Search results for: Cost assessment
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11393

Search results for: Cost assessment

3503 Electrochemical Detection of the Chemotherapy Agent Methotrexate in vitro from Physiological Fluids Using Functionalized Carbon Nanotube past Electrodes

Authors: Shekher Kummari, V. Sunil Kumar, K. Vengatajalabathy Gobi

Abstract:

A simple, cost-effective, reusable and reagent-free electrochemical biosensor is developed with functionalized multiwall carbon nanotube paste electrode (f-CNTPE) for the sensitive and selective determination of the important chemotherapeutic drug methotrexate (MTX), which is widely used for the treatment of various cancer and autoimmune diseases. The electrochemical response of the fabricated electrode towards the detection of MTX is examined by cyclic voltammetry (CV), differential pulse voltammetry (DPV) and square wave voltammetry (SWV). CV studies have shown that f-CNTPE electrode system exhibited an excellent electrocatalytic activity towards the oxidation of MTX in phosphate buffer (0.2 M) compared with a conventional carbon paste electrode (CPE). The oxidation peak current is enhanced by nearly two times in magnitude. Applying the DPV method under optimized conditions, a linear calibration plot is achieved over a wide range of concentration from 4.0×10⁻⁷ M to 5.5×10⁻⁶ M with the detection limit 1.6×10⁻⁷ M. further, by applying the SWV method a parabolic calibration plot was achieved starting from a very low concentration of 1.0×10⁻⁸ M, and the sensor could detect as low as 2.9×10⁻⁹ M MTX in 10 s and 10 nM were detected in steady state current-time analysis. The f-CNTPE shows very good selectivity towards the specific recognition of MTX in the presence of important biological interference. The electrochemical biosensor detects MTX in-vitro directly from pharmaceutical sample, undiluted urine and human blood serum samples at a concentration range 5.0×10⁻⁷ M with good recovery limits.

Keywords: amperometry, electrochemical detection, human blood serum, methotrexate, MWCNT, SWV

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3502 Opinion Mining to Extract Community Emotions on Covid-19 Immunization Possible Side Effects

Authors: Yahya Almurtadha, Mukhtar Ghaleb, Ahmed M. Shamsan Saleh

Abstract:

The world witnessed a fierce attack from the Covid-19 virus, which affected public life socially, economically, healthily and psychologically. The world's governments tried to confront the pandemic by imposing a number of precautionary measures such as general closure, curfews and social distancing. Scientists have also made strenuous efforts to develop an effective vaccine to train the immune system to develop antibodies to combat the virus, thus reducing its symptoms and limiting its spread. Artificial intelligence, along with researchers and medical authorities, has accelerated the vaccine development process through big data processing and simulation. On the other hand, one of the most important negatives of the impact of Covid 19 was the state of anxiety and fear due to the blowout of rumors through social media, which prompted governments to try to reassure the public with the available means. This study aims to proposed using Sentiment Analysis (AKA Opinion Mining) and deep learning as efficient artificial intelligence techniques to work on retrieving the tweets of the public from Twitter and then analyze it automatically to extract their opinions, expression and feelings, negatively or positively, about the symptoms they may feel after vaccination. Sentiment analysis is characterized by its ability to access what the public post in social media within a record time and at a lower cost than traditional means such as questionnaires and interviews, not to mention the accuracy of the information as it comes from what the public expresses voluntarily.

Keywords: deep learning, opinion mining, natural language processing, sentiment analysis

Procedia PDF Downloads 171
3501 Corporate Water Footprint Assessment: The Case of Tata Steel

Authors: Sujata Mukherjee, Arunavo Mukherjee

Abstract:

Water covers 70 per cent of our planet; however, freshwater is incredibly rare, and scarce has been listed as the highest impact global risk. The problems related to freshwater scarcity multiplies with the human population having more than doubled coupled with climate change, changing water cycles leading to droughts and floods and a rise in water pollution. Businesses, governments, and local communities are constrained by water scarcity and are facing growing challenges to their growth and sustainability. Water foot printing as an indicator for water use was introduced in 2002. Business water footprint measures the total water consumed to produce the goods and services it provides. It is a combination of the water that goes into the production and manufacturing of a product or service and the water used throughout the supply chain, as well as during the use of the product. A case study approach was applied describing the efforts of Tata Steel. It is based on a series of semi-structured in-depth interviews with top executives of the company as well as observation and content analysis of internal and external documents about the company’s efforts in sustainable water management. Tata Steel draws water required for industrial use from surface water sources, primarily perennial rivers and streams, internal reservoirs and water from municipal sources. The focus of the present study was to explore Tata Steel’s engagement in sustainable water management focusing on water foot printing accounting as a tool to account for water use in the steel supply chain at its Jamshedpur plant. The findings enabled the researchers to conclude that no sources of water are adversely affected by the company’s production of steel at Jamshedpur.

Keywords: sustainability, corporate responsibility water management, risk management, business engagement

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3500 Bio-Surfactant Production and Its Application in Microbial EOR

Authors: A. Rajesh Kanna, G. Suresh Kumar, Sathyanaryana N. Gummadi

Abstract:

There are various sources of energies available worldwide and among them, crude oil plays a vital role. Oil recovery is achieved using conventional primary and secondary recovery methods. In-order to recover the remaining residual oil, technologies like Enhanced Oil Recovery (EOR) are utilized which is also known as tertiary recovery. Among EOR, Microbial enhanced oil recovery (MEOR) is a technique which enables the improvement of oil recovery by injection of bio-surfactant produced by microorganisms. Bio-surfactant can retrieve unrecoverable oil from the cap rock which is held by high capillary force. Bio-surfactant is a surface active agent which can reduce the interfacial tension and reduce viscosity of oil and thereby oil can be recovered to the surface as the mobility of the oil is increased. Research in this area has shown promising results besides the method is echo-friendly and cost effective compared with other EOR techniques. In our research, on laboratory scale we produced bio-surfactant using the strain Pseudomonas putida (MTCC 2467) and injected into designed simple sand packed column which resembles actual petroleum reservoir. The experiment was conducted in order to determine the efficiency of produced bio-surfactant in oil recovery. The column was made of plastic material with 10 cm in length. The diameter was 2.5 cm. The column was packed with fine sand material. Sand was saturated with brine initially followed by oil saturation. Water flooding followed by bio-surfactant injection was done to determine the amount of oil recovered. Further, the injection of bio-surfactant volume was varied and checked how effectively oil recovery can be achieved. A comparative study was also done by injecting Triton X 100 which is one of the chemical surfactant. Since, bio-surfactant reduced surface and interfacial tension oil can be easily recovered from the porous sand packed column.

