Search results for: consumer data right
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 25973

Search results for: consumer data right

17573 Pre-Transformation Phase Reconstruction for Deformation-Induced Transformation in AISI 304 Austenitic Stainless Steel

Authors: Manendra Singh Parihar, Sandip Ghosh Chowdhury

Abstract:

Austenitic stainless steels are widely used and give a good combination of properties. When this steel is plastically deformed, a phase transformation of the metastable Face Centred Cubic Austenite to the stable Body Centred Cubic (α’) or to the Hexagonal close packed (ԑ) martensite may occur, leading to the enhancement in the mechanical properties like strength. The work was based on variant selection and corresponding texture analysis for the strain induced martensitic transformation during deformation of the parent austenite FCC phase to form the product HCP and the BCC martensite phases separately, obeying their respective orientation relationships. The automated method for reconstruction of the parent phase orientation using the EBSD data of the product phase orientation is done using the MATLAB and TSL-OIM software. The method of triplets was used which involves the formation of a triplet of neighboring product grains having a common variant and linking them using a misorientation-based criterion. This led to the proper reconstruction of the pre-transformation phase orientation data and thus to its microstructure and texture. The computational speed of current method is better compared to the previously used methods of reconstruction. The reconstruction of austenite from ԑ and α’ martensite was carried out for multiple samples and their IPF images, pole figures, inverse pole figures and ODFs were compared. Similar type of results was observed for all samples. The comparison gives the idea for estimating the correct sequence of the transformation i.e. γ → ε → α’ or γ → α’, during deformation of AISI 304 austenitic stainless steel.

Keywords: variant selection, reconstruction, EBSD, austenitic stainless steel, martensitic transformation

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17572 The Effects of Six Weeks Endurance Training and Aloe Vera on COX-2 and VEGF Levels in Mice with Breast Cancer

Authors: Alireza Barari, Ahmad Abdi

Abstract:

The aim of this study was to determine the effects of the effects of six weeks endurance training and Aloe Vera on cyclooxygenase 2 (COX-2) and VEGF levels in mice with breast cancer. For this purpose, 35 rats were randomly divided into 5 groups: control (healthy), control (cancer), training (cancer), Aloe Vera (cancer) and Aloe Vera + training (cancer). Induction of breast cancer tumors were done in mice by planting method. The training program includes six weeks of swimming training was done in three sessions per week. Training time from 10 minutes on the first day increased to 60 minutes in second week, and by stabilizing this time, the water flow rate was increased from 7 to 15 liters per minute. 300 mg per kg body weight of Aloe Vera extract was injected into the peritoneal. Sampling was done 48 hours after the last exercise session. K-S test to determine the normality of the data and analysis of variance for repeated measures and Tukey test was used to analyze the data. A significant difference in the p<0.05 accepted. The results showed that induction of cancer cells significantly increased levels of COX-2 in aloe group and VEGF in training and Aloe Vera + training groups. The results suggest that swimming exercise and Aloe Vera can reduce levels of COX-2 and VEGF in mice with breast cancer.The results of this study, Induction of cancer cells significantly increased levels of COX-2 and MMP-9 in the control group compared with the cancer control group. The results suggest that Aloe Vera can probably inhibit the cyclooxygenase pathway and thus production of prostaglandin E2 decrease of arachidonic acid.

Keywords: endurance training, aloe vera, COX-2, VEGF

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17571 Simulation of Solar Assisted Absorption Cooling and Electricity Generation along with Thermal Storage

Authors: Faezeh Mosallat, Eric L. Bibeau, Tarek El Mekkawy

Abstract:

Availability of a wide variety of renewable resources, such as large reserves of hydro, biomass, solar and wind in Canada provides significant potential to improve the sustainability of energy uses. As buildings represent a considerable portion of energy use in Canada, application of distributed solar energy systems for heating and cooling may increase the amount of renewable energy use. Parabolic solar trough systems have seen limited deployments in cold northern climates as they are more suitable for electricity production in southern latitudes. Heat production by concentrating solar rays using parabolic troughs can overcome the poor efficiencies of flat panels and evacuated tubes in cold climates. A numerical dynamic model is developed to simulate an installed parabolic solar trough facility in Winnipeg. The results of the numerical model are validated using the experimental data obtained from this system. The model is developed in Simulink and will be utilized to simulate a tri-generation system for heating, cooling and electricity generation in remote northern communities. The main objective of this simulation is to obtain operational data of solar troughs in cold climates as this is lacking in the literature. In this paper, the validated Simulink model is applied to simulate a solar assisted absorption cooling system along with electricity generation using organic Rankine cycle (ORC) and thermal storage. A control strategy is employed to distribute the heated oil from solar collectors among the above three systems considering the temperature requirements. This modeling provides dynamic performance results using real time minutely meteorological data which are collected at the same location the solar system is installed. This is a big step ahead of the current models by accurately calculating the available solar energy at each time step considering the solar radiation fluctuations due to passing clouds. The solar absorption cooling is modeled to use the generated heat from the solar trough system and provide cooling in summer for a greenhouse which is located next to the solar field. A natural gas water heater provides the required excess heat for the absorption cooling at low or no solar radiation periods. The results of the simulation are presented for a summer month in Winnipeg which includes the amount of generated electric power from ORC and contribution of solar energy in the cooling load provision

Keywords: absorption cooling, parabolic solar trough, remote community, validated model

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17570 Measurements and Predictions of Hydrates of CO₂-rich Gas Mixture in Equilibrium with Multicomponent Salt Solutions

Authors: Abdullahi Jibril, Rod Burgass, Antonin Chapoy

Abstract:

Carbon dioxide (CO₂) is widely used in reservoirs to enhance oil and gas production, mixing with natural gas and other impurities in the process. However, hydrate formation frequently hinders the efficiency of CO₂-based enhanced oil recovery, causing pipeline blockages and pressure build-ups. Current hydrate prediction methods are primarily designed for gas mixtures with low CO₂ content and struggle to accurately predict hydrate formation in CO₂-rich streams in equilibrium with salt solutions. Given that oil and gas reservoirs are saline, experimental data for CO₂-rich streams in equilibrium with salt solutions are essential to improve these predictive models. This study investigates the inhibition of hydrate formation in a CO₂-rich gas mixture (CO₂, CH₄, N₂, H₂ at 84.73/15/0.19/0.08 mol.%) using multicomponent salt solutions at concentrations of 2.4 wt.%, 13.65 wt.%, and 27.3 wt.%. The setup, test fluids, methodology, and results for hydrates formed in equilibrium with varying salt solution concentrations are presented. Measurements were conducted using an isochoric pressure-search method at pressures up to 45 MPa. Experimental data were compared with predictions from a thermodynamic model based on the Cubic-Plus-Association equation of state (EoS), while hydrate-forming conditions were modeled using the van der Waals and Platteeuw solid solution theory. Water activity was evaluated based on hydrate suppression temperature to assess consistency in the inhibited systems. Results indicate that hydrate stability is significantly influenced by inhibitor concentration, offering valuable guidelines for the design and operation of pipeline systems involved in offshore gas transport of CO₂-rich streams.

