Search results for: opioid withdrawal management

Authors: Abhishek Oswal

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Background: Inconsistencies between the guidelines for childhood asthma can pose a diagnostic challenge to clinicians. NICE guidelines are the most commonly followed guidelines in primary care in the UK; they state that to be diagnosed with asthma, a child must be more than 5 years old and must have objective evidence of the disease. When diagnoses are coded in general practice (GP), these guidelines may be superseded by communications from secondary care. Hence it is imperative that diagnoses are correct, as per up to date guidelines and evidence, as this affects follow up and management both in primary and secondary care. Methods: A snapshot audit at a general practice surgery was undertaken of children (less than 16 years old) with a coded diagnosis of 'asthma', to review the age at diagnosis and whether any objective evidence of asthma was documented at diagnosis. 50 cases of asthma in children presenting to the emergency department (ED) were then audited to review the age at presentation, whether there was evidence of previous asthma diagnosis and whether the patient was discharged from ED. A repeat audit is planned in ED this winter. Results: In a GP surgery, there were 83 coded cases of asthma in children. 51 children (61%) were diagnosed under 5, with 9 children (11%) who had objective evidence of asthma documented at diagnosis. In ED, 50 cases were collected, of which 4 were excluded as they were referred to the other services, or for incorrect coding. Of the 46 remaining, 27 diagnoses confirmed to NICE guidelines (59%). 33 children (72%) were discharged from ED. Discussion: The most likely reason for the apparent low rate of a correct diagnosis is the significant challenge of obtaining objective evidence of asthma in children. There were a number of patients who were diagnosed from secondary care services and then coded as 'asthma' in GP, without having objective documented evidence. The electronic patient record (EPR) system used in our emergency department (ED) did not allow coding of 'suspected diagnosis' or of 'viral induced wheeze'. This may have led to incorrect diagnoses coded in primary care, of children who had no confirmed diagnosis of asthma. We look forward to the re-audit, as the EPR system has been updated to allow suspected diagnoses. In contrast to the NICE guidelines used here, British Thoracic Society (BTS) guidelines allow for a trial of treatment and subsequent confirmation of diagnosis without objective evidence. It is possible that some of the cases which have been classified as incorrect in this audit may still meet other guidelines. Conclusion: The diagnosis of asthma in children is challenging. Incorrect diagnoses may be related to clinical pressures and the provision of services to allow compliance with NICE guidelines. Consensus statements between the various groups would also aid the decision-making process and diagnostic dilemmas that clinicians face, to allow more consistent care of the patient.

Keywords: asthma, diagnosis, primary care, emergency department, guidelines, audit

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Authors: Mwafaq Ibdah, Mossab, Yahyaa, Dor Rachmany, Yoram Gerchman, Doron Holland, Liora Shaltiel-Harpaz

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Pear Psylla is the most important pest of pear in all pear-growing regions, in Asian, European, and the USA. Pear psylla damages pears in several ways: high-density populations of these insects can cause premature leaf and fruit drop, diminish plant growth, and reduce fruit size. In addition, their honeydew promotes sooty mold on leaves and russeting on fruit. Pear psyllas are also considered vectors of pear pathogens such as Candidatus Phytoplasma pyri causing pear decline that can lead to loss of crop and tree vigor, and sometimes loss of trees. Psylla control is a major obstacle to efficient integrated pest management. Recently we have identified two naturally resistance pear accessions (Py.760-261 and Py.701-202) in the Newe Ya’ar live collection. GC-MS volatile metabolic profiling identified several volatile compounds common in these accessions but lacking, or much less common, in a sensitive accession, the commercial Spadona variety. Among these volatiles were styrene and its derivatives. When the resistant accessions were used as inter-stock, the volatile compounds appear in commercial Spadona scion leaves, and it showed reduced susceptibility to pear psylla. Laboratory experiments and applications of some of these volatile compounds were very effective against psylla eggs, nymphs, and adults. The genes and enzymes involved in the specific reactions that lead to the biosynthesis of styrene in plant are unknown. We have identified a phenolic acid decarboxylase that catalyzes the formation of p-hydroxystyrene, which occurs as a styrene analog in resistant pear genotypes. The His-tagged and affinity chromatography purified E. coli-expressed pear PyPAD1 protein could decarboxylate p-coumaric acid and ferulic acid to p-hydroxystyrene and 3-methoxy-4-hydroxystyrene. In addition, PyPAD1 had the highest activity toward p-coumaric acid. Expression analysis of the PyPAD gene revealed that its expressed as expected, i.e., high when styrene levels and psylla resistance were high.

