Search results for: reduced resource burden
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7202

Search results for: reduced resource burden

1802 The Usefulness of Medical Scribes in the Emengecy Department

Authors: Victor Kang, Sirene Bellahnid, Amy Al-Simaani

Abstract:

Efficient documentation and completion of clerical tasks are pillars of efficient patient-centered care in acute settings such as the emergency department (ED). Medical scribes aid physicians with documentation, navigation of electronic health records, results gathering, and communication coordination with other healthcare teams. However, the use of medical scribes is not widespread, with some hospitals even continuing to discontinue their programs. One reason for this could be the lack of studies that have outlined concrete improvements in efficiency and patient and provider satisfaction in emergency departments before and after incorporating scribes. Methods: We conducted a review of the literature concerning the implementation of a medical scribe program and emergency department performance. For this review, a narrative synthesis accompanied by textual commentaries was chosen to present the selected papers. PubMed was searched exclusively. Initially, no date limits were set, but seeing as the electronic medical record was officially implemented in Canada in 2013, studies published after this date were preferred as they provided insight into the interplay between its implementation and scribes on quality improvement. Results: Throughput, efficiency, and cost-effectiveness were the most commonly used parameters in evaluating scribes in the Emergency Department. Important throughput metrics, specifically door-to-doctor and disposition time, were significantly decreased in emergency departments that utilized scribes. Of note, this was shown to be the case in community hospitals, where the burden of documentation and clerical tasks would fall directly upon the attending physician. Academic centers differ in that they rely heavily on residents and students; so the implementation of scribes has been shown to have limited effect on these metrics. However, unique to academic centers was the provider’s perception of incrased time for teaching was unique to academic centers. Consequently, providers express increased work satisfaction in relation to time spent with patients and in teaching. Patients, on the other hand, did not demonstrate a decrease in satisfaction in regards to the care that was provided, but there was no significant increase observed either. Of the studies we reviewed, one of the biggest limitations was the lack of significance in the data. While many individual studies reported that medical scribes in emergency rooms improved relative value units, patient satisfaction, provider satisfaction, and increased number of patients seen, there was no statistically significant improvement in the above criteria when compiled in a systematic review. There is also a clear publication bias; very few studies with negative results were published. To prove significance, data from more emergency rooms with scribe programs would need to be compiled which also includes emergency rooms who did not report noticeable benefits. Furthermore, most data sets focused only on scribes in academic centers. Conclusion: Ultimately, the literature suggests that while emergency room physicians who have access to medical scribes report higher satisfaction due to lower clerical burdens and can see more patients per shift, there is still variability in terms of patient and provider satisfaction. Whether or not this variability exists due to differences in training (in-house trainees versus contractors), population profile (adult versus pediatric), setting (academic versus community), or which shifts scribe work cannot be determined based on the studies that exist. Ultimately, more scribe programs need to be evaluated to determine whether these variables affect outcomes and prove whether scribes significantly improve emergency room efficiency.

Keywords: emergency medicine, medical scribe, scribe, documentation

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1801 The Effects of Damping Devices on Displacements, Velocities and Accelerations of Structures

Authors: Radhwane Boudjelthia

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The most recent earthquakes occurred in the world have killed thousands of people and severe damage. For all the actors involved in the building process, the earthquake is the litmus test for construction. The goal we set ourselves is to contribute to the implementation of a thoughtful approach to the seismic protection of structures. For many engineers, the most conventional approach to protection works (buildings and bridges) the effects of earthquakes is to increase rigidity. This approach is not always effective, especially when there is a context that favors the phenomenon of resonance and amplification of seismic forces. Therefore, the field of earthquake engineering has made significant inroads, among others catalyzed by the development of computational techniques in computer form and the use of powerful test facilities. This has led to the emergence of several innovative technologies, such as the introduction of special devices insulation between infrastructure and superstructure. This approach, commonly known as "seismic isolation," to absorb the significant efforts without the structure is damaged and thus ensuring the protection of lives and property. In addition, the restraints to the construction by the ground shaking are located mainly at the supports. With these moves, the natural period of construction is increasing, and seismic loads are reduced. Thus, there is an attenuation of the seismic movement. Likewise, the insulation of the base mechanism may be used in combination with earthquake dampers in order to control the deformation of the insulation system and the absolute displacement of the superstructure located above the isolation interface. On the other hand, only can use these earthquake dampers to reduce the oscillation amplitudes and thus reduce seismic loads. The use of damping devices represents an effective solution for the rehabilitation of existing structures. Given all these acceleration reducing means considered passive, much research has been conducted for several years to develop an active control system of the response of buildings to earthquakes.

Keywords: earthquake, building, seismic forces, displacement, resonance, response.

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1800 Regenerative Therapeutic Effect of Statin Nanoparticle-Loaded Adipose-Derived Stem Cells on Myocardial Infarction

Authors: Masaaki Ii, Takashi Saito, Yasuhiko Tabata, Shintaro Nemoto

Abstract:

Background: Clinical trials of autologous adipose-derived stem cell (AdSC) therapy for ischemic heart diseases (IHD) are now on-going. We have investigated the hypothesis that combination of AdSCs and statin, an agent with pleiotropic effects, could augment the therapeutic effect on myocardial infarction (MI). Methods and Results: Human AdSC functions with different doses of simvastatin-conjugated nanoparticle (STNP) uptake were evaluated by in vitro assays. STNP promoted the migration activity without changing the proliferation activity, and also up-regulated growth factors. Next, MI was induced by LAD ligation in nude mice, and the mice were assigned in the following groups 3 days after MI: 1) PBS (control), 2) NP-AdSCs (50000 cells), 3) STNP, and 4) STNP-AdSCs (50000 cells). Cardiac functional recovery assessed by echocardiography was improved at 4 weeks after surgery in STNP-AdSC group. Masson’s trichrome-stained sections revealed that LV fibrosis length was reduced, and the number of TUNEL-positive cardiomyocytes was less in STNP-AdSC group. Surprisingly, a number of de novo endogenous Nkx-2.5/GATA4 positive immature cardiomyocytes as well as massive vascular formation were observed in outer layer of infarcted myocardium despite of a few recruited/retained transfused STNP-AdSCs 4 weeks after MI in STNP-AdSC group. Finally, massive myocardial regeneration was observed 8 weeks after MI. Conclusions: Intravenously injected small number of statin nanoparticle-loaded hAdSCs exhibited a potent therapeutic effect inducing endogenous cardiac tissue regeneration.

