaching communities across multiple higher education sites in the ATU (Atlantic Technological University *) ( 2020-2025), including the proposal of an evidence-based digital teaching model for use in a future pandemic. The research strategy undertaken for this study is a multi-site study using mixed methods. Qualitative & quantitative methods are being used in the study to collect data. A pilot study was carried out initially, feedback was collected and the research instrument was edited to reflect this feedback before being administered. The purpose of the staff questionnaire is to evaluate the impact of professional development in the area of TEL, and to capture the practitioner's views on the perceived impact on their teaching practice in the higher education sector across ATU (West of Ireland – 5 Higher education locations ). The phenomenon being explored is ‘ the impact of professional development in the area of technology-enhanced learning and on teaching practice in a higher education institution. The research methodology chosen for this study is an Action based Research Study. The researcher has chosen this approach as it is a prime strategy for developing educational theory and enhancing educational practice. This study includes quantitative and qualitative methods to elicit data that will quantify the impact that continuous professional development in the area of digital teaching practice and technologies has on the practitioner’s teaching practice in higher education. The research instruments/data collection tools for this study include a lecturer survey with a targeted TEL Practice group ( Pre and post covid experience) and semi-structured interviews with lecturers. This research is currently being conducted across the ATU multi-site campus and targeting Higher education lecturers that have completed formal CPD in the area of digital teaching. ATU, a West of Ireland university, is the focus of the study. The research questionnaire has been deployed, with 75 respondents to date across the ATU - the primary questionnaire and semi-formal interviews are ongoing currently – the purpose being to evaluate the impact of formal professional development in the area of TEL and its perceived impact on the practitioners teaching practice in the area of digital teaching and learning. This paper will present initial findings, reflections and data from this ongoing research study.

Keywords: TEL, technology, digital, education

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484 Cartilage Mimicking Coatings to Increase the Life-Span of Bearing Surfaces in Joint Prosthesis

Authors: L. Sánchez-Abella, I. Loinaz, H-J. Grande, D. Dupin

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Aseptic loosening remains as the principal cause of revision in total hip arthroplasty (THA). For long-term implantations, submicron particles are generated in vivo due to the inherent wear of the prosthesis. When this occurs, macrophages undergo phagocytosis and secretion of bone resorptive cytokines inducing osteolysis, hence loosening of the implanted prosthesis. Therefore, new technologies are required to reduce the wear of the bearing materials and hence increase the life-span of the prosthesis. Our strategy focuses on surface modification of the bearing materials with a hydrophilic coating based on cross-linked water-soluble (meth)acrylic monomers to improve their tribological behavior. These coatings are biocompatible, with high swelling capacity and antifouling properties, mimicking the properties of natural cartilage, i.e. wear resistance with a permanent hydrated layer that prevents prosthesis damage. Cartilage mimicking based coatings may be also used to protect medical device surfaces from damage and scratches that will compromise their integrity and hence their safety. However, there are only a few reports on the mechanical and tribological characteristics of this type of coatings. Clear beneficial advantages of this coating have been demonstrated in different conditions and different materials, such as Ultra-high molecular weight polyethylene (UHMWPE), Polyethylene (XLPE), Carbon-fiber-reinforced polyetheretherketone (CFR-PEEK), cobalt-chromium (CoCr), Stainless steel, Zirconia Toughened Alumina (ZTA) and Alumina. Using routine tribological experiments, the wear for UHMWPE substrate was decreased by 75% against alumina, ZTA and stainless steel. For PEEK-CFR substrate coated, the amount of material lost against ZTA and CrCo was at least 40% lower. Experiments on hip simulator allowed coated ZTA femoral heads and coated UHMWPE cups to be validated with a decrease of 80% of loss material. Further experiments on hip simulator adding abrasive particles (1 micron sized alumina particles) during 3 million cycles, on a total of 6 million, demonstrated a decreased of around 55% of wear compared to uncoated UHMWPE and uncoated XLPE. In conclusion, CIDETEC‘s hydrogel coating technology is versatile and can be adapted to protect a large range of surfaces, even in abrasive conditions.

Keywords: cartilage, hydrogel, hydrophilic coating, joint

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483 Energy Efficiency Measures in Canada’s Iron and Steel Industry

Authors: A. Talaei, M. Ahiduzzaman, A. Kumar

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In Canada, an increase in the production of iron and steel is anticipated for satisfying the increasing demand of iron and steel in the oil sands and automobile industries. It is predicted that GHG emissions from iron and steel sector will show a continuous increase till 2030 and, with emissions of 20 million tonnes of carbon dioxide equivalent, the sector will account for more than 2% of total national GHG emissions, or 12% of industrial emissions (i.e. 25% increase from 2010 levels). Therefore, there is an urgent need to improve the energy intensity and to implement energy efficiency measures in the industry to reduce the GHG footprint. This paper analyzes the current energy consumption in the Canadian iron and steel industries and identifies energy efficiency opportunities to improve the energy intensity and mitigate greenhouse gas emissions from this industry. In order to do this, a demand tree is developed representing different iron and steel production routs and the technologies within each rout. The main energy consumer within the industry is found to be flared heaters accounting for 81% of overall energy consumption followed by motor system and steam generation each accounting for 7% of total energy consumption. Eighteen different energy efficiency measures are identified which will help the efficiency improvement in various subsector of the industry. In the sintering process, heat recovery from coolers provides a high potential for energy saving and can be integrated in both new and existing plants. Coke dry quenching (CDQ) has the same advantages. Within the blast furnace iron-making process, injection of large amounts of coal in the furnace appears to be more effective than any other option in this category. In addition, because coal-powered electricity is being phased out in Ontario (where the majority of iron and steel plants are located) there will be surplus coal that could be used in iron and steel plants. In the steel-making processes, the recovery of Basic Oxygen Furnace (BOF) gas and scrap preheating provides considerable potential for energy savings in BOF and Electric Arc Furnace (EAF) steel-making processes, respectively. However, despite the energy savings potential, the BOF gas recovery is not applicable in existing plants using steam recovery processes. Given that the share of EAF in steel production is expected to increase the application potential of the technology will be limited. On the other hand, the long lifetime of the technology and the expected capacity increase of EAF makes scrap preheating a justified energy saving option. This paper would present the results of the assessment of the above mentioned options in terms of the costs and GHG mitigation potential.

