Search results for: problems of care
2732 The Inhibitory Effect of Riceberry Rice Extract on Acetylcholinesterase Activity
Authors: Yaiprae Chatree, Tawan Chaiwon, Rodjana Chunhabundit, Kritsana Piriyawatcharakon, Waralai Ratwiset, Sasiwimol Chaiya
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The world is facing a serious situation of aging society. Elderly may have many physical health problems due to degenerative diseases including Alzheimer’s disease. Riceberry rice relatively contain high levels of carbohydrate, vitamin E, -oryzanol, and also abundant of bioactive compound of anthocyanin. This study aimed to determine the inhibitory effect of Riceberry rice crude extract on acetylcholinesterase activity. The active compound was extracted by using 70% ethanol (v/v). The inhibitory effect of Riceberry rice on acetylcholinesterase was evaluated by using slightly modified method of Ellman’s method. The 120 seconds time interval of kinetics measurement showed that Riceberry rice extract at concentrations of 2.5-12.5 mg/ml presented the acetylcholinesterase inhibitory activity at the statistically significant difference at p 0.05 compared to control group over 60 -120 seconds. At the concentrations of 10 and 12.5 mg/ml of Riceberry rice extract expressed the high percentage of inhibitory activity of 50.86 and 71.22%, respectively. The half maximal inhibitory concentration (IC50) of acetylcholinesterase inhibitory activity of Riceberry rice extract; considered to the end point, was found at concentration of 9.34 mg/ml. The physostigmine (positive control); however, showed a higher inhibitory capacity than that of Riceberry rice extract. The inhibitory activity of the positive control group was around at 80.40 – 90.41%. In conclusion, the results of this study indicated that Riceberry rice extract possessed the inhibitory capacity of acetylcholinesterase activity. Moreover, at the concentrations of 12.5 mg/ml it showed the identical inhibitory effect with physostigmine group. The Riceberry rice extract might be able to alleviate the clinical manifestations of Alzheimer’s disease.Keywords: acetylcholine, acetylcholinesterase, Alzheimer's disease, riceberry rice
Procedia PDF Downloads 2172731 Vitamin D Levels in Relation to Thyroid Disorders
Authors: Binaya Tamang, Buddhhi Raj Pokhrel, Narayan Gautam
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Background: There may be a connection between thyroid function and vitamin D status since both bind to similar nuclear hormone receptors and have similar response regions on gene promoters. The purpose of the current study was to investigate the relationship between thyroid hormones and vitamin D levels in females who were attending a tertiary care center in western Nepal and were either hypothyroid or euthyroid. Methods: This hospital-based cross-sectional study was carried out between March 2020 and March 2021 by the Biochemistry department of the Universal College of Medical Sciences (UCMS), Bhairahawa, Province No. 5, Nepal, in cooperation with Internal medicine. Prior to the study, institutional review committee approval (UCMS/IRC/008/20) was acquired from UCMS. Women who visited the Internal Medicine OPD of UCMS and were advised to get a thyroid function test (TFT) were included in the study population. Only those who were willing to participate in the study were enrolled after the goals and advantages of the study had been explained to them. Participants who had recently used vitamin D supplements and medications that affected thyroid hormones were excluded. The participants gave their consent verbally and in writing. After getting the consent, a convenient sample technique was applied. Serum was isolated after drawing 3 ml of blood in a plain vial. Chemiluminescence assay was used to analyze vitamin D and thyroid hormones (MAGLUMI 2000). SPSS version 16.0 for Windows was used to conduct the statistical analysis. Statistical significance was defined as a P-value < 0.05. Results: Majority of the study population (n=214, 71%) had insufficient serum vitamin D levels. Among the thyroid groups, the median Vitamin D levels were significantly lower in hypothyroid (16.88 ng/ml) as compared to the euthyroid groups (25.01 ng/ml) (P<0.001). Similarly, serum Vitamin D levels were considerably lower in the obese population (16.86 ng/ml) as compared to the normal BMI group (24.90 ng/ml) (P<0.001) as well as in the vegetarian (15.43 ng.ml) than mixed diet consumer (24.89 ng/ml) (P<0.01). Even after the adjustment for these variables, the Vitamin D levels were significantly lower in the hypothyroid population than in the euthyroid group (P<0.001). Conclusion: Comparing the hypothyroid population to the euthyroid, the median serum vitamin D levels were considerably lower. We were alarmed to see that the majority of euthyroid participants also had low levels of vitamin D. Therefore if left untreated, low vitamin D levels in hypothyroid patients could worsen their health further.Keywords: vitamin D, thyroid hormones, euthyroid, hypothyroid, Nepal
Procedia PDF Downloads 1422730 The Material Behavior in Curved Glulam Beam of Jabon Timber
Authors: Erma Desmaliana, Saptahari Sugiri
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Limited availability of solid timber in large dimensions becomes a problem. The demands of timbers in Indonesia is more increasing compared to its supply from natural forest. It is associated with the issues of global warming and environmental preservation. The uses of timbers from HTI (Industrial Planting Forest) and HTR (Society Planting Forest), such as Jabon, is an alternative source that required to solve these problems. Having shorter lifespan is the benefit of HTI/HTR timbers, although they are relatively smaller in dimension and lower in strength. Engineering Wood Product (EWP) such as glulam (glue-laminated) timber, is required to overcome their losses. Glulam is fabricated by gluing the wooden planks that having a thickness of 20 to 45 mm with an adhesive material and a certain pressure. Glulam can be made a curved beam, is one of the advantages, thus making it strength is greater than a straight beam. This paper is aimed to know the material behavior of curved glue-laminated beam of Jabon timber. Preliminary methods was to gain physical and mechanical properties, and glue spread strength of Jabon timber, which following the ASTM D-143 standard test method. Dimension of beams were 50 mm wide, 760 mm span, 50 mm thick, and 50 mm rise. Each layer of Jabon has a thickness of 5 mm and is glued with polyurethane. Cold press will be applied to beam laminated specimens for more than 5 hours. The curved glue-laminated beams specimens will be tested about the bending behavior. This experiments aims to obtain the increasing of load carrying capacity and stiffness of curved glulam beam.Keywords: curved glulam beam, HTR&HTI, load carrying, strength
Procedia PDF Downloads 2992729 Public Health Emergency Management (PHEM) to COVID-19 Pandemic in North-Eastern Part of Thailand
Authors: Orathai Srithongtham, Ploypailin Mekathepakorn, Tossaphong Buraman, Pontida Moonpradap, Rungrueng Kitpati, Chulapon Kratet, Worayuth Nak-ai, Suwaree Charoenmukkayanan, Peeranuch Keawkanya
