Search results for: integrated care delivery
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8194

Search results for: integrated care delivery

1144 Neonatal Subcutaneous Fat Necrosis with Severe Hypercalcemia: Case Report

Authors: Atitallah Sofien, Bouyahia Olfa, Krifi farah, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Subcutaneous fat necrosis of the newborn (SCFN) is a rare acute hypodermatitis characterized by skin lesions in the form of infiltrated, hard plaques and subcutaneous nodules, with a purplish-red color, occurring between the first and sixth week of life. SCFN is generally a benign condition that spontaneously regresses without sequelae, but it can be complicated by severe hypercalcemia. Methodology: This is a retrospective case report of neonatal subcutaneous fat necrosis complicated with severe hypercalcemia and nephrocalcinosis. Results: This is a case of a female newborn with a family history of a hypothyroid mother on Levothyrox, born to non-consanguineous parents and from a well-monitored pregnancy. The newborn was delivered by cesarean section at 39 weeks gestation due to severe preeclampsia. She was admitted to the Neonatal Intensive Care Unit at 1 hour of life for the management of grade 1 perinatal asphyxia and immediate neonatal respiratory distress related to transient respiratory distress. Hospitalization was complicated by a healthcare-associated infection, requiring intravenous antibiotics for ten days, with a good clinical and biological response. On the 20th day of life, she developed skin lesions in the form of indurated purplish-red nodules on the back and on both arms. A SCFN was suspected. A calcium level test was conducted, which returned a result of 3 mmol/L. The rest of the phosphocalcic assessment was normal, with early signs of nephrocalcinosis observed on renal ultrasound. The diagnosis of SCFN complicated by nephrocalcinosis associated with severe hypercalcemia was made, and the condition improved with intravenous hydration and corticosteroid therapy. Conclusion: SCFN is a rare and generally benign hypodermatitis in newborns with an etiology that is still poorly understood. Despite its benign nature, SCFN can be complicated by hypercalcemia, which can sometimes be life-threatening. Therefore, it is important to conduct a thorough skin examination of newborns, especially those with risk factors, to detect and correct any potential hypercalcemia.

Keywords: subcutaneous fat necrosis, newborn, hypercalcemia, nephrocalcinosis

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1143 Integrated Information Approach to Inbound Logistics in Indian Steel Sector

Authors: N. Jena, Nitin Seth

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Globalization and free trade has forced the organizations to continuously rethink and rework on the increasing cost of logistics. World wide, it is visualized that on one side the steel sector is witnessing rapid growth and on the other side it is facing huge challenges in terms of availability of raw materials for uninterrupted production. Inbound logistics also gains significant importance for ensuring the timely availability of raw materials. It is seen that in Indian steel sector logistic cost is still very large and challenging. Effectively managing the inbound logistics in steel decides the profitability and serviceability of the organization. Effective management of inbound logistics also has a major role on the inventory of the organization. Since, the logistics for the steel industry in India is evolving rapidly and it is the interplay of infrastructure, technology and new types of service providers that will define whether the industry is able to help its customers to reduce their logistics costs. Integration of Logistics has been treated as one of the most potential area for the companies to provide a base for cost reduction. In spite of the proven area for benefits for the industry, it is very surprising that none of the researchers have explored this area. Although, many researchers explored the subject of logistics in steel industry, but their perspective varied from exploring and understanding the associated cost and finding out the relations between them. Visualizing a potential gap, the present research is under taken to explore the integration opportunities in inbound logistics for steel sector. Typically in Indian steel sector where in most of the manufacturers depend on imported materials for processing the logistics is very challenging and accounts for transactions at supplier – who is situated in different country, shipper- who is transporting the material to the host country, regulators in both countries-that include customs and various clearing agents, local logistics service providers and local transporters/handlers. It is seen that In bound logistics cost in the steel sector is very high and accounts for about 15-16% of the turn over, integration of information across different channels provides and opportunity for improvements and growth of the organization. In the present paper, a case of leading steel manufacturer has been taken and the potentials for integration of information across various partners have been identified. The paper provides the identification of grey area in steel sector for major improvements in cycle time and lowering the inventories by integration of information. Finally, based on integration of information, the paper presents a business information framework for steel sector.

Keywords: integration, steel sectors, suppliers, shippers, customs and cargo agents, transporters

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1142 Efficacy Of Tranexamic Acid On Blood Loss After Primary Total Hip Replacement : A Case-control Study In 154 Patients

Authors: Fedili Benamar, Belloulou Mohamed Lamine, Ouahes Hassane, Ghattas Samir

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Introduction: Perioperative blood loss is a frequent cause of complications in total hip replacement (THR). The present prospective study assessed the efficacy of tranexamic acid (Exacyl(®)) in reducing blood loss in primary THR. Hypothesis: Tranexamic acid reduces blood loss in THR. Material and method: -This is a prospective randomized study on the effectiveness of Exacyl (tranexamic acid) in total hip replacement surgery performed on a standardized technique between 2019 and September 2022. -It involved 154 patients, of which 84 received a single injection of Exacyl (group 1) at a dosage of 10 mg/kg over 20 minutes during the perioperative period. -All patients received postoperative thromboprophylaxis with enoxaparin 0.4 ml subcutaneously. -All patients were admitted to the post-interventional intensive care unit for a duration of 24 hours for monitoring and pain management as per the service protocol. Results: 154 patients, of which 84 received a single injection of Exacyl (group 1) and 70 patients patients who did not receive Exacyl perioperatively : (Group 2 ) The average age is 57 +/- 15 years The distribution by gender was nearly equal with 56% male and 44% female; "The distribution according to the ASA score was as follows: 20.2% ASA1, 82.3% ASA2, and 17.5% ASA3. "There was a significant difference in the average volume of intraoperative and postoperative bleeding during the 48 hours." The average bleeding volume for group 1 (received Exacyl) was 614 ml +/- 228, while the average bleeding volume for group 2 was 729 +/- 300, with a chi-square test of 6.35 and a p-value < 0.01, which is highly significant. The ANOVA test showed an F-statistic of 7.11 and a p-value of 0.008. A Bartlett test revealed a chi-square of 6.35 and a p-value < 0.01." "In Group 1 (patients who received Exacyl), 73% had bleeding less than 750 ml (Group A), and 26% had bleeding exceeding 750 ml (Group B). In Group 2 (patients who did not receive Exacyl perioperatively), 52% had bleeding less than 750 ml (Group A), and 47% had bleeding exceeding 750 ml (Group B). "Thus, the use of Exacyl reduced perioperative bleeding and specifically decreased the risk of severe bleeding exceeding 750 ml by 43% with a relative risk (RR) of 1.37 and a p-value < 0.01. The transfusion rate was 1.19% in the population of Group 1 (Exacyl), whereas it was 10% in the population of Group 2 (no Exacyl). It can be stated that the use of Exacyl resulted in a reduction in perioperative blood transfusion with an RR of 0.1 and a p-value of 0.02. Conclusions: The use of Exacyl significantly reduced perioperative bleeding in this type of surgery.

Keywords: acid tranexamic, blood loss, anesthesia, total hip replacement, surgery

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1141 Management of Acute Biliary Pathology at Gozo General Hospital

Authors: Kristian Bugeja, Upeshala A. Jayawardena, Clarissa Fenech, Mark Zammit Vincenti

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Introduction: Biliary colic, acute cholecystitis, and gallstone pancreatitis are some of the most common surgical presentations at Gozo General Hospital (GGH). National Institute for Health and Care Excellence (NICE) guidelines advise that suitable patients with acute biliary problems should be offered a laparoscopic cholecystectomy within one week of diagnosis. There has traditionally been difficulty in achieving this mainly due to the reluctance of some surgeons to operate in the acute setting, limited, timely access to MRCP and ERCP, and organizational issues. Methodology: A retrospective study was performed involving all biliary pathology-related admissions to GGH during the two-year period of 2019 and 2020. Patients’ files and electronic case summary (ECS) were used for data collection, which included demographic data, primary diagnosis, co-morbidities, management, waiting time to surgery, length of stay, readmissions, and reason for readmissions. NICE clinical guidance 188 – Gallstone disease were used as the standard. Results: 51 patients were included in the study. The mean age was 58 years, and 35 (68.6%) were female. The main diagnoses on admission were biliary colic in 31 (60.8%), acute cholecystitis in 10 (19.6%). Others included gallstone pancreatitis in 3 (5.89%), chronic cholecystitis in 2 (3.92%), gall bladder malignancy in 4 (7.84%), and ascending cholangitis in 1 (1.97%). Management included laparoscopic cholecystectomy in 34 (66.7%); conservative in 8 (15.7%) and ERCP in 6 (11.7%). The mean waiting time for laparoscopic cholecystectomy for patients with acute cholecystitis was 74 days – range being between 3 and 146 days since the date of diagnosis. Only one patient who was diagnosed with acute cholecystitis and managed with laparoscopic cholecystectomy was done so within the 7-day time frame. Hospital re-admissions were reported in 5 patients (9.8%) due to vomiting (1), ascending cholangitis (1), and gallstone pancreatitis (3). Discussion: Guidelines were not met for patients presenting to Gozo General Hospital with acute biliary pathology. This resulted in 5 patients being re-admitted to hospital while waiting for definitive surgery. The local issues resulting in the delay to surgery need to be identified and steps are taken to facilitate the provision of urgent cholecystectomy for suitable patients.

