Search results for: advanced care planning
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9057

Search results for: advanced care planning

2307 Revolutionizing Legal Drafting: Leveraging Artificial Intelligence for Efficient Legal Work

Authors: Shreya Poddar

Abstract:

Legal drafting and revising are recognized as highly demanding tasks for legal professionals. This paper introduces an approach to automate and refine these processes through the use of advanced Artificial Intelligence (AI). The method employs Large Language Models (LLMs), with a specific focus on 'Chain of Thoughts' (CoT) and knowledge injection via prompt engineering. This approach differs from conventional methods that depend on comprehensive training or fine-tuning of models with extensive legal knowledge bases, which are often expensive and time-consuming. The proposed method incorporates knowledge injection directly into prompts, thereby enabling the AI to generate more accurate and contextually appropriate legal texts. This approach substantially decreases the necessity for thorough model training while preserving high accuracy and relevance in drafting. Additionally, the concept of guardrails is introduced. These are predefined parameters or rules established within the AI system to ensure that the generated content adheres to legal standards and ethical guidelines. The practical implications of this method for legal work are considerable. It has the potential to markedly lessen the time lawyers allocate to document drafting and revision, freeing them to concentrate on more intricate and strategic facets of legal work. Furthermore, this method makes high-quality legal drafting more accessible, possibly reducing costs and expanding the availability of legal services. This paper will elucidate the methodology, providing specific examples and case studies to demonstrate the effectiveness of 'Chain of Thoughts' and knowledge injection in legal drafting. The potential challenges and limitations of this approach will also be discussed, along with future prospects and enhancements that could further advance legal work. The impact of this research on the legal industry is substantial. The adoption of AI-driven methods by legal professionals can lead to enhanced efficiency, precision, and consistency in legal drafting, thereby altering the landscape of legal work. This research adds to the expanding field of AI in law, introducing a method that could significantly alter the nature of legal drafting and practice.

Keywords: AI-driven legal drafting, legal automation, futureoflegalwork, largelanguagemodels

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2306 Indigo Dye Wastewater Treatment by Fenton Oxidation

Authors: Anurak Khrueakham, Tassanee Chanphuthin

Abstract:

Indigo is a well-known natural blue dye that is used hither to even though synthetic ones are commercially available. The removal of indigo from effluents is difficult due to its resistance towards biodegradation which causes an aquatic environment effect. Fenton process is a reaction between hydrogen peroxide H2O2 and Fe2+ to generate •OH (highly reactive oxidant (E◦= 2.8 V)). Additionally, •OH is non-selective oxidant which is capable of destroying wide range of organic pollutants in water and wastewater. The aims of this research were to investigate the effect of H2O2, Fe2+ and pH on indigo wastewater oxidation by Fenton process. A liter reactor was operated in all experiments. The batch reactor was prepared by filling 1 liter of indigo wastewater. The pH was adjusted to the desired value; then, FeSO4 at predetermined amount was added. Finally, H2O2 was immediately added to start the Fenton’s reaction. The Fenton oxidation of indigo wastewater was operated for 60 minutes. Residual H2O2 was analyzed using titanium oxalate method. The Fe2+ concentration was determined by phenanthroline method. COD was determined using closed-reflux titrimetric method to indicate the removal efficiency. The results showed that at pH 2 increasing the initial ferrous concentration from 0.1 mM to 1 mM enhanced the indigo removal from 36% to 59%. Fenton reaction was rapidly due to the high generation rate of •OH. The degradation of indigo increased with increasing pH up to pH 3. This can be explained that the scavenging effect of the •OH by H+ in the condition of low pH is severe to form an oxonium ion, resulting in decrease the production of •OH and lower the decolorization efficiency of indigo. Increasing the initial H2O2 concentration from 5 mM to 20 mM could enhance the decolorization. The COD removal was increased from 35% to 65% with increasing H2O2 concentration from 5 mM to 20 mM. The generations of •OH were promoted by the increase of initial H2O2 concentration. However, the higher concentration of H2O2 resulted in the reduction of COD removal efficiency. The initial ferrous concentrations were studied in the range of 0.05-15.0 mM. The results found that the COD removals increased with increasing ferrous concentrations. The COD removals were increased from 32% to 65% when increase the ferrous concentration from 0.5 mM to 10.0 mM. However, the COD removal did not significantly change at higher 10.0 mM. This is because •OH yielding was lower level of oxidation, therefore, the COD removals were not improved. According to the studies, the Fenton’s reagents were important factors for COD removal by Fenton process. The optimum condition for COD removal of indigo dye wastewater was 10.0 mM of ferrous, 20 mM of H2O2 and at pH 3.

Keywords: indigo dye, fenton oxidation, wastewater treatment, advanced oxidation processes

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2305 Digital Tools in Education and Online Learning in the Field of Accounting

Authors: Marina Ercegović, Mateja Brozović, Nikolina Dečman

Abstract:

The extent of using digital technologies in teaching has definitely intensified during the pandemic, leading to the replacement of traditional learning with online learning. The experiences through the pandemic have shown that not all fields of study and all levels of education are equally suitable for the implementation of digital tools and online learning. It is generally expected that students at higher levels of study have better digital competences and are therefore more equipped and prepared to participate in online education or traditional education in classrooms that include the use of digital tools. Accounting as a field of study has good predispositions to be suitable for the use of digital tools and online learning: it can usually be taught remotely, while modern accounting also incorporates the use of different digital tools. The goals of the research are: 1) to systematize the results of the existing literature regarding the use of digital tools and online learning in education, with a special emphasis on teaching accounting, 2) to analyze the current level of digital competences of accounting students in Croatia, 3) to investigate the current attitudes of accounting students in Croatia regarding the use of digital tools in education, as well as the advantages and disadvantages of online learning, and 4) to compare the results of the research conducted in 2024/2025 with the same research conducted in 2021/2022. In addition to the literature review, a primary research using an online questionnaire was conducted among accounting students in Croatia. The sample included students enrolled in the university or professional study program related to accounting and finance, or accounting and auditing. The original research was conducted in 2021/2022, i.e. during the pandemic, when students had to suddenly transition from traditional learning to online learning, mostly without proper preparation and planning, which might have negatively affected the attitudes of students towards online learning and digital tools. This is why it repeated the research in 2024/2025, to compare the results and to explore if there are any significant differences.

