Search results for: voltage improvement
Commenced in January 2007
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Edition: International
Paper Count: 5370

Search results for: voltage improvement

870 Application and Evaluation of Teaching-Learning Guides Based on Swebok for the Requirements Engineering Area

Authors: Mauro Callejas-Cuervo, Andrea Catherine Alarcon-Aldana, Lorena Paola Castillo-Guerra

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The software industry requires highly-trained professionals, capable of developing the roles integrated in the cycle of software development. That is why a large part of the task is the responsibility of higher education institutions; often through a curriculum established to orientate the academic development of the students. It is so that nowadays there are different models that support proposals for the improvement of the curricula for the area of Software Engineering, such as ACM, IEEE, ABET, Swebok, of which the last stands out, given that it manages and organises the knowledge of Software Engineering and offers a vision of theoretical and practical aspects. Moreover, it has been applied by different universities in the pursuit of achieving coverage in delivering the different topics and increasing the professional quality of future graduates. This research presents the structure of teaching and learning guides from the objectives of training and methodological strategies immersed in the levels of learning of Bloom’s taxonomy with which it is intended to improve the delivery of the topics in the area of Requirements Engineering. Said guides were implemented and validated in a course of Requirements Engineering of the Systems and Computer Engineering programme in the Universidad Pedagógica y Tecnológica de Colombia (Pedagogical and Technological University of Colombia) using a four stage methodology: definition of the evaluation model, implementation of the guides, guide evaluation, and analysis of the results. After the collection and analysis of the data, the results show that in six out of the seven topics proposed in the Swebok guide, the percentage of students who obtained total marks within the 'High grade' level, that is between 4.0 and 4.6 (on a scale of 0.0 to 5.0), was higher than the percentage of students who obtained marks within the 'Acceptable' range of 3.0 to 3.9. In 86% of the topics and the strategies proposed, the teaching and learning guides facilitated the comprehension, analysis, and articulation of the concepts and processes of the students. In addition, they mainly indicate that the guides strengthened the argumentative and interpretative competencies, while the remaining 14% denotes the need to reinforce the strategies regarding the propositive competence, given that it presented the lowest average.

Keywords: pedagogic guide, pedagogic strategies, requirements engineering, Swebok, teaching-learning process

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869 Participatory Financial Inclusion Hypothesis: A Preliminary Empirical Validation Using Survey Design

Authors: Edward A. Osifodunrin, Jose Manuel Dias Lopes

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In Nigeria, enormous efforts/resources had, over the years, been expended on promoting financial inclusion (FI); however, it is seemingly discouraging that many of its self-declared targets on FI remained unachieved, especially amongst the Rural Dwellers and Actors in the Informal Sectors (RDAIS). Expectedly, many reasons had been earmarked for these failures: low literacy level, huge informal/rural sectors, etc. This study posits that in spite of these truly-debilitating factors, these FI policy failures could have been avoided or mitigated if the principles of active and better-managed citizens’ participation had been strictly followed in the (re)design/implementation of its FI policies. In other words, in a bid to mitigate the prevalent FE in Nigeria, this study hypothesizes the positive impact of increased/active citizens’ participation on FI outcome(s), backed by a preliminary empirical validation. Also, the study introduces the RDAIS-focused participatory financial inclusion policy (PFIP) as a major FI policy regeneration/improvement tool. The three categories of respondents that served as research subjects are FI experts in Nigeria (n = 72), RDAIS from the very rural/remote village of Unguwar Dogo in Northern Nigeria (n = 43), and RDAIS from another rural village of Sekere (n = 56) in the Southern region of Nigeria. Using survey design (5-point Likert scale questionnaires), random/stratified sampling, and descriptive/inferential statistics, the study often recorded independent consensus (amongst these three categories of respondents) that RDAIS’s active participation in iterative FI policy initiation, (re)design, implementation, (re)evaluation could indeed give improved FI outcomes. However, some questionnaire items also recorded divergent opinions and various statistically significant differences in the mean scores of these three categories. The PFIP (or any customized version of it) should then be carefully integrated into the NFIS of Nigeria (and possibly in the NFIS of other developing countries) to truly/fully provide FI policy integration for these excluded RDAIS and arrest the prevalence of FE.

Keywords: citizens’ participation, development, financial inclusion, formal financial services, national financial inclusion strategy, participatory financial inclusion policy, rural dwellers and actors in the informal sectors

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868 Effect of Nicorandil, Bone Marrow-Derived Mesenchymal Stem Cells and Their Combination in Isoproterenol-Induced Heart Failure in Rats

Authors: Sarah Elsayed Mohammed, Lamiaa Ahmed Ahmed, Mahmoud Mohammed Khattab

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Aim: The aim of the present study was to investigate whether combined nicorandil and bone marrow-derived mesenchymal stem cells (BMDMSC) treatment could offer an additional benefit in ameliorating isoproterenol (ISO)-induced heart failure in rats. Methods: ISO (85 and 170 mg/kg/day) was injected subcutaneously for 2 successive days, respectively. By day 3, electrocardiographic changes were recorded and serum was separated for determination of CK-MB level for confirmation of myocardial damage. Nicorandil (3 mg/kg/day) was then given orally with or without a single i.v. BMDMSC administration. Electrocardiography and echocardiography were recorded 2 weeks after beginning of treatment. Rats were then sacrificed and ventricles were isolated for estimation of vascular endothelial growth factor (VEGF), tumor necrosis factor-alpha (TNF-α) and transforming growth factor-beta (TGF-β) contents, caspase-3 activity as well as inducible nitric oxide synthase (iNOS) and connexin-43 protein expressions. Moreover, histological analysis of myocardial fibrosis was performed and cryosections were done for estimation of homing of BMDMSC. Results: ISO induced a significant increase in ventricles/body weight ratio, left ventricular end diastolic (LVEDD) and systolic dimensions (LVESD), ST segment and QRS duration. Moreover, myocardial fibrosis as well as VEGF, TNF-α and TGF-β contents were significantly increased. On the other hand, connexin-43 protein expression was significantly decreased, while caspase-3 and iNOS protein expressions were significantly increased. Combined therapy provided additional improvement compared to cell treatment alone towards reducing cardiac hypertrophy, fibrosis and inflammation. Furthermore, combined therapy induced significant increase in angiogenesis and BMDMSC homing and prevented ISO induced changes in iNOS, connexin-43 and caspase-3 protein expressions. Conclusion: Combined nicorandil/BMDMSC treatment was superior to BMDMSC alone towards preventing ISO-induced heart failure in rats.

Keywords: fibrosis, isoproterenol, mesenchymal stem cells, nicorandil

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867 Low-Surface Roughness and High Optical Quality CdS Thin Film Deposited on Heated Substrate Using Room-Temperature Chemical Solution

Authors: A. Elsayed, M. H. Dewaidar, M. Ghali, M. Elkemary

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The high production cost of the conventional solar cells requires the search for economic methods suitable for solar energy conversion. Cadmium Sulfide (CdS) is one of the most important semiconductors used in photovoltaics, especially in large area solar cells; and can be prepared in a thin film form by a wide variety of deposition techniques. The preparation techniques include vacuum evaporation, sputtering and molecular beam epitaxy. Other techniques, based on chemical solutions, are also used for depositing CdS films with dramatically low-cost compared to other vacuum-based methods. Although this technique is widely used during the last decades, due to simplicity and low-deposition temperature (~100°C), there is still a strong need for more information on the growth process and its relation with the quality of the deposited films. Here, we report on deposition of high-quality CdS thin films; with low-surface roughness ( < 3.0 nm) and sharp optical absorption edge; on low-temperature glass substrates (70°C) using a new method based on the room-temperature chemical solution. In this method, a mixture solution of cadmium acetate and thiourea at room temperature was used under special growth conditions for deposition of CdS films. X-ray diffraction (XRD) measurements were used to examine the crystal structure properties of the deposited CdS films. In addition, UV-VIS transmittance and low-temperature (4K) photoluminescence (PL) measurements were performed for quantifying optical properties of the deposited films. The deposited films show high optical quality as confirmed by observation of both, sharp edge in the transmittance spectra and strong PL intensity at room temperature. Furthermore, we found a strong effect of the growth conditions on the optical band gap of the deposited films; where remarkable red-shift in the absorption edge with temperature is clearly seen in both transmission and PL spectra. Such tuning of both optical band gap of the deposited CdS films can be utilized for tuning the electronic bands' alignments between CdS and other light-harvesting materials, like CuInGaSe or CdTe, for potential improvement in the efficiency of solar cells devices based on these heterostructures.