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The COVID-19 pandemic was effect to the health security of the Thai people. The PHEM principle was essential to the surveillance, prevention, and control of COVID-19. This study aimed to present the process of prevention and control of COVID-19 from February 29, 2021- April 30, 2022, and the factors and conditions influent the successful outcome. The study areas were three provinces. The target group was 37 people, composed of public health personnel. The data was collected in-depth, and group interviews followed the non-structure interview guide and were analyzed by content analysis. The components of COVID-19 prevention and control were found in the process of PHEM as follows; 1) Emergency Operation Center (EOC) with an incidence command system (ICS) from the district to provincial level and to propose the provincial measure, 2) Provincial Communicable Disease Committee (PCDC) to decide the provincial measure 3) The measure for surveillance, prevention, control, and treatment of COVID-19, and 4) outcomes and best practices for surveillance and control of COVID-19. The success factors of 4S and EC were as follows; Space: prepare the quarantine (HQ, LQ), Cohort Ward (CW), field hospital, and community isolation and home isolation to face with the patient and risky group, Staff network from various organization and group cover the community leader and Health Volunteer (HV), Stuff the management and sharing of the medical and non-medical equipment, System of Covid-19 respond were EOC, ICS, Joint Investigation Team (JIT) and Communicable Disease Control Unit (CDCU) for monitoring the real-time of surveillance and control of COVID-19 output, Environment management in hospital and the community with Infections Control (IC) principle, and Culture in term of social capital on “the relationship of Isan people” supported the patient provide the good care and support. The structure of PHEM, Isan’s Culture, and good preparation was a significant factor in the three provinces.Keywords: public health, emergency management, covid-19, pandemic
Procedia PDF Downloads 812728 Solar Photovoltaic Pumping and Water Treatment Tools: A Case Study in Ethiopian Village
Authors: Corinna Barraco, Ornella Salimbene
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This research involves the Ethiopian locality of Jeldi (North Africa), an area particularly affected by water shortage and in which the pumping and treatment of drinking water are extremely sensitive issues. The study aims to develop and apply low-cost tools for the design of solar water pumping and water purification systems in a not developed country. Consequently, two technical tools have been implemented in Excel i) Solar photovoltaic Pumping (Spv-P) ii) Water treatment (Wt). The Spv-P tool was applied to the existing well (depth 110 [m], dynamic water level 90 [m], static water level 53 [m], well yield 0.1728 [m³h⁻¹]) in the Jeldi area, where estimated water demand is about 50 [m3d-1]. Through the application of the tool, it was designed the water extraction system of the well, obtaining the number of pumps and solar panels necessary for water pumping from the well of Jeldi. Instead, the second tool Wt has been applied in the subsequent phase of extracted water treatment. According to the chemical-physical parameters of the water, Wt returns as output the type of purification treatment(s) necessary to potable the extracted water. In the case of the well of Jeldi, the tool identified a high criticality regarding the turbidity parameter (12 [NTU] vs 5 [NTU]), and a medium criticality regarding the exceeding limits of sodium concentration (234 [mg/L Na⁺] vs 200 [mg/L Na⁺]) and ammonia (0.64 [mg/L NH³-N] vs 0.5 [mg/L NH³-N]). To complete these tools, two specific manuals are provided for the users. The joint use of the two tools would help reduce problems related to access to water resources compared to the current situation and represents a simplified solution for the design of pumping systems and analysis of purification treatments to be performed in undeveloped countries.Keywords: drinking water, Ethiopia, treatments, water pumping
Procedia PDF Downloads 1562727 Evaluation of Non-Staggered Body-Fitted Grid Based Solution Method in Application to Supercritical Fluid Flows
Authors: Suresh Sahu, Abhijeet M. Vaidya, Naresh K. Maheshwari
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The efforts to understand the heat transfer behavior of supercritical water in supercritical water cooled reactor (SCWR) are ongoing worldwide to fulfill the future energy demand. The higher thermal efficiency of these reactors compared to a conventional nuclear reactor is one of the driving forces for attracting the attention of nuclear scientists. In this work, a solution procedure has been described for solving supercritical fluid flow problems in complex geometries. The solution procedure is based on non-staggered grid. All governing equations are discretized by finite volume method (FVM) in curvilinear coordinate system. Convective terms are discretized by first-order upwind scheme and central difference approximation has been used to discretize the diffusive parts. k-ε turbulence model with standard wall function has been employed. SIMPLE solution procedure has been implemented for the curvilinear coordinate system. Based on this solution method, 3-D Computational Fluid Dynamics (CFD) code has been developed. In order to demonstrate the capability of this CFD code in supercritical fluid flows, heat transfer to supercritical water in circular tubes has been considered as a test problem. Results obtained by code have been compared with experimental results reported in literature.Keywords: curvilinear coordinate, body-fitted mesh, momentum interpolation, non-staggered grid, supercritical fluids
Procedia PDF Downloads 1302726 Enhancement of Seed Longevity in Japonica Rice Cultivars Using Weed Rice
Authors: Jun-Hyeon Cho, Ji-Yoon Lee, Young-Bo Sohn, Dong-Jin Shin, You-Chun Song, Dong-Soo Park, Min-Hee Nam, Young-Up Kwon
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Seed germination is a main factor in japonica rice cultivation. For japonica strains unlike indica lines, fast loss of germination ability during storage leads to risk of seeding and deterioration in the quality. To resolve these problems, germplasms screening for longevity was conducted using six days of compulsory aging stress of high temperature (50℃) and humidity (~95% RH). ‘Dharial’, a weedy rice collected in Bangladesh, was chosen as a source of seed longevity for long term storage. The strong germination trait originated from ‘Dharial’ was incorporated into Korean elite japonica cultivars, ‘Ilmi’ and ‘Gopum’, through backcross method. The germination ratio was evaluated after two years of room temperature storage conditions. A high germination ratio of 80.5% in donor plant of ‘Dharial’ and 77.3% in an introgression line were observed based on the two years of storage while the recurrent japonica cultivars, ‘Ilmi’ and ‘Gopum’, were failed in germination. As a result, we investigated the changes of quality affected by germination ability during storage. A gentle slope of palatability which is one of the measurement items for indirect selection indicator of high eating quality in japonica varieties was studied in a high germination ratio introgression line during storage. The introgression line could be useful to increase longevity and quality of japonica rice seed if molecular breeding strategy such as QTLs analysis is combined.Keywords: rice, longevity, germination, storage
Procedia PDF Downloads 4262725 A Questionnaire-Based Survey: Therapists Response towards Upper Limb Disorder Learning Tool
Authors: Noor Ayuni Che Zakaria, Takashi Komeda, Cheng Yee Low, Kaoru Inoue, Fazah Akhtar Hanapiah
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Previous studies have shown that there are arguments regarding the reliability and validity of the Ashworth and Modified Ashworth Scale towards evaluating patients diagnosed with upper limb disorders. These evaluations depended on the raters’ experiences. This initiated us to develop an upper limb disorder part-task trainer that is able to simulate consistent upper limb disorders, such as spasticity and rigidity signs, based on the Modified Ashworth Scale to improve the variability occurring between raters and intra-raters themselves. By providing consistent signs, novice therapists would be able to increase training frequency and exposure towards various levels of signs. A total of 22 physiotherapists and occupational therapists participated in the study. The majority of the therapists agreed that with current therapy education, they still face problems with inter-raters and intra-raters variability (strongly agree 54%; n = 12/22, agree 27%; n = 6/22) in evaluating patients’ conditions. The therapists strongly agreed (72%; n = 16/22) that therapy trainees needed to increase their frequency of training; therefore believe that our initiative to develop an upper limb disorder training tool will help in improving the clinical education field (strongly agree and agree 63%; n = 14/22).Keywords: upper limb disorder, clinical education tool, inter/intra-raters variability, spasticity, modified Ashworth scale