Keywords: Iron and Steel Sectors, Energy Efficiency Improvement, Blast Furnace Iron-making Process, GHG Mitigation

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482 The Diversity of Contexts within Which Adolescents Engage with Digital Media: Contributing to More Challenging Tasks for Parents and a Need for Third Party Mediation

Authors: Ifeanyi Adigwe, Thomas Van der Walt

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Digital media has been integrated into the social and entertainment life of young children, and as such, the impact of digital media appears to affect young people of all ages and it is believed that this will continue to shape the world of young children. Since, technological advancement of digital media presents adolescents with diverse contexts, platforms and avenues to engage with digital media outside the home environment and from parents' supervision, a wide range of new challenges has further complicated the already difficult tasks for parents and altered the landscape of parenting. Despite the fact that adolescents now have access to a wide range of digital media technologies both at home and in the learning environment, parenting practices such as active, restrictive, co-use, participatory and technical mediations are important in mitigating of online risks adolescents may encounter as a result of digital media use. However, these mediation practices only focus on the home environment including digital media present in the home and may not necessarily transcend outside the home and other learning environments where adolescents use digital media for school work and other activities. This poses the question of who mediates adolescent's digital media use outside the home environment. The learning environment could be a ''loose platform'' where an adolescent can maximise digital media use considering the fact that there is no restriction in terms of content and time allotted to using digital media during school hours. That is to say that an adolescent can play the ''bad boy'' online in school because there is little or no restriction of digital media use and be exposed to online risks and play the ''good boy'' at home because of ''heavy'' parental mediation. This is the reason why parent mediation practices have been ineffective because a parent may not be able to track adolescents digital media use considering the diversity of contexts, platforms and avenues adolescents use digital media. This study argues that due to the diverse nature of digital media technology, parents may not be able to monitor the 'whereabouts' of their children in the digital space. This is because adolescent digital media usage may not only be confined to the home environment but other learning environments like schools. This calls for urgent attention on the part of teachers to understand the intricacies of how digital media continue to shape the world in which young children are developing and learning. It is, therefore, imperative for parents to liaise with the schools of their children to mediate digital media use during school hours. The implication of parents- teachers mediation practices are discussed. The article concludes by suggesting that third party mediation by teachers in schools and other learning environments should be encouraged and future research needs to consider the emergent strategy of teacher-children mediation approach and the implication for policy for both the home and learning environments.

Keywords: digital media, digital age, parent mediation, third party mediation

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481 Virulence Factors and Drug Resistance of Enterococci Species Isolated from the Intensive Care Units of Assiut University Hospitals, Egypt

Authors: Nahla Elsherbiny, Ahmed Ahmed, Hamada Mohammed, Mohamed Ali

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Background: The enterococci may be considered as opportunistic agents particularly in immunocompromised patients. It is one of the top three pathogens causing many healthcare associated infections (HAIs). Resistance to several commonly used antimicrobial agents is a remarkable characteristic of most species which may carry various genes contributing to virulence. Objectives: to determine the prevalence of enterococci species in different intensive care units (ICUs) causing health care-associated infections (HAIs), intestinal carriage and environmental contamination. Also, to study the antimicrobial susceptibility pattern of the isolates with special reference to vancomycin resistance. In addition to phenotypic and genotypic detection of gelatinase, cytolysin and biofilm formation among isolates. Patients and Methods: This study was carried out in the infection control laboratory at Assiut University Hospitals over a period of one year. Clinical samples were collected from 285 patients with various (HAIs) acquired after admission to different ICUs. Rectal swabs were taken from 14 cases for detection of enterococci carriage. In addition, 1377 environmental samples were collected from the surroundings of the patients. Identification was done by conventional bacteriological methods and confirmed by analytical profile index (API). Antimicrobial sensitivity testing was performed by Kirby Bauer disc diffusion method and detection of vancomycin resistance was done by agar screen method. For the isolates, phenotypic detection of cytolysin, gelatinase production and detection of biofilm by tube method, Congo red method and microtiter plate. We performed polymerase chain reaction (PCR) for detection of some virulence genes (gelE, cylA, vanA, vanB and esp). Results: Enterococci caused 10.5% of the HAIs. Respiratory tract infection was the predominant type (86.7%). The commonest species were E.gallinarum (36.7%), E.casseliflavus (30%), E.faecalis (30%), and E.durans (3.4 %). Vancomycin resistance was detected in a total of 40% (12/30) of those isolates. The risk factors associated with acquiring vancomycin resistant enterococci (VRE) were immune suppression (P= 0.031) and artificial feeding (P= 0.008). For the rectal swabs, enterococci species were detected in 71.4% of samples with the predominance of E. casseliflavus (50%). Most of the isolates were vancomycin resistant (70%). Out of a total 1377 environmental samples, 577 (42%) samples were contaminated with different microorganisms. Enterococci were detected in 1.7% (10/577) of total contaminated samples, 50% of which were vancomycin resistant. All isolates were resistant to penicillin, ampicillin, oxacillin, ciprofloxacin, amikacin, erythromycin, clindamycin and trimethoprim-sulfamethaxazole. For the remaining antibiotics, variable percentages of resistance were reported. Cytolysin and gelatinase were detected phenotypically in 16% and 48 % of the isolates respectively. The microtiter plate method showed the highest percentages of detection of biofilm among all isolated species (100%). The studied virulence genes gelE, esp, vanA and vanB were detected in 62%, 12%, 2% and 12% respectively, while cylA gene was not detected in any isolates. Conclusions: A significant percentage of enterococci was isolated from patients and environments in the ICUs. Many virulence factors were detected phenotypically and genotypically among isolates. The high percentage of resistance, coupled with the risk of cross transmission to other patients make enterococci infections a significant infection control issue in hospitals.

Keywords: antimicrobial resistance, enterococci, ICUs, virulence factors

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480 Kinetic, Equilibrium and Thermodynamic Studies of the Adsorption of Crystal Violet Dye Using Groundnut Hulls

Authors: Olumuyiwa Ayoola Kokapi, Olugbenga Solomon Bello

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Dyes are organic compounds with complex aromatic molecular structure that resulted in fast colour on a substance. Dye effluent found in wastewater generated from the dyeing industries is one of the greatest contributors to water pollution. Groundnut hull (GH) is an agricultural material that constitutes waste in the environment. Environmental contamination by hazardous organic chemicals is an urgent problem, which is partially solved through adsorption technologies. The choice of groundnut hull was promised on the understanding that some materials of agricultural origin have shown potentials to act as Adsorbate for hazardous organic chemicals. The aim of this research is to evaluate the potential of groundnut hull to adsorb Crystal violet dye through kinetic, isotherm and thermodynamic studies. The prepared groundnut hulls was characterized using Brunauer, Emmett and Teller (BET), Fourier transform infrared (FTIR) and scanning electron microscopy (SEM). Operational parameters such as contact time, initial dye concentration, pH, and effect of temperature were studied. Equilibrium time for the adsorption process was attained in 80 minutes. Adsorption isotherms used to test the adsorption data were Langmuir and Freundlich isotherms model. Thermodynamic parameters such as ∆G°, ∆H°, and ∆S° of the adsorption processes were determined. The results showed that the uptake of dye by groundnut hulls occurred at a faster rate, corresponding to an increase in adsorption capacity at equilibrium time of 80 min from 0.78 to 4.45 mg/g and 0.77 to 4.45mg/g with an increase in the initial dye concentration from 10 to 50 mg/L for pH 3.0 and 8.0 respectively. High regression values obtained for pseudo-second-order kinetic model, sum of square error (SSE%) values along with strong agreement between experimental and calculated values of qe proved that pseudo second-order kinetic model fitted more than pseudo first-order kinetic model. The result of Langmuir and Freundlich model showed that the adsorption data fit the Langmuir model more than the Freundlich model. Thermodynamic study demonstrated the feasibility, spontaneous and endothermic nature of the adsorption process due to negative values of free energy change (∆G) at all temperatures and positive value of enthalpy change (∆H) respectively. The positive values of ∆S showed that there was increased disorderliness and randomness at the solid/solution interface of crystal violet dye and groundnut hulls. The present investigation showed that, groundnut hulls (GH) is a good low-cost alternative adsorbent for the removal of Crystal Violet (CV) dye from aqueous solution.

