Search results for: copolymer-based grinding aids
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 594

Search results for: copolymer-based grinding aids

144 Value Gaps Between Patients and Doctors

Authors: Yih-Jer Wu, Ling-Lang Huang

Abstract:

Shared decision-making (SDM) is a critical aspect of determining optimal medical strategies. However, current patient decision aids (PDAs) often prioritize evidence-based discussions over value-based considerations. Despite its significance, there is limited research addressing the 'value gap' between patients and healthcare providers. To address this gap, we developed the 'Patient-Doctor Relationship Questionnaire,' consisting of 12 questions. To explore potential variations in the patient-doctor value gap across different medical specialties, we conducted interviews with physicians, surgeons, and their respective patients, utilizing the questionnaire. Between 2020 and 2022, we interviewed a total of 144 patients and 19 doctors. Among the 12 questions, physicians demonstrated significant patient-doctor value gaps in 5 questions, while surgeons in 3 questions. Only one question turned out significant gaps in both physicians and surgeons. When asking both doctors and their patients to choose one from the following 6 answers (1. No issue significant; 2. Not knowing how to make a medical decision; 3. Not confident in the doctor’s clinical judgment; 4. Not knowing how to articulate one’s own condition; 5. Unable to afford medical expenses; 6. Not understanding what doctors explain) in response to the question “what the most significant issue is in the medical consultation”, over 50% of doctors chose “Not knowing how to make a medical decision” (physicians vs. patients, 50% vs. 11%, p=0.046; surgeon vs. patients, 83% vs. 29%, p=0.001), while significantly more patients chose “No issue significant” (10% vs. 52%, p=0.002; 0% vs. 33%, p<0.001, respectively). Our findings indicate that value gaps do exist between patients and doctors and that most patients in Taiwan "fully trust" their doctors' recommendations for medical decisions. However, when treatment outcomes are far from ideal, this overinflated "trust" may turn into frustration, which could become the catalyst for medical disputes. Doctors should spend more time having more effective communication with their patients, particularly regarding potentially dissatisfactory treatment outcomes. This study underscores the substantial variability in the patient-doctor value gap, often overlooked in SDM. Patients from different clinical backgrounds may hold values distinct from those of their healthcare providers. Bridging this value gap is imperative for achieving genuine and effective SDM.

Keywords: share-decision making, value gaps, communication, doctor-patient relationship

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143 Assessing the Impact of Construction Projects on Disabled Accessibility and Inclusion

Authors: Yasser Aboel-Magd

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This research addresses the critical issue of accessibility for individuals with special needs and the broader implications of disability on one's ability to lead an independent and integrated life within society. It highlights the consequences of injury, illness, or disability not only on the physical level but also on psychological, social, educational, economic, and functional aspects of life. The study emphasizes the importance of inclusive design in urban spaces, reflecting on how a society's treatment of individuals with disabilities serves as a measure of its progress. The research delves into the challenges faced by people with special needs in the Kingdom, where, despite advancements in various sectors, there is a noticeable lack of accommodating public opportunities for this significant demographic. It argues for the necessity of a Saudi building code that considers the needs of a diverse population during the design phase. The paper discusses the role of urban space as a fundamental element in urban formation and its impact on the societal integration of individuals with special needs. The study explores a variety of inclusive design principles, ranging from physical features like ramps and tactile paving to digital and cognitive accessibility measures such as screen readers, closed captions, plain language, and visual aids. It also considers the impact of wayfinding and appropriate lighting design on the orientation and assistance of individuals within urban spaces at the lowest cost. The researchers connect inclusive design with sustainable practices, advocating for environments that are not only environmentally friendly but also adaptable and lasting. The paper concludes with the assertion that the integration of accessibility, universal design, and sustainability signifies a society's commitment to inclusivity and the empowerment of all individuals, paving the way for a future where everyone can participate fully and independently in society.

Keywords: accessibility, inclusive design, Saudi building code, disability inclusion, socioeconomic progress

Procedia PDF Downloads 48
142 Better Defined WHO International Classification of Disease Codes for Relapsing Fever Borreliosis, and Lyme Disease Education Aiding Diagnosis, Treatment Improving Human Right to Health

Authors: Mualla McManus, Jenna Luche Thaye

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World Health Organisation International Classification of Disease codes were created to define disease including infections in order to guide and educate diagnosticians. Most infectious diseases such as syphilis are clearly defined by their ICD 10 codes and aid/help to educate the clinicians in syphilis diagnosis and treatment globally. However, current ICD 10 codes for relapsing fever Borreliosis and Lyme disease are less clearly defined and can impede appropriate diagnosis especially if the clinician is not familiar with the symptoms of these infectious diseases. This is despite substantial number of scientific articles published in peer-reviewed journals about relapsing fever and Lyme disease. In the USA there are estimated 380,000 people annually contacting Lyme disease, more cases than breast cancer and 6x HIV/AIDS cases. This represents estimated 0.09% of the USA population. If extrapolated to the global population (7billion), 0.09% equates to 63 million people contracting relapsing fever or Lyme disease. In many regions, the rate of contracting some form of infection from tick bite may be even higher. Without accurate and appropriate diagnostic codes, physicians are impeded in their ability to properly care for their patients, leaving those patients invisible and marginalized within the medical system and to those guiding public policy. This results in great personal hardship, pain, disability, and expense. This unnecessarily burdens health care systems, governments, families, and society as a whole. With accurate diagnostic codes in place, robust data can guide medical and public health research, health policy, track mortality and save health care dollars. Better defined ICD codes are the way forward in educating the diagnosticians about relapsing fever and Lyme diseases.

Keywords: WHO ICD codes, relapsing fever, Lyme diseases, World Health Organisation

Procedia PDF Downloads 170
141 Family Planning Programming for Youths and Adolescents in Nigeria

Authors: Ashimolowo Olubunmi

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Contraception use helps prevent pregnancy as well as health-related challenges, most especially among youths and girls. Our communities are bedeviled with many problems, including rape, defilement, neglect by the spouse, and intimate partner violence. Current interventions target only adults, with most facilities having youth and unfriendly adolescent services. To further support the need for this research, especially with our target beneficiaries, the partnership embarked on qualitative evidence-finding research through focus group discussions and in-depth-interview in Abeokuta and Ibadan (the capital cities of Ogun). The Focus Group Discussion (FGD) sessions were held in the state with adolescents (10-18 years) and young women (18-30 years). The result revealed that teenagers and youths who receive formal and sexual education on abstinence, and birth control methods, are likely to have healthier sexual behaviours through the promotion of abstinence and the use of condoms and other forms of contraceptives at their first intercourse, thereby protecting themselves against HIV/AIDs (Human Immunodeficiency Virus/Acquired immunodeficiency syndrome. The result further revealed that parents do not discuss issues around Adolescent and Sexual Reproductive Health (ASRH) with their adolescent girls, leading to gaps in knowledge of ASRH. Stakeholders’ involvement and trust are low. Respondents noted that there were few outreaches on ASRH and that youth-friendly adolescent centres are not common in the community. Respondents noted that there were few outreaches on ASRH organised within the community. Also, youth-friendly services were not common. There is a need to work with all stakeholders to promote those foundational life skills on pubertal changes, menstruation, and sexual life to prepare youths and girls for challenges ahead through sex education; we should work to institutionalize youth and adolescent-friendly Sexual and Reproductive Health (SRH) in our communities.