Keywords: chemical deposition, CdS, optical properties, surface, thin film

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866 Diabetes Care in Detention Settings: A Systematic Review

Authors: A. Papachristou, A. Ntikoudi, L. Makris, V. Saridakis

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Introduction: More than 10 million people are imprisoned or detained worldwide. Figures from 2011-12 show that prison inmates are more likely than the general population to suffer from chronic or infectious diseases, while most inmates are overweight or obese, and more than a quarter have high blood pressure. In 2011/12, the proportion of prisoners reporting diabetes or hyperglycemia was 899 per 10,000 prisoners, almost double the 2004 figure (483 per 10,000). It is important to ensure that this population has access to the same standard of care as people outside prisons, as access to services should be need-based. Diabetes is a public health problem associated with increased morbidity and mortality worldwide. According to the International Diabetes Federation (IDF) in 2017, approximately 425 million people worldwide had diabetes. This number is expected to increase to 629 million by 2045. Poor management of diabetes in prisons can lead to poor blood sugar control and increase the risk of complications. Aim: The aim of this review was to systematically evaluate all the available literature on diabetes care in custodial settings. Methods: An extensive literature search was conducted through electronic databases (PubMed, Scopus and CINAHL) with the terms ‘custody’, ‘diabetes Mellitus, ‘detention centers and ‘chronic disease’. Articles published in English until September 2022, were included; no other criteria on publication dates were set. Results: Most of the studies mentioned a diabetes prevalence of approximately 10%, among other common chronic. Hypertension, obesity, smoking, sedentary lifestyle were the most common comorbidities associated with diabetes. Conclusion: Good glycemic control is fundamental to managing diabetes, and while many prisoners enter prison poorly, access to regular medication and meals, as well as exercise, offers the potential for improvement. Not being able to get help as quickly as in the past can be extremely stressful, and some prisoners may deliberately raise their blood sugar levels to avoid the risk of developing hypoglycemia, especially if they know they have had previous episodes of nocturnal hypoglycemia. Thus, appropriate training and resources are critical to providing quality care to incarcerated people with diabetes.

Keywords: custody, diabetes mellitus, detention centers, chronic disease

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865 Different Approaches to Teaching a Database Course to Undergraduate and Graduate Students

Authors: Samah Senbel

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Database Design is a fundamental part of the Computer Science and Information technology curricula in any school, as well as in the study of management, business administration, and data analytics. In this study, we compare the performance of two groups of students studying the same database design and implementation course at Sacred Heart University in the fall of 2018. Both courses used the same textbook and were taught by the same professor, one for seven graduate students and one for 26 undergraduate students (juniors). The undergraduate students were aged around 20 years old with little work experience, while the graduate students averaged 35 years old and all were employed in computer-related or management-related jobs. The textbook used was 'Database Systems, Design, Implementation, and Management' by Coronel and Morris, and the course was designed to follow the textbook roughly a chapter per week. The first 6 weeks covered the design aspect of a database, followed by a paper exam. The next 6 weeks covered the implementation aspect of the database using SQL followed by a lab exam. Since the undergraduate students are on a 16 week semester, we spend the last three weeks of the course covering NoSQL. This part of the course was not included in this study. After the course was over, we analyze the results of the two groups of students. An interesting discrepancy was observed: In the database design part of the course, the average grade of the graduate students was 92%, while that of the undergraduate students was 77% for the same exam. In the implementation part of the course, we observe the opposite: the average grade of the graduate students was 65% while that of the undergraduate students was 73%. The overall grades were quite similar: the graduate average was 78% and that of the undergraduates was 75%. Based on these results, we concluded that having both classes follow the same time schedule was not beneficial, and an adjustment is needed. The graduates could spend less time on design and the undergraduates would benefit from more design time. In the fall of 2019, 30 students registered for the undergraduate course and 15 students registered for the graduate course. To test our conclusion, the undergraduates spend about 67% of time (eight classes) on the design part of the course and 33% (four classes) on the implementation part, using the exact exams as the previous year. This resulted in an improvement in their average grades on the design part from 77% to 83% and also their implementation average grade from 73% to 79%. In conclusion, we recommend using two separate schedules for teaching the database design course. For undergraduate students, it is important to spend more time on the design part rather than the implementation part of the course. While for the older graduate students, we recommend spending more time on the implementation part, as it seems that is the part they struggle with, even though they have a higher understanding of the design component of databases.

Keywords: computer science education, database design, graduate and undergraduate students, pedagogy

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864 On the Survival of Individuals with Type 2 Diabetes Mellitus in the United Kingdom: A Retrospective Case-Control Study

Authors: Njabulo Ncube, Elena Kulinskaya, Nicholas Steel, Dmitry Pshezhetskiy

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Life expectancy in the United Kingdom (UK) has been near constant since 2010, particularly for the individuals of 65 years and older. This trend has been also noted in several other countries. This slowdown in the increase of life expectancy was concurrent with the increase in the number of deaths caused by non-communicable diseases. Of particular concern is the world-wide exponential increase in the number of diabetes related deaths. Previous studies have reported increased mortality hazards among diabetics compared to non-diabetics, and on the differing effects of antidiabetic drugs on mortality hazards. This study aimed to estimate the all-cause mortality hazards and related life expectancies among type 2 diabetes (T2DM) patients in the UK using the time-variant Gompertz-Cox model with frailty. The study also aimed to understand the major causes of the change in life expectancy growth in the last decade. A total of 221 182 (30.8% T2DM, 57.6% Males) individuals aged 50 years and above, born between 1930 and 1960, inclusive, and diagnosed between 2000 and 2016, were selected from The Health Improvement Network (THIN) database of the UK primary care data and followed up to 31 December 2016. About 13.4% of participants died during the follow-up period. The overall all-cause mortality hazard ratio of T2DM compared to non-diabetic controls was 1.467 (1.381-1.558) and 1.38 (1.307-1.457) when diagnosed between 50 to 59 years and 60 to 74 years, respectively. The estimated life expectancies among T2DM individuals without further comorbidities diagnosed at the age of 60 years were 2.43 (1930-1939 birth cohort), 2.53 (1940-1949 birth cohort) and 3.28 (1950-1960 birth cohort) years less than those of non-diabetic controls. However, the 1950-1960 birth cohort had a steeper hazard function compared to the 1940-1949 birth cohort for both T2DM and non-diabetic individuals. In conclusion, mortality hazards for people with T2DM continue to be higher than for non-diabetics. The steeper mortality hazard slope for the 1950-1960 birth cohort might indicate the sub-population contributing to a slowdown in the growth of the life expectancy.