Keywords: bio-surfactant, bacteria, interfacial tension, sand column

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3499 A Finite Element/Finite Volume Method for Dam-Break Flows over Deformable Beds

Authors: Alia Alghosoun, Ashraf Osman, Mohammed Seaid

Abstract:

A coupled two-layer finite volume/finite element method was proposed for solving dam-break flow problem over deformable beds. The governing equations consist of the well-balanced two-layer shallow water equations for the water flow and a linear elastic model for the bed deformations. Deformations in the topography can be caused by a brutal localized force or simply by a class of sliding displacements on the bathymetry. This deformation in the bed is a source of perturbations, on the water surface generating water waves which propagate with different amplitudes and frequencies. Coupling conditions at the interface are also investigated in the current study and two mesh procedure is proposed for the transfer of information through the interface. In the present work a new procedure is implemented at the soil-water interface using the finite element and two-layer finite volume meshes with a conservative distribution of the forces at their intersections. The finite element method employs quadratic elements in an unstructured triangular mesh and the finite volume method uses the Rusanove to reconstruct the numerical fluxes. The numerical coupled method is highly efficient, accurate, well balanced, and it can handle complex geometries as well as rapidly varying flows. Numerical results are presented for several test examples of dam-break flows over deformable beds. Mesh convergence study is performed for both methods, the overall model provides new insight into the problems at minimal computational cost.

Keywords: dam-break flows, deformable beds, finite element method, finite volume method, hybrid techniques, linear elasticity, shallow water equations

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3498 Assessment of the Impact of the Application of Kinesiology Taping on Joint Position Sense in Knee Joint

Authors: Anna Słupik, Patryk Wąsowski, Anna Mosiołek, Dariusz Białoszewski

Abstract:

Introduction: Kinesiology Taping is one of the most popular techniques used for treatment and supporting physiological processes in sports medicine and physiotherapy. Often it is used to sensorimotor skills of lower limbs by athletes. The aim of the study was to determine the effect of the application of muscle Kinesiology Taping to feel the position setting in motion the joint active. Material and methods: The study involved 50 healthy people between 18 and 30 years of age, 30 men and 20 women (mean age 23.24 years). The participants were divided into two groups. The study group was qualified for Kinesiology Taping application (muscle application, type Y, for quadriceps femoris muscle), while the remaining people used the application made of plaster (placebo group). Testing was performed prior to applying taping, with the applied application (after 30 minutes), then 24 hours after wearing, and after removing the tape. Each evaluated joint position sense - Error of Active Reproduction of Joint Position. Results: The survey revealed no significant differences in measurement between the study group and the placebo group (p> 0.05). No significant differences in time taking into account all four measurements in the group with the applied CT application, which was supported by pairs (p> 0.05). Also in the placebo group showed no significant differences over time (p> 0.05). There was no significant difference between the errors committed in the direction of flexion and extension. Conclusions: 1. Application muscle Kinesiology Taping had no significant effect on the knee joint proprioception. Its use in order to improve sensorimotor seems therefore unjustified. 2. There are no differences between applications Kinesiology Taping and placebo indicates that the clinical effect of stretch tape is minimal or absent. 3. The results are the basis for the continuation of prospective, randomized trials of numerous and study group.

Keywords: joint position sense, kinesiology taping, knee joint, proprioception

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3497 Analgesic, Toxicity and Anti-Pyretic Activities of Methanolic Extract from Hyoscyamus albus Leaves in Albinos Rats

Authors: Yahia Massinissa, Henhouda Affaf, Yahia Mouloud

Abstract:

The aim of this study was to investigate the toxicity; analgesic and anti-pyretic properties of standardized HA methanolic extract (HAMeOH) in vivo. The acute toxicity study was performed on rats while adopting the OECD-420 Guidelines (fixed dose procedure). Assessment of analgesic activity was performed in rats with two analgesic models. One was acetic acid induced writhing response and the other formalin-induced paw licking. The anti-pyretic effect was tested by brewer’s yeast induced fever in rats. For the acute toxicity test, the higher dose administration of 2000 mg/kg bw. of Hyoscyamus albus did not produce any toxic signs or deaths in rats. There were no significant differences (p>0.05) in the body and organ weights between control and treated groups. The (LD50) of Hyoscyamus albus was higher than 2000 g/kg bw. In subacute toxicity study, no mortality and toxic signs were observed with the doses of 100 and 200 mg/kg bw. of extracts of for 28 consecutive days. These analgesic experimental results indicated that HAMeOH (100 mg/kg and 200 mg/kg) decreased the acetic acid-induced writhing responses and HAMeOH (100 mg/kg and 200 mg/kg) decreased the licking time in the second phase of the formalin test. Moreover, in the model of yeast induced elevation of the body temperature HAMeOH showed dose-dependent lowering of the body temperature up to 3h at both the doses these results obtained, were comparable to that of paracetamol. The present findings indicate that the leaves of Hyoscyamus albus L. possess potent analgesic and antipyretic activity.

Keywords: Hyoscyamus albus, methanolic extract, toxicity, analgesic activity, antipyretic activity, formalin test

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3496 Impact of Nutritional Status on the Pubertal Transition in a Sample of Egyptian School Girls

Authors: Nayera E. Hassan, Salah Mostafa, Hamed Elkhayat, Kalled Hassan Sewidan, Sahar A. El-Masry, Manal Mouhamed Ali, Mones M. Abu Shady

Abstract:

Pubertal growth is influenced by many factors including environmental and nutritional factors. Objective: To assess impact of nutritional status on pubertal staging, ovarian and uterine volumes among school girls. Method: Study was cross sectional and carried out on 1000 healthy school girls, aged 8-18 years selected randomly. They were categorized according to their ages into three groups: 8-12 years, 13-15 years and 16-18 years ±6 months, then according to their body mass index percentile to normal weight: (≥15-<85.), overweight (≥85-<95) and obese (≥95). All girls were subjected for physical, anthropometric (weight, height, body mass index), nutritional markers WAZ (weight/age Z score), HAZ (height/age Z score) and BMI-Z (body mass index Z score), pubertal assessment (Tanner stage) and pelvic transabdominal sonography (uterine and ovarian volumes). Results: Highly significant differences in ovarian and uterine volumes and nutritional markers (WAZ, HAZ and BMI-Z score) were detected among different grades of puberty in the two age groups (8-12 years, 13-15 years) coming in advance of obese girls (with increase of BMI); except HAZ in the second age group. Girls aged 16-18 years reached to final volume for the uterus and ovary with insignificant differences. Pubertal stage, ovarian and uterine sizes were highly significantly correlated with nutritional markers. Mean ages of onset: of puberty, menarche and complete puberty were, 11.65 + 1.84, 14.79 + 1.75 and 15.02 + 1.68 years respectively. Conclusion: Nutritional status has a crucial role in determining pubertal stage, ovarian and uterine volumes among Egyptian girls during the pubertal process.