Keywords: contraception, family planning, focus group discussion, adolescents

Procedia PDF Downloads 52
140 A Correlational Study between Sexual Awareness, Behaviour and Sources of Sexual Knowledge among Youth in Context of Bihar

Authors: Kanika Naresh Singh, Uday Shankar

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Background: Human behaviours are influenced by drives. Sexual drive is one of them. Education regarding sexual behaviour plays a great role in shaping one’s attitude towards it. These days after attaining the age of puberty, adolescents are confused and feel shy to talk about it. In order to get information, they refer to various types of sources and these sources play a greater role in spreading awareness in the mass adolescent population. Sometimes it also leads to the building of myths and misconceptions. Due to increasing incidences of HIV/AIDS, RTIs/STIs and teenage pregnancies, there is a rising need to impart sex education. Aim: The aim of this research was to study the level of sexual awareness among the youth of Bihar and also study their sexual behaviour and sources of influence. It also aims to study the correlation between sexual awareness, behaviour and sources of sexual knowledge among youth in Bihar. Methods: The sample size for the project was 50 youth consisting of both boys and girls, in between the age group of 18 to 23 years from urban and semi-urban areas. The purposive sampling method was used in the research. The tools used were the Sexual Awareness Questionnaire and Sexual Behavior and Sources of Influence (SBSI) scale. The sexual Awareness Questionnaire was developed by Snell, having 35 items. A socio-demographic data sheet was also used. Results: The youth had poor sexual awareness. Internet and Friends were found to be the major source for gathering information. The youth of Bihar were less inclined towards resolving their doubts with their parents. There was a positive correlation between sexual awareness, behaviour and sources of knowledge. Conclusion: The youth of Bihar has poor sexual knowledge. Internet and Friends are major sources of information. Sex Education should be promoted as suggested by various institutions like World Health Organization United Nations. Psychiatrists and psychologists have a key leadership role in introducing these potentially emotionally challenging issues to the youth with consideration of psychosocial and cultural factors.

Keywords: sexual awareness, sexual behavior, sources of influence, youths, Bihar, India

Procedia PDF Downloads 114
139 Anti-Intellectualism in Populist Discourse and Its Role in Identity Construction: A Comparative Study between the United States of America and France

Authors: Iuliana-Erika Köpeczi

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‘Language is no longer regarded as peripheral to our grasp of the world we live in, but as central to it. Words are not mere vocal labels or communicational adjuncts superimposed upon an already given order of things. They are collective products of social interaction, essential instruments through which human beings constitute and articulate their world’, said Roy Harris. If we were to accept the above-mentioned premise, then we surely must accept that discourse, generally, - and political discourse, specifically -, bears a crucial importance to one’s perception of reality. The way in which political rhetoric constructs reality changes the relationship between the voter and his/her view of the world, which, in turn, influences greatly the future trends of political participation. In this context, our inquiry focuses on the role of populist discourses in the post 9/11 political rhetoric, and how this led to the formation, construction and reconstruction of identity within the ‘us’ vs. ‘them’ dichotomy. It is our hypothesis that anti-intellectualistic elements played a significant role in the manner in which identity construction had been carried out on a discursive level. By adopting a comparative approach, we intend to identify the similarities and differences between the use of such anti-intellectualist elements in the United States of America on one hand – within the discourse of Rick Santorum, – and France on the other – with Marine le Pen’s discourse. Our methodological approach uses close textual analysis of primary source material (discourse analysis); historical contextualization of both primary documents and broader socio-political and cultural framework through archival research and secondary sources; as well as interpretation of primary texts through theoretical frameworks (qualitative research). We hope that the output of our endeavor will be useful in better understanding the different correlations that exist between anti-intellectualism and populism and how the interactions between these two elements aids in political identity construction through discourse.

Keywords: anti-intellectualism, discourse theory, France, identity construction, populism, United States of America

Procedia PDF Downloads 275
138 Consumers Perception of Slogans/ Taglines: A Study of Higher Education Sector in India

Authors: Puja Mahesh

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Purpose: A good slogan captures the essence of your brand's promised consumer benefit in one short phrase. A good slogan conjures up positive imagery about your business or your product. A good slogan has the element of immediacy. Immediacy does not necessarily mean that the slogan will inspire consumers to run right out and buy your product. It does mean, however, that your slogan has an immediate cognitive impact. It forces your audience to "stop-and-think" after exposure as a necessary first step toward remembering your slogan promise. A good slogan is memorable and durability. When your slogan promise is occupying prime real estate in the consumer's subconscious, it aids in recall and activates preference for your brand when you want it -when consumers are ready to buy. The objective of current study is to understand the consumer perception of slogans/taglines of higher education sector in India. Design/Methodology/Approach: Survey of 500 consumers (largely comprising of youth) will be done using questionnaire. Universities and institutes will be chosen on the basis of various streams and Credible Rankings. The perception will be taken from the respondents on the basis of scale. Findings: Catchy phrases, rhymes, music, jingles, avatars (visual representations) and unique imagery are just a few of the mnemonic clutter-busting tactics commonly used in slogans to stand apart from the competition and to aid in memory recall. The study will reveal whether it is true that catchy phrases, rhymes, music, jingles, avatars (visual representations) and unique imagery across disciplines and universities help in building stronger brands. It will also be found whether consumers pay more attention to reputation of University/ College or brand identity. Originality/Value: Researcher has not come across any study of Consumer Perception of Slogans/Taglines of Higher Education Brands in India. Also, it would be interesting to understand Consumer Perception of various colleges/streams particularly Management colleges who invest a lot of time in branding exercise.

Keywords: consumer perception, higher education, slogans, taglines

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137 Cup-Cage Construct for Treatment of Severe Acetabular Bone Loss in Revision Total Hip Arthroplasty: Midterm Clinical and Radiographic Outcomes

Authors: Faran Chaudhry, Anser Daud, Doris Braunstein, Oleg Safir, Allan Gross, Paul Kuzyk

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Background: Acetabular reconstruction in the context of massive acetabular bone loss is challenging. In rare scenarios where the extent of bone loss precludes shell placement (cup-cage), reconstruction at our center consisted of a cage combined with highly porous metal augments. This study evaluates survivorship, complications, and functional outcomes using this technique. Methods: A total of 131 cup-cage implants (129 patients) were included in our retrospective review of revisions of total hip arthroplasty from January 2003 to January 2022. Among these cases, 100/131 (76.3%) were women, the mean age at surgery time was 68.7 years (range, 29.0 to 92.0; SD, 12.4), and the mean follow-up was 7.7 years (range, 0.02 to 20.3; SD, 5.1). Kaplan-Meier survivorship analysis was conducted with failure defined as revision surgery and/or failure of the cup-cage reconstruction. Results: A total of 30 implants (23%) reached the study endpoint involving all-cause revision. Overall survivorship was 74.8% at 10 years and 69.8% at 15 years. Reasons for revision included infection 12/131 (9.1%), dislocation 10/131 (7.6%), aseptic loosening of cup and/or cage 5/131 (3.8%), and aseptic loosening of the femoral stem 2/131 (1.5%). The mean LLD improved from 12.2 ± 15.9 mm to 3.9 ± 11.8 (p<0.05). The horizontal and vertical hip centres on plain film radiographs were significantly improved (p<0.05). Functionally, there was a decrease in the number of patients requiring the use of gait aids, with fewer patients (34, 25.9%) using a cane, walker, or wheelchair post-operatively compared to pre-operatively (58, 44%). There was a significant increase in the number of independent ambulators from 24 to 47 (36%). Conclusion: The cup-cage construct is a reliable treatment option for the treatment of various acetabular defects. There are favourable survivorship, clinical and radiographic outcomes, with a satisfactory complication rate.