Procedia PDF Downloads 3102724 Passing the Charity Walking Tours as a Poverty Reduction Establishment in Denpasar City, Bali
Authors: I. Wayan Wiwin
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Poverty is one of the big problems faced by big cities in the world. Urbanization one cause, many rural communities trying to earn a living to the city in the hope that they can improve the level of economy, but not equipped with adequate skills so that it becomes an urban demographic problem. Denpasar as the capital of the province of Bali one of them, in the city area of Denpasar there are many slum dwellings inhabited by the poor, whereas Bali is known as one of the best tourist destinations in the world. This condition is very inversely proportional to the progress of tourism in Bali. For that it is necessary to attempt to overcome poverty in the city of Denpasar, one with the development of city tours in the form of charity walking tours, where tourists are invited to take a walk to see directly the state of the poor in the city of Denpasar and provide assistance to them in the form of home assistance, educational scholarships, health assistance, as well as skill and business capital assistance. This research is explorative-qualitative, that is exploring the potential of charity walking tour to overcome poverty in Denpasar City, which is written qualitatively. In the end based on potential data and information, then analyzed into a decision whether it is possible to develop. Therefore, this study only requires respondents or informants who are able to provide answers or qualitative information about matters related to the potential development of charity walking tour. Thus, informants in this study are tourism stakeholders, such as Municipal government officials, businessmen, community leaders and tourism actors, who are considered to be providing information relating to the development of urban tourism.Keywords: tourism, city tours, charity walking tours, poverty
Procedia PDF Downloads 1592723 Sustainable Affordable Housing Development in Indonesia
Authors: Gina Cynthia Raphita Hasibuan
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The housing sector in Indonesia is in critical condition where majority of low-income citizens live in substandard dwellings, and the number housing backlog is increasing every year. The housing problem becomes more urgent when the term 'sustainability' is considered, and sustainable affordable housing is yet to gain its successful implementation. Global urbanization develops fastest in developing countries like Indonesia where informal settlements are rapidly escalating, hence, making sustainable affordable housing strategies very critical in this context. The problem in developing countries like Indonesia lies on the institutional capacity of newly-established local governments having greater power to determine a development policy but apparently still lacking institutional capability and coordination with the central government and collaborative governance are still not established yet. The concept of upgrading informal settlements are seen changed over time and inconsistent. Despite much research on theme such as sustainable housing concept within Indonesian context, there has been a dearth of research examining the role of collaborative governance, as the current approach still shows fragmented approach between the stakeholders and the lack of community participation as the end user, and thus this research attempts to fill the gap on the aforementioned problems. By using case study with multi-methods conducted in Jakarta, this research has an overall aim to critically assess the role of collaborative governance in addressing sustainable affordable housing in Indonesia and to understand informal settlements and interventions in Indonesia rather than imposing a framework from western perspectives.Keywords: affordable housing, collaborative governance, sustainability, urban planning
Procedia PDF Downloads 4102722 Integrating Carbon Footprint into Supply Chain Management of Manufacturing Companies: Sri Lanka
Authors: Shirekha Layangani, Suneth Dharmaparakrama
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When the manufacturing industry is concerned the Environment Management System (EMS) is a common term. Currently most organizations have obtained the environmental standard certification, ISO 14001. In the Sri Lankan context even though the organizations adopt Environmental Management, a very limited number of companies tend to calculate their Carbon Footprints. This research discusses the demotivating factors of manufacturing organizations in Sri Lanka to integrate calculation of carbon footprint into their supply chains. Further it also identifies the benefits that manufacturing organizations can gain by implementing calculation of carbon footprint. The manufacturing companies listed under “ISO 14001” certification were considered in this study in order to investigate the problems mentioned above. 100% enumeration was used when the surveys were carried out. In order to gather essential data two surveys were designed to be done among manufacturing organizations that are currently engaged in calculating their carbon footprint and the organizations that have not. The survey among the first set of manufacturing organizations revealed the benefits the organizations were able to gain by implementing calculation of carbon footprint. The latter set organizations revealed the demotivating factors that have influenced not to integrate calculation of carbon footprint into their supply chains. This paper has summarized the results obtained by the surveys and segregated depending on the market share of the manufacturing organizations. Further it has indicated the benefits that can be obtained by implementing carbon footprint calculation, depending on the market share of the manufacturing entity. Finally the research gives suggestions to manufacturing organizations on applicability of adopting carbon footprint calculation depending on the benefits that can be obtained.Keywords: carbon footprint, environmental management systems (EMS), benefits of carbon footprint, ISO14001
Procedia PDF Downloads 3742721 Revealing Potential Drug Targets against Proto-Oncogene Wnt10B by Comparative Molecular Docking
Authors: Shazia Mannan, Zunera Khalid, Hammad-Ul-Mubeen
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Wingless type Mouse mammary tumor virus (MMTV) Integration site-10B (Wnt10B) is an important member of the Wnt protein family that functions as cellular messenger in paracrine manner. Aberrant Wnt10B activity is the cause of several abnormalities including cancers of breast, cervix, liver, gastric tract, esophagus, pancreas as well as physiological problems like obesity, and osteoporosis. The objective of this study was to determine the possible inhibitors against aberrant expression of Wnt10B in order to prevent and treat the physiological disorders associated with it. Wnt10B3D structure was predicted by using comparative modeling and then analyzed by PROCHECK, Verify3D, and Errat. The model having 84.54% quality value was selected and acylated to satisfy the hydrophobic nature of Wnt10B. For search of inhibitors, virtual screening was performed on Natural Products (NP) database. The compounds were filtered and ligand-based screening was performed using the antagonist for mouse Wnt-3A. This resulted in a library of 272 unique compounds having most potent drug like activities for Wnt-4. Out of the 271 molecules analyzed three small molecules ZINC35442871, ZINC85876388, and ZINC00754234 having activity against Wnt4 abbarent expression were found common through docking experiment of Wnt10B. It is concluded that the three molecules ZINC35442871, ZINC85876388, and ZINC00754234 can be considered as lead compounds for performing further drug designing experiments against aberrant Wnt expressions.Keywords: Wnt10B inhibitors, comparative computational studies, proto-oncogene, molecular docking