Keywords: biliary colic, acute cholecystits, laparoscopic cholecystectomy, conservative management

Procedia PDF Downloads 161
1140 Antibacterial Bioactive Glasses in Orthopedic Surgery and Traumatology

Authors: V. Schmidt, L. Janovák, N. Wiegand, B. Patczai, K. Turzó

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Large bone defects are not able to heal spontaneously. Bioactive glasses seem to be appropriate (bio)materials for bone reconstruction. Bioactive glasses are osteoconductive and osteoinductive, therefore, play a useful role in bony regeneration and repair. Because of their not optimal mechanical properties (e.g., brittleness, low bending strength, and fracture toughness), their applications are limited. Bioactive glass can be used as a coating material applied on metal surfaces. In this way -when using them as implants- the excellent mechanical properties of metals and the biocompatibility and bioactivity of glasses will be utilized. Furthermore, ion release effects of bioactive glasses regarding osteogenic and angiogenic responses have been shown. Silicate bioactive glasses (45S5 Bioglass) induce the release and exchange of soluble Si, Ca, P, and Na ions on the material surface. This will lead to special cellular responses inducing bone formation, which is favorable in the biointegration of the orthopedic prosthesis. The incorporation of other additional elements in the silicate network such as fluorine, magnesium, iron, silver, potassium, or zinc has been shown, as the local delivery of these ions is able to enhance specific cell functions. Although hip and knee prostheses present a high success rate, bacterial infections -mainly implant associated- are serious and frequent complications. Infection can also develop after implantation of hip prostheses, the elimination of which means more surgeries for the patient and additional costs for the clinic. Prosthesis-related infection is a severe complication of orthopedic surgery, which often causes prolonged illness, pain, and functional loss. While international efforts are made to reduce the risk of these infections, orthopedic surgical infections (SSIs) continue to occur in high numbers. It is currently estimated that up to 2.5% of primary hip and knee surgeries and up to 20% of revision arthroplasties are complicated by periprosthetic joint infection (PJIs). According to some authors, these numbers are underestimated, and they are also increasing. Staphylococcus aureus is the leading cause of both SSIs and PJIs, and the prevalence of methicillin-resistant S. aureus (MRSA) is on the rise, particularly in the United States. These deep infections lead to implant removal and consequently increase morbidity and mortality. The study targets this clinical problem using our experience so far with the Ag-doped polymer coatings on Titanium implants. Non-modified or modified (e.g., doped with antibacterial agents, like Ag) bioactive glasses could play a role in the prevention of infections or the therapy of infected tissues. Bioactive glasses have excellent biocompatibility, proved by in vitro cell culture studies of human osteoblast-like MG-63 cells. Ag-doped bioactive glass-scaffold has a good antibacterial ability against Escherichia coli and other bacteria. It may be concluded that these scaffolds have great potential in the prevention and therapy of implant-associated bone infection.

Keywords: antibacterial agents, bioactive glass, hip and knee prosthesis, medical implants

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1139 Double Functionalization of Magnetic Colloids with Electroactive Molecules and Antibody for Platelet Detection and Separation

Authors: Feixiong Chen, Naoufel Haddour, Marie Frenea-Robin, Yves MéRieux, Yann Chevolot, Virginie Monnier

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Neonatal thrombopenia occurs when the mother generates antibodies against her baby’s platelet antigens. It is particularly critical for newborns because it can cause coagulation troubles leading to intracranial hemorrhage. In this case, diagnosis must be done quickly to make platelets transfusion immediately after birth. Before transfusion, platelet antigens must be tested carefully to avoid rejection. The majority of thrombopenia (95 %) are caused by antibodies directed against Human Platelet Antigen 1a (HPA-1a) or 5b (HPA-5b). The common method for antigen platelets detection is polymerase chain reaction allowing for identification of gene sequence. However, it is expensive, time-consuming and requires significant blood volume which is not suitable for newborns. We propose to develop a point-of-care device based on double functionalized magnetic colloids with 1) antibodies specific to antigen platelets and 2) highly sensitive electroactive molecules in order to be detected by an electrochemical microsensor. These magnetic colloids will be used first to isolate platelets from other blood components, then to capture specifically platelets bearing HPA-1a and HPA-5b antigens and finally to attract them close to sensor working electrode for improved electrochemical signal. The expected advantages are an assay time lower than 20 min starting from blood volume smaller than 100 µL. Our functionalization procedure based on amine dendrimers and NHS-ester modification of initial carboxyl colloids will be presented. Functionalization efficiency was evaluated by colorimetric titration of surface chemical groups, zeta potential measurements, infrared spectroscopy, fluorescence scanning and cyclic voltammetry. Our results showed that electroactive molecules and antibodies can be immobilized successfully onto magnetic colloids. Application of a magnetic field onto working electrode increased the detected electrochemical signal. Magnetic colloids were able to capture specific purified antigens extracted from platelets.

Keywords: Magnetic Nanoparticles , Electroactive Molecules, Antibody, Platelet

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1138 Crime Prevention with Artificial Intelligence

Authors: Mehrnoosh Abouzari, Shahrokh Sahraei

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Today, with the increase in quantity and quality and variety of crimes, the discussion of crime prevention has faced a serious challenge that human resources alone and with traditional methods will not be effective. One of the developments in the modern world is the presence of artificial intelligence in various fields, including criminal law. In fact, the use of artificial intelligence in criminal investigations and fighting crime is a necessity in today's world. The use of artificial intelligence is far beyond and even separate from other technologies in the struggle against crime. Second, its application in criminal science is different from the discussion of prevention and it comes to the prediction of crime. Crime prevention in terms of the three factors of the offender, the offender and the victim, following a change in the conditions of the three factors, based on the perception of the criminal being wise, and therefore increasing the cost and risk of crime for him in order to desist from delinquency or to make the victim aware of self-care and possibility of exposing him to danger or making it difficult to commit crimes. While the presence of artificial intelligence in the field of combating crime and social damage and dangers, like an all-seeing eye, regardless of time and place, it sees the future and predicts the occurrence of a possible crime, thus prevent the occurrence of crimes. The purpose of this article is to collect and analyze the studies conducted on the use of artificial intelligence in predicting and preventing crime. How capable is this technology in predicting crime and preventing it? The results have shown that the artificial intelligence technologies in use are capable of predicting and preventing crime and can find patterns in the data set. find large ones in a much more efficient way than humans. In crime prediction and prevention, the term artificial intelligence can be used to refer to the increasing use of technologies that apply algorithms to large sets of data to assist or replace police. The use of artificial intelligence in our debate is in predicting and preventing crime, including predicting the time and place of future criminal activities, effective identification of patterns and accurate prediction of future behavior through data mining, machine learning and deep learning, and data analysis, and also the use of neural networks. Because the knowledge of criminologists can provide insight into risk factors for criminal behavior, among other issues, computer scientists can match this knowledge with the datasets that artificial intelligence uses to inform them.