Keywords: revision total hip arthroplasty, acetabular defect, pelvic discontinuity, trabecular metal augment, cup-cage

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136 The Use of Additives to Prevent Fouling in Polyethylene and Polypropylene Gas and Slurry Phase Processes

Authors: L. Shafiq, A. Rigby

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All polyethylene processes are highly exothermic, and the safe removal of the heat of reaction is a fundamental issue in the process design. In slurry and gas processes, the velocity of the polymer particles in the reactor and external coolers can be very high, and under certain conditions, this can lead to static charging of these particles. Such static charged polymer particles may start building up on the reactor wall, limiting heat transfer, and ultimately leading to severe reactor fouling and forced reactor shut down. Statsafe™ is an FDA approved anti-fouling additive currently used around the world for polyolefin production as an anti-fouling additive. The unique polymer chemistry aids static discharge, which prevents the build-up of charged polyolefin particles, which could lead to fouling. Statsafe™ is being used and trailed in gas, slurry, and a combination of these technologies around the world. We will share data to demonstrate how the use of Statsafe™ allows more stable operation at higher solids level by eliminating static, which would otherwise prevent closer packing of particles in the hydrocarbon slurry. Because static charge generation depends also on the concentration of polymer particles in the slurry, the maximum slurry concentration can be higher when using Statsafe™, leading to higher production rates. The elimination of fouling also leads to less downtime. Special focus will be made on the impact anti-static additives have on catalyst performance within the polymerization process and how this has been measured. Lab-scale studies have investigated the effect on the activity of Ziegler Natta catalysts when anti-static additives are used at various concentrations in gas and slurry, polyethylene and polypropylene processes. An in-depth gas phase study investigated the effect of additives on the final polyethylene properties such as particle size, morphology, fines, bulk density, melt flow index, gradient density, and melting point.

Keywords: anti-static additives, catalyst performance, FDA approved anti-fouling additive, polymerisation

Procedia PDF Downloads 174
135 Image Based Landing Solutions for Large Passenger Aircraft

Authors: Thierry Sammour Sawaya, Heikki Deschacht

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In commercial aircraft operations, almost half of the accidents happen during approach or landing phases. Automatic guidance and automatic landings have proven to bring significant safety value added for this challenging landing phase. This is why Airbus and ScioTeq have decided to work together to explore the capability of image-based landing solutions as additional landing aids to further expand the possibility to perform automatic approach and landing to runways where the current guiding systems are either not fitted or not optimum. Current systems for automated landing often depend on radio signals provided by airport ground infrastructure on the airport or satellite coverage. In addition, these radio signals may not always be available with the integrity and performance required for safe automatic landing. Being independent from these radio signals would widen the operations possibilities and increase the number of automated landings. Airbus and ScioTeq are joining their expertise in the field of Computer Vision in the European Program called Clean Sky 2 Large Passenger Aircraft, in which they are leading the IMBALS (IMage BAsed Landing Solutions) project. The ultimate goal of this project is to demonstrate, develop, validate and verify a certifiable automatic landing system guiding an airplane during the approach and landing phases based on an onboard camera system capturing images, enabling automatic landing independent from radio signals and without precision instrument for landing. In the frame of this project, ScioTeq is responsible for the development of the Image Processing Platform (IPP), while Airbus is responsible for defining the functional and system requirements as well as the testing and integration of the developed equipment in a Large Passenger Aircraft representative environment. The aim of this paper will be to describe the system as well as the associated methods and tools developed for validation and verification.

Keywords: aircraft landing system, aircraft safety, autoland, avionic system, computer vision, image processing

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134 Socio-Economic Analysis of Child Homelessness in South Africa: Implication for Policy Making

Authors: Chigozie Azunna, Lucius Botes

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Child homelessness is one of the critical challenges in South Africa in recent times. While children constitute a very significant demography of South Africa, child homeless broods a socio-economic crisis of varying magnitude. In order for the UN 2030 Agenda for Sustainable Development Goals (SDGs) to be achieved, especially with respect to equality and non-discrimination, child homeless needs to be effectively curbed. This will, in turn, contribute positively to the economic derivative of South Africa’s dynamic demography. Methodically, this research employed content analysis involving a comprehensive review of existing literature on child homelessness in South Africa. The study found a convergence of national policy and international agenda on curbing child homelessness in South Africa in spite of the following is a representation of the statistics of child homelessness in South Africa: in the metros, homelessness was (74,1%), while in non-metro is at 25.9%. The figure shows that the City of Tshwane has the highest number of homeless persons (18,1%), followed by the City of Johannesburg (15,6%) while the Nelson Mandela Bay metropolitan has the lowest percentage of homeless persons (2,7%). The study concluded that despite the existence of national policy options, child homeless has remained persistent. Worse still, there is a lack of accurate data, while the Covid pandemic, poverty, economic challenges, the HIV/AIDS epidemic, and implementation gaps in government policies have contributed to the widening challenge. The implication is severe, affecting children's physical and emotional health, education, and future opportunities. The study recommends strengthening actionable policies in addressing child homelessness by bridging the urban-rural gap as well as providing an intra-community network that ensures that child homelessness is effectively addressed, including addressing those manifold challenges like access to education and susceptibility to diseases and vulnerability of the homeless child.

Keywords: South Africa, child, homeless, SDGs, covid, urban, rural

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133 Experimental Assessment of the Effectiveness of Judicial Instructions and of Expert Testimony in Improving Jurors’ Evaluation of Eyewitness Evidence

Authors: Alena Skalon, Jennifer L. Beaudry

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Eyewitness misidentifications can sometimes lead to wrongful convictions of innocent people. This occurs in part because jurors tend to believe confident eyewitnesses even when the identification took place under suggestive conditions. Empirical research demonstrated that jurors are often unaware of the factors that can influence the reliability of eyewitness identification. Most common legal safeguards that are designed to educate jurors about eyewitness evidence are judicial instructions and expert testimony. To date, very few studies assessed the effectiveness of judicial instructions and most of them found that judicial instructions make jurors more skeptical of eyewitness evidence or do not have any effect on jurors’ judgments. Similar results were obtained for expert testimony. However, none of the previous studies focused on the ability of legal safeguards to improve jurors’ assessment of evidence obtained from suggestive identification procedures—this is one of the gaps addressed by this paper. Furthermore, only three studies investigated whether legal safeguards improve the ultimate accuracy of jurors’ judgments—that is, whether after listening to judicial instructions or expert testimony jurors can differentiate between accurate and inaccurate eyewitnesses. This presentation includes two studies. Both studies used genuine eyewitnesses (i.e., eyewitnesses who watched the crime) and manipulated the suggestiveness of identification procedures. The first study manipulated the presence of judicial instructions; the second study manipulated the presence of one of two types of expert testimony: a traditional, verbal expert testimony or expert testimony accompanied by visual aids. All participant watched a video-recording of an identification procedure and of an eyewitness testimony. The results indicated that neither judicial instructions nor expert testimony affected jurors’ judgments. However, consistent with the previous findings, when the identification procedure was non-suggestive, jurors believed accurate eyewitnesses more often than inaccurate eyewitnesses. When the procedure was suggestive, jurors believed accurate and inaccurate eyewitnesses at the same rate. The paper will discuss the implications of these studies and directions for future research.