Keywords: T2DM, Gompetz-Cox model with frailty, all-cause mortality, life expectancy

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863 Enhancing Skills of Mothers of Asthmatic Children in Techniques of Drug Administration

Authors: Erna Judith Roach, Nalini Bhaskaranand

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Background & Significance: Asthma is the most common chronic disease among children. Education is the cornerstone of management of asthma to help the affected children. In India there are about 1.5- 3.0 million asthmatic children in the age group of 5-11 years. Many parents face management dilemmas in administration of medications to their children. Mothers being primary caregivers of children are often responsible for administering medications to them. The purpose of the study was to develop an educational package on techniques of drug administration for mothers of asthmatic children and determine its effectiveness in terms of improvement in skill in drug administration. Methodology: A quasi- experimental time series pre-test post -test control group design was used. Mothers of asthmatic children attending paediatric outpatient departments of selected hospitals along with their children between 5 and 12 years were included. Sample size consisted of 40 mothers in the experimental and 40 mothers in the control groups. Block randomization was used to assign samples to both the groups. The data collection instruments used were Baseline Proforma, Clinical Proforma, Daily asthma drug intake and symptoms diary and Observation Rating Scales on technique of using a metered dose inhaler with spacer; metered dose inhaler with facemask; metered dose inhaler alone and dry powder inhaler. The educational package consisted of a video and booklet on techniques of drug administration. Data were collected at baseline, 1, 3 and 6 months. Findings: The mean post-test scores in techniques of drug administration were higher than the mean pre-test scores in the experimental group in all techniques. The Friedman test (p < 0.01), Wilcoxon Signed Rank test (p < 0.008) and Mann Whitney U (p < 0.01) showed statistically significant difference in the experimental group than the control group. There was significant decrease in the average number of symptom days (11 Vs. 4 days/ month) and hospital visits (5 to 1 per month) in the experimental group when compared to the control group. Conclusion: The educational package was found to be effective in improving the skill of mothers in drug administration in all the techniques, especially with using the metered dose inhaler with spacer.

Keywords: childhood asthma, drug administration, mothers of children, inhaler

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862 Intensification of Heat Transfer Using AL₂O₃-Cu/Water Hybrid Nanofluid in a Circular Duct Using Inserts

Authors: Muluken Biadgelegn Wollele, Mebratu Assaye Mengistu

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Nanotechnology has created new opportunities for improving industrial efficiency and performance. One of the proposed approaches to improving the effectiveness of temperature exchangers is the use of nanofluids to improve heat transfer performance. The thermal conductivity of nanoparticles, as well as their size, diameter, and volume concentration, all played a role in influencing the rate of heat transfer. Nanofluids are commonly used in automobiles, energy storage, electronic component cooling, solar absorbers, and nuclear reactors. Convective heat transfer must be improved when designing thermal systems in order to reduce heat exchanger size, weight, and cost. Using roughened surfaces to promote heat transfer has been tried several times. Thus, both active and passive heat transfer methods show potential in terms of heat transfer improvement. There will be an added advantage of enhanced heat transfer due to the two methods adopted; however, pressure drop must be considered during flow. Thus, the current research aims to increase heat transfer by adding a twisted tap insert in a plain tube using a working fluid hybrid nanofluid (Al₂O₃-Cu) with a base fluid of water. A circular duct with inserts, a tube length of 3 meters, a hydraulic diameter of 0.01 meters, and tube walls with a constant heat flux of 20 kW/m² and a twist ratio of 125 was used to investigate Al₂O₃-Cu/H₂O hybrid nanofluid with inserts. The temperature distribution is better than with conventional tube designs due to stronger tangential contact and swirls in the twisted tape. The Nusselt number values of plain twisted tape tubes are 1.5–2.0 percent higher than those of plain tubes. When twisted tape is used instead of plain tube, performance evaluation criteria improve by 1.01 times. A heat exchanger that is useful for a number of heat exchanger applications can be built utilizing a mixed flow of analysis that incorporates passive and active methodologies.

Keywords: nanofluids, active method, passive method, Nusselt number, performance evaluation criteria

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861 Family Medicine Residents in End-of-Life Care

Authors: Goldie Lynn Diaz, Ma. Teresa Tricia G. Bautista, Elisabeth Engeljakob, Mary Glaze Rosal

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Introduction: Residents are expected to convey unfavorable news, discuss prognoses, and relieve suffering, and address do-not-resuscitate orders, yet some report a lack of competence in providing this type of care. Recognizing this need, Family Medicine residency programs are incorporating end-of-life care from symptom and pain control, counseling, and humanistic qualities as core proficiencies in training. Objective: This study determined the competency of Family Medicine Residents from various institutions in Metro Manila on rendering care for the dying. Materials and Methods: Trainees completed a Palliative Care Evaluation tool to assess their degree of confidence in patient and family interactions, patient management, and attitudes towards hospice care. Results: Remarkably, only a small fraction of participants were confident in performing independent management of terminal delirium and dyspnea. Fewer than 30% of residents can do the following without supervision: discuss medication effects and patient wishes after death, coping with pain, vomiting and constipation, and reacting to limited patient decision-making capacity. Half of the respondents had confidence in supporting the patient or family member when they become upset. Majority expressed confidence in many end-of-life care skills if supervision, coaching and consultation will be provided. Most trainees believed that pain medication should be given as needed to terminally ill patients. There was also uncertainty as to the most appropriate person to make end-of-life decisions. These attitudes may be influenced by personal beliefs rooted in cultural upbringing as well as by personal experiences with death in the family, which may also affect their participation and confidence in caring for the dying. Conclusion: Enhancing the quality and quantity of end-of-life care experiences during residency with sufficient supervision and role modeling may lead to knowledge and skill improvement to ensure quality of care. Fostering bedside learning opportunities during residency is an appropriate venue for teaching interventions in end-of-life care education.

Keywords: end of life care, geriatrics, palliative care, residency training skill

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860 The Role of Hemoglobin in Psychological Well Being and Academic Achievement of College Female Students

Authors: Ramesh Adsul, Vikas Minchekar

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The present study attempts to explore the differences in academic achievement and psychological well being and its components – satisfaction, efficiency, sociability, mental health, interpersonal relations in low and moderate level of hemoglobin of college female students. It also tries to find out how hemoglobin, psychological well –being and academic achievement correlate to each other. For this study 200 (100 low hemoglobin level and 100 moderate hemoglobin level) college female students were selected by random sampling method. This sample is collected from the project ‘Health awareness and hemoglobin improvement programme’, which is being collaboratively conducted by ‘Akshyabhasha, MESA, U.S.A. and Smt. M.G. Kanya Mahavidyalaya, Sangli, Maharashtra, India. Psychological Well-Being Scale was used to collect the data. Students’ academic achievement was collected through college record, and hemoglobin level of female students was collected from project record. Data was analyzed by using independent ‘t’ test and Pearson’s correlation coefficient. The finding of the study revealed significant differences between low hemoglobin and moderate hemoglobin groups regarding efficiency and mental health. No significant difference was observed on satisfaction, sociability and interpersonal relations. It is also found that there is significant difference between low hemoglobin and moderate hemoglobin groups on academic achievement. The study revealed positive correlation between hemoglobin and academic achievement and psychological well-being and academic achievement. Moderate hemoglobin level create more efficiency, better mental health and good academic achievement in female students. One could say that there is significant role hemoglobin plays in psychological well being and academic achievement of college female students. Anemia is widely prevalent in all the states if India among all age groups. In India, college girls contribute major portion of population. It has been reported that 80% female population has hemoglobin deficiency, due to illiteracy of female, family structure, status of women, diet habits, gender discrimination and various superstitions. The deficiency of hemoglobin affects physical and mental health, general behavior and academic performance of students. This study is useful to educational managements, counselors, parents, students and Government also. In the development of personality physical as well as psychological health is essential. This research findings will create awareness about physical and mental health among people and society.