Procedia PDF Downloads 1562720 Graph-Based Semantical Extractive Text Analysis
Authors: Mina Samizadeh
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In the past few decades, there has been an explosion in the amount of available data produced from various sources with different topics. The availability of this enormous data necessitates us to adopt effective computational tools to explore the data. This leads to an intense growing interest in the research community to develop computational methods focused on processing this text data. A line of study focused on condensing the text so that we are able to get a higher level of understanding in a shorter time. The two important tasks to do this are keyword extraction and text summarization. In keyword extraction, we are interested in finding the key important words from a text. This makes us familiar with the general topic of a text. In text summarization, we are interested in producing a short-length text which includes important information about the document. The TextRank algorithm, an unsupervised learning method that is an extension of the PageRank (algorithm which is the base algorithm of Google search engine for searching pages and ranking them), has shown its efficacy in large-scale text mining, especially for text summarization and keyword extraction. This algorithm can automatically extract the important parts of a text (keywords or sentences) and declare them as a result. However, this algorithm neglects the semantic similarity between the different parts. In this work, we improved the results of the TextRank algorithm by incorporating the semantic similarity between parts of the text. Aside from keyword extraction and text summarization, we develop a topic clustering algorithm based on our framework, which can be used individually or as a part of generating the summary to overcome coverage problems.Keywords: keyword extraction, n-gram extraction, text summarization, topic clustering, semantic analysis
Procedia PDF Downloads 712719 Haematological Responses on Amateur Cycling Stages Race
Authors: Renato André S. Silva, Nana L. F. Sampaio, Carlos J. G. Cruz, Bruno Vianna, Flávio O. Pires
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multiple stage bicycle races require high physiological loads from professional cyclists. Such demands can lead to immunosuppression and health problems. However, in this type of competition, little is known about its physiological effects on amateur athletes, who generally receive less medical support. Thus, this study analyzes the hematological effects of a multiple stage bicycle race on amateur cyclists. Seven Brazilian national amateur cyclists (34 ± 4.21 years) underwent a laboratory test to evaluate VO2Max (69.89 ± 7.43 ml⋅kg-1⋅min-1). Six days later, these volunteers raced in the Tour of Goiás, participating in five races in four days (435 km) of competition. Arterial blood samples were collected one day before and one day after the competition. The Kolmogorov-Smirnov tests were used to evaluate the data distribution and Wilcoxon to compare the two moments (p <0.05) of data collection. The results show: Red cells ↓ 7.8% (5.1 ± 0.28 vs 4.7 ± 0.37 106 / mm 3, p = 0.01); Hemoglobin ↓ 7.9% (15.1 ± 0.31 vs 13.9 ± 0.27 g / dL, p = 0.01); Leukocytes ↑ 9.5% (4946 ± 553 versus 5416 ± 1075 / mm 3, p = 0.17); Platelets ↓ 7.0% (200.2 ± 51.5 vs 186.1 ± 39.5 / mm 3, p = 0.01); LDH ↑ 11% (164.4 ± 28.5 vs 182.5 ± 20.5 U / L, p = 0.17); CK ↑ 13.5% (290.7 ± 206.1 vs 330.1 ± 90.5 U / L, p = 0.39); CK-MB ↑ 2% (15.7 ± 3.9 vs. 20.1 ± 2.9 U / L, p = 0.06); Cortizol ↓ 13.5% (12.1 ± 2.4 vs 9.9 ± 1.9 μg / dL, p = 0.01); Total testosterone ↓ 7% (453.6 ± 120.1 vs 421.7 ± 74.3 ng / dL, p = 0.12); IGF-1 ↓ 15.1% (213.8 ± 18.8 vs 181.5 ± 34.7 ng / mL, p = 0.04). This means that there was significant reductions in O2 allocation / transport capacities, vascular injury disruption, and a fortuitous reduction of muscle skeletal anabolism along with maintenance and / or slight elevation of immune function, glucose and lipid energy and myocardial damage. Therefore, the results suggest that no abnormal health effect was identified among the athletes after participating in the Tour de Goiás.Keywords: cycling, health effects, cycling stages races, haematology
Procedia PDF Downloads 2002718 Effect of the Community Chair-Based Exercise Programme on the Balance of the Elderly in Hong Kong
Authors: Wai Sang Wu, Florence Pik Sze Mok
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Introduction: Ageing population is one of the hot topics nowadays in the world and this phenomenon is believed to exacerbate continuously in the future. According to the latest information from World Health Organization (WHO) in 2016, the proportion of people aged more than 60 years is projected to be doubled from 12% in 2015 to 22% in 2050 of the world's population. Similarly, according to figures released by the Census and Statistic Department of Hong Kong in 2015, the contribution of elderly aged more than 65 years olds is projected to increase from 15% in 2014 to 34% in 2064 in local community. On the other hand, falls in elderly is a common problem, and it can bring along many negative consequences among elders, such as reducing their mobility level as well as their quality of life. In addition, it can also increase the caring stress of their family caregivers and as well increase the reliance and burden on the medical care system of Hong Kong. Therefore, appropriate measures should be implemented in order to minimize the risk of fall among elders. The objective of this study is to evaluate the effectiveness of the chair-based exercise programme in affecting the balance of the elderly in Hong Kong. Methods: Thirteen healthy subjects (males = 2; females = 11; mean age: 76.2 ± 7.8 years old) were recruited from an elderly social centre in the community to participate in a structural chair-based exercise programme for 6 weeks (1 session per week; 60-minutes per session). Subjects were being assessed on their balance ability using three commonly used clinical assessments, namely, 1) single leg stance (SLS) test, 2) functional reach test, and 3) 360-degree turn test, before and after their participation in the chair-based exercise programme. Pre and post within-subject comparison was adopted to assess the effectiveness of the programme. Results: There was significant improvement (p < 0.05) in all balance parameters of the subjects after their participation in the exercise programme. Elderly demonstrated significant improvement in SLS (p < 0.012), functional reach (p < 0.030) and 360 degree turn (p < 0.043). Conclusions: This study showed that a community chair-based exercise programme is effective in improving the balance ability of the elders. It seems to be another exercise regime that should be promoted among the elders in order to minimize their risk of falls and its negative consequence.Keywords: balance, chair-based exercise programme, community, elderly
Procedia PDF Downloads 2812717 Aromatic Medicinal Plant Classification Using Deep Learning
Authors: Tsega Asresa Mengistu, Getahun Tigistu