Keywords: statin, drug delivery system, stem cells, cardiac regeneration

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1799 Operative versus Non-Operative Treatment of Scaphoid Non-Union in Children: A Case Presentation and Review of the Literature

Authors: Ilja Käch, Abdul R. Jandali, Nadja Zechmann-Müller

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Introduction: We discuss the treatment of two young male patients suffering from scaphoid non-union after a traumatic scaphoid fracture. The currently propagated techniques for treating a scaphoid non-union in children are either the operative reconstruction of the scaphoid or the conservative treatment with splinting in a scaphoid cast. Cases: In the first case, we operated on a 13 years old male patient with a posttraumatic scaphoid non-union in the middle third with a humpback deformity. We resected the middle third of the scaphoid and grafted the defect with an iliac crest bone, and the DISI-Deformity was reduced. Fixation was performed with K-Wires and immobilisation in a scaphoid cast. In the second case a 13 years old male patient also with a posttraumatic scaphoid non-union in the middle third and humpback deformity, DISI-deformity, was treated conservatively. Immobilisation in a scaphoid cast for four months was performed. Results: Operative: One year postoperatively the patient achieved a painless free arc of motion. Flexion/Extension 70/0/60°, Radial-/Ulnarduction 30/0/30° and Pro-/Supination 90/0/90°. The computer tomogram showed complete consolidation and bony fusion of the iliac crest bone. Conservative: Six to eight months after conservative treatment the patient demonstrated painless motion and AROM Flexion/Extension 80/0/80°, Radial-/Ulnarduction and Pro-/Supination in maximum range. Complete consolidation in the computer tomogram with persistent humpback- and DISI deformity. Conclusion: In the literature, both techniques are described, either the operative scaphoid reconstruction or the conservative treatment with splinting. In our cases, both the operative and conservative treatments showed comparable good results. However, the humpback- and DISI deformity can only be addressed with a surgical approach.

Keywords: scaphoid, non-union, trauma, operative vs. non operative

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1798 Harnessing Community Benefits; Case Study of REDD+ in Ghana

Authors: Abdul-Razak Saeed

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Addressing the climate change crisis that this generation faces has evolved to include the consideration of a policy mechanism referred to as reduced emissions from deforestation and forest degradation with plus components of conservation, sustainable forest management and enhancement of forest carbon stocks (REDD+). REDD+ emerged from the International level of UNFCCC but its implementation is by developing countries. It challenges the development paradigm of nations that depend on the unsustainable clearing of forests and land use change for economic development whilst posing as an opportunity or risk for forest community livelihoods, institutions and their interaction with the forest resources. As a novel policy mechanism, it is imperative to gain global insight into local contexts of its implementation and to understand local level mobilization of their agency for institutional sustainability as reconfigured by new carbon economy initiatives like REDD+. Using a systematic review process, as the initial stages of this study, secondary data of REDD+ projects across the globe were evaluated to pick up gaps in research and that of on ground REDD+ implementation. Primary data was gathered from 30 actors in the government, NGO, private sector and traditional authorities using face-to-face semi structured interviews in Ghana; participation in meetings and workshops and policy and strategy document reviews. Preliminary findings of the study include REDD+ knowledge being a key determinant of power distribution and affects who shapes the process; in Ghana, informal relationships are playing key roles in advancing REDD+ unlike in traditional forestry and a subjectivity shift of local communities from an 'emotive-link' of environmental care to one of 'economic self-seeking and enriching' domain of thought.

Keywords: climate change, communities, forests, REDD+

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1797 Finite Element Modelling for the Development of a Planar Ultrasonic Dental Scaler for Prophylactic and Periodontal Care

Authors: Martin Hofmann, Diego Stutzer, Thomas Niederhauser, Juergen Burger

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Dental biofilm is the main etiologic factor for caries, periodontal and peri-implant infections. In addition to the risk of tooth loss, periodontitis is also associated with an increased risk of systemic diseases such as atherosclerotic cardiovascular disease and diabetes. For this reason, dental hygienists use ultrasonic scalers for prophylactic and periodontal care of the teeth. However, the current instruments are limited to their dimensions and operating frequencies. The innovative design of a planar ultrasonic transducer introduces a new type of dental scalers. The flat titanium-based design allows the mass to be significantly reduced compared to a conventional screw-mounted Langevin transducer, resulting in a more efficient and controllable scaler. For the development of the novel device, multi-physics finite element analysis was used to simulate and optimise various design concepts. This process was supported by prototyping and electromechanical characterisation. The feasibility and potential of a planar ultrasonic transducer have already been confirmed by our current prototypes, which achieve higher performance compared to commercial devices. Operating at the desired resonance frequency of 28 kHz with a driving voltage of 40 Vrms results in an in-plane tip oscillation with a displacement amplitude of up to 75 μm by having less than 8 % out-of-plane movement and an energy transformation factor of 1.07 μm/mA. In a further step, we will adapt the design to two additional resonance frequencies (20 and 40 kHz) to obtain information about the most suitable mode of operation. In addition to the already integrated characterization methods, we will evaluate the clinical efficiency of the different devices in an in vitro setup with an artificial biofilm pocket model.

Keywords: ultrasonic instrumentation, ultrasonic scaling, piezoelectric transducer, finite element simulation, dental biofilm, dental calculus

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1796 Interaction of Elevated Carbon Dioxide and Temperature on Strawberry (Fragaria × ananassa) Growth and Fruit Yield

Authors: Himali N. Balasooriya, Kithsiri B. Dassanayake, Saman Seneweera, Said Ajlouni

Abstract:

Increase in atmospheric CO2 concentration [CO2] and ambient temperature associated with changing climatic conditions will have significant impacts on agriculture crop productivity and quality. Independent effects of the above two environmental variables on the growth, yield and quality of strawberry were well documented. Higher temperatures over the optimum range (20-25ºC) lead to crop failures, while elevated [CO2] stimulated plant growth and yield but compromised the physical quality of fruits. However, there is very limited understanding of the interaction between these variables on the plant growth, yield and quality. Therefore, this study was designed to investigate the interactive effect of high temperature and elevated [CO2] on growth, yield and quality of strawberries. Strawberry cultivars ‘Albion’ and ‘San Andreas’ were grown under six different combinations of two temperatures (25 and 30ºC) and three [CO2] (400, 650 and 950 µmol mol-1) in controlled-environmental growth chambers. Plant growth measurements such as plant height, canopy area, number of flowers, and fruit yield were measured during phonological development. Photosynthesis and transpiration, the ratio of intercellular to atmospheric [CO2] (Ci/Ca) were measured to estimate the physiological adjustment to climate stress. The impact of temperature and [CO2] interaction on growth and yield of strawberry was significant (p < 0.05). Across both cultivars, highest fruit yields were observed at 650 µmol mol-1 [CO2], which was particularly clear at 25°C. The fruit yield gradually decreased at 30°C under all the treatment combinations. However, photosynthesis rates were highest at 650 µmol mol-1 [CO2] but no increment was found at 900 µmol mol-1 [CO2]. Interestingly, Ci/Ca ratio increased with increasing atmospheric [CO2] which was predominant at high temperature. Similarly, fruit yield was substantially reduced at high [CO2] under high temperature. Our findings suggest that increased Ci/Ca ratio at high temperature is likely reduces the photosynthesis and thus yield response to elevated [CO2].