Keywords: CO₂-rich streams, hydrates, monoethylene glycol, phase equilibria

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17569 Wildlife Habitat Corridor Mapping in Urban Environments: A GIS-Based Approach Using Preliminary Category Weightings

Authors: Stefan Peters, Phillip Roetman

Abstract:

The global loss of biodiversity is threatening the benefits nature provides to human populations and has become a more pressing issue than climate change and requires immediate attention. While there have been successful global agreements for environmental protection, such as the Montreal Protocol, these are rare, and we cannot rely on them solely. Thus, it is crucial to take national and local actions to support biodiversity. Australia is one of the 17 countries in the world with a high level of biodiversity, and its cities are vital habitats for endangered species, with more of them found in urban areas than in non-urban ones. However, the protection of biodiversity in metropolitan Adelaide has been inadequate, with over 130 species disappearing since European colonization in 1836. In this research project we conceptualized, developed and implemented a framework for wildlife Habitat Hotspots and Habitat Corridor modelling in an urban context using geographic data and GIS modelling and analysis. We used detailed topographic and other geographic data provided by a local council, including spatial and attributive properties of trees, parcels, water features, vegetated areas, roads, verges, traffic, and census data. Weighted factors considered in our raster-based Habitat Hotspot model include parcel size, parcel shape, population density, canopy cover, habitat quality and proximity to habitats and water features. Weighted factors considered in our raster-based Habitat Corridor model include habitat potential (resulting from the Habitat Hotspot model), verge size, road hierarchy, road widths, human density, and presence of remnant indigenous vegetation species. We developed a GIS model, using Python scripting and ArcGIS-Pro Model-Builder, to establish an automated reproducible and adjustable geoprocessing workflow, adaptable to any study area of interest. Our habitat hotspot and corridor modelling framework allow to determine and map existing habitat hotspots and wildlife habitat corridors. Our research had been applied to the study case of Burnside, a local council in Adelaide, Australia, which encompass an area of 30 km2. We applied end-user expertise-based category weightings to refine our models and optimize the use of our habitat map outputs towards informing local strategic decision-making.

Keywords: biodiversity, GIS modeling, habitat hotspot, wildlife corridor

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17568 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

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17567 Metformin Protects Cardiac Muscle against the Pro-Apoptotic Effects of Hyperglycaemia, Elevated Fatty Acid and Nicotine

Authors: Christopher R. Triggle, Hong Ding, Khaled Machaca, Gnanapragasam Arunachalam

Abstract:

The antidiabetic drug, metformin, has been in clinical use for over 50 years and remains the first choice drug for the treatment of type two diabetes. In addition to its effectiveness as an oral anti-hyperglycaemic drug metformin also possesses vasculoprotective effects that are assumed to be secondary to its ability to reduce insulin resistance and control glycated hemoglobin levels; however, recent data from our laboratory indicate that metformin also has direct vasoprotective effects that are mediated, at least in part, via the anti-ageing gene, SIRT1. Diabetes is a major risk factor for the development of cardiovascular disease (CVD) and it is also well established that tobacco use further enhances the risk of CVD; however, it is not known whether treatment with metformin can offset the negative effects of diabetes and tobacco use on cardiac function. The current study was therefore designed to investigate 1: the effects of hyperglycaemia (HG) either alone or in the presence of elevated fatty acids (palmitate) and nicotine on the protein expression levels of the deacetylase sirtuin 1 (the protein product of SIRT1), anti-apoptotic Bcl-2, pro-apoptotic BIM and the pro-apoptotic, tumour suppressor protein, acetylated p53 in cardiomyocytes. 2: the ability of metformin to prevent the detrimental effects of HG, palmitate and nicotine on cardiomyocyte survival. Cell culture protocols were designed using a rat cardiomyocyte cell line, H9c2, either under normal glycaemic (NG) conditions of 5.5mM glucose, or hyperglycaemic conditions (HG) of 25mM glucose with, or without, added palmitate (250μM) or nicotine (1.0mM) for 24h. Immuno-blotting was used to detect the expression of sirtuin 1, Bcl-2, BIM, acetylated (Ac)-p53, p53 with β-actin used as the reference protein. Exposure to HG, palmitate, or nicotine alone significantly reduced expression of sirtuin1, Bcl-2 and raised the expression levels of acetylated p53 and BIM; however, the combination of HG, palmitate and nicotine had a synergistic effect to significantly suppress the expression levels of sirtuin 1 and Bcl-2, but further enhanced the expression of Ac-p53, and BIM. The inclusion of 1000μM, but not 50μM, metformin in the H9c2 cell culture protocol prevented the effects of HG, palmitate and nicotine on the pro-apoptotic pathways. Collectively these data indicate that metformin, in addition to its anti-hyperglycaemic and vasculoprotective properties, also has direct cardioprotective actions that offset the negative effects of hyerglycaemia, elevated free fatty acids and nicotine on cardiac cell survival. These data are of particular significance for the treatment of patients with diabetes who are also smokers as the inclusion of metformin in their therapeutic treatment plan should help reduce cardiac-related morbidity and mortality.

Keywords: apoptosis, cardiac muscle, diabetes, metformin, nicotine

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17566 The Effort of Nutrition Status Improvement through Partnership with Early Age Education Institution on Urban Region, City of Semarang, Indonesia

Authors: Oktia Woro Kasmini Handayani, Sri Ratna Rahayu, Efa Nugroho, Bertakalswa Hermawati

Abstract:

In Indonesia, from 2007 until 2013, the prevalence of overnutrition in children under five years and school age tends to increase. Clean and Health Life Behavior of school children supporting nutrition status still below the determined target. On the other side, school institution is an ideal place to educate and form health behavior, that should be initiated as early as possible (Early Age Education/PAUD level). The objective of this research was to find out the effectivity of education model through partnership with school institution in urban region, city of Semarang, Central Java Province, Indonesia. The research used quantitative approach supported with qualitative data. The population consist of all mother having school children of ages 3-5 years within the research region; sampling technique was purposive sampling, as many as 237 mothers. Research instrument was Clean and Health Life Behavior evaluation questionaire, and video as education media. The research used experimental design. Data analysis used effectivity criteria from Sugiyono and 2 paired sampel t test. Education model optimalization in the effort to improve nutrition status indicates t test result with signification < 0.05 (there was significant effect before and after model intervention), with effectivity test result of 79% (effective), but still below expected target which is 80%. Education model need to be utilized and optimallized the implementation so that expected target reached.

