Search results for: hospital industry
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7393

Search results for: hospital industry

1423 Analysis of the Learning Effectiveness of the Steam-6e Course: A Case Study on the Development of Virtual Idol Product Design as an Example

Authors: Mei-Chun. Chang

Abstract:

STEAM (Science, Technology, Engineering, Art, and Mathematics) represents a cross-disciplinary and learner-centered teaching model that cultivates students to link theory with the presentation of real situations, thereby improving their various abilities. This study explores students' learning performance after using the 6E model in STEAM teaching for a professional course in the digital media design department of technical colleges, as well as the difficulties and countermeasures faced by STEAM curriculum design and its implementation. In this study, through industry experts’ work experience, activity exchanges, course teaching, and experience, learners can think about the design and development value of virtual idol products that meet the needs of users and to employ AR/VR technology to innovate their product applications. Applying action research, the investigation has 35 junior students from the department of digital media design of the school where the researcher teaches as the research subjects. The teaching research was conducted over two stages spanning ten weeks and 30 sessions. This research collected the data and conducted quantitative and qualitative data sorting analyses through ‘design draft sheet’, ‘student interview record’, ‘STEAM Product Semantic Scale’, and ‘Creative Product Semantic Scale (CPSS)’. Research conclusions are presented, and relevant suggestions are proposed as a reference for teachers or follow-up researchers. The contribution of this study is to teach college students to develop original virtual idols and product designs, improve learning effectiveness through STEAM teaching activities, and effectively cultivate innovative and practical cross-disciplinary design talents.

Keywords: STEAM, 6E model, virtual idol, learning effectiveness, practical courses

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1422 Extraction of Dye from Coconut Husk and Its Application on Wool and Silk

Authors: Deepali Rastogi

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Natural dyes are considered to be eco-friendly as they cause no pollution and are safe to use. With the growing interest in natural dyes, new sources of natural dyes are being explored. Coconut (Cocos nucifera) is native to tropical eastern region. It is abundantly available in Asia, Africa and South America. While coconut has tremendous commercial value in food, oil, pharmaceutical and cosmetic industry, the most important use of coconut husk has been as coir which is used for making mats, ropes, etc. In the present study an attempt has been made to extract dye from the coconut husk and study its application on wool and silk. Dye was extracted from coconut husk in an aqueous medium at three different pH. The coconut husk fibres were boiled in water at different pH of 4, 7 and 9 for one hour. On visual inspection of the extracted dye solution, maximum colour was found to be extracted at pH 9. The solution was obtained in neutral medium whereas, no dye was extracted in acidic medium. Therefore, alkaline medium at pH 9 was selected for the extraction of dye from coconut husk. The extracted dye was applied on wool and silk at three different pH, viz., 4, 7 and 9. The effect of pre- and post- mordanting with alum and ferrous sulphate on the colour value of coconut husk dye was also studied. The L*a*b*/L*c*h* values were measured to see the effect of the mordants on the colour values of all the dyed and mordanted samples. Bright golden brown to dark brown colours were obtained at pH 4 on both wool and silk. The colour yield was not very good at pH 7 and 9. Mordanting with alum resulted in darker and brighter shades of brown, whereas mordanting with ferrous sulphate resulted in darker and duller shades. All the samples were tested for colourfastness to light, rubbing, washing and perspiration. Both wool and silk dyed with dye extracted from coconut husk exhibited good to excellent wash, rub and perspiration fastness. Fastness to light was moderate to good.

Keywords: coconut husk, wool, silk, natural dye, mordants

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1421 Experimental Investigation of Physical Properties of Bambusa Oldhamii and Yushania Alpina on the Influence of Age and Harvesting Season

Authors: Tigist Girma Kedane

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The purpose of the current research work is to measure the physical properties of bamboo species in Ethiopia on the impact of age, harvesting seasons and culm height. Three representatives of bamboo plants are harvested in three groups of ages, 2 harvesting months, and 3 regions of Ethiopia. Research has not been done on the physical properties of bamboo species in Ethiopia so far. Moisture content and shrinkage of bamboo culm increase when the culm ages younger and moves from top to bottom position. The harvesting month of November has a higher moisture content and shrinkage compared to February. One year old of Injibara, Kombolcha, and Mekaneselam bamboo culm has 40%, 30%, and 33% higher moisture content, 29%, 24%, and 28% higher radial shrinkage, 32%, 37%, and 32% higher tangential shrinkage compared to 3 years old respectively. The bottom position of Injibara, Kombolcha, and Mekaneselam in November have 45%, 28%, and 25% higher moisture content, 41%, 29%, and 34% radial shrinkage, 29%, 28%, and 42% tangential shrinkage than the top position, respectively. The basic density increases as the age of the bamboo becomes older and moves from the bottom to the top position. November has the lowest basic density compared to February. 3 years old of Injibara, Kombolcha, and Mekaneselam at the age of 3 years have 32%, 50%, and 24% higher basic density compared to 1 year, whereas the top position has 35%, 26%, and 22% higher than the bottom position in February, respectively. The current research proposed that 3 years and February are suited for structural purposes and furniture making, but 1 year and November are suited for fiber extraction in the composite industry. The existence of water in the culm improves an easy extraction of the fibers without damage from the culm.

Keywords: bamboo age, bamboo height, harvesting seasons, physical properties

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1420 Evaluation of the Risk Factors on the Incidence of Adjacent Segment Degeneration After Anterior Neck Discectomy and Fusion

Authors: Sayyed Mostafa Ahmadi, Neda Raeesi

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Background and Objectives: Cervical spondylosis is a common problem that affects the adult spine and is the most common cause of radiculopathy and myelopathy in older patients. Anterior discectomy and fusion is a well-known technique in degenerative cervical disc disease. However, one of the late undesirable complications is adjacent disc degeneration, which affects about 91% of patients in ten years. Many factors can be effective in causing this complication, but some are still debatable. Discovering these risk factors and eliminating them can improve the quality of life. Methods: This is a retrospective cohort study. All patients who underwent anterior discectomy and fusion surgery in the neurosurgery ward of Imam Khomeini Hospital between 2013 and 2016 were evaluated. Their demographic information was collected. All patients were visited and examined for radiculopathy, myelopathy, and muscular force. At the same visit, all patients were asked to have a facelift, and neck profile, as well as a neck MRI(General Tesla 3). Preoperative graphs were used to measure the diameter of the cervical canal(Pavlov ratio) and to evaluate sagittal alignment(Cobb Angle). Preoperative MRI of patients was reviewed for anterior and posterior longitudinal ligament calcification. Result: In this study, 57 patients were studied. The mean age of patients was 50.63 years, and 49.1% were male. Only 3.5% of patients had anterior and posterior longitudinal ligament calcification. Symptomatic ASD was observed in 26.6%. The X-rays and MRIs showed evidence of 80.7% radiological ASD. Among patients who underwent one-level surgery, 20% had symptomatic ASD, but among patients who underwent two-level surgery, the rate of ASD was 50%.In other words, the higher the number of surfaces that are operated and fused, the higher the probability of symptomatic ASD(P-value <0.05). The X-rays and MRIs showed 80.7% of radiological ASD. Among patients who underwent surgery at one level, 78% had radiological ASD, and this number was 92% among patients who underwent two-level surgery(P-value> 0.05). Demographic variables such as age, sex, height, weight, and BMI did not have a significant effect on the incidence of radiological ASD(P-value> 0.05), but sex and height were two influential factors on symptomatic ASD(P-value <0.05). Other related variables such as family history, smoking and exercise also have no significant effect(P-value> 0.05). Radiographic variables such as Pavlov ratio and sagittal alignment were also unaffected by the incidence of radiological and symptomatic ASD(P-value> 0.05). The number of surgical surfaces and the incidence of anterior and posterior longitudinal ligament calcification before surgery also had no statistically significant effect(P-value> 0.05). In the study of the ability of the neck to move in different directions, none of these variables are statistically significant in the two groups with radiological and symptomatic ASD and the non-affected group(P-value> 0.05). Conclusion: According to the findings of this study, this disease is considered to be a multifactorial disease. The incidence of radiological ASD is much higher than symptomatic ASD (80.7% vs. 26.3%) and sex, height and number of fused surfaces are the only factors influencing the incidence of symptomatic ASD and no variable influences radiological ASD.