Keywords: expert testimony, eyewitness evidence, judicial instructions, jurors’ decision making, legal safeguards

Procedia PDF Downloads 159
132 Descriptive Analysis of Alcohol Abuse and Sexual Behaviour of Adolescent Males in Eastern Cape

Authors: Jabulani Gilford Kheswa, Sinovuyo Takatshana

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Literature documented that the combination of permissive attitudes, sexual experimentation and lack of accurate information from parents to educate male adolescents, poses a threat to the sexual health of adolescent males and exposes them to risky sexual behaviours. Grounded in problem behaviour theory as a theoretical framework for this study in understanding health-related behaviours of adolescent males, the weaker one’s perceived self-efficacy, the more social and affective factors increase the likelihood of risky sexual behaviour, such as alcohol abuse and intimate partner violence. The purpose of this study was to determine the correlation between alcohol use and sexual behaviour among 176 purposively selected Xhosa- speaking adolescent males, from one school in the Nkonkobe Municipality, Eastern Cape Province, South Africa. These learners were in grade ten, eleven and twelve with an age range from a low of 14 to a high of 25 years. The mean age was 18.06 years while the standard deviation was .144. To be ethically bound, the researchers sought permission from the school principal to distribute self-administered questionnaires and assured the participants of confidentiality and anonymity. A survey was conducted by means of self-administered questionnaires. A cross-sectional study was carried out within the quantitative paradigm using the SPSS version 18 and the Chronbach’s alpha of 0.79 were found for alcohol and sexual behaviour of adolescent males. Findings showed that 59.6% (N=105) of the learners indicated that their caregivers talk about safe sex practice as compared to only 40.4% (N=71) who indicated that their caregivers do not talk to them about safe sex practice. A statistically significant association between alcohol and negotiation of safe sex at p-value of 0.05 (chi-square of 34.529, degree of freedom of 16) was reported. In conclusion, as young people in South Africa become sexually active at an early age, schools should initiate psycho-educational programmes to equip adolescents against risk- behaviours (such as HIV/AIDS, substance abuse, crime).

Keywords: adolescent males, alcohol, parents, sex

Procedia PDF Downloads 233
131 Exploring the Design of Prospective Human Immunodeficiency Virus Type 1 Reverse Transcriptase Inhibitors through a Comprehensive Approach of Quantitative Structure Activity Relationship Study, Molecular Docking, and Molecular Dynamics Simulations

Authors: Mouna Baassi, Mohamed Moussaoui, Sanchaita Rajkhowa, Hatim Soufi, Said Belaaouad

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The objective of this paper is to address the challenging task of targeting Human Immunodeficiency Virus type 1 Reverse Transcriptase (HIV-1 RT) in the treatment of AIDS. Reverse Transcriptase inhibitors (RTIs) have limitations due to the development of Reverse Transcriptase mutations that lead to treatment resistance. In this study, a combination of statistical analysis and bioinformatics tools was adopted to develop a mathematical model that relates the structure of compounds to their inhibitory activities against HIV-1 Reverse Transcriptase. Our approach was based on a series of compounds recognized for their HIV-1 RT enzymatic inhibitory activities. These compounds were designed via software, with their descriptors computed using multiple tools. The most statistically promising model was chosen, and its domain of application was ascertained. Furthermore, compounds exhibiting comparable biological activity to existing drugs were identified as potential inhibitors of HIV-1 RT. The compounds underwent evaluation based on their chemical absorption, distribution, metabolism, excretion, toxicity properties, and adherence to Lipinski's rule. Molecular docking techniques were employed to examine the interaction between the Reverse Transcriptase (Wild Type and Mutant Type) and the ligands, including a known drug available in the market. Molecular dynamics simulations were also conducted to assess the stability of the RT-ligand complexes. Our results reveal some of the new compounds as promising candidates for effectively inhibiting HIV-1 Reverse Transcriptase, matching the potency of the established drug. This necessitates further experimental validation. This study, beyond its immediate results, provides a methodological foundation for future endeavors aiming to discover and design new inhibitors targeting HIV-1 Reverse Transcriptase.

Keywords: QSAR, ADMET properties, molecular docking, molecular dynamics simulation, reverse transcriptase inhibitors, HIV type 1

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130 Anti Oxidant Ayurvedic Rasyan Herbs Concept to Disease Managment

Authors: Mohammed Khalil Ur Rahman, Khanita Aammatullh

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Rasayana is one of the eight clinical specialities of classical Ayurveda The disease preventive and health promotive approach of ‘Ayurveda’, which takes into consideration the whole body, mind and spirit while dealing with the maintenance of health, promotion of health and treating ailments is holistic and finds increasing acceptability in many regions of the world. Ancient Ayurvedic physicians had developed certain dietary and therapeutic measures to arrest/delay ageing and rejuvenating whole functional dynamics of the body system. This revitalization and rejuvenation is known as the ‘Rasayan chikitsa’ (rejuvenation therapy). Traditionally, Rasayana drugs are used against a plethora of seemingly diverse disorders with no pathophysiological connections according to modern medicine. Though, this group of plants generally possesses strong antioxidant activity, only a few have been investigated in detail. Over about 100 disorders like rheumatoid arthritis, hemorrhagic shock, CVS disorders, cystic fibrosis, metabolic disorders, neurodegenerative diseases, gastrointestinal ulcerogenesis and AIDS have been reported as reactive oxygen species mediated. In this review, the role of free radicals in these diseases has been briefly reviewed. ‘Rasayana’ plants with potent antioxidant activity have been reviewed for their traditional uses, and mechanism of antioxidant action. Fifteen such plants have been dealt with in detail and some more plants with less work have also been reviewed briefly The Rasayanas are rejuvenators, nutritional supplements and possess strong antioxidant activity. They also have antagonistic actions on the oxidative stressors, which give rise to the formation of different free radicals. Ocimum sanctum, Tinospora cordifolia, Emblica officinalis, Convolvulus pluricaulis, Centella asiatica, Bacopa monniera, Withania somnifera, Triphala rasayana, Chyawanprash, Brahma rasayana are very important rasayanas which are described in ayurveda and proved by new researches.