Keywords: adsorption, crystal violet dye, groundnut halls, kinetics

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479 Case Study of Mechanised Shea Butter Production in South-Western Nigeria Using the LCA Approach from Gate-to-Gate

Authors: Temitayo Abayomi Ewemoje, Oluwamayowa Oluwafemi Oluwaniyi

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Agriculture and food processing, industry are among the largest industrial sectors that uses large amount of energy. Thus, a larger amount of gases from their fuel combustion technologies is being released into the environment. The choice of input energy supply not only directly having affects the environment, but also poses a threat to human health. The study was therefore designed to assess each unit production processes in order to identify hotspots using life cycle assessments (LCA) approach in South-western Nigeria. Data such as machine power rating, operation duration, inputs and outputs of shea butter materials for unit processes obtained at site were used to modelled Life Cycle Impact Analysis on GaBi6 (Holistic Balancing) software. Four scenarios were drawn for the impact assessments. Material sourcing from Kaiama, Scenarios 1, 3 and Minna Scenarios 2, 4 but different heat supply sources (Liquefied Petroleum Gas ‘LPG’ Scenarios 1, 2 and 10.8 kW Diesel Heater, scenarios 3, 4). Modelling of shea butter production on GaBi6 was for 1kg functional unit of shea butter produced and the Tool for the Reduction and Assessment of Chemical and other Environmental Impacts (TRACI) midpoint assessment was tool used to was analyse the life cycle inventories of the four scenarios. Eight categories in all four Scenarios were observed out of which three impact categories; Global Warming Potential (GWP) (0.613, 0.751, 0.661, 0.799) kg CO2¬-Equiv., Acidification Potential (AP) (0.112, 0.132, 0.129, 0.149) kg H+ moles-Equiv., and Smog (0.044, 0.059, 0.049, 0.063) kg O3-Equiv., categories had the greater impacts on the environment in Scenarios 1-4 respectively. Impacts from transportation activities was also seen to contribute more to these environmental impact categories due to large volume of petrol combusted leading to releases of gases such as CO2, CH4, N2O, SO2, and NOx into the environment during the transportation of raw shea kernel purchased. The ratio of transportation distance from Minna and Kaiama to production site was approximately 3.5. Shea butter unit processes with greater impacts in all categories was the packaging, milling and with the churning processes in ascending order of magnitude was identified as hotspots that may require attention. From the 1kg shea butter functional unit, it was inferred that locating production site at the shortest travelling distance to raw material sourcing and combustion of LPG for heating would reduce all the impact categories assessed on the environment.

Keywords: GaBi6, Life cycle assessment, shea butter production, TRACI

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478 Study on the Focus of Attention of Special Education Students in Primary School

Authors: Tung-Kuang Wu, Hsing-Pei Hsieh, Ying-Ru Meng

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Special Education in Taiwan has been facing difficulties including shortage of teachers and lack in resources. Some students need to receive special education are thus not identified or admitted. Fortunately, information technologies can be applied to relieve some of the difficulties. For example, on-line multimedia courseware can be used to assist the learning of special education students and take pretty much workload from special education teachers. However, there may exist cognitive variations between students in special or regular educations, which suggests the design of online courseware requires different considerations. This study aims to investigate the difference in focus of attention (FOA) between special and regular education students of primary school in viewing the computer screen. The study is essential as it helps courseware developers in determining where to put learning elements that matter the most on the right position of screen. It may also assist special education specialists to better understand the subtle differences among various subtypes of learning disabilities. This study involves 76 special education students (among them, 39 are students with mental retardation, MR, and 37 are students with learning disabilities, LDs) and 42 regular education students. The participants were asked to view a computer screen showing a picture partitioned into 3 × 3 areas with each area filled with text or icon. The subjects were then instructed to mark on the prior given paper sheets, which are also partitioned into 3 × 3 grids, the areas corresponding to the pictures on the computer screen that they first set their eyes on. The data are then collected and analyzed. Major findings are listed: 1. In both text and icon scenario, significant differences exist in the first preferred FOA between special and regular education students. The first FOA for the former is mainly on area 1 (upper left area, 53.8% / 51.3% for MR / LDs students in text scenario; and 53.8% / 56.8% for MR / LDs students in icons scenario), while the latter on area 5 (middle area, 50.0% and 57.1% in text and icons scenarios). 2. The second most preferred area in text scenario for students with MR and LDs are area 2 (upper-middle, 20.5%) and 5 (middle area, 24.3%). In icons scenario, the results are similar, but lesser in percentage. 3. Students with LDs that show similar preference (either in text or icons scenarios) in FOA to regular education students tend to be of some specific sub-type of learning disabilities. For instance, students with LDs that chose area 5 (middle area, either in text or icon scenario) as their FOA are mostly ones that have reading or writing disability. Also, three (out of 13) subjects in this category, after going through the rediagnosis process, were excluded from being learning disabilities. In summary, the findings suggest when designing multimedia courseware for students with MR and LDs, the essential learning elements should be placed on area 1, 2 and 5. In addition, FOV preference may also potentially be used as an indicator for diagnosing students with LDs.

Keywords: focus of attention, learning disabilities, mental retardation, on-line multimedia courseware, special education

Procedia PDF Downloads 153
477 The Knowledge, Attitude, and Practice About Health Information Technology Among First-Generation Muslim Immigrant Women in Atlanta City During the Pandemic