Keywords: artificial intelligence, criminology, crime, prevention, prediction

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1137 On the Survival of Individuals with Type 2 Diabetes Mellitus in the United Kingdom: A Retrospective Case-Control Study

Authors: Njabulo Ncube, Elena Kulinskaya, Nicholas Steel, Dmitry Pshezhetskiy

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Life expectancy in the United Kingdom (UK) has been near constant since 2010, particularly for the individuals of 65 years and older. This trend has been also noted in several other countries. This slowdown in the increase of life expectancy was concurrent with the increase in the number of deaths caused by non-communicable diseases. Of particular concern is the world-wide exponential increase in the number of diabetes related deaths. Previous studies have reported increased mortality hazards among diabetics compared to non-diabetics, and on the differing effects of antidiabetic drugs on mortality hazards. This study aimed to estimate the all-cause mortality hazards and related life expectancies among type 2 diabetes (T2DM) patients in the UK using the time-variant Gompertz-Cox model with frailty. The study also aimed to understand the major causes of the change in life expectancy growth in the last decade. A total of 221 182 (30.8% T2DM, 57.6% Males) individuals aged 50 years and above, born between 1930 and 1960, inclusive, and diagnosed between 2000 and 2016, were selected from The Health Improvement Network (THIN) database of the UK primary care data and followed up to 31 December 2016. About 13.4% of participants died during the follow-up period. The overall all-cause mortality hazard ratio of T2DM compared to non-diabetic controls was 1.467 (1.381-1.558) and 1.38 (1.307-1.457) when diagnosed between 50 to 59 years and 60 to 74 years, respectively. The estimated life expectancies among T2DM individuals without further comorbidities diagnosed at the age of 60 years were 2.43 (1930-1939 birth cohort), 2.53 (1940-1949 birth cohort) and 3.28 (1950-1960 birth cohort) years less than those of non-diabetic controls. However, the 1950-1960 birth cohort had a steeper hazard function compared to the 1940-1949 birth cohort for both T2DM and non-diabetic individuals. In conclusion, mortality hazards for people with T2DM continue to be higher than for non-diabetics. The steeper mortality hazard slope for the 1950-1960 birth cohort might indicate the sub-population contributing to a slowdown in the growth of the life expectancy.

Keywords: T2DM, Gompetz-Cox model with frailty, all-cause mortality, life expectancy

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1136 Bioefficacy of Ocimum sanctum on Survival, Development and Reproduction of Dengue Vector Aedes aegypti L. (Diptera: Culicidae)

Authors: Mohd Shazad, K. K. Gupta

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Vector borne diseases are a serious global concern. Aedes aegypti, the primary vector for viruses that cause dengue fever, dengue haemorrhagic fever, chikungunya and yellow fever is widespread over large areas of the tropics and subtropics. In last decade, diseases transmitted by Aedes aegypti are of serious concern. In past decade, number of cases of dengue fever, dengue hemorrhagic fever, and chikungunya has increased multifold. Present research work focused on impact of ethanol extract of Ocimum sanctum on dengue vector Aedes aegypti. 0-24 hr. old fourth instar larvae of lab-bred population of Aedes aegypti were exposed to ethanol leaf extract of Ocimum with concentrations ranging from 50 ppm to 400 ppm. Survival and development and the treated larvae and reproductive behaviour of the adults emerged from the treated larvae was evaluated. Our results indicated larvicidal potential of the leaf ethanol extract. The influence of the extract was dose dependent. 77.2% mortality was observed in the larvae exposed to 400 ppm for 24 hr. Treatment at lower concentrations revealed delayed toxicity. The larvae survived after treatment showed severe developmental anomalies. Consequently, there was the significant increase in duration of fourth instar larva. The L4 treated with 400-ppm extract moulted after 4.6 days; this was in sharp contrast to control where the larval period of the fourth instar lasts three days. The treated fourth instar larvae in many cases transformed into larva-pupa intermediates with the combination of larva, pupa characters. The larva-pupa intermediates had reduced life span and failed to moult successfully. The adults emerged from the larvae treated with lower doses had reduced reproductive potential. The females exhibited longer preoviposition period, reduced oviposition rate, abnormal oviposition behaviour and decreased fertility. Our studies indicated the possibility of the presence of JH mimic or JH analogue in the leaf ethanol extract of Ocimum. The present research work explored the potentials of Ocimum sanctum, also known as the queen of herbs, in integrated vector management programme of Aedes aegypti, which is a serious threat to human health.

Keywords: Aedes aegypti, development, mortality, Ocimum sanctum reproduction

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1135 Ammonia Cracking: Catalysts and Process Configurations for Enhanced Performance

Authors: Frea Van Steenweghen, Lander Hollevoet, Johan A. Martens

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Compared to other hydrogen (H₂) carriers, ammonia (NH₃) is one of the most promising carriers as it contains 17.6 wt% hydrogen. It is easily liquefied at ≈ 9–10 bar pressure at ambient temperature. More importantly, NH₃ is a carbon-free hydrogen carrier with no CO₂ emission at final decomposition. Ammonia has a well-defined regulatory framework and a good track record regarding safety concerns. Furthermore, the industry already has an existing transport infrastructure consisting of pipelines, tank trucks and shipping technology, as ammonia has been manufactured and distributed around the world for over a century. While NH₃ synthesis and transportation technological solutions are at hand, a missing link in the hydrogen delivery scheme from ammonia is an energy-lean and efficient technology for cracking ammonia into H₂ and N₂. The most explored option for ammonia decomposition is thermo-catalytic cracking which is, by itself, the most energy-efficient approach compared to other technologies, such as plasma and electrolysis, as it is the most energy-lean and robust option. The decomposition reaction is favoured only at high temperatures (> 300°C) and low pressures (1 bar) as the thermocatalytic ammonia cracking process is faced with thermodynamic limitations. At 350°C, the thermodynamic equilibrium at 1 bar pressure limits the conversion to 99%. Gaining additional conversion up to e.g. 99.9% necessitates heating to ca. 530°C. However, reaching thermodynamic equilibrium is infeasible as a sufficient driving force is needed, requiring even higher temperatures. Limiting the conversion below the equilibrium composition is a more economical option. Thermocatalytic ammonia cracking is documented in scientific literature. Among the investigated metal catalysts (Ru, Co, Ni, Fe, …), ruthenium is known to be most active for ammonia decomposition with an onset of cracking activity around 350°C. For establishing > 99% conversion reaction, temperatures close to 600°C are required. Such high temperatures are likely to reduce the round-trip efficiency but also the catalyst lifetime because of the sintering of the supported metal phase. In this research, the first focus was on catalyst bed design, avoiding diffusion limitation. Experiments in our packed bed tubular reactor set-up showed that extragranular diffusion limitations occur at low concentrations of NH₃ when reaching high conversion, a phenomenon often overlooked in experimental work. A second focus was thermocatalyst development for ammonia cracking, avoiding the use of noble metals. To this aim, candidate metals and mixtures were deposited on a range of supports. Sintering resistance at high temperatures and the basicity of the support were found to be crucial catalyst properties. The catalytic activity was promoted by adding alkaline and alkaline earth metals. A third focus was studying the optimum process configuration by process simulations. A trade-off between conversion and favorable operational conditions (i.e. low pressure and high temperature) may lead to different process configurations, each with its own pros and cons. For example, high-pressure cracking would eliminate the need for post-compression but is detrimental for the thermodynamic equilibrium, leading to an optimum in cracking pressure in terms of energy cost.