Keywords: nutrition status, early age education, clean dan health life behavior, education model

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17565 Examining Awareness, Foresight and Expectations about Fatih Project Increasing the Occasions and Normalizing the Technology Movement

Authors: Agah Tugrul Korucu, Mustafa Mucahit Gundogdu, Tarık Gencturk, Ahmet Yucel

Abstract:

Countries are developing big projects and supplying financial resource for developing technological substructure and integrating technology into the education. In Turkey, the Ministry of Education, with the aim of integrating ICT into learning and teaching processes, created a project named increasing occasions and normalizing the technology movement. FATIH Project with this project, the aim is to create teaching environments which are enriched with technology. In orientating people with the technology and integrating technology into the education, teacher and teacher candidates have a big responsibility. While teachers are using technology in lesson, the devices in class and the methods developed are important factors. The aim of this research is to examine awareness, and foresight about FATIH Project in different aspects. This study was conducted during the practice period of the second semester in the 2014-2015 academic years. The working group of the research was created from 209 teacher candidates which are from different teaching departments in the Ahmet Kelesoglu Education Faculty of Necmettin Erbakan University. Scanning model was used in this research. In research, as a getting data tool evaluation of “opinion about FATIH Project: awareness, foresight and expectation scale” which was developed by Karal et. al.; personal information form which was developed by researchers were used. Cronbach coefficient which is the reliability of the scale is 0.91. In analyzing the data, statistical package program average, standard deviation, percentage, correlation, t-test and variance analysis test were used.

Keywords: Fatih Project, information and communication technologies, information technology integration, views on the Fatih Project, technology integration in education

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17564 Organizational Culture and Its Internalization of Change in the Manufacturing and Service Sector Industries in India

Authors: Rashmi Uchil, A. H. Sequeira

Abstract:

Post-liberalization era in India has seen an unprecedented growth of mergers, both domestic as well as cross-border deals. Indian organizations have slowly begun appreciating this inorganic method of growth. However, all is not well as is evidenced in the lowering value creation of organizations after mergers. Several studies have identified that organizational culture is one of the key factors that affects the success of mergers. But very few studies have been attempted in this realm in India. The current study attempts to identify the factors in the organizational culture variable that may be unique to India. It also focuses on the difference in the impact of organizational culture on merger of organizations in the manufacturing and service sectors in India. The study uses a mixed research approach. An exploratory research approach is adopted to identify the variables that constitute organizational culture specifically in the Indian scenario. A few hypotheses were developed from the identified variables and tested to arrive at the Grounded Theory. The Grounded Theory approach used in the study, attempts to integrate the variables related to organizational culture. Descriptive approach is used to validate the developed grounded theory with a new empirical data set and thus test the relationship between the organizational culture variables and the success of mergers. Empirical data is captured from merged organizations situated in major cities of India. These organizations represent significant proportions of the total number of organizations which have adopted mergers. The mix of industries included software, banking, manufacturing, pharmaceutical and financial services. Mixed sampling approach was adopted for this study. The first phase of sampling was conducted using the probability method of stratified random sampling. The study further used the non-probability method of judgmental sampling. Adequate sample size was identified for the study which represents the top, middle and junior management levels of the organizations that had adopted mergers. Validity and reliability of the research instrument was ensured with appropriate tests. Statistical tools like regression analysis, correlation analysis and factor analysis were used for data analysis. The results of the study revealed a strong relationship between organizational culture and its impact on the success of mergers. The study also revealed that the results were unique to the extent that they highlighted a marked difference in the manner of internalization of change of organizational culture after merger by the organizations in the manufacturing sector. Further, the study reveals that the organizations in the service sector internalized the changes at a slower rate. The study also portrays the industries in the manufacturing sector as more proactive and can contribute to a change in the perception of the said organizations.

Keywords: manufacturing industries, mergers, organizational culture, service industries

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17563 Nurse-Reported Perceptions of Medication Safety in Private Hospitals in Gauteng Province.

Authors: Madre Paarlber, Alwiena Blignaut

Abstract:

Background: Medication administration errors remains a global patient safety problem targeted by the WHO (World Health Organization), yet research on this matter is sparce within the South African context. Objective: The aim was to explore and describe nurses’ (medication administrators) perceptions regarding medication administration safety-related culture, incidence, causes, and reporting in the Gauteng Province of South Africa, and to determine any relationships between perceived variables concerned with medication safety (safety culture, incidences, causes, reporting of incidences, and reasons for non-reporting). Method: A quantitative research design was used through which self-administered online surveys were sent to 768 nurses (medication administrators) (n=217). The response rate was 28.26%. The survey instrument was synthesised from the Agency of Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety Culture, the Registered Nurse Forecasting (RN4CAST) survey, a survey list prepared from a systematic review aimed at generating a comprehensive list of medication administration error causes and the Medication Administration Error Reporting Survey from Wakefield. Exploratory and confirmatory factor analyses were used to determine the validity and reliability of the survey. Descriptive and inferential statistical data analysis were used to analyse quantitative data. Relationships and correlations were identified between items, subscales and biographic data by using Spearmans’ Rank correlations, T-Tests and ANOVAs (Analysis of Variance). Nurses reported on their perceptions of medication administration safety-related culture, incidence, causes, and reporting in the Gauteng Province. Results: Units’ teamwork deemed satisfactory, punitive responses to errors accentuated. “Crisis mode” working, concerns regarding mistake recording and long working hours disclosed as impacting patient safety. Overall medication safety graded mostly positively. Work overload, high patient-nurse ratios, and inadequate staffing implicated as error-inducing. Medication administration errors were reported regularly. Fear and administrative response to errors effected non-report. Non-report of errors’ reasons was affected by non-punitive safety culture. Conclusions: Medication administration safety improvement is contingent on fostering a non-punitive safety culture within units. Anonymous medication error reporting systems and auditing nurses’ workload are recommended in the quest of improved medication safety within Gauteng Province private hospitals.