Authors: Awatef Ahmed Ben Ramadan, Aqsa Arshad

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Background: There is a huge Muslim migration movement to North America and Europe for several reasons, primarily refuge from war areas and partly to search for better work and educational chances. There are always concerns regarding first-Generation Immigrant women's health and computer literacy, an adequate understanding of the health systems, and the use of the existing healthcare technology and services effectively and efficiently. Language proficiency level, preference for cultural and traditional remedies, socioeconomic factors, fear of stereotyping, limited accessibility to health services, and general unfamiliarity with the existing health services and resources are familiar variables among these women. Aims: The current study aims to assess the health and digital literacy of first-generation Muslim women in Atlanta city. Also, the study aims to examine how the COVID-19 pandemic has encouraged the use of health information technology and increased technology awareness among the targeted women. Methods: The study design is cross-sectional correlational research. The study will be conducted to produce preliminary results that the investigators want to have to supplement an NIH grant application about leveraging information technology to reduce the health inequalities amongst the first-generation immigrant Muslim women in Atlanta City. The investigators will collect the study data in two phases using different tools. Phase one was conducted in June 2022; the investigators used tools to measure health and digital literacy amongst 42 first-generation immigrant Muslim women. Phase two was conducted in November 2022; the investigators measured the Knowledge, Attitude, and Practice (KAP) of using health information technology such as telehealth from a sample of 45 first-generation Muslim immigrant women in Atlanta; in addition, the investigators measured how the current pandemic has affected their KAP to use telemedicine and telehealth services. Both phases' study participants were recruited using convenience sampling methodology. The investigators collected around 40 of 18 years old or older first-generation Muslim immigrant women for both study phases. The study excluded Immigrants who hold work visas and second-generation immigrants. Results: At the point of submitting this abstract, the investigators are still analyzing the study data to produce preliminary results to apply for an NIH grant entitled "Leveraging Health Information Technology (Health IT) to Address and Reduce Health Care Disparities (R01 Clinical Trial Optional)". This research will be the first step of a comprehensive research project to assess and measure health and digital literacy amongst a vulnerable community group. The targeted group might have different points of view from the U.S.-born inhabitants on how to: promote their health, gain healthy lifestyles and habits, screen for diseases, adhere to health treatment and follow-up plans, perceive the importance of using available and affordable technology to communicate with their providers and improve their health, and help in making serious decisions for their health. The investigators aim to develop an educational and instructional health mobile application considering the language and cultural factors that affect immigrants' ability to access different health and social support sources, know their health rights and obligations in their communities, and improve their health behavior and behavior lifestyles.

Keywords: first-generation immigrant Muslim women, telehealth, COVID-19 pandemic, health information technology, health and digital literacy

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476 Advancing Early Intervention Strategies for United States Adolescents and Young Adults with Schizophrenia in the Post-COVID-19 Era

Authors: Peggy M. Randon, Lisa Randon

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Introduction: The post-COVID-19 era has presented unique challenges for addressing complex mental health issues, particularly due to exacerbated stress, increased social isolation, and disrupted continuity of care. This article outlines relevant health disparities and policy implications within the context of the United States while maintaining international relevance. Methods: A comprehensive literature review (including studies, reports, and policy documents) was conducted to examine concerns related to childhood-onset schizophrenia and the impact on patients and their families. Qualitative and quantitative data were synthesized to provide insights into the complex etiology of schizophrenia, the effects of the pandemic, and the challenges faced by socioeconomically disadvantaged populations. Case studies were employed to illustrate real-world examples and areas requiring policy reform. Results: Early intervention in childhood is crucial for preventing or mitigating the long-term impact of complex psychotic disorders, particularly schizophrenia. A comprehensive understanding of the genetic, environmental, and physiological factors contributing to the development of schizophrenia is essential. The COVID-19 pandemic worsened symptoms and disrupted treatment for many adolescent patients with schizophrenia, emphasizing the need for adaptive interventions and the utilization of virtual platforms. Health disparities, including stigma, financial constraints, and language or cultural barriers, further limit access to care, especially for socioeconomically disadvantaged populations. Policy implications: Current US health policies inadequately support patients with schizophrenia. The limited availability of longitudinal care, insufficient resources for families, and stigmatization represent ongoing policy challenges. Addressing these issues necessitates increased research funding, improved access to affordable treatment plans, and cultural competency training for healthcare providers. Public awareness campaigns are crucial to promote knowledge, awareness, and acceptance of mental health disorders. Conclusion: The unique challenges faced by children and families in the US affected by schizophrenia and other psychotic disorders have yet to be adequately addressed on institutional and systemic levels. The relevance of findings to an international audience is emphasized by examining the complex factors contributing to the onset of psychotic disorders and their global policy implications. The broad impact of the COVID-19 pandemic on mental health underscores the need for adaptive interventions and global responses. Addressing policy challenges, improving access to care, and reducing the stigma associated with mental health disorders are crucial steps toward enhancing the lives of adolescents and young adults with schizophrenia and their family members. The implementation of virtual platforms can help overcome barriers and ensure equitable access to support and resources for all patients, enabling them to lead healthy and fulfilling lives.

Keywords: childhood, schizophrenia, policy, United, States, health, disparities

Procedia PDF Downloads 60
475 Informational Habits and Ideology as Predictors for Political Efficacy: A Survey Study of the Brazilian Political Context

Authors: Pedro Cardoso Alves, Ana Lucia Galinkin, José Carlos Ribeiro

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Political participation, can be a somewhat tricky subject to define, not in small part due to the constant changes in the concept fruit of the effort to include new forms of participatory behavior that go beyond traditional institutional channels. With the advent of the internet and mobile technologies, defining political participation has become an even more complicated endeavor, given de amplitude of politicized behaviors that are expressed throughout these mediums, be it in the very organization of social movements, in the propagation of politicized texts, videos and images, or in the micropolitical behaviors that are expressed in daily interaction. In fact, the very frontiers that delimit physical and digital spaces have become ever more diluted due to technological advancements, leading to a hybrid existence that is simultaneously physical and digital, not limited, as it once was, to the temporal limitations of classic communications. Moving away from those institutionalized actions of traditional political behavior, an idea of constant and fluid participation, which occurs in our daily lives through conversations, posts, tweets and other digital forms of expression, is discussed. This discussion focuses on the factors that precede more direct forms of political participation, interpreting the relation between informational habits, ideology, and political efficacy. Though some of the informational habits can be considered political participation, by some authors, a distinction is made to establish a logical flow of behaviors leading to participation, that is, one must gather and process information before acting on it. To reach this objective, a quantitative survey is currently being applied in Brazilian social media, evaluating feelings of political efficacy, social and economic issue-based ideological stances and informational habits pertaining to collection, fact-checking, and diversity of sources and ideological positions present in the participant’s political information network. The measure being used for informational habits relies strongly on a mix of information literacy and political sophistication concepts, bringing a more up-to-date understanding of information and knowledge production and processing in contemporary hybrid (physical-digital) environments. Though data is still being collected, preliminary analysis point towards a strong correlation between information habits and political efficacy, while ideology shows a weaker influence over efficacy. Moreover, social ideology and economic ideology seem to have a strong correlation in the sample, such intermingling between social and economic ideals is generally considered a red flag for political polarization.

Keywords: political efficacy, ideology, information literacy, cyberpolitics

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474 Temporal Delays along the Neurosurgical Care Continuum for Traumatic Brain Injury Patients in Mulago Hospital in Kampala Uganda

Authors: Silvia D. Vaca, Benjamin J. Kuo, Joao Ricardo N. Vissoci, Catherine A. Staton, Linda W. Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Henry E. Rice, Gerald A. Grant, Michael M. Haglund