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Computer vision is an artificial intelligence subfield that allows computers and systems to retrieve meaning from digital images. It is applied in various fields of study self-driving cars, video surveillance, agriculture, Quality control, Health care, construction, military, and everyday life. Aromatic and medicinal plants are botanical raw materials used in cosmetics, medicines, health foods, and other natural health products for therapeutic and Aromatic culinary purposes. Herbal industries depend on these special plants. These plants and their products not only serve as a valuable source of income for farmers and entrepreneurs, and going to export not only industrial raw materials but also valuable foreign exchange. There is a lack of technologies for the classification and identification of Aromatic and medicinal plants in Ethiopia. The manual identification system of plants is a tedious, time-consuming, labor, and lengthy process. For farmers, industry personnel, academics, and pharmacists, it is still difficult to identify parts and usage of plants before ingredient extraction. In order to solve this problem, the researcher uses a deep learning approach for the efficient identification of aromatic and medicinal plants by using a convolutional neural network. The objective of the proposed study is to identify the aromatic and medicinal plant Parts and usages using computer vision technology. Therefore, this research initiated a model for the automatic classification of aromatic and medicinal plants by exploring computer vision technology. Morphological characteristics are still the most important tools for the identification of plants. Leaves are the most widely used parts of plants besides the root, flower and fruit, latex, and barks. The study was conducted on aromatic and medicinal plants available in the Ethiopian Institute of Agricultural Research center. An experimental research design is proposed for this study. This is conducted in Convolutional neural networks and Transfer learning. The Researcher employs sigmoid Activation as the last layer and Rectifier liner unit in the hidden layers. Finally, the researcher got a classification accuracy of 66.4 in convolutional neural networks and 67.3 in mobile networks, and 64 in the Visual Geometry Group.Keywords: aromatic and medicinal plants, computer vision, deep convolutional neural network
Procedia PDF Downloads 4382716 The Impact of Data Science on Geography: A Review
Authors: Roberto Machado
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We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology, analyzing 2,996 studies and synthesizing 41 of them to explore the evolution of data science and its integration into geography. By employing optimization algorithms, we accelerated the review process, significantly enhancing the efficiency and precision of literature selection. Our findings indicate that data science has developed over five decades, facing challenges such as the diversified integration of data and the need for advanced statistical and computational skills. In geography, the integration of data science underscores the importance of interdisciplinary collaboration and methodological innovation. Techniques like large-scale spatial data analysis and predictive algorithms show promise in natural disaster management and transportation route optimization, enabling faster and more effective responses. These advancements highlight the transformative potential of data science in geography, providing tools and methodologies to address complex spatial problems. The relevance of this study lies in the use of optimization algorithms in systematic reviews and the demonstrated need for deeper integration of data science into geography. Key contributions include identifying specific challenges in combining diverse spatial data and the necessity for advanced computational skills. Examples of connections between these two fields encompass significant improvements in natural disaster management and transportation efficiency, promoting more effective and sustainable environmental solutions with a positive societal impact.Keywords: data science, geography, systematic review, optimization algorithms, supervised learning
Procedia PDF Downloads 302715 High Pressure Delignification Process for Nanocrystalline Cellulose Production from Agro-Waste Biomass
Authors: Sakinul Islam, Nhol Kao, Sati Bhattacharya, Rahul Gupta
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Nanocrystalline cellulose (NCC) has been widely used for miscellaneous applications due to its superior properties over other nanomaterials. However, the major problems associated with the production of NCC are long reaction time, low production rate and inefficient process. The mass production of NCC within a short period of time is still a great challenge. The main objective of this study is to produce NCC from rice husk agro waste biomass from a high pressure delignification process (HPDP), followed by bleaching and hydrolysis processes. The HPDP has not been explored for NCC production from rice husk biomass (RHB) until now. In order to produce NCC, powder rice husk (PRH) was placed into a stainless steel reactor at 80 ˚C under 5 bars. Aqueous solution of NaOH (4M) was used for the dissolution of lignin and other amorphous impurities from PRH. After certain experimental times (1h, 3.5h and 6h), bleaching and hydrolysis were carried out on delignified samples. NaOCl (20%) and H2SO4 (4M) solutions were used for bleaching and hydrolysis processes, respectively. The NCC suspension from hydrolysis was sonicated and neutralized by buffer solution for various characterisations. Finally NCC suspension was dried and analyzed by FTIR, XRD, SEM, AFM and TEM. The chemical composition of NCC and PRH was estimated by TAPPI (Technical Association of Pulp and Paper Industry) standard methods to observe the product purity. It was found that, the 6h of the HPDP was more efficient to produce good quality NCC than that at 1h and 3.5h due to low separation of non-cellulosic components from RHB. The analyses indicated the crystallinity of NCC to be 71 %, particle size of 20-50 nm (diameter) and 100-200 nm in length.Keywords: nanocrystalline cellulose, NCC, high pressure delignification, bleaching, hydrolysis, agro-waste biomass
Procedia PDF Downloads 2642714 Investigating the relationship between Emotional Intelligence of principals in high schools(secondary school principals) and Teachers Conflict Management: A Case Study on secondary schools, Tehran, Iran
Authors: Amir Ahmadi, Hossein Ahmadi, Alireza Ahmadi
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Emotional Intelligence (EI) has been defined as the ability to empathize, persevere, control impulses, communicate clearly, make thoughtful decisions, solve problems, and work with others in a way that earns friends and success. These abilities allow an individual to recognize and regulate emotion, develop self-control, set goals, develop empathy, resolve conflicts, and develop skills needed for leadership and effective group participation. Due to the increasing complexity of organizations and different ways of thinking, attitudes and beliefs of individuals, conflict as an important part of organizational life has been examined frequently. The main point is that the conflict is not necessarily in organization, unnecessary; but it can be more creative (increase creativity), to promote innovation. The purpose of this study was to investigate the relation between principals emotional intelligence as one of the factors affecting conflict management among teachers. This relation was analyzed through cluster sampling with a sample size consisting of 120 individuals. The results of the study showed that at the 95% level of confidence, the two secondary hypotheses (i.e. relation between emotional intelligence of principals and use of competition and cooperation strategies of conflict management among teachers) were confirmed, but the other three secondary hypotheses (i.e. the relation between emotional intelligence of managers and use of avoidance, adaptation and adaptability strategies of conflict management among teachers) were rejected. The primary hypothesis (i.e. relation between emotional intelligence of principals with conflict management among teachers) is supported.Keywords: emotional intelligence, conflict, conflict management, strategies of conflict management
Procedia PDF Downloads 3552713 Improving Comfort and Energy Mastery: Application of a Method Based on Indicators Morpho-Energetic
Authors: Khadidja Rahmani, Nahla Bouaziz