Keywords: academic achievement, college female students, hemoglobin, psychological well-being

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859 Improving Knowledge Management Practices in the South African Healthcare System

Authors: Kgabo H. Badimo, Sheryl Buckley

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Knowledge is increasingly recognised in this, the knowledge era, as a strategic resource, by public sector organisations, in view of the public sector reform initiatives. People and knowledge play a vital role in attaining improved organisational performance and high service quality. Many government departments in the public sector have started to realise the importance of knowledge management in streamlining their operations and processes. This study focused on knowledge management in the public healthcare service organisations, where the concept of service provider competitiveness pales to insignificance, considering the huge challenges emanating from the healthcare and public sector reforms. Many government departments are faced with challenges of improving organisational performance and service delivery, improving accountability, making informed decisions, capturing the knowledge of the aging workforce, and enhancing partnerships with stakeholders. The purpose of this paper is to examine the knowledge management practices of the Gauteng Department of Health in South Africa, in order to understand how knowledge management practices influence improvement in organisational performance and healthcare service delivery. This issue is explored through a review of literature on dominant views on knowledge management and healthcare service delivery, as well as results of interviews with, and questionnaire responses from, the general staff of the Gauteng Department of Health. Web-based questionnaires, face-to-face interviews and organisational documents were used to collect data. The data were analysed using both the quantitative and qualitative methods. The central question investigated was: To what extent can the conditions required for successful knowledge management be observed, in order to improve organisational performance and healthcare service delivery in the Gauteng Department of Health. The findings showed that the elements of knowledge management capabilities investigated in this study, namely knowledge creation, knowledge sharing and knowledge application, have a positive, significant relationship with all measures of organisational performance and healthcare service delivery. These findings thus indicate that by employing knowledge management principles, the Gauteng Department of Health could improve its ability to achieve its operational goals and objectives, and solve organisational and healthcare challenges, thereby improving organisational.

Keywords: knowledge management, Healthcare Service Delivery, public healthcare, public sector

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858 Preliminary Short-Term Results of a Population of Patients Treated with Mitraclip Therapy: One Center Experience

Authors: Rossana Taravella, Gilberto M. Cellura, Giuseppe Cirrincione, Salvatore Asciutto, Marco Caruso, Massimo Benedetto, Renato Ciofalo, Giuliana Pace, Salvatore Novo

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Objectives: This retrospective analysis sought to evaluate 1-month outcomes and therapy effectiveness of a population of patients treated with MitraClip therapy. We describe in this article the preliminary results of primary effectiveness endpoint. Background: Percutaneous Mitral Repair is being developed to treat severe mitral regurgitation (MR), with increasing real-world cases of functional MR (FMR). In the EVEREST (Endovascular Valve Edge-to-Edge Repair Study)II trial, the percutaneous device showed superior safety but less reduction in MR at 1year. 4-year outcomes from EVEREST II trial showed no difference in the prevalence of moderate-severe and severe MR or mortality at 4years between surgical mitral repair and percutaneous approach. Methods: We analysed retrospectively collected data from one center experience in Italy enrolled from January 2011 to December 2016. The study included 62 patients [mean age 74±11years, 43 men (69%)] with MR of at least grade3+. Most of the patients had functional MR, were in New York Heart Association (NYHA) functional class III or IV, with a large portion (78%) of mild-to-moderate Tricuspid Regurgitation (TR). One or more clips were implanted in 67 procedures (62 patients). Results and Conclusions: Severity of MR was reduced in all successfully treated patients,54(90%) were discharged with MR≤2+ (primary effectiveness endpoint). Clinical 1-month follow-up data showed an improvement in NYHA functional class (42 patients (70%) in NYHA class I-II). 60 of 62 (97 %) successfully treated patients were free from death and mitral valve surgery at 1-month follow-up. MitraClip therapy reduces functional MR with acute MR reduction to <2+ in the great majority of patients, with a large freedom from death, surgery or recurrent MR in a great portion of patients.

Keywords: MitraClip, mitral regurgitation, heart valves, catheter-based therapy

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857 Mapping and Characterizing the Jefoure Cultural Landscape Which Provides Multiple Ecosystem Services to the Gurage People in Ethiopia

Authors: M. Achemo, O. Saito

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Jefoure land use system is one of the traditional landscape human settlement patterns, and it is a cultural design and peculiar art of the people of Gurage in Ethiopia via which houses and trees flank roads left and right. Assessment of the multiple benefits of the traditional road that benefit society and development could enhance the understanding of the land use planners and decision makers to pay attention while planning and managing the land use system. Recent trend shows that the Jefoure land use is on the threshold of change as a result of flourishing road networks, overgrazing, and agricultural expansion. This study aimed to evaluate the multiple ecosystem services provided by the Jefoure land use system after characterization of the socio-ecological landscape. Information was compiled from existing data sources such as ordnance survey maps, aerial photographs, recent high resolution satellite imageries, designated questionnaires and interviews, and local authority contacts. The result generated scientific data on the characteristics, ecosystem services provision, and drivers of changes. The cultural landscape has novel characteristics and providing multiple ecosystem services to the community for long period of time. It is serving as road for humans, livestock and vehicles, habitat for plant species, regulating local temperature, climate, runoff and infiltration, and place for meeting, conducting religious and spiritual activities, holding social events such as marriage and mourning, playing station for children and court for football and other traditional games. As a result of its aesthetic quality and scenic beauty, it is considered as recreational place for improving mental and physical health. The study draws relevant land use planning and management solution in the improvement of socio-ecological resilience in the Jefoure land use system. The study suggests the landscape needs to be registrar as heritage site for recognizing the wisdom of the community and enhancing the conservation mechanisms.

Keywords: cultural landscape, ecosystem services, Gurage, Jefoure

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856 Problems concerning Formation of Institutional Framework for Electronic Democracy in Georgia

Authors: Giorgi Katamadze

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Open public service and accountability towards citizens is an important feature of democratic state based on rule of law. Effective use of electronic resources simplifies bureaucratic procedures, makes direct communications, helps exchange information, ensures government’s openness and in general helps develop electronic/digital democracy. Development of electronic democracy should be a strategic dimension of Georgian governance. Formation of electronic democracy, its functional improvement should become an important dimension of the state’s information policy. Electronic democracy is based on electronic governance and implies modern information and communication systems, their adaptation to universal standards. E-democracy needs involvement of governments, voters, political parties and social groups in an electronic form. In the last years the process of interaction between the citizen and the state becomes simpler. This process is achieved by the use of modern technological systems which gives to a citizen a possibility to use different public services online. For example, the website my.gov.ge makes interaction between the citizen, business and the state more simple, comfortable and secure. A higher standard of accountability and interaction is being established. Electronic democracy brings new forms of interactions between the state and the citizen: e-engagement – participation of society in state politics via electronic systems; e-consultation – electronic interaction among public officials, citizens and interested groups; e-controllership – electronic rule and control of public expenses and service. Public transparency is one of the milestones of electronic democracy as well as representative democracy as only on mutual trust and accountability can democracy be established. In Georgia, institutional changes concerning establishment and development of electronic democracy are not enough. Effective planning and implementation of a comprehensive and multi component e-democracy program (central, regional, local levels) requires telecommunication systems, institutional (public service, competencies, logical system) and informational (relevant conditions for public involvement) support. Therefore, a systematic project of formation of electronic governance should be developed which will include central, regional, municipal levels and certain aspects of development of instrumental basis for electronic governance.