Keywords: ammonia cracking, catalyst research, kinetics, process simulation, thermodynamic equilibrium

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1134 Pathway Linking Early Use of Electronic Device and Psychosocial Wellbeing in Early Childhood

Authors: Rosa S. Wong, Keith T.S. Tung, Winnie W. Y. Tso, King-Wa Fu, Nirmala Rao, Patrick Ip

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Electronic devices have become an essential part of our lives. Various reports have highlighted the alarming usage of electronic devices at early ages and its long-term developmental consequences. More sedentary screen time was associated with increased adiposity, worse cognitive and motor development, and psychosocial health. Apart from the problems caused by children’s own screen time, parents today are often paying less attention to their children due to hand-held device. Some anecdotes suggest that distracted parenting has negative impact on parent-child relationship. This study examined whether distracted parenting detrimentally affected parent-child activities which may, in turn, impair children’s psychosocial health. In 2018/19, we recruited a cohort of preschoolers from 32 local kindergartens in Tin Shui Wai and Sham Shui Po for a 5-year programme aiming to build stronger foundations for children from disadvantaged backgrounds through an integrated support model involving medical, education and social service sectors. A comprehensive set of questionnaires were used to survey parents on their frequency of being distracted while parenting and their frequency of learning and recreational activities with children. Furthermore, they were asked to report children’s screen time amount and their psychosocial problems. Mediation analyses were performed to test the direct and indirect effects of electronic device-distracted parenting on children’s psychosocial problems. This study recruited 873 children (448 females and 425 males, average age: 3.42±0.35). Longer screen time was associated with more psychosocial difficulties (Adjusted B=0.37, 95%CI: 0.12 to 0.62, p=0.004). Children’s screen time positively correlated with electronic device-distracted parenting (r=0.369, p < 01). We also found that electronic device-distracted parenting was associated with more hyperactive/inattentive problems (Adjusted B=0.66, p < 0.01), fewer prosocial behavior (Adjusted B=-0.74, p < 0.01), and more emotional symptoms (Adjusted B=0.61, p < 0.001) in children. Further analyses showed that electronic device-distracted parenting exerted influences both directly and indirectly through parent-child interactions but to different extent depending upon the outcome under investigation (38.8% for hyperactivity/inattention, 31.3% for prosocial behavior, and 15.6% for emotional symptoms). We found that parents’ use of devices and children’s own screen time both have negative effects on children’s psychosocial health. It is important for parents to set “device-free times” each day so as to ensure enough relaxed downtime for connecting with children and responding to their needs.

Keywords: early childhood, electronic device, psychosocial wellbeing, parenting

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1133 The Future Control Rooms for Sustainable Power Systems: Current Landscape and Operational Challenges

Authors: Signe Svensson, Remy Rey, Anna-Lisa Osvalder, Henrik Artman, Lars Nordström

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The electric power system is undergoing significant changes. Thereby, the operation and control are becoming partly modified, more multifaceted and automated, and thereby supplementary operator skills might be required. This paper discusses developing operational challenges in future power system control rooms, posed by the evolving landscape of sustainable power systems, driven in turn by the shift towards electrification and renewable energy sources. A literature review followed by interviews and a comparison to other related domains with similar characteristics, a descriptive analysis was performed from a human factors perspective. Analysis is meant to identify trends, relationships, and challenges. A power control domain taxonomy includes a temporal domain (planning and real-time operation) and three operational domains within the power system (generation, switching and balancing). Within each operational domain, there are different control actions, either in the planning stage or in the real-time operation, that affect the overall operation of the power system. In addition to the temporal dimension, the control domains are divided in space between a multitude of different actors distributed across many different locations. A control room is a central location where different types of information are monitored and controlled, alarms are responded to, and deviations are handled by the control room operators. The operators’ competencies, teamwork skills, team shift patterns as well as control system designs are all important factors in ensuring efficient and safe electricity grid management. As the power system evolves with sustainable energy technologies, challenges are found. Questions are raised regarding whether the operators’ tacit knowledge, experience and operation skills of today are sufficient to make constructive decisions to solve modified and new control tasks, especially during disturbed operations or abnormalities. Which new skills need to be developed in planning and real-time operation to provide efficient generation and delivery of energy through the system? How should the user interfaces be developed to assist operators in processing the increasing amount of information? Are some skills at risk of being lost when the systems change? How should the physical environment and collaborations between different stakeholders within and outside the control room develop to support operator control? To conclude, the system change will provide many benefits related to electrification and renewable energy sources, but it is important to address the operators’ challenges with increasing complexity. The control tasks will be modified, and additional operator skills are needed to perform efficient and safe operations. Also, the whole human-technology-organization system needs to be considered, including the physical environment, the technical aids and the information systems, the operators’ physical and mental well-being, as well as the social and organizational systems.

Keywords: operator, process control, energy system, sustainability, future control room, skill

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1132 The Use of Artificial Intelligence in Digital Forensics and Incident Response in a Constrained Environment

Authors: Dipo Dunsin, Mohamed C. Ghanem, Karim Ouazzane

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Digital investigators often have a hard time spotting evidence in digital information. It has become hard to determine which source of proof relates to a specific investigation. A growing concern is that the various processes, technology, and specific procedures used in the digital investigation are not keeping up with criminal developments. Therefore, criminals are taking advantage of these weaknesses to commit further crimes. In digital forensics investigations, artificial intelligence is invaluable in identifying crime. It has been observed that an algorithm based on artificial intelligence (AI) is highly effective in detecting risks, preventing criminal activity, and forecasting illegal activity. Providing objective data and conducting an assessment is the goal of digital forensics and digital investigation, which will assist in developing a plausible theory that can be presented as evidence in court. Researchers and other authorities have used the available data as evidence in court to convict a person. This research paper aims at developing a multiagent framework for digital investigations using specific intelligent software agents (ISA). The agents communicate to address particular tasks jointly and keep the same objectives in mind during each task. The rules and knowledge contained within each agent are dependent on the investigation type. A criminal investigation is classified quickly and efficiently using the case-based reasoning (CBR) technique. The MADIK is implemented using the Java Agent Development Framework and implemented using Eclipse, Postgres repository, and a rule engine for agent reasoning. The proposed framework was tested using the Lone Wolf image files and datasets. Experiments were conducted using various sets of ISA and VMs. There was a significant reduction in the time taken for the Hash Set Agent to execute. As a result of loading the agents, 5 percent of the time was lost, as the File Path Agent prescribed deleting 1,510, while the Timeline Agent found multiple executable files. In comparison, the integrity check carried out on the Lone Wolf image file using a digital forensic tool kit took approximately 48 minutes (2,880 ms), whereas the MADIK framework accomplished this in 16 minutes (960 ms). The framework is integrated with Python, allowing for further integration of other digital forensic tools, such as AccessData Forensic Toolkit (FTK), Wireshark, Volatility, and Scapy.

Keywords: artificial intelligence, computer science, criminal investigation, digital forensics

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1131 Insights on the Social-Economic Implications of the Blue Economy Concept on Coastal Tourism in Tonga

Authors: Amelia Faotusia

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The blue economy concept was coined by Pacific nations in recognition of the importance of sustainably managing their extensive marine territories. This is especially important for major ocean-based economic sectors of Pacific economies, such as coastal tourism. There is an absence of research, however, on the key ways in which the blue economy concept has emerged in discourse and public policy in Pacific countries, as well as how it articulates with coastal tourism. This research helps to fill such a gap with a specific focus on Tonga through the application of a post-positivist research approach to conduct a desktop study of relevant national documents and qualitative interviews with relevant government staff, civil society organizations, and tourism operators. The findings of the research reflect the importance of institutional integration and partnerships for a successful blue economy transition and are presented in the form of two case studies corresponding to two sub-sectors of Tonga’s coastal tourism sector: (i) the whale-watching and swimming industry, and (ii) beach resorts and restaurants. A thematic analysis applied to the interview data of both cases then enabled the identification of key areas and issues for socio-economic policy intervention and recommendations in support of blue economy transitions in Tonga’s coastal tourism sector. Examples of the relevant areas and issues that emerged included the importance of foreign direct investment, local market access, community-based special management areas, as well as the need to address the anthropogenic impacts of tropical cyclones, whale tourism, plastic litter on coastal assets, and ecosystems. Policy and practical interventions in support of addressing such issues include a proposed restructuring of the whale-watching and swimming licensing system; integration of climate resilience, adaptation, and capacity building as priorities of local blue economy interventions; as well as strengthening of the economic sustainability dimension of blue economy policies. Finally, this research also revealed the need for further specificity and research on the influence and value of local Tongan culture and traditional knowledge, particularly within existing customary marine tenure systems, on Tonga’s national and sectoral blue economy policies and transitions.