Keywords: risk factors, anterior neck disectomy and fusion, adjucent segment degeneration, complication

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1419 Puerto Rico and Pittsburg: A Social Psychology Perspective on How Perceived Infringement on Job and Cultural Identity Unite Racially Different Working-Class Groups

Authors: Reagan Rodriguez

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With a growing divide between political echo chambers in the United States, exacerbated by race and income inequality, it might seem to be unfathomable to draw connections that tie working class in an industrial city and a U.S. territory. Yet, in regions where either the economy has been hit due to dwindling job infrastructure or natural disasters have left indelible marks on an island already once marked by colonial imperialism, a larger social shared identity is at play. Fracking has long been an intergenerational and stable work opportunity for many in the Pittsburg PA, yet the rising severity of global climate change may soon impact the policy and even presidential elections which could result in the reduction of jobs in the industry. Cock-fighting, considered a cultural mainstay within the island of Puerto Rico, has already had legislation banning activity and thus cutting out one of the most lucrative aspects of a severely injured economy. Insecurity, infringement, and isolation while being tied to a working-class bracket with no other opportunities in proximity have left both groups expressing similar frustration and while another larger shared identity politic is giving little other options to develop social mobility. This paper utilizes a thematic analysis and compares convergent and divergent themes on internet forums amongst unionized fracking workers in Pittsburg and cockfighters in Puerto Rico. This research examines how group identity in relation to job and cultural identity is most strong and at which points its most malleable; when intergenerational job identity becomes a part of one’s cultural identity, its override may be strongest when it is perceived as threatened. Final findings and limitations were comprehensively outlined.

Keywords: identity threat, social psychology, group identity, culture and social mobility

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1418 Conducting Quality Planning, Assurance and Control According to GMP (Good Manufacturing Practices) Standards and Benchmarking Data for Kuwait Food Industries

Authors: Alaa Alateeqi, Sara Aldhulaiee, Sara Alibraheem, Noura Alsaleh

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For the past few decades or so, Kuwait's local food industry has grown remarkably due to increase in demand for processed or semi processed food products in the market. It is important that the ever increasing food manufacturing/processing units maintain the required quality standards as per regional and to some extent international quality requirements. It has been realized that all Kuwait food manufacturing units should understand and follow the international standard practices, and moreover a set of guidelines must be set for quality assurance such that any new business in this area is aware of the minimum requirements. The current study has been undertaken to identify the gaps in Kuwait food industries in following the Good Manufacturing Practices (GMP) in terms of quality planning, control and quality assurance. GMP refers to Good Manufacturing Practices, which are a set of rules, laws or regulations that certify producing products within quality standards and ensuring that it is safe, pure and effective. The present study therefore reports about a ‘case study’ in a reputed food manufacturing unit in Kuwait; starting from assessment of the current practices followed by diagnosis, report of the diagnosis and road map and corrective measures for GMP implementation in the unit. The case study has also been able to identify the best practices and establish a benchmarking data for other companies to follow, through measuring the selected company's quality, policies, products and strategies and compare it with the established benchmarking data. A set of questionnaires and assessment mechanism has been established for companies to identify their ‘benchmarking score’ in relation to the number of non-conformities and conformities with the GMP standard requirements.

Keywords: good manufacturing practices, GMP, benchmarking, Kuwait Food Industries, food quality

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1417 Insights on Workplace Bullying in the Nonprofit Sector

Authors: Shariffah Dawood

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During the past decade, workplace bullying has attracted increasing attention from researchers internationally as it is reported to be a major social problem and has severe consequences towards the job satisfaction and health of victims and towards the organization. It is characterized by “systematic aggression or violence targeted towards one or more individuals by one individual or by a group, consists of repeated and enduring acts, and the target is or ends up in an inferior position from which it is difficult to defend oneself.” Despite the seriousness of workplace bullying, not all sectors have received the same degree of scholarly attention. Most studies have been undertaken in the public and private sectors, such as, in hospitals, universities, retail industry, local council, and restaurant kitchens. The nonprofit sector has received limited attention despite its significant economic and social role in the society. In order to understand the nature of workplace bullying in non-profit sector, this research explored 29 British nonprofit organizations through surveys and interviews. Despite the nonprofit sector’s emphasis on an egalitarianism ethos, their reputation to be the defenders of the most vulnerable/disadvantaged and the perception that they are protected from such negative behaviors in the workplace, the findings uncovered pertinent factors that make this sector highly vulnerable towards workplace bullying. Overall, the study identifies some organizational factors which need to be addressed in order to curb bullying in this sector: management commitment towards a zero-tolerance bullying policy; management training in areas such as conflict resolution, organizational changes, and maintenance of the commitment of a conscientious workforce. The researcher further recommends that the nonprofit organizations work towards improving relationships with voluntary board members and funding bodies. The researcher will also outline the second phase of the study, which aims to investigate bullying in the nonprofit sector across cultures (the USA, Malaysia and Japan), and implications for the research will be identified.

Keywords: nonprofit sector, workplace bullying, harassment, management, HRM

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1416 Antimicrobial Resistance of Acinetobacter baumannii in Veterinary Settings: A One Health Perspective from Punjab, Pakistan

Authors: Minhas Alam, Muhammad Hidayat Rasool, Mohsin Khurshid, Bilal Aslam

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The genus Acinetobacter has emerged as a significant concern in hospital-acquired infections, particularly due to the versatility of Acinetobacter baumannii in causing nosocomial infections. The organism's remarkable metabolic adaptability allows it to thrive in various environments, including the environment, animals, and humans. However, the extent of antimicrobial resistance in Acinetobacter species from veterinary settings, especially in developing countries like Pakistan, remains unclear. This study aimed to isolate and characterize Acinetobacter spp. from veterinary settings in Punjab, Pakistan. A total of 2,230 specimens were collected, including 1,960 samples from veterinary settings (nasal and rectal swabs from dairy and beef cattle), 200 from the environment, and 70 from human clinical settings. Isolates were identified using routine microbiological procedures and confirmed by polymerase chain reaction (PCR). Antimicrobial susceptibility was determined by the disc diffusion method, and minimum inhibitory concentration (MIC) was measured by the micro broth dilution method. Molecular techniques, such as PCR and DNA sequencing, were used to screen for antimicrobial-resistant determinants. Genetic diversity was assessed using standard techniques. The results showed that the overall prevalence of A. baumannii in cattle was 6.63% (65/980). However, among cattle, a higher prevalence of A. baumannii was observed in dairy cattle, 7.38% (54/731), followed by beef cattle, 4.41% (11/249). Out of 65 A. baumannii isolates, the carbapenem resistance was found in 18 strains, i.e. 27.7%. The prevalence of A. baumannii in nasopharyngeal swabs was higher, i.e., 87.7% (57/65), as compared to rectal swabs, 12.3% (8/65). Class D β-lactamases genes blaOXA-23 and blaOXA-51 were present in all the CRAB from cattle. Among carbapenem-resistant isolates, 94.4% (17/18) were positive for class B β-lactamases gene blaIMP, whereas the blaNDM-1 gene was detected in only one isolate of A. baumannii. Among 70 clinical isolates of A. baumannii, 58/70 (82.9%) were positive for the blaOXA-23-like gene, and 87.1% (61/70) were CRAB isolates. Among all clinical isolates of A. baumannii, blaOXA-51-like gene was present. Hence, the co-existence of blaOXA-23 and blaOXA-51 was found in 82.85% of clinical isolates. From the environmental settings, a total of 18 A. baumannii isolates were recovered; among these, 38.88% (7/18) strains showed carbapenem resistance. All environmental isolates of A. baumannii harbored class D β-lactamases genes, i.e., blaOXA-51 and blaOXA-23 were detected in 38.9% (7/18) isolates. Hence, the co-existence of blaOXA-23 and blaOXA-51 was found in 38.88% of isolates. From environmental settings, 18 A. baumannii isolates were recovered, with 38.88% showing carbapenem resistance. All environmental isolates harbored blaOXA-51 and blaOXA-23 genes, with co-existence in 38.88% of isolates. MLST results showed ten different sequence types (ST) in clinical isolates, with ST 589 being the most common in carbapenem-resistant isolates. In veterinary isolates, ST2 was most common in CRAB isolates from cattle. Immediate control measures are needed to prevent the transmission of CRAB isolates among animals, the environment, and humans. Further studies are warranted to understand the mechanisms of antibiotic resistance spread and implement effective disease control programs.