Keywords: atmospheric CO₂ concentration, fruit yield, strawberry, temperature

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1795 Personality Profiles, Emotional Disturbance and Health-Related Quality of Life in Patients with Epilepsy

Authors: Usha Barahmand, Ruhollah Heydari Sheikh Ahmad, Sara Alaie Khoraem

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Introduction: The association of epilepsy with several psychological disorders and reduced quality of life has long been recognized. The present study aimed at comparing the personality profiles, quality of life and symptomatology of anxiety and depression in patients with epilepsy and healthy controls. Materials and Methods: Forty seven patients (29 men and 18 women) with diagnosed epilepsy participated in this study. Forty seven healthy controls who matched the patients in age and gender were also recruited. The participants’ personality and psychological profiles were assessed using the Depression, Anxiety, and Stress Scale (DASS-21), the Short-Form Health Survey (SF-36) and the HEXACO Personality Inventory (HEXACO-PI). Scoring algorithms were applied to the SF-36 produce the physical and mental component scores (PCS and MCS). Results: There were statistically significant differences in the total SF-36 score, anxiety, depression and stress scores of the DASS-21 between patients and controls. Anxiety, stress and depression scores significantly correlated inversely with the PCS and MCS. Data analysis showed that females had higher depression scores than males in both patients and controls, while males in both groups scored higher on stress. Patients’ personality scores were also different from those reported by controls on emotional, agreeableness and extroversion. Patients scored higher on emotionality, and lower on agreeableness and extraversion. Patients also scored lower on indices of quality of life. Regression analysis revealed that emotionality, anxiety, stress and MCS accounted for a significant proportion of the variance in severity of epileptic seizures. Conclusion: Stressful situations and psychological conditions as well as the personality trait of neuroticism were related to the occurrence of recurrent epileptic seizures.

Keywords: anxiety, depression, epilepsy, neuroticism, personality, quality of life, stress

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1794 A Comparative Legal Enquiry on the Concept of Invention

Authors: Giovanna Carugno

Abstract:

The concept of invention is rarely scrutinized by legal scholars since it is a slippery one, full of nuances and difficult to be defined. When does an idea become relevant for the patent law? When is it simply possible to talk of what an invention is? It is the first question to be answered to obtain a patent, but it is sometimes neglected by treaties or reduced to very simple and automatically re-cited definitions. Maybe, also because it is more a transnational and cultural concept than a mere institution of law. Tautology is used to avoid the challenge (in the United States patent regulation, the inventor is the one who contributed to have a patentable invention); in other case, a clear definition is surprisingly not even provided (see, e.g., the European Patent Convention). In Europe, the issue is still more complicated because there are several different solutions elaborate inorganically be national systems of courts varying one to the other only with the aim of solving different IP cases. Also a neighbor domain, like copyright law, is not assisting us in the research, since an author in this field is entitles to be the 'inventor' or the 'author' and to protect as far as he produces something new. Novelty is not enough in patent law. A simple distinction between mere improvement that can be achieved by a man skilled in the art (a sort of reasonable man, in other sectors) or a change that is not obvious rising to the dignity of protection seems not going too far. It is not still defining this concept; it is rigid and not fruitful. So, setting aside for the moment the issue related to the definition of the invention/inventor, our proposal is to scrutinize the possible self-sufficiency of a system in which the inventor or the improver should be awarded of royalties or similar compensation according to the economic improvement he was able to bring. The law, in this case, is in the penumbras of misleading concepts, divided between facts that are obscure and technical, and not involving necessarily legal issues. The aim of this paper is to find out a single definition (or, at least, the minimum elements common in the different legal systems) of what is (legally) an invention and what can be the hints to practically identify an authentic invention. In conclusion, it will propose an alternative system in which the invention is not considered anymore and the only thing that matters are the revenues generated by technological improvement, caused by the worker's activity.

Keywords: comparative law, intellectual property, invention, patents

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1793 Fragility Analysis of a Soft First-Story Building in Mexico City

Authors: Rene Jimenez, Sonia E. Ruiz, Miguel A. Orellana

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On 09/19/2017, a Mw = 7.1 intraslab earthquake occurred in Mexico causing the collapse of about 40 buildings. Many of these were 5- or 6-story buildings with soft first story; so, it is desirable to perform a structural fragility analysis of typical structures representative of those buildings and to propose a reliable structural solution. Here, a typical 5-story building constituted by regular R/C moment-resisting frames in the first story and confined masonry walls in the upper levels, similar to the collapsed structures on the 09/19/2017 Mexico earthquake, is analyzed. Three different structural solutions of the 5-story building are considered: S1) it is designed in accordance with the Mexico City Building Code-2004; S2) then, the column dimensions of the first story corresponding to S1 are reduced, and S3) viscous dampers are added at the first story of solution S2. A number of dynamic incremental analyses are performed for each structural solution, using a 3D structural model. The hysteretic behavior model of the masonry was calibrated with experiments performed at the Laboratory of Structures at UNAM. Ten seismic ground motions are used to excite the structures; they correspond to ground motions recorded in intermediate soil of Mexico City with a dominant period around 1s, where the structures are located. The fragility curves of the buildings are obtained for different values of the maximum inter-story drift demands. Results show that solutions S1 and S3 give place to similar probabilities of exceedance of a given value of inter-story drift for the same seismic intensity, and that solution S2 presents a higher probability of exceedance for the same seismic intensity and inter-story drift demand. Therefore, it is concluded that solution S3 (which corresponds to the building with soft first story and energy dissipation devices) can be a reliable solution from the structural point of view.

Keywords: demand hazard analysis, fragility curves, incremental dynamic analyzes, soft-first story, structural capacity

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1792 Nutrition Program Planning Based on Local Resources in Urban Fringe Areas of a Developing Country

Authors: Oktia Woro Kasmini Handayani, Bambang Budi Raharjo, Efa Nugroho, Bertakalswa Hermawati

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Obesity prevalence and severe malnutrition in Indonesia has increased from 2007 to 2013. The utilization of local resources in nutritional program planning can be used to program efficiency and to reach the goal. The aim of this research is to plan a nutrition program based on local resources for urban fringe areas in a developing country. This research used a qualitative approach, with a focus on local resources including social capital, social system, cultural system. The study was conducted in Mijen, Central Java, as one of the urban fringe areas in Indonesia. Purposive and snowball sampling techniques are used to determine participants. A total of 16 participants took part in the study. Observation, interviews, focus group discussion, SWOT analysis, brainstorming and Miles and Huberman models were used to analyze the data. We have identified several local resources, such as the contributions from nutrition cadres, social organizations, social financial resources, as well as the cultural system and social system. The outstanding contribution of nutrition cadres is the participation and creativity to improve nutritional status. In addition, social organizations, like the role of the integrated health center for children (Pos Pelayanan Terpadu), can be engaged in the nutrition program planning. This center is supported by House of Nutrition to assist in nutrition program planning, and provide social support to families, neighbors and communities as social capitals. The study also reported that cultural systems that show appreciation for well-nourished children are a better way to improve the problem of balanced nutrition. Social systems such as teamwork and mutual cooperation can also be a potential resource to support nutritional programs and overcome associated problems. The impact of development in urban areas such as the introduction of more green areas which improve the perceived status of local people, as well as new health services facilitated by people and companies, can also be resources to support nutrition programs. Local resources in urban fringe areas can be used in the planning of nutrition programs. The expansion of partnership with all stakeholders, empowering the community through optimizing the roles of nutrition care centers for children as our recommendation with regard to nutrition program planning.