Keywords: blue economy, coastal tourism, integrated ocean management, ecosystem resilience

Procedia PDF Downloads 91
1130 Economic Analysis of Post-Harvest Losses in Plantain (and Banana): A Case Study of South Western Nigeria

Authors: O. R. Adeniyi, A. Ayandiji

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Losses are common in most vegetables because the fruit ripens rapidly and most plantain products can only be stored for a few days thereby limiting their utilization. Plantain (and banana) is highly perishable at the ambient temperature prevalent in the tropics. The specific objective of this study is to identify the socioeconomic characteristics of banana/plantain dealers and determine the perceived effect of the losses incurred in the process of marketing banana/plantain. The study was carried out in Ondo and Lagos states of south-western Nigeria. Purposive sampling technique was used to collect information from “Kolawole plantain depot”, the point of purchase in Ondo State and “Alamutu plantain market” in Mushin the point of sales in Lagos state. Preliminary study was conducted with the use of primary data collected through well-structured questionnaires administered on 60 respondents and 55 fully completed ones analysed. Budgeting, gross margin and multiple linear regression were used for analyses. Most merchants were found to be in the middle age class (30-50 years), majority of whom were female and completed their secondary school education, with eighty percent having more than 5 years’ experience of in banana/plantain marketing. The highest losses were incurred during transportation and these losses constitute about 5.62 percent of the potential total revenue. On the average, loss in gross margin is about ₦6,000.00 per merchant. The impacts of these losses are reflected in the continuously reducing level of their income. Age of the respondents played a major role in determining the level of care in the handling of the fruits. The middle age class tends to be more favoured. In conclusion, the merchants need adequate and sustainable transportation and storage facilities as a matter of utmost urgency. There is the need for government to encourage producers of the product (farmers) by giving them motivating incentives and ensuring that the environment is made conducive also for dealers by providing adequate storage facilities and ready markets locally and possibly for export.

Keywords: post-harvest, losses, plantain, banana, simple regression

Procedia PDF Downloads 319
1129 Assessment of Post-surgical Donor-Site Morbidity in Vastus lateralis Free Flap for Head and Neck Reconstructive Surgery: An Observational Study

Authors: Ishith Seth, Lyndel Hewitt, Takako Yabe, James Wykes, Jonathan Clark, Bruce Ashford

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Background: Vastus lateralis (VL) can be used to reconstruct defects of the head and neck. Whilst the advantages are documented, donor-site morbidity is not well described. This study aimed to assess donor-site morbidity after VL flap harvest. The results will determine future directions for preventative and post-operative care to improve patient health outcomes. Methods: Ten participants (mean age 55 years) were assessed for the presence of donor-site morbidity after VL harvest. Musculoskeletal (pain, muscle strength, muscle length, tactile sensation), quality of life (SF-12), and lower limb function (lower extremity function, gait (function and speed), sit to stand were assessed using validated and standardized procedures. Outcomes were compared to age-matched healthy reference values or the non-operative side. Analyses were conducted using descriptive statistics and non-parametric tests. Results: There was no difference in muscle strength (knee extension), muscle length, ability to sit-to-stand, or gait function (all P > 0.05). Knee flexor muscle strength was significantly less on the operated leg compared to the non-operated leg (P=0.02) and walking speed was slower than age-matched healthy values (P<0.001). Thigh tactile sensation was impaired in 89% of participants. Quality of life was significantly less for the physical health component of the SF-12 (P<0.001). The mental health component of the SF-12 was similar to healthy controls (P=0.26). Conclusion: There was no effect on donor site morbidity with regards to knee extensor strength, pain, walking function, ability to sit-to-stand, and muscle length. VL harvest affected donor-site knee flexion strength, walking speed, tactile sensation, and physical health-related quality of life.

Keywords: vastus lateralis, morbidity, head and neck, surgery, donor-site morbidity

Procedia PDF Downloads 242
1128 To Allow or to Forbid: Investigating How Europeans Reason about Endorsing Rights to Minorities: A Vignette Methodology Based Cross-Cultural Study

Authors: Silvia Miele, Patrice Rusconi, Harriet Tenenbaum

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An increasingly multi-ethnic Europe has been pushing citizens’ boundaries on who should be entitled and to what extent to practise their own diversity. Indeed, according to a Standard Eurobarometer survey conducted in 2017, immigration is seen by Europeans as the most serious issue facing the EU, and a third of respondents reported they do not feel comfortable interacting with migrants from outside the EU. Many of these come from Muslim countries, accounting for 4.9% of Europe population in 2016. However, the figure is projected to rise up to 14% by 2050. Additionally, political debates have increasingly focused on Muslim immigrants, who are frequently portrayed as difficult to integrate, while nationalist parties across Europe have fostered the idea of insuperable cultural differences, creating an atmosphere of hostility. Using a 3 X 3 X 2 between-subjects design, it was investigated how people reason about endorsing religious and non-religious rights to minorities. An online survey has been administered to university students of three different countries (Italy, Spain and the UK) via Qualtrics, presenting hypothetical scenarios through a vignette methodology. Each respondent has been randomly allocated to one of the three following conditions: Christian, Muslim or non-religious (vegan) target. Each condition entailed three questions about children self-determination rights to exercise some control over their own lives and 3 questions about children nurturance rights of care and protection. Moreover, participants have been required to further elaborate on their answers via free-text entries and have been asked about their contact and quality of contact with the three targets, and to self-report religious, national and ethnic identification. Answers have been recorded on a Likert scale of 1-5, 1 being "not at all", 5 being "very much". A two-way ANCOVA will be used to analyse answers to closed-ended questions, while free-text answers will be coded and data will be dichotomised based on Social Cognitive Domain Theory for four categories: moral, social conventional and psychological reasons, and analysed via ANCOVAs. This study’s findings aim to contribute to the implementation of educational interventions and speak to the introduction of governmental policies on human rights.

Keywords: children's rights, Europe, migration, minority

Procedia PDF Downloads 129
1127 A Focused, High-Intensity Spread-Spectrum Ultrasound Solution to Prevent Biofouling

Authors: Alan T. Sassler

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Biofouling is a significant issue for ships, especially those based in warm water ports. Biofouling damages hull coatings, degrades platform hydrodynamics, blocks cooling water intakes, and returns, reduces platform range and speed, and increases fuel consumption. Although platforms are protected to some degree by antifouling paints, these paints are much less effective on stationary platforms, and problematic biofouling can occur on antifouling paint-protected stationary platforms in some environments in as little as a matter of weeks. Remediation hull cleaning operations are possible, but they are very expensive, sometimes result in damage to the vessel’s paint or hull and are generally not completely effective. Ultrasound with sufficient intensity focused on specific frequency ranges can be used to prevent the growth of biofouling organisms. The use of ultrasound to prevent biofouling isn't new, but systems to date have focused on protecting platforms by shaking the hull using internally mounted transducers similar to those used in ultrasonic cleaning machines. While potentially effective, this methodology doesn't scale well to large platforms, and there are significant costs associated with installing and maintaining these systems, which dwarf the initial purchase price. An alternative approach has been developed, which uses highly directional pier-mounted transducers to project high-intensity spread-spectrum ultrasonic energy into the water column focused near the surface. This focused energy has been shown to prevent biofouling at ranges of up to 50 meters from the source. Spreading the energy out over a multi-kilohertz band makes the system both more effective and more environmentally friendly. This system has been shown to be both effective and inexpensive in small-scale testing and is now being characterized on a larger scale in selected marinas. To date, test results have been collected in Florida marinas suggesting that this approach can be used to keep ensonified areas of thousands of square meters free from biofouling, although care must be taken to minimize shaded areas.

Keywords: biofouling, ultrasonic, environmentally friendly antifoulant, marine protection, antifouling

Procedia PDF Downloads 60
1126 Tea and Its Working Methodology in the Biomass Estimation of Poplar Species

Authors: Pratima Poudel, Austin Himes, Heidi Renninger, Eric McConnel

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Populus spp. (poplar) are the fastest-growing trees in North America, making them ideal for a range of applications as they can achieve high yields on short rotations and regenerate by coppice. Furthermore, poplar undergoes biochemical conversion to fuels without complexity, making it one of the most promising, purpose-grown, woody perennial energy sources. Employing wood-based biomass for bioenergy offers numerous benefits, including reducing greenhouse gas (GHG) emissions compared to non-renewable traditional fuels, the preservation of robust forest ecosystems, and creating economic prospects for rural communities.In order to gain a better understanding of the potential use of poplar as a biomass feedstock for biofuel in the southeastern US, the conducted a techno-economic assessment (TEA). This assessment is an analytical approach that integrates technical and economic factors of a production system to evaluate its economic viability. the TEA specifically focused on a short rotation coppice system employing a single-pass cut-and-chip harvesting method for poplar. It encompassed all the costs associated with establishing dedicated poplar plantations, including land rent, site preparation, planting, fertilizers, and herbicides. Additionally, we performed a sensitivity analysis to evaluate how different costs can affect the economic performance of the poplar cropping system. This analysis aimed to determine the minimum average delivered selling price for one metric ton of biomass necessary to achieve a desired rate of return over the cropping period. To inform the TEA, data on the establishment, crop care activities, and crop yields were derived from a field study conducted at the Mississippi Agricultural and Forestry Experiment Station's Bearden Dairy Research Center in Oktibbeha County and Pontotoc Ridge-Flatwood Branch Experiment Station in Pontotoc County.