Keywords: e-democracy, e-governance, e-services, information technology, public administration

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855 Drug Delivery Nanoparticles of Amino Acid Based Biodegradable Polymers

Authors: Sophio Kobauri, Tengiz Kantaria, Temur Kantaria, David Tugushi, Nina Kulikova, Ramaz Katsarava

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Nanosized environmentally responsive materials are of special interest for various applications, including targeted drug to a considerable potential for treatment of many human diseases. The important technological advantages of nanoparticles (NPs) usage as drug carriers (nanocontainers) are their high stability, high carrier capacity, feasibility of encapsulation of both hydrophilic or hydrophobic substances, as well as a high variety of possible administration routes, including oral application and inhalation. NPs can also be designed to allow controlled (sustained) drug release from the matrix. These properties of NPs enable improvement of drug bioavailability and might allow drug dosage decrease. The targeted and controlled administration of drugs using NPs might also help to overcome drug resistance, which is one of the major obstacles in the control of epidemics. Various degradable and non-degradable polymers of both natural and synthetic origin have been used for NPs construction. One of the most promising for the design of NPs are amino acid-based biodegradable polymers (AABBPs) which can clear from the body after the fulfillment of their function. The AABBPs are composed of naturally occurring and non-toxic building blocks such as α-amino acids, fatty diols and dicarboxylic acids. The particles designed from these polymers are expected to have an improved bioavailability along with a high biocompatibility. The present work deals with a systematic study of the preparation of NPs by cost-effective polymer deposition/solvent displacement method using AABBPs. The influence of the nature and concentration of surfactants, concentration of organic phase (polymer solution), and the ratio organic phase/inorganic (water) phase, as well as of some other factors on the size of the fabricated NPs have been studied. It was established that depending on the used conditions the NPs size could be tuned within 40-330 nm. As the next step of this research an evaluation of biocompatibility and bioavailability of the synthesized NPs has been performed, using two stable human cell culture lines – HeLa and A549. This part of study is still in progress now.

Keywords: amino acids, biodegradable polymers, nanoparticles (NPs), non-toxic building blocks

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854 An Automatic Large Classroom Attendance Conceptual Model Using Face Counting

Authors: Sirajdin Olagoke Adeshina, Haidi Ibrahim, Akeem Salawu

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large lecture theatres cannot be covered by a single camera but rather by a multicamera setup because of their size, shape, and seating arrangements. Although, classroom capture is achievable through a single camera. Therefore, a design and implementation of a multicamera setup for a large lecture hall were considered. Researchers have shown emphasis on the impact of class attendance taken on the academic performance of students. However, the traditional method of carrying out this exercise is below standard, especially for large lecture theatres, because of the student population, the time required, sophistication, exhaustiveness, and manipulative influence. An automated large classroom attendance system is, therefore, imperative. The common approach in this system is face detection and recognition, where known student faces are captured and stored for recognition purposes. This approach will require constant face database updates due to constant changes in the facial features. Alternatively, face counting can be performed by cropping the localized faces on the video or image into a folder and then count them. This research aims to develop a face localization-based approach to detect student faces in classroom images captured using a multicamera setup. A selected Haar-like feature cascade face detector trained with an asymmetric goal to minimize the False Rejection Rate (FRR) relative to the False Acceptance Rate (FAR) was applied on Raspberry Pi 4B. A relationship between the two factors (FRR and FAR) was established using a constant (λ) as a trade-off between the two factors for automatic adjustment during training. An evaluation of the proposed approach and the conventional AdaBoost on classroom datasets shows an improvement of 8% TPR (output result of low FRR) and 7% minimization of the FRR. The average learning speed of the proposed approach was improved with 1.19s execution time per image compared to 2.38s of the improved AdaBoost. Consequently, the proposed approach achieved 97% TPR with an overhead constraint time of 22.9s compared to 46.7s of the improved Adaboost when evaluated on images obtained from a large lecture hall (DK5) USM.

Keywords: automatic attendance, face detection, haar-like cascade, manual attendance

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853 Study on Pd Catalyst Supported on Carbon Materials for C₂ Hydrogenation

Authors: Huanru Wang, Jianzhun Jiang

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At present, the preparation of the catalyst by carbon carrier is one of the improvement directions of the C₂ pre-hydrogenation catalyst. Carbon materials can be prepared from coal direct liquefaction residues, coconut shells, biomass, etc., and the pore structure of carbon carrier materials can be adjusted through the preparation process; at high temperatures, the carbon carrier itself also shows certain catalytic activity. Therefore, this paper mainly selected typical activated carbon and coconut shell carbon as carbon carrier materials, studied their microstructure and surface properties, prepared a series of carbon-based catalysts loaded with Pd, and investigated the effects of the content of promoter Ag and the concentration of reductant on the structure and performance of the catalyst and its catalytic performance for the pre hydrogenation of C₂. In this paper, the carbon supports from two sources and the catalysts prepared by them were characterized in detail. The results showed that the morphology and structure of different supports and the performance of the catalysts prepared were also obviously different. The catalyst supported on coconut shell carbon has a small specific surface area and large pore diameter. The catalyst supported on activated carbon has a large specific surface area and rich pore structure. The active carbon support is mainly a mixture of amorphous graphite and microcrystalline graphite. For the catalyst prepared with coconut shell carbon as the carrier, the sample is very uneven, and its specific surface area and pore volume are irregular. Compared with coconut shell carbon, activated carbon is more suitable as the carrier of the C₂ hydrogenation catalyst. The conversion of acetylene, methyl acetylene, and butadiene decreased, and the ethylene selectivity increased after Ag was added to the supported Pd catalyst. When the amount of promoter Ag is 0.01-0.015%, the catalyst has relatively good catalytic performance. Ag and Pd form an alloying effect, thus reducing the effective demand for Ag. The Pd Ag ratio is the key factor affecting the catalytic performance. When the addition amount of Ag is 0.01-0.015%, the dispersion of Pd on the carbon support surface can be significantly improved, and the size of active particles can be reduced. The Pd Ag ratio is the main factor in improving the selectivity of the catalyst. When the additional amount of sodium formate is 1%, the catalyst prepared has both high acetylene conversion and high ethylene selectivity.

Keywords: C₂ hydrogenation, activated carbon, Ag promoter, Pd catalysts

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852 Infographics to Identify, Diagnose, and Review Medically Important Microbes and Microbial Diseases: A Tool to Ignite Minds of Undergraduate Medical Students

Authors: Mohan Bilikallahalli Sannathimmappa, Vinod Nambiar, Rajeev Aravindakshan

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Background: Image-based teaching-learning module is innovative student-centered andragogy. The objective of our study was to explore medical students’ perception of effectiveness of image-based learning strategy in promoting their lifelong learning skills and evaluate its impact on improving students’ exam grades. Methods: A prospective single-cohort study was conducted on undergraduate medical students of the academic year 2021-22. The image-based teaching-learning module was assessed through pretest, posttest, and exam grades. Students’ feedback was collected through a predesigned questionnaire on a 3-point Likert Scale. The reliability of the questionnaire was assessed using Cronbach’s alpha coefficient test. In-Course Exam-4 results were compared with In-Course Exams 1, 2, and 3. Correlation coefficients were worked out wherever relevant to find the impact of the exercise on grades. Data were collected, entered into Microsoft Excel, and statistically analyzed using SPSS version 22. Results: In total, 127 students were included in the study. The posttest scores of the students were significantly high (24.75±) as compared to pretest scores (8.25±). Students’ opinion towards the effectiveness of image-based learning in promoting their lifelong learning skills was overwhelmingly positive (Cronbach’s alpha for all items was 0.756). More than 80% of the students indicated image-based learning was interesting, encouraged peer discussion, and helped them to identify, explore, and revise key information and knowledge improvement. Nearly 70% expressed image-based learning enhanced their critical thinking and problem-solving skills. Nine out of ten students recommended image-based learning module for future topics. Conclusion: Overall, Image-based learning was found to be effective in achieving undergraduate medical students learning outcomes. The results of the study are in favor of the implementation of Image-based learning in Microbiology courses. However, multicentric studies are required to authenticate our study findings.