Keywords: developing country, local resources, nutrition program, urban fringe

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1791 Barriers and Facilitators of Community Based Mental Health Intervention (CMHI) in Rural Bangladesh: Findings from a Descriptive Study

Authors: Rubina Jahan, Mohammad Zayeed Bin Alam, Sazzad Chowdhury, Sadia Chowdhury

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Access to mental health services in Bangladesh is a tale of urban privilege and rural struggle. Mental health services in the country are primarily centered in urban medical hospitals, with only 260 psychiatrists for a population of more than 162 million, while rural populations face far more severe and daunting challenges. In alignment with the World Health Organization's perspective on mental health as a basic human right and a crucial component for personal, community, and socioeconomic development; SAJIDA Foundation a value driven non-government organization in Bangladesh has introduced a Community Based Mental Health (CMHI) program to fill critical gaps in mental health care, providing accessible and affordable community-based services to protect and promote mental health, offering support for those grappling with mental health conditions. The CMHI programme is being implemented in 3 districts in Bangladesh, 2 of them are remote and most climate vulnerable areas targeting total 6,797 individual. The intervention plan involves a screening of all participants using a 10-point vulnerability assessment tool to identify vulnerable individuals. The assumption underlying this is that individuals assessed as vulnerable is primarily due to biological, psychological, social and economic factors and they are at an increased risk of developing common mental health issues. Those identified as vulnerable with high risk and emergency conditions will receive Mental Health First Aid (MHFA) and undergo further screening with GHQ-12 to be identified as cases and non-cases. The identified cases are then referred to community lay counsellors with basic training and knowledge in providing 4-6 sessions on problem solving or behavior activation. In situations where no improvement occurs post lay counselling or for individuals with severe mental health conditions, a referral process will be initiated, directing individuals to ensure appropriate mental health care. In our presentation, it will present the findings from 6-month pilot implementation focusing on the community-based screening versus outcome of the lay counseling session and barriers and facilitators of implementing community based mental health care in a resource constraint country like Bangladesh.

Keywords: community-based mental health, lay counseling, rural bangladesh, treatment gap

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1790 Analysis of Brownfield Soil Contamination Using Local Government Planning Data

Authors: Emma E. Hellawell, Susan J. Hughes

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BBrownfield sites are currently being redeveloped for residential use. Information on soil contamination on these former industrial sites is collected as part of the planning process by the local government. This research project analyses this untapped resource of environmental data, using site investigation data submitted to a local Borough Council, in Surrey, UK. Over 150 site investigation reports were collected and interrogated to extract relevant information. This study involved three phases. Phase 1 was the development of a database for soil contamination information from local government reports. This database contained information on the source, history, and quality of the data together with the chemical information on the soil that was sampled. Phase 2 involved obtaining site investigation reports for development within the study area and extracting the required information for the database. Phase 3 was the data analysis and interpretation of key contaminants to evaluate typical levels of contaminants, their distribution within the study area, and relating these results to current guideline levels of risk for future site users. Preliminary results for a pilot study using a sample of the dataset have been obtained. This pilot study showed there is some inconsistency in the quality of the reports and measured data, and careful interpretation of the data is required. Analysis of the information has found high levels of lead in shallow soil samples, with mean and median levels exceeding the current guidance for residential use. The data also showed elevated (but below guidance) levels of potentially carcinogenic polyaromatic hydrocarbons. Of particular concern from the data was the high detection rate for asbestos fibers. These were found at low concentrations in 25% of the soil samples tested (however, the sample set was small). Contamination levels of the remaining chemicals tested were all below the guidance level for residential site use. These preliminary pilot study results will be expanded, and results for the whole local government area will be presented at the conference. The pilot study has demonstrated the potential for this extensive dataset to provide greater information on local contamination levels. This can help inform regulators and developers and lead to more targeted site investigations, improving risk assessments, and brownfield development.

Keywords: Brownfield development, contaminated land, local government planning data, site investigation

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1789 Physiological Effects of Myrrh and Ginseng Extracts in Diabetic Rats

Authors: Ismail I. Abo-Ghanema, Faheim E. Wehaish, Rasha M. Saleh , Walaa F. Awadin, Mohamed F. Elshal

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The antidiabetic activity of myrrh and ginseng ethanolic extracts were investigated in streptozotocin (STZ)-induced diabetic rats. Thirty male albino rats were divided into five groups, each consisted of six rats. The first group (G1) is the negative control that was fed basal diet, the second group (G2) was injected with STZ and received no treatment, the third group (G3) injected with STZ and received metformin (50 mg/kg, b.wt) as standard anti-diabetic drug, the fourth group (G4) injected with STZ and ginseng (50 mg/kg, b.wt), the fifth group (G5) injected with STZ and received myrrh (500 mg/kg, b.wt). As compared with G1-group, STZ injection increased blood concentrations of glucose (6.2 fold), glycated hemoglobin (HbA1c) (2.51 fold), aspartateaminotransferase (AST), and alanine aminotransferase (ALT) (2.64, 4.60 fold respectively), creatinine (2.91 fold), cholesterol (1.79 fold), triglycerides (2.06 fold), low density lipoprotein-cholesterol (LDL) (2.92 fold), nitric oxide (NO) (20.18 fold), and malondialdehyde (MDA) (2.25 fold), whereas it decreased blood insulin (0.40 fold), albumin (0.60 fold), high density lipoprotein-cholesterol (HDL) (0.33 fold), and reduced glutathione (GSH) (0.49 fold). Vascular permeability index (VPI as measured by Evan's Blue; EB extravasations test) was significantly increased in the skin of diabetic animals (9.6 fold) when compared with the G1-group. In addition, histological alterations in liver, pancreas, kidneys and heart were observed. After 4 weeks of treatment, rats in G4 and G5 showed significant corrections in the all measured parameters and indices. In conclusions, the ethanolic extracts of ginseng and myrrh exhibited promising and safe anti-diabetic activity especially on peripheral circulation as manifested by decreased vascular permeability and improved histopathological alterations of examined organs and insulin secretion. Hence, it may be pursued for their clinical usefulness in the management of diabetes mellitus (DM) and associated vascular complications.

Keywords: diabetic rats, peripheral circulation, natural plants, myrrh, ginseng

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1788 In vitro Effects of Salvia officinalis on Bovine Spermatozoa

Authors: Eva Tvrdá, Boris Botman, Marek Halenár, Tomáš Slanina, Norbert Lukáč

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In vitro storage and processing of animal semen represents a risk factor to spermatozoa vitality, potentially leading to reduced fertility. A variety of substances isolated from natural sources may exhibit protective or antioxidant properties on the spermatozoon, thus extending the lifespan of stored ejaculates. This study compared the ability of different concentrations of the Salvia officinalis extract on the motility, mitochondrial activity, viability and reactive oxygen species (ROS) production by bovine spermatozoa during different time periods (0, 2, 6 and 24 h) of in vitro culture. Spermatozoa motility was assessed using the Computer-assisted sperm analysis (CASA) system. Cell viability was examined using the metabolic activity MTT assay, the eosin-nigrosin staining technique was used to evaluate the sperm viability and ROS generation was quantified using luminometry. The CASA analysis revealed that the motility in the experimental groups supplemented with 0.5-2 µg/mL Salvia extract was significantly lower in comparison with the control (P<0.05; Time 24 h). At the same time, a long-term exposure of spermatozoa to concentrations ranging between 0.05 µg/mL and 2 µg/mL had a negative impact on the mitochondrial metabolism (P<0.05; Time 24 h). The viability staining revealed that 0.001-1 µg/mL Salvia extract had no effects on bovine male gametes, however 2 µg/mL Salvia had a persisting negative effect on spermatozoa (P<0.05). Furthermore 0.05-2 µg/mL Salvia exhibited an immediate ROS-promoting effect on the sperm culture (P>0.05; Time 0 h and 2 h), which remained significant throughout the entire in vitro culture (P<0.05; Time 24 h). Our results point out to the necessity to examine specific effects the biomolecules present in Salvia officinalis may have individually or collectively on the in vitro sperm vitality and oxidative profile.