Keywords: Acinetobacter baumannii, carbapenemases, drug resistance, MSLT

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1415 Experience of Two Major Research Centers in the Diagnosis of Cardiac Amyloidosis from Transthyretin

Authors: Ioannis Panagiotopoulos, Aristidis Anastasakis, Konstantinos Toutouzas, Ioannis Iakovou, Charalampos Vlachopoulos, Vasilis Voudris, Georgios Tziomalos, Konstantinos Tsioufis, Efstathios Kastritis, Alexandros Briassoulis, Kimon Stamatelopoulos, Alexios Antonopoulos, Paraskevi Exadaktylou, Evanthia Giannoula, Anastasia Katinioti, Maria Kalantzi, Evangelos Leontiadis, Eftychia Smparouni, Ioannis Malakos, Nikolaos Aravanis, Argyrios Doumas, Maria Koutelou

Abstract:

Introduction: Cardiac amyloidosis from Transthyretin (ATTR-CA) is an infiltrative disease characterized by the deposition of pathological transthyretin complexes in the myocardium. This study describes the characteristics of patients diagnosed with ATTR-CA from 2019 until present at the Nuclear Medicine Department of Onassis Cardiac Surgery Center and AHEPA Hospital. These centers have extensive experience in amyloidosis and modern technological equipment for its diagnosis. Materials and Methods: Records of consecutive patients (N=73) diagnosed with any type of amyloidosis were collected, analyzed, and prospectively followed. The diagnosis of amyloidosis was made using specific myocardial scintigraphy with Tc-99m DPD. Demographic characteristics, including age, gender, marital status, height, and weight, were collected in a database. Clinical characteristics, such as amyloidosis type (ATTR and AL), serum biomarkers (BNP, troponin), electrocardiographic findings, ultrasound findings, NYHA class, aortic valve replacement, device implants, and medication history, were also collected. Some of the most significant results are presented. Results: A total of 73 cases (86% male) were diagnosed with amyloidosis over four years. The mean age at diagnosis was 82 years, and the main symptom was dyspnea. Most patients suffered from ATTR-CA (65 vs. 8 with AL). Out of all the ATTR-CA patients, 61 were diagnosed with wild-type and 2 with two rare mutations. Twenty-eight patients had systemic amyloidosis with extracardiac involvement, and 32 patients had a history of bilateral carpal tunnel syndrome. Four patients had already developed polyneuropathy, and the diagnosis was confirmed by DPD scintigraphy, which is known for its high sensitivity. Among patients with isolated cardiac involvement, only 6 had left ventricular ejection fraction below 40%. The majority of ATTR patients underwent tafamidis treatment immediately after diagnosis. Conclusion: In conclusion, the experiences shared by the two centers and the continuous exchange of information provide valuable insights into the diagnosis and management of cardiac amyloidosis. Clinical suspicion of amyloidosis and early diagnostic approach are crucial, given the availability of non-invasive techniques. Cardiac scintigraphy with DPD can confirm the presence of the disease without the need for a biopsy. The ultimate goal still remains continuous education and awareness of clinical cardiologists so that this systemic and treatable disease can be diagnosed and certified promptly and treatment can begin as soon as possible.

Keywords: amyloidosis, diagnosis, myocardial scintigraphy, Tc-99m DPD, transthyretin

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1414 Optimization of Process Parameters for Copper Extraction from Wastewater Treatment Sludge by Sulfuric Acid

Authors: Usarat Thawornchaisit, Kamalasiri Juthaisong, Kasama Parsongjeen, Phonsiri Phoengchan

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In this study, sludge samples that were collected from the wastewater treatment plant of a printed circuit board manufacturing industry in Thailand were subjected to acid extraction using sulfuric acid as the chemical extracting agent. The effects of sulfuric acid concentration (A), the ratio of a volume of acid to a quantity of sludge (B) and extraction time (C) on the efficiency of copper extraction were investigated with the aim of finding the optimal conditions for maximum removal of copper from the wastewater treatment sludge. Factorial experimental design was employed to model the copper extraction process. The results were analyzed statistically using analysis of variance to identify the process variables that were significantly affected the copper extraction efficiency. Results showed that all linear terms and an interaction term between volume of acid to quantity of sludge ratio and extraction time (BC), had statistically significant influence on the efficiency of copper extraction under tested conditions in which the most significant effect was ascribed to volume of acid to quantity of sludge ratio (B), followed by sulfuric acid concentration (A), extraction time (C) and interaction term of BC, respectively. The remaining two-way interaction terms, (AB, AC) and the three-way interaction term (ABC) is not statistically significant at the significance level of 0.05. The model equation was derived for the copper extraction process and the optimization of the process was performed using a multiple response method called desirability (D) function to optimize the extraction parameters by targeting maximum removal. The optimum extraction conditions of 99% of copper were found to be sulfuric acid concentration: 0.9 M, ratio of the volume of acid (mL) to the quantity of sludge (g) at 100:1 with an extraction time of 80 min. Experiments under the optimized conditions have been carried out to validate the accuracy of the Model.

Keywords: acid treatment, chemical extraction, sludge, waste management

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1413 Land Layout and Urban Design of New Cities in Underdeveloped Areas of China: A Case Study of Xixian New Area

Authors: Libin Ouyang

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China has experienced a very fast urbanization process in the past two decades. Due to the uncoordinated characteristics of regional development in China, a large number of people from rural areas or small towns have flooded into regional central cities, which are building new cities around them due to the shortage of construction land or the need for urban development. However, the construction of some new cities has not achieved the expected effect, the absorption capacity of industry and population is limited, and the phenomenon of capital and land waste is obvious. This paper takes the Xixian New Area in Shaanxi Province, an inland region in Northwest China, as an example, and tries to analyse the reasons for the lack of vitality in the current situation of the Xixian New Area from the perspective of site layout and urban design, analyses the practical experience of the construction of new city cores in developed countries and regions, and studies how to optimise at the level of site layout planning and urban design to improve the vitality and attractiveness of the new city, decongest the population of large cities, effectively solve the problems of large cities, and promote The study will also examine how to optimise land use planning and urban design to enhance the vitality and attractiveness of new cities, relieve the population of large cities, effectively solve the problems of large cities and promote sustainable development of new cities. The study can serve as a reference for urban planners and policy makers, provide theoretical assistance for new city construction in other less developed regions of China, and provide some case references for urban construction in other developing countries undergoing rapid urbanisation.