Keywords: digital tools, accounting, online learning, education

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2304 Making Waves: Preparing the Next Generation of Bilingual Medical Doctors

Authors: Edith Esparza-Young, Ángel M. Matos, Yaritza Gonzalez, Kirthana Sugunathevan

Abstract:

Introduction: This research describes the existing medical school program which supports a multicultural setting and bilingualism. The rise of Spanish speakers in the United States has led to the recruitment of bilingual medical students who can serve the evolving demographics. This paper includes anecdotal evidence, narratives and the latest research on the outcomes of supporting a multilingual academic experience in medical school and beyond. People in the United States will continue to need health care from physicians who have experience with multicultural competence. Physicians who are bilingual and possess effective communication skills will be in high demand. Methodologies: This research is descriptive. Through this descriptive research, the researcher will describe the qualities and characteristics of the existing medical school programs, curriculum, and student services. Additionally, the researcher will shed light on the existing curriculum in the medical school and also describe specific programs which help to serve as safety nets to support diverse populations. The method included observations of the existing program and the implementation of the medical school program, specifically the Accelerated Review Program, the Language Education and Professional Communication Program, student organizations and the Global Health Institute. Concluding Statement: This research identified and described characteristics of the medical school’s program. The research explained and described the current and present phenomenon of this medical program, which has focused on increasing the graduation of bilingual and minority physicians. The findings are based on observations of the curriculum, programs and student organizations which evolves and remains innovative to stay current with student enrollment.

Keywords: bilingual, English, medicine, doctor

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2303 Seven Brothers and Sisters of Severely Disabled Children Speak up about Their Everyday Challenges and Needs : A Multiple Case Study

Authors: Myriam Castonguay, Florence Vinit

Abstract:

This study aims to gain a better understanding of the lived experience of seven children growing up in a family where another child is severely disabled, informed by family systems theory and the socio-ecological model of development. In depth semi-structured interviews were conducted with seven children who described they everyday life since their brother’s or sister’s diagnosis. Thematic analysis revealed four themes : struggling with loneliness inside the family, supporting the disabled child through its journey, accommodating to a changing routine and keeping a “bubble” for oneself. Brothers and sisters depict a family life characterized by much loneliness, with severe disabilities requiring ongoing care and prolonged hospitalizations. In the midst of adversity, siblings describe themselves as highly committed to supporting the disabled child and to preserve family cohesion, even if that means getting exposed to emotionally challenging situations and adjusting their daily routine frequently. Children recount that keeping up with schoolwork and leisure activities of their own is central to their well-being. Having a space where one can reconnect with his ordinary life as a kid is also deemed very important. This study reminds us that more needs to be done to counteract the loneliness experienced by siblings through the family experience of disability. Family members and clinicians need to be extra vigilant to ensure siblings’ needs don’t go unnoticed or dismissed, as it may be difficult for this population of children to voice their own experience and needs. Family, school and other actors in the community may help brothers and sisters pursue their personal dreams, goals and projects, to continue experiencing well-being despite adverse life circumstances.

Keywords: sibling’s lived experience of disability, sibling’s needs at various levels of the ecosystem, family adjustment to the disability experience, supporting family wellness through the disability experience

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2302 Second Language Perception of Japanese /Cju/ and /Cjo/ Sequences by Mandarin-Speaking Learners of Japanese

Authors: Yili Liu, Honghao Ren, Mariko Kondo

Abstract:

In the field of second language (L2) speech learning, it is well-known that that learner’s first language (L1) phonetic and phonological characteristics will be transferred into their L2 production and perception, which lead to foreign accent. For L1 Mandarin learners of Japanese, the confusion of /u/ and /o/ in /CjV/ sequences has been observed in their utterance frequently. L1 transfer is considered to be the cause of this issue, however, other factors which influence the identification of /Cju/ and /Cjo/ sequences still under investigation. This study investigates the perception of Japanese /Cju/ and /Cjo/ units by L1 Mandarin learners of Japanese. It further examined whether learners’ proficiency, syllable position, phonetic features of preceding consonants and background noise affect learners’ performance in perception. Fifty-two Mandarin-speaking learners of Japanese and nine native Japanese speakers were recruited to participate in an identification task. Learners were divided into beginner, intermediate and advanced level according to their Japanese proficiency. The average correct rate was used to evaluate learners’ perceptual performance. Furthermore, the comparison of the correct rate between learners’ groups and the control group was conducted as well to examine learners’ nativelikeness. Results showed that background noise tends to pose an adverse effect on distinguishing /u/ and /o/ in /CjV/ sequences. Secondly, Japanese proficiency has no influence on learners’ perceptual performance in the quiet and in background noise. Then all learners did not reach a native-like level without the distraction of noise. Beginner level learners performed less native-like, although higher level learners appeared to have achieved nativelikeness in the multi-talker babble noise. Finally, syllable position tends to affect distinguishing /Cju/ and /Cjo/ only under the noisy condition. Phonetic features of preceding consonants did not impact learners’ perception in any listening conditions. Findings in this study can give an insight into a further understanding of Japanese vowel acquisition by L1 Mandarin learners of Japanese. In addition, this study indicates that L1 transfer is not the only explanation for the confusion of /u/ and /o/ in /CjV/ sequences, factors such as listening condition and syllable position are also needed to take into consideration in future research. It also suggests the importance of perceiving speech in a noisy environment, which is close to the actual conversation required more attention to pedagogy.

Keywords: background noise, Chinese learners of Japanese, /Cju/ and /Cjo/ sequences, second language perception

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2301 Sleep Disturbance in Indonesian School-Aged Children and Its Relationship to Nutritional Aspect

Authors: William Cheng, Rini Sekartini

Abstract:

Background: Sleep is essential for children because it provides enhancement for the neural system activities that give physiologic effects for the body to support growth and development. One of the modifiable factors that relates with sleep is nutrition, which includes nutritional status, iron intake, and magnesium intake. Nutritional status represents the balance between nutritional intake and expenditure, while iron and magnesium are micronutrients that are related to sleep regulation. The aim of this study is to identify prevalence of sleep disturbance among Indonesian children and to evaluate its relation with aspect to nutrition. Methods : A cross-sectional study involving children aged 5 to 7-years-old in an urban primary health care between 2012 and 2013 was carried out. Related data includes anthropometric status, iron intake, and magnesium intake. Iron and magnesium intake was obtained by 24-hours food recall procedure. Sleep Disturbance Scale for Children (SDSC) was used as the diagnostic tool for sleep disturbance, with score under 39 indicating presence of problem. Results: Out of 128 school-aged children included in this study, 28 (23,1%) of them were found to have sleep disturbance. The majority of children had good nutritional status, with only 15,7% that were severely underweight or underweight, and 12,4% that were identified as stunted. On the contrary, 99 children (81,8%) were identified to have inadequate magnesium intake and 56 children (46,3%) with inadequate iron intake. Our analysis showed there was no significant relation between all of the nutritional status indicators and sleep disturbance (p>0,05%). Moreover, inadequate iron and magnesium intake also failed to prove significant relation with sleep disturbance in this population. Conclusion: Almost fourth of school-aged children in Indonesia were found to have sleep disturbance and further study are needed to overcome this problem. According to our finding, there is no correlation between nutritional status, iron intake, magnesium intake, and sleep disturbance.

Keywords: iron intake, magnesium intake, nutritional status, school-aged children, sleep disturbance

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2300 Improving Self-Administered Medication Adherence for Older Adults: A Systematic Review

Authors: Mathumalar Loganathan, Lina Syazana, Bryony Dean Franklin

Abstract:

Background: The therapeutic benefit of self-administered medication for long-term use is limited by an average 50% non-adherence rate. Patient forgetfulness is a common factor in unintentional non-adherence. With a growing ageing population, strategies to improve self-administration of medication adherence are essential. Our aim was to review systematically the effects of interventions to optimise self-administration of medication. Method: Database searched were MEDLINE, EMBASE, PsynINFO, CINAHL from 1980 to 31 October 2013. Search terms included were ‘self-administration’, ‘self-care’, ‘medication adherence’, and ‘intervention’. Two independent reviewers undertook screening and methodological quality assessment, using the Downs and Black rating scale. Results: The search strategy retrieved 6 studies that met the inclusion and exclusion criteria. Three intervention strategies were identified: self-administration medication programme (SAMP), nursing education and medication packaging (pill calendar). A nursing education programme focused on improving patients’ behavioural self-management of drug prescribing. This was the most studied area and three studies highlighting an improvement in self-administration of medication. Conclusion: Results are mixed and there is no one interventional strategy that has proved to be effective. Nevertheless, self-administration of medication programme seems to show most promise. A multi-faceted approach and clearer policy guideline are likely to be required to improve prescribing for these vulnerable patients. Mixed results were found for SAMP. Medication packaging (pill calendar) was evaluated in one study showing a significant improvement in self-administration of medication. A meta-analysis could not be performed due to heterogeneity in the outcome measures.

Keywords: self-administered medication, intervention, prescribing, older patients

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2299 The Impact of Artificial Intelligence on Pharmacy and Pharmacology

Authors: Mamdouh Milad Adly Morkos

Abstract:

Despite having the greatest rates of mortality and morbidity in the world, low- and middle-income (LMIC) nations trail high-income nations in terms of the number of clinical trials, the number of qualified researchers, and the amount of research information specific to their people. Health inequities and the use of precision medicine may be hampered by a lack of local genomic data, clinical pharmacology and pharmacometrics competence, and training opportunities. These issues can be solved by carrying out health care infrastructure development, which includes data gathering and well-designed clinical pharmacology training in LMICs. It will be advantageous if there is international cooperation focused at enhancing education and infrastructure and promoting locally motivated clinical trials and research. This paper outlines various instances where clinical pharmacology knowledge could be put to use, including pharmacogenomic opportunities that could lead to better clinical guideline recommendations. Examples of how clinical pharmacology training can be successfully implemented in LMICs are also provided, including clinical pharmacology and pharmacometrics training programmes in Africa and a Tanzanian researcher's personal experience while on a training sabbatical in the United States. These training initiatives will profit from advocacy for clinical pharmacologists' employment prospects and career development pathways, which are gradually becoming acknowledged and established in LMICs. The advancement of training and research infrastructure to increase clinical pharmacologists' knowledge in LMICs would be extremely beneficial because they have a significant role to play in global health

Keywords: electromagnetic solar system, nano-material, nano pharmacology, pharmacovigilance, quantum theoryclinical simulation, education, pharmacology, simulation, virtual learning low- and middle-income, clinical pharmacology, pharmacometrics, career development pathways

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2298 Design and Creation of a BCI Videogame for Training and Measure of Sustained Attention in Children with ADHD

Authors: John E. Muñoz, Jose F. Lopez, David S. Lopez

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Attention Deficit Hyperactivity Disorder (ADHD) is a disorder that affects 1 out of 5 Colombian children, converting into a real public health problem in the country. Conventional treatments such as medication and neuropsychological therapy have been proved to be insufficient in order to decrease high incidence levels of ADHD in the principal Colombian cities. This work demonstrates a design and development of a videogame that uses a brain computer interface not only to serve as an input device but also as a tool to monitor neurophysiologic signal. The video game named “The Harvest Challenge” puts a cultural scene of a Colombian coffee grower in its context, where a player can use his/her avatar in three mini games created in order to reinforce four fundamental aspects: i) waiting ability, ii) planning ability, iii) ability to follow instructions and iv) ability to achieve objectives. The details of this collaborative designing process of the multimedia tool according to the exact clinic necessities and the description of interaction proposals are presented through the mental stages of attention and relaxation. The final videogame is presented as a tool for sustained attention training in children with ADHD using as an action mechanism the neuromodulation of Beta and Theta waves through an electrode located in the central part of the front lobe of the brain. The processing of an electroencephalographic signal is produced automatically inside the videogame allowing to generate a report of the theta/beta ratio evolution - a biological marker, which has been demonstrated to be a sufficient measure to discriminate of children with deficit and without.

Keywords: BCI, neuromodulation, ADHD, videogame, neurofeedback, theta/beta ratio

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2297 A Comprehensive Approach to Sustainable Building Design: Bridging Design for Adaptability and Circular Economy with LCA

Authors: Saba Baienat, Ivanka Iordanova, Bechara Helal

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Incorporating the principles of Design for Adaptability (DfAd) and Circular Economy (CE) into the service life planning of buildings and construction engineering projects can significantly enhance sustainable development. By employing DfAd, both the service life and design process can be optimized, gradually postponing the building’s End of Life (EoL) and extending the service life of buildings, thereby closing material cycles and making them more circular. This paper presents a comprehensive framework that addresses adaptability strategies and considerations to objectively assess the role of DfAd in circularity. The framework aims to provide a streamlined approach for accessing DfAd strategies and identifying the most effective ones for enhancing a project's adaptability. Key strategies include anticipating changes in requirements, enabling adaptations and transformations of the building for better use and reuse, preparing for future lives of the building and its components, and contributing to the circular material life cycle. Furthermore, the framework seeks to enhance the awareness of stakeholders about the subject of Design for Adaptability through the lens of the Circular Economy. Additionally, this paper integrates Life Cycle Assessment (LCA) methodologies to evaluate the environmental impacts of implementing DfAd strategies within the context of the Circular Economy. By utilizing LCA, the framework provides a quantitative basis for assessing the sustainability benefits of adaptable building designs, offering insights into how these strategies can minimize resource consumption, reduce emissions, and enhance overall environmental performance. This holistic approach underscores the critical role of LCA in bridging DfAd and CE, ultimately fostering more resilient and sustainable construction practices.

Keywords: circular economy (CE), design for adaptability (DfAd), life cycle assessment (LCA), sustainable development

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2296 A Proposal of a Method to Measure the Satisfaction Indicator of the Local Community Concerning Tourism: A Case Study of Jalapão State Park, Tocantins

Authors: Veruska C. Dutra, Mary L. G. S. Senna, Afonso R. Aquino

Abstract:

Tourists bring many benefits to a local community, encouraging it to be involved in that activity; however, it may also have detrimental effects like garbage, noise, violence, external culture and the damaging of the natural environment among others, which may promote community dissatisfaction. The contact between the tourist and the local community is a concern, especially when the community is located near protected areas. In this case, the community must know the tourist destination well, so it can collaborate in the tourism development without harming the environment. In this context, the present article aims to demonstrate the results of a research study conducted as part of a doctorate program in Sciences from the University of Sao Paulo, Brazil. It had as an objective to elaborate a methodology proposal to measure the local community satisfaction indicator, with applicability on a case study in the Mateiros community located in the surrounding area of the Parque Estadual do Jalapão –PEJ conservation unit in the state of Tocantins, Brazil. This is a study of an interdisciplinary nature that had the deductive method as its guide. The indicator result is going to be presented in this study. It pointed out as negative factors: there is no involvement between the local community and the tourism sector, and there is also dissatisfaction with regard to the town’s basic services. The study showed as positive the local community knowledge about the various attractions in the surrounding area and that the group recognizes the importance of the tourism for the town and life. Concerning the methodology that was used, the results showed that it can collaborate in seeking actions of improvement and involvement of the community in the planning and development of the local tourism. It comes out as an efficient analysis tool, thus enabling the perceiving of the local community point of view.

Keywords: satisfaction indicator, tourism, community, Jalapão

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2295 Graph Neural Network-Based Classification for Disease Prediction in Health Care Heterogeneous Data Structures of Electronic Health Record

Authors: Raghavi C. Janaswamy

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In the healthcare sector, heterogenous data elements such as patients, diagnosis, symptoms, conditions, observation text from physician notes, and prescriptions form the essentials of the Electronic Health Record (EHR). The data in the form of clear text and images are stored or processed in a relational format in most systems. However, the intrinsic structure restrictions and complex joins of relational databases limit the widespread utility. In this regard, the design and development of realistic mapping and deep connections as real-time objects offer unparallel advantages. Herein, a graph neural network-based classification of EHR data has been developed. The patient conditions have been predicted as a node classification task using a graph-based open source EHR data, Synthea Database, stored in Tigergraph. The Synthea DB dataset is leveraged due to its closer representation of the real-time data and being voluminous. The graph model is built from the EHR heterogeneous data using python modules, namely, pyTigerGraph to get nodes and edges from the Tigergraph database, PyTorch to tensorize the nodes and edges, PyTorch-Geometric (PyG) to train the Graph Neural Network (GNN) and adopt the self-supervised learning techniques with the AutoEncoders to generate the node embeddings and eventually perform the node classifications using the node embeddings. The model predicts patient conditions ranging from common to rare situations. The outcome is deemed to open up opportunities for data querying toward better predictions and accuracy.

Keywords: electronic health record, graph neural network, heterogeneous data, prediction

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2294 Consumer Preferences towards Sorbets: A Questionnaire Study

Authors: Kinga Topolska, Agnieszka Filipiak-Florkiewicz, Adam Florkiewicz, Daria Chechelska, Iwona Cieślik, Ewa Cieślik

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Food choice is a complex human behaviour, that is influenced by many interrelating factors. It is important to understand what consumers really want to eat. Nowadays, the growing popularity of frozen desserts is observed. Among them, sorbets are of the special interest. They are made primarily of fruit juice or fruit purée, water and sugar. A questionnaire study was done to evaluate the consumer preferences towards sorbets. A hundred respondents were included in the study. The respondents answered the questions concerning, inter alia, on the favourite taste of sorbets, additional ingredients (pieces of fruits, nuts etc.), the reason for choosing the product and also the opinion about potential purchasing or not the new product. Women, more frequently than men, indicated strawberry sorbet or the product on the basis of citrus fruits as a favourite one. In turn, 14% of men chose the apple taste. Pieces of chocolate were chosen by most of respondents. Men, more often than women, regarded raisins, alcohol and nuts as the most desirable additional ingredients of sorbets. The candied fruits and spices were indicated more frequently by women. Most of respondents indicated the taste as the major reason for sorbet buying. In turn, for 20% women the most important determinant was the care for their figure. It was observed that more than a half of women regarded sorbets as healthier than traditional ice creams. Answering the question: 'If you had the opportunity to try a new sorbet, containing the ingredient with proven healthy properties, would you buy it?', significantly more men than women answered 'yes, because I like novelty'. Meanwhile, for 14% respondents (independently of gender) it would be only a publicity stunt. Knowing what the consumers desire in selecting a product, is a very important information to design and offer them a new one. Sorbets could be an interesting alternative to ice creams.

Keywords: consumer, preferences, sorbets, questionnaire study

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2293 Perceived Stigma, Perception of Burden and Psychological Distress among Parents of Intellectually Disable Children: Role of Perceived Social Support

Authors: Saima Shafiq, Najma Iqbal Malik

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This study was aimed to explore the relationship of perceived stigma, perception of burden and psychological distress among parents of intellectually disabled children. The study also aimed to explore the moderating role of perceived social support on all the variables of the study. The sample of the study comprised of (N = 250) parents of intellectually disabled children. The present study utilized the co-relational research design. It consists of two phases. Phase-I consisted of two steps which contained the translation of two scales that were used in the present study and tried out on the sample of parents (N = 70). The Affiliated Stigma Scale and Care Giver Burden Inventory were translated into Urdu for the present study. Phase-1 revealed that translated scaled entailed satisfactory psychometric properties. Phase -II of the study was carried out in order to test the hypothesis. Correlation, linear regression analysis, and t-test were computed for hypothesis testing. Hierarchical regression analysis was applied to study the moderating effect of perceived social support. Findings revealed that there was a positive relationship between perceived stigma and psychological distress, perception of burden and psychological distress. Linear regression analysis showed that perceived stigma and perception of burden were positive predictors of psychological distress. The study did not show the moderating role of perceived social support among variables of the present study. The major limitation of the study is the sample size and the major implication is awareness regarding problems of parents of intellectually disabled children.

Keywords: perceived stigma, perception of burden, psychological distress, perceived social support

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2292 Computational System for the Monitoring Ecosystem of the Endangered White Fish (Chirostoma estor estor) in the Patzcuaro Lake, Mexico

Authors: Cesar Augusto Hoil Rosas, José Luis Vázquez Burgos, José Juan Carbajal Hernandez

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White fish (Chirostoma estor estor) is an endemic species that habits in the Patzcuaro Lake, located in Michoacan, Mexico; being an important source of gastronomic and cultural wealth of the area. Actually, it have undergone an immense depopulation of individuals, due to the high fishing, contamination and eutrophication of the lake water, resulting in the possible extinction of this important species. This work proposes a new computational model for monitoring and assessment of critical environmental parameters of the white fish ecosystem. According to an Analytical Hierarchy Process, a mathematical model is built assigning weights to each environmental parameter depending on their water quality importance on the ecosystem. Then, a development of an advanced system for the monitoring, analysis and control of water quality is built using the virtual environment of LabVIEW. As results, we have obtained a global score that indicates the condition level of the water quality in the Chirostoma estor ecosystem (excellent, good, regular and poor), allowing to provide an effective decision making about the environmental parameters that affect the proper culture of the white fish such as temperature, pH and dissolved oxygen. In situ evaluations show regular conditions for a success reproduction and growth rates of this species where the water quality tends to have regular levels. This system emerges as a suitable tool for the water management, where future laws for white fish fishery regulations will result in the reduction of the mortality rate in the early stages of development of the species, which represent the most critical phase. This can guarantees better population sizes than those currently obtained in the aquiculture crop. The main benefit will be seen as a contribution to maintain the cultural and gastronomic wealth of the area and for its inhabitants, since white fish is an important food and economical income of the region, but the species is endangered.

Keywords: Chirostoma estor estor, computational system, lab view, white fish

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2291 CAGE Questionnaire as a Screening Tool for Hazardous Drinking in an Acute Admissions Ward: Frequency of Application and Comparison with AUDIT-C Questionnaire

Authors: Ammar Ayad Issa Al-Rifaie, Zuhreya Muazu, Maysam Ali Abdulwahid, Dermot Gleeson

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The aim of this audit was to examine the efficiency of alcohol history documentation and screening for hazardous drinkers at the Medical Admission Unit (MAU) of Northern General Hospital (NGH), Sheffield, to identify any potential for enhancing clinical practice. Data were collected from medical clerking sheets, ICE system and directly from 82 patients by three junior medical doctors using both CAGE questionnaire and AUDIT-C tool for newly admitted patients to MAU in NGH, in the period between January and March 2015. Alcohol consumption was documented in around two-third of the patient sample and this was documented fairly accurately by health care professionals. Some used subjective words such as 'social drinking' in the alcohol units’ section of the history. CAGE questionnaire was applied to only four patients and none of the patients had documented advice, education or referral to an alcohol liaison team. AUDIT-C tool had identified 30.4%, while CAGE 10.9%, of patients admitted to the NGH MAU as hazardous drinkers. The amount of alcohol the patient consumes positively correlated with the score of AUDIT-C (Pearson correlation 0.83). Re-audit is planned to be carried out after integrating AUDIT-C tool as labels in the notes and presenting a brief teaching session to junior doctors. Alcohol misuse screening is not adequately undertaken and no appropriate action is being offered to hazardous drinkers. CAGE questionnaire is poorly applied to patients and when satisfactory and adequately used has low sensitivity to detect hazardous drinkers in comparison with AUDIT-C tool. Re-audit of alcohol screening practice after introducing AUDIT-C tool in clerking sheets (as labels) is required to compare the findings and conclude the audit cycle.

Keywords: alcohol screening, AUDIT-C, CAGE, hazardous drinking

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2290 Reflecting and Teaching on the Dialectical Nature of Social Work

Authors: Eli Buchbinder

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Dialectics theory perceives two or more forces or themes as mutually opposed and negating on the one hand and as interdependent for their definition, existence, and resolution on the other. Such opposites might never be fully reconciled but might, simultaneously, continue to produce a higher level of integration and synthesis as well as tension, contradictions, and paradoxes. The identity of social work is constructed by poles; an understanding that emerges through key concepts that shape the profession. The key concept of person-in-environment creates dialectical tensions between the psychological versus the social pole. Important examples that reflect this focus on the psychological versus the social nature of human beings. This meta-perspective influences and constructs the implementation of values, ways of intervention, and professional relationships, e.g., creating a conflict between personal/social empowerment and social control and correction as the aims of the profession. Social work is dynamic and changing, with a unique way of perceiving and conceptualizing human behavior. Social workers must be able to face and accept the contradicting elements inherent in practicing social work. The basic philosophy for social work education is a dialectic conceptualization. In light of the above, social work students require dialectics as a critical mode of perception, reflection, and intervention. In the presentation, the focus will be on reflection on teaching students to conceptualize dialectics as a frame when training to be social workers. It is believed that the focus should emphasis two points: 1) the need to assist students to identify poles and to analyze the interrelationships created between them while coping emotionally with the tension and difficulties involved in containing these poles; 2) teaching students to integrate poles as a basis for assessment, planning, and intervention.

Keywords: professional ontology, a generic social work education, skills and values of social work, reflecting on social work teaching methods

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2289 Practical Ways to Acquire the Arabic Language through Electronic Means

Authors: Hondozi Jahja

Abstract:

There is an obvious need to learn Arabic language and teach it to other speakers through the new curricula. The idea is to bridge the gap between theory and practice. To that end, we have sought to offer some means of help to master the Arabic language, in addition to our efforts to apply these means, enriching the culture of the student and develop his vocabulary. There is no doubt that taking care of the practical aspect of the grammar was our constant goal, and this particular aspect is what builds the student’s positive values and refine his taste and develop his language. In addressing these issues, we have adopted a school-based approach based primarily on the active and positive participation of the student. The theoretical linguistic issues - in our opinion - are not a primary goal, but the goal is to be used them by students through speaking and applying them. Among the objectives of this research is to establish the basic language skills of the students using new means that help the student to acquire these skills and apply them in various subjects of interest in his progress and development. Unfortunately, some of our students consider the grammar as ‘difficult’, ‘complex’ and ‘heavy’ in itself. This is one of the obstacles that stand in the way of their desired results. As a consequence, they end up talking – mumbling - about the difficulties they face in applying those rules. Therefore, some of our students finish their university studies and are unable to express what they feel using language correctly. For this purpose, we have sought in this research to follow a new integrated approach, which is to study the grammar of the language through modern means of the consolidation of the principle of functional language, and that the rule implies to control tongues and linguistic expressions properly. This research is a result of a practical experience as a teacher of Arabic language for non-native speakers at the ‘Hassan Pristina’ University, located in Pristina, the capital of Kosovo and at the Qatar Training Center since its establishment in 2012.

Keywords: arabic, applied methods, acquire, learning

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2288 Evaluating the Implementation of a Quality Management System in the COVID-19 Diagnostic Laboratory of a Tertiary Care Hospital in Delhi

Authors: Sukriti Sabharwal, Sonali Bhattar, Shikhar Saxena

Abstract:

Introduction: COVID-19 molecular diagnostic laboratory is the cornerstone of the COVID-19 disease diagnosis as the patient’s treatment and management protocol depend on the molecular results. For this purpose, it is extremely important that the laboratory conducting these results adheres to the quality management processes to increase the accuracy and validity of the reports generated. We started our own molecular diagnostic setup at the onset of the pandemic. Therefore, we conducted this study to generate our quality management data to help us in improving on our weak points. Materials and Methods: A total of 14561 samples were evaluated by the retrospective observational method. The quality variables analysed were classified into pre-analytical, analytical, and post-analytical variables, and the results were presented in percentages. Results: Among the pre-analytical variables, sample leaking was the most common cause of the rejection of samples (134/14561, 0.92%), followed by non-generation of SRF ID (76/14561, 0.52%) and non-compliance to triple packaging (44/14561, 0.3%). The other pre-analytical aspects assessed were incomplete patient identification (17/14561, 0.11%), insufficient quantity of samples (12/14561, 0.08%), missing forms/samples (7/14561, 0.04%), samples in the wrong vials/empty VTM tubes (5/14561, 0.03%) and LIMS entry not done (2/14561, 0.01%). We are unable to obtain internal quality control in 0.37% of samples (55/14561). We also experienced two incidences of cross-contamination among the samples resulting in false-positive results. Among the post-analytical factors, a total of 0.07% of samples (11/14561) could not be dispatched within the stipulated time frame. Conclusion: Adherence to quality control processes is foremost for the smooth running of any diagnostic laboratory, especially the ones involved in critical reporting. Not only do the indicators help in keeping in check the laboratory parameters but they also allow comparison with other laboratories.

Keywords: laboratory quality management, COVID-19, molecular diagnostics, healthcare

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2287 Advancing Aviation: A Multidisciplinary Approach to Innovation, Management, and Technology Integration in the 21st Century

Authors: Fatih Frank Alparslan

Abstract:

The aviation industry is at a crucial turning point due to modern technologies, environmental concerns, and changing ways of transporting people and goods globally. The paper examines these challenges and opportunities comprehensively. It emphasizes the role of innovative management and advanced technology in shaping the future of air travel. This study begins with an overview of the current state of the aviation industry, identifying key areas where innovation and technology could be highly beneficial. It explores the latest advancements in airplane design, propulsion, and materials. These technological advancements are shown to enhance aircraft performance and environmental sustainability. The paper also discusses the use of artificial intelligence and machine learning in improving air traffic control, enhancing safety, and making flight operations more efficient. The management of these technologies is critically important. Therefore, the research delves into necessary changes in organization, culture, and operations to support innovation. It proposes a management approach that aligns with these modern technologies, underlining the importance of forward-thinking leaders who collaborate across disciplines and embrace innovative ideas. The paper addresses challenges in adopting these innovations, such as regulatory barriers, the need for industry-wide standards, and the impact of technological changes on jobs and society. It recommends that governments, aviation businesses, and educational institutions collaborate to address these challenges effectively, paving the way for a more innovative and eco-friendly aviation industry. In conclusion, the paper argues that the future of aviation relies on integrating new management practices with innovative technologies. It urges a collective effort to push beyond current capabilities, envisioning an aviation industry that is safer, more efficient, and environmentally responsible. By adopting a broad approach, this research contributes to the ongoing discussion about resolving the complex issues facing today's aviation sector, offering insights and guidance to prepare for future advancements.

Keywords: aviation innovation, technology integration, environmental sustainability, management strategies, multidisciplinary approach

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2286 Virtual Reality and Avatars in Education

Authors: Michael Brazley

Abstract:

Virtual Reality (VR) and 3D videos are the most current generation of learning technology today. Virtual Reality and 3D videos are being used in professional offices and Schools now for marketing and education. Technology in the field of design has progress from two dimensional drawings to 3D models, using computers and sophisticated software. Virtual Reality is being used as collaborative means to allow designers and others to meet and communicate inside models or VR platforms using avatars. This research proposes to teach students from different backgrounds how to take a digital model into a 3D video, then into VR, and finally VR with multiple avatars communicating with each other in real time. The next step would be to develop the model where people from three or more different locations can meet as avatars in real time, in the same model and talk to each other. This research is longitudinal, studying the use of 3D videos in graduate design and Virtual Reality in XR (Extended Reality) courses. The research methodology is a combination of quantitative and qualitative methods. The qualitative methods begin with the literature review and case studies. The quantitative methods come by way of student’s 3D videos, survey, and Extended Reality (XR) course work. The end product is to develop a VR platform with multiple avatars being able to communicate in real time. This research is important because it will allow multiple users to remotely enter your model or VR platform from any location in the world and effectively communicate in real time. This research will lead to improved learning and training using Virtual Reality and Avatars; and is generalizable because most Colleges, Universities, and many citizens own VR equipment and computer labs. This research did produce a VR platform with multiple avatars having the ability to move and speak to each other in real time. Major implications of the research include but not limited to improved: learning, teaching, communication, marketing, designing, planning, etc. Both hardware and software played a major role in project success.

Keywords: virtual reality, avatars, education, XR

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2285 Accessibility Analysis of Urban Green Space in Zadar Settlement, Croatia

Authors: Silvija Šiljeg, Ivan Marić, Ante Šiljeg

Abstract:

The accessibility of urban green spaces (UGS) is an integral element in the quality of life. Due to rapid urbanization, UGS studies have become a key element in urban planning. The potential benefits of space for its inhabitants are frequently analysed. A functional transport network system and the optimal spatial distribution of urban green surfaces are the prerequisites for maintaining the environmental equilibrium of the urban landscape. An accessibility analysis was conducted as part of the Urban Green Belts Project (UGB). The development of a GIS database for Zadar was the first step in generating the UGS accessibility indicator. Data were collected using the supervised classification method of multispectral LANDSAT images and manual vectorization of digital orthophoto images (DOF). An analysis of UGS accessibility according to the ANGst standard was conducted in the first phase of research. The accessibility indicator was generated on the basis of seven objective measurements, which included average UGS surface per capita and accessibility according to six functional levels of green surfaces. The generated indicator was compared with subjective measurements obtained by conducting a survey (718 respondents) within statistical units. The collected data reflected individual assessments and subjective evaluations of UGS accessibility. This study highlighted the importance of using objective and subjective measures in the process of understanding the accessibility of urban green surfaces. It may be concluded that when evaluating UGS accessibility, residents emphasize the immediate residential environment, ignoring higher UGS functional levels. It was also concluded that large areas of UGS within a city do not necessarily generate similar satisfaction with accessibility. The heterogeneity of output results may serve as guidelines for the further development of a functional UGS city network.

Keywords: urban green spaces (UGS), accessibility indicator, subjective and objective measurements, Zadar

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2284 A Literature Review of Precision Agriculture: Applications of Diagnostic Diseases in Corn, Potato, and Rice Based on Artificial Intelligence

Authors: Carolina Zambrana, Grover Zurita

Abstract:

The food loss production that occurs in deficient agricultural production is one of the major problems worldwide. This puts the population's food security and the efficiency of farming investments at risk. It is to be expected that this food security will be achieved with the own and efficient production of each country. It will have an impact on the well-being of its population and, thus, also on food sovereignty. The production losses in quantity and quality occur due to the lack of efficient detection of diseases at an early stage. It is very difficult to solve the agriculture efficiency using traditional methods since it takes a long time to be carried out due to detection imprecision of the main diseases, especially when the production areas are extensive. Therefore, the main objective of this research study is to perform a systematic literature review, of the latest five years, of Precision Agriculture (PA) to be able to understand the state of the art of the set of new technologies, procedures, and optimization processes with Artificial Intelligence (AI). This study will focus on Corns, Potatoes, and Rice diagnostic diseases. The extensive literature review will be performed on Elsevier, Scopus, and IEEE databases. In addition, this research will focus on advanced digital imaging processing and the development of software and hardware for PA. The convolution neural network will be handling special attention due to its outstanding diagnostic results. Moreover, the studied data will be incorporated with artificial intelligence algorithms for the automatic diagnosis of crop quality. Finally, precision agriculture with technology applied to the agricultural sector allows the land to be exploited efficiently. This system requires sensors, drones, data acquisition cards, and global positioning systems. This research seeks to merge different areas of science, control engineering, electronics, digital image processing, and artificial intelligence for the development, in the near future, of a low-cost image measurement system that allows the optimization of crops with AI.

Keywords: precision agriculture, convolutional neural network, deep learning, artificial intelligence

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2283 A Rare Case of Synchronous Colon Adenocarcinoma

Authors: Mohamed Shafi Bin Mahboob Ali

Abstract:

Introduction: Synchronous tumor is defined as the presence of more than one primary malignant lesion in the same patient at the indexed diagnosis. It is a rare occurrence, especially in the spectrum of colorectal cancer, which accounts for less than 4%. The underlying pathology of a synchronous tumor is thought to be due to a genomic factor, which is microsatellite instability (MIS) with the involvement of BRAF, KRAS, and the GSRM1 gene. There are no specific sites of occurrence for the synchronous colorectal tumor, but many studies have shown that a synchronous tumor has about 43% predominance in the ascending colon with rarity in the sigmoid colon. Case Report: We reported a case of a young lady in the middle of her 30's with no family history of colorectal cancer that was diagnosed with a synchronous adenocarcinoma at the descending colon and rectosigmoid region. The lady's presentation was quite perplexing as she presented to the district hospital initially with simple, uncomplicated hemorrhoids and constipation. She was then referred to our center for further management as she developed a 'football' sized right gluteal swelling with a complete intestinal obstruction and bilateral lower-limb paralysis. We performed a CT scan and biopsy of the lesion, which found that the tumor engulfed the sacrococcygeal region with more than one primary lesion in the colon as well as secondaries in the liver. The patient was operated on after a multidisciplinary meeting was held. Pelvic exenteration with tumor debulking and anterior resection were performed. Postoperatively, she was referred to the oncology team for chemotherapy. She had a tremendous recovery in eight months' time with a partial regain of her lower limb power. The patient is still under our follow-up with an improved quality of life post-intervention. Discussion: Synchronous colon cancer is rare, with an incidence of 2.4% to 12.4%. It has male predominance and is pathologically more advanced compared to a single colon lesion. Down staging the disease by means of chemoradiotherapy has shown to be effective in managing this tumor. It is seen commonly on the right colon, but in our case, we found it on the left colon and the rectosigmoid. Conclusion: Managing a synchronous colon tumor could be challenging to surgeons, especially in deciding the extent of resection and postoperative functional outcomes of the bowel; thus, individual treatment strategies are needed to tackle this pathology.

Keywords: synchronous, colon, tumor, adenocarcinoma

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2282 Key Principles and Importance of Applied Geomorphological Maps for Engineering Structure Placement

Authors: Sahar Maleki, Reza Shahbazi, Nayere Sadat Bayat Ghiasi

Abstract:

Applied geomorphological maps are crucial tools in engineering, particularly for the placement of structures. These maps provide precise information about the terrain, including landforms, soil types, and geological features, which are essential for making informed decisions about construction sites. The importance of these maps is evident in risk assessment, as they help identify potential hazards such as landslides, erosion, and flooding, enabling better risk management. Additionally, these maps assist in selecting the most suitable locations for engineering projects. Cost efficiency is another significant benefit, as proper site selection and risk assessment can lead to substantial cost savings by avoiding unsuitable areas and minimizing the need for extensive ground modifications. Ensuring the maps are accurate and up-to-date is crucial for reliable decision-making. Detailed information about various geomorphological features is necessary to provide a comprehensive overview. Integrating geomorphological data with other environmental and engineering data to create a holistic view of the site is one of the most fundamental steps in engineering. In summary, the preparation of applied geomorphological maps is a vital step in the planning and execution of engineering projects, ensuring safety, efficiency, and sustainability. In the Geological Survey of Iran, the preparation of these applied maps has enabled the identification and recognition of areas prone to geological hazards such as landslides, subsidence, earthquakes, and more. Additionally, areas with problematic soils, potential groundwater zones, and safe construction sites are identified and made available to the public.

Keywords: geomorphological maps, geohazards, risk assessment, decision-making

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2281 Classification System for Soft Tissue Injuries of Face: Bringing Objectiveness to Injury Severity

Authors: Garg Ramneesh, Uppal Sanjeev, Mittal Rajinder, Shah Sheerin, Jain Vikas, Singla Bhupinder

Abstract:

Introduction: Despite advances in trauma care, a classification system for soft tissue injuries of the face still needs to be objectively defined. Aim: To develop a classification system for soft tissue injuries of the face; that is objective, easy to remember, reproducible, universally applicable, aids in surgical management and helps to develop a structured data that can be used for future use. Material and Methods: This classification system includes those patients that need surgical management of facial injuries. Associated underlying bony fractures have been intentionally excluded. Depending upon the severity of soft tissue injury, these can be graded from 0 to IV (O-Abrasions, I-lacerations, II-Avulsion injuries with no skin loss, III-Avulsion injuries with skin loss that would need graft or flap cover, and IV-complex injuries). Anatomically, the face has been divided into three zones (Zone 1/2/3), as per aesthetic subunits. Zone 1e stands for injury of eyebrows; Zones 2 a/b/c stand for nose, upper eyelid and lower eyelid respectively; Zones 3 a/b/c stand for upper lip, lower lip and cheek respectively. Suffices R and L stand for right or left involved side, B for presence of foreign body like glass or pellets, C for extensive contamination and D for depth which can be graded as D 1/2/3 if depth is still fat, muscle or bone respectively. I is for damage to facial nerve or parotid duct. Results and conclusions: This classification system is easy to remember, clinically applicable and would help in standardization of surgical management of soft tissue injuries of face. Certain inherent limitations of this classification system are inability to classify sutured wounds, hematomas and injuries along or against Langer’s lines.

Keywords: soft tissue injuries, face, avulsion, classification

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2280 Molecular Epidemiology of Circulating Adenovirus Types in Acute Conjunctivitis Cases in Chandigarh, North India

Authors: Mini P. Singh, Jagat Ram, Archit Kumar, Tripti Rungta, Jasmine Khurana, Amit Gupta, R. K. Ratho

Abstract:

Introduction: Human adenovirus is the most common agent involved in viral conjunctivitis. The clinical manifestations vary with different serotypes. The identification of the circulating strains followed by phylogenetic analysis can be helpful in understanding the origin and transmission of the disease. The present study aimed to carry out molecular epidemiology of the adenovirus types in the patients with conjunctivitis presenting to the eye centre of a tertiary care hospital in North India. Materials and Methods: The conjunctival swabs were collected from 23 suspected adenoviral conjunctivitis patients between April-August, 2014 and transported in viral transport media. The samples were subjected to nested PCR targeting hexon gene of human adenovirus. The band size of 956bp was eluted and 8 representative positive samples were subjected to sequencing. The sequences were analyzed by using CLUSTALX2.1 and MEGA 5.1 software. Results: The male: female ratio was found to be 3.6:1. The mean age of presenting patients was 43.95 years (+17.2). Approximately 52.1% (12/23) of patients presented with bilateral involvement while 47.8% (11/23) with unilateral involvement of the eye. Human adenovirus DNA could be detected in 65.2% (15/23) of the patients. The phylogenetic analysis revealed presence of serotype 8 in 7 patients and serotype 4 in one patient. The serotype 8 sequences showed 99-100% identity with Tunisian, Indian and Japanese strains. The adenovirus serotype 4 strains had 100% identity with strains from Tunisia, China and USA. Conclusion: Human adenovirus was found be an important etiological agent for conjunctivitis in our set up. The phylogenetic analysis showed that the predominant circulating strains in our epidemic keratoconjunctivitis were serotypes 8 and 4.

Keywords: conjunctivitis, human adenovirus, molecular epidemiology, phylogenetics

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2279 Acceptance of Health Information Application in Smart National Identity Card (SNIC) Using a New I-P Framework

Authors: Ismail Bile Hassan, Masrah Azrifah Azmi Murad

Abstract:

This study discovers a novel framework of individual level technology adoption known as I-P (Individual- Privacy) towards Smart National Identity Card health information application. Many countries introduced smart national identity card (SNIC) with various applications such as health information application embedded inside it. However, the degree to which citizens accept and use some of the embedded applications in smart national identity remains unknown to many governments and application providers as well. Moreover, the previous studies revealed that the factors of trust, perceived risk, privacy concern and perceived credibility need to be incorporated into more comprehensive models such as extended Unified Theory of Acceptance and Use of Technology known as UTAUT2. UTAUT2 is a mainly widespread and leading theory existing in the information system literature up to now. This research identifies factors affecting the citizens’ behavioural intention to use health information application embedded in SNIC and extends better understanding on the relevant factors that the government and the application providers would need to consider in predicting citizens’ new technology acceptance in the future. We propose a conceptual framework by combining the UTAUT2 and Privacy Calculus Model constructs and also adding perceived credibility as a new variable. The proposed framework may provide assistance to any government planning, decision, and policy makers involving e-government projects. The empirical study may be conducted in the future to provide proof and empirically validate this I-P framework.

Keywords: unified theory of acceptance and use of technology (UTAUT) model, UTAUT2 model, smart national identity card (SNIC), health information application, privacy calculus model (PCM)

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2278 Surgical Management of Distal Femur Fracture Using Locking Compression Plate: Our Experience in a Rural Tertiary Care Centre in India

Authors: Pagadaplly Girish, P. V. Manohar

Abstract:

Introduction: Management of distal femur fractures is challenging. Recently, treatment has evolved towards indirect reduction and minimally invasive techniques. Objectives: To assess the fracture union and functional outcome following open reduction and internal fixation of distal femur fractures with locking compression plate and to achieve restoration of the anatomical alignment of fracture fragments and stable internal fixation. Methodology: Patients with distal femur fracture treated by locking compression during Oct 2011 to April 2013 were assessed prospectively. Patients below 18 years and those with neuro-vascular deficits were excluded. Age, sex of the patient, type of fracture, mechanism of injury, type of implant used, operative time and postoperative complications were analysed. The Neer’s scale was used to assess the outcome of the patients. Results: The total number of patients was 30; 28 males and 2 females; mean age was 41.53 years. Road traffic accidents were the major causes of injury followed by falls. The average duration of hospital stay was 21.3 days. The overall complication rate note was 23.33%. The mean range of movement around the knee joint after 6 months of follow-up was 114.330. The average time for the radiological union was 14 weeks. Excellent to good results were noted in 26 patients (86.6%) and average to poor results were observed in 4 (13.33%) patients. Conclusions: The locking compression plate gives a rigid fixation for the fracture. It also provides a good purchase in osteoporotic bones. LCP is simple and a reliable implant appropriate for fixation of femoral fractures with promising results.

Keywords: distal femur fractures, locking compression plate, Neer’s criteria, neuro-vascular deficits

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