Keywords: biomass, populus species, sensitivity analysis, technoeconomic analysis

Procedia PDF Downloads 83
1125 Impact of Electric Field on the Optical Properties of Hydrophilic Quantum Dots

Authors: Valentina V. Goftman, Vladislav A. Pankratov, Alexey V. Markin, Tangi Aubert, Zeger Hens, Sarah De Saeger, Irina Yu. Goryacheva

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The most important requirements for biochemical applicability of quantum dots (QDs) are: 1) the surface cap should render intact or improved optical properties; 2) mono-dispersion and good stability in aqueous phase in a wide range of pH and ionic strength values; 3) presence of functional groups, available for bioconjugation; 4) minimal impact from the environment on the QDs’ properties and, vice versa, minimal influence of the QDs’ components on the environment; and 5) stability against chemical/biochemical/physical influence. The latter is especially important for in vitro and in vivo applications. For example, some physical intracellular delivery strategies (e.g., electroporation) imply a rapid high-voltage electric field impulse in order to temporarily generate hydrophilic pores in the cell plasma membrane, necessary for the passive transportation of QDs into the cell. In this regard, it is interesting to investigate how different capping layers, which can provide high stability and sufficient fluorescent properties of QDs in a water solution, behave under these abnormal conditions. In this contribution, hydrophobic core-shell CdSe/CdS/CdZnS/ZnS QDs (λem=600 nm), produced by means of the Successive Ion Layer Adsorption and Reaction (SILAR) technique, were transferred to a water solution using two of the most commonly used methods: (i) encapsulation in an amphiphilic brush polymer based on poly(maleic anhydride-alt-1-octadecene) (PMAO) modified with polyethylene glycol (PEG) chains and (ii) silica covering. Polymer encapsulation preserves the initial ligands on the QDs’ surface owing to the hydrophobic attraction between the hydrophobic groups of the amphiphilic molecules and the surface hydrophobic groups of the QDs. This covering process allows maintaining the initial fluorescent properties, but it leads to a considerable increase of the QDs’ size. However, covering with a silica shell, by means of the reverse microemulsion method, allows maintaining both size and fluorescent properties of the initial QDs. The obtained water solutions of polymer covered and silica-coated QDs in three different concentrations were exposed to a low-voltage electric field for a short time and the fluorescent properties were investigated. It is shown that the PMAO-PEG polymer acquires some additional charges in the presence of the electric field, which causes repulsion between the polymer and the QDs’ surface. This process destroys the homogeneity of the whole amphiphilic shell and it dramatically decreases the fluorescent properties (dropping to 10% from its initial value) because of the direct contact of the QDs with the strongly oxidative environment (water). In contrast, a silica shell possesses dielectric properties which allow retaining 90% of its initial fluorescence intensity, even after a longer electric impact. Thus, silica shells are clearly a preferable covering for bio-application of QDs, because – besides the high uniform morphology, controlled size and biocompatibility – it allows protecting QDs from oxidation, even under the influence of an electric field.

Keywords: electric field, polymer coating, quantum dots, silica covering, stability

Procedia PDF Downloads 458
1124 A Practical Approach Towards Disinfection Challenges in Sterile Manufacturing Area

Authors: Doris Lacej, Eni Bushi

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Cleaning and disinfection procedures are essential for maintaining the cleanliness status of the pharmaceutical manufacturing environment particularly of the cleanrooms and sterile unit area. The Good Manufacturing Practice (GMP) Annex 1 recommendation highly requires the implementation of the standard and validated cleaning and disinfection protocols. However, environmental monitoring has shown that even a validated cleaning method with certified agents may result in the presence of atypical microorganisms’ colony that exceeds GMP limits for a specific cleanroom area. In response to this issue, this case study aims to arrive at the root cause of the microbial contamination observed in the sterile production environment in Profarma pharmaceutical industry in Albania through applying a problem-solving practical approach that ensures the appropriate sterility grade. The guidelines and literature emphasize the importance of several factors in the prevention of possible microbial contamination occurring in cleanrooms, grade A and C. These factors are integrated into a practical framework, to identify the root cause of the presence of Aspergillus Niger colony in the sterile production environment in Profarma pharmaceutical industry in Albania. In addition, the application of a semi-automatic disinfecting system such as H2O2 FOG into sterile grade A and grade C cleanrooms has been an effective solution in eliminating the atypical colony of Aspergillus Niger. Selecting the appropriate detergents and disinfectants at the right concentration, frequency, and combination; the presence of updated and standardized guidelines for cleaning and disinfection as well as continuous training of operators on these practices in accordance with the updated GMP guidelines are some of the identified factors that influence the success of achieving sterility grade. However, to ensure environmental sustainability it is important to be prepared for identifying the source of contamination and making the appropriate decision. The proposed case-based practical approach may help pharmaceutical companies to achieve sterile production and cleanliness environmental sustainability in challenging situations. Apart from the integration of valid agents and standardized cleaning and disinfection protocols according to GMP Annex 1, pharmaceutical companies must be careful and investigate the source and all the steps that can influence the results of an abnormal situation. Subsequently apart from identifying the root cause it is important to solve the problem with a successful alternative approach.

Keywords: cleanrooms, disinfectants, environmental monitoring, GMP Annex 1

Procedia PDF Downloads 216
1123 Design and Implementation of Generative Models for Odor Classification Using Electronic Nose

Authors: Kumar Shashvat, Amol P. Bhondekar

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In the midst of the five senses, odor is the most reminiscent and least understood. Odor testing has been mysterious and odor data fabled to most practitioners. The delinquent of recognition and classification of odor is important to achieve. The facility to smell and predict whether the artifact is of further use or it has become undesirable for consumption; the imitation of this problem hooked on a model is of consideration. The general industrial standard for this classification is color based anyhow; odor can be improved classifier than color based classification and if incorporated in machine will be awfully constructive. For cataloging of odor for peas, trees and cashews various discriminative approaches have been used Discriminative approaches offer good prognostic performance and have been widely used in many applications but are incapable to make effectual use of the unlabeled information. In such scenarios, generative approaches have better applicability, as they are able to knob glitches, such as in set-ups where variability in the series of possible input vectors is enormous. Generative models are integrated in machine learning for either modeling data directly or as a transitional step to form an indeterminate probability density function. The algorithms or models Linear Discriminant Analysis and Naive Bayes Classifier have been used for classification of the odor of cashews. Linear Discriminant Analysis is a method used in data classification, pattern recognition, and machine learning to discover a linear combination of features that typifies or divides two or more classes of objects or procedures. The Naive Bayes algorithm is a classification approach base on Bayes rule and a set of qualified independence theory. Naive Bayes classifiers are highly scalable, requiring a number of restraints linear in the number of variables (features/predictors) in a learning predicament. The main recompenses of using the generative models are generally a Generative Models make stronger assumptions about the data, specifically, about the distribution of predictors given the response variables. The Electronic instrument which is used for artificial odor sensing and classification is an electronic nose. This device is designed to imitate the anthropological sense of odor by providing an analysis of individual chemicals or chemical mixtures. The experimental results have been evaluated in the form of the performance measures i.e. are accuracy, precision and recall. The investigational results have proven that the overall performance of the Linear Discriminant Analysis was better in assessment to the Naive Bayes Classifier on cashew dataset.