Keywords: incidence, medication administration errors, medication safety, reporting, safety culture

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17562 Web-Based Decision Support Systems and Intelligent Decision-Making: A Systematic Analysis

Authors: Serhat Tüzün, Tufan Demirel

Abstract:

Decision Support Systems (DSS) have been investigated by researchers and technologists for more than 35 years. This paper analyses the developments in the architecture and software of these systems, provides a systematic analysis for different Web-based DSS approaches and Intelligent Decision-making Technologies (IDT), with the suggestion for future studies. Decision Support Systems literature begins with building model-oriented DSS in the late 1960s, theory developments in the 1970s, and the implementation of financial planning systems and Group DSS in the early and mid-80s. Then it documents the origins of Executive Information Systems, online analytic processing (OLAP) and Business Intelligence. The implementation of Web-based DSS occurred in the mid-1990s. With the beginning of the new millennia, intelligence is the main focus on DSS studies. Web-based technologies are having a major impact on design, development and implementation processes for all types of DSS. Web technologies are being utilized for the development of DSS tools by leading developers of decision support technologies. Major companies are encouraging its customers to port their DSS applications, such as data mining, customer relationship management (CRM) and OLAP systems, to a web-based environment. Similarly, real-time data fed from manufacturing plants are now helping floor managers make decisions regarding production adjustment to ensure that high-quality products are produced and delivered. Web-based DSS are being employed by organizations as decision aids for employees as well as customers. A common usage of Web-based DSS has been to assist customers configure product and service according to their needs. These systems allow individual customers to design their own products by choosing from a menu of attributes, components, prices and delivery options. The Intelligent Decision-making Technologies (IDT) domain is a fast growing area of research that integrates various aspects of computer science and information systems. This includes intelligent systems, intelligent technology, intelligent agents, artificial intelligence, fuzzy logic, neural networks, machine learning, knowledge discovery, computational intelligence, data science, big data analytics, inference engines, recommender systems or engines, and a variety of related disciplines. Innovative applications that emerge using IDT often have a significant impact on decision-making processes in government, industry, business, and academia in general. This is particularly pronounced in finance, accounting, healthcare, computer networks, real-time safety monitoring and crisis response systems. Similarly, IDT is commonly used in military decision-making systems, security, marketing, stock market prediction, and robotics. Even though lots of research studies have been conducted on Decision Support Systems, a systematic analysis on the subject is still missing. Because of this necessity, this paper has been prepared to search recent articles about the DSS. The literature has been deeply reviewed and by classifying previous studies according to their preferences, taxonomy for DSS has been prepared. With the aid of the taxonomic review and the recent developments over the subject, this study aims to analyze the future trends in decision support systems.

Keywords: decision support systems, intelligent decision-making, systematic analysis, taxonomic review

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17561 Psycho-Social Problems Faced by Transgenders in Pakistani Society: A Qualitative Study

Authors: Amna bibi, Hina Rana

Abstract:

In the social, behavioral, and medical sciences, and particularly in Pakistani popular culture and political discourse, transgender issues are a relatively recent subject of research. The present study aimed to explore the lived experiences related to psycho-social issues faced by transgenders in Pakistani society. In this qualitative study, phenomenology research design was used. The purposive and snowball sampling techniques were used for data collection and in-depth interviews were conducted with N= 8 transgenders belonging to Lahore city, Pakistan. All interviews were audio recorded and transcribed properly. Interpretative phenomenological analysis was used to generate results in terms of themes. The results of the current study revealed different major themes such as psychological, social, and financial problems. Several emergent and sub-themes were also generated such as insomnia, suicidal ideation, stress, physical abuse, social rejection, discrimination at work workplace, less job opportunities, and harassment. Current study indicate that transgender suffer from different problems and struggle hard for their daily living. It was concluded that there should be a step taken at government level for the betterment of this community. The findings of the present study can help out transgender communities and activist to uncover their problem and empowering transgender individuals through education, skill development, and opportunities for growth. Their abilities can be utilized by providing education, polishing their skills, and employment opportunities. The data provides the knowledge that there should be strategies at family, society and government level for the betterment of transgenders.

Keywords: psychological issues, social issues, financial issues, transgender, Pakistani society

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17560 Psycho-Social Problems Faced by Transgenders in Pakistani Society: A Qualitative Study”

Authors: Amna Bibi, Hina Rana

Abstract:

In the social, behavioral, and medical sciences, and particularly in Pakistani popular culture and political discourse, transgender issues are a relatively recent subject of research. The present study aimed to explore the lived experiences related to psycho-social issues faced by transgenders in Pakistani society. In this qualitative study, phenomenology research design was used. The purposive and snowball sampling techniques were used for data collection and in-depth interviews were conducted with N= 8 transgenders belonging to Lahore city, Pakistan. All interviews were audio recorded and transcribed properly. Interpretative phenomenological analysis was used to generate results in terms of themes. The results of the current study revealed different major themes such as psychological, social, and financial problems. Several emergent and sub-themes were also generated such as insomnia, suicidal ideation, stress, physical abuse, social rejection, discrimination at work workplace, less job opportunities, and harassment. Current study indicate that transgender suffer from different problems and struggle hard for their daily living. It was concluded that there should be a step taken at government level for the betterment of this community. The findings of the present study can help out transgender communities and activist to uncover their problem and empowering transgender individuals through education, skill development, and opportunities for growth. Their abilities can be utilized by providing education, polishing their skills, and employment opportunities. The data provides the knowledge that there should be strategies at family, society and government level for the betterment of transgenders.

Keywords: psychological issues, social issues, financial issues, transgender, Pakistani society

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17559 Modulation of Alternative Respiration Pathyway under Salt Stress in Exogenous Estrogen-Treated Maize Seedlings

Authors: Farideh K. Khosroushahi, Serkan Erdal, Mucip Geni̇şel

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Soil salinity is one of the major abiotic stress factors that restricts arable land and reduces crop productivity worldwide. High salt concentration adversely affects plant growth and development inducing water deficit, ionic toxicity, nutrient imbalance, and lead to oxidative stress. Although the stimulating role of mammalian sex hormones on various biological and biochemical processes under normal and stress condition have been proven, there is no study regarding with these hormone's effect on modulation of the alternative respiration pathway and AOX gene expression. In this study, changes in alternative respiration pathway in leaves of maize seedlings under salinity and the possible modulating effect of estrogen on these changes were investigated. Maize seedlings were grown in a hydroponic media for 11 days and then were exposed to salt stress for 3 days after being sprayed estrogen. The data obtained from oxygen consumption revealed that salt stress elevated cellular respiration value in the leaves. In addition, a marked increase was observed at alternative respiration level in salt-stressed seedlings. Compared to salt application alone, supplementation with estrogen resulted in a significant rise in alternative oxidase (AOX) activities. Similarly, while salt stress caused to rise in expressions of AOX gene compared to control seedlings, estrogen application resulted in further activation of these genes’ expression compared to stressed-seedlings alone. These data revealed that mitigating role of estrogen against the detrimental effects of salt stress is linked to modulation of alternative respiration pathway.