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The climate change and the economic crisis, which are currently running, are the origin of the emergence of many issues and problems, which are related to the domain of energy and environment in à direct or indirect manner. Since the urban space is the core element and the key to solve the current problem, particular attention is given to it in this study. For this reason, we rented to the later a very particular attention; this is for the opportunities that it provides and that can be invested to attenuate a little this situation, which is disastrous and worried, especially in the face of the requirements of sustainable development. Indeed, the purpose of this work is to develop a method, which will allow us to guide designers towards projects with a certain degree of thermo-aeraulic comfort while requiring a minimum energy consumption. In this context, the architects, the urban planners and the engineers (energeticians) have to collaborate jointly to establish a method based on indicators for the improvement of the urban environmental quality (aeraulic-thermo comfort), correlated with a reduction in the energy demand of the entities that make up this environment, in areas with a sub-humid climate. In order to test the feasibility and to validate the method developed in this work, we carried out a series of simulations using computer-based simulation. This research allows us to evaluate the impact of the use of the indicators in the design of the urban sets, on the economic and ecological plan. Using this method, we prove that an urban design, which carefully considered energetically, can contribute significantly to the preservation of the environment and the reduction of the consumption of energy.Keywords: comfort, energy consumption, energy mastery, morpho-energetic indicators, simulation, sub-humid climate, urban sets
Procedia PDF Downloads 2752712 Improving Functionality of Radiotherapy Department Through: Systemic Periodic Clinical Audits
Authors: Kamal Kaushik, Trisha, Dandapni, Sambit Nanda, A. Mukherjee, S. Pradhan
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INTRODUCTION: As complexity in radiotherapy practice and processes are increasing, there is a need to assure quality control to a greater extent. At present, no international literature available with regards to the optimal quality control indicators for radiotherapy; moreover, few clinical audits have been conducted in the field of radiotherapy. The primary aim is to improve the processes that directly impact clinical outcomes for patients in terms of patient safety and quality of care. PROCEDURE: A team of an Oncologist, a Medical Physicist and a Radiation Therapist was formed for weekly clinical audits of patient’s undergoing radiotherapy audits The stages for audits include Pre planning audits, Simulation, Planning, Daily QA, Implementation and Execution (with image guidance). Errors in all the parts of the chain were evaluated and recorded for the development of further departmental protocols for radiotherapy. EVALUATION: The errors at various stages of radiotherapy chain were evaluated and recorded for comparison before starting the clinical audits in the department of radiotherapy and after starting the audits. It was also evaluated to find the stage in which maximum errors were recorded. The clinical audits were used to structure standard protocols (in the form of checklist) in department of Radiotherapy, which may lead to further reduce the occurrences of clinical errors in the chain of radiotherapy. RESULTS: The aim of this study is to perform a comparison between number of errors in different part of RT chain in two groups (A- Before Audit and B-After Audit). Group A: 94 pts. (48 males,46 female), Total no. of errors in RT chain:19 (9 needed Resimulation) Group B: 94 pts. (61 males,33 females), Total no. of errors in RT chain: 8 (4 needed Resimulation) CONCLUSION: After systematic periodic clinical audits percentage of error in radiotherapy process reduced more than 50% within 2 months. There is a great need in improving quality control in radiotherapy, and the role of clinical audits can only grow. Although clinical audits are time-consuming and complex undertakings, the potential benefits in terms of identifying and rectifying errors in quality control procedures are potentially enormous. Radiotherapy being a chain of various process. There is always a probability of occurrence of error in any part of the chain which may further propagate in the chain till execution of treatment. Structuring departmental protocols and policies helps in reducing, if not completely eradicating occurrence of such incidents.Keywords: audit, clinical, radiotherapy, improving functionality
Procedia PDF Downloads 882711 Feasibility Study of Friction Stir Welding Application for Kevlar Material
Authors: Ahmet Taşan, Süha Tirkeş, Yavuz Öztürk, Zafer Bingül
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Friction stir welding (FSW) is a joining process in the solid state, which eliminates problems associated with the material melting and solidification, such as cracks, residual stresses and distortions generated during conventional welding. Among the most important advantages of FSW are; easy automation, less distortion, lower residual stress and good mechanical properties in the joining region. FSW is a recent approach to metal joining and although originally intended for aluminum alloys, it is investigated in a variety of metallic materials. The basic concept of FSW is a rotating tool, made of non-consumable material, specially designed with a geometry consisting of a pin and a recess (shoulder). This tool is inserted as spinning on its axis at the adjoining edges of two sheets or plates to be joined and then it travels along the joining path line. The tool rotation axis defines an angle of inclination with which the components to be welded. This angle is used for receiving the material to be processed at the tool base and to promote the gradual forge effect imposed by the shoulder during the passage of the tool. This prevents the material plastic flow at the tool lateral, ensuring weld closure on the back of the pin. In this study, two 4 mm Kevlar® plates which were produced with the Kevlar® fabrics, are analyzed with COMSOL Multiphysics in order to investigate the weldability via FSW. Thereafter, some experimental investigation is done with an appropriate workbench in order to compare them with the analysis results.Keywords: analytical modeling, composite materials welding, friction stir welding, heat generation
Procedia PDF Downloads 1582710 Colors and Interiority - A Study on the Relationship of Colors and Interior Spaces
Authors: Mahwish Ghulam Rasool
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The design of a space is a complex process that involves multiple stages, from conceptualization, identifying design problems to understanding the context, materiality, and functionality of the space. Out of all the design elements, color is one of the most dominant and expressive factors that affect the spatial dynamics of the interior space. Color affects aesthetic comfort in space and has a lasting impact on human perception and psychology. Using color as a tool for creating spatial experiences is a new paradigm. Color semantics in spaces are not only used for surface treatment or aesthetics, but it also has more powerful functional characteristics. As interior spaces are evolving and becoming experiential with each decade, designers are looking for new processes to enhance the spatial and experiential quality of interior spaces. The relationship between color and interior typologies is a relatively new paradigm. This paper discusses the role of colors in interior spaces from various perspectives, exploring their impact on the formation of interior typologies and the use of colors in space design. The paper analyzes interior typologies worldwide, from residential to commercial interior spaces, where color semantics plays a prominent role in the design. The paper also emphasizes the design process and the creation of design language, unveiling the possibilities of applying colors in interior spaces that can be in harmony with the building context, space functionality, or in opposition to the existing building envelope or environment. The paper aims to contribute to the field of interior design education and practices. By using experimental and various research methodologies for investigation, it aims to fill the gap in the literature regarding color semantics and the relationship between interior typologies.Keywords: color psychology, color semantics, interior environments, interior typologies