Keywords: pear Psylla, volatile, GC-MS, resistance

Procedia PDF Downloads 146

Authors: Sweta Pandey, Samridhi Dhyani, Susmita Chaudhuri

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Klebsiella pneumoniae causes a wide range of infections, including urinary tract infections, sepsis, bacteremia, pneumonia, and liver abscesses. The emergence of multi-drug resistance in this bacterium led to a major setback for clinical management. WHO also endorsed a need for finding alternative therapy to antibiotics for the treatment of these infections. Development of vaccines and passive antibody therapy has been proven as a potent alternative to antibiotics in the case of MDR, XDR, and PDR Klebsiella infections. Siderophore receptors have been demonstrated to be overexpressed for the internalization of iron siderophore complexes during infections in most Gram-negative bacteria. For the present study, immune response to siderophore receptors to establish this protein as a potential immunogen for the development of therapeutic leads was explored. Clinical strains of Klebsiella pneumoniae were grown in iron-deficient conditions, and the iron-regulated outer membrane proteins were extracted and characterized through mass spectrometry for specific identification. The gene for identified protein was cloned in pET- 28a vector and expressed in E. coli. The native protein and the recombinant protein were isolated and purified and used as antigens for the generation of immune response in BALB/c mice. The native protein of Klebsiella pneumoniae grown in iron-deficient conditions was identified as FepA (Ferrienterobactin receptor) and other siderophore receptors. This 80 kDa protein generated an immune response in BALB/c mice. The antiserum from mice after subsequent booster doses was collected and showed binding with FepA protein in western blot and phagocytic uptake of the K. pneumoniae in the presence antiserum from immunized mice also observed from the animal studies after bacterial challenge post immunisation in mice have shown bacterial clearance. The antiserum from mice showed binding and clearance of the Klebsiella pneumoniae bacteria in vitro and in vivo. These antigens used for generating an active immune response in mice can further be used for therapeutic monoclonal antibody development against Klebsiella pneumoniae infections.

Keywords: antiserum, FepA, Klebsiella pneumoniae, multi drug resistance, siderophore receptor

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Authors: Hyun-Ju Oh, Soon-Rim Suh, Mihan Kim

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The steady and rapid increase of the older population is a global phenomenon. Chronic diseases and disabilities are increased due to aging. In general, exercise has been known to be most effective in preventing and managing chronic back pain. However, it is hard for the older women to initiate and maintain the exercise. Transtheoretical model (TTM) is one of the theories explain behavioral changes such as exercise. The application of the program considering the stage of behavior change is effective for the elderly woman to start and maintain the exercise. The purpose of this study was to develop TTM based exercise program and to examine its effect for elderly women with chronic back-pain. For the program evaluation, the non-equivalent control pre-posttest design was applied. The independent variable of this study is exercise intervention program. The contents of the program were constructed considering the characteristics of the elderly women with chronic low back pain, focusing on the process of change, the stage of change by the previous studies. The developed exercise program was applied to the elderly women with chronic low back pain in the planning stage and the preparation stage. The subjects were 50 older women over 65 years of age with chronic back-pain who did not practice regular exercise. The experimental group (n=25) received the 8weeks TTM based exercise program. The control group received the book which named low back pain management. Data were collected at three times: before the exercise intervention, right after the intervention, and 4weeks after the intervention. The dependent variables were the processes of change, decisional balance, exercise self-efficacy, back-pain, depression and muscle strength. The results of this study were as follows. Processes of change (<.001), pros of decisional balance (<.001), exercise self-efficacy (<.001), back pain (<.001), depression (<.001), muscle strength (<.001) were higher in the experimental group than in the control group right after the program and 4weeks after the programs. The results of this study show that applying the TTM based exercise program increases the use of the change process, increases the exercise self-efficacy, increases the stage of changing the exercise behavior and strengthens the muscular strength by lowering the degree of pain and depression Respectively. The significance of the study was to confirm the effect of continuous exercise by maintaining regular exercise habits by applying exercise program of the transtheoretical model to the chronic low back pain elderly with exercise intention.

