Search results for: cardiovascular disease risk
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9192

Search results for: cardiovascular disease risk

1842 Implementing the Quality of Care Partnership to Reduce the Cost of Screenings for Sexually Transmitted Infections on a Southeastern College Campus

Authors: Amy Guidera, Steven Busby, Christian Williams, David Phillippi

Abstract:

College students are a priority preventative healthcare population that can engage in high-risk behaviors which may concurrently increase the potential for unsafe sexual practices, including contracting sexually transmitted infections (STIs). Early education, screening, treatment, and partner notification are important interventions for breaking the chain of transmission and recurrence in relation to preventing poor health outcomes and mitigating college dropout rates. The aim of this quality improvement project was to determine if the reduction in STI screening costs for college students (aged 18-30 years old) would increase the amount of STI screenings conducted at a university health center over the course of an academic semester while evaluating our ability to achieve an improved quality of care at a reduced cost, along with improved STI reporting and documentation. This study was conducted through retrospective chart reviews of STI-related visits and utilized the RADAR matrix to provide a guiding, iterative mechanism to continuously reassess goals and outcomes defined in a memorandum of agreement (MOA) between a university health center and the state department of health (DOH) laboratory. The project failed to increase the amount of STI screenings, most likely due to the emergence of COVID-19, but resulted in improved quality of care for students, improved STI-related visit documentation and reporting, and significantly reduced costs for STI screening for collegiate students at a southeastern private university campus.

Keywords: college health, college students, preventive health, reproductive health, sexually transmitted infections, young adults

Procedia PDF Downloads 135
1841 Use of Dual-Energy CT Post Endovascular Treatment of Cerebral Aneurysm

Authors: Mitchell Stanton

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Background: Endovascular management is well established as a mainstay treatment option for cerebral aneurysms. It is also well established that immediate post procedural imaging can be difficult to interpret due to the presence of contrast material. However, through the use of Dual-Energy computed tomography, it has become possible to differentiate contrast extravasation and intracranial haemorrhage. This case illustrates the importance of this technology following endovascular treatment of an unruptured cerebral aneurysm. Case Presentation: A 79-year-old female was found to have an unruptured large intracavernous ICA fusiform aneurysm on CT Brain Angiogram after presenting with acute ophthalmoplegia. This ophthalmoplegia was caused by mass effect from the aneurysm and subsequently the aneurysm was treated with an endovascular flow diverting stent. CT brain was performed post operatively due to a reduced level of consciousness and this showed diffuse subarachnoid hyperdensity of the left hemisphere. The use of Dual-Energy CT allowed accurate differentiation and illustrated diffuse contrast material extravasation, allowing patient to continue on dual-antiplatelets and therapeutic anticoagulation to reduce the risk of ischaemic injury post endovascular stent. Conclusion: Endovascular treatment options for management of intracranial aneurysms are constantly evolving. The use of Dual-Energy CT therefore has an integral role in accurately diagnosing any post-operative complications. Specifically, differentiating between subarachnoid haemorrhage and contrast extravasation is vital in these patients due to the significant consequences to their ongoing management in regards to continuation or cessation of antiplatelets or anticoagulation. With increasing access to this technology, its use should become standard practice in the post-operative investigation of these patients undergoing endovascular treatment.

Keywords: aneurysm, computed tomography, contrast extravasation, dual-energy CT, endovascular, subarachnoid haemorrhage

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1840 Optimizing Nitrogen Fertilizer Application in Rice Cultivation: A Decision Model for Top and Ear Dressing Dosages

Authors: Ya-Li Tsai

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Nitrogen is a vital element crucial for crop growth, significantly influencing crop yield. In rice cultivation, farmers often apply substantial nitrogen fertilizer to maximize yields. However, excessive nitrogen application increases the risk of lodging and pest infestation, leading to yield losses. Additionally, conventional flooded irrigation methods consume significant water resources, necessitating precise agricultural and intelligent water management systems. In this study, it leveraged physiological data and field images captured by unmanned aerial vehicles, considering fertilizer treatment and irrigation as key factors. Statistical models incorporating rice physiological data, yield, and vegetation indices from image data were developed. Missing physiological data were addressed using multiple imputation and regression methods, and regression models were established using principal component analysis and stepwise regression. Target nitrogen accumulation at key growth stages was identified to optimize fertilizer application, with the difference between actual and target nitrogen accumulation guiding recommendations for ear dressing dosage. Field experiments conducted in 2022 validated the recommended ear dressing dosage, demonstrating no significant difference in final yield compared to traditional fertilizer levels under alternate wetting and drying irrigation. These findings highlight the efficacy of applying recommended dosages based on fertilizer decision models, offering the potential for reduced fertilizer use while maintaining yield in rice cultivation.

Keywords: intelligent fertilizer management, nitrogen top and ear dressing fertilizer, rice, yield optimization

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1839 Biorisk Management Education for Undergraduates Studying Clinical Microbiology at University in Japan

Authors: Shuji Fujimoto, Fumiko Kojima, Mika Shigematsu

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Biorisk management (Biosafety/Biosecurity) is required for anyone working in a clinical laboratory (including medical/clinical research laboratories) where infectious agents and potentially hazardous biological materials are examined/stored. Proper education and training based on international standards of biorisk management should be provided not only as a part of laboratory safety program in work place but also as a part of introductory training at educational institutions for continuity and to elevate overall baseline of the biorisk management. We reported results of the pilot study of biorisk management education for graduate students majored in laboratory diagnostics previously. However, postgraduate education is still late in their profession and the participants’ interview also revealed importance and demands of earlier biorisk management education for undergraduates. The aim of this study is to identify the need for biosafety/biosecurity education and training program which is designed for undergraduate students who are entering the profession in clinical microbiology. We modified the previous program to include more basic topics and explanations (risk management, principles of safe clinical lab practices, personal protective equipment, disinfection, disposal of biological substances) and provided incorporating in the routine educational system for faculty of medical sciences in Kyushu University. The results of the pre and post examinations showed that the knowledge of the students on biorisk control had developed effectively as a proof of effectiveness of the program even in the undergraduate students. Our study indicates that administrating the basic biorisk management program in the earlier stage of learning will add positive impact to the understanding of biosafety to the health professional education.