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Background: While delays to care exist in resource rich settings, greater delays are seen along the care continuum in low- and middle-income countries (LMICs) largely due to limited healthcare capacity to address the disproportional rates of traumatic brain injury (TBI) in Sub Saharan Africa (SSA). While many LMICs have government subsidized systems to offset surgical costs, the burden of securing funds by the patients for medications, supplies, and CT diagnostics poses a significant challenge to timely surgical interventions. In Kampala Uganda, the challenge of obtaining timely CT scans is twofold. First, due to a lack of a functional CT scanner at the tertiary hospital, patients need to arrange their own transportation to the nearby private facility for CT scans. Second, self-financing for the private CT scans ranges from $80 - $130, which is near the average monthly income in Kampala. These bottlenecks contribute significantly to the care continuum delays and are associated with poor TBI outcomes. Objective: The objectives of this study are to 1) describe the temporal delays through a modified three delays model that fits the context of neurosurgical interventions for TBI patients in Kampala and 2) investigate the association between delays and mortality. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Four time intervals were constructed along five time points: injury, hospital arrival, neurosurgical evaluation, CT results, and definitive surgery. Time interval differences among mild, moderate and severe TBI and their association with mortality were analyzed. Results: The mortality rate of all TBI patients presenting to MNRH was 9.6%, which ranged from 4.7% for mild and moderate TBI patients receiving surgery to 81.8% for severe TBI patients who failed to receive surgery. The duration from injury to surgery varied considerably across TBI severity with the largest gap seen between mild TBI (174 hours) and severe TBI (69 hours) patients. Further analysis revealed care continuum differences for interval 3 (neurosurgical evaluation to CT result) and 4 (CT result to surgery) between severe TBI patients (7 hours for interval 3 and 24 hours for interval 4) and mild TBI patients (19 hours for interval 3, and 96 hours for interval 4). These post-arrival delays were associated with mortality for mild (p=0.05) and moderate TBI (p=0.03) patients. Conclusions: To our knowledge, this is the first analysis using a modified ‘three delays’ framework to analyze the care continuum of TBI patients in Uganda from injury to surgery. We found significant associations between delays and mortality for mild and moderate TBI patients. As it currently stands, poorer outcomes were observed for these mild and moderate TBI patients who were managed non-operatively or failed to receive surgery while surgical services were shunted to more severely ill patients. While well intentioned, high mortality rates were still observed for the severe TBI patients managed surgically. These results suggest the need for future research to optimize triage practices, understand delay contributors, and improve pre-hospital logistical referral systems.

Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, prospective registry, traumatic brain injury

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473 Prospects for the Development of e-Commerce in Georgia

Authors: Nino Damenia

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E-commerce opens a new horizon for business development, which is why the presence of e-commerce is a necessary condition for the formation, growth, and development of the country's economy. Worldwide, e-commerce turnover is growing at a high rate every year, as the electronic environment provides great opportunities for product promotion. E-commerce in Georgia is developing at a fast pace, but it is still a relatively young direction in the country's economy. Movement restrictions and other public health measures caused by the COVID-19 pandemic have reduced economic activity in most economic sectors and countries, significantly affecting production, distribution, and consumption. The pandemic has accelerated digital transformation. Digital solutions enable people and businesses to continue part of their economic and social activities remotely. This has also led to the growth of e-commerce. According to the data of the National Statistics Service of Georgia, the share of online trade is higher in cities (27.4%) than in rural areas (9.1%). The COVID-19 pandemic has forced local businesses to expand their digital offerings. The size of the local market increased 3.2 times in 2020 to 138 million GEL. And in 2018-2020, the share of local e-commerce increased from 11% to 23%. In Georgia, the state is actively engaged in the promotion of activities based on information technologies. Many measures have been taken for this purpose, but compared to other countries, this process is slow in Georgia. The purpose of the study is to determine development prospects for the economy of Georgia based on the analysis of electronic commerce. Research was conducted around the issues using Georgian and foreign scientists' articles, works, reports of international organizations, collections of scientific conferences, and scientific electronic databases. The empirical base of the research is the data and annual reports of the National Statistical Service of Georgia, internet resources of world statistical materials, and others. While working on the article, a questionnaire was developed, based on which an electronic survey of certain types of respondents was conducted. The conducted research was related to determining how intensively Georgian citizens use online shopping, including which age category uses electronic commerce, for what purposes, and how satisfied they are. Various theoretical and methodological research tools, as well as analysis, synthesis, comparison, and other types of methods, are used to achieve the set goal in the research process. The research results and recommendations will contribute to the development of e-commerce in Georgia and economic growth based on it.

Keywords: e-commerce, information technology, pandemic, digital transformation

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472 Cost-Conscious Treatment of Basal Cell Carcinoma

Authors: Palak V. Patel, Jessica Pixley, Steven R. Feldman

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Introduction: Basal cell carcinoma (BCC) is the most common skin cancer worldwide and requires substantial resources to treat. When choosing between indicated therapies, providers consider their associated adverse effects, efficacy, cosmesis, and function preservation. The patient’s tumor burden, infiltrative risk, and risk of tumor recurrence are also considered. Treatment cost is often left out of these discussions. This can lead to financial toxicity, which describes the harm and quality of life reductions inflicted by high care costs. Methods: We studied the guidelines set forth by the American Academy of Dermatology for the treatment of BCC. A PubMed literature search was conducted to identify the costs of each recommended therapy. We discuss costs alongside treatment efficacy and side-effect profile. Results: Surgical treatment for BCC can be cost-effective if the appropriate treatment is selected for the presenting tumor. Curettage and electrodesiccation can be used in low-grade, low-recurrence tumors in aesthetically unimportant areas. The benefits of cost-conscious care are not likely to be outweighed by the risks of poor cosmesis or tumor return ($471 BCC of the cheek). When tumor burden is limited, MMS offers better cure rates and lower recurrence rates than surgical excision, and with comparable costs (MMS $1263; SE $949). Surgical excision with permanent sections may be indicated when tumor burden is more extensive or if molecular testing is necessary. The utility of surgical excision with frozen sections, which costs substantially more than MMS without comparable outcomes, is less clear (SE with frozen sections $2334-$3085). Less data exists on non-surgical treatments for BCC. These techniques cost less, but recurrence-risk is high. Side-effects of nonsurgical treatment are limited to local skin reactions, and cosmesis is good. Cryotherapy, 5-FU, and MAL-PDT are all more affordable than surgery, but high recurrence rates increase risk of secondary financial and psychosocial burden (recurrence rates 21-39%; cost $100-270). Radiation therapy offers better clearance rates than other nonsurgical treatments but is associated with similar recurrence rates and a significantly larger financial burden ($2591-$3460 BCC of the cheek). Treatments for advanced or metastatic BCC are extremely costly, but few patients require their use, and the societal cost burden remains low. Vismodegib and sonidegib have good response rates but substantial side effects, and therapy should be combined with multidisciplinary care and palliative measures. Expert-review has found sonidegib to be the less expensive and more efficacious option (vismodegib $128,358; sonidegib $122,579). Platinum therapy, while not FDA-approved, is also effective but expensive (~91,435). Immunotherapy offers a new line of treatment in patients intolerant of hedgehog inhibitors ($683,061). Conclusion: Dermatologists working within resource-compressed practices and with resource-limited patients must prudently manage the healthcare dollar. Surgical therapies for BCC offer the lowest risk of recurrence at the most reasonable cost. Non-surgical therapies are more affordable, but high recurrence rates increase the risk of secondary financial and psychosocial burdens. Treatments for advanced BCC are incredibly costly, but the low incidence means the overall cost to the system is low.