Keywords: chronic back pain, elderly, exercise, women

Procedia PDF Downloads 251

Authors: Babajide S. Adeokin, Oguntoyinbo O. Kazeem

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The not so pleasing state of the nation's quality of education has been a major area of research. Many researchers have looked into various aspects of the educational system and organizational structure in relation to the quality of service delivery of the staff members. However, there is paucity of research in areas relating to the sense of competence and commitment in relation to leadership styles. Against this backdrop, this study investigated the impact of leadership style and sense of competence on the performance of post-primary school teachers in Oyo state Nigeria. Data were generated across public secondary schools in the city using survey design method. Ibadan as a metropolis has eleven local government areas contained in it. A systematic random sampling technique of the eleven local government areas in Ibadan was done and five local government areas were selected. The selected local government areas are Akinyele, Ibadan North, Ibadan North-East, Ibadan South and Ibadan South-West. Data were obtained from a range of two – three public secondary schools selected in each of the local government areas mentioned above. Also, these secondary schools are a representation of the variations in the constructs under consideration across the Ibadan metropolis. Categorically, all secondary school teachers in Ibadan were clustered into selected schools in those found across the five local government areas. In all, a total of 272 questionnaires were administered to public secondary school teachers, while 241 were returned. Findings revealed that transformational leadership style makes room for job commitment when compared with transactional and laissez-faire leadership styles. Teachers with a high sense of competence are more likely to demonstrate more commitment to their job than others with low sense of competence. We recommend that, it is important an assessment is made of the leadership styles employed by principals and school administrators. This guides administrators and principals in to having a clear, comprehensive knowledge of the style they currently adopt in the management of the staff and the school as a whole; and know where to begin the adjustment process from. Also to make an impact on student achievement, being attentive to teachers’ levels of commitment may be an important aspect of leadership for school principals.

Keywords: Ibadan, leadership style, sense of competence, teachers, public secondary schools

Procedia PDF Downloads 291

Authors: M. Manzoor, J. N. Ahmad, R. M. Giblin Davis, N. Javed, M. S. Haider

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The invasive Red Palm Weevil (RPW) (Rhynchophorus ferrugineus [Olivier] (Coleoptera: Curculionidae) is one of the most destructive palm pests in the world. Synthetic pesticides are environmentally hazardous pest control strategies being used in the past with emerging need of eco-friendly biological approaches including microbial entomopathogens for RPW management. The sublethal effects of a single entomopathogenic fungus (EPF) Beauveria bassiana (WG-11) (Ascomycota: Hypocreales) and two entomopathogenic nematode (EPN) species Heterorhabditis bacteriophora (Poinar) and Steinernema carpocapsae (Weiser) (Nematoda: Rhabditida) were evaluated in various combinations against laboratory-reared 3rd, 5th and 8th instar larvae of RPW in laboratory assays. Individual and combined effects of both entomopathogens (EP) were observed after the pre-application of B. bassiana fungus at 1-2-week intervals. A number of parameters were measured after the application of sub-lethal doses of EPF such as diet consumption, development, frass production, mortality, and weight gain. Combined treatments were tested for additive and synergistic effects. Synergism was more frequently observed in B. bassiana and S. carpocapsae combined treatments than in B. bassiana and H. bacteriophora combinations. Early instar larvae of RPW were more susceptible than older instars. Synergistic effects were observed in the 3rd and 5th instars exposed to B. bassiana and S. carpocapsae at 0, 7 and 14-day intervals. Whereas, in 8th instar larvae, the synergistic effect was observed only in B. bassiana and S. carpocapsae treatments after 0 and 7 days intervals. EPN treatments decreased pupation, egg hatching and emergence of adults. Lethal effects of nematodes were also observed in all growth stages of R. ferrugineus. Reduced larval weight, increased larval, pre-pupal and pupal duration, reduced adult weight and life span were observed. Sub-lethal concentrations of both entomopathogens induced variations in the different developmental stages and reduced food consumption, frass production, growth, and weight gain. So, on the basis of results, it is concluded that synthetic pesticides should be replaced with environmentally friendly sustainable biopesticides.