Keywords: biorisk management, biosafety, biosecurity, clinical microbiology, education for undergraduates

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1838 Acceptance of Health Information Application in Smart National Identity Card (SNIC) Using a New I-P Framework

Authors: Ismail Bile Hassan, Masrah Azrifah Azmi Murad

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

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

Procedia PDF Downloads 467
1837 The Use of Microbiological Methods to Reduce Aflatoxin M1 in Cheese

Authors: Bruna Goncalves, Jennifer Henck, Romulo Uliana, Eliana Kamimura, Carlos Oliveira, Carlos Corassin

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Studies have shown evidence of human exposure to aflatoxin M1 due to the consumption of contaminated milk and dairy products (mainly cheeses). This poses a great risk to public health, since milk and milk products are frequently consumed by a portion of the population considered immunosuppressed, children and the elderly. Knowledge of the negative impacts of aflatoxins on health and economics has led to investigations of strategies to prevent their formation in food, as well as to eliminate, inactivate or reduce the bioavailability of these toxins in contaminated products This study evaluated the effect of microbiological methods using lactic acid bacteria on aflatoxin M1 (AFM1) reduction in Minas Frescal cheese (typical Brazilian product, being among the most consumed cheeses in Brazil) spiked with 1 µg/L AFM1. Inactivated lactic acid bacteria (0,5%, v/v de L. rhamnosus e L. lactis) were added during the cheese production process. Nine cheeses were produced, divided into three treatments: negative controls (without AFM1 or lactic acid bacteria), positive controls (AFM1 only), and lactic acid bacteria + AFM1. Samples of cheese were collected on days 2, 10, 20 and 30 after the date of production and submitted to composition analyses and determination of AFM1 by high-performance liquid chromatography. The reductions of AFM1 in cheese by lactic acid bacteria at the end of the trial indicate a potential application of inactivated lactic acid bacteria in reducing the bioavailability of AFM1 in Minas frescal cheese without physical-chemical and microbiological modifications during the 30-day experimental period. The authors would like to thank São Paulo Research Foundation – FAPESP (grants #2017/20081-6 and #2017/19683-1).

Keywords: aflatoxin, milk, minas frescal cheese, decontamination

Procedia PDF Downloads 194
1836 Development of a Myocardial Patch with 3D Hydrogel Electrical Stimulation System

Authors: Yung-Gi Chen, Pei-Leun Kang, Yu-Hsin Lin, Shwu-Jen Chang

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Myocardial tissue has limited self-repair ability due to its loss of differentiation characteristic for most mature cardiomyocytes. Therefore, the effective use of stem cell technology in regenerative medicine is an important development to alleviate the current difficulties in cardiac disease treatment. The main purpose of this project was to develop a 3-D hydrogel electrical stimulating system for promoting the differentiation of stem cells into myocardial cells, and the patch will be used to repair damaged myocardial tissue. This project was focused on the preparation of the electrical stimulation system with carbon/CaCl₂ electrodes covered with carbon nanotube-hydrogel. In this study, we utilized screen imprinting techniques and used Poly(lactic-co-glycolic acid)(PLGA) membranes as printing substrates to fabricate a carbon/CaCl₂ interdigitated electrode that covered with alginate/carbon nanotube hydrogels. The single-walled carbon nanotube was added in the hydrogel to enhance the mechanical strength and conductivity of hydrogel. In this study, we used PLGA (85:15) as electrode preparing substrate. The CaCl₂/ EtOH solution (80% w/v) was mixed into carbon paste to prepare various concentration calcium-containing carbon paste (2.5%, 5%, 7.5%, 10% v/v). Different concentrations of alginate (1%, 1.5%, 2% v/v) and SWCNT(Diameter < 2nm, length between 5-15μm) (1, 1.5, 3 mg/ml) are gently immobilized on the electrode by cross-linking with calcium chloride. The three-dimensional hydrogel electrode was tested for its redox efficiency by cyclic voltammetry to determine the optimal parameters for the hydrogel electrode preparation. From the result of the final electrodes, it indicated that the electrode was not easy to maintain the pattern of the interdigitated electrode when the concentration of calcium of chloride was more than 10%. According to the gel rate test and cyclic voltammetry experiment results showed the SWCNT could increase the electron conduction of hydrogel electrodes significantly. So far the 3D electrode system has been completed, 2% alginate mixed with 3mg SWCNT is the optimal condition to construct the most complete structure for the hydrogel preparation.

Keywords: myocardial tissue engineering, screen printing technology, poly (lactic-co-glycolic acid), alginate, single walled carbon nanotube

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1835 Evaluation of Heavy Metal Contamination and Assessment of the Suitability of Water for Irrigation: A Case Study of the Sand River, Limpopo Province, South Africa

Authors: Ngonidzashe Moyo, Mmaditshaba Rapatsa

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The primary objective of this study was to determine heavy metal contamination in the water, sediment, grass and fish in Sand River, South Africa. This river passes through an urban area and sewage effluent is discharged into it. Water from the Sand river is subsequently used for irrigation downstream of the sewage treatment works. The suitability of this water and the surrounding boreholes for irrigation was determined. This study was undertaken between January, 2014 and January, 2015. Monthly samples were taken from four sites. Sites 1 was upstream of the Polokwane Wastewater Treatment Plant, sites 2, 3 and 4 were downstream. Ten boreholes in the vicinity of the Sand River were randomly selected and the water was tested for heavy metal contamination. The concentration of heavy metals in Sand River water followed the order Mn>Fe>Pb>Cu≥Zn≥Cd. Manganese concentration averaged 0.34 mg/L. Heavy metal concentration in the sediment, grass and fish followed the order Fe>Mn>Zn>Cu>Pb>Cd. The bioaccumulation factor from grass to fish was highest in manganese (19.25), followed by zinc (16.39) and iron (14.14). Soil permeability index (PI) and sodium adsorption ratio (SAR) were used to determine the suitability of Sand River and borehole water for irrigation. The PI index for Sand River water was 75.1% and this indicates that Sand River water is suitable for irrigation of crops. The PI index for the borehole water ranged from 65.8-72.8% and again this indicates suitability of borehole water for crop irrigation. The sodium adsorption ratio also indicated that both Sand River and borehole water were suitable for irrigation. A risk assessment study is recommended to determine the suitability of the fish for human consumption.

Keywords: bioaccumulation, bioavailability, heavy metals, sodium adsorption ratio

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1834 Assessment of Health Literacy and Awareness of Female Residents of Barangay Dagatan, Sabang, and Marauoy Lipa, Batangas on Polycystic Ovarian Syndrome: A Cross-Sectional Study

Authors: Jean Gray C. Achapero, Mary Margareth P. Ancheta, Patricia Anjelika A. Angeles, Shannon Denzel S. Ao Tai, Carl Brandon C. Barlis, Chrislen Mae B. Benavidez

Abstract:

Health literacy and awareness of Polycystic ovarian syndrome (PCOS) is a global issue that is under-addressed in the Philippines. Conducting a thorough review of the country's ability to recognize and comprehend the severity of the syndrome should be undertaken, as early treatment is essential to avoid further disorder complications. This research aims to assess the health literacy and awareness of the female residents of Barangay Dagatan, Sabang, and Marauoy Lipa, Batangas on PCOS. It followed a cross-sectional study, and data gathering was done through a pre-assessment using the Single Item Literacy Screener (SILS) and an online population-based survey questionnaire about PCOS awareness. The participants, as based on the objectives and purposive sampling method, were females aged 18-45 years old. Data were analyzed statistically using STATA 13.1 software. The study showed that 339 (76%) out of 444 respondents passed the SILS meaning the residents have proficient health literacy. Among the 339 respondents, 87% (287) had previous knowledge about PCOS. The respondents showed minimal awareness of PCOS symptoms which could be attributed to its broad spectrum of information. Respondents were shown to be most knowledgeable about PCOS physiology, treatment, beliefs, and its remedies. The respondents’ age had no significant association with their health literacy (p=0.31) and PCOS awareness (p=0.60). A significant association was noted, however, in their educational attainment linked with their health literacy (p=<0.0001) and PCOS awareness (p=0.001). It is suggested that reproductive health education even in the lower year levels must be optimized and Local Government Unit (LGU)/Non-Government Organization (NGO)-held seminars should be conducted for knowledge reinforcement. Reliable health information should be more accessible to the public and clinicians must emphasize the importance of the majority of early screening as part of routine physical examination for women of reproductive age to increase health literacy and awareness about PCOS and actively engage in the management of the disease.

Keywords: age, awareness, educational attainment, health literacy, polycystic ovarian syndrome

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1833 Assets Integrity Management in Oil and Gas Production Facilities through Corrosion Mitigation and Inspection Strategy: A Case Study of Sarir Oilfield

Authors: Iftikhar Ahmad, Youssef Elkezza

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Sarir oilfield is in North Africa. It has facilities for oil and gas production. The assets of the Sarir oilfield can be divided into five following categories, namely: (i) well bore and wellheads; (ii) vessels such as separators, desalters, and gas processing facilities; (iii) pipelines including all flow lines, trunk lines, and shipping lines; (iv) storage tanks; (v) other assets such as turbines and compressors, etc. The nature of the petroleum industry recognizes the potential human, environmental and financial consequences that can result from failing to maintain the integrity of wellheads, vessels, tanks, pipelines, and other assets. The importance of effective asset integrity management increases as the industry infrastructure continues to age. The primary objective of assets integrity management (AIM) is to maintain assets in a fit-for-service condition while extending their remaining life in the most reliable, safe, and cost-effective manner. Corrosion management is one of the important aspects of successful asset integrity management. It covers corrosion mitigation, monitoring, inspection, and risk evaluation. External corrosion on pipelines, well bores, buried assets, and bottoms of tanks is controlled with a combination of coatings by cathodic protection, while the external corrosion on surface equipment, wellheads, and storage tanks is controlled by coatings. The periodic cleaning of the pipeline by pigging helps in the prevention of internal corrosion. Further, internal corrosion of pipelines is prevented by chemical treatment and controlled operations. This paper describes the integrity management system used in the Sarir oil field for its oil and gas production facilities based on standard practices of corrosion mitigation and inspection.

Keywords: assets integrity management, corrosion prevention in oilfield assets, corrosion management in oilfield, corrosion prevention, inspection activities

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1832 Treatment of Premalignant Lesions: Curcumin a Promising Non-Surgical Option

Authors: Heba A. Hazzah, Ragwa M. Farid, Maha M. A. Nasra, Mennatallah Zakria, Magda A. El Massik, Ossama Y. Abdallah

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Introduction: Curcumin (Cur) is a polyphenol derived from the herbal remedy and dietary spice turmeric. It possesses diverse anti-inflammatory and anti-cancer properties following oral or topical administration. The buccal delivery of curcumin can be useful for both systemic and local disease treatments such as gingivitis, periodontal diseases, oral carcinomas, and precancerous oral lesions. Despite of its high activity, it suffers a limited application due to its low oral bioavailability, poor aqueous solubility, and instability. Aim: Preparation and characterization of curcumin solid lipid nanoparticles with a high loading capacity into a mucoadhesive gel for buccal application. Methodology: Curcumin was formulated as nanoparticles using different lipids, namely Gelucire 39/01, Gelucire 50/13, Precirol, Compritol, and Polaxomer 407 as a surfactant. The SLN were dispersed in a mucoadhesive gel matrix to be applied to the buccal mucosa. All formulations were evaluated for their content, entrapment efficiency, particle size, in vitro drug dialysis, ex vivo mucoadhesion test, and ex vivo permeation study using chicken buccal mucosa. Clinical evaluation was conducted on 15 cases suffering oral erythroplakia and erosive lichen planus. Results: The results showed high entrapment efficiency reaching almost 90 % using Gelucire 50, the loaded gel with Cur-SLN showed good adhesion property and 25 minutes in vivo residence time. In addition to stability enhancement for the Cur powder. All formulae did not show any drug permeated however, a significant amount of Cur was retained within the mucosal tissue. Pain and lesion sizes were significantly reduced upon topical treatment. Complete healing was observed after 6 weeks of treatment. Conclusion: These results open a room for the pharmaceutical technology to optimize the use of this golden magical powder to get the best out of it. In addition, the lack of local anti-inflammatory compounds with reduced side effects intensifies the importance of studying natural products for this purpose.

Keywords: curcumin, erythroplakia, mucoadhesive, pain, solid lipid nanoparticles

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1831 The Effect of Vitamin D Supplementation on Prostate Cancer: A Systematic Review and Meta-Analysis of Clinical Trials

Authors: Simin Shahvazi, Sepideh Soltani, Seyed Mehdi Ahmadi, Russell J. De Souza, Amin Salehi-Abargouei

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Background and Objectives: Vitamin D has received attention for its potential to disrupt cancer processes such as attenuating cell proliferation and exacerbating differentiation and apoptosis. However, whether there exists a role for vitamin D in the treatment of prostate cancer specifically remains controversial. We systematically review the literature to assess whether supplementation with vitamin D influences PSA response and overall survival in patients with prostate cancer. Methods: We searched PubMed, Scopus, ISI Web of Science and Google scholar from inception through up to 10 September 2017 for both before-and-after and randomized trials that evaluated the effect of vitamin D supplementation on the prostate specific antigen (PSA) response rate in participants with prostate cancer. The DerSimonian and Laird, inverse-weighted random-effects model was used to pool effect estimates from the studies. Heterogeneity and potential publication bias were evaluated. Subgroup analyses were also performed. Results: Twenty-two studies (16 before-after and 6 randomized controlled trials) were found and included in meta-analysis. The analysis on controlled clinical trials revealed that PSA change from baseline [weighted mean difference (WMD) = -1.66 ng/ml, 95%CI: -0.69, 0.36, P= 0.543)], PSA response (RR=1.18, 95%CI: 0.97, 1.45, P=0.104) and mortality rate (risk ratio (RR) = 1.05, 95% CI: 0.81-1.36; P=0.713) was not significantly different between vitamin D supplementation and placebo groups. Single arm trials revealed that vitamin D supplementation had had a modest effect on PSA response rate: 19% of those enrolled had at least a 50% reduction in PSA by the end of treatment (95% CI: 7% to 31%; p=0.002). Conclusion: We found that vitamin D modestly increases the PSA response rate in single arm studies. No effect on serum PSA levels, PSA response and mortality was seen in randomized controlled clinical trials. It does not seem patients with prostate cancer benefit from vitamin D supplementation.