Keywords: bulls, CASA, MTT test, reactive oxygen species, sage, Salvia officinalis, spermatozoa

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1787 Supply Side Barriers to Maternal Health Care Utilization in District Gwadar, Balochistan

Authors: Changaiz Khan

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Pakistan has the highest rates of maternal mortality in South Asia. From the year 2000 to 2017 the global rate of maternal mortality has decreased up to 39 %. In the context of South Asia, it has decreased by 59% since 2000s. Pakistan has also reduced the rate of maternal mortality, but there is a difference on the provincial level. According to the report of the National Institute of Population Studies (NIPS) conducted in 2020, the MMR in Balochistan has crossed the ratio of most of the South Asian countries, i.e., 298 maternal deaths per 100,000 live births. In comparison, the province of Punjab has the lowest maternal mortality rate i.e. 157 deaths (per 100,000 live births). The rate of maternal mortality is much higher in Balochistan as compared to the other provinces. This research is aimed to discuss the supply side barriers and utilization of maternal healthcare services in the District Gwadar. Likert scale survey method has been used to collect data from the Healthcare Professionals from hospitals -private and government- and the maternal healthcare receiver, that is patient. Semi-structured interviews of healthcare professionals such as doctors, nurses, and Lab technicians have also been conducted. It has been found in this research study that the hospitals in Gwadar district are lagging behind in providing modern maternal healthcare to women due to the lack of staff training, medicine supply, and Laboratories. Moreover, the system of the lady health worker is also not catering to the needs of the women in District Gwadar. It has been recommended in the study that first of all the government should fulfill the supply of the medicine in the hospital. Secondly, the government should open laboratories in the hospitals. Thirdly, the government should increase the funding of the government hospital and the allocation of lady health workers in District Gwadar, Balochistan should be increased.

Keywords: maternal mortality, neonatal, postnatal, supply barriers, patients, healthcare professionals, laboratory, medical supply, training

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1786 An Intelligent Controller Augmented with Variable Zero Lag Compensation for Antilock Braking System

Authors: Benjamin Chijioke Agwah, Paulinus Chinaenye Eze

Abstract:

Antilock braking system (ABS) is one of the important contributions by the automobile industry, designed to ensure road safety in such way that vehicles are kept steerable and stable when during emergency braking. This paper presents a wheel slip-based intelligent controller with variable zero lag compensation for ABS. It is required to achieve a very fast perfect wheel slip tracking during hard braking condition and eliminate chattering with improved transient and steady state performance, while shortening the stopping distance using effective braking torque less than maximum allowable torque to bring a braking vehicle to a stop. The dynamic of a vehicle braking with a braking velocity of 30 ms⁻¹ on a straight line was determined and modelled in MATLAB/Simulink environment to represent a conventional ABS system without a controller. Simulation results indicated that system without a controller was not able to track desired wheel slip and the stopping distance was 135.2 m. Hence, an intelligent control based on fuzzy logic controller (FLC) was designed with a variable zero lag compensator (VZLC) added to enhance the performance of FLC control variable by eliminating steady state error, provide improve bandwidth to eliminate the effect of high frequency noise such as chattering during braking. The simulation results showed that FLC- VZLC provided fast tracking of desired wheel slip, eliminate chattering, and reduced stopping distance by 70.5% (39.92 m), 63.3% (49.59 m), 57.6% (57.35 m) and 50% (69.13 m) on dry, wet, cobblestone and snow road surface conditions respectively. Generally, the proposed system used effective braking torque that is less than the maximum allowable braking torque to achieve efficient wheel slip tracking and overall robust control performance on different road surfaces.

Keywords: ABS, fuzzy logic controller, variable zero lag compensator, wheel slip tracking

Procedia PDF Downloads 147
1785 Microbial and Oocyst Count in Feacal Material of Broilers Birds Administered Phytochemicals (Naringin and Hesperidin)

Authors: Adeleye Oluwagbemmiga, Obuotor Tolulope, Dosumu Adebisi, Opowoye I., Olasoju M., Kolawole Amos, Egbeyale Lawrence

Abstract:

Gut Microbiota plays a vital role in animal health and welfare. This study investigated the effect of naringin and hesperidin administration on broiler birds. A total of 80 day – old broiler chicks were randomly divided into eight groups, with ten birds per group. Four groups were not inoculated but administered coccidiostat (1A), hesperidin alone (2A), naringin alone (3A) and a combination of naringin and hesperidin (4A) from day eight (8) to day fourteen (14) while four other groups (5A – 8A) were inoculated with 2 x 10⁴ oocysts per 0.5ml of Eimeria tenella on the 16th and 19th day of age after they were administered conventional antibiotics and coccidiostat, naringin (50mg/body weight), hesperidin (50mg/body weight) and a combination from day 8 - 14. McMaster counting technique was used to count the oocysts, while pour plate technique was used to determine the bacterial load. The results showed a significant increase in their performance with an average weight ranging from 1.55kg – 2.00kg, microbial load also improved with colony count values from 3.5 x 104 - 4.5 x 10⁴ CFU/ml. The study also found that the inclusion of naringin and hesperidin in the diets of broiler birds inoculated with coccidia oocysts significantly reduced the fecal oocyst counts, with the lowest count in combined treatment (8A) (10%) and indicating a lower degree of coccidiosis infection in the treated groups whereas control group (5A) had the highest oocyst count (35%). Mortality and Morbidity rate was 0% as none of the bird showed signs and symptoms. The reduction in oocyst counts could help to strengthen the immune system of broiler birds and limit the severity of coccidiosis infection, which could be an effective strategy for improving performance, immune function and mitigating the impact of coccidiosis infection in broiler birds.

Keywords: gut colonization, naringin, hesperidin, eimeria tenella, broilers

Procedia PDF Downloads 88
1784 Solution of Reduced Mass in Solar Glider with Electric Engine

Authors: Piotr Żabicki, Paweł Skutta

Abstract:

The project of a glider with an electric motor charged by solar power is an step toward the future of Polish gliding. Due to the popularity of the SZD-50-3 glider and its type of usage, the project was developed based on this model. By placing an auxiliary engine in the glider, the pilot is guaranteed a safe return to the airport. Since it is a training glider, and routes are mainly flown by student pilots and instructors, the guarantee of returning to the airport allows flights in more challenging thermal conditions, which contributes to better pilot training. In case of worsening weather, the pilot has a reliable return option, which prevents time loss due to field landings and saves money by avoiding delays in training. The glider uses the NOVA 15 LW engine, a solar installation, and technical modifications to reduce the glider's weight. This includes the Misztal spar solution, previously used in the PZL 19 aircraft. Additionally, the use of lighter coverings and materials that handle loads from pulling, straining, and sharing improves the aerodynamic performance of the glider, enhancing its overall efficiency. Every component added to the glider's construction (battery, engine, etc.) has been placed to avoid shifting loads along the axis, thus preventing unintended spins and flat spins. Safety concerns were also addressed. In the event of a battery or engine fire, the pilot's cabin is designed as a detachable part of the structure and is made of composites covered with non-flammable resin. The batteries are also enclosed in separate boxes located in the former "luggage" compartment. Access to the installation connecting the engine, panel, and battery is convenient due to the detachable cabin from the structure and the fact that the entire installation runs under the structure. The batteries also have easy access due to the current closed hatch. Cooling for the battery is provided this way.