Keywords: rasayana, antioxidant activity, Bacopa monniera, Withania somnifera Triphala, chyawanprash

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129 Use of Serum Creatinine as an Incentive to Increase Prep Uptake Among Key Population Groups in South-South Nigeria

Authors: Akhigbe Mark, Abang Roger, Mwoltu Nanaribet, Edet Blessing

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Introduction.: The introduction of pre- exposure prophylaxis (PrEP) as a biomedical prevention method for HIV/AIDS has been around for more than a decade since the first confirmed evidence of its effectiveness when used daily as an oral pill. It is now a very valuable addition for people who are at higher risk of contracting HIV. Although globalacceptanceof PrEP hasincreased, PrEP is still highly concentrated in a small number of countries and within a small sub-population, with Kenya and South Africa accounting for only 19% of people who have received PrEP in Africa region, there is still a significant regionGap in PrEP availability and use, with only 28% of the target of 3 million in low-and middle countries currently using PrEP. Description: The purpose of this study is to find out if serum creatinine could be used as an incentive to improve PrEP uptake among Key population.Numerous approaches to increasing the uptake ofPrEP as a prevention mechanism for HIV in KPs has beenemployed, and one of them is serum creatinine. This approach is a biomarker of renal function, which was used in study as an incentive to increase PrEP uptake among key population groups (female sex workers, men who have sex with men, persons who inject drugs, transgender) in 3 states from South-South Nigeria. Whole blood samples are collected from clients, analysis of the samples is done using the clinical chemistry analyzer before they are initiated onto PrEP. Lessons learned and Recommendations: Secondary data was extracted from 3 states of HALG Implementing facilities in Southern part of Nigeria, PrEP uptake before and afterthe introduction of serum creatinine between March 2020 and August 2020 among key populationsin Nigeria. A total of 5664 patients were initiated on PrEP before, and after the introduction of serum creatinine, the PrEP uptake rate before (March 2020 to May 2020) introduction of serum creatinine accounted for only 5% of the total onset, and after (June 2020 to August 2020) introduction of serum creatinine, the uptake rate accounted for 95% of the total onset. These finding shows that increased uptake of PrEP before/after serum creatineindicates that serum creatine may be an effective stimulus for promoting PrEP in key populations.

Keywords: serum creatinine, incentives, PrEP, key populations, Nigeria

Procedia PDF Downloads 83
128 Evaluating and Improving Healthcare Staff Knowledge of the [NG179] NICE Guidelines on Elective Surgical Care during the COVID-19 Pandemic: A Quality Improvement Project

Authors: Stavroula Stavropoulou-Tatla, Danyal Awal, Mohammad Ayaz Hossain

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The first wave of the COVID-19 pandemic saw several countries issue guidance postponing all non-urgent diagnostic evaluations and operations, leading to an estimated backlog of 28 million cases worldwide and over 4 million in the UK alone. In an attempt to regulate the resumption of elective surgical activity, the National Institute for Health and Care Excellence (NICE) introduced the ‘COVID-19 rapid guideline [NG179]’. This project aimed to increase healthcare staff knowledge of the aforementioned guideline to a targeted score of 100% in the disseminated questionnaire within 3 months at the Royal Free Hospital. A standardized online questionnaire was used to assess the knowledge of surgical and medical staff at baseline and following each 4-week-long Plan-Study-Do-Act (PDSA) cycle. During PDSA1, the A4 visual summary accompanying the guideline was visibly placed in all relevant clinical areas and the full guideline was distributed to the staff in charge together with a short briefing on the salient points. PDSA2 involved brief small-group teaching sessions. A total of 218 responses was collected. Mean percentage scores increased significantly from 51±19% at baseline to 81±16% after PDSA1 (t=10.32, p<0.0001) and further to 93±8% after PDSA2 (t=4.9, p<0.0001), with 54% of participants achieving a perfect score. In conclusion, the targeted distribution of guideline printouts and visual aids, combined with small-group teaching sessions, were simple and effective ways of educating healthcare staff about the new standards of elective surgical care at the time of COVID-19. This could facilitate the safe restoration of surgical activity, which is critical in order to mitigate the far-reaching consequences of surgical delays on an unprecedented scale during a time of great crisis and uncertainty.

Keywords: COVID-19, elective surgery, NICE guidelines, quality improvement

Procedia PDF Downloads 169
127 Management of Blood Exposure Risk: Knowledge and Attitudes of Caregivers in Pediatric Dapartments

Authors: Hela Ghali, Oumayma Ben Amor, Salwa Khefacha, Mohamed Ben Rejeb, Sirine Frigui, Meriam Tourki Dhidah, Lamine Dhidah, Houyem Said Laatiri

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Background: Blood exposure accidents are the most common problem in hospitals that threaten healthcare professionals with a high risk of infectious complications which weighs heavily on health systems worldwide. Paramedics are the highest risk group due to the nature of their daily activities. We aimed to determine knowledge and attitudes about the management of blood-exposure accidents among nurses and technicians in two pediatric departments. Materials/Methods: This is a cross-sectional descriptive study conducted on March 2017, carried out with the care staff of the pediatric ward of the Farhat Hached Teaching Hospital of Sousse and pediatric surgery of the Fattouma Bourguiba University Hospital in Monastir, using a pre- tested and self-administered questionnaire. Data entry and analysis were performed using Excel software. Results: The response rate was 85.1%. A female predominance (82.5%) was reported among respondents with a sex ratio of 0.21. 80% of the participants were under 35 years old. Seniority of less than 10 years was found in 77.5% of respondents. Only 22.5% knew the definition of a blood- exposure accident. 100% and 95% of participants reported the relative risk, respectively, to hepatitis and AIDS viruses. However, only 15% recognized the severity factors of a blood-exposure accident. Hygiene compliance was the most important dimension for almost the entire population for the prevention. On the other hand, only 12.5% knew the meaning of 'standard precautions' and ¼ considered them necessary for at-risk patients only. 40% reported being exposed at least once, among them, 87.5% used betadine, and 77.5% said that anti-infectious chemoprophylaxis is necessary regardless of the patient's serological status. However, 52.5% did not know the official reporting circuit of management of blood-exposure accident in their institutions. Conclusion: For better management of risks in hospitals and an improvement of the safety of the care, a reinforcement of the sensibilization of the caregivers with regard to the risks of blood exposure accident is necessary, while developing their knowledge to act in security.

Keywords: attitudes, blood-exposure accident, knowledge, pediatric department

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126 Dust Particle Removal from Air in a Self-Priming Submerged Venturi Scrubber

Authors: Manisha Bal, Remya Chinnamma Jose, B.C. Meikap

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Dust particles suspended in air are a major source of air pollution. A self-priming submerged venturi scrubber proven very effective in cases of handling nuclear power plant accidents is an efficient device to remove dust particles from the air and thus aids in pollution control. Venturi scrubbers are compact, have a simple mode of operation, no moving parts, easy to install and maintain when compared to other pollution control devices and can handle high temperatures and corrosive and flammable gases and dust particles. In the present paper, fly ash particles recognized as a high air pollutant substance emitted mostly from thermal power plants is considered as the dust particle. Its exposure through skin contact, inhalation and indigestion can lead to health risks and in severe cases can even root to lung cancer. The main focus of this study is on the removal of fly ash particles from polluted air using a self-priming venturi scrubber in submerged conditions using water as the scrubbing liquid. The venturi scrubber comprising of three sections: converging section, throat and diverging section is submerged inside a water tank. The liquid enters the throat due to the pressure difference composed of the hydrostatic pressure of the liquid and static pressure of the gas. The high velocity dust particles atomize the liquid droplets at the throat and this interaction leads to its absorption into water and thus removal of fly ash from the air. Detailed investigation on the scrubbing of fly ash has been done in this literature. Experiments were conducted at different throat gas velocities, water levels and fly ash inlet concentrations to study the fly ash removal efficiency. From the experimental results, the highest fly ash removal efficiency of 99.78% is achieved at the throat gas velocity of 58 m/s, water level of height 0.77m with fly ash inlet concentration of 0.3 x10⁻³ kg/Nm³ in the submerged condition. The effect of throat gas velocity, water level and fly ash inlet concentration on the removal efficiency has also been evaluated. Furthermore, experimental results of removal efficiency are validated with the developed empirical model.