Keywords: mortality, prostatic neoplasms, PSA response, vitamin D

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1830 Impact of Social Distancing on the Correlation Between Adults’ Participation in Learning and Acceptance of Technology

Authors: Liu Yi Hui

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The COVID-19 pandemic in 2020 has globally affected all aspects of life, with social distancing and quarantine orders causing turmoil and learning in community colleges being temporarily paused. In fact, this is the first time that adult education has faced such a severe challenge. It forces researchers to reflect on the impact of pandemics on adult education and ways to respond. Distance learning appears to be one of the pedagogical tools capable of dealing with interpersonal isolation and social distancing caused by the pandemic. This research aims to examine whether the impact of social distancing during COVID-19 will lead to increased acceptance of technology and, subsequently, an increase in adults ’ willingness to participate in distance learning. The hypothesis that social distancing and the desire to participate in distance learning affects learners’ tendency to accept technology is investigated. Teachers ’ participation in distance education and acceptance of technology are used as adjustment variables with the relationship to “social distancing,” “participation in distance learning,” and “acceptance of technology” of learners. A questionnaire survey was conducted over a period of twelve months for teachers and learners at all community colleges in Taiwan who enrolled in a basic unit course. Community colleges were separated using multi-stage cluster sampling, with their locations being metropolitan, non-urban, south, and east as criteria. Using the G*power software, 660 samples were selected and analyzed. The results show that through appropriate pedagogical strategies or teachers ’ own acceptance of technology, adult learners’ willingness to participate in distance learning could be influenced. A diverse model of participation can be developed, improving adult education institutions’ ability to plan curricula to be flexible to avoid the risk associated with epidemic diseases.

Keywords: social distancing, adult learning, community colleges, technology acceptance model

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1829 Genomic and Transcriptomic Analysis of Antibiotic Resistance Genes in Biological Wastewater Treatment Systems Treating Domestic and Hospital Effluents

Authors: Thobela Conco, Sheena Kumari, Chika Nnadozie, Mahmoud Nasr, Thor A. Stenström, Mushal Ali, Arshad Ismail, Faizal Bux

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The discharge of antibiotics and its residues into the wastewater treatment plants (WWTP’s) create a conducive environment for the development of antibiotic resistant pathogens. This presents a risk of potential dissemination of antibiotic resistant pathogens and antibiotic resistance genes into the environment. It is, therefore, necessary to study the level of antibiotic resistance genes (ARG’s) among bacterial pathogens that proliferate in biological wastewater treatment systems. In the current study, metagenomic and meta-transcriptomic sequences of samples collected from the influents, secondary effluents and post chlorinated effluents of three wastewater treatment plants treating domestic and hospital effluents in Durban, South Africa, were analyzed for profiling of ARG’s among bacterial pathogens. Results show that a variety of ARG’s, mostly, aminoglycoside, β-lactamases, tetracycline and sulfonamide resistance genes were harbored by diverse bacterial genera found at different stages of treatment. A significant variation in diversity of pathogen and ARGs between the treatment plant was observed; however, treated final effluent samples from all three plants showed a significant reduction in bacterial pathogens and detected ARG’s. Both pre- and post-chlorinated samples showed the presence of mobile genetic elements (MGE’s), indicating the inefficiency of chlorination to remove of ARG’s integrated with MGE’s. In conclusion, the study showed the wastewater treatment plant efficiently caused the reduction and removal of certain ARG’s, even though the initial focus was the removal of biological nutrients.

Keywords: antibiotic resistance, mobile genetic elements, wastewater, wastewater treatment plants

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1828 A Framework for Auditing Multilevel Models Using Explainability Methods

Authors: Debarati Bhaumik, Diptish Dey

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Multilevel models, increasingly deployed in industries such as insurance, food production, and entertainment within functions such as marketing and supply chain management, need to be transparent and ethical. Applications usually result in binary classification within groups or hierarchies based on a set of input features. Using open-source datasets, we demonstrate that popular explainability methods, such as SHAP and LIME, consistently underperform inaccuracy when interpreting these models. They fail to predict the order of feature importance, the magnitudes, and occasionally even the nature of the feature contribution (negative versus positive contribution to the outcome). Besides accuracy, the computational intractability of SHAP for binomial classification is a cause of concern. For transparent and ethical applications of these hierarchical statistical models, sound audit frameworks need to be developed. In this paper, we propose an audit framework for technical assessment of multilevel regression models focusing on three aspects: (i) model assumptions & statistical properties, (ii) model transparency using different explainability methods, and (iii) discrimination assessment. To this end, we undertake a quantitative approach and compare intrinsic model methods with SHAP and LIME. The framework comprises a shortlist of KPIs, such as PoCE (Percentage of Correct Explanations) and MDG (Mean Discriminatory Gap) per feature, for each of these three aspects. A traffic light risk assessment method is furthermore coupled to these KPIs. The audit framework will assist regulatory bodies in performing conformity assessments of AI systems using multilevel binomial classification models at businesses. It will also benefit businesses deploying multilevel models to be future-proof and aligned with the European Commission’s proposed Regulation on Artificial Intelligence.

Keywords: audit, multilevel model, model transparency, model explainability, discrimination, ethics

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1827 Economic Analysis of Coffee Cultivation in Kodagu District of Karnataka State, India

Authors: P. S. Dhananjaya Swamy, B. Chinnappa, G. B. Ramesh, Naveen P. Kumar

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Kodagu district is one of the most densely forested districts in the India as around sixty five per cent of geographical areas under tree cover. Nearly 53 per cent of the flora of Kodagu is endemic. The district is also a hotspot of endemic orchids found mainly in the Thadiandamol. Shade grown, eco-friendly coffee farms are perhaps a selected few places on this planet where nature runs wild. The Kodagu accounts for more than 8.8 per cent of floral diversity of Karnataka state. Estimation of unit cost of cultivation plays a vital role in determining the governmental program their market intervention policies. On an average, planters incurred around Rs. 17041 per acre. The extent of production risk was highest among small category of planters (66 %) compared to other two exhibiting production instability. The result shows that, the coffee productivity in medium plantations was 1051.2 kg per acre as against 758.5 and 789.2 kg in the case of small and large plantations. An annual net return per acre was highest in the case of medium planters (Rs. 26109.3) as against Rs. 20566.7 and Rs. 18572.7 in the case of small and large planters. Cost of production was lowest in the case of small planters (Rs. 18.9 per kg of output) followed by medium planters (Rs. 21.2 per kg of output) and large planters (Rs. 22.5 per kg of output). The productivity of coffee is less whenever it is grown under high shade and native tree cover; it is around 6 quintals per acre when compared with low shade conditions, which is around 8.9 quintals per acre, without a significant difference in the amount invested for growing coffee. Net gain was lower by Rs. 15.5 per kg for the planters growing under high shade and native trees cover when compared with low shade and exotic trees cover.