Keywords: pubertal stage, nutritional markers, girls, ovarian and uterine volumes

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3495 The Concept of Accounting in Islamic Transactions

Authors: Ahmad Abdulkadir Ibrahim

Abstract:

The Islamic law of transactions laid down the methods and instruments of accounting and analyzed its basic assumptions in the modern world. There is a need to examine the implications of accounting initiatives in the Muslim world and attempt to outline the important characteristics of Islamic accounting and how Islamic accounting resolves the problem of measuring the cost of Murabaha goods in case of exchange rate variation. The research tends to discuss an analytical approach to the Islamic accounting concept as well as elaborating the jurisprudential matter and practical aspects of accounting in Islamic financial transactions. It also aims to alert the practitioners of accounting in the Islamic world to be aware of the concept of accounting in Islamic jurisprudence and its historical development. The methodology adopted in this research is the qualitative method through the consultation of relevant literature, which focuses on the thematic study of the subject matter. This is followed by an analysis and discussion of the contents of the materials used. It is concluded that Islamic accounting is unique in its norms as it has been characterized by fairness, accuracy in measuring tools, truthfulness, mutual trust, moderation in making a profit, and tolerance. It was also qualified by capacity and flexibility in terms of the tools and terminology used and invented by Islamic jurisprudence in the accounting system, which indicates its validity and consistency anytime and anywhere. An important conclusion of the research also lies in the refutation of the popular idea that an Italian writer known as Luca Pacilio was the first writer who developed the basis of double-entry due to the presented proofs by Muslim scholars of critical accounting developments, which cannot be ignored. It concludes further that Islamic jurisprudence draws the accounting system codified in the foundations of a market that is far from usury, fraud, cheating, and unfair competition in all areas.

Keywords: accounting, Islamic accounting, Islamic transactions, Islamic jurisprudence, double entry, murabaha, characteristics

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3494 CMPD: Cancer Mutant Proteome Database

Authors: Po-Jung Huang, Chi-Ching Lee, Bertrand Chin-Ming Tan, Yuan-Ming Yeh, Julie Lichieh Chu, Tin-Wen Chen, Cheng-Yang Lee, Ruei-Chi Gan, Hsuan Liu, Petrus Tang

Abstract:

Whole-exome sequencing focuses on the protein coding regions of disease/cancer associated genes based on a priori knowledge is the most cost-effective method to study the association between genetic alterations and disease. Recent advances in high throughput sequencing technologies and proteomic techniques has provided an opportunity to integrate genomics and proteomics, allowing readily detectable mutated peptides corresponding to mutated genes. Since sequence database search is the most widely used method for protein identification using Mass spectrometry (MS)-based proteomics technology, a mutant proteome database is required to better approximate the real protein pool to improve disease-associated mutated protein identification. Large-scale whole exome/genome sequencing studies were launched by National Cancer Institute (NCI), Broad Institute, and The Cancer Genome Atlas (TCGA), which provide not only a comprehensive report on the analysis of coding variants in diverse samples cell lines but a invaluable resource for extensive research community. No existing database is available for the collection of mutant protein sequences related to the identified variants in these studies. CMPD is designed to address this issue, serving as a bridge between genomic data and proteomic studies and focusing on protein sequence-altering variations originated from both germline and cancer-associated somatic variations.

Keywords: TCGA, cancer, mutant, proteome

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3493 Enhancing Secondary School Mathematics Retention with Blended Learning: Integrating Concepts for Improved Understanding

Authors: Felix Oromena Egara, Moeketsi Mosia

Abstract:

The study aimed to evaluate the impact of blended learning on mathematics retention among secondary school students. Conducted in the Isoko North Local Government Area of Delta State, Nigeria, the research involved 1,235 senior class one (SS 1) students. Employing a non-equivalent control group pre-test-post-test quasi-experimental design, a sample of 70 students was selected from two secondary schools with ICT facilities through purposive sampling. Random allocation of students into experimental and control groups was achieved through balloting within each selected school. The investigation included three assessment points: pre-Mathematics Achievement Test (MAT), post-MAT, and post-post-MAT (retention), administered systematically by the researchers. Data collection utilized the established MAT instrument, which demonstrated a high reliability score of 0.86. Statistical analysis was conducted using the Statistical Package for Social Sciences (SPSS) version 28, with mean and standard deviation addressing study questions and analysis of covariance scrutinizing hypotheses at a significance level of .05. Results revealed significantly greater improvements in mathematics retention scores among students exposed to blended learning compared to those instructed through conventional methods. Moreover, noticeable differences in mean retention scores were observed, with male students in the blended learning group exhibiting notably higher performance. Based on these findings, recommendations were made, advocating for mathematics educators to integrate blended learning, particularly in geometry teaching, to enhance students’ retention of mathematical concepts.

Keywords: blended learning, flipped classroom model, secondary school students, station rotation model

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3492 Impure CO₂ Solubility Trapping in Deep Saline Aquifers: Role of Operating Conditions

Authors: Seyed Mostafa Jafari Raad, Hassan Hassanzadeh

Abstract:

Injection of impurities along with CO₂ into saline aquifers provides an exceptional prospect for low-cost carbon capture and storage technologies and can potentially accelerate large-scale implementation of geological storage of CO₂. We have conducted linear stability analyses and numerical simulations to investigate the effects of permitted impurities in CO₂ streams on the onset of natural convection and dynamics of subsequent convective mixing. We have shown that the rate of dissolution of an impure CO₂ stream with H₂S highly depends on the operating conditions such as temperature, pressure, and composition of impurity. Contrary to findings of previous studies, our results show that an impurity such as H₂S can potentially reduce the onset time of natural convection and can accelerate the subsequent convective mixing. However, at the later times, the rate of convective dissolution is adversely affected by the impurities. Therefore, the injection of an impure CO₂ stream can be engineered to improve the rate of dissolution of CO₂, which leads to higher storage security and efficiency. Accordingly, we have identified the most favorable CO₂ stream compositions based on the geophysical properties of target aquifers. Information related to the onset of natural convection such as the scaling relations and the most favorable operating conditions for CO₂ storage developed in this study are important in proper design, site screening, characterization and safety of geological storage. This information can be used to either identify future geological candidates for acid gas disposal or reviewing the current operating conditions of licensed injection sites.