Keywords: new city, land use layout, urban design, attraction

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1412 Experimental Study and Numerical Simulation of the Reaction and Flow on the Membrane Wall of Entrained Flow Gasifier

Authors: Jianliang Xu, Zhenghua Dai, Zhongjie Shen, Haifeng Liu, Fuchen Wang

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In an entrained flow gasifier, the combustible components are converted into the gas phase, and the mineral content is converted into ash. Most of the ash particles or droplets are deposited on the refractory or membrane wall and form a slag layer that flows down to the quenching system. The captured particle reaction process and slag flow and phase transformation play an important role in gasifier performance and safe and stable operation. The reaction characteristic of captured char particles on the molten slag had been studied by applied a high-temperature stage microscope. The gasification process of captured chars with CO2 on the slag surface was observed and recorded, compared to the original char gasification. The particle size evolution, heat transfer process are discussed, and the gasification reaction index of the capture char particle are modeled. Molten slag layer promoted the char reactivity from the analysis of reaction index, Coupled with heat transfer analysis, shrinking particle model (SPM) was applied and modified to predict the gasification time at carbon conversion of 0.9, and results showed an agreement with the experimental data. A comprehensive model with gas-particle-slag flow and reaction models was used to model the different industry gasifier. The carbon conversion information in the spatial space and slag layer surface are investigated. The slag flow characteristic, such as slag velocity, molten slag thickness, slag temperature distribution on the membrane wall and refractory brick are discussed.

Keywords: char, slag, numerical simulation, gasification, wall reaction, membrane wall

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1411 Potentials and Challenges of Adventure Tourism Development: A Case Study of Kashmir Valley, India

Authors: Abdul Hamid Mir

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Tourism which is considered as the economic bonanza of Jammu and Kashmir plays an important role in the socio-economic development of Jammu and Kashmir. It is considered as a multi-segmented industry which provides different type of jobs like hotel managers, receptionists, guides, tour operators, travel agents, photographers, etc. Kashmir Valley which is one of the three meso regions (Jammu, Kashmir and Ladakh) of Jammu and Kashmir State is famous all over the world due to its natural beauty. It attracts tourists from the every corner of the globe that is why it has earned name as ‘Paradise on Earth’ and ‘Switzerland of Asia’. It is full of natural treasure and gratifies the several types of tourists. The tourists are experiences fun, thrilling events and safe experience in Kashmir valley, but on the other hand, the adventure tourists are experiencing the physical risks, dangers and losses (injuries, death etc) too. Kashmir valley has greater potential to become one of the best adventure tourism destinations in the world. It offers immense opportunities to the adventurists to explore the wonderful exotic Himalayan ranges and landscapes, in addition, to facing the challenges of fast flowing rivers. Adventure tourism is at the initial stage of development in Kashmir valley and virgin areas needs to be explored and develop which in result will increase not only tourist arrivals but also enhance the business opportunities and economy of local people in Kashmir. Thus the exploitation of virginity of adventure tourism potentials in Kashmir valley is need of the hour. Therefore the present study highlights the potentials of adventure tourism in Kashmir valley and also focuses on the problems in the development of adventure tourism. Furthermore, the study extends to give various recommendations and suggestions in order to develop adventure tourism and broaden the base of tourist arrivals on one hand and sustained the growth on the other hand.

Keywords: adventure, Kashmir, tourism, tourists, potential, rafting, skiing

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1410 Ecological Art in the Nuclear Anthropocene

Authors: Eve-Andree Laramee

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The aesthetics and ethics of the Nuclear Anthropocene are explored through artists responses to the impact of radioactive materials on ecological systems, global issues, energy policies and ourselves. This presentation tracks and reveals the invisible traces of the nuclear weapons complex and the nuclear energy industry, in relation to environmental justice. Radioactive pollution transgresses international borders, boundaries between land and water, contaminating ecological systems. Radioactive waste is never disposed of; it is dispositioned, placed out of sight and out of mind. These materials leave behind an invisible toxic legacy lasting millions of years. As we are learning post-Fukushima, when climate change occurs and vulnerability spectrums shift, nuclear sites and the life forms surrounding them are at increased risk. By visualizing this contamination through art installations, videos, and social-sculpture interventions, information is shared with the public, raising awareness, and activating community participation in remediation and nonproliferation efforts. The emerging Ecological Art genre proposes paradigms sustainable with the life forms and resources of our planet. It is comprised of artists, scientists, philosophers and activists devoted to these. EcoArt is distinguished by a focus on systems and interrelationships within our environment: the ecological, geographic, political, biological and cultural. This presentation will cover artworks addressing the recent Fukushima meltdowns, weapons proliferation, climate change, radioactive waste disposal and environmental justice. Possibilities for art-and-science collaborations will be discussed as projects that sharpen our ethics and politics in our behaviors and social interactions. The presentation will consist of a PowerPoint talk (paper presentation) accompanied by images and video clips.

Keywords: art, ecology, environment, anthropocene, nuclear

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1409 The Influence of Group Heuristics on Corporate Social Responsibility Messages Designed to Reduce Illegal Consumption

Authors: Kate Whitman, Zahra Murad, Joe Cox

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Corporate social responsibility projects are suggested to motivate consumers to reciprocate good corporate deeds with their custom. When the projects benefit the ingroup vs the outgroup, such as locals rather than foreigners, the effect on reciprocity is suggested to be more powerful. This may be explained by group heuristics, a theory which indicates that favours to the ingroup (but not outgroup) are expected to be reciprocated, resulting in ingroup favouritism. The heuristic is theorised to explain prosocial behaviours towards the ingroup. The aim of this study is to test whether group heuristics similarly explain a reduction in antisocial behaviours towards the ingroup, measured by illegal consumption which harms a group that consumers identify with. In order to test corporate social responsibility messages, a population of interested consumers is required, so sport fans are recruited. A pre-registered experiment (N = 600) tests the influence of a focused “team” benefiting message vs a broader “sport” benefiting message on change in illegal intentions. The influence of group (team) identity and trait reciprocity on message efficacy are tested as measures of group heuristics. Results suggest that the “team” treatment significantly reduces illegal consumption intentions. The “sport” treatment interacted with the team identification measure, increasing illegal consumption intentions for low team identification individuals. The results suggest that corporate social responsibility may be effective in reducing illegal consumption, if the messages are delivered directly from brands to consumers with brand identification. Messages delivered on the behalf of an industry may have an undesirable effect.

Keywords: live sports, piracy, counterfeiting, corporate social responsibility, group heuristics, ingroup bias, team identification

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1408 A Clinical Audit on Screening Women with Subfertility Using Transvaginal Scan and Hysterosalpingo Contrast Sonography

Authors: Aarti M. Shetty, Estela Davoodi, Subrata Gangooly, Anita Rao-Coppisetty

Abstract:

Background: Testing Patency of Fallopian Tubes is among one of the several protocols for investigating Subfertile Couples. Both, Hysterosalpingogram (HSG) and Laparoscopy and dye test have been used as Tubal patency test for several years, with well-known limitation. Hysterosalpingo Contrast Sonography (HyCoSy) can be used as an alternative tool to HSG, to screen patency of Fallopian tubes, with an advantage of being non-ionising, and also, use of transvaginal scan to diagnose pelvic pathology. Aim: To determine the indication and analyse the performance of transvaginal scan and HyCoSy in Broomfield Hospital. Methods: We retrospectively analysed fertility workup of 282 women, who attended HyCoSy clinic at our institution from January 2015 to June 2016. An Audit proforma was designed, to aid data collection. Data was collected from patient notes and electronic records, which included patient demographics; age, parity, type of subfertility (primary or secondary), duration of subfertility, past medical history and base line investigation (hormone profile and semen analysis). Findings of the transvaginal scan, HyCoSy and Laparoscopy were also noted. Results: The most common indication for referral were as a part of primary fertility workup on couples who had failure to conceive despite intercourse for a year, other indication for referral were recurrent miscarriage, history of ectopic pregnancy, post reversal of sterilization(vasectomy and tuboplasty), Post Gynaecology surgery(Loop excision, cone biopsy) and amenorrhea. Basic Fertility workup showed 34% men had abnormal semen analysis. HyCoSy was successfully completed in 270 (95%) women using ExEm foam and Transvaginal Scan. Of the 270 patients, 535 tubes were examined in total. 495/535 (93%) tubes were reported as patent, 40/535 (7.5%) tubes were reported as blocked. A total of 17 (6.3%) patients required laparoscopy and dye test after HyCoSy. In these 17 patients, 32 tubes were examined under laparoscopy, and 21 tubes had findings similar to HyCoSy, with a concordance rate of 65%. In addition to this, 41 patients had some form of pelvic pathology (endometrial polyp, fibroid, cervical polyp, fibroid, bicornuate uterus) detected during transvaginal scan, who referred to corrective surgeries after attending HyCoSy Clinic. Conclusion: Our audit shows that HyCoSy and Transvaginal scan can be a reliable screening test for low risk women. Furthermore, it has competitive diagnostic accuracy to HSG in identifying tubal patency, with an additional advantage of screening for pelvic pathology. With addition of 3D Scan, pulse Doppler and other non-invasive imaging modality, HyCoSy may potentially replace Laparoscopy and chromopertubation in near future.