Keywords: coffee, cultivation, economics, Kodagu

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1826 Effects of Intergenerational Social Mobility on General Health, Oral Health and Physical Function among Older Adults in England

Authors: Alejandra Letelier, Anja Heilmann, Richard G. Watt, Stephen Jivraj, Georgios Tsakos

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Background: Socioeconomic position (SEP) influences adult health. People who experienced material disadvantages in childhood or adulthood tend to have higher adult disease levels than their peers from more advantaged backgrounds. Even so, life is a dynamic process and contains a series of transitions that could lead people through different socioeconomic paths. Research on social mobility takes this into account by adopting a trajectory approach, thereby providing a long-term view of the effect of SEP on health. Aim: The aim of this research examines the effects of intergenerational social mobility on adult general health, oral health and functioning in a population aged 50 and over in England. Methods: This study is based on the secondary analysis of data from the English Longitudinal Study of Ageing (ELSA). Using cross-sectional data, nine social trajectories were created based on parental and adult occupational socio-economic position. Regression models were used to estimate the associations between social trajectories and the following outcomes: adult self-rated health, self-rated oral health, oral health related quality of life, total tooth loss and grip strength; while controlling for socio-economic background and health related behaviours. Results: Associations with adult SEP were generally stronger than with childhood SEP, suggesting a stronger influence of proximal rather than distal SEP on health and oral health. Compared to the stable high group, being in the low SEP groups in childhood and adulthood was associated with poorer health and oral health for all examined outcome measures. For adult self-rated health and edentulousness, graded associations with social mobility trajectories were observed. Conclusion: Intergenerational social mobility was associated with self-rated health and total tooth loss. Compared to only those who remained in a low SEP group over time reported worse self-rated oral health and oral health related quality of life, and had lower grip strength measurements. Potential limitations in relation to data quality will be discussed.

Keywords: social determinants of oral health, social mobility, socioeconomic position and oral health, older adults oral health

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1825 Women as Victims of Land Grabbing: Implications for Household Food Security and Livelihoods in Cameroon

Authors: Valentine Ndi

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This multi-sited research will make use of primary and secondary data to understand the multiple implications of land grabbing for local food production and rural livelihoods in Cameroon. Amidst restricted access to land and forest resources, this study will demonstrate how land previously accessed by communities to grow crops and to harvest forest resources is being acquired and transformed into commercial oil palm plantations by Herakles Farms, a US-based company, with Sithe Global Sustainable Oils Cameroon as its local subsidiary. Focusing on selected land grabbing communities in Cameroon, the study uses a feminist political ecology lens to examine the gendered nature in resources access and its impacts for women’s food production in particular, and rural livelihoods in general. The paper will argue that the change in land use particularly erodes women’s rights to access land and forest resources, and in turn negatively affects local food production and rural livelihood in the region. It will show how women in the region play instrumental and dominant roles in ensuring local food production through subsistence and semi-subsistence agriculture but are unfortunately the main losers of territory that the state considers as ‘empty’ or underutilized - and is subjected to appropriation. The paper will conclude that, rural women’s active participation in the decision-making processes concerning the use of and/or allotment of land to foreign investors is indispensable to guarantee local, national and global food security, but also to ensure that alternative livelihood options are provided, particularly to those rural women facing dispossession or at risk of being dispossessed.

Keywords: land grabbing, feminst political ecology, gender, access to resources, rural livelihoods, Cameroon

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1824 Prevalence and Mechanisms of Antibiotic Resistance in Escherichia coli Isolated from Mastitic Dairy Cattle in Canada

Authors: Satwik Majumder, Dongyun Jung, Jennifer Ronholm, Saji George

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Bovine mastitis is the most common infectious disease in dairy cattle, with major economic implications for the dairy industry worldwide. Continuous monitoring for the emergence of antimicrobial resistance (AMR) among bacterial isolates from dairy farms is vital not only for animal husbandry but also for public health. In this study, the prevalence of AMR in 113 Escherichia coli isolates from cases of bovine clinical mastitis in Canada was investigated. Kirby-Bauer disk diffusion test with 18 antibiotics and microdilution method with three heavy metals (copper, zinc, and silver) was performed to determine the antibiotic and heavy-metal susceptibility. Resistant strains were assessed for efflux and ß-lactamase activities besides assessing biofilm formation and hemolysis. Whole-genome sequences for each of the isolates were examined to detect the presence of genes corresponding to the observed AMR and virulence factors. Phenotypic analysis revealed that 32 isolates were resistant to one or more antibiotics, and 107 showed resistance against at least one heavy metal. Quinolones and silver were the most efficient against the tested isolates. Among the AMR isolates, AcrAB-TolC efflux activity and ß-lactamase enzyme activities were detected in 13 and 14 isolates, respectively. All isolates produced biofilm but with different capacities, and 33 isolates showed α-hemolysin activity. A positive correlation (Pearson r = +0.89) between efflux pump activity and quantity of biofilm was observed. Genes associated with aggregation, adhesion, cyclic di-GMP, quorum sensing were detected in the AMR isolates, corroborating phenotype observations. This investigation showed the prevalence of AMR in E. coli isolates from bovine clinical mastitis. The results also suggest the inadequacy of antimicrobials with a single mode of action to curtail AMR bacteria with multiple mechanisms of resistance and virulence factors. Therefore, it calls for combinatorial therapy for the effective management of AMR infections in dairy farms and combats its potential transmission to the food supply chain through milk and dairy products.

Keywords: antimicrobial resistance, E. coli, bovine mastitis, antibiotics, heavy-metals, efflux pump, ß-lactamase enzyme, biofilm, whole-genome sequencing

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1823 Increasing Cervical Screening Uptake during the Covid-19 Pandemic at Lakeside Healthcare, Corby, UK