Keywords: engineering, girder, glider, solar, spar

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1783 Nano-Enhanced In-Situ and Field Up-Gradation of Heavy Oil

Authors: Devesh Motwani, Ranjana S. Baruah

Abstract:

The prime incentive behind up gradation of heavy oil is to increase its API gravity for ease of transportation to refineries, thus expanding the market access of bitumen-based crude to the refineries. There has always been a demand for an integrated approach that aims at simplifying the upgrading scheme, making it adaptable to the production site in terms of economics, environment, and personnel safety. Recent advances in nanotechnology have facilitated the development of two lines of heavy oil upgrading processes that make use of nano-catalysts for producing upgraded oil: In Situ Upgrading and Field Upgrading. The In-Situ upgrading scheme makes use of Hot Fluid Injection (HFI) technique where heavy fractions separated from produced oil are injected into the formations to reintroduce heat into the reservoir along with suspended nano-catalysts and hydrogen. In the presence of hydrogen, catalytic exothermic hydro-processing reactions occur that produce light gases and volatile hydrocarbons which contribute to increased oil detachment from the rock resulting in enhanced recovery. In this way the process is a combination of enhanced heavy oil recovery along with up gradation that effectively handles the heat load within the reservoirs, reduces hydrocarbon waste generation and minimizes the need for diluents. By eliminating most of the residual oil, the Synthetic Crude Oil (SCO) is much easier to transport and more amenable for processing in refineries. For heavy oil reservoirs seriously impacted by the presence of aquifers, the nano-catalytic technology can still be implemented on field though with some additional investments and reduced synergies; however still significantly serving the purpose of production of transportable oil with substantial benefits with respect to both large scale upgrading, and known commercial field upgrading technologies currently on the market. The paper aims to delve deeper into the technology discussed, and the future compatibility.

Keywords: upgrading, synthetic crude oil, nano-catalytic technology, compatibility

Procedia PDF Downloads 408
1782 Effect of Exercise Training on Body Composition and Metabolic Profile in Older Adults during Cancer Treatment

Authors: Adeline Fontvieille, Hugo Parent-Roberge, Marie-France Langlois, Tamas Fulop, Michel Pavic, Eleonor Riesco

Abstract:

Introduction: Total lean body mass is reduced during cancer treatment. This loss is called cancer cachexia and is accompanied by a progressive loss of fat mass. In older adults, these body composition changes can have a larger impact on metabolic health, physical autonomy, and cancer survival. Although currently untreatable, exercise training could reduce these effects. Hence, the objective of this pilot study is to investigate if 12 weeks of exercise training during cancer treatment can mitigate the loss of muscle mass and fat mass in older adults. Methods: A total of 40 older adults (65-80 years) with an ongoing treatment for a curable cancer are currently recruited and randomised in two groups: 1) Combined training (EX, n=20) and 2) Control group (CON, n=20). All variables are measured before and after 12 weeks of intervention: Anthropometry (weight, height, body mass index), body composition (total fat mass, visceral adipose tissue, total and appendicular muscle mass; DXA), metabolic profile (HDL-C and LDL-C, triglycerides, glucose and insulin levels). Results: Preliminary analyses revealed no impact of exercise training on appendicular muscle mass (p=0,31) and fat mass (p=0,31). Furthermore, total body weight, waist circumference, HDL-cholesterol, LDL-cholesterol, glucose and insulin levels remained unchanged (all p ≥ 0.79) after 12 weeks of training. However, statistical analyses revealed that triglyceride levels slightly increased (p=0.03), irrespective of the group. Conclusion: Preliminary analyses did not reveal any impact of aerobic and resistance exercise training on body composition in oncogeriatric patients. Furthermore, exercise training seems not efficient to prevent the cancer treatment-related triglyceride levels increase.

Keywords: muscle mass, fat mass, metabolic profile, combined training, aging, cancer

Procedia PDF Downloads 364
1781 Performance, Yolk and Serum Cholesterol of Shaver-Brown Layers Fed Moringa Leaf Meal and Sun Dried Garlic Powder

Authors: Anselm Onyimonyi, A. Abaponitus

Abstract:

One hundred and ninety two Shaver-Brown layers aged 40 weeks were used in a 10 weeks feeding trial to investigate the effect of supplementary moringa leaf meal and sun-dried garlic powder (MOGA) on the performance, egg yolk and serum cholesterol profiles of the birds. The birds were randomly assigned to four treatments in a 2 x 2 factorial in a Completely Randomized Design with 48 birds per treatment. Each treatment had 24 replicates with 2 birds, each separately housed in a cell in a battery cage. Birds on treatment 1 received a standard layers mash (16.5% CP and 3000 kcalME/kg) without any MOGA. Treatment 2 birds received the control diet with 5 g moringa leaf meal/kg of feed, treatment 3 received the control diet with 5 g sun-dried garlic powder/kg of feed, treatment 4 had a combination of 5 g each of moringa leaf meal and sun dried garlic powder/kg of feed. Data were kept on daily egg production, egg weight and feed intake. 10 eggs were collected per treatment at the end of the study for yolk cholesterol determination. Blood samples from four birds per treatment were collected and used for the serum cholesterol and triglycerides determination. Results showed that bird on treatment 3 (5% moringa leaf meal/kg of feed) had significantly higher (P < 0.05) Hen Day Egg Production record of 83.3% as against 78.75%, 65.05% and 66.67% recorded for the control, T2 and T4 birds, respectively. Egg weight of 56.39 g recorded for the same birds on treatment 3 was significantly (P< 0.05) lower than the values of 62.61 g, 60.99 g and 59.33 g recorded for birds on T4, T1 and T2, respectively. Yolk and serum cholesterol profiles of the moringa leaf meal fed birds were significantly (P<0.05) lowered when compared to those of the other treatments. Comparatively, the birds on the MOGA diets had significantly reduced yolk and serum cholesterol than the control. It is concluded that supplementation of moringa leaf meal and sun dried garlic powder at the levels used in this study will result in the production of nutritionally healthier eggs with less yolk and serum cholesterol.