Keywords: hysterosalpingo contrast sonography (HyCoSy), transvaginal scan, tubal infertility, tubal patency test

Procedia PDF Downloads 237
1407 Poor Proficiency of English Language among Tertiary Level Students in Bangladesh and Its Effect on Employability: An Investigation to Find Facts and Solutions

Authors: Tanvir Ahmed, Nahian Fyrose Fahim, Subrata Majumder, Sarker Kibria

Abstract:

English is unanimously recognized as the standard second language in the world, and no one can deny this fact. Many people believe that possessing English proficiency skills is the key to communicating effectively globally, especially for developing countries, which can bring further success to itself on many fronts, as well as to other countries, by ensuring its people worldwide access to education, business, and technology. Bangladesh is a developing country of about 160 million people. A notable number of students in Bangladesh are currently pursuing higher education, especially at the tertiary or collegiate level, in more than 150 public and private universities. English is the dominant linguistic medium through which college instruction and lectures are given to students in Bangladesh. However, many of our students who have only completed their primary and secondary levels of education in the Bangla medium or language are generally in an awkward position to suddenly take and complete many unfamiliar requirements by the time they enter the university as freshmen. As students, they struggle to complete at least 18 courses to acquire proficiency in English. After obtaining a tertiary education certificate, the students could then have the opportunity to acquire a sustainable position in the job market industry; however, many of them do fail, unfortunately, because of poor English proficiency skills. Our study focuses on students in both public and private universities (N=150) as well as education experts (N=30) in Bangladesh. We had prepared two sets of questionnaires that were based upon a literature review on this subject, as we had also collected data and identified the reasons, and arrived at probable solutions to overcoming these problems. After statistical analysis, the study suggested certain remedial measures that could be taken in order to increase student's proficiency in English as well as to ensure their employability potential.

Keywords: tertiary education, English language proficiency, employability, unemployment problems

Procedia PDF Downloads 88
1406 Evidence for Replication of an Unusual G8P[14] Human Rotavirus Strain in the Feces of an Alpine Goat: Zoonotic Transmission from Caprine Species

Authors: Amine Alaoui Sanae, Tagjdid Reda, Loutfi Chafiqa, Melloul Merouane, Laloui Aziz, Touil Nadia, El Fahim, E. Mostafa

Abstract:

Background: Rotavirus group A (RVA) strains with G8P[14] specificities are usually detected in calves and goats. However, these strains have been reported globally in humans and have often been characterized as originating from zoonotic transmissions, particularly in area where ruminants and humans live side-by-side. Whether human P[14] genotypes are two-way and can be transmitted to animal species remains to be established. Here we describe VP4 deduced amino-acid relationships of three Moroccan P[14] genotypes originating from different species and the receptiveness of an alpine goat to a human G8P[14] through an experimental infection. Material/methods: the human MA31 RVA strain was originally identified in a four years old girl presenting an acute gastroenteritis hospitalized at the pediatric care unit in Rabat Hospital in 2011. The virus was isolated and propagated in MA104 cells in the presence of trypsin. Ch_10S and 8045_S animal RVA strains were identified in fecal samples of a 2-week-old native goat and 3-week-old calf with diarrhea in 2011 in Bouaarfa and My Bousselham respectively. Genomic RNAs of all strains were subjected to a two-step RT-PCR and sequenced using the consensus primers VP4. The phylogenetic tree for MA31, Ch_10S and 8045_S VP4 and a set of published P[14] genotypes was constructed using MEGA6 software. The receptivity of MA31 strain by an eight month-old alpine goat was assayed. The animal was orally and intraperitonally inoculated with a dose of 8.5 TCID50 of virus stock at passage level 3. The shedding of the virus was tested by a real time RT-PCR assay. Results: The phylogenetic tree showed that the three Moroccan strains MA31, Ch_10S and 8045_S VP4 were highly related to each other (100% similar at the nucleotide level). They were clustered together with the B10925, Sp813, PA77 and P169 strains isolated in Belgium, Spain and Italy respectively. The Belgian strain B10925 was the most closely related to the Moroccan strains. In contrast, the 8045_S and Ch_10S strains were clustered distantly from the Tunisian calf strain B137 and the goat strain cap455 isolated in South Africa respectively. The human MA31 RVA strain was able to induce bloody diarrhea at 2 days post infection (dpi) in the alpine goat kid. RVA virus shedding started by 2 dpi (Ct value of 28) and continued until 5 dpi (Ct value of 25) with a concomitant elevation in the body temperature. Conclusions: Our study while limited to one animal, is the first study proving experimentally that a human P[14] genotype causes diarrhea and virus shedding in the goat. This result reinforce the potential role of inter- species transmission in generating novel and rare rotavirus strains such G8P[14] which infect humans.

Keywords: interspecies transmission, rotavirus, goat, human

Procedia PDF Downloads 273
1405 Sustainability and Cultural Preservation: Lessons from the Tourism Industry in Bali and Guam

Authors: Briante Barretto, Haley Carreon, Anesha-Maelene Ignacio

Abstract:

This research paper explores the dynamic process of cultural resilience within the context of the modern tourism of two traditional island communities (Bali, Indonesia and Guam, Micronesia). It asks the question: How do indigenous people hold on to their foundational values that define their culture while moving forward in the modern world? Both Bali and Guam serve as famous destinations for tourists from all over the world, with millions of visitors on an annual basis. Both are continually being shaped in profound ways by the forces of modernity through globalization. And both are demonstrating cultural resilience while striving to find creative ways to sustain, preserve and strengthen their values and traditions within the context of a thriving modern tourist economy. This research paper, drawing on ethnographic methodologies, and in particular participant observation and in-depth interviews, explores the many challenges both communities face and the strategies and approaches they are learning to employ that help promote sustainable tourism while contributing to cultural preservation. Drawing on the insights gained from field work in both island communities, as well as the growing literature in this field study, the paper posits important lessons that can guide and inform indigenous communities that are being drawn into the global tourism market. One powerful idea emerges in the research and one that seems to guide and shape tourism policy both indigenous communities - that this current generation should be thought of as the ancestors of future generations, and thus they have a weighty responsibility to continue to learn and strive to sustain and preserve their cultures and traditions, their natural environments, and spiritual foundations for the future.

Keywords: bali, culture, environment, guam, tourism, values

Procedia PDF Downloads 59
1404 Hydraulic Optimization of an Adjustable Spiral-Shaped Evaporator

Authors: Matthias Feiner, Francisco Javier Fernández García, Michael Arneman, Martin Kipfmüller

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To ensure reliability in miniaturized devices or processes with increased heat fluxes, very efficient cooling methods have to be employed in order to cope with small available cooling surfaces. To address this problem, a certain type of evaporator/heat exchanger was developed: It is called a swirl evaporator due to its flow characteristic. The swirl evaporator consists of a concentrically eroded screw geometry in which a capillary tube is guided, which is inserted into a pocket hole in components with high heat load. The liquid refrigerant R32 is sprayed through the capillary tube to the end face of the blind hole and is sucked off against the injection direction in the screw geometry. Its inner diameter is between one and three millimeters. The refrigerant is sprayed into the pocket hole via a small tube aligned in the center of the bore hole and is sucked off on the front side of the hole against the direction of injection. The refrigerant is sucked off in a helical geometry (twisted flow) so that it is accelerated against the hot wall (centrifugal acceleration). This results in an increase in the critical heat flux of up to 40%. In this way, more heat can be dissipated on the same surface/available installation space. This enables a wide range of technical applications. To optimize the design for the needs in various fields of industry, like the internal tool cooling when machining nickel base alloys like Inconel 718, a correlation-based model of the swirl-evaporator was developed. The model is separated into 3 subgroups with overall 5 regimes. The pressure drop and heat transfer are calculated separately. An approach to determine the locality of phase change in the capillary and the swirl was implemented. A test stand has been developed to verify the simulation.