Keywords: active learning, knowledge, medical education, microbes, problem solving

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851 Efficacy of the Culturally Adapted Stepping Stones Positive Parenting Program on Parents of Children with Autism and down Syndrome

Authors: Afsheen Masood, Sumaira Rashid, Shama Mazahir

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The main aim of this research is to evaluate the efficacy of a culturally adapted management program The Stepping Stones Positive Parenting Program (Tripple P; SSTP) for caregivers of children with autism spectrum disorders and Down syndrome. Positive psychology has catered new dimensions to the traditional perspectives of parenting. The current study was designed to determine the adoptions of positive parenting elements such as parenting styles, parental satisfaction, parental competency, and management of parental stress in alignment with behavioral problems of children with special needs after their parents get trained on Positive Parenting Techniques. This research study was devised in liaison with rehabilitation institute that is extending services for children with Autism Spectrum Disorder and Down syndrome. A Quasi experimental research design was employed with pre-test, post-test control group study in order to evaluate the changes in parenting patterns of parents with children (with Autism and Down syndrome). Caregivers of children diagnosed with Autism and Down syndrome between the age ranges of 25 to 45 years, n=20 from autism group and 20 from Down syndrome group (while their children with special needs in the age ranges of 8 to 14 years) participated in the current research. Parenting scale encompassing areas of parental efficacy, parental satisfaction was used in addition to Parenting Stress Index (SF), indigenously developed Child Behavior Problems Checklist and demographic sheet. Findings revealed statistically significant improvement for caregivers in intervention group from pretest to posttest situation. There was considerable decrease in reported mean behavioral issues of children with Down syndrome when parents in experimental group started practicing Positive Parenting Techniques with their special needs children. This change was somehow not recorded in parents of children with autism. Thus these findings establish the efficacy of culturally adapted parenting program that is evidence based and is established in western empirical research. This carries significant implication for practitioners in special needs domain and for school psychologists in Pakistan.

Keywords: Autism and Parenting, Downsyndrome and Parenting , Positive Parenting, Stepping Stone Positive Parenting Program, Mangement of Behavioral Problems with positive parenting

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850 Energy Certification Labels and Comfort Assessment for Dwellings Located in a Mild Climate

Authors: Silvia A. Magalhaes, Vasco P. De Freitas, Jose L. Alexandre

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Most of the European literature concerning energy efficiency and thermal comfort of dwellings assumes permanent heating and focuses on energy-saving measures. European National regulations are designed for those permanent comfort conditions. On the other hand, very few studies focus on the effect of the improvement measures in comfort reduction, for free-floating conditions or intermittent heating, in fuel poverty vulnerable countries. In Portugal, only 21% of the household energy consumptions (and 10% of the cost) are spent in space heating, while, on average European bills, this value rises to 67%. The mild climate, but mainly fuel poverty and cultural background, justifies these low heating practices. This study proposes a “passive discomfort” index definition, considering free-floating temperatures or with intermittent heating profiles (more realistic conditions), putting the focus on comfort rather than energy consumption (which is low for these countries). The aim is to compare both energy (regarding the legal framework of national regulation) and comfort (considering realistic conditions of use) to identify some correlation. It was developed an experimental campaign of indoor thermal conditions in a 19th building located in Porto with several apartments. One dwelling was chosen as a case study to carry out a sensitivity analysis. The results are discussed comparing both theoretical energy consumption (energy rates from national regulation) and discomfort (new index defined), for different insulation thicknesses, orientations, and intermittent heating profiles. The results show that the different passive options (walls insulation and glazing options) have a small impact on winter discomfort, which is always high for low heating profiles. Moreover, it was shown that the insulation thickness on walls has no influence, and the minimum insulation thickness considered is enough to achieve the same impact on discomfort reduction. Plus, for these low heating profiles, other conditions are critical, as the orientation. Finally, there isn’t an unequivocal relation between the energy label and the discomfort index. These and other results are surprising when compared with the most usual approaches, which assume permanent heating.

Keywords: dwellings in historical buildings, low-heating countries, mild climates, thermal comfort

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849 Innovation in the Provision of Medical Services in the Field of Qualified Sports and Services Related to the Therapy of Metabolism Disorders and the Treatment of Obesity

Authors: Jerzy Slowik, Elzbieta Grochowska-Niedworok

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The analysis of the market needs and trends in both treatment and prophylaxis shows the growing need to implement comprehensive solutions that would enable safe contact of the beneficiaries with the therapeutic and diagnostic support group. Based on the evaluation of the medical and sports industry services market, projects co-financed by the EFRR in the form of comprehensive care systems using IT tools for patients under treatment in the field of obesity and metabolism using the system were implemented under the Regional Operational Program of the Silesian Voivodeship for 2014-2020. SFAO 1.0 (Support for the Fight Against Obesity) number of the WND-RPSL project. 01.02.00-24-06EA / 16) as well as for competitors in qualified sports SK system (qualified sports) project number WND-RPSL. 01.02.00-24-0630 / 17-002. The service provided in accordance with SFAO 1.0 has shown a wide range of therapy possibilities - from monitoring the body's reactions during sports activities of healthy people to remote care for sick patients. As a result of the introduction of an innovative service, it was possible to increase the effectiveness of the therapy, which was manifested in the reduction of the starting doses of drugs by 10%, improvement of the efficiency of the respiratory and blood circulation system, and a 10% increase in bone density. Innovation in the provision of medical services in the field of qualified sports SK was a response to the needs of the athletes and their parents, coaches, physiotherapists, dieticians, and doctors who take care of people actively practicing qualified sports. The creation of the platform made it possible to constantly monitor the trainers necessary for both the proper training process and the control over the health of patients. Monitoring the patient's health by a specialized team in the field of various specialties allows for the proper targeting of the treatment and training process due to the increase in the availability of medical counseling. Specialists taking care of the patient can provide additional advice and modify the medical treatment of the patient on an ongoing basis, which is why we are dealing with a holistic approach.

Keywords: innovation of medical services, sport, obesity, innovation

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848 Rapid Strategic Consensus Building in Land Readjustment in Kabul

Authors: Nangialai Yousufzai, Eysosiyas Etana, Ikuo Sugiyama

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Kabul population has been growing continually since 2001 and reaching six million in 2025 due to the rapid inflow from the neighboring countries. As a result of the population growth, lack of living facilities supported by infrastructure services is becoming serious in social and economic aspects. However, about 70% of the city is still occupied illegally and the government has little information on the infrastructure demands. To improve this situation, land readjustment is one of the powerful development tools, because land readjustment does not need a high governmental budget of itself. Instead, the method needs cooperation between stakeholders such as landowners, developers and a local government. So it is becoming crucial for both government and citizens to implement land readjustment for providing tidy urban areas with enough public services to realize more livable city as a whole. On the contrary, the traditional land readjustment tends to spend a long time until now to get consensus on the new plan between stakeholders. One of the reasons is that individual land area (land parcel) is decreased due to the contribution to public such as roads/parks/squares for improving the urban environment. The second reason is that the new plan is difficult for dwellers to imagine new life after the readjustment. Because the paper-based plan is made by an authority not for dwellers but for specialists to precede the project. This paper aims to shorten the time to realize quick consensus between stakeholders. The first improvement is utilizing questionnaire(s) to assess the demand and preference of the landowners. The second one is utilizing 3D model for dwellers to visualize the new environment easily after the readjustment. In additions, the 3D model is reflecting the demand and preference of the resident so that they could select a land parcel according to their sense value of life. The above-mentioned two improvements are carried out after evaluating total land prices of the new plans to select for maximizing the project value. The land price forecasting formula is derived from the current market ones in Kabul. Finally, it is stressed that the rapid consensus-building of land readjustment utilizing ICT and open data analysis is essential to redevelop slums and illegal occupied areas in Kabul.