Keywords: performance, cholesterol, moringa, garlic

Procedia PDF Downloads 520
1780 Thriving Private-Community Partnerships in Ecotourism: Perspectives from Fiji’s Upper Navua Conservation Area

Authors: Jeremy Schultz, Kelly Bricker

Abstract:

Ecotourism has proven itself to be a forerunner in the advancement of environmental conservation all the while supporting cultural tradition, uniqueness, and pride among indigenous communities. Successful private-community partnerships associated with ecotourism operations are vital to the overall prosperity of both the businesses and the local communities. Such accomplishments can be seen through numerous livelihood goals including income, food security, health, reduced vulnerability, governance, and empowerment. Private-community partnerships also support global initiatives such as the sustainable development goals and sustainable development frameworks including those proposed by the United Nations World Tourism Organization (WTO). Understanding such partnerships assists not only large organizations such as the WTO, but it also benefits smaller ecotourism operators and entrepreneurs who are trying to achieve their sustainable tourism development goals. This study examined the partnership between an ecotourism company (Rivers Fiji) and two rural villages located in Fiji’s Upper Navua Conservation Area. Focus groups were conducted in each village. Observation journals were also used to record conversations outside of the focus groups. Data were thematically organized and analyzed to offer researcher interpretations and understandings. This research supported the notion that respectful and emboldening partnerships between communities and private enterprise are vital to the composition of successful ecotourism operations that support sustainable development protocol. Understanding these partnerships can assist in shaping future ecotourism development and re-molding existing businesses. This study has offered an example of a thriving partnership through community input and critical researcher analysis. Research has identified six contributing factors to successful ecotourism partnerships, and this study provides additional support to that framework.

Keywords: community partnerships, conservation areas, ecotourism, Fiji, sustainability

Procedia PDF Downloads 135
1779 Characterization and Modelling of Groundwater Flow towards a Public Drinking Water Well Field: A Case Study of Ter Kamerenbos Well Field

Authors: Buruk Kitachew Wossenyeleh

Abstract:

Groundwater is the largest freshwater reservoir in the world. Like the other reservoirs of the hydrologic cycle, it is a finite resource. This study focused on the groundwater modeling of the Ter Kamerenbos well field to understand the groundwater flow system and the impact of different scenarios. The study area covers 68.9Km2 in the Brussels Capital Region and is situated in two river catchments, i.e., Zenne River and Woluwe Stream. The aquifer system has three layers, but in the modeling, they are considered as one layer due to their hydrogeological properties. The catchment aquifer system is replenished by direct recharge from rainfall. The groundwater recharge of the catchment is determined using the spatially distributed water balance model called WetSpass, and it varies annually from zero to 340mm. This groundwater recharge is used as the top boundary condition for the groundwater modeling of the study area. During the groundwater modeling using Processing MODFLOW, constant head boundary conditions are used in the north and south boundaries of the study area. For the east and west boundaries of the study area, head-dependent flow boundary conditions are used. The groundwater model is calibrated manually and automatically using observed hydraulic heads in 12 observation wells. The model performance evaluation showed that the root means the square error is 1.89m and that the NSE is 0.98. The head contour map of the simulated hydraulic heads indicates the flow direction in the catchment, mainly from the Woluwe to Zenne catchment. The simulated head in the study area varies from 13m to 78m. The higher hydraulic heads are found in the southwest of the study area, which has the forest as a land-use type. This calibrated model was run for the climate change scenario and well operation scenario. Climate change may cause the groundwater recharge to increase by 43% and decrease by 30% in 2100 from current conditions for the high and low climate change scenario, respectively. The groundwater head varies for a high climate change scenario from 13m to 82m, whereas for a low climate change scenario, it varies from 13m to 76m. If doubling of the pumping discharge assumed, the groundwater head varies from 13m to 76.5m. However, if the shutdown of the pumps is assumed, the head varies in the range of 13m to 79m. It is concluded that the groundwater model is done in a satisfactory way with some limitations, and the model output can be used to understand the aquifer system under steady-state conditions. Finally, some recommendations are made for the future use and improvement of the model.

Keywords: Ter Kamerenbos, groundwater modelling, WetSpass, climate change, well operation

Procedia PDF Downloads 152
1778 Field Study on Thermal Performance of a Green Office in Bangkok, Thailand: A Possibility of Increasing Temperature Set-Points

Authors: T. Sikram, M. Ichinose, R. Sasaki

Abstract:

In the tropics, indoor thermal environment is usually provided by a cooling mode to maintain comfort all year. Indoor thermal environment performance is sometimes different from the standard or from the first design process because of operation, maintenance, and utilization. The field study of thermal environment in the green building is still limited in this region, while the green building continues to increase. This study aims to clarify thermal performance and subjective perception in the green building by testing the temperature set-points. A Thai green office was investigated twice in October 2018 and in May 2019. Indoor environment variables (temperature, relative humidity, and wind velocity) were collected continuously. The temperature set-point was normally set as 23 °C, and it was changed into 24 °C and 25 °C. The study found that this gap of temperature set-point produced average room temperature from 22.7 to 24.6 °C and average relative humidity from 55% to 62%. Thermal environments slight shifted out of the ASHRAE comfort zone when the set-point was increased. Based on the thermal sensation vote, the feeling-colder vote decreased by 30% and 18% when changing +1 °C and +2 °C, respectively. Predicted mean vote (PMV) shows that most of the calculated median values were negative. The values went close to the optimal neutral value (0) when the set-point was set at 25 °C. The neutral temperature was slightly decreased when changing warmer temperature set-points. Building-related symptom reports were found in this study that the number of votes reduced continuously when the temperature was warmer. The symptoms that occurred by a cooler condition had the number of votes more than ones that occurred by a warmer condition. In sum, for this green office, there is a possibility to adjust a higher temperature set-point to +1 °C (24 °C) in terms of reducing cold sensitivity, discomfort, and symptoms. All results could support the policy of changing a warmer temperature of this office to become “a better green building”.

Keywords: thermal environment, green office, temperature set-point, comfort

Procedia PDF Downloads 119
1777 Improving Fingerprinting-Based Localization System Using Generative AI

Authors: Getaneh Berie Tarekegn

Abstract:

A precise localization system is crucial for many artificial intelligence Internet of Things (AI-IoT) applications in the era of smart cities. Their applications include traffic monitoring, emergency alarming, environmental monitoring, location-based advertising, intelligent transportation, and smart health care. The most common method for providing continuous positioning services in outdoor environments is by using a global navigation satellite system (GNSS). Due to nonline-of-sight, multipath, and weather conditions, GNSS systems do not perform well in dense urban, urban, and suburban areas.This paper proposes a generative AI-based positioning scheme for large-scale wireless settings using fingerprinting techniques. In this article, we presented a semi-supervised deep convolutional generative adversarial network (S-DCGAN)-based radio map construction method for real-time device localization. It also employed a reliable signal fingerprint feature extraction method with t-distributed stochastic neighbor embedding (t-SNE), which extracts dominant features while eliminating noise from hybrid WLAN and long-term evolution (LTE) fingerprints. The proposed scheme reduced the workload of site surveying required to build the fingerprint database by up to 78.5% and significantly improved positioning accuracy. The results show that the average positioning error of GAILoc is less than 0.39 m, and more than 90% of the errors are less than 0.82 m. According to numerical results, SRCLoc improves positioning performance and reduces radio map construction costs significantly compared to traditional methods.