Keywords: H. bacteriophora, S. carpocapsae, B. bassiana, mortality

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Authors: Masoud Sheidaei, Mohammad-Reza Kordasti, Fahimeh Koohdar

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Calotropis procera (Aiton) W.T.Aiton, (Apocynaceae), is an economically and medicinally important plant species which is an evergreen, perennial shrub growing in arid and semi-arid climates, and can tolerate very low annual rainfall (150 mm) and a dry season. The plant can also tolerate temperature ran off 20 to30°C and is not frost tolerant. This plant species prefers free-draining sandy soils but can grow also in alkaline and saline soils.It is found at a range of altitudes from exposed coastal sites to medium elevations up to 1300 m. Due to morpho-physiological adaptations of C. procera and its ability to tolerate various abiotic stresses. This taxa can compete with desirable pasture species and forms dense thickets that interfere with stock management, particularly mustering activities. Caloteropis procera grows only in southern part of Iran where in comprises a limited number of geographical populations. We used different population genetics and r landscape analysis to produce data on geographical populations of C. procera based on molecular genetic study using SCoT molecular markers. First, we used spatial principal components (sPCA), as it can analyze data in a reduced space and can be used for co-dominant markers as well as presence / absence data as is the case in SCoT molecular markers. This method also carries out Moran I and Mantel tests to reveal spatial autocorrelation and test for the occurrence of Isolation by distance (IBD). We also performed Random Forest analysis to identify the importance of spatial and geographical variables on genetic diversity. Moreover, we used both RDA (Redundency analysis), and LFMM (Latent factor mixed model), to identify the genetic loci significantly associated with geographical variables. A niche modellng analysis was carried our to predict present potential area for distribution of these plants and also the area present by the year 2050. The results obtained will be discussed in this paper.

Keywords: population genetics, landscape genetic, Calotreropis procera, niche modeling, SCoT markers

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Authors: Nashaat Mazrui, Oarabile Mogobe, Barbara Ngwenya, Ketlhatlogile Mosepele, Mangaliso Gondwe

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Over the last several decades, the world has seen a rapid increase in activities such as deforestation, agriculture, and energy use. Subsequently, trace elements are being deposited into our water bodies, where they can accumulate to toxic levels in aquatic organisms and can be transferred to humans through fish consumption. Thus, though fish is a good source of essential minerals and omega-3 fatty acids, it can also be a source of toxic elements. Monitoring trace elements in fish is important for the proper management of aquatic systems and the protection of human health. The aim of this study was to determine concentrations of trace elements in sediment and muscle tissues of Clarias gariepinus at Lake Ngami, in the Okavango Delta in northern Botswana, during low floods. The fish were bought from local fishermen, and samples of muscle tissue were acid-digested and analyzed for iron, zinc, copper, manganese, molybdenum, nickel, chromium, cadmium, lead, and arsenic using inductively coupled plasma optical emission spectroscopy (ICP-OES). Sediment samples were also collected and analyzed for the elements and for organic matter content. Results show that in all samples, iron was found in the greatest amount while cadmium was below the detection limit. Generally, the concentrations of elements in sediment were higher than in fish except for zinc and arsenic. While the concentration of zinc was similar in the two media, arsenic was almost 3 times higher in fish than sediment. To evaluate the risk to human health from fish consumption, the target hazard quotient (THQ) and cancer risk for an average adult in Botswana, sub-Saharan Africa, and riparian communities in the Okavango Delta was calculated for each element. All elements were found to be well below regulatory limits and do not pose a threat to human health except arsenic. The results suggest that other benthic feeding fish species could potentially have high arsenic levels too. This has serious implications for human health, especially riparian households to whom fish is a key component of food and nutrition security.