Keywords: land readjustment, consensus building, land price formula, 3D simulation

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847 Sustainable Integrated Waste Management System

Authors: Lidia Lombardi

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Waste management in Europe and North America is evolving towards sustainable materials management, intended as a systemic approach to using and reusing materials more productively over their entire life cycles. Various waste management strategies are prioritized and ranked from the most to the least environmentally preferred, placing emphasis on reducing, reusing, and recycling as key to sustainable materials management. However, non-recyclable materials must also be appropriately addressed, and waste-to-energy (WtE) offers a solution to manage them, especially when a WtE plant is integrated within a complex system of waste and wastewater treatment plants and potential users of the output flows. To evaluate the environmental effects of such system integration, Life Cycle Assessment (LCA) is a helpful and powerful tool. LCA has been largely applied to the waste management sector, dating back to the late 1990s, producing a large number of theoretical studies and applications to the real world as support to waste management planning. However, LCA still has a fundamental role in helping the development of waste management systems supporting decisions. Thus, LCA was applied to evaluate the environmental performances of a Municipal Solid Waste (MSW) management system, with improved separate material collection and recycling and an integrated network of treatment plants including WtE, anaerobic digestion (AD) and also wastewater treatment plant (WWTP), for a reference study case area. The proposed system was compared to the actual situation, characterized by poor recycling, large landfilling and absence of WtE. The LCA results showed that the increased recycling significantly increases the environmental performances, but there is still room for improvement through the introduction of energy recovery (especially by WtE) and through its use within the system, for instance, by feeding the heat to the AD, to sludge recovery processes and supporting the water reuse practice. WtE offers a solution to manage non-recyclable MSW and allows saving important resources (such as landfill volumes and non-renewable energy), reducing the contribution to global warming, and providing an essential contribution to fulfill the goals of really sustainable waste management.

Keywords: anaerobic digestion, life cycle assessment, waste-to-energy, municipal solid waste

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846 A Comparative Analysis of Innovation Maturity Models: Towards the Development of a Technology Management Maturity Model

Authors: Nikolett Deutsch, Éva Pintér, Péter Bagó, Miklós Hetényi

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Strategic technology management has emerged and evolved parallelly with strategic management paradigms. It focuses on the opportunity for organizations operating mainly in technology-intensive industries to explore and exploit technological capabilities upon which competitive advantage can be obtained. As strategic technology management involves multifunction within an organization, requires broad and diversified knowledge, and must be developed and implemented with business objectives to enable a firm’s profitability and growth, excellence in strategic technology management provides unique opportunities for organizations in terms of building a successful future. Accordingly, a framework supporting the evaluation of the technological readiness level of management can significantly contribute to developing organizational competitiveness through a better understanding of strategic-level capabilities and deficiencies in operations. In the last decade, several innovation maturity assessment models have appeared and become designated management tools that can serve as references for future practical approaches expected to be used by corporate leaders, strategists, and technology managers to understand and manage technological capabilities and capacities. The aim of this paper is to provide a comprehensive review of the state-of-the-art innovation maturity frameworks, to investigate the critical lessons learned from their application, to identify the similarities and differences among the models, and identify the main aspects and elements valid for the field and critical functions of technology management. To this end, a systematic literature review was carried out considering the relevant papers and articles published in highly ranked international journals around the 27 most widely known innovation maturity models from four relevant digital sources. Key findings suggest that despite the diversity of the given models, there is still room for improvement regarding the common understanding of innovation typologies, the full coverage of innovation capabilities, and the generalist approach to the validation and practical applicability of the structure and content of the models. Furthermore, the paper proposes an initial structure by considering the maturity assessment of the technological capacities and capabilities - i.e., technology identification, technology selection, technology acquisition, technology exploitation, and technology protection - covered by strategic technology management.

Keywords: innovation capabilities, innovation maturity models, technology audit, technology management, technology management maturity models

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845 A Review of Lexical Retrieval Intervention in Primary Progressive Aphasia and Alzheimer's Disease: Mechanisms of Change, Cognition, and Generalisation

Authors: Ashleigh Beales, Anne Whitworth, Jade Cartwright

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Background: While significant benefits of lexical retrieval intervention are evident within the Primary Progressive Aphasia (PPA) and Alzheimer’s disease (AD) literature, an understanding of the mechanisms that underlie change or improvement is limited. Change mechanisms have been explored in the non-progressive post-stroke literature that may offer insight into how interventions affect change with progressive language disorders. The potential influences of cognitive factors may also play a role here, interacting with the aims of intervention. Exploring how such processes have been applied is likely to grow our understanding of how interventions have, or have not, been effective, and how and why generalisation is likely, or not, to occur. Aims: This review of the literature aimed to (1) investigate the proposed mechanisms of change which underpin lexical interventions, mapping the PPA and AD lexical retrieval literature to theoretical accounts of mechanisms that underlie change within the broader intervention literature, (2) identify whether and which nonlinguistic cognitive functions have been engaged in intervention with these populations and any proposed influence, and (3) explore evidence of linguistic generalisation, with particular reference to change mechanisms employed in interventions. Main contribution: A search of Medline, PsycINFO, and CINAHL identified 36 articles that reported data for individuals with PPA or AD following lexical retrieval intervention. A review of the mechanisms of change identified 10 studies that used stimulation, 21 studies utilised relearning, three studies drew on reorganisation, and two studies used cognitive-relay. Significant treatment gains, predominantly based on linguistic performance measures, were reported for all client groups for each of the proposed mechanisms. Reorganisation and cognitive-relay change mechanisms were only targeted in PPA. Eighteen studies incorporated nonlinguistic cognitive functions in intervention; these were limited to autobiographical memory (16 studies), episodic memory (three studies), or both (one study). Linguistic generalisation outcomes were inconsistently reported in PPA and AD studies. Conclusion: This review highlights that individuals with PPA and AD may benefit from lexical retrieval intervention, irrespective of the mechanism of change. Thorough application of a theory of intervention is required to gain a greater understanding of the change mechanisms, as well as the interplay of nonlinguistic cognitive functions.