Keywords: nonmelanoma skin cancer, basal cell skin cancer, squamous cell skin cancer, cost of care

Procedia PDF Downloads 107
471 Sludge Marvel (Densification): The Ultimate Solution For Doing More With Less Effort!

Authors: Raj Chavan

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At present, the United States is home to more than 14,000 Water Resource Recovery Facilities (WRRFs), of which approximately 35% have implemented nutrient limits of some kind. These WRRFs contribute 10 to 15% of the total nutrient burden to surface rivers in the United States and account for approximately 1% of total power demand and 2% of total greenhouse gas emissions (GHG). There are several factors that have influenced the development of densification technologies in the direction of more compact and energy-efficient nutrient removal processes. Prior to surface water discharge, existing facilities that necessitate capacity expansion or biomass densification for greater treatability within the same footprint are being subjected to stricter nutrient removal requirements. Densification of activated sludge as a method for nutrient removal and process intensification at WRRFs has garnered considerable attention in recent times. The biological processes take place within the aerobic sediment granules, which form the basis of the technology. The possibility of generating granular sludge through continuous (or conventional) activated sludge processes (CAS) or densification of biomass through the transfer of activated sludge flocs to a denser biomass aggregate as an exceptionally efficient intensification technique has generated considerable interest. This presentation aims to furnish attendees with a foundational comprehension of densification through the illustration of practical concerns and insights. The subsequent subjects will be deliberated upon. What are some potential techniques for producing and preserving densified granules? What processes are responsible for the densification of biological flocs? How do physical selectors contribute to the process of biological flocs becoming denser? What viable strategies exist for the management of densified biological flocs, and which design parameters of physical selection influence the retention of densified biological flocs? determining operational solutions for floc and granule customization in order to meet capacity and performance objectives? The answers to these pivotal questions will be derived from existing full-scale treatment facilities, bench-scale and pilot-scale investigations, and existing literature data. By the conclusion of the presentation, the audience will possess a fundamental comprehension of the densification concept and its significance in attaining effective effluent treatment. Additionally, case studies pertaining to the design and operation of densification procedures will be incorporated into the presentation.

Keywords: densification, intensification, nutrient removal, granular sludge

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470 Peer Corrective Feedback on Written Errors in Computer-Mediated Communication

Authors: S. H. J. Liu

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This paper aims to explore the role of peer Corrective Feedback (CF) in improving written productions by English-as-a- foreign-language (EFL) learners who work together via Wikispaces. It attempted to determine the effect of peer CF on form accuracy in English, such as grammar and lexis. Thirty-four EFL learners at the tertiary level were randomly assigned into the experimental (with peer feedback) or the control (without peer feedback) group; each group was subdivided into small groups of two or three. This resulted in six and seven small groups in the experimental and control groups, respectively. In the experimental group, each learner played a role as an assessor (providing feedback to others), as well as an assessee (receiving feedback from others). Each participant was asked to compose his/her written work and revise it based on the feedback. In the control group, on the other hand, learners neither provided nor received feedback but composed and revised their written work on their own. Data collected from learners’ compositions and post-task interviews were analyzed and reported in this study. Following the completeness of three writing tasks, 10 participants were selected and interviewed individually regarding their perception of collaborative learning in the Computer-Mediated Communication (CMC) environment. Language aspects to be analyzed included lexis (e.g., appropriate use of words), verb tenses (e.g., present and past simple), prepositions (e.g., in, on, and between), nouns, and articles (e.g., a/an). Feedback types consisted of CF, affective, suggestive, and didactic. Frequencies of feedback types and the accuracy of the language aspects were calculated. The results first suggested that accurate items were found more in the experimental group than in the control group. Such results entail that those who worked collaboratively outperformed those who worked non-collaboratively on the accuracy of linguistic aspects. Furthermore, the first type of CF (e.g., corrections directly related to linguistic errors) was found to be the most frequently employed type, whereas affective and didactic were the least used by the experimental group. The results further indicated that most participants perceived that peer CF was helpful in improving the language accuracy, and they demonstrated a favorable attitude toward working with others in the CMC environment. Moreover, some participants stated that when they provided feedback to their peers, they tended to pay attention to linguistic errors in their peers’ work but overlook their own errors (e.g., past simple tense) when writing. Finally, L2 or FL teachers or practitioners are encouraged to employ CMC technologies to train their students to give each other feedback in writing to improve the accuracy of the language and to motivate them to attend to the language system.

Keywords: peer corrective feedback, computer-mediated communication (CMC), second or foreign language (L2 or FL) learning, Wikispaces

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469 Assessing Image Quality in Mobile Radiography: A Phantom-Based Evaluation of a New Lightweight Mobile X-Ray Equipment

Authors: May Bazzi, Shafik Tokmaj, Younes Saberi, Mats Geijer, Tony Jurkiewicz, Patrik Sund, Anna Bjällmark

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Mobile radiography, employing portable X-ray equipment, has become a routine procedure within hospital settings, with chest X-rays in intensive care units standing out as the most prevalent mobile X-ray examinations. This approach is not limited to hospitals alone, as it extends its benefits to imaging patients in various settings, particularly those too frail to be transported, such as elderly care residents in nursing homes. Moreover, the utility of mobile X-ray isn't confined solely to traditional healthcare recipients; it has proven to be a valuable resource for vulnerable populations, including the homeless, drug users, asylum seekers, and patients with multiple co-morbidities. Mobile X-rays reduce patient stress, minimize costly hospitalizations, and offer cost-effective imaging. While studies confirm its reliability, further research is needed, especially regarding image quality. Recent advancements in lightweight equipment with enhanced battery and detector technology provide the potential for nearly handheld radiography. The main aim of this study was to evaluate a new lightweight mobile X-ray system with two different detectors and compare the image quality with a modern stationary system. Methods: A total of 74 images of the chest (chest anterior-posterior (AP) views and chest lateral views) and pelvic/hip region (AP pelvis views, hip AP views, and hip cross-table lateral views) were acquired on a whole-body phantom (Kyotokagaku, Japan), utilizing varying image parameters. These images were obtained using a stationary system - 18 images (Mediel, Sweden), a mobile X-ray system with a second-generation detector - 28 images (FDR D-EVO II; Fujifilm, Japan) and a mobile X-ray system with a third-generation detector - 28 images (FDR D-EVO III; Fujifilm, Japan). Image quality was assessed by visual grading analysis (VGA), which is a method to measure image quality by assessing the visibility and accurate reproduction of anatomical structures within the images. A total of 33 image criteria were used in the analysis. A panel of two experienced radiologists, two experienced radiographers, and two final-term radiographer students evaluated the image quality on a 5-grade ordinal scale using the software Viewdex 3.0 (Viewer for Digital Evaluation of X-ray images, Sweden). Data were analyzed using visual grading characteristics analysis. The dose was measured by the dose-area product (DAP) reported by the respective systems. Results: The mobile X-ray equipment (both detectors) showed significantly better image quality than the stationary equipment for the pelvis, hip AP and hip cross-table lateral images with AUCVGA-values ranging from 0.64-0.92, while chest images showed mixed results. The number of images rated as having sufficient quality for diagnostic use was significantly higher for mobile X-ray generation 2 and 3 compared with the stationary X-ray system. The DAP values were higher for the stationary compared to the mobile system. Conclusions: The new lightweight radiographic equipment had an image quality at least as good as a fixed system at a lower radiation dose. Future studies should focus on clinical images and consider radiographers' viewpoints for a comprehensive assessment.