Keywords: odor classification, generative models, naive bayes, linear discriminant analysis

Procedia PDF Downloads 387
1122 A Prospective Audit to Look into Antimicrobial Prescribing in the Clinical Setting: In a Teaching Hospital in the UK

Authors: Richa Sinha, Mohammad Irfan Javed, Sanjay Singh

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Introduction: Good antimicrobial prescribing reduces length of stay in hospital, risk of adverse events, antimicrobial resistance, and unnecessary hospital expenditure. The aim of this prospective audit was to identify any problems with antimicrobial prescribing including documentation of the relevant aspects as well as appropriateness of antibiotics use. The audit was conducted on the surgical wards in a teaching hospital in the UK. Methods: Standards included the indication, duration, choice, and prescription of antibiotic should be in line with current Regional Guidelines and should be clearly documented on the prescription chart. There should be an entry in each patients’ medical record of the diagnosis and indication for each acute antibiotic prescription issued. All prescriptions should clearly document the route, frequency and dose of antibiotic. Data collection was done for 2 weeks in the month of March 2014. A proforma including all the questions above was completed for all the patients. The results were analysed using Excel. Results: 35 patients in total were selected for the audit. 85.7% of patients had indication of antibiotic documented on the prescription chart and 68.5% of patients had indication documented in the notes. The antibiotic used was in line with hospital guidelines in 45.7% of patients, however, in a further 28.5% of patients the reason for the antibiotic prescription was microbiology approved. Therefore, in total 74.2% of patients had been prescribed appropriate antibiotics. The duration of antibiotic was documented in 68.6% of patients and the antibiotic was reviewed in 37.1% of patients. The dose, frequency and route was documented clearly in 100% of patients. Conclusion: Overall, prescribing can be improved on the surgical wards in this hospital. Only 37.1% of patients had clear documentation of a review of antibiotics. It may be that antibiotics have been reviewed but this should be clearly highlighted on the prescription chart or the notes. Failure to review antibiotics can lead to poor patient care and antimicrobial resistance and therefore it is important to address this. It is also important to address the appropriateness of antibiotics as inappropriate antibiotic prescription can lead to failure of treatment as well as antimicrobial resistance. The good points from the audit was that all patients had clear documentation of dose, route and frequency which is extremely important in the administration of antibiotics. Recommendations from this audit included to emphasize good antimicrobial prescribing at induction (twice yearly), an antimicrobial handbook for junior doctors, and re-audit in 6 months time.

Keywords: prescribing, antimicrobial, indication, duration

Procedia PDF Downloads 303
1121 A Review on Silicon Based Induced Resistance in Plants against Insect Pests

Authors: Asim Abbasi, Muhammad Sufyan, Muhammad Kamran, Iqra

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Development of resistance in insect pests against various groups of insecticides has prompted the use of alternative integrated pest management approaches. Among these induced host plant resistance represents an important strategy as it offers a practical, cheap and long lasting solution to keep pests populations below economic threshold level (ETL). Silicon (Si) has a major role in regulating plant eco-relationship by providing strength to the plant in the form of anti-stress mechanism which was utilized in coping with the environmental extremes to get a better yield and quality end produce. Among biotic stresses, insect herbivore signifies one class against which Si provide defense. Silicon in its neutral form (H₄SiO₄) is absorbed by the plants via roots through an active process accompanied by the help of different transporters which were located in the plasma membrane of root cells or by a passive process mostly regulated by transpiration stream, which occurs via the xylem cells along with the water. Plants tissues mainly the epidermal cell walls are the sinks of absorbed silicon where it polymerizes in the form of amorphous silica or monosilicic acid. The noteworthy function of this absorbed silicon is to provide structural rigidity to the tissues and strength to the cell walls. Silicon has both direct and indirect effects on insect herbivores. Increased abrasiveness and hardness of epidermal plant tissues and reduced digestibility as a result of deposition of Si primarily as phytoliths within cuticle layer is now the most authenticated mechanisms of Si in enhancing plant resistance to insect herbivores. Moreover, increased Si content in the diet also impedes the efficiency by which insects transformed consumed food into the body mass. The palatability of food material has also been changed by Si application, and it also deters herbivore feeding for food. The production of defensive compounds of plants like silica and phenols have also been amplified by the exogenous application of silicon sources which results in reduction of the probing time of certain insects. Some studies also highlighted the role of silicon at the third trophic level as it also attracts natural enemies of insects attacking the crop. Hence, the inclusion of Si in pest management approaches can be a healthy and eco-friendly tool in future.

Keywords: defensive, phytoliths, resistance, stresses

Procedia PDF Downloads 188
1120 The Effectiveness of the Recovering from Child Abuse Programme (RCAP) for the Treatment of CPTSD: A Pilot Study

Authors: Siobhan Hegarty, Michael Bloomfield, Kim Entholt, Dorothy Williams, Helen Kennerley

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Complex Post-Traumatic Stress Disorder (CPTSD) confers greater risk of poor outcomes than does Post-Traumatic Stress Disorder (PTSD). Despite this, the current treatment guidelines for CPTSD aim to reduce only the ‘core’ symptoms of re-experiencing, hyper-vigilance and avoidance, while not addressing the Disturbances of Self Organisation (DSO) symptoms that distinguish this novel diagnosis from PTSD. The Recovering from Child Abuse Programme (RCAP) is a group protocol, based on the principles of cognitive behavioural therapy (CBT). Preliminary evidence suggests the program is effective at reducing DSO symptoms. This pilot study is the first to investigate the potential effectiveness of the RCAP for the specific treatment of CPTSD. This study was conducted as a service evaluation in a secondary care, traumatic stress service. Treatment was delivered once a week, in two-hour sessions, to ten existing female CPTSD patients of the service, who had experienced sexual abuse in childhood. The programme was administered by two therapists and two additional facilitators, following the RCAP protocol manual. Symptom severity was measured before the administration of therapy and was tracked across a range of measures (International Trauma Questionnaire; Patient Health Questionnaire; Community Assessment of Psychic Experience; Work and Social Adjustment Scale) at five time points, over the course of treatment. Qualitative appraisal of the programme was gathered via weekly feedback forms and from audio-taped recordings of verbal feedback given during group sessions. Preliminary results suggest the programme causes a slight reduction in CPTSD and depressive symptom severity and preliminary qualitative analysis suggests that the RCAP is both helpful and acceptable to group members. Final results and conclusions will follow completed thematic analysis of results.

Keywords: Child sexual abuse, Cognitive behavioural therapy, Complex post-traumatic stress disorder, Recovering from child abuse programme

Procedia PDF Downloads 135
1119 Barriers to Health Promotion Advice Delivered by Paramedics and Emergency Department Nurses – Promoted Study

Authors: B. Schofield, F. Gul, S. McClean, R. Hoskins, R. Terry, U. Rolfe, A. Gibson, S. Voss, J. Benger

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Aim: The aim of this study is to determine whether and how health promotion activities are undertaken by paramedics and emergency department nurses and investigate ways of overcoming potential barriers. Background: Paramedics and emergency department nurses are uniquely placed to reach millions of people and could use these contacts as positive opportunities to help people improve their health by identifying people with risk factors and provide information, brief interventions, and signposting to locally provided services. These interventions can be carried out when the opportunity arises, typically take no more than a few minutes, have a low financial cost and can be a highly efficient method of health promotion. Methodology: Three NHS Emergency Departments and four Ambulance Trusts in England were recruited to the study. A link to an online survey was distributed to paramedics and emergency department nurses at participating sites. Staff were invited to participate in virtual semi-structured interviews. Patients seen, treated, and discharged at the participating sites were invited to virtual semistructured interviews. Findings: A total of 331 survey responses were received, 21 virtual semi-structured staff interviews and 11 patient interviews were completed. Staff reported lack of time to prioritise, lack of knowledge, resources, and confidence as barriers. Receptiveness of patients guided their decision to undertake health promotion activities. They reported a desire to learn how to undertake health promotion conversations. Emergency department nurses felt more supported than paramedics by their organisations to undertake health promotion activities. Patients were not aware of health promotion activities and reported fear and lack of privacy as barriers. Conclusions: These results will guide the development of an intervention to support the provision of health promotion by staff in urgent and emergency care settings. The components of the intervention will be mapped to a framework which will consider the needs of staff working within these settings, patients they treat, and organisational issues and practices related to the implementation of such an intervention.