Keywords: alternative oxidase, estrogen, Ssalt stress, AOX, maize

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17558 Non-Adherence to Antidepressant Treatment and Its Predictors among Outpatients with Depressive Disorders

Authors: Selam Mulugeta, Barkot Milkias, Mesfin Araya, Abel Worku, Eyasu Mulugeta

Abstract:

In Ethiopia, there is inadequate information on non-adherence to antidepressant treatment in patients with depressive disorders. Having awareness of the pattern of adherence is important in future prognosis, quality of life, and functionality in these patients. This hospital-based cross-sectional quantitative study was done on a sample of 216 consecutive outpatients with depressive disorders. Data were collected using questionnaires through in-person and phone call interviews. The 8-item Morisky scale was used to assess the pattern of medication adherence. Other specially developed tools were used to obtain sociodemographic and clinical information from electronic medical records and patient interviews. Data were analyzed using the Statistical Package for the Social Sciences Version - 25. Univariate and multivariable analyses were carried out to assess factors associated with non-adherence. 90% of the participants had a primary diagnosis of major depressive disorder. Based on the 8-item Morisky Medication Adherence Scale, the prevalence of non-adherence was found to be 84.7%. Living distance between 11 to 50 km from the hospital (AOR= 11, 95% CI (29,46.6)), post-secondary level of education (AOR= 8.3, 95% CI (1, 64.4)) and taking multiple medications (AOR= 6.1, 95% CI (1, 34.9)) were found to have significantly increased odds of non-adherence. Non-adherence was significantly associated with factors such as increased living distance from the hospital, relatively higher educational level, and polypharmacy. Proper and patient-centered psychoeducation, addressing the communication gap between patients and doctors, adherence to prescribing guidelines, avoiding polypharmacy unless indicated & working on accessibility of treatment is essential to decrease non-adherence.

Keywords: depressive disorders, Ethiopia, medication adherence, Addis Ababa

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17557 The Comparison between Public's Social Distances against Syrian Refugees and Perceptions of Access to Healthcare Services: Istanbul Sample

Authors: Pinar Dogan, Merve Tarhan, Ahu Kurklu

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Syrian refugees who sheltering due to war has protected by the Government of Turkey since 2011. Since Syria was a medium-low income country prior to the war, it is known that chronic health problems weren’t common among citizens. However, it is also known that they frequently use health services in our country because of the spread of infectious and acute diseases due to insufficient sanitation and crowding after the war. This study was planned to compare the social distances of the community against the Syrian refugees and the perceptions of accessing health care services. The descriptive-cross sectional study was carried out on 1262 individuals living in Istanbul. A questionnaire form consisted of Personal Information Form, The Bogardus Social Distance Scale (BSDS) and The Survey of Access to Healthcare Services (AHS) was used as data collection tool. Descriptive tests and chi-square test were used for statistical analysis. It was found that the majorities of participants was satisfied with the health services and were waiting for more than 40 minutes to be examined. It was determined that participants have high scores from BSDS. At the same time, the majority of participants stated that their level of access to health care is diminishing due to refugees. Participants who experienced disruption in access to health services due to refugees were found to have higher scores from BSDS. The data collection process in the study will continue until 2400 individuals are reached. With these conclusions, it is considered necessary that the effect of the presence of the refugees in reaching the health services and nursing care of the society should be revealed through extensive researches to be conducted in Turkey.

Keywords: health care services, nursing care, social distances, Syrian refugees

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17556 Predicting Resistance of Commonly Used Antimicrobials in Urinary Tract Infections: A Decision Tree Analysis

Authors: Meera Tandan, Mohan Timilsina, Martin Cormican, Akke Vellinga

Abstract:

Background: In general practice, many infections are treated empirically without microbiological confirmation. Understanding susceptibility of antimicrobials during empirical prescribing can be helpful to reduce inappropriate prescribing. This study aims to apply a prediction model using a decision tree approach to predict the antimicrobial resistance (AMR) of urinary tract infections (UTI) based on non-clinical features of patients over 65 years. Decision tree models are a novel idea to predict the outcome of AMR at an initial stage. Method: Data was extracted from the database of the microbiological laboratory of the University Hospitals Galway on all antimicrobial susceptibility testing (AST) of urine specimens from patients over the age of 65 from January 2011 to December 2014. The primary endpoint was resistance to common antimicrobials (Nitrofurantoin, trimethoprim, ciprofloxacin, co-amoxiclav and amoxicillin) used to treat UTI. A classification and regression tree (CART) model was generated with the outcome ‘resistant infection’. The importance of each predictor (the number of previous samples, age, gender, location (nursing home, hospital, community) and causative agent) on antimicrobial resistance was estimated. Sensitivity, specificity, negative predictive (NPV) and positive predictive (PPV) values were used to evaluate the performance of the model. Seventy-five percent (75%) of the data were used as a training set and validation of the model was performed with the remaining 25% of the dataset. Results: A total of 9805 UTI patients over 65 years had their urine sample submitted for AST at least once over the four years. E.coli, Klebsiella, Proteus species were the most commonly identified pathogens among the UTI patients without catheter whereas Sertia, Staphylococcus aureus; Enterobacter was common with the catheter. The validated CART model shows slight differences in the sensitivity, specificity, PPV and NPV in between the models with and without the causative organisms. The sensitivity, specificity, PPV and NPV for the model with non-clinical predictors was between 74% and 88% depending on the antimicrobial. Conclusion: The CART models developed using non-clinical predictors have good performance when predicting antimicrobial resistance. These models predict which antimicrobial may be the most appropriate based on non-clinical factors. Other CART models, prospective data collection and validation and an increasing number of non-clinical factors will improve model performance. The presented model provides an alternative approach to decision making on antimicrobial prescribing for UTIs in older patients.