Keywords: mobile x-ray, visual grading analysis, radiographer, radiation dose

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468 Democratic Information Behavior of Social Scientists and Policy Makers in India

Authors: Mallikarjun Vaddenkeri, Suresh Jange

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This research study reports results of information behaviour by members of faculty and research scholars of various departments of social sciences working at universities with a sample of 300 and Members of Legislative Assembly and Council with 216 samples in Karnataka State, India. The results reveal that 29.3% and 20.3% of Social Scientists indicated medium and high level of awareness of primary sources - Primary Journals are found to be at scale level 5 and 9. The usage of primary journals by social scientists is found to be 28% at level 4, 24% of the respondent’s opined use of primary Conference Proceedings at level 5 as medium level of use. Similarly, the use of Secondary Information Sources at scale 8 and 9 particularly in case of Dictionaries (31.0% and 5.0%), Encyclopaedias (22.3% and 6.3%), Indexing Periodicals (7.0% and 15.3%) and Abstracting Periodicals (5.7% and 20.7%). For searching information from Journals Literature available in CD-ROM version, Keywords (43.7%) followed by Keywords with logical operators (39.7%) have been used for finding the required information. Statistical inference reveals rejection of null hypothesis `there is no association between designation of the respondents and awareness of primary information resources’. On the other hand, educational qualification possessed by Legislative members, more than half of them possess graduate degree as their academic qualification (57.4%) and just 16.7% of the respondents possess graduate degree while only 26.8% of the respondents possess degree in law and just 1.8% possess post-graduate degree in law. About 42.6% indicated the importance of information required to discharge their duties and responsibilities as a Policy Maker in the scale 8, as a Scholar (27.8%) on a scale 6, as a politician (64.8%) on a scale 10 and as a Councillor (51.9%) on a scale 8. The most preferred information agencies/sources very often contacted for obtaining useful information are by means of contacting the people of Karnataka State Legislative Library, listening Radio programmes, viewing Television programmes and reading the newspapers. The methods adopted for obtaining needed information quite often by means of sending their assistants to libraries to gather information (35.2%) and personally visiting the information source (64.8%). The null hypotheses `There is no association between Members of Legislature and Opinion on the usefulness of the resources of the Karnataka State Legislature Library’ is accepted using F ANOVA test. The studies conclude with a note revamp the existing library system in its structure and adopt latest technologies and educate and train social scientists and Legislators in using these resources in the interest of academic, government policies and decision making of the country.

Keywords: information use behaviour, government information, searching behaviour, policy makers

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467 The Influence of Absorptive Capacity on Process Innovation: An Exploratory Study in Seven Leading and Emerging Countries

Authors: Raphael M. Rettig, Tessa C. Flatten

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This empirical study answer calls for research on Absorptive Capacity and Process Innovation. Due to the fourth industrial revolution, manufacturing companies face the biggest disruption of their production processes since the rise of advanced manufacturing technologies in the last century. Therefore, process innovation will become a critical task to master in the future for many manufacturing firms around the world. The general ability of organizations to acquire, assimilate, transform, and exploit external knowledge, known as Absorptive Capacity, was proven to positively influence product innovation and is already conceptually associated with process innovation. The presented research provides empirical evidence for this influence. The findings are based on an empirical analysis of 732 companies from seven leading and emerging countries: Brazil, China, France, Germany, India, Japan, and the United States of America. The answers to the survey were collected in February and March 2018 and addressed senior- and top-level management with a focus on operations departments. The statistical analysis reveals the positive influence of potential and Realized Absorptive Capacity on successful process innovation taking the implementation of new digital manufacturing processes as an example. Potential Absorptive Capacity covering the acquisition and assimilation capabilities of an organization showed a significant positive influence (β = .304, p < .05) on digital manufacturing implementation success and therefore on process innovation. Realized Absorptive Capacity proved to have significant positive influence on process innovation as well (β = .461, p < .01). The presented study builds on prior conceptual work in the field of Absorptive Capacity and process innovation and contributes theoretically to ongoing research in two dimensions. First, the already conceptually associated influence of Absorptive Capacity on process innovation is backed by empirical evidence in a broad international context. Second, since Absorptive Capacity was measured with a focus on new product development, prior empirical research on Absorptive Capacity was tailored to the research and development departments of organizations. The results of this study highlight the importance of Absorptive Capacity as a capability in mechanical engineering and operations departments of organizations. The findings give managers an indication of the importance of implementing new innovative processes into their production system and fostering the right mindset of employees to identify new external knowledge. Through the ability to transform and exploit external knowledge, own production processes can be innovated successfully and therefore have a positive influence on firm performance and the competitive position of their organizations.

Keywords: absorptive capacity, digital manufacturing, dynamic capabilities, process innovation

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466 A Risk-Based Modeling Approach for Successful Adoption of CAATTs in Audits: An Exploratory Study Applied to Israeli Accountancy Firms

Authors: Alon Cohen, Jeffrey Kantor, Shalom Levy

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Technology adoption models are extensively used in the literature to explore drivers and inhibitors affecting the adoption of Computer Assisted Audit Techniques and Tools (CAATTs). Further studies from recent years suggested additional factors that may affect technology adoption by CPA firms. However, the adoption of CAATTs by financial auditors differs from the adoption of technologies in other industries. This is a result of the unique characteristics of the auditing process, which are expressed in the audit risk elements and the risk-based auditing approach, as encoded in the auditing standards. Since these audit risk factors are not part of the existing models that are used to explain technology adoption, these models do not fully correspond to the specific needs and requirements of the auditing domain. The overarching objective of this qualitative research is to fill the gap in the literature, which exists as a result of using generic technology adoption models. Followed by a pretest and based on semi-structured in-depth interviews with 16 Israeli CPA firms of different sizes, this study aims to reveal determinants related to audit risk factors that influence the adoption of CAATTs in audits and proposes a new modeling approach for the successful adoption of CAATTs. The findings emphasize several important aspects: (1) while large CPA firms developed their own inner guidelines to assess the audit risk components, other CPA firms do not follow a formal and validated methodology to evaluate these risks; (2) large firms incorporate a variety of CAATTs, including self-developed advanced tools. On the other hand, small and mid-sized CPA firms incorporate standard CAATTs and still need to catch up to better understand what CAATTs can offer and how they can contribute to the quality of the audit; (3) the top management of mid-sized and small CPA firms should be more proactive and updated about CAATTs capabilities and contributions to audits; and (4) All CPA firms consider professionalism as a major challenge that must be constantly managed to ensure an optimal CAATTs operation. The study extends the existing knowledge of CAATTs adoption by looking at it from a risk-based auditing approach. It suggests a new model for CAATTs adoption by incorporating influencing audit risk factors that auditors should examine when considering CAATTs adoption. Since the model can be used in various audited scenarios and supports strategic, risk-based decisions, it maximizes the great potential of CAATTs on the quality of the audits. The results and insights can be useful to CPA firms, internal auditors, CAATTs developers and regulators. Moreover, it may motivate audit standard-setters to issue updated guidelines regarding CAATTs adoption in audits.