Keywords: dust particles, fly ash, pollution control, self-priming venturi scrubber

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125 Investigating the Antimicrobial Activity of Essential Oil Derived from Pistacia atlantica Gum against Extensively Drug-Resistant Gram-Negative Acinetobacter baumannii

Authors: Zhala Ahmad, Zainab Lazim, Haider Hamzah

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Bacterial resistance is a pressing global health issue, with multidrug-resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant (PDR) strains to pose a serious threat. In this context, researchers are investigating effective, safe, and affordable metabolites to combat these pathogens. This study focuses on gum essential oil (GEO) extracted from Pistacia atlantica and its activity and the mechanism of action against XDR Gram-negative Acinetobacter baumannii. GEO was extracted by hydrodistillation and analyzed using GC-MS. Eleven A. baumannii isolates were collected from the ward environment of Burn and Plastic Surgery Hospital in Al Sulaymaniyah City, Iraq. They were identified using the VITEK 2 system, 16S rRNA gene, and confirmed with the blaₒₓₐ₋₅₁ gene; A. baumannii ATCC 19606 was used as a reference strain. The isolates were identified as resistant to twelve different antibiotics spanning six distinct antibiotic classes while showing susceptibility to tetracycline and trimethoprim. Over 40 chemical constituents were detected in the gum's essential oils, with α-pinene being the most abundant. GEO was found to inhibit the growth of A. baumannii isolates; the minimum inhibitory concentration (MIC) of GEO was 2.5 µl/ml. GEO induced protein leakage, phosphate, and potassium ion efflux, distorted cell morphology, and cell death in the tested bacteria. GEO exhibited bacterial clearance and anti-adhesion activity using Band-Aids. This study's findings suggest that GEO could be used as a potential alternative treatment for infectious diseases caused by XRD pathogens, shedding further light on the importance of GEO in biomedical applications. Future studies must focus on generating clinically feasible sources of GEO for testing in small animal models before proceeding to human trials, ensuring safe and effective translation from the laboratory to the clinic.

Keywords: antibiotic resistance, Acinetobacter baumannii, essential oils, Pistacia atlantica, alpha-pinene

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124 Sense-Based Approach in the Design of Anti-Violence Shelters: A Comparative Analysis

Authors: Annunziata Albano

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Intimate Partner Violence (IPV) and Non-Partner Sexual Violence (NPSV) are still the most common forms of interpersonal violence against women today, and numerous studies have shown how they can affect women's physical and psychological well-being, frequently leading to depression, posttraumatic stress disorder (PTSD), and substance abuse. The primary goal of Italian Anti-Violence Centres (AVCs) is to provide an appropriate context for women to embark on a personalised path out of violence by providing various services such as listening groups, psychological and legal support, housing support in collaboration with shelters, work orientation, and specific support in the case of minor children. However, their physical environment is frequently overlooked, partly because these centres are typically established in pre-existing buildings and have a limited budget. Several studies on healthcare design and mental health, on the other hand, emphasise the potential of the built environment to facilitate healing by providing a restorative setting that aids in coping with stress and traumatic experiences, investigating the positive role of natural features and sensorial qualities such as light, colours, sound, and smell. This research aims to collect and summarise the key evidence-based principles derived from a multidisciplinary literature review about interior design elements that can help women recover after their traumatic experience. Furthermore, the study examines multiple case studies of Italian AVCs through the lens of previously determined principles, to understand how and whether these guidelines have been applied and which outcomes can provide relevant insights for design practice, with an emphasis on sensory qualities, usually overlooked in favour of other requirements. The outlined guidelines may serve as a framework for various typologies of services provided to women who are the victims of interpersonal violence, such as women's crisis centres and shelters.

Keywords: anti-violence centres, environmental psychology, interior design, interpersonal violence, restorative environments

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123 In vitro and in vivo Potential Effect of the N-Acylsulfonamide Bis-oxazolidin-2-ones on Toxoplasma gondii

Authors: Benlaifa Meriem, Berredjem Hajira, Bouasla Radia, Berredjem Malika, Djebar Med Reda

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Toxoplasmosis is a cosmopolitan infection due to Toxoplasma gondii (T.gondii). It is a significant cause of congenital disease and an important opportunistic pathogen which has become a worldwide increasing problem due to the AIDS epidemic. Current available drugs do not give satisfactory results and often have only a static and several adverse side effects as it is the case of pyrimethamine. So, the need to develop and evaluate new drugs is critical. The purpose of this study is to investigate the in vitro and in vivo effects of the new chiral N-acylsulfonamide bis-oxazolidin-2-ones on T.gondii. In this study, anti-T.gondii RH strain activities, of two new chiral N-acylsulfonamide bis-oxazolidin-2-ones were evaluated in vitro, using a MRC-5 fibroblast tissue cultures to determine the concentration that inhibit parasite multiplication by 50% (IC50) of each drug and in vivo, by PCR detection of the tachyzoites in mice ascites after new molecules treatment, using the 35-fold repetitive B1 gene of T.gondii. The in vitro results demonstrated that the treatment with the tested molecules decreased the amount of tachyzoites in cell culture in a dose-dependent manner. The inhibition was complete for concentrations over 4 mg/ml. The IC50 of Mol 1 and Mol 2 were 1.5 and 3 mg/ml, respectively, and were quite similar to the control one (2 mg/ml). The Mol 1 was highly active against T.gondii in cell cultures than Mol 2; these results were similar to those of sulfadiazine-treated group (p < 0.05). Toxoplasma-specific DNA was demonstrated in all ascites samples from infected mice of the different tested groups. Mol 1 showed better effect than Mol 2, but it did not completely inhibit the parasite proliferation. The intensity of amplification products increased when the treatment started late after infection. These findings suggest continuous parasite replication despite the treatment. In conclusion, our results showed a promising treatment effect of the tested molecules and suggest that in vitro, the Mol 1, and Mol 2 have a dose-dependent effect and a high cytotoxicity on the studied cells. The present study revealed that concentration and duration of tested molecules treatment are major factors that influence the course of Toxoplasma infection in infected mice.

Keywords: cytotoxicity, PCR, sulfonamide, Toxoplasma gondii

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122 Emotional Intelligence in Educational Arena and Its Pragmatic Concerns

Authors: Mehar Fatima

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This study intends to make analysis of Emotional Intelligence (EI) in the process of pedagogy and look into its repercussions in different educational institutions including school, college, and university in the capital state of India, Delhi in 2015. Field of education is a complex area with challenging issues in a modern society. Education is the breeding ground for nurturing human souls, and personalities. Since antiquity, man has been in search of truth, wisdom, contentment, peace. His efforts have brought him to acquire these through hardship, evidently through the process of teaching and learning. Computer aids and artificial intelligence have made life easy but complex. Efficient pedagogy involves direct human intervention despite the flux of technological advancements. Time and again, pedagogical practices demand sincere human efforts to understand and improve upon life’s many pragmatic concerns. Apart from the intense academic scientific approaches, EI in academia plays a vital role in the growth of education, positively achieving national progression; ‘pedagogy of pragmatic purpose.’ Use of literature is found to be one of the valuable pragmatic tools of Emotional Intelligence. This research examines the way literature provides useful influence in building better practices in teaching-learning process. The present project also scrutinizes various pieces of world literature and translation, incorporating efforts of intellectuals in promoting comprehensive amity. The importance of EI in educational arena with its pragmatic uses was established by the study of interviews, and questionnaire collected from teachers and students. In summary the analysis of obtained empirical data makes it possible to accomplish that the use Emotional Intelligence in academic scenario yields multisided positive pragmatic outcomes; positive attitude, constructive aptitude, value-added learning, enthusiastic participation, creative thinking, lower apprehension, diminished fear, leading to individual as well as collective advancement, progress, and growth of pedagogical agents.