Authors: Devyani Shete, Sudeep Rai

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Background: The COVID-19 pandemic has caused one of the highest disruptions to the NHS (National Health Service), especially to the fundamental cervical cancer screening service. To prioritize screening response effectively, it is vital to understand the underlying disease risks amongst groups of women who are less likely to resume their screening/follow up at General Practices. The current government target is to have>=80% of women have an adequate test within the previous 3.5 years (ages 25-49) or 5.5 years (ages 50-64). Aims/Objectives: To increase the number of eligible people aged 25-49 attending cervical screening by 5% at Lakeside Healthcare (a General Practice in Corby). Methods: An online survey was posted on the Lakeside Healthcare website to find out what the barriers towards cervical screening were. It was apparent that patients needed more information catered to their responses. 6 informational videos and a “Cervical Screening Guide” were created for Lakeside patients about cervical screening, which were posted on the Healthcare website. Lakeside also started sending reminder texts to those eligible, with a link to a booking form. Results: On 18th January 2022, 69.7% of patients aged 25-49 years (7207) had an adequate cervical screening test in the last 3.5 years. There were 80 total responders to the online survey. In response to “which of the following are reasons why you have not attended screening”, 30% ticked “I kept putting it off/did not get around to it,” and 13% ticked “I was worried it would be painful or daunting.” In response to “which of the following would make you more likely to book an appointment”, 23% ticked “More detailed explanations of what the risks are if I don’t have screening,” and 20% ticked “I would like more information about the test and what the smear entails.” 10% of responders had previous trauma, whilst 28% of responders said the pandemic had impacted them getting a smear. Survey results were used to carry out interventions to increase smear uptake. On 23rdMarch 2022 (after a 2-month period), 75%of patients aged 25-49 (7119) attended the screening, which was a 5.3% increase from January. Discussion/Conclusion: The survey was vital in carrying out the exact interventions that were required for patients to increase screening uptake, as it is important to know what the populations’ needs are in order to create personalized invitations. This helps to optimise response during a pandemic. A HPV self-sample kit at home could be a popular method of dealing with further outbreaks.

Keywords: gynaecology, cervical screening, public health, COVID-19

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1822 Spectrum and Prevalence of Candida Infection in Diabetic Foot Ulcers

Authors: Seyed Reza Aghili, Tahereh Shokohi, Lotfollah Davoodi, Zahra Kashi, Azam Moslemi, Mahdi Abastabar, Iman Haghani, Sabah Mayahi, Asoudeh A.

Abstract:

Introduction: In diabetic foot ulcers, if fungal agents such as Candida species penetrate into the cutaneous or depth of ulcer, can increase the degree of the wound and cause Candia infection and make it more difficult to heal. Material & Methods: A cross-sectional study was performed on 100 diabetic foot ulcer patients in 2020 in Sari, Iran. patient's data and wound grade were recorded in a questionnaire. Candida infection was diagnosed with direct microscopic examination and culture of samples. Colony-PCR molecular method was used for ITS region of DNA and then PCR-RFLP with Msp1 enzyme and using HWP1 specific gene to determine species of Candida agent. Results: Of 100 patients, the mean age 62.1 ± 10.8 years, 95% type 2 diabetes, 83%>10 years duration diabetes, 59% male, 66%> poor education level, 99% married, 52% rural, 95% neuropathic symptoms, 88% using antibiotics, 69%HbA1C >9%, and mean ulcer degree 2.6±1.05 were. Candida infection was seen in 13% of the deep tissue of the wound and 7% cutaneous around the wound. The predominant Candida isolated was C. parapsilosis (71.5%), C .albicans (14.3%). Fungal infections caused by mold fungi were not detected. There was a statistically significant relationship between yeast infection and gender, rural, HbA1C and ulcer degree. Conclusion: Mycological evaluations often are ignored. Candida parapsilosis is the most common infectious agent in these patients and may require specific treatment. Therefore, more attention of physicians to Candida infections particularly, early diagnosis and effective treatment can help faster recovery and prevent amputation.

Keywords: diabetic foot ulcer, candida infection, risk factors, c. parapsilosis

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1821 Women's Use of Maternal Health-Care Services in Hawassa Zuriya Worda: A Qualitative Study of Women's Childbearing Preference Location

Authors: Elin Mordal, Meseret Tsegaye, Hirut Gemeda, Ingeborg Ulvund

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Background: Even the rural-urban gap in the provision of skilled care during childbirth has narrowed, developing countries have the highest percentage of maternal deaths. More important than uncovering deficiencies during pregnancy, is preventing situations of risk during childbirth. The aim of this study was to identify factors women in the rural area consider before they decide where to give birth. Methods: This study utilizes a qualitative descriptive design based on individual interviews with 25 women of childbearing age who has given birth at least once, where women who delivered both at home and a health centre were included. Data collection took place in rural areas around Hawassa Zuriya Worda in Ethiopia February 2015. To identify conditions associated to where women prefer to give birth a thematic analysis was carried out. Result: Experienced risks regarding child birth were the most common reason for women and their families to seek help from skilled birth attendants. Decision-making and planning were identified as a major factor contributing to where women give birth. The women’s position and responsibilities pointed to the fact that women's role is mainly to take care of children and manage the household, while husbands, mother in laws and the elderly are the family members who take most of the decisions. This includes decision about where women give birth. The infrastructure also influences where women choose to give birth. Conclusion: To further improve childbirth care in Hawassa Zuriya Worda it’s important that women get positive experiences, and are met in a safe and supportive way at Health Centers. Challenges appear to women’s autonomy, quality aspects, and infrastructure.

Keywords: childbirth, women, health care utilization, Hawassa Zuriya Worda, Ethiopia, rural area

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1820 Agro-Insurance and Farming Development Opportunities in Georgia

Authors: Tamar Lazariashvili

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Introduction: The agro-insurance has great importance for agricultural development in the country. In the article, the insurance market of the Georgian agricultural sector has been studied, the level of interest of farmers with insurance products and the trend of demand for those products are revealed; also, the importance of insurance is substantiated. Methodology: The following research methods are applied in the presented paper: statistical (selection, grouping, observation, trend) and qualitative research (in-depth interview with farmers). They claim that the main reason for aggravation is the low level of trust, less awareness about the conditions of the insurance contract. In order to eradicate distrust towards agro-insurance, it is recommended to increase awareness of insured farmers in terms of an insurance agreement. In the case of disputable issues between insurance companies and the customers (farmers), it is advisable to enact the Mediation Service, which will be able to protect the rights of insured farmers. Main Findings: Insurance companies prefer to deal with large farmers, the number of them is very small in Georgia as the credit market. The government interference in this sector is also a very cautious topic. However, the government can strengthen the awareness of farmers about the characteristics and advantages of the insurance system in order to increase the number of insured and reduce insurance premiums for farmers. Conclusion: Enactment of agro-insurance will increase the interest and confidence of financial institutions in the farming sector, financial resources will be accessible to the farmers that will facilitate the stable development of the sector in the country. The size of the agro-insurance market in the country should be increased, and the new territories should be covered. The State must have an obligation to ensure the risk of farmers and subsidize insurance companies. Based on the analysis of the insurance market, the conclusions on agro-insurance issues and the relevant recommendations are proposed.