Keywords: helically-shaped, oil-free, R-32, swirl-evaporator, twist-flow

Procedia PDF Downloads 98
1403 Preparation of Chemically Activated Carbon from Waste Tire Char for Lead Ions Adsorption and Optimization Using Response Surface Methodology

Authors: Lucky Malise, Hilary Rutto, Tumisang Seodigeng

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The use of tires in automobiles is very important in the automobile industry. However, there is a serious environmental problem concerning the disposal of these rubber tires once they become worn out. The main aim of this study was to prepare activated carbon from waste tire pyrolysis char by impregnating KOH on pyrolytic char. Adsorption studies on lead onto chemically activated carbon was carried out using response surface methodology. The effect of process parameters such as temperature (°C), adsorbent dosage (g/1000ml), pH, contact time (minutes) and initial lead concentration (mg/l) on the adsorption capacity were investigated. It was found that the adsorption capacity increases with an increase in contact time, pH, temperature and decreases with an increase in lead concentration. Optimization of the process variables was done using a numerical optimization method. Fourier Transform Infrared Spectra (FTIR) analysis, XRay diffraction (XRD), Thermogravimetric analysis (TGA) and scanning electron microscope was used to characterize the pyrolytic carbon char before and after activation. The optimum points 1g/ 100 ml for adsorbent dosage, 7 for pH value of the solution, 115.2 min for contact time, 100 mg/l for initial metal concentration, and 25°C for temperature were obtained to achieve the highest adsorption capacity of 93.176 mg/g with a desirability of 0.994. Fourier Transform Infrared Spectra (FTIR) analysis and Thermogravimetric analysis (TGA) show the presence of oxygen-containing functional groups on the surface of the activated carbon produced and that the weight loss taking place during the activation step is small.

Keywords: waste tire pyrolysis char, chemical activation, central composite design (CCD), adsorption capacity, numerical optimization

Procedia PDF Downloads 215
1402 Evaluation of Ocular Changes in Hypertensive Disorders of Pregnancy

Authors: Rajender Singh, Nidhi Sharma, Aastha Chauhan, Meenakshi Barsaul, Jyoti Deswal, Chetan Chhikara

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Introduction: Pre-eclampsia and eclampsia are hypertensive disorders of pregnancy with multisystem involvement and are common causes of morbidity and mortality in obstetrics. It is believed that changes in retinal arterioles may indicate similar changes in the placenta. Therefore, this study was undertaken to evaluate the ocular manifestations in cases of pre-eclampsia and eclampsia and to deduce any association between the retinal changes and blood pressure, the severity of disease, gravidity, proteinuria, and other lab parameters so that a better approach could be devised to ensure maternal and fetal well-being. Materials and Methods: This was a hospital-based cross-sectional study conducted over a period of one year, from April 2021 to May 2022. 350 admitted patients with diagnosed pre-eclampsia, eclampsia, and pre-eclampsia superimposed on chronic hypertension were included in the study. A pre-structured proforma was used. After taking consent and ocular history, a bedside examination to record visual acuity, pupillary size, corneal curvature, field of vision, and intraocular pressure was done. Dilated fundus examination was done with a direct and indirect ophthalmoscope. Age, parity, BP, proteinuria, platelet count, liver and kidney function tests were noted down. The patients with positive findings only were followed up after 72 hours and 6 weeks of termination of pregnancy. Results: The mean age of patients was 26.18±4.33 years (range 18-39 years).157 (44.9%) were primigravida while 193(55.1%) were multigravida.53 (15.1%) patients had eclampsia, 128(36.5%) had mild pre-eclampsia,128(36.5%) had severe pre-eclampsia and 41(11.7%) had chronic hypertension with superimposed pre-eclampsia. Retinal changes were found in 208 patients (59.42%), and grade I changes were the most common. 82(23.14%) patients had grade I changes, 75 (21.4%) had grade II changes, 41(11.71%) had grade III changes, and 11(3.14%) had serous retinal detachment/grade IV changes. 36 patients had unaided visual acuity <6/9, of these 17 had refractive error and 19(5.4%) had varying degrees of retinal changes. 3(0.85%) out of 350 patients had an abnormal field of vision in both eyes. All 3 of them had eclampsia and bilateral exudative retinal detachment. At day 4, retinopathy in 10 patients resolved, and 3 patients had improvement in visual acuity. At 6 weeks, retinopathy in all the patients resolved spontaneously except persistence of grade II changes in 23 patients with chronic hypertension with superimposed pre-eclampsia, while visual acuity and field of vision returned to normal in all patients. Pupillary size, intraocular pressure, and corneal curvature were found to be within normal limits at all times of examination. There was a statistically significant positive association between retinal changes and mean arterial pressure. The study showed a positive correlation between fundus findings and severity of disease (p value<0.05) and mean arterial pressure (p value<0.005). Primigravida had more retinal changes than multigravida patients. A significant association was found between fundus changes and thrombocytopenia and deranged liver and kidney function tests (p value<0.005). Conclusion: As the severity of pre-eclampsia and eclampsia increases, the incidence of retinopathy also increases, and it affects visual acuity and visual fields of the patients. Thus, timely ocular examination should be done in all such cases to prevent complications.

Keywords: eclampsia, hypertensive, ocular, pre-eclampsia

Procedia PDF Downloads 66
1401 Antecedents of MNE Performance and Managing Firm-Specific and Country-Specific Advantages: An Empirical Study of Optoelectronics Industry in Taiwan

Authors: Jyh-Yi Shih, Chie-Bein Chen, Kuang-Yi Lin, Yu-Wei Huang

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Because of the trend toward globalization, Taiwanese companies have gradually focused more on overseas market operations. Overseas market performance has gradually increased as a proportion of Taiwanese companies’ total business revenues. Existing international investment theories cannot explain numerous new phenomena in this domain. Opinions are inconsistent, and contradictory positions exist regarding the antecedents of multinational enterprise (MNE) performance. This study applied contemporary internalization theory to establish and extend approaches adopted by previous relevant studies. In the context of the overseas market, the influence that MNE investment in research and development (R&D) and marketing has on enterprise performance was investigated from the firm-specific advantages (FSAs) and country-specific advantages (CSAs) perspectives. CSAs and internationalization speed were addressed as moderators, and hypotheses regarding how internationalization and performance were achieved through MNE overseas market operation were explored to ensure the completeness of the investigation. The list of enterprises was sourced from the Taiwan Economic Journal. After examining the relevant data, the following conclusions were obtained: (a) The relationship between the level of FSAs in R&D and enterprise performance exhibited an S-shaped curve. (b) The relationship between the level of FSAs in marketing and enterprise performance displayed a U-shaped curve. (c) The extent to which potential CFAs were obtained positively moderated the relationship between enterprise investment in R&D to gain FSAs and MNE performance. (d) Internationalization speed positively moderated the relationship between MNEs and enterprise investment in R&D and marketing to gain FSAs.