Keywords: antimicrobial resistance, urinary tract infection, prediction, decision tree

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17555 Performance the SOFA and APACHEII Scoring System to Predicate the Mortality of the ICU Cases

Authors: Yu-Chuan Huang

Abstract:

Introduction: There is a higher mortality rate for unplanned transfer to intensive care units. It also needs a longer length of stay and makes the intensive care unit beds cannot be effectively used. It affects the immediate medical treatment of critically ill patients, resulting in a drop in the quality of medical care. Purpose: The purpose of this study was using SOFA and APACHEII score to analyze the mortality rate of the cases transferred from ED to ICU. According to the score that should be provide an appropriate care as early as possible. Methods: This study was a descriptive experimental design. The sample size was estimated at 220 to reach a power of 0.8 for detecting a medium effect size of 0.30, with a 0.05 significance level, using G-power. Considering an estimated follow-up loss, the required sample size was estimated as 242 participants. Data were calculated by medical system of SOFA and APACHEII score that cases transferred from ED to ICU in 2016. Results: There were 233 participants meet the study. The medical records showed 33 participants’ mortality. Age and sex with QSOFA , SOFA and sex with APACHEII showed p>0.05. Age with APCHHII in ED and ICU showed r=0.150, 0,268 (p < 0.001**). The score with mortality risk showed: ED QSOFA is r=0.235 (p < 0.001**), exp(B)=1.685(p = 0.007); ICU SOFA 0.78 (p < 0.001**), exp(B)=1.205(p < 0.001). APACHII in ED and ICU showed r= 0.253, 0.286 (p < 0.001**), exp(B) = 1.041,1.073(p = 0.017,0.001). For SOFA, a cutoff score of above 15 points was identified as a predictor of the 95% mortality risk. Conclusions: The SOFA and APACHE II were calculated based on initial laboratory data in the Emergency Department, and during the first 24 hours of ICU admission. In conclusion, the SOFA and APACHII score is significantly associated with mortality and strongly predicting mortality. Early predictors of morbidity and mortality, which we can according the predicting score, and provide patients with a detail assessment and proper care, thereby reducing mortality and length of stay.

Keywords: SOFA, APACHEII, mortality, ICU

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17554 Parametric Study for Optimal Design of Hybrid Bridge Joint

Authors: Bongsik Park, Jae Hyun Park, Jae-Yeol Cho

Abstract:

Mixed structure, which is a kind of hybrid system, is incorporating steel beam and prestressed concrete beam. Hybrid bridge adopting mixed structure have some merits. Main span length can be made longer by using steel as main span material. In case of cable-stayed bridge having asymmetric span length, negative reaction at side span can be restrained without extra restraining devices by using weight difference between main span material and side span material. However angle of refraction might happen because of rigidity difference between materials and stress concentration also might happen because of abnormal loading transmission at joint in the hybrid bridge. Therefore the joint might be a weak point of the structural system and it needs to pay attention to design of the joint. However, design codes and standards about the joint in the hybrid-bridge have not been established so the joint designs in most of construction cases have been very conservative or followed previous design without extra verification. In this study parametric study using finite element analysis for optimal design of hybrid bridge joint is conducted. Before parametric study, finite element analysis was conducted based on previous experimental data and it is verified that analysis result approximated experimental data. Based on the finite element analysis results, parametric study was conducted. The parameters were selected as those have influences on joint behavior. Based on the parametric study results, optimal design of hybrid bridge joint has been determined.

Keywords: parametric study, optimal design, hybrid bridge, finite element analysis

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17553 A U-Net Based Architecture for Fast and Accurate Diagram Extraction

Authors: Revoti Prasad Bora, Saurabh Yadav, Nikita Katyal

Abstract:

In the context of educational data mining, the use case of extracting information from images containing both text and diagrams is of high importance. Hence, document analysis requires the extraction of diagrams from such images and processes the text and diagrams separately. To the author’s best knowledge, none among plenty of approaches for extracting tables, figures, etc., suffice the need for real-time processing with high accuracy as needed in multiple applications. In the education domain, diagrams can be of varied characteristics viz. line-based i.e. geometric diagrams, chemical bonds, mathematical formulas, etc. There are two broad categories of approaches that try to solve similar problems viz. traditional computer vision based approaches and deep learning approaches. The traditional computer vision based approaches mainly leverage connected components and distance transform based processing and hence perform well in very limited scenarios. The existing deep learning approaches either leverage YOLO or faster-RCNN architectures. These approaches suffer from a performance-accuracy tradeoff. This paper proposes a U-Net based architecture that formulates the diagram extraction as a segmentation problem. The proposed method provides similar accuracy with a much faster extraction time as compared to the mentioned state-of-the-art approaches. Further, the segmentation mask in this approach allows the extraction of diagrams of irregular shapes.

Keywords: computer vision, deep-learning, educational data mining, faster-RCNN, figure extraction, image segmentation, real-time document analysis, text extraction, U-Net, YOLO

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17552 Research on the Aeration Systems’ Efficiency of a Lab-Scale Wastewater Treatment Plant

Authors: Oliver Marunțălu, Elena Elisabeta Manea, Lăcrămioara Diana Robescu, Mihai Necșoiu, Gheorghe Lăzăroiu, Dana Andreya Bondrea

Abstract:

In order to obtain efficient pollutants removal in small-scale wastewater treatment plants, uniform water flow has to be achieved. The experimental setup, designed for treating high-load wastewater (leachate), consists of two aerobic biological reactors and a lamellar settler. Both biological tanks were aerated by using three different types of aeration systems - perforated pipes, membrane air diffusers and tube ceramic diffusers. The possibility of homogenizing the water mass with each of the air diffusion systems was evaluated comparatively. The oxygen concentration was determined by optical sensors with data logging. The experimental data was analyzed comparatively for all three different air dispersion systems aiming to identify the oxygen concentration variation during different operational conditions. The Oxygenation Capacity was calculated for each of the three systems and used as performance and selection parameter. The global mass transfer coefficients were also evaluated as important tools in designing the aeration system. Even though using the tubular porous diffusers leads to higher oxygen concentration compared to the perforated pipe system (which provides medium-sized bubbles in the aqueous solution), it doesn’t achieve the threshold limit of 80% oxygen saturation in less than 30 minutes. The study has shown that the optimal solution for the studied configuration was the radial air diffusers which ensure an oxygen saturation of 80% in 20 minutes. An increment of the values was identified when the air flow was increased.