Keywords: emergency service, hospital, nursing, allied health personnel, emergency medical services, health promotion

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1118 Apathetic Place, Hostile Space: A Qualitative Study on the Ability of Immigration Detention in the UK to Promote the Health and Dignity of Detainees

Authors: P. Dhesi, R. Burns

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Background: The UK has one of the largest immigration detention estates in Europe and is under increasing scrutiny, particularly regarding the lack of transparency over the use of detention and the conditions. Therefore, this research seeks to explore the professional perceptions of the ability of immigration detention in the UK to promote health and dignity. Methods: A phenomenological approach to qualitative methods were used, with social constructivist theorisations of health and dignity. Seven semi-structured interviews were conducted using Microsoft Teams. Participants included a range of immigration detention stakeholders who have visited closed immigration detention centres in the UK in a professional capacity. Recorded interviews were transcribed verbatim, and analysis was data-driven through inductive reflexive thematic analysis of the entire data set to account for the small sample size. This study received ethical approval from University College London Research Ethics Committee. Results: Two global themes were created through analysis: apathetic place and hostile space. Apathetic place discusses the lack of concern for detainees' daily living and healthcare needs within immigration detention in the UK. This is explored through participants' perceptions of the lack of ability of monitoring and evaluation processes to ensure detainees are able to live with dignity and understand the unfulfilled duty of care that exists in detention. Hostile space discusses immigration detention in the UK as a wider system of hostility. This is explored through the disempowering impact on detainees, the perception of a failing system as a result of inadequate safeguarding procedures, and a belief that the intention of immigration detention is misaligned with its described purpose. Conclusion: This research explains why the current immigration detention system in the UK is unable to promote health and dignity, offering a social justice and action-orientated approach to research in this sphere. The findings strengthen the discourse against the use of detention as an immigration control tool in the UK. Implications for further research include a stronger emphasis on investigating alternatives to detention and culturally considerate opportunities for patient-centred healthcare.

Keywords: access to healthcare, dignity, health, immigration detention, migrant, refugee, UK

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1117 Water Supply and Demand Analysis for Ranchi City under Climate Change Using Water Evaluation and Planning System Model

Authors: Pappu Kumar, Ajai Singh, Anshuman Singh

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There are different water user sectors such as rural, urban, mining, subsistence and commercial irrigated agriculture, commercial forestry, industry, power generation which are present in the catchment in Subarnarekha River Basin and Ranchi city. There is an inequity issue in the access to water. The development of the rural area, construction of new power generation plants, along with the population growth, the requirement of unmet water demand and the consideration of environmental flows, the revitalization of small-scale irrigation schemes is going to increase the water demands in almost all the water-stressed catchment. The WEAP Model was developed by the Stockholm Environment Institute (SEI) to enable evaluation of planning and management issues associated with water resources development. The WEAP model can be used for both urban and rural areas and can address a wide range of issues including sectoral demand analyses, water conservation, water rights and allocation priorities, river flow simulation, reservoir operation, ecosystem requirements and project cost-benefit analyses. This model is a tool for integrated water resource management and planning like, forecasting water demand, supply, inflows, outflows, water use, reuse, water quality, priority areas and Hydropower generation, In the present study, efforts have been made to access the utility of the WEAP model for water supply and demand analysis for Ranchi city. A detailed works have been carried out and it was tried to ascertain that the WEAP model used for generating different scenario of water requirement, which could help for the future planning of water. The water supplied to Ranchi city was mostly contributed by our study river, Hatiya reservoir and ground water. Data was collected from various agencies like PHE Ranchi, census data of 2011, Doranda reservoir and meteorology department etc. This collected and generated data was given as input to the WEAP model. The model generated the trends for discharge of our study river up to next 2050 and same time also generated scenarios calculating our demand and supplies for feature. The results generated from the model outputs predicting the water require 12 million litter. The results will help in drafting policies for future regarding water supplies and demands under changing climatic scenarios.

Keywords: WEAP model, water demand analysis, Ranchi, scenarios

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1116 Process of Production of an Artisanal Brewery in a City in the North of the State of Mato Grosso, Brazil

Authors: Ana Paula S. Horodenski, Priscila Pelegrini, Salli Baggenstoss

Abstract:

The brewing industry with artisanal concepts seeks to serve a specific market, with diversified production that has been gaining ground in the national environment, also in the Amazon region. This growth is due to the more demanding consumer, with a diversified taste that wants to try new types of beer, enjoying products with new aromas, flavors, as a differential of what is so widely spread through the big industrial brands. Thus, through qualitative research methods, the study aimed to investigate how is the process of managing the production of a craft brewery in a city in the northern State of Mato Grosso (BRAZIL), providing knowledge of production processes and strategies in the industry. With the efficient use of resources, it is possible to obtain the necessary quality and provide better performance and differentiation of the company, besides analyzing the best management model. The research is descriptive with a qualitative approach through a case study. For the data collection, a semi-structured interview was elaborated, composed of the areas: microbrewery characterization, artisan beer production process, and the company supply chain management. Also, production processes were observed during technical visits. With the study, it was verified that the artisan brewery researched develops preventive maintenance strategies with the inputs, machines, and equipment, so that the quality of the product and the production process are achieved. It was observed that the distance from the supplying centers makes the management of processes and the supply chain be carried out with a longer planning time so that the delivery of the final product is satisfactory. The production process of the brewery is composed of machines and equipment that allows the control and quality of the product, which the manager states that for the productive capacity of the industry and its consumer market, the available equipment meets the demand. This study also contributes to highlight one of the challenges for the development of small breweries in front of the market giants, that is, the legislation, which fits the microbreweries as producers of alcoholic beverages. This makes the micro and small business segment to be taxed as a major, who has advantages in purchasing large batches of raw materials and tax incentives because they are large employers and tax pickers. It was possible to observe that the supply chain management system relies on spreadsheets and notes that are done manually, which could be simplified with a computer program to streamline procedures and reduce risks and failures of the manual process. In relation to the control of waste and effluents affected by the industry is outsourced and meets the needs. Finally, the results showed that the industry uses preventive maintenance as a productive strategy, which allows better conditions for the production and quality of artisanal beer. The quality is directly related to the satisfaction of the final consumer, being prized and performed throughout the production process, with the selection of better inputs, the effectiveness of the production processes and the relationship with the commercial partners.

Keywords: artisanal brewery, production management, production processes, supply chain

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1115 The Practice and Research of Computer-Aided Language Learning in China

Authors: Huang Yajing

Abstract:

Context: Computer-aided language learning (CALL) in China has undergone significant development over the past few decades, with distinct stages marking its evolution. This paper aims to provide a comprehensive review of the practice and research in this field in China, tracing its journey from the early stages of audio-visual education to the current multimedia network integration stage. Research Aim: The study aims to analyze the historical progression of CALL in China, identify key developments in the field, and provide recommendations for enhancing CALL practices in the future. Methodology: The research employs document analysis and literature review to synthesize existing knowledge on CALL in China, drawing on a range of sources to construct a detailed overview of the evolution of CALL practices and research in the country. Findings: The review highlights the significant advancements in CALL in China, showcasing the transition from traditional audio-visual educational approaches to the current integrated multimedia network stage. The study identifies key milestones, technological advancements, and theoretical influences that have shaped CALL practices in China. Theoretical Importance: The evolution of CALL in China reflects not only technological progress but also shifts in educational paradigms and theories. The study underscores the significance of cognitive psychology as a theoretical underpinning for CALL practices, emphasizing the learner's active role in the learning process. Data Collection and Analysis Procedures: Data collection involved extensive review and analysis of documents and literature related to CALL in China. The analysis was carried out systematically to identify trends, developments, and challenges in the field. Questions Addressed: The study addresses the historical development of CALL in China, the impact of technological advancements on teaching practices, the role of cognitive psychology in shaping CALL methodologies, and the future outlook for CALL in the country. Conclusion: The review provides a comprehensive overview of the evolution of CALL in China, highlighting key stages of development and emerging trends. The study concludes by offering recommendations to further enhance CALL practices in the Chinese context.

Keywords: English education, educational technology, computer-aided language teaching, applied linguistics

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