Keywords: emotional intelligence, human efforts, pedagogy, pragmatic concerns

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121 Changing Patterns of Marriage and Sexual Relations among Young Single Female Workers in Garment Factories in Gazipur, Bangladesh

Authors: Runa Laila

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In Bangladesh, migration and employment opportunities in the ready-made garment factories presented an alternative to early and arranged-marriage to many young women from the countryside. Although the positive impact of young women’s labour migration and employment in the garment industry on economic independence, increased negotiation power, and enhancement of self-esteem have been well documented, impact of employment on sexual norms and practices remained under-researched. This ethnographic study comprising of an in-depth interview of 21 single young women working in various garment factories in Gazipur, Dhaka, explores the implication of work on sexual norms and practices. This study found young single garment workers experience a range of consensual and coercive sexual relations. The mixed-sex work environment in the garment manufacturing industry and private housing arrangements provide young single women opportunities to develop romantic and sexual relationships in the transient urban space, which was more restricted in the rural areas. The use of mobile phones further aids lovers to meet in amusement parks, friends’ houses, or residential hotels beyond the gaze of colleagues and neighbors. Due to sexual double standard, men’s sexual advantage is seen as natural and accepted, while women are being blamed as immoral for being engaged in pre-marital sex. Although self-choice marriage and premarital relations reported to be common among garment workers, stigma related to premarital sex lead young single women to resort to secret abortion practices. Married men also use power position to lure women in a subordinate position in coerce sexual relations, putting their reproductive and psychological health at risk. To improve sexual and reproductive health and wellbeing of young female garment workers, it is important to understand these changing sexual practices which otherwise remain taboo in public health discourses.

Keywords: female migration, ready-made garment, reproductive health, sexual practice

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120 Safety Profile of Anti-Retroviral Medicine in South Africa Based on Reported Adverse Drug Reactions

Authors: Sarah Gounden, Mukesh Dheda, Boikhutso Tlou, Elizabeth Ojewole, Frasia Oosthuizen

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Background: Antiretroviral therapy (ART) has been effective in the reduction of mortality and resulted in an improvement in the prognosis of HIV-infected patients. However, treatment with antiretrovirals (ARVs) has led to the development of many adverse drug reactions (ADRs). It is, therefore, necessary to determine the safety profile of these medicines in a South African population in order to ensure safe and optimal medicine use. Objectives: The aim of this study was to quantify ADRs experienced with the different ARVs currently used in South Africa, to determine the safety profile of ARV medicine in South Africa based on reported ADRs, and to determine the ARVs with the lowest risk profile based on specific patient populations. Methodology: This was a quantitative study. Individual case safety reports for the period January 2010 – December 2013 were obtained from the National Pharmacovigilance Center; these reports contained information on ADRs, ARV medicine, and patient demographics. Data was analysed to find associations that may exist between ADRs experienced, ARV medicines used and patient demographics. Results: A total of 1916 patient reports were received of which 1534 met the inclusion criteria for the study. The ARV with the lowest risk of ADRs were found to be lamivudine (0.51%, n=12), followed by lopinavir/ritonavir combination (0.8%, n=19) and abacavir (0.64%, n=15). A higher incidence of ADRs was observed in females compared to males. The age group 31–50 years and the weight group 61–80 kg had the highest incidence of ADRs reported. Conclusion: This study found that the safest ARVs to be used in a South African population are lamivudine, abacavir, and the lopinavir/ritonavir combination. Gender differences play a significant role in the occurrence of ADRs and both anatomical and physiological differences account for this. An increased BMI (body mass index) in both men and women showed an increase in the incidence of ADRs associated with ARV therapy.

Keywords: adverse drug reaction, antiretrovirals, HIV/AIDS, pharmacovigilance, South Africa

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119 Dermatomyositis: It is Not Always an Allergic Reaction

Authors: Irfan Abdulrahman Sheth, Sohil Pothiawala

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Dermatomyositis is an idiopathic inflammatory myopathy, traditionally characterized by a progressive, symmetrical proximal muscle weakness and pathognomonic or characteristic cutaneous manifestations. We report a case of a 60-year old Chinese female who was referred from polyclinic for allergic rash over the body after applying hair dye 3 weeks ago. It was associated with puffiness of face, shortness of breath and hoarse voice since last 2 weeks with decrease effort tolerance. She also complained of dysphagia/ myalgia with progressive weakness of proximal muscles and palpitations. She denied chest pain, loss of appetite, weight loss, orthopnea or fever. She had stable vital signs and appeared cushingoid. She was noted to have rash over the scalp/ face and ecchymosis over the right arm with puffiness of face and periorbital oedema. There was symmetrical muscle weakness and other neurological examination was normal. Initial impression was of allergic reaction and underlying nephrotic syndrome and Cushing’s syndrome from TCM use. Diagnostic tests showed high Creatinine kinase (CK) of 1463 u/l, CK–MB of 18.7 ug/l and Troponin –T of 0.09 ug/l. The Full blood count and renal panel was normal. EMG showed inflammatory myositis. Patient was managed by rheumatologist and discharged on oral prednisolone with methotrexate/ ergocalciferol capsule and calcium carb, vitamin D tablets and outpatient follow up. In some patients, cutaneous disease exists in the absence of objective evidence of muscle inflammation. Management of dermatomyositis begins with careful investigation for the presence of muscle disease or of additional systemic involvement, particularly of the pulmonary, cardiac or gastrointestinal systems, and for the possibility of an accompanying malignancy. Muscle disease and systemic involvement can be refractory and may require multiple sequential therapeutic interventions or, at times, combinations of therapies. Thus, we want to highlight to the physicians that the cutaneous disease of dermatomyositis should not be confused with allergic reaction. It can be particularly challenging to diagnose. Early recognition aids appropriate management of this group of patients.