Keywords: flow, aeration, bioreactor, oxygen concentration

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17551 Contribution of Different Farming Systems to Soil and Ecological Health in Trans Nzoia County, Kenya

Authors: Janeth Chepkemoi, Richard Onwonga, Noel Templer, Elkana Kipkoech, Angela Gitau

Abstract:

Conventional agriculture is one of the leading causes of land degradation, threatening the sustainability of food production. Organic farming promotes practices that have the potential of feeding the world while also promoting ecological health. A study was therefore carried out with the aim of conceptualizing how such farming systems are contributing to ecological health in Trans Nzoia County. 71 farmers were interviewed and data was collected on parameters such as land preparation, agroforestry, soil fertility management, soil and water conservation, and pests and diseases. A soil sample was also collected from each farm for laboratory analysis. Data collected were analyzed using Microsoft Excel and SPSS version 21. Results showed that 66% of the respondents practiced organic farming whereas 34% practiced conventional farming. Intercropping and crop rotations were the most common cropping systems and the most preferred land preparation tools among both organic and conventional farmers were tractors and hand hoes. Organic farms fared better in agroforestry, organic soil amendments, land and water conservation, and soil chemical properties. Pests and disease, however, affected organic farms more than conventional. The average nitrogen (%), K (Cmol/ kg and P (ppm) of organic soils were 0.26, 0.7 and 26.18 respectively, conventional soils were 0.21, 0.66 and 22.85. Soil organic carbon content of organic farms averaged a higher percentage of 2.07% as compared to 1.91 for the conventional. In conclusion, most farmers in Trans Nzoia County had transitioned into ecologically friendly farming practices that improved the quality and health of the soil and therefore promoted its sustainability.

Keywords: organic farming, conventional farming, ecological health, soil health

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17550 Drama Education: Towards Building Multicultural Adolescent Peer Relationships

Authors: Tahnee West

Abstract:

Drama education is increasingly understood as a useful tool in promoting positive social change and cultural awareness. The effects of both positive and negative peer relationships are also a researched facet of education systems. Despite this, very little research has been conducted in the intersection of these two areas, even given current, significant public interest surrounding multicultural relationships. This research addresses a problem faced by educators and students: facilitating meaningful multicultural relationships. The research explores the following question in an Australian context: in what ways does Drama education affect peer relationships between culturally diverse students? In doing so, the study explores the various challenges and experiences of a multicultural group of adolescents, in terms of forming and maintaining effective intercultural friendships, while participating in a series of drama workshops. The project presents a starting point for providing educators with strategies for inclusivity and relationship development amongst diverse student populations. Findings show that Drama education can positively affect culturally diverse young people’s peer relationships; interactions between participants and data collected in focus groups throughout the eight-week Drama program show a steady improvement in sense of trust, support, tolerance, empathy, familiarity with other participants, and enjoyment. Data also points to a positive correlation between the Drama activities and improved conflict resolution and communication skills, as well as an improved understanding of the other participants’ cultures. Diversities and commonalities within the group were explored, with similarities encouraging social cohesion, and decreasing cultural ‘cliques’.

Keywords: cultural diversity, drama education, friendship, multicultural, peer relationships

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17549 A Qualitative Study to Explore the Experiences of Muslim Nurses Working in an Acute Setting During the Covid-19 Pandemic

Authors: Sujatha Shanmugasundaram

Abstract:

Background: It has been since one year that COVID-19 has emerged into the world. Since then, healthcare professionals facing a great challenge in to fight against this deadly virus. According to World Health Organization (WHO) 2021, it is estimated that more than 131 million confirmed cases and 2million deaths around the world due to this pandemic. Nurses are the frontline workers who play a major role in safeguarding the lives of the people in acute care settings. Evidence suggests that there are numbers of research have been carried out on nurses' and healthcare provider’s experiences during the pandemic. But, unfortunately, there are no or little evidence available on Muslim nurse’s perspective. Hence, this research will investigate the experiences of Muslim nurses working in an acute care setting during the pandemic. Purpose: The purpose of the study is to explore the experiences of Muslim nurses working in an acute setting during the COVID-19 pandemic. Research Methods: A qualitative research approach will be utilized for the study. Semi-structured interview schedule will be used to collect the data. Face to face interviews will be conducted. All interviews will be conducted in Arabic, and it will be audio recorded. Verbatim will be noted. Muslim nurses working in an acute setting will be included in the study. Convenient sampling technique will be used to recruit the participants. Ethical approval will be obtained from the study sites. Strauss and Corbin's thematic analysis will be used to analyze the data. Conclusion: Considering that nurses are the frontline workers, they have a significant role in dealing with this COVID-19. It is a great challenge for the nurses working in an acute care setting. Thus, this study will bring out significant findings that will impact the nursing practice.

Keywords: acute care, COVID-19, experiences, muslim nurses

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17548 Artificial Intelligence in Bioscience: The Next Frontier

Authors: Parthiban Srinivasan

Abstract:

With recent advances in computational power and access to enough data in biosciences, artificial intelligence methods are increasingly being used in drug discovery research. These methods are essentially a series of advanced statistics based exercises that review the past to indicate the likely future. Our goal is to develop a model that accurately predicts biological activity and toxicity parameters for novel compounds. We have compiled a robust library of over 150,000 chemical compounds with different pharmacological properties from literature and public domain databases. The compounds are stored in simplified molecular-input line-entry system (SMILES), a commonly used text encoding for organic molecules. We utilize an automated process to generate an array of numerical descriptors (features) for each molecule. Redundant and irrelevant descriptors are eliminated iteratively. Our prediction engine is based on a portfolio of machine learning algorithms. We found Random Forest algorithm to be a better choice for this analysis. We captured non-linear relationship in the data and formed a prediction model with reasonable accuracy by averaging across a large number of randomized decision trees. Our next step is to apply deep neural network (DNN) algorithm to predict the biological activity and toxicity properties. We expect the DNN algorithm to give better results and improve the accuracy of the prediction. This presentation will review all these prominent machine learning and deep learning methods, our implementation protocols and discuss these techniques for their usefulness in biomedical and health informatics.

Keywords: deep learning, drug discovery, health informatics, machine learning, toxicity prediction

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17547 Role and Impact of Artificial Intelligence in Sales and Distribution Management

Authors: Kiran Nair, Jincy George, Suhaib Anagreh

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Artificial intelligence (AI) in a marketing context is a form of a deterministic tool designed to optimize and enhance marketing tasks, research tools, and techniques. It is on the verge of transforming marketing roles and revolutionize the entire industry. This paper aims to explore the current dissemination of the application of artificial intelligence (AI) in the marketing mix, reviewing the scope and application of AI in various aspects of sales and distribution management. The paper also aims at identifying the areas of the strong impact of AI in factors of sales and distribution management such as distribution channel, purchase automation, customer service, merchandising automation, and shopping experiences. This is a qualitative research paper that aims to examine the impact of AI on sales and distribution management of 30 multinational brands in six different industries, namely: airline; automobile; banking and insurance; education; information technology; retail and telecom. Primary data is collected by means of interviews and questionnaires from a sample of 100 marketing managers that have been selected using convenient sampling method. The data is then analyzed using descriptive statistics, correlation analysis and multiple regression analysis. The study reveals that AI applications are extensively used in sales and distribution management, with a strong impact on various factors such as identifying new distribution channels, automation in merchandising, customer service, and purchase automation as well as sales processes. International brands have already integrated AI extensively in their day-to-day operations for better efficiency and improved market share while others are investing heavily in new AI applications for gaining competitive advantage.