Keywords: location-aware services, feature extraction technique, generative adversarial network, long short-term memory, support vector machine

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1776 Exploring the Effectiveness of End-Of-Life Patient Decision Add in the ICU

Authors: Ru-Yu Lien, Shih-Hsin Hung, Shu-Fen Lu, Ju-Jen Shie, Wen-Ju Yang, Yuann-Meei Tzeng, Chien-Ying Wang

Abstract:

Background: The quality of care in intensive care units (ICUs) is crucial, especially for terminally ill patients. Shared decision-making (SDM) with families is essential to ensure appropriate care and reduce suffering. Aim: This study explores the effectiveness of an end-of-life decision support Patient Decision Aid (PDA) in an ICU setting. Methods: This study employed a cross-sectional research design conducted in an ICU from August 2020 to June 2023. Participants included family members of end-of-life patients aged 20 or older. A total of 319 participants. Family members of end-of-life patients received the PDA, and data were collected after they made medical decisions. Data collection involved providing family members with a PDA during family meetings. A post-PDA questionnaire with 17 questions assessed PDA effectiveness and anxiety levels. Statistical analysis was performed using SPSS 22.0. Results: The PDA significantly reduced anxiety levels among family members (p < 0.001). It helped them organize their thoughts, prepare for discussions with doctors, and understand critical decision factors. Most importantly, it influenced decision outcomes, with a shift towards palliative care and withdrawal of life-sustaining treatment. Conclusion: This study highlights the importance of family-centered end-of-life care in ICUs. PDAs promote informed decision-making, reduce conflicts, and enhance patient and family involvement. These tools align patient values and goals with medical recommendations, ultimately leading to decisions that prioritize comfort and quality of life. Implementing PDAs in healthcare systems can ensure that patients' care aligns with their values.

Keywords: shared decision-making, patient decision aid, end-of-life care, intensive care unit, family-centered care

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1775 Anti-Inflammatory, Anti-Nociceptive and Anti-Arthritic Effects of Mirtazapine, Venalfaxine and Escitalopram in Rats

Authors: Sally A. El Awdan

Abstract:

Objective and Design: The purpose of this study was to evaluate the anti inflammatory, anti-arthritic and analgesic effects of antidepressants. Methods: Carrageenan model was used to assess effect on acute inflammation. Paw volume were measured at 1, 2, 3 and 4th hour post challenge. Anti-nociceptive effect was evaluated by hot plate method. Chronic inflammation was developed using Complete Freund's Adjuvant (CFA). The animals were injected with Freund’s adjuvant in sub-plantar tissue of the right posterior paw. Paw volume, ankle flexion scores, adjuvant-induced hyperalgesia and serum cytokine levels were assessed. Results: Results obtained demonstrate that mirtazapine, venalfaxine and escitalopram significantly and dose-dependently inhibited carrageenan-induced rat paw oedema. Mirtazapine, venalfaxine and escitalopram increased the reaction time of rats in hot plate test. We observed an increase in paw volume, ankle flexion scores, thermal hyperalgesia, serum levels of interleukin-1β, PGE2 and TNF-α, induced by intraplantar CFA injection. Regular treatment up to 28 days of adjuvant-induced arthritic rats with mirtazapine, venalfaxine and escitalopram showed anti anti-inflammatory and analgesic activities by suppressing the paw volume, recovering the paw withdrawal latency, and by inhibiting the ankle flexion scores in CFA-induced rats. In addition significant reduction in serum levels of interleukin-1β, PGE2 and TNF-α level in arthritic rats was reduced by treatment with drugs. Conclusion: These results suggest that antidepressants have significant anti-inflammatory and anti-nociceptive effects in acute and chronic models in rats, which may be associated with the reduction of interleukin-1β, PGE2 and TNF-α levels.

Keywords: antidepressants, carrageenan, anti-nociceptive, Complete Freund's Adjuvant

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1774 Gilgel Gibe III: Dam-Induced Displacement in Ethiopia and Kenya

Authors: Jonny Beirne

Abstract:

Hydropower developments have come to assume an important role within the Ethiopian government's overall development strategy for the country during the last ten years. The Gilgel Gibe III on the Omo river, due to become operational in September 2014, represents the most ambitious, and controversial, of these projects to date. Further aspects of the government's national development strategy include leasing vast areas of designated 'unused' land for large-scale commercial agricultural projects and 'voluntarily' villagizing scattered, semi-nomadic agro-pastoralist groups to centralized settlements so as to use land and water more efficiently and to better provide essential social services such as education and healthcare. The Lower Omo valley, along the Omo River, is one of the sites of this villagization programme as well as of these large-scale commercial agricultural projects which are made possible owing to the regulation of the river's flow by Gibe III. Though the Ethiopian government cite many positive aspects of these agricultural and hydropower developments there are still expected to be serious regional and transnational effects, including on migration flows, in an area already characterized by increasing climatic vulnerability with attendant population movements and conflicts over scarce resources. The following paper is an attempt to track actual and anticipated migration flows resulting from the construction of Gibe III in the immediate vicinity of the dam, downstream in the Lower Omo Valley and across the border in Kenya around Lake Turkana. In the case of those displaced in the Lower Omo Valley, this will be considered in view of the distinction between voluntary villagization and forced resettlement. The research presented is not primary-source material. Instead, it is drawn from the reports and assessments of the Ethiopian government, rights-based groups, and academic researchers as well as media articles. It is hoped that this will serve to draw greater attention to the issue and encourage further methodological research on the dynamics of dam constructions (and associated large-scale irrigation schemes) on migration flows and on the ultimate experience of displacement and resettlement for environmental migrants in the region.

Keywords: forced displacement, voluntary resettlement, migration, human rights, human security, land grabs, dams, commercial agriculture, pastoralism, ecosystem modification, natural resource conflict, livelihoods, development

Procedia PDF Downloads 381
1773 Assessment of Multi-Domain Energy Systems Modelling Methods

Authors: M. Stewart, Ameer Al-Khaykan, J. M. Counsell

Abstract:

Emissions are a consequence of electricity generation. A major option for low carbon generation, local energy systems featuring Combined Heat and Power with solar PV (CHPV) has significant potential to increase energy performance, increase resilience, and offer greater control of local energy prices while complementing the UK’s emissions standards and targets. Recent advances in dynamic modelling and simulation of buildings and clusters of buildings using the IDEAS framework have successfully validated a novel multi-vector (simultaneous control of both heat and electricity) approach to integrating the wide range of primary and secondary plant typical of local energy systems designs including CHP, solar PV, gas boilers, absorption chillers and thermal energy storage, and associated electrical and hot water networks, all operating under a single unified control strategy. Results from this work indicate through simulation that integrated control of thermal storage can have a pivotal role in optimizing system performance well beyond the present expectations. Environmental impact analysis and reporting of all energy systems including CHPV LES presently employ a static annual average carbon emissions intensity for grid supplied electricity. This paper focuses on establishing and validating CHPV environmental performance against conventional emissions values and assessment benchmarks to analyze emissions performance without and with an active thermal store in a notional group of non-domestic buildings. Results of this analysis are presented and discussed in context of performance validation and quantifying the reduced environmental impact of CHPV systems with active energy storage in comparison with conventional LES designs.

Keywords: CHPV, thermal storage, control, dynamic simulation

Procedia PDF Downloads 240