Keywords: audit risk, CAATTs, financial auditing, information technology, technology adoption models

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465 Bringing German History to Tourists

Authors: Gudrun Görlitz, Christian Schölzel, Alexander Vollmar

Abstract:

Sites of Jewish Life in Berlin 1933-1945. Between Persecution and Self-assertion” was realized in a project funded by the European Regional Development Fund. A smartphone app, and a associated web site enable tourists and other participants of this educational offer to learn in a serious way more about the life of Jews in the German capital during the Nazi era. Texts, photos, video and audio recordings communicate the historical content. Interactive maps (both current and historical) make it possible to use predefined or self combined routes. One of the manifold challenges was to create a broad ranged guide, in which all detailed information are well linked with each other. This enables heterogeneous groups of potential users to find a wide range of specific information, corresponding with their particular wishes and interests. The multitude of potential ways to navigate through the diversified information causes (hopefully) the users to utilize app and web site for a second or third time and with a continued interest. Therefore 90 locations, a lot of them situated in Berlin’s city centre, have been chosen. For all of them text-, picture and/or audio/video material gives extensive information. Suggested combinations of several of these “site stories” are leading to the offer of detailed excursion routes. Events and biographies are also presented. A few of the implemented biographies are especially enriched with source material concerning the aspect of (forced) migration of these persons during the Nazi time. All this was done in a close and fruitful interdisciplinary cooperation of computer scientists and historians. The suggested conference paper aims to show the challenges shaping complex source material for practical use by different user-groups in a proper technical and didactic way. Based on the historical research in archives, museums, libraries and digital resources the quantitative dimension of the project can be sized as follows: The paper focuses on the following historiographical and technical aspects: - Shaping the text material didactically for the use in new media, especially a Smartphone-App running on differing platforms; - Geo-referencing of the sites on historical and current map material; - Overlay of old and new maps to present and find the sites; - Using Augmented Reality technologies to re-visualize destroyed buildings; - Visualization of black-/white-picture-material; - Presentation of historical footage and the resulting problems to need too much storage space; - Financial and juridical aspects in gaining copyrights to present archival material.

Keywords: smartphone app, history, tourists, German

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464 Bacterial Recovery of Copper Ores

Authors: Zh. Karaulova, D. Baizhigitov

Abstract:

At the Aktogay deposit, the oxidized ore section has been developed since 2015; by now, the reserves of easily enriched ore are decreasing, and a large number of copper-poor, difficult-to-enrich ores has been accumulated in the dumps of the KAZ Minerals Aktogay deposit, which is unprofitable to mine using the traditional mining methods. Hence, another technology needs to be implemented, which will significantly expand the raw material base of copper production in Kazakhstan and ensure the efficient use of natural resources. Heap and dump bacterial recovery are the most acceptable technologies for processing low-grade secondary copper sulfide ores. Test objects were the copper ores of Aktogay deposit and chemolithotrophic bacteria Leptospirillum ferrooxidans (L.f.), Acidithiobacillus caldus (A.c.), Sulfobacillus Acidophilus (S.a.), which are mixed cultures were both used in bacterial oxidation systems. They can stay active in the 20-400C temperature range. These bacteria were the most extensively studied and widely used in sulfide mineral recovery technology. Biocatalytic acceleration was achieved as a result of bacteria oxidizing iron sulfides to form iron sulfate, which subsequently underwent chemical oxidation to become sulfate oxide. The following results have been achieved at the initial stage: the goal was to grow and maintain the life activity of bacterial cultures under laboratory conditions. These bacteria grew the best within the pH 1,2-1,8 range with light stirring and in an aerated environment. The optimal growth temperature was 30-33оC. The growth rate decreased by one-half for each 4-5°C fall in temperature from 30°C. At best, the number of bacteria doubled every 24 hours. Typically, the maximum concentration of cells that can be grown in ferrous solution is about 107/ml. A further step researched in this case was the adaptation of microorganisms to the environment of certain metals. This was followed by mass production of inoculum and maintenance for their further cultivation on a factory scale. This was done by adding sulfide concentrate, allowing the bacteria to convert the ferrous sulfate as indicated by the Eh (>600 mV), then diluting to double the volume and adding concentrate to achieve the same metal level. This process was repeated until the desired metal level and volumes were achieved. The final stage of bacterial recovery was the transportation and irrigation of secondary sulfide copper ores of the oxidized ore section. In conclusion, the project was implemented at the Aktogay mine since the bioleaching process was prolonged. Besides, the method of bacterial recovery might compete well with existing non-biological methods of extraction of metals from ores.

Keywords: bacterial recovery, copper ore, bioleaching, bacterial inoculum

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463 Air Breakdown Voltage Prediction in Post-arcing Conditions for Compact Circuit Breakers

Authors: Jing Nan

Abstract:

The air breakdown voltage in compact circuit breakers is a critical factor in the design and reliability of electrical distribution systems. This voltage determines the threshold at which the air insulation between conductors will fail or 'break down,' leading to an arc. This phenomenon is highly sensitive to the conditions within the breaker, such as the temperature and the distance between electrodes. Typically, air breakdown voltage models have been reliable for predicting failure under standard operational temperatures. However, in conditions post-arcing, where temperatures can soar above 2000K, these models face challenges due to the complex physics of ionization and electron behaviour at such high-energy states. Building upon the foundational understanding that the breakdown mechanism is initiated by free electrons and propelled by electric fields, which lead to ionization and, potentially, to avalanche or streamer formation, we acknowledge the complexity introduced by high-temperature environments. Recognizing the limitations of existing experimental data, a notable research gap exists in the accurate prediction of breakdown voltage at elevated temperatures, typically observed post-arcing, where temperatures exceed 2000K.To bridge this knowledge gap, we present a method that integrates gap distance and high-temperature effects into air breakdown voltage assessment. The proposed model is grounded in the physics of ionization, accounting for the dynamic behaviour of free electrons which, under intense electric fields at elevated temperatures, lead to thermal ionization and potentially reach the threshold for streamer formation as Meek's criterion. Employing the Saha equation, our model calculates equilibrium electron densities, adapting to the atmospheric pressure and the hot temperature regions indicative of post-arc temperature conditions. Our model is rigorously validated against established experimental data, demonstrating substantial improvements in predicting air breakdown voltage in the high-temperature regime. This work significantly improves the predictive power for air breakdown voltage under conditions that closely mimic operational stressors in compact circuit breakers. Looking ahead, the proposed methods are poised for further exploration in alternative insulating media, like SF6, enhancing the model's utility for a broader range of insulation technologies and contributing to the future of high-temperature electrical insulation research.

Keywords: air breakdown voltage, high-temperature insulation, compact circuit breakers, electrical discharge, saha equation

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