Keywords: Alzheimer's disease, lexical retrieval, mechanisms of change, primary progressive aphasia

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844 The Effect of Modified Posterior Shoulder Stretching Exercises on Posterior Shoulder Tightness, Shoulder Pain, and Dysfunction in Patients with Subacromial Impingement

Authors: Ozge Tahran, Sevgi Sevi Yesilyaprak

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Objective: The aim of the study was to investigate the effect of the Wilk’s modified two different stretching exercises on posterior shoulder tightness, pain, and dysfunction in patients with subacromial impingement syndrome (SIS). Method: This study was carried out on 67 patients who have more than 15° difference in shoulder internal rotation range of motion between two sides and had been diagnosed as SIS. Before treatment, all patients were randomly assigned into three groups. Standard physiotherapy programme was applied to the Group 3 (n=23), standard physiotherapy program with Wilk’s modified cross-body stretching exercises were applied to Group 1 (n=22), and standard physiotherapy program with Wilk’s modified sleeper stretching exercises were applied to Group 2 (n= 23). All the patients received 20 sessions of physiotherapy during 4 weeks, 5 days in a week by a physiotherapist. The patients continued their exercises at home at the weekends. Pain severity, shoulder rotation range of motion, posterior shoulder tightness, upper extremity functionality with Constant and Murley Score (CMS) and disability level with The Disabilities of the Arm, Shoulder and Hand Score (QuickDASH) were evaluated before and after physiotherapy programme. Results: Before treatment, demographic and anthropometric characteristics were similar in groups and there was no statistical difference (p > 0.05). It was determined that pain severity decreased, shoulder rotation range of motion, posterior shoulder tightness, upper extremity functionality, and disability were improved after physiotherapy in both groups (p < 0.05). Group 1 and 2 had better results in terms of reduction of pain severity during activity, increase in shoulder rotation range of motion, posterior shoulder mobility and upper extremity functionality and improvement in upper extremity disability, compared to Group 3 (p < 0.05). Conclusion: Modified posterior shoulder stretching exercises in addition to standard physiotherapy programme is more effective for reduction of pain during activity, to improve shoulder rotation range of motion, posterior shoulder mobility, and upper extremity functionality in patients with SIS compared to standard physiotherapy programme alone.

Keywords: modified posterior shoulder stretching exercises, posterior shoulder tightness, shoulder complex, subacromial impingement syndrome

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843 Tablet Computer Based Cognitive Rehabilitation Program, Injini, for Children with Cognitive Impairment

Authors: Eun Jae Ko, In Young Sung, Eui Soo Joeng

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Cognitive impairment is commonly encountered problem in children with various clinical diseases, including Down syndrome, autism spectrum disorder, brain injury, and others. Cognitive impairment limits participation in education and society, and this further hinders development in cognition. However, young children with cognitive impairment tend not to respond well to traditional cognitive treatments, therefore alternative treatment choices are need. As a cognitive training program, touch screen technology can easily be applied to very young children by involving visual and auditory support. Injini was developed as tablet computer based cognitive rehabilitation program for young children or individuals with severe cognitive impairment, which targeted on cognitive ages of 18 to 36 months. The aim of this study was to evaluate the efficacy of a tablet computer based cognitive rehabilitation program (Injini) for children with cognitive impairment. 38 children between cognitive ages of 18 to 36 months confirmed by cognitive evaluations were recruited and randomly assigned to the intervention group (n=20) and the control group (n=18). The intervention group received tablet computer based cognitive rehabilitation program (Injini) for 30 minutes per session, twice a week, over a period of 12 weeks, in addition to the traditional rehabilitation program. The control group received traditional rehabilitation program only. Mental score of Bayley Scales of Infant Development II (BSID II), Pediatric Evaluation of Disability Inventory (PEDI), Laboratory Temperament Assessment Battery (Lab-TAB), Early Childhood Behavior Questionnaire (ECBQ), and Goal Attainment Scale (GAS) were evaluated before and after 12 weeks of therapeutic intervention. When comparing the baseline characteristics, there was no significant difference between the two groups in the measurements of cognitive function. After 12 weeks of treatment, both group showed improvements in all measurements. However, in comparison of improvements after treatment, the intervention group showed more improvements in the mental score of BSID II, social function domain of PEDI, observation domain of Lab-TAB, and GAS, as compared to the control group. Application of the tablet computer based cognitive rehabilitation program (Injini) would be beneficial for improvement of cognitive function in young children with cognitive impairment.

Keywords: cognitive therapy, computer-assisted therapy, early intervention, tablets

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842 Effects of Turmeric on Uterine Tissue in Rats with Metabolic Syndrome Induced by High Fructose Diet

Authors: Mesih Kocamuftuoglu, Gonca Ozan, Enver Ozan, Nalan Kaya, Sema Temizer Ozan

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Metabolic Syndrome, one of the common metabolic disorder, occurs with co-development of insulin resistance, obesity, dislipidemia and hypertension problems. Insulin resistance appears to play a pathogenic role in the metabolic syndrome. Also, there is a relationship between insulin resistance and infertility as known. Turmeric (Curcuma longa L.) a polyphenolic chemical is widely used for its coloring, flavoring, and medicinal properties, and exhibits a strong antioxidant activity. In this study, we assess the effects of turmeric on rat uterine tissue in metabolic syndrome model induced by high fructose diet. Thirty-two adult female Wistar rats weighing 220±20 g were randomly divided into four groups (n=8) as follows; control, fructose, turmeric, and fructose plus turmeric. Metabolic syndrome was induced by fructose solution 20% (w/v) in tap water, and turmeric (C.Longa) administered at the dose of 80 mg/kg body weight every other day by oral gavage. After the experimental period of 8 weeks, rats were decapitated, serum and uterine tissues were removed. Serum lipid profile, glucose, insülin levels were measured. Uterine tissues were fixed for histological analyzes. The uterine tissue sections were stained with hematoxylin-eosin (H & E) stain, then examined and photographed on a light microscope (Novel N-800Mx20). As a result, fructose consumption effected serum lipids, insulin levels, and insulin resistance significantly. Endometrium and myometrium layers were observed in normal structure in control group of uterine tissues. Perivascular edema, peri glandular fibrosis, and inflammatory cell increase were detected in fructose group. Sections of the fructose plus turmeric group showed a significant improvement in findings when compared to the fructose group. Turmeric group cell structures were observed similar with the control group. These results demonstrated that high-fructose consumption could change the structure of the uterine tissue. On the other hand, turmeric administration has beneficial effects on uterine tissue at that dose and duration when administered with fructose.

Keywords: metabolic syndrome, rat, turmeric, uterus

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841 Protection of Patients and Staff in External Beam Radiotherapy Using Linac in Kenya

Authors: Calvince Okome Odeny

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There is a current action to increase radiotherapy services in Kenya. The National government of Kenya, in collaboration with the county governments, has embarked on building radiotherapy centers in all 47 regions of the country. As these new centers are established in Kenya, it has to be ensured that minimum radiation safety standards are in place prior to operation. For full implementation of this, it is imperative that more Research and training for regulators are done on radiation protection, and safety and national regulatory infrastructure is geared towards ensuring radiation protection and safety in all aspects of the use of external radiotherapy practices. The present work aims at reviewing the level of protection and safety for patients and staff during external beam radiotherapy using Linac in Kenya and provides relevant guidance to improve protection and safety. A retrospective evaluation was done to verify whether those occupationally exposed workers and patients are adequately protected from the harmful effect of radiation exposure during the treatment procedures using Linac. The project was experimental Research, also including an analysis of resource documents obtained from the literature and international organizations. The critical findings of the work revealed that the key elements of protection of occupationally exposed workers and patients include a comprehensive quality Management system governing all planned activities from siting, safety, and design of the Facility, construction, acceptance testing, commissioning, operation, and decommissioning of the Facility; Government empowering the Regulatory Authority to license Medical Linear facilities and to enforce the applicable regulations to ensure adequate protection; A comprehensive Radiation Protection and Safety program must be established to ensure adequate safety and protection of workers and patients during treatment planning and treatment delivery of patients and categories of staff associated with the Facility must be well educated and trained to perform professionally with a commitment to sound safety culture. Relevant recommendations from the findings are shared with the Medical Linear Accelerator facilities and the regulatory authority to provide guidance and continuous improvement of protection and safety to improve regulatory oversight.

Keywords: oncology, radiotherapy, protection, staff

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