Keywords: Arsenic, African sharp tooth cat fish, Okavango delta, trace elements

Procedia PDF Downloads 191

Authors: Fusun Akdag

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Today, as business becomes increasingly global, managers/leaders of multinational companies or local companies work with employees or customers from a variety of cultural backgrounds. To do this effectively, they need to develop cultural competence. Therefore, cultural intelligence (CQ) becomes a vitally important aptitude and skill, especially for leaders. The organizational success or failure depends upon the way, the kind of leadership which has been provided to its members. The culture we are born into deeply effects our values, beliefs, and behavior. Cultural intelligence (CQ) focuses on how well individuals can relate and work across cultures. CQ helps minimize conflict and maximize performance of a diverse workforce. The term 'decision,' refers to a commitment to a course of action that is intended to serve the interests and values of particular people. One dimension of culture that has received attention is individualism-collectivism or, independence-interdependence. These dimensions are associated with different conceptualizations of the 'self.' Individualistic cultures tend to value personal goal pursuit as opposed to pursuit of others’ goals. Collectivistic cultures, by contrast, view the 'self' as part of a whole. Each person is expected to work with his or her in-group toward goals, generally pursue group harmony. These differences underlie cross-cultural variation in decision-making, such as the decision modes people use, their preferences, negotiation styles, creativity, and more. The aim of this study is determining the effect of CQ on decision making styles of male and female managers in Turkey, an emergent economy framework. The survey is distributed to gather data from managers at various companies. The questionnaire consists of three parts: demographics, The Cultural Intelligence Scale (CQS) to measure the four dimensions of cultural intelligence and General Decision Making Style (GMDS) Inventory to measure the five subscales of decision making. The results will indicate the Turkish managers’ score at metacognitive, cognitive, motivational and behavioral aspects of cultural intelligence and to what extent these scores affect their rational, avoidant, dependent, intuitive and spontaneous decision making styles since business leaders make dozens of decisions every day that influence the success of the company and also having an impact on employees, customers, shareholders and the market.

Keywords: cultural intelligence, decision making, gender differences, management styles,

Procedia PDF Downloads 369

Authors: Mihretu Erjabo

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Halaba special district is characterized by drought, soil erosion, high population pressure, poor livestock production, lack of feed for livestock, very deep water table, very low productivity of crops and food insufficiency. In order to address these problems, the woreda agricultural development office along with other management practices such as soil physical conservation measures agroforestry was introduced decades ago as a means to alleviate the problem. However, the level of agroforestry adoption remains low. Objective of this study was to identify the factors that influence adoption of agroforestry technologies by farmers in the district. Random sampling was employed to select two kebele administrations and respondents. Data collection was conducted by rural household questionnaire survey, participatory rural appraisal, questionnaires for local and woreda extension staff, secondary data resources and field observation. A sample of 12 key informants, 6 extension staffs, and 182 households, were used in the data collection. Chi square test used to determine significant relationships between adoption of agroforestry and 15 selected variables. Out of which eleven were found to be significant to affect farmers’ adoptiveness. These were frequency of visits of farmers (13.39%), participation in training (11.49%), farmers’ attitude towards agroforestry practices (10.61%), frequency of visits of extensionists (10.38%), participation in extension meeting (10.34%), participation in field day (10.28%), land holding size (9.29%), level of literacy (8.78%), awareness about the importance of agroforestry technology packages (7.06%), time taken from their residence to nearest extension (5.04%) and gender of respondents (3.34%). This study also identified various factors that result in low adoption rates of agroforestry including fear of competition, seedling, rainfall and labour shortage, free grazing, financial problem, expecting trees as soil degrader and long span of trees and lack of need ranking. To improve farmers’ adoption, the factors identified should be well addressed by launching a series and recurrent outreach extension program appropriate and suitable to farmers need.

Keywords: farmers attitude, farmers participation, soil degradation, technology packages

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Authors: Joyce K. Anastasi, Bernadette Capili

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Community Engagement Strategies to Assist with the Development of an RCT Among People Living with HIV Our research team focuses on developing and testing protocols to manage chronic symptoms. For many years, our team designed and implemented symptom management studies for people living with HIV (PLWH). We identify symptoms that are not curative and are not adequately controlled by conventional therapies. As an exemplar, we describe how we successfully engaged PLWH in developing and refining our research feasibility protocol for distal sensory peripheral neuropathy (DSP) associated with HIV. With input from PLWH with DSP, our research received National Institutes of Health (NIH) research funding support. Significance: DSP is one of the most common neurologic complications in HIV. It is estimated that DSP affects 21% to 50% of PLWH. The pathogenesis of DSP in HIV is complex and unclear. Proposed mechanisms include cytokine dysregulation, viral protein-produced neurotoxicity, and mitochondrial dysfunction associated with antiretroviral medications. There are no FDA-approved treatments for DSP in HIV. Purpose: Aims: 1) to explore the impact of DSP on the lives of PLWH, 2) to identify patients’ perspectives on successful treatments for DSP, 3) to identify interventions considered feasible and sensitive to the needs of PLWH with DSP, and 4) to obtain participant input for protocol/study design. Description of Process: We conducted a needs assessment with PLWH with DSP. From our needs assessment, we learned from the patients’ perspective detailed descriptions of their symptoms; physical functioning with DSP; self-care remedies tried, and desired interventions. We also asked about protocol scheduling, instrument clarity, study compensation, study-related burdens, and willingness to participate in a randomized controlled trial (RCT) with a placebo and a waitlist group. Implications: We incorporated many of the suggestions learned from the need assessment. We developed and completed a feasibility study that provided us with invaluable information that informed subsequent NIH-funded studies. In addition to our extensive clinical and research experience working with PLWH, learning from the patient perspective helped in developing our protocol and promoting a successful plan for recruitment and retention of study participants.