Keywords: dermatomyositis, myopathy, allergy, cutaneous disease

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118 Overcoming Barriers to Improve HIV Education and Public Health Outcomes in the Democratic Republic of Congo

Authors: Danielle A. Walker, Kyle L. Johnson, Tara B. Thomas, Sandor Dorgo, Jacen S. Moore

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Approximately 37 million people worldwide are infected with the Human Immunodeficiency Virus (HIV), with the majority located in sub-Saharan Africa. The relationship existing between HIV incidence and socioeconomic inequity confirms the critical need for programs promoting HIV education, prevention and treatment access. This literature review analyzed 36 sources with a specific focus on the Democratic Republic of Congo, whose critically low socioeconomic status and education rate have resulted in a drastically high HIV rates. Relationships between HIV testing and treatment and barriers to care were explored. Cultural and religious considerations were found to be vital when creating and implementing HIV education and testing programs. Partnerships encouraging active support from community-based spiritual leaders to implement HIV educational programs were also key mechanisms to reach communities and individuals. Gender roles were highlighted as a key component for implementation of effective community trust-building and successful HIV education programs. The efficacy of added support by hospitals and clinics in rural areas to facilitate access to HIV testing and care for people living with HIV/AIDS (PLWHA) was discussed. This review highlighted the need for healthcare providers to provide a network of continued education for PLWHA in clinical settings during disclosure and throughout the course of treatment to increase retention in care and promote medication adherence for viral load suppression. Implementation of culturally sensitive models that rely on community familiarity with HIV educators such as ‘train-the-trainer’ were also proposed as efficacious tools for educating rural communities about HIV. Further research is needed to promote community partnerships for HIV education, understand the cultural context of gender roles as barriers to care, and empower local health care providers to be successful within the HIV Continuum of Care.

Keywords: cultural sensitivity, Democratic Republic of the Congo, education, HIV

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117 Ph-Triggered Cationic Solid Lipid Nanoparticles Mitigated Colitis in Mice

Authors: Muhammad Naeem, Juho Lee, Jin-Wook Yoo

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In this study, we hypothesized that prolonged gastrointestinal transit at the inflamed colon conferred by a pH-triggered mucoadhesive smart nanoparticulate drug delivery system aids in achieving selective and sustained levels of the drug within the inflamed colon for the treatment of ulcerative colitis. We developed budesonide-loaded pH-sensitive charge-reversal solid lipid nanoparticles (SLNs) using a hot homogenization method. Polyetylenimine (PEI) was used to render SLNs cationic (PEI-SLNs). Eudragit S100 (ES) was coated on PEI-SLNs for pH-trigger charge-reversal SLNs (ES-PEI-SLNs). Therapeutic potential of the prepared SNLs formulation was evaluated in ulcerative colitis in mice. The transmission electron microscopy, zeta size and zeta potential data showed the successful formation of SLNs formulations. SLNs and PEI-SLNs showed burst drug release in acidic pH condition mimicking stomach and early small intestine environment which limiting their application as oral delivery systems. However, ES-PEI-SLNs prevented a burst drug release in acidic pH conditions and showed sustained release at a colonic pH. Most importantly, the surface charge of ES-PEI-SLNs switched from negative to positive in colonic conditions by pH-triggered removal of ES coating and accumulated selectively in inflamed colon. Furthermore, a charge reversal ES-PEI-SLNs showed a superior mitigation of dextran sulfate sodium (DSS)-induced acute colitis in mice as compared to SLNs and PEI-SLNs treated groups. Moreover, histopathological analysis of distal colon sections stained with hematoxylin/eosin and E-cadherin immunostaining revealed attenuated inflammation in an ES-PEI-SLNs-treated group. We also found that ES-PEI-SLNs markedly reduced the myeloperoxidase level and expression of TNF-alpha in colon tissue. Our results suggest that the pH-triggered charge reversal SLNs presented in this study would be a promising approach for ulcerative colitis therapy.

Keywords: solid lipid nanoparticles, stimuli-triggered charge-reversal, ulcerative colitis, methacrylate copolymer, budesonide

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116 Diffusion Magnetic Resonance Imaging and Magnetic Resonance Spectroscopy in Detecting Malignancy in Maxillofacial Lesions

Authors: Mohamed Khalifa Zayet, Salma Belal Eiid, Mushira Mohamed Dahaba

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Introduction: Malignant tumors may not be easily detected by traditional radiographic techniques especially in an anatomically complex area like maxillofacial region. At the same time, the advent of biological functional MRI was a significant footstep in the diagnostic imaging field. Objective: The purpose of this study was to define the malignant metabolic profile of maxillofacial lesions using diffusion MRI and magnetic resonance spectroscopy, as adjunctive aids for diagnosing of such lesions. Subjects and Methods: Twenty-one patients with twenty-two lesions were enrolled in this study. Both morphological and functional MRI scans were performed, where T1, T2 weighted images, diffusion-weighted MRI with four apparent diffusion coefficient (ADC) maps were constructed for analysis, and magnetic resonance spectroscopy with qualitative and semi-quantitative analyses of choline and lactate peaks were applied. Then, all patients underwent incisional or excisional biopsies within two weeks from MR scans. Results: Statistical analysis revealed that not all the parameters had the same diagnostic performance, where lactate had the highest areas under the curve (AUC) of 0.9 and choline was the lowest with insignificant diagnostic value. The best cut-off value suggested for lactate was 0.125, where any lesion above this value is supposed to be malignant with 90 % sensitivity and 83.3 % specificity. Despite that ADC maps had comparable AUCs still, the statistical measure that had the final say was the interpretation of likelihood ratio. As expected, lactate again showed the best combination of positive and negative likelihood ratios, whereas for the maps, ADC map with 500 and 1000 b-values showed the best realistic combination of likelihood ratios, however, with lower sensitivity and specificity than lactate. Conclusion: Diffusion weighted imaging and magnetic resonance spectroscopy are state-of-art in the diagnostic arena and they manifested themselves as key players in the differentiation process of orofacial tumors. The complete biological profile of malignancy can be decoded as low ADC values, high choline and/or high lactate, whereas that of benign entities can be translated as high ADC values, low choline and no lactate.

Keywords: diffusion magnetic resonance imaging, magnetic resonance spectroscopy, malignant tumors, maxillofacial

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115 Integrating Technology into Foreign Language Teaching: A Closer Look at Arabic Language Instruction at the Australian National University

Authors: Kinda Alsamara

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Foreign language education is a complex endeavor that often presents educators with a range of challenges and difficulties. This study shed light on the specific challenges encountered in the context of teaching Arabic as a foreign language at the Australian National University (ANU). Drawing from real-world experiences and insights, we explore the multifaceted nature of these challenges and discuss strategies that educators have employed to address them. The challenges in teaching the Arabic language encompass various dimensions, including linguistic intricacies, cultural nuances, and diverse learner backgrounds. The complex Arabic script, grammatical structures, and pronunciation patterns pose unique obstacles for learners. Moreover, the cultural context embedded within the language demands a nuanced understanding of cultural norms and practices. The diverse backgrounds of learners further contribute to the challenge of tailoring instruction to meet individual needs and proficiency levels. This study also underscores the importance of technology in tackling these challenges. Technological tools and platforms offer innovative solutions to enhance language acquisition and engagement. Online resources, interactive applications, and multimedia content can provide learners with immersive experiences, aiding in overcoming barriers posed by traditional teaching methods. Furthermore, this study addresses the role of instructors in mitigating challenges. Educators often find themselves adapting teaching approaches to accommodate different learning styles, abilities, and motivations. Establishing a supportive learning environment and fostering a sense of community can contribute significantly to overcoming challenges related to learner diversity. In conclusion, this study provides a comprehensive overview of the challenges faced in teaching Arabic as a foreign language at ANU. By recognizing these challenges and embracing technological and pedagogical advancements, educators can create more effective and engaging learning experiences for students pursuing Arabic language proficiency.

Keywords: Arabic, Arabic online, blended learning, teaching and learning, Arabic language, educational aids, technology

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