Keywords: CO₂ storage, solubility trapping, convective dissolution, storage efficiency

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3491 An Investigation on the Effect of Railway Track Elevation Project in Taichung Based on the Carbon Emissions

Authors: Kuo-Wei Hsu, Jen-Chih, Chao, Pei-Chen, Wu

Abstract:

With the rapid development of global economy, the increasing population, the highly industrialization, greenhouse gas emission and the ozone layer damage, the Global Warming happens. Facing the impact of global warming, the issue of “green transportation” began to be valued and promoted in each city. Taichung has been elected as the model of low-carbon city in Taiwan. To comply with international trends and the government policy, we tried to promote the energy saving and carbon reduction to create a “low-carbon Taichung with green life and eco-friendly economy”. To cooperate with the “green transportation” project, Taichung has promoted a number of public transports constructions and traffic policy in recent years like BRT, MRT, etc. The elevated railway is one of those important constructions. Cooperating with the green transport policy, elevated railway could help to achieve the carbon reduction for this low-carbon city. The current studies of the carbon emissions associated with railways and roads are focusing on the assessment on paving material, institutional policy and economic benefit. Except for changing the mode of transportation, elevated railways/roads also create space under the bridge. However, there is no research about the carbon emissions of the space underneath the elevated section up until now. This study investigated the effect of railway track elevation project in Taichung based on the carbon emissions and the factors that affect carbon emissions by research related theory and literature analysis. This study concluded that : railway track elevation increased the public transit, the bike lanes, the green areas and walking spaces. In the other hand it reduced the traffic congestions, the use of motorcycles as well as automobiles for carbon emissions.

Keywords: low-carbon city, green transportation, carbon emissions, Taichung, Taiwan

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3490 Energy Budgeting, Carbon and Water Footprints Under Conventional and Conservation Tillage Practices of Rice-Wheat Double Cropping System

Authors: Ahmad Latif Virk, Naeem Ahmad, Muhammad Ishaq Asif Rehmani

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Amid the present environmental crises, developing environment-resilient and cost-effective conservation agriculture strategies to feed the world's ever-growing population is pertinent. Therefore, a field study was conducted to test the hypothesis that residue retention under no-till (NTR) would enhance energy productivity (EP) and energy use efficiency (EUE) while offsetting the carbon footprints (CF), water footprints (WF) and greenhouse gases emissions (GHGs) in rice (Oryza sativa L.)-wheat (Triticum aestivum L.) double cropping system. Two tillage systems viz., conventional tillage (CT) and conservation tillage (no-till; NT), with or without residue retention, were combined into four treatments as CT0 (puddled rice, conventional wheat - residue); CTR (puddled rice, conventional wheat + residue); NT0 (direct rice seeding, zero-tilled wheat - residue); NTR (direct rice seeding, zero-tilled wheat + residue) were evaluated. Overall, results showed that the NT system had 34.2% lower energy consumption, 1.2 times more EP than CT system. Moreover, NTR had 19.8% higher EUE than CT0. The overall system grain yield ranged from 7.8 to 9.3 Mg ha−1 under NT0 and CTR, respectively. The NTR had 56.6% and 17.9% lesser CF and WF, respectively, than CT0. The net GHGs emissions (CO2-eq kg ha−1) under CT0 were the highest, while NTR had the lowest emissions. The NTR enhanced carbon sequestration in soil that can offset half of the system's CO2 emissions. The findings of this study might help develop a suitable strategy for resource/energy conservation and higher productivity while offsetting GHGs emissions in the Indo-Gangetic Plains.

Keywords: residue, yield, indirect emissions, energy use efficiency, carbon sequestration

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3489 Computed Tomography Guided Bone Biopsies: Experience at an Australian Metropolitan Hospital

Authors: K. Hinde, R. Bookun, P. Tran

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Percutaneous CT guided biopsies provide a fast, minimally invasive, cost effective and safe method for obtaining tissue for histopathology and culture. Standards for diagnostic yield vary depending on whether the tissue is being obtained for histopathology or culture. We present a retrospective audit from Western Health in Melbourne Australia over a 12-month period which aimed to determine the diagnostic yield, technical success and complication rate for CT guided bone biopsies and identify factors affecting these results. The digital imaging storage program (Synapse Picture Archiving and Communication System – Fujifilm Australia) was analysed with key word searches from October 2015 to October 2016. Nineteen CT guided bone biopsies were performed during this time. The most common referring unit was oncology, work up imaging included CT, MRI, bone scan and PET scan. The complication rate was 0%, overall diagnostic yield was 74% with a technical success of 95%. When performing biopsies for histologic analysis diagnostic yield was 85% and when performing biopsies for bacterial culture diagnostic yield was 60%. There was no significant relationship identified between size of lesion, distance of lesion to skin, lesion appearance on CT, the number of samples taken or gauge of needle to diagnostic yield or technical success. CT guided bone biopsy at Western Health meets the standard reported at other major clinical centres for technical success and safety. It is a useful investigation in identification of primary malignancy in distal bone metastases.