Keywords: multinational corporation, firm-specific advantages, country-specific advantages, international speed

Procedia PDF Downloads 382
1400 Cognitive Behaviour Hypnotherapy as an Effective Intervention for Nonsuicidal Self Injury Disorder

Authors: Halima Sadia Qureshi, Urooj Sadiq, Noshi Eram Zaman

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The goal of this study was to see how cognitive behavior hypnotherapy affected nonsuicidal self-injury. DSM 5 invites the researchers to explore the newly added condition under the chapter of conditions under further study named Nonsuicidal self-injury disorder. To date, no empirical sound intervention has been proven effective for NSSI as given in DSM 5. Nonsuicidal self-injury is defined by DSM 5 as harming one's self physically, without suicidal intention. Around 7.6% of teenagers are expected to fulfill the NSSI disorder criteria. 3 Adolescents, particularly university students, account for around 87 percent of self-harm studies. Furthermore, one of the risks associated with NSSI is an increased chance of suicide attempts, and in most cases, the cycle repeats again. 6 The emotional and psychological components of the illness might lead to suicide, either intentionally or unintentionally. 7 According to a research done at a Pakistani military hospital, over 80% of participants had no intention of committing suicide. Furthermore, it has been determined that improvements in NSSI prevention and intervention are necessary as a stand-alone strategy. The quasi-experimental study took place in Islamabad and Rawalpindi, Pakistan, from May 2019 to April 2020 and included students aged 18 to 25 years old from several institutions and colleges in the twin cities. According to the Diagnostic and Statistical Manual of Mental Disorders 5th edition, the individuals were assessed for >2 episodes without suicidal intent using the intentional self-harm questionnaire. The Clinician Administered Nonsuicidal Self-Injury Disorder Index (CANDI) was used to assess the individual for NSSI condition. Symptom checklist-90 (SCL-90) was used to screen the participants for differential diagnosis. Mclean Screening Instrument for Borderline Personality Disorder (MSI-BPD) was used to rule out the BPD cases. The selected participants, n=106 from the screening sample of 600, were selected. They were further screened to meet the inclusion and exclusion criteria, and the total of n=71 were split into two groups: intervention and control. The intervention group received cognitive behavior hypnotherapy for the next three months, whereas the control group received no treatment. After the period of three months, both the groups went through the post assessment, and after the three months’ period, follow-up assessment was conducted. The groups were evaluated, and SPSS 25 was used to analyse the data. The results showed that each of the two groups had 30 (50 percent) of the 60 participants. There were 41 males (68 percent) and 19 girls (32 percent) in all. The bulk of the participants were between the ages of 21 and 23. (48 percent). Self-harm events were reported by 48 (80 percent) of the pupils, and suicide ideation was found in 6 (ten percent). In terms of pre- and post-intervention values (d=4.90), post-intervention and follow-up assessment values (d=0.32), and pre-intervention and follow-up values (d=5.42), the study's effect size was good. The comparison of treatment and no-treatment groups revealed that treatment was more successful than no-treatment, F (1, 58) = 53.16, p.001. The results reveal that the treatment manual of CBH is effective for Nonsuicidal self-injury disorder.

Keywords: NSSI, nonsuicidal self injury disorder, self-harm, self-injury, Cognitive behaviour hypnotherapy, CBH

Procedia PDF Downloads 173
1399 Using the Clinical Decision Support Platform, Dem DX, to Assess the ‘Urgent Community Care Team’s Notes Regarding Clinical Assessment, Management, and Healthcare Outcomes

Authors: R. Tariq, R. Lee

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Background: Heywood, Middleton & Rochdale Urgent Community Care Team (UCCT)1 is a great example of using a multidisciplinary team to cope with demand. The service reduces unnecessary admissions to hospitals and ensures that patients can leave the hospital quicker by making care more readily available within the community and patient’s homes. The team comprises nurses, community practitioners, and allied health professions, including physiotherapy, occupational therapy, pharmacy, and GPs. The main challenge for a team with a range of experiences and skill sets is to maintain consistency of care, which technology can help address. Allied healthcare professionals (HCPs) are often used in expanded roles with duties mainly involving patient consultations and decision making to ease pressure on doctors. The Clinical Reasoning Platform (CRP) Dem Dx is used to support new as well as experienced professionals in the decision making process. By guiding HCPs through diagnosing patients from an expansive directory of differential diagnoses, patients can receive quality care in the community. Actions on the platform are determined using NICE guidelines along with local guidance influencing the assessment and management of a patient. Objective: To compare the clinical assessment, decisions, and actions taken by the UCCT multidisciplinary team in the community and Dem Dx, using retrospective clinical cases. Methodology: Dem Dx was used to analyse 192 anonymised cases provided by the HMR UCCT. The team’s performance was compared with Dem Dx regarding the quality of the documentation of the clinical assessment and the next steps on the patient’s journey, including the initial management, actions, and any onward referrals made. The cases were audited by two medical doctors. Results: The study found that the actions outlined by the Dem Dx platform were appropriate in almost 87% of cases. When in a direct comparison between DemDX and the actions taken by the clinical team, it was found that the platform was suitable 83% (p<0.001) of the time and could lead to a potential improvement of 66% in the assessment and management of cases. Dem Dx also served to highlight the importance of comprehensive and high quality clinical documentation. The quality of documentation of cases by UCCT can be improved to provide a detailed account of the assessment and management process. By providing step-by-step guidance and documentation at every stage, Dem Dx may ensure that legal accountability has been fulfilled. Conclusion: With the ever expanding workforce in the NHS, technology has become a key component in driving healthcare outcomes. To improve healthcare provision and clinical reasoning, a decision support platform can be integrated into HCPs’ clinical practice. Potential assistance with clinical assessments, the most appropriate next step and actions in a patient’s care, and improvements in the documentation was highlighted by this retrospective study. A further study has been planned to ascertain the effectiveness of improving outcomes using the clinical reasoning platform within the clinical setting by clinicians.

Keywords: allied health professional, assessment, clinical reasoning, clinical records, clinical decision-making, ocumentation

Procedia PDF Downloads 155
1398 Pediatric Drug Resistance Tuberculosis Pattern, Side Effect Profile and Treatment Outcome: North India Experience

Authors: Sarika Gupta, Harshika Khanna, Ajay K Verma, Surya Kant

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Background: Drug-resistant tuberculosis (DR-TB) is a growing health challenge to global TB control efforts. Pediatric DR-TB is one of the neglected infectious diseases. In our previously published report, we have notified an increased prevalence of DR-TB in the pediatric population at a tertiary health care centre in North India which was estimated as 17.4%, 15.1%, 18.4%, and 20.3% in (%) in the year 2018, 2019, 2020, and 2021. Limited evidence exists about a pattern of drug resistance, side effect profile and programmatic outcomes of Paediatric DR-TB treatment. Therefore, this study was done to find out the pattern of resistance, side effect profile and treatment outcome. Methodology: This was a prospective cohort study conducted at the nodal drug-resistant tuberculosis centre of a tertiary care hospital in North India from January 2021 to December 2022. Subjects included children aged between 0-18 years of age with a diagnosis of DR-TB, on the basis of GeneXpert (rifampicin [RIF] resistance detected), line probe assay and drug sensitivity testing (DST) of M. tuberculosis (MTB) grown on a culture of body fluids. Children were classified as monoresistant TB, polyresistant TB (resistance to more than 1 first-line anti-TB drug, other than both INH and RIF), MDR-TB, pre-XDR-TB and XDR-TB, as per the WHO classification. All the patients were prescribed DR TB treatment as per the standard guidelines, either shorter oral DR-TB regimen or a longer all-oral MDR/XDR-TB regimen (age below five years needed modification). All the patients were followed up for side effects of treatment once per month. The patient outcomes were categorized as good outcomes if they had completed treatment and cured or were improving during the course of treatment, while bad outcomes included death or not improving during the course of treatment. Results: Of the 50 pediatric patients included in the study, 34 were females (66.7%) and 16 were male (31.4%). Around 33 patients (64.7%) were suffering from pulmonary TB, while 17 (33.3%) were suffering from extrapulmonary TB. The proportions of monoresistant TB, polyresistant TB, MDR-TB, pre-XDR-TB and XDR-TB were 2.0%, 0%, 50.0%, 30.0% and 18.0%, respectively. Good outcome was reported in 40 patients (80.0%). The 10 bad outcomes were 7 deaths (14%) and 3 (6.0%) children who were not improving. Adverse events (single or multiple) were reported in all the patients, most of which were mild in nature. The most common adverse events were metallic taste 16(31.4%), rash and allergic reaction 15(29.4%), nausea and vomiting 13(26.0%), arthralgia 11 (21.6%) and alopecia 11 (21.6%). Serious adverse event of QTc prolongation was reported in 4 cases (7.8%), but neither arrhythmias nor symptomatic cardiac side effects occurred. Vestibular toxicity was reported in 2(3.9%), and psychotic symptoms in 4(7.8%). Hepatotoxicity, hypothyroidism, peripheral neuropathy, gynaecomastia, and amenorrhea were reported in 2 (4.0%), 4 (7.8%), 2 (3.9%), 1(2.0%), and 2 (3.9%) respectively. None of the drugs needed to be withdrawn due to uncontrolled adverse events. Conclusion: Paediatric DR TB treatment achieved favorable outcomes in a large proportion of children. DR TB treatment regimen drugs were overall well tolerated in this cohort.