Keywords: artificial intelligence, sales and distribution, marketing mix, distribution channel, customer service

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17546 Clouds Influence on Atmospheric Ozone from GOME-2 Satellite Measurements

Authors: S. M. Samkeyat Shohan

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This study is mainly focused on the determination and analysis of the photolysis rate of atmospheric, specifically tropospheric, ozone as function of cloud properties through-out the year 2007. The observational basis for ozone concentrations and cloud properties are the measurement data set of the Global Ozone Monitoring Experiment-2 (GOME-2) sensor on board the polar orbiting Metop-A satellite. Two different spectral ranges are used; ozone total column are calculated from the wavelength window 325 – 335 nm, while cloud properties, such as cloud top height (CTH) and cloud optical thick-ness (COT) are derived from the absorption band of molecular oxygen centered at 761 nm. Cloud fraction (CF) is derived from measurements in the ultraviolet, visible and near-infrared range of GOME-2. First, ozone concentrations above clouds are derived from ozone total columns, subtracting the contribution of stratospheric ozone and filtering those satellite measurements which have thin and low clouds. Then, the values of ozone photolysis derived from observations are compared with theoretical modeled results, in the latitudinal belt 5˚N-5˚S and 20˚N - 20˚S, as function of CF and COT. In general, good agreement is found between the data and the model, proving both the quality of the space-borne ozone and cloud properties as well as the modeling theory of ozone photolysis rate. The found discrepancies can, however, amount to approximately 15%. Latitudinal seasonal changes of photolysis rate of ozone are found to be negatively correlated to changes in upper-tropospheric ozone concentrations only in the autumn and summer months within the northern and southern tropical belts, respectively. This fact points to the entangled roles of temperature and nitrogen oxides in the ozone production, which are superimposed on its sole photolysis induced by thick and high clouds in the tropics.

Keywords: cloud properties, photolysis rate, stratospheric ozone, tropospheric ozone

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17545 Disability and Sexuality: A Human Right Approach to Sexual and Reproductive Health of the Hearing Impaired Adolescents In Developing Countries

Authors: Doctor Akanle Florence Foluso

Abstract:

Access to health care and people’s ability to having a responsible, satisfying and safe sexual life is clearly a defined human right of people with hearing impairment and others with disabilities this paper looks at disability and sexuality: a human right approach to sexual and reproductive health of the hearing impaired adolescents in developing countries. This paper investigates the extent to which the hearing impaired has a satisfying, safe sexual life and whether their human right in regards to information education is violated. The study population consists of all hearing impaired adolescents and young adults aged 10-24 years who are currently enrolled in the primary and secondary schools in Nigeria. A sample of 389 hearing impaired adolescents was selected, an adapted version of the illustrative questionnaire for interview – survey by Johncleland was used to collect the data. A correlation of 0.80 was obtained at p<0.05 level of significance. Teachers in the schools of the deaf who used sign language were used in the administration of the questionnaire. The data generated were analyzed using Frequency Counts, Percentages, Means and Standard Deviation to give a Summary on responses on access to information, education, voluntary testing and counselling and other reproductive services. This is to investigate if the sexual and reproductive right violated or protected. Findings show that a gap exists in the level of knowledge of SRH services, voluntary counselling because more than half the respondents are not aware of these services in their community. Access to information, education and health services are rights denied the hearing impaired. So their SRH rights are violated.

Keywords: sexual right diability, family planning, pregnancy, diability

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17544 Medical Examiner Collection of Comprehensive, Objective Medical Evidence for Conducted Electrical Weapons and Their Temporal Relationship to Sudden Arrest

Authors: Michael Brave, Mark Kroll, Steven Karch, Charles Wetli, Michael Graham, Sebastian Kunz, Dorin Panescu

Abstract:

Background: Conducted electrical weapons (CEW) are now used in 107 countries and are a common law enforcement less-lethal force practice in the United Kingdom (UK), United States of America (USA), Canada, Australia, New Zealand, and others. Use of these devices is rarely temporally associated with the occurrence of sudden arrest-related deaths (ARD). Because such deaths are uncommon, few Medical Examiners (MEs) ever encounter one, and even fewer offices have established comprehensive investigative protocols. Without sufficient scientific data, the role, if any, played by a CEW in a given case is largely supplanted by conjecture often defaulting to a CEW-induced fatal cardiac arrhythmia. In addition to the difficulty in investigating individual deaths, the lack of information also detrimentally affects being able to define and evaluate the ARD cohort generally. More comprehensive, better information leads to better interpretation in individual cases and also to better research. The purpose of this presentation is to provide MEs with a comprehensive evidence-based checklist to assist in the assessment of CEW-ARD cases. Methods: PUBMED and Sociology/Criminology data bases were queried to find all medical, scientific, electrical, modeling, engineering, and sociology/criminology peer-reviewed literature for mentions of CEW or synonymous terms. Each paper was then individually reviewed to identify those that discussed possible bioelectrical mechanisms relating CEW to ARD. A Naranjo-type pharmacovigilance algorithm was also employed, when relevant, to identify and quantify possible direct CEW electrical myocardial stimulation. Additionally, CEW operational manuals and training materials were reviewed to allow incorporation of CEW-specific technical parameters. Results: Total relevant PUBMED citations of CEWs were less than 250, and reports of death extremely rare. Much relevant information was available from Sociology/Criminology data bases. Once the relevant published papers were identified, and reviewed, we compiled an annotated checklist of data that we consider critical to a thorough CEW-involved ARD investigation. Conclusion: We have developed an evidenced-based checklist that can be used by MEs and their staffs to assist them in identifying, collecting, documenting, maintaining, and objectively analyzing the role, if any, played by a CEW in any specific case of sudden death temporally associated with the use of a CEW. Even in cases where the collected information is deemed by the ME as insufficient for formulating an opinion or diagnosis to a reasonable degree of medical certainty, information collected as per the checklist will often be adequate for other stakeholders to use as a basis for informed decisions. Having reviewed the appropriate materials in a significant number of cases careful examination of the heart and brain is likely adequate. Channelopathy testing should be considered in some cases, however it may be considered cost prohibitive (aprox $3000). Law enforcement agencies may want to consider establishing a reserve fund to help manage such rare cases. The expense may stay the enormous costs associated with incident-precipitated litigation.

Keywords: ARD, CEW, police, TASER

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