Keywords: bone biopsy, computed tomography, core biopsy, histopathology

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3488 Characterization of Hyaluronic Acid-Based Injections Used on Rejuvenation Skin Treatments

Authors: Lucas Kurth de Azambuja, Loise Silveira da Silva, Gean Vitor Salmoria, Darlan Dallacosta, Carlos Rodrigo de Mello Roesler

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This work provides a physicochemical and thermal characterization assessment of three different hyaluronic acid (HA)-based injections used for rejuvenation skin treatments. The three products analyzed are manufactured by the same manufacturer and commercialized for application on different skin levels. According to the manufacturer, all three HA-based injections are crosslinked and have a concentration of 23 mg/mL of HA, and 0.3% of lidocaine. Samples were characterized by Fourier-transformed infrared (FTIR), differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), and scanning electron microscope (SEM) techniques. FTIR analysis resulted in a similar spectrum when comparing the different products. DSC analysis demonstrated that the fusion points differ in each product, with a higher fusion temperature observed in specimen A, which is used for subcutaneous applications, when compared with B and C, which are used for the middle dermis and deep dermis, respectively. TGA data demonstrated a considerable mass loss at 100°C, which means that the product has more than 50% of water in its composition. TGA analysis also showed that Specimen A had a lower mass loss at 100°C when compared to Specimen C. A mass loss of around 220°C was observed on all samples, characterizing the presence of hyaluronic acid. SEM images displayed a similar structure on all samples analyzed, with a thicker layer for Specimen A when compared with B and C. This series of analyses demonstrated that, as expected, the physicochemical and thermal properties of the products differ according to their application. Furthermore, to better characterize the crosslinking degree of each product and their mechanical properties, a set of different techniques should be applied in parallel to correlate the results and, thereby, relate injection application with material properties.

Keywords: hyaluronic acid, characterization, soft-tissue fillers, injectable gels

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3487 Disaster Recovery and Tourism Development: The Case of Diving Industry in Coron Island Palawan

Authors: Kimberly Joyce A. Roguis, Mica Lorraine L. Fernando, Alan Vito B. Macadangdang, Jennina Mari C. Mijares, Maria Carinnes A. Gonzalez

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The paper showcases the vulnerability of the tourism industry especially the inevitable occurrence of natural disasters, implicating the necessity for post-disaster analysis on tourist attractions. This study discusses the aftermath of the super typhoon ‘Yolanda’ incident in the locality of Coron Island, Palawan, assessing its general effect on the community and its tourism livelihood through the analysis of responses from key role-players in the tourism industry of the area gathered through semi-structured interviews and direct observation. The local government’s instigation of recovery programs to their locality has been a pivotal factor in reviving the vitality of their tourism industry and the involvement of the community has been the determining condition that shifted the industry towards revival a year after the incidence. The study illuminates the disaster mitigation processes in the local tourism livelihood perspective, predominantly the diving industry. It did not suffer physical damage to a great extent but was affected because of the public imagery the disaster brought upon. Collaboration between the local government and the community is the highlight of the research for they maneuvered recovery revealing that cooperation between these two parties bridged the correlation of recovery to tourism development. The disaster paved way to a stance towards promoting progressive tourism outlooks, raising awareness among the public and private sectors and re-assessment of the tourism vitality in their locality. The mayhem and destruction proved to be a liberating creative process to give way to progression and was deemed to be of high significance in the over-all tourism system process despite its impediments in the case of the tourism industry in Coron, Palawan.

Keywords: disaster recovery, tourism development, diving, Palawan

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3486 A Methodological Approach to Development of Mental Script for Mental Practice of Micro Suturing

Authors: Vaikunthan Rajaratnam

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Intro: Motor imagery (MI) and mental practice (MP) can be an alternative to acquire mastery of surgical skills. One component of using this technique is the use of a mental script. The aim of this study was to design and develop a mental script for basic micro suturing training for skill acquisition using a low-fidelity rubber glove model and to describe the detailed methodology for this process. Methods: This study was based on a design and development research framework. The mental script was developed with 5 expert surgeons performing a cognitive walkthrough of the repair of a vertical opening in a rubber glove model using 8/0 nylon. This was followed by a hierarchal task analysis. A draft script was created, and face and content validity assessed with a checking-back process. The final script was validated with the recruitment of 28 participants, assessed using the Mental Imagery Questionnaire (MIQ). Results: The creation of the mental script is detailed in the full text. After assessment by the expert panel, the mental script had good face and content validity. The average overall MIQ score was 5.2 ± 1.1, demonstrating the validity of generating mental imagery from the mental script developed in this study for micro suturing in the rubber glove model. Conclusion: The methodological approach described in this study is based on an instructional design framework to teach surgical skills. This MP model is inexpensive and easily accessible, addressing the challenge of reduced opportunities to practice surgical skills. However, while motor skills are important, other non-technical expertise required by the surgeon is not addressed with this model. Thus, this model should act a surgical training augment, but not replace it.

Keywords: mental script, motor imagery, cognitive walkthrough, verbal protocol analysis, hierarchical task analysis

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3485 A Knowledge-Based Development of Risk Management Approaches for Construction Projects

Authors: Masoud Ghahvechi Pour

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Risk management is a systematic and regular process of identifying, analyzing and responding to risks throughout the project's life cycle in order to achieve the optimal level of elimination, reduction or control of risk. The purpose of project risk management is to increase the probability and effect of positive events and reduce the probability and effect of unpleasant events on the project. Risk management is one of the most fundamental parts of project management, so that unmanaged or untransmitted risks can be one of the primary factors of failure in a project. Effective risk management does not apply to risk regression, which is apparently the cheapest option of the activity. However, the main problem with this option is the economic sensitivity, because what is potentially profitable is by definition risky, and what does not pose a risk is economically interesting and does not bring tangible benefits. Therefore, in relation to the implemented project, effective risk management is finding a "middle ground" in its management, which includes, on the one hand, protection against risk from a negative direction by means of accurate identification and classification of risk, which leads to analysis And it becomes a comprehensive analysis. On the other hand, management using all mathematical and analytical tools should be based on checking the maximum benefits of these decisions. Detailed analysis, taking into account all aspects of the company, including stakeholder analysis, will allow us to add what will become tangible benefits for our project in the future to effective risk management. Identifying the risk of the project is based on the theory that which type of risk may affect the project, and also refers to specific parameters and estimating the probability of their occurrence in the project. These conditions can be divided into three groups: certainty, uncertainty, and risk, which in turn support three types of investment: risk preference, risk neutrality, specific risk deviation, and its measurement. The result of risk identification and project analysis is a list of events that indicate the cause and probability of an event, and a final assessment of its impact on the environment.