Keywords: pediatric, drug-resistant, tuberculosis, adverse events, treatment

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1397 Shape Memory Alloy Structural Damper Manufactured by Selective Laser Melting

Authors: Tiziana Biasutti, Daniela Rigamonti, Lorenzo Palmiotti, Adelaide Nespoli, Paolo Bettini

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Aerospace industry is based on the continuous development of new technologies and solutions that allows constant improvement of the systems. Shape Memory Alloys are smart materials that can be used as dampers due to their pseudoelastic effect. The purpose of the research was to design a passive damper in Nitinol, manufactured by Selective Laser Melting, for space applications to reduce vibration between different structural parts in space structures. The powder is NiTi (50.2 at.% of Ni). The structure manufactured by additive technology allows us to eliminate the presence of joint and moving parts and to have a compact solution with high structural strength. The designed dampers had single or double cell structures with three different internal angles (30°, 45° and 60°). This particular shape has damping properties also without the pseudoelastic effect. For this reason, the geometries were reproduced in different materials, SS316L and Ti6Al4V, to test the geometry loss factor. The mechanical performances of these specimens were compared to the ones of NiTi structures, pointing out good damping properties of the designed structure and the highest performances of the NiTi pseudoelastic effect. The NiTi damper was mechanically characterized by static and dynamic tests and with DSC and microscope observations. The experimental results were verified with numerical models and with some scaled steel specimens in which optical fibers were embedded. The realized structure presented good mechanical and damping properties. It was observed that the loss factor and the dissipated energy increased with the angles of the cells.

Keywords: additive manufacturing, damper, nitinol, pseudo elastic effect, selective laser melting, shape memory alloys

Procedia PDF Downloads 94
1396 Evaluation of Heat of Hydration and Strength Development in Natural Pozzolan-Incorporated Cement from the Gulf Region

Authors: S. Al-Fadala, J. Chakkamalayath, S. Al-Bahar, A. Al-Aibani, S. Ahmed

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Globally, the use of pozzolan in blended cement is gaining great interest due to the desirable effect of pozzolan from the environmental and energy conservation standpoint and the technical benefits they provide to the performance of cement. The deterioration of concrete structures in the marine environment and extreme climates demand the use of pozzolana cement in concrete construction in the Gulf region. Also, natural sources of cement clinker materials are limited in the Gulf region, and cement industry imports the raw materials for the production of Portland cement, resulting in an increase in the greenhouse gas effect due to the CO₂ emissions generated from transportation. Even though the Gulf region has vast deposits of natural pozzolana, it is not explored properly for the production of high performance concrete. Hence, an optimum use of regionally available natural pozzolana for the production of blended cement can result in sustainable construction. This paper investigates the effect of incorporating natural pozzolan sourced from the Gulf region on the performance of blended cement in terms of heat evolution and strength development. For this purpose, a locally produced Ordinary Portland Cement (OPC) and pozzolan-incorporated blended cements containing different amounts of natural pozzolan (volcanic ash) were prepared on laboratory scale. The strength development and heat evolution were measured and quantified. Promising results of strength development were obtained for blends with the percentages of Volcanic Ash (VA) replacement varying from 10 to 30%. Results showed that the heat of hydration decreased with increase in percentage of replacement of OPC with VA, indicating increased retardation in hydration due to the addition of VA. This property could be used in mass concreting in which a reduction in heat of hydration is required to reduce cracking in concrete, especially in hot weather concreting.

Keywords: blended cement, hot weather, hydration, volcanic ash

Procedia PDF Downloads 315
1395 The Effect of Corporate Social Responsibility in the National Commercial Bank in Saudi Arabia

Authors: Nada Azhar

Abstract:

The aim of the paper is to investigate the effect of corporate social responsibility (CSR) CSR on the National Commercial Bank (NCB) in Saudi Arabia. In order to achieve this, a case study was made of the CSR activities of this bank from the perspective of its branch managers. The NCB was chosen as it was one of the first Saudi banks to engage in CSR and currently has a wide range of CSR initiatives. A qualitative research method was used. Open-ended questionnaires were administered to eighty branch managers of the NCB, with fifty-five usable questionnaires returned and twenty managers were interviewed as part of the primary research. Data from both questionnaires and interviews were analysed using qualitative content analysis. Six themes emerged from the questionnaire findings were used to develop the interview questions. These themes are the following: Awareness of employees about CSR in the NCB; CSR activities as a type of investment; Government and media support; Increased employee loyalty in the NCB; Prestige and profit to the NCB; and View of CSR in Islam. This paper makes a theoretical contribution in that it investigates and increases understanding of the effect of CSR on the NCB in Saudi Arabia. In addition, it makes a practical contribution by making recommendations which can support the development of CSR in the NCB. A limitation of the paper is that it is a case study of only one bank. It is therefore recommended that future research could be conducted with other banks in Saudi Arabia, or indeed, with a range of other types of firm within the financial services area in Saudi Arabia. In this way, the same issues could be explored but with a greater potential generalisability of findings of CSR within the Saudi Arabian financial services industry. In addition, this paper takes a qualitative approach and it is suggested that future research be carried out using mixed methods, which could provide a greater depth of analysis.

Keywords: branch managers, corporate social responsibility, national commercial bank, Saudi Arabia

Procedia PDF Downloads 246
1394 Geographic Information System Based Development Potentiality Assessment for Rural Villages: Case Study in Fuliang County, Jingdezhen

Authors: Sishen Wang

Abstract:

Chinese rural industry development is the major task currently during rapid urbanization. Development of potentiality assessment, evaluate the overall suitability of each village for further industrial development, could offer reference for policy makers, especially considering the limited data available in Chinese rural regions. The study focuses on 157 official villages in Fuliang County and evaluates their development potentiality by their topography, transportation condition, population, income of villagers, infrastructure and environmental conditions. Land cover changes for Fuliang county and surrounding areas of each village is also investigated for reference. The final development potentiality of each village was calculated by adding different weighted scores of different categories. Besides, inverse distance weighting (IDW) images for both final score of development potentiality and each factor were made and compared to help to understand the final result. The study found that village in the southern and northern regions have higher development potentiality than villages in the eastern and western regions, mainly because of higher income of villagers, good accessibilities and a large amount of population size. In addition, the Fuliang county was divided into five regions based on final result and policy reference for the development of each region were put forward individually. In addition, three suggestions were made for better local development potentiality: Firstly, the transportation accessibility needs to be improved in the northern regions by building more public transit system there. Secondly, the environmental conditions and infrastructure conditions in the eastern region of the county need some improvement. Thirdly, some encouragement and job opportunities should beset up in the western regions to attract labor force to move in and settle down.

Keywords: development potentiality, Fuliang GIS-Based, GIS, official village

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