Keywords: clinical trial development, peripheral neuropathy, traditional medicine, HIV, AIDS

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Authors: Ayda Youssef, Tarek Rafaat, Iman zaky

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Purpose: Langerhans’ cell histiocytosis (LCH) is not uncommon pathology that implies aberrant proliferation of a specific dendritic (Langerhans) cell. These atypical but mature cells of monoclonal origin can infiltrate many sites of the body and may occur as localized lesions or as widespread systemic disease. Liver is one of the uncommon sites of affection. The twofold objective of this study is to illustrate the radiological presentation of this disease, and to compare these results with previously reported series. Methods and Materials: Between 2007 and 2012, 150 patients with biopsy-proven LCH were treated in our hospital, a paediatric cancer tertiary care center. A retrospective review of radiographic images and reports was performed. There were 33 patients with liver affection are stratified. All patients underwent imaging studies, mostly US and CT. A chart review was performed to obtain demographic, clinical and radiological data. They were analyzed and compared to other published series. Results: Retrospective assessment of 150 patients with LCH was performed, among them 33 patients were identified who had liver involvement. All these patients developed multisystemic disease; They were 12 females and 21 males with (n= 32), seven of them had marked hepatomegaly. Diffuse hypodense liver parenchyma was encountered in five cases, the periportal location has a certain predilection in cases of focal affection where three cases has a hypodense periportal soft tissue sheets, one of them associated with dilated biliary radicals, only one case has multiple focal lesions unrelated to portal tracts. On follow up of the patients, two cases show abnormal morphology of liver with bossy outline. Conclusion: LCH is a not infrequent disease. A high-index suspicion should be raised in the context of diagnosis of liver affection. A biopsy is recommended in the presence of radiological suspicion. Chemotherapy is the preferred therapeutic modality. Liver histiocytosis are not disease specific features but should be interpreted in conjunction with the clinical history and the results of biopsy. Clinical Relevance/Application: Radiologist should be aware of different patterns of hepatobiliary histiocytosis, Thus early diagnosis and proper management of patient can be conducted.

Keywords: langerhans’ cell histiocytosis, liver, medical and health sciences, radiology

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Authors: Airy Huang, Fuji Foo, Aries Prasetya Wibowo

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In recent years, the focus of Natural Language Processing (NLP) development has been gradually shifting from the semantics-based approach to deep learning one, which performs faster with fewer resources. Although it performs well in many applications, the deep learning approach, due to the lack of semantics understanding, has difficulties in noticing and expressing a novel business case with a pre-defined scope. In order to meet the requirements of specific robotic services, deep learning approach is very labor-intensive and time consuming. It is very difficult to improve the capabilities of conversational AI in a short time, and it is even more difficult to self-learn from experiences to deliver the same service in a better way. In this paper, we present an adaptive conversational AI algorithm that combines both semantic knowledge and deep learning to address this issue by learning new business cases through conversations. After self-learning from experience, the robot adapts to the business cases originally out of scope. The idea is to build new or extended robotic services in a systematic and fast-training manner with self-configured programs and constructed dialog flows. For every cycle in which a chat bot (conversational AI) delivers a given set of business cases, it is trapped to self-measure its performance and rethink every unknown dialog flows to improve the service by retraining with those new business cases. If the training process reaches a bottleneck and incurs some difficulties, human personnel will be informed of further instructions. He or she may