Keywords: risk, management, knowledge, risk management

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3484 Flexural Behavior of Eco-Friendly Prefabricated Low Cost Bamboo Reinforced Wall Panels

Authors: Vishal Puri, Pradipta Chakrabortty, Swapan Majumdar

Abstract:

Precast concrete construction is the most commonly used technique for a rapid construction. This technique is very frequently used in the developed countries. Different guidelines required to utilize the potential of prefabricated construction are still not available in the developing countries. This causes over dependence on in-situ construction procedure which further affects the quality, scheduling, and duration of construction. Also with the ever increasing costs of building materials and their negative impact on the environment it has become imperative to look out for alternate construction materials which are cheap and sustainable. Bamboo and fly ash are alternate construction materials having great potential in the construction industry. Thus there is a great need to develop prefabricated components by utilizing the potential of these materials. Bamboo reinforced beams, bamboo reinforced columns and bamboo arches as researched previously have shown great prospects for prefabricated construction industry. But, many other prefabricated components still need to be studied and widely tested before their utilization in the prefabricated construction industry. In the present study, authors have showcased prefabricated bamboo reinforced wall panel for the prefabricated construction industry. It presents a detailed methodology for the development of such prefabricated panels. It also presents the flexural behavior of such panels as tested under flexural loads following ASTM guidelines. It was observed that these wall panels are much flexible and do not show brittle failure as observed in traditional brick walls. It was observed that prefabricated walls are about 42% cheaper as compared to conventional brick walls. It was also observed that prefabricated walls are considerably lighter in weight and are environment friendly. It was thus concluded that this type of wall panels are an excellent alternative for partition brick walls.

Keywords: bamboo, prefabricated walls, reinforced structure, sustainable infrastructure

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3483 Exploring Visual Arts through the Blue Humanities: The Case Study of Jason deCaires Taylor's Underwater Sculptures

Authors: Mohammed Muharram

Abstract:

The Blue Humanities aims to deepen our understanding of the oceans through the integration of arts and sciences, emphasizing their cultural, historical, and ecological significance. This study explores the role of visual arts within this interdisciplinary framework, focusing on the underwater sculptures of Jason deCaires Taylor as a case study. The research employs a multidisciplinary approach, combining art history, environmental science, and cultural studies to explore the significance of Taylor's underwater installations. Methodologies include analysis of the artistic elements and themes in Taylor's work, assessment of the ecological impact of the sculptures on marine environments, and examination of the cultural narratives they evoke. Key findings highlight how Taylor's sculptures serve as artificial reefs, promoting marine biodiversity while simultaneously raising awareness about ocean conservation. The artworks act as powerful symbols, merging environmental activism with artistic expression and transforming underwater spaces into immersive art galleries that challenge traditional notions of viewing art. By bridging the gap between visual arts and environmental science, this study demonstrates how Taylor's sculptures contribute to the Blue Humanities by fostering a deeper, more holistic appreciation of the marine world. The research advocates for the continued integration of artistic perspectives into marine conservation efforts, emphasizing the role of visual arts in shaping public perceptions and promoting ecological sustainability. In conclusion, this study underscores the transformative potential of visual arts within the Blue Humanities, exemplified by Jason deCaires Taylor's underwater sculptures, which inspire both aesthetic appreciation and environmental consciousness.

Keywords: blue humanities, visual art, underwater sculptures, Jason deCaires Taylor

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3482 Assessment of Toxic Impact of Metals on Different Instars of Silkworm, Bombyx Mori

Authors: Muhammad Dildar Gogi, Muhammad Arshad, Muhammad Ahsan Khan, M. Sufian, Ahmad Nawaz, Mubashir Iqbal, Muhammad Junaid Nisar, Waleed Afzal Naveed

Abstract:

Larvae of silkworm (Bombyx mori) exhibit very high mortality when reared on mulberry leaves collected from mulberry orchards which get contaminated with metallic/nonmetallic compounds through either drift-deposition or chemigation. There is need to screen out such metallic compound for their toxicity at their various concentrations. The present study was carried out to assess toxicity of metals in different instars of silkworm. Aqueous solutions of nine heavy-metal based salts were prepared by dissolving 50, 100, 150, 200, 250, 300, 350 and 400 mg of each salt in one liter of water and were applied on the mulberry leaves by leaf-dip methods. The results reveal that mortality in 1st, 2nd, 3rd, 4th and 5th instar larvae caused by each heavy metal salts increased with an increase in their concentrations. The 1st instar larvae were found more susceptible to metal salts followed by 2nd, 3rd, 4th and 5th instar larvae of silkworm. Overall, Nickel chloride proved more toxic for all larval instar as it demonstrated approximately 40-99% mortality. On the basis of LC2 and larval mortality, the order of toxicity of heavy metals against all five larval instar was Nickel chloride (LC₂ = 1.9-13.9 mg/L; & 15.0±1.2-69.2±1.7% mortality) followed by Chromium nitrate (LC₂ = 3.3-14.8 mg/L; & 13.3±1.4-62.4±2.8% mortality), Cobalt nitrate (LC₂ = 4.3-30.9; &11.4±0.07-54.9±2.0% mortality), Lead acetate (LC₂ =8.8-53.3 mg/L; & 9.5±1.3-46.4±2.9% mortality), Aluminum sulfate (LC₂ = 15.5-76.6 mg/L; & 8.4±0.08-42.1±2.8% mortality), Barium sulfide (LC₂ = 20.9-105.9; & 7.7±1.1-39.2±2.5% mortality), Copper sulfate (LC2 = 28.5-12.4 mg/L; & 7.3±0.06-37.1±2.4% mortality), Manganese chloride (LC₂ = 29.9-136.9 mg/L; & 6.8±0.09-35.3±1.6% mortality) and Zinc nitrate (LC₂ = 36.3-15 mg/L; & 6.2±1.2-32.1±1.9% mortality). Zinc nitrate @ 50 and 100 mg/L, Barium sulfide @ 50 mg/L, Manganese chloride @ 50 and 100 mg/L and Copper sulfate @ 50 mg/L proved safe for 5th instar larvae as these interaction attributed no mortality. All the heavy metal salts at a concentration of 50 mg/L demonstrated less than 10% mortality.

Keywords: heavy-metals, larval-instars, lethal-concentration, mortality, silkworm

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3481 Assessment of the Knowledge and Practices of Healthcare Workers and Patients Regarding Prevention of Tuberculosis at a Tertiary Care Hospital of Southern Punjab

Authors: Muhammad Shahbaz Akhtar

Abstract:

Background; Tuberculosis remains a significant public health challenge in Pakistan, with high incidence and prevalence rates, particularly among vulnerable populations. Addressing the TB burden requires comprehensive efforts to improve healthcare infrastructure, increase access to quality diagnosis and treatment services, raise public awareness, and address socioeconomic determinants of health. Objective; To assess the knowledge and practices of healthcare workers and patients regarding prevention of tuberculosis at a tertiary care hospital of Southern Punjab.Material and methods; Data will be collected from 135 healthcare workers and 135 TB patients visiting Nishtar Hospital, Multan in this descriptive cross – sectional study using non – probability consecutive sampling technique. Proper approval will be taken from Hospital authorities to conduct this study. Study participants will be recruited after taking informed written consent, describing them objectives of this study. The study participants will be ensured of their confidentiality of the data and interviewed to assess their knowledge and practices regarding prevention of tuberculosis. Data Analysis Procedure; Data will be entered and analyzed by using SPSS version 25 to calculated mean and standard deviation for the numerical data such as age, duration of disease and duration of experience. Frequencies and percentages will be calculated for gender, age groups, level of knowledge, qualification, designation and practices. Impact of confounders like gender, age groups, duration of experience, disease duration, years of experience and designation will be assessed by stratification. Post stratification chi – square test will be applied at 0.05 level of significance at 95 % CI.

Keywords: tuberculosis, data analysis, HIV/AIDS, preventable

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3480 Production of Mycelial Biomass, Exopolysaccharide, and Enzyme during Solid-State Fermentation of Plant Raw Materials by Medicinal Mushrooms

Authors: Tamar Khardziani, Violeta Berikashvili, Amrosi Chkuaseli, Vladimir Elisashvili

Abstract:

The main objectives of this proposal are to develop low-cost, innovative, and competitive technologies for the production of mycelial biomass of medicinal mushrooms as a natural food supplement for poultry. To fulfill this task, industrial strains of Lentinus edodes, Ganoderma lucidum, and Pleurotus ostreatus were used in this study. The solid-state fermentation (SSF) of wheat grains, wheat bran, and soy flour was performed in flasks and bags. Among nine mushroom strains, P. ostreatus 2191 appeared to be the most productive in protein biomass accumulation in the SSF of wheat bran. All mushrooms produced exopolysaccharide with the highest yield of 5-8 mg/mL depending on fungal strain and growth substrate. Supplementation of medium with 1% glycerol and 2-4% peptone favored mushroom growth and protein accumulation. Among inorganic nitrogen sources, KNO₃ also provided high biomass and protein production. The SSF of all growth substrates was accompanied by the secretion of cellulase and xylanase activities. The highest CMCase activity (12-13 U/g) was revealed in the cultivation of P. ostreatus 2191 using wheat bran as a growth substrate and ammonium sulfate or yeast extract as a nitrogen source, whereas the highest xylanase activity was detected in the fermentation of soy flour supplemented with peptone. Acknowledgments: This work was supported by the Shota Rustaveli National Science Foundation of Georgia (Grant number STEM-22-2077).

Keywords: mushrooms, plant raw materials, fermentation, biomass protein, cellulase

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3479 African Swine Fewer Situation and Diagnostic Methods in Lithuania

Authors: Simona Pileviciene

Abstract:

On 24th January 2014, Lithuania notified two primary cases of African swine fever (ASF) in wild boars. The animals were tested positive for ASF virus (ASFV) genome by real-time PCR at the National Reference Laboratory for ASF in Lithuania (NRL), results were confirmed by the European Union Reference Laboratory for African swine fever (CISA-INIA). Intensive wild and domestic animal monitoring program was started. During the period of 2014-2017 ASF was confirmed in two large commercial pig holding with the highest biosecurity. Pigs were killed and destroyed. Since 2014 ASF outbreak territory from east and south has expanded to the middle of Lithuania. Diagnosis by PCR is one of the highly recommended diagnostic methods by World Organization for Animal Health (OIE) for diagnosis of ASF. The aim of the present study was to compare singleplex real-time PCR assays to a duplex assay allowing the identification of ASF and internal control in a single PCR tube and to compare primers, that target the p72 gene (ASF 250 bp and ASF 75 bp) effectivity. Multiplex real-time PCR assays prove to be less time consuming and cost-efficient and therefore have a high potential to be applied in the routine analysis. It is important to have effective and fast method that allows virus detection at the beginning of disease for wild boar population and in outbreaks for domestic pigs. For experiments, we used reference samples (INIA, Spain), and positive samples from infected animals in Lithuania. Results show 100% sensitivity and specificity.

Keywords: African swine fewer, real-time PCR, wild boar, domestic pig

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3478 Scheduling in a Single-Stage, Multi-Item Compatible Process Using Multiple Arc Network Model

Authors: Bokkasam Sasidhar, Ibrahim Aljasser

Abstract:

The problem of finding optimal schedules for each equipment in a production process is considered, which consists of a single stage of manufacturing and which can handle different types of products, where changeover for handling one type of product to the other type incurs certain costs. The machine capacity is determined by the upper limit for the quantity that can be processed for each of the products in a set up. The changeover costs increase with the number of set ups and hence to minimize the costs associated with the product changeover, the planning should be such that similar types of products should be processed successively so that the total number of changeovers and in turn the associated set up costs are minimized. The problem of cost minimization is equivalent to the problem of minimizing the number of set ups or equivalently maximizing the capacity utilization in between every set up or maximizing the total capacity utilization. Further, the production is usually planned against customers’ orders, and generally different customers’ orders are assigned one of the two priorities – “normal” or “priority” order. The problem of production planning in such a situation can be formulated into a Multiple Arc Network (MAN) model and can be solved sequentially using the algorithm for maximizing flow along a MAN and the algorithm for maximizing flow along a MAN with priority arcs. The model aims to provide optimal production schedule with an objective of maximizing capacity utilization, so that the customer-wise delivery schedules are fulfilled, keeping in view the customer priorities. Algorithms have been presented for solving the MAN formulation of the production planning with customer priorities. The application of the model is demonstrated through numerical examples.

Keywords: scheduling, maximal flow problem, multiple arc network model, optimization

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3477 Growth Performance and Nutrient Digestibility of Cirrhinus mrigala Fingerlings Fed on Sunflower Meal Based Diet Supplemented with Phytase

Authors: Syed Makhdoom Hussain, Muhammad Afzal, Farhat Jabeen, Arshad Javid, Tasneem Hameed

Abstract:

A feeding trial was conducted with Cirrhinus mrigala fingerlings to study the effects of microbial phytase with graded levels (0, 500, 1000, 1500, and 2000 FTUkg-1) by sunflower meal based diet on growth performance and nutrient digestibility. The chromic oxide was added as an indigestible marker in the diets. Three replicate groups of 15 fish (Average wt 5.98 g fish-1) were fed once a day and feces were collected twice daily. The results of present study showed improved growth and feed performance of Cirrhinus mrigala fingerlings in response to phytase supplementation. Maximum growth performance was obtained by the fish fed on test diet-III having 1000 FTU kg-1 phytase level. Similarly, nutrient digestibility was also significantly increased (p<0.05) by phytase supplementation. Digestibility coefficients for sunflower meal based diet increased 15.76%, 17.70%, and 12.70% for crude protein, crude fat and apparent gross energy as compared to the reference diet, respectively at 1000 FTU kg-1 level. Again, maximum response of nutrient digestibility was recorded at the phytase level of 1000 FTU kg-1 diet. It was concluded that the phytase supplementation to sunflower meal based diet at 1000 FTU kg-1 level is optimum to release adequate chelated nutrients for maximum growth performance of C. mrigala fingerlings. Our results also suggested that phytase supplementation to sunflower meal based diet can help in the development of sustainable aquaculture by reducing the feed cost and nutrient discharge through feces in the aquatic ecosystem.

Keywords: sunflower meal, Cirrhinus mrigala, growth, nutrient digestibility, phytase

Procedia PDF Downloads 298
3476 Increasing National Health Insurance Scheme Enrolment in Ghana: Pro-Rata Insurance Premium Payment with Mobile Phone as the Answer

Authors: Joseph Marfo Boaheng, Daniel Ansong, Eugenia Amporfo

Abstract:

Health Insurance is proposed to provide financial protection against catastrophic health care cost arising from disease. Ghana has had a National Health Insurance Scheme (NHIS) since 2003 with the current enrolment/retention rate of 36%. The main goal of the scheme is to provide equity in the health sector as well as ensuring affordable health care for the poor. However, the current payment system is not flexible to attract significant proportion of the poor informal sector onto the scheme. Looking at the extensive use of mobiles in the Ghana where about 29,220,602.00 registered mobile phone lines are actively in used as of June 2014, paying health insurance premium through mobile phone could be feasible to attract larger proportion of the informal sector onto the scheme. Methodology: The quantitative cross-sectional survey was used to solicit the required information from 877 respondents living in Kumasi, the second capital city of Ghana. The magnitude of the effect of Pro-rata system (flexible payment terms) on NHIS enrollment rate was estimated with binary logistic regression model. Results: The odds for an individual to enroll onto NHIS with mobile phone increases about 2 times more when payment of insurance premium is on pro-rata basis ie. flexible payment terms (p=0.008, CI=1.212-3.565). Conclusion: The study advocates the National Health Insurance Authority consider this alternative payment system that has the potential of attracting a greater proportion of the informal sector to be enrolled or retained onto the scheme.

Keywords: enrollment, health insurance, mobile phone, pro-rata

Procedia PDF Downloads 393
3475 Role of Human Wharton’s Jelly Mesenchymal Stem Cells Conditioned Media in Alleviating Kidney Injury via Inhibition of Renin-Angiotensin System in Diabetic Nephropathy

Authors: Pardis Abolghasemi, Benyamin Hatamsaz

Abstract:

Background: Diabetic nephropathy is a serious health problem described by specific kidney structure and functional disturbance. Renoprotective effects of the stem cells secretase have been shown in many kidney diseases. The aim is to evaluate the capability of human Wharton’s jelly mesenchymal stem cells conditioned media (hWJMSCs-CM) to alleviate DN in streptozotocin (STZ)-induced diabetes. Methods: Diabetic nephropathy was induced by injection of STZ (60 mg/kg, IP) in twenty rats. Conditioned media was extracted from hWJMSCs at third passages. At week 8, diabetic rats were divided into two groups: treated (hWJMSCs-CM, 500 μl/rat for three weeks, IP) and not treated (DN). In the 11th week, three groups (control, DN and DN+hWJMSCs-CM) were kept in metabolic cages and urine was collected for 24h. Blood pressure (BP) and heart rate (HR) were continuously recorded. The serum samples were maintained for measuring BUN, Cr and angiotensin-converting enzyme (ACE) activity. The left kidney was kept at -80°C for ACE activity assessment. The right kidney and pancreas were used for histopathologic evaluation. Result: Diabetic nephropathy was detected by microalbuminuria and increased albumin/creatinine ratio, as well as the pancreas and renal structural disturbance. Glomerular filtration rate, BP and HR increased in the DN group. The ACE activity was elevated in the serum and kidneys of the DN group. Administration of hWJMSCs-CM modulated the renal functional and structural disturbance and decreased the ACE activity. Conclusion: Conditioned media was extracted from hWJMSCs may have a Renoprotective effect in diabetic nephropathy. This may happen through regulation of ACE activity and renin-angiotensin system inhibition.

Keywords: diabetic nephropathy, mesenchymal stem cells, immunomodulation, anti-inflammation

Procedia PDF Downloads 201
3474 Impact of Out-Of-Pocket Payments on Health Care Finance and Access to Health Care Services: The Case of Health Transformation Program in Turkey

Authors: Bengi Demirci

Abstract:

Out-of-pocket payments have become one of the common models adopted by health care reforms all over the world, and they have serious implications for not only the financial set-up of the health care systems in question but also for the people involved in terms of their access to the health care services provided. On the one hand, out-of-pocket payments are used in raising resources for the finance of the health care system and in decreasing non-essential health care expenses by having a deterrent role on the patients. On the other hand, out-of-pocket payment model causes regressive distribution effect by putting more burdens on the lower income groups and making them refrain from using health care services. Being a relatively incipient country having adopted the out-of-pocket payment model within the context of its Health Transformation Program which has been ongoing since the early 2000s, Turkey provides a good case for re-evaluating the pros and cons of this model in order not to sacrifice equality in access to health care for raising revenue for health care finance and vice versa. Therefore this study aims at analyzing the impact of out-of-pocket payments on the health finance system itself and on the patients’ access to healthcare services in Turkey where out-of-pocket payment model has been in use for a while. In so doing, data showing the revenue obtained from out-of-pocket payments and their share in health care finance are analyzed. In addition to this, data showing the change in the amount of expenditure made by patients on health care services after the adoption of out-of-pocket payments and the change in the use of various health care services in the meanwhile are examined. It is important for the incipient countries like Turkey to be careful in striking the right balance between the objective of cost efficiency and that of equality in accessing health care services while adopting the out-of-pocket payment model.

Keywords: health care access, health care finance, health reform, out-of-pocket payments

Procedia PDF Downloads 371