Procedia PDF Downloads 872709 Critical Design Futures: A Foresight 3.0 Approach to Business Transformation and Innovation
Authors: Nadya Patel, Jawn Lim
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Foresight 3.0 is a synergistic methodology that encompasses systems analysis, future studies, capacity building, and forward planning. These components are interconnected, fostering a collective anticipatory intelligence that promotes societal resilience (Ravetz, 2020). However, traditional applications of these strands can often fall short, leading to missed opportunities and narrow perspectives. Therefore, Foresight 3.0 champions a holistic approach to tackling complex issues, focusing on systemic transformations and power dynamics. Businesses are pivotal in preparing the workforce for an increasingly uncertain and complex world. This necessitates the adoption of innovative tools and methodologies, such as Foresight 3.0, that can better equip young employees to anticipate and navigate future challenges. Firstly, the incorporation of its methodology into workplace training can foster a holistic perspective among employees. This approach encourages employees to think beyond the present and consider wider social, economic, and environmental contexts, thereby enhancing their problem-solving skills and resilience. This paper discusses our research on integrating Foresight 3.0's transformative principles with a newly developed Critical Design Futures (CDF) framework to equip organisations with the ability to innovate for the world's most complex social problems. This approach is grounded in 'collective forward intelligence,' enabling mutual learning, co-innovation, and co-production among a diverse stakeholder community, where business transformation and innovation are achieved.Keywords: business transformation, innovation, foresight, critical design
Procedia PDF Downloads 812708 Early Outcomes and Lessons from the Implementation of a Geriatric Hip Fracture Protocol at a Level 1 Trauma Center
Authors: Peter Park, Alfonso Ayala, Douglas Saeks, Jordan Miller, Carmen Flores, Karen Nelson
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Introduction Hip fractures account for more than 300,000 hospital admissions every year. Many present as fragility fractures in geriatric patients with multiple medical comorbidities. Standardized protocols for the multidisciplinary management of this patient population have been shown to improve patient outcomes. A hip fracture protocol was implemented at a Level I Trauma center with a focus on pre-operative medical optimization and early surgical care. This study evaluates the efficacy of that protocol, including the early transition period. Methods A retrospective review was performed of all patients ages 60 and older with isolated hip fractures who were managed surgically between 2020 and 2022. This included patients 1 year prior and 1 year following the implementation of a hip fracture protocol at a Level I Trauma center. Results 530 patients were identified: 249 patients were treated before, and 281 patients were treated after the protocol was instituted. There was no difference in mean age (p=0.35), gender (p=0.3), or Charlson Comorbidity Index (p=0.38) between the cohorts. Following the implementation of the protocol, there were observed increases in time to surgery (27.5h vs. 33.8h, p=0.01), hospital length of stay (6.3d vs. 9.7d, p<0.001), and ED LOS (5.1h vs. 6.2h, p<0.001). There were no differences in in-hospital mortality (2.01% pre vs. 3.20% post, p=0.39) and complication rates (25% pre vs 26% post, p=0.76). A trend towards improved outcomes was seen after the early transition period but failed to yield statistical significance. Conclusion Early medical management and surgical intervention are key determining factors affecting outcomes following fragility hip fractures. The implementation of a hip fracture protocol at this institution has not yet significantly affected these parameters. This could in part be due to the restrictions placed at this institution during the COVID-19 pandemic. Despite this, the time to OR pre-and post-implementation was quicker than figures reported elsewhere in literature. Further longitudinal data will be collected to determine the final influence of this protocol. Significance/Clinical Relevance Given the increasing number of elderly people and the high morbidity and mortality associated with hip fractures in this population finding cost effective ways to improve outcomes in the management of these injuries has the potential to have enormous positive impact for both patients and hospital systems.Keywords: hip fracture, geriatric, treatment algorithm, preoperative optimization
Procedia PDF Downloads 792707 Starchy Wastewater as Raw Material for Biohydrogen Production by Dark Fermentation: A Review
Authors: Tami A. Ulhiza, Noor I. M. Puad, Azlin S. Azmi, Mohd. I. A. Malek
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High amount of chemical oxygen demand (COD) in starchy waste can be harmful to the environment. In common practice, starch processing wastewater is discharged to the river without proper treatment. However, starchy waste still contains complex sugars and organic acids. By the right pretreatment method, the complex sugar can be hydrolyzed into more readily digestible sugars which can be utilized to be converted into more valuable products. At the same time, the global demand of energy is inevitable. The continuous usage of fossil fuel as the main source of energy can lead to energy scarcity. Hydrogen is a renewable form of energy which can be an alternative energy in the future. Moreover, hydrogen is clean and carries the highest energy compared to other fuels. Biohydrogen produced from waste has significant advantages over chemical methods. One of the major problems in biohydrogen production is the raw material cost. The carbohydrate-rich starchy wastes such as tapioca, maize, wheat, potato, and sago wastes is a promising candidate to be used as a substrate in producing biohydrogen. The utilization of those wastes for biohydrogen production can provide cheap energy generation with simultaneous waste treatment. Therefore this paper aims to review variety source of starchy wastes that has been widely used to synthesize biohydrogen. The scope includes the source of waste, the performance in yielding hydrogen, the pretreatment method and the type of culture that is suitable for starchy waste.Keywords: biohydrogen, dark fermentation, renewable energy, starchy waste
Procedia PDF Downloads 2232706 Effects of Screen Time on Children from a Systems Engineering Perspective
Authors: Misagh Faezipour
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This paper explores the effects of screen time on children from a systems engineering perspective. We reviewed literature from several related works on the effects of screen time on children to explore all factors and interrelationships that would impact children that are subjected to using long screen times. Factors such as kids' age, parent attitudes, parent screen time influence, amount of time kids spend with technology, psychosocial and physical health outcomes, reduced mental imagery, problem-solving and adaptive thinking skills, obesity, unhealthy diet, depressive symptoms, health problems, disruption in sleep behavior, decrease in physical activities, problematic relationship with mothers, language, social, emotional delays, are examples of some factors that could be either a cause or effect of screen time. A systems engineering perspective is used to explore all the factors and factor relationships that were discovered through literature. A causal model is used to illustrate a graphical representation of these factors and their relationships. Through the causal model, the factors with the highest impacts can be realized. Future work would be to develop a system dynamics model to view the dynamic behavior of the relationships and observe the impact of changes in different factors in the model. The different changes on the input of the model, such as a healthier diet or obesity rate, would depict the effect of the screen time in the model and portray the effect on the children’s health and other factors that are important, which also works as a decision support tool.Keywords: children, causal model, screen time, systems engineering, system dynamics