Keywords: Agro-insurance, agricultural product, Agro-market, farming

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1819 Corporate Governance Development in Mongolia: The Role of Professional Accountants

Authors: Ernest Nweke

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The work of Professional Accountants and Corporate governance are synonymous and cannot be divorced from each other. Organizations, profit and non-profit alike cannot implement sound corporate practices without inputs from Professional Accountants. In today’s dynamic corporate world, good corporate governance practice is a sine qua non. More so, following the corporate failures of the past decades like Enron and WorldCom, governments around the world, including Mongolia are becoming more proactive in ensuring sound corporate governance mechanisms. In the past fifteen years, the Mongolian government has taken several measures to establish and strengthen internal corporate governance structures in firms. This paper highlights the role of professional accountants and auditors play in ensuring that good corporate governance mechanisms are entrenched in listed companies in Mongolia. Both primary and secondary data are utilized in this research. In collection of primary data, Delphi method was used, securing responses from only knowledgeable senior employees, top managers, and some CEOs. Using this method, a total of 107 top-level company employees and executives randomly selected from 22 companies were surveyed; maximum of 5 and minimum of 4 from each company. These companies cut across several sectors. It was concluded that Professional Accountants play key roles in setting and maintaining firm governance. They do this by ensuring full compliance with all the requirements of good and sound corporate governance, establishing reporting, monitoring and evaluating standards, assisting in the setting up of proper controls, efficient and effective audit systems, sound fraud risk management and putting in place an overall vision for the enterprise. Companies with effective corporate governance mechanisms are usually strong and fraud-resilient. It was also discovered that companies with big 4 audit firms tend to have better governance structures in Mongolia.

Keywords: accountants, corporate disclosure, corporate failure, corporate governance

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1818 Critical Reading Achievement of Rural Migrant Children in China: The Roles of Educational Expectation

Authors: Liman Zhao, Jianlong Zhang, Mingman Ren, Chuang Wang, Jian Liu

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Rural migrant children have become a fast-growing population in China as a consequence of the large-scale population flow from rural to urban areas in the context of urbanization. In China, the socioeconomic status of migrant children is relatively low in comparison to non-migrant children. Parents of migrant children often work in occupations with long working hours, high labor intensity, and low pay due to their poor academic qualifications. Most migrant children's parents have not received higher education and have no time to read with their children. The family of migrant children usually does not have a good collection of books either, which leads to these children’s insufficient reading and low reading levels. Moreover, migrant children frequently relocate with their parents, and their needs for knowledge and reading are often neglected by schools, which puts migrant children at risk of academic failure in China. Therefore, the academic achievement of rural migrant children has become a focus of education in China. This study explores the relationship between the educational expectation of rural migrant children and their critical reading competence in general and the moderating effect of the difference between parental educational expectation to their children and the children’s own educational expectation. The responses to a survey from 5113 seventh-grade children in a district of the capital city in China revealed that children who moved to cities in grades 4-6 of primary school performed the best in critical reading, and children who moved to cities after middle school showed the worst performance in critical reading. In addition, parents’ educational expectations of their children and their own educational expectations were both significant predictors of rural migrant children’s reading competence. The higher a child's expectations of a degree and the smaller the gap between parents' expectations of a child's education and the child's own education expectations, the better the child's performance in critical reading.

Keywords: educational expectation, critical reading competence, rural migrant children, moderating effect

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1817 The Effects of Orally Administered Bacillus Coagulans and Inulin on Prevention and Progression of Rheumatoid Arthritis in Rats

Authors: Khadijeh Abhari, Seyed Shahram Shekarforoush, Saeid Hosseinzadeh

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Probiotics have been considered as an approach to treat and prevent a wide range of inflammatory diseases. The spore forming probiotic strain Bacillus coagulans has demonstrated anti-inflammatory and immune-modulating effects in both animals and humans. The prebiotic, inulin, also potentially affects the immune system as a result of the change in the composition or fermentation profile of the gastrointestinal microbiota. An in vivo trial was conducted to evaluate the effects of probiotic B. coagulans, and inulin, either separately or in combination, on down regulate immune responses and progression of rheumatoid arthritis using induced arthritis rat model. Forty-eight male Wistar rats were randomly divided into 6 groups and fed as follow: 1) control: Normal healthy rats fed by standard diet, 2) Disease control (RA): Arthritic induced (RA) rats fed by standard diet, 3) Prebiotic (PRE): RA+ 5% w/w long chain inulin, 4) Probiotic (PRO): RA+ 109 spores/day B. coagulans by orogastric gavage, 5) Synbiotic (SYN): RA+ 5% w/w long chain inulin and 109 spores/day B. coagulans and 6) Treatment control: (INDO): RA+ 3 mg/kg/day indomethacin by orogastric gavage. Feeding with mentioned diets started on day 0 and continued to the end of study. On day 14, rats were injected with complete Freund’s adjuvant (CFA) to induce arthritis. Arthritis activity was evaluated by biochemical parameters and paw thickness. Biochemical assay for Fibrinogen (Fn), Serum Amyloid A (SAA), TNF-α and Alpha-1-acid glycoprotein (α1AGp) was performed on day 21, 28 and 35 (1, 2 and 3 weeks post RA induction). Pretreatment with PRE, PRO and SYN diets significantly inhibit SAA and Fn production in arthritic rats (P < 0.001). A significant decrease in production of pro-inflammatory cytokines, TNF-α, was seen in PRE, PRO and SYN groups (P < 0.001) which was similar to the effect of the anti-inflammatory drug Indomethacin. Further, there were no significant anti-inflammatory effects observed following different treatments using α1AGp as a RA indicator. Pretreatment with all supplied diets significantly inhibited the development of paw swelling induced by CFA (P < 0.001). Conclusion: Results of this study support that oral intake of probiotic B. coagulans and inulin are able to improve biochemical and clinical parameters of induced RA in rat.

Keywords: rheumatoid arthritis, bacillus coagulans, inulin, animal model

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1816 Exploring the Types of Infants and Toddlers' Reading Responses in Nursery Centers: A Qualitative Study

Authors: Ming Fang Hsieh

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The purpose of this study was to investigate the reading responses of infants and toddlers across different contexts in nursery centers. The study adopted Sipe’s framework for children’s literacy education to explore the reading behavior of infants and toddlers. The study was conducted at two nurseries. The sample comprised 46 infants and toddlers and 6 caregivers. The methods of data collection included observation of various reading activities, including shared reading in a group, one-on-one reading, and unstructured reading activities, as well as interviews with caregivers. The data obtained through observations and interviews were transcribed and analyzed. The caregivers and the children’s parents signed an informed consent form before the start of the study. There was no risk anticipated during the course of the study. The analysis revealed five types of reading responses exhibited by the infants and toddlers: (1) linguistic- verbally responding to reading, repeating vocabulary, and answering questions; (2) affective- concentrating on reading or requesting for repeated reading, leaning on books, and gazing at caregivers; (3) explosive- children under 18 months were observed manipulating books through their bodies or different movements like flipping, rotating, or tapping on books; (4) social- during unstructured reading context, children were seen interacting with peers or following the rules of reading, sitting properly, and choosing one book at a time; and (5) distracted responses- paying attention to something else instead of reading, walking around, and playing, which was usually observed during shared reading in a group. The study concluded that children’s distraction and explosive reading behaviors may be a part of the process of their emergent reading behavior. As children develop, they demonstrate an increase in verbal responses, improved concentration, and better behavior. The study suggests that adults should continue to provide appropriate reading opportunities beginning from infancy to nurture children’s reading behaviors.

Keywords: reading response, infants and toddlers, early reading, picture books

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1815 Numerical Simulation of the Fractional Flow Reserve in the Coronary Artery with Serial Stenoses of Varying Configuration

Authors: Mariia Timofeeva, Andrew Ooi, Eric K. W. Poon, Peter Barlis

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Atherosclerotic plaque build-up, commonly known as stenosis, limits blood flow and hence oxygen and nutrient supplies to the heart muscle. Thus, assessment of its severity is of great interest to health professionals. Numerical simulation of the fractional flow reserve (FFR) has proved to be well correlated with invasively measured FFR used for physiological assessment of the severity of coronary stenosis in arteries. Atherosclerosis may impact the diseased artery in several locations causing serial stenoses, which is a complicated subset of coronary artery disease that requires careful treatment planning. However, hemodynamic of the serial sequential stenoses in coronary arteries has not been extensively studied. The hemodynamics of the serial stenoses is complex because the stenoses in the series interact and affect the flow through each other. To address this, serial stenoses in a 3.4 mm left anterior descending (LAD) artery are examined in this study. Two diameter stenoses (DS) are considered, 30 and 50 percent of the reference diameter. Serial stenoses configurations are divided into three groups based on the order of the stenoses in the series, spacing between them, and deviation of the stenoses’ symmetry (eccentricity). A patient-specific pulsatile waveform is used in the simulations. Blood flow within the stenotic artery is assumed to be laminar, Newtonian, and incompressible. Results for the FFR are reported. Based on the simulation results, it can be deduced that the larger drop in pressure (smaller value of the FFR) is expected when the percentage of the second stenosis in the series is bigger. Varying the distance between the stenoses affects the location of the maximum drop in the pressure, while the minimal FFR in the artery remains unchanged. Eccentric serial stenoses are characterized by a noticeably larger decrease in pressure through the stenoses and by the development of the chaotic flow downstream of the stenoses. The largest drop in the pressure (about 4% difference compared to the axisymmetric case) is obtained for the serial stenoses, where both the stenoses are highly eccentric with the centerlines deflected to the different sides of the LAD. In conclusion, varying configuration of the sequential serial stenoses results in a different distribution of FFR through the LAD. Results presented in this study provide insight into the clinical assessment of the severity of the coronary serial stenoses, which is proved to depend on the relative position of the stenoses and the deviation of the stenoses’ symmetry.

Keywords: computational fluid dynamics, coronary artery, fractional flow reserve, serial stenoses

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1814 Anti-Corruption Education in Ukraine during Martial Law and in Lithuania during the State of Emergency

Authors: Kateryna Kulyk

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Anti-corruption education is an integral element of the corruption prevention mechanism of any state. Effective implementation of anti-corruption policy is impossible without awareness-raising activities. Information campaigns should target different social groups and aim to reduce tolerance to any form of corruption. Today, Ukraine and Lithuania have all the necessary infrastructure to actively work in this direction. Anti-corruption measures and building a society resistant to corruption are particularly important in the context of martial law in Ukraine and the state of emergency in Lithuania, as these conditions increase the risks of corrupt practices. To implement this area of activity, it is recommended to actively involve all state and local authorities, business representatives, non-governmental organisations, and all interested citizens. As of today, educational institutions, specialised anti-corruption bodies, and the public are already involved in this process. The purpose of the research is to draw public attention to the need and importance of obtaining basic knowledge on combating and preventing corruption, even in a state of emergency or martial law. This topic remains relevant even during the period of a state of emergency or martial law, as the risk of corrupt practices increases during these periods. The study is based on a comprehensive analysis of the anti-corruption policies of Ukraine and Lithuania, sociological research, and our own survey of anti-corruption experts. Legislation, reports of anti-corruption bodies and civil society organisations were analysed. We also conducted an anonymous survey of 13 anti-corruption experts on the most important anti-corruption measures in the countries studied. The main contribution of the research is to draw attention to the problem of low awareness of the population of countries about the importance of anti-corruption education as one of the necessary conditions for reducing corruption practices.

Keywords: corruption, prevention and combating of corruption, education, anti-corruption education, martial law, state of emergency

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1813 Qualitative Modeling of Transforming Growth Factor Beta-Associated Biological Regulatory Network: Insight into Renal Fibrosis

Authors: Ayesha Waqar Khan, Mariam Altaf, Jamil Ahmad, Shaheen Shahzad

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Kidney fibrosis is an anticipated outcome of possibly all types of progressive chronic kidney disease (CKD). Epithelial-mesenchymal transition (EMT) signaling pathway is responsible for production of matrix-producing fibroblasts and myofibroblasts in diseased kidney. In this study, a discrete model of TGF-beta (transforming growth factor) and CTGF (connective tissue growth factor) was constructed using Rene Thomas formalism to investigate renal fibrosis turn over. The kinetic logic proposed by Rene Thomas is a renowned approach for modeling of Biological Regulatory Networks (BRNs). This modeling approach uses a set of constraints which represents the dynamics of the BRN thus analyzing the pathway and predicting critical trajectories that lead to a normal or diseased state. The molecular connection between TGF-beta, Smad 2/3 (transcription factor) phosphorylation and CTGF is modeled using GenoTech. The order of BRN is CTGF, TGF-B, and SMAD3 respectively. The predicted cycle depicts activation of TGF-B (TGF-β) via cleavage of its own pro-domain (0,1,0) and presentation to TGFR-II receptor phosphorylating SMAD3 (Smad2/3) in the state (0,1,1). Later TGF-B is turned off (0,0,1) thereby activating SMAD3 that further stimulates the expression of CTGF in the state (1,0,1) and itself turns off in (1,0,0). Elevated CTGF expression reactivates TGF-B (1,1,0) and the cycle continues. The predicted model has generated one cycle and two steady states. Cyclic behavior in this study represents the diseased state in which all three proteins contribute to renal fibrosis. The proposed model is in accordance with the experimental findings of the existing diseased state. Extended cycle results in enhanced CTGF expression through Smad2/3 and Smad4 translocation in the nucleus. The results suggest that the system converges towards organ fibrogenesis if CTGF remains constructively active along with Smad2/3 and Smad 4 that plays an important role in kidney fibrosis. Therefore, modeling regulatory pathways of kidney fibrosis will escort to the progress of therapeutic tools and real-world useful applications such as predictive and preventive medicine.

Keywords: CTGF, renal fibrosis signaling pathway, system biology, qualitative modeling

Procedia PDF Downloads 179