Procedia PDF Downloads 1442705 Utility of Thromboelastography to Reduce Coagulation-Related Mortality and Blood Component Rate in Neurosurgery ICU
Authors: Renu Saini, Deepak Agrawal
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Background: Patients with head and spinal cord injury frequently have deranged coagulation profiles and require blood products transfusion perioperatively. Thromboelastography (TEG) is a ‘bedside’ global test of coagulation which may have role in deciding the need of transfusion in such patients. Aim: To assess the usefulness of TEG in department of neurosurgery in decreasing transfusion rates and coagulation-related mortality in traumatic head and spinal cord injury. Method and Methodology: A retrospective comparative study was carried out in the department of neurosurgery over a period of 1 year. There are two groups in this study. ‘Control’ group constitutes the patients in whom data was collected over 6 months (1/6/2009-31/12/2009) prior to installation of TEG machine. ‘Test’ group includes patients in whom data was collected over 6months (1/1/2013-30/6/2013) post TEG installation. Total no. of platelet, FFP, and cryoprecipitate transfusions were noted in both groups along with in hospital mortality and length of stay. Result: Both groups were matched in age and sex of patients, number of head and spinal cord injury cases, number of patients with thrombocytopenia and number of patients who underwent operation. Total 178 patients (135 head injury and 43 spinal cord injury patents) were admitted in neurosurgery department during time period June 2009 to December 2009 i.e. prior to TEG installation and after TEG installation a total of 243 patients(197 head injury and 46 spinal cord injury patents) were admitted. After TEG introduction platelet transfusion significantly reduced (p=0.000) compare to control group (67 units to 34 units). Mortality rate was found significantly reduced after installation (77 patients to 57 patients, P=0.000). Length of stay was reduced significantly (Prior installation 1-211days and after installation 1-115days, p=0.02). Conclusion: Bedside TEG can dramatically reduce platelet transfusion components requirement in department of neurosurgery. TEG also lead to a drastic decrease in mortality rate and length of stay in patients with traumatic head and spinal cord injuries. We recommend its use as a standard of care in the patients with traumatic head and spinal cord injuries.Keywords: blood component transfusion, mortality, neurosurgery ICU, thromboelastography
Procedia PDF Downloads 3252704 A Second Order Genetic Algorithm for Traveling Salesman Problem
Authors: T. Toathom, M. Munlin, P. Sugunnasil
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The traveling salesman problem (TSP) is one of the best-known problems in optimization problem. There are many research regarding the TSP. One of the most usage tool for this problem is the genetic algorithm (GA). The chromosome of the GA for TSP is normally encoded by the order of the visited city. However, the traditional chromosome encoding scheme has some limitations which are twofold: the large solution space and the inability to encapsulate some information. The number of solution for a certain problem is exponentially grow by the number of city. Moreover, the traditional chromosome encoding scheme fails to recognize the misplaced correct relation. It implies that the tradition method focuses only on exact solution. In this work, we relax some of the concept in the GA for TSP which is the exactness of the solution. The proposed work exploits the relation between cities in order to reduce the solution space in the chromosome encoding. In this paper, a second order GA is proposed to solve the TSP. The term second order refers to how the solution is encoded into chromosome. The chromosome is divided into 2 types: the high order chromosome and the low order chromosome. The high order chromosome is the chromosome that focus on the relation between cities such as the city A should be visited before city B. On the other hand, the low order chromosome is a type of chromosome that is derived from a high order chromosome. In other word, low order chromosome is encoded by the traditional chromosome encoding scheme. The genetic operation, mutation and crossover, will be performed on the high order chromosome. Then, the high order chromosome will be mapped to a group of low order chromosomes whose characteristics are satisfied with the high order chromosome. From the mapped set of chromosomes, the champion chromosome will be selected based on the fitness value which will be later used as a representative for the high order chromosome. The experiment is performed on the city data from TSPLIB.Keywords: genetic algorithm, traveling salesman problem, initial population, chromosomes encoding
Procedia PDF Downloads 2722703 Community Engagement Strategies to Assist with the Development of an RCT Among People Living with HIV
Authors: Joyce K. Anastasi, Bernadette Capili
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Community Engagement Strategies to Assist with the Development of an RCT Among People Living with HIV Our research team focuses on developing and testing protocols to manage chronic symptoms. For many years, our team designed and implemented symptom management studies for people living with HIV (PLWH). We identify symptoms that are not curative and are not adequately controlled by conventional therapies. As an exemplar, we describe how we successfully engaged PLWH in developing and refining our research feasibility protocol for distal sensory peripheral neuropathy (DSP) associated with HIV. With input from PLWH with DSP, our research received National Institutes of Health (NIH) research funding support. Significance: DSP is one of the most common neurologic complications in HIV. It is estimated that DSP affects 21% to 50% of PLWH. The pathogenesis of DSP in HIV is complex and unclear. Proposed mechanisms include cytokine dysregulation, viral protein-produced neurotoxicity, and mitochondrial dysfunction associated with antiretroviral medications. There are no FDA-approved treatments for DSP in HIV. Purpose: Aims: 1) to explore the impact of DSP on the lives of PLWH, 2) to identify patients’ perspectives on successful treatments for DSP, 3) to identify interventions considered feasible and sensitive to the needs of PLWH with DSP, and 4) to obtain participant input for protocol/study design. Description of Process: We conducted a needs assessment with PLWH with DSP. From our needs assessment, we learned from the patients’ perspective detailed descriptions of their symptoms; physical functioning with DSP; self-care remedies tried, and desired interventions. We also asked about protocol scheduling, instrument clarity, study compensation, study-related burdens, and willingness to participate in a randomized controlled trial (RCT) with a placebo and a waitlist group. Implications: We incorporated many of the suggestions learned from the need assessment. We developed and completed a feasibility study that provided us with invaluable information that informed subsequent NIH-funded studies. In addition to our extensive clinical and research experience working with PLWH, learning from the patient perspective helped in developing our protocol and promoting a successful plan for recruitment and retention of study participants.Keywords: clinical trial development, peripheral neuropathy, traditional medicine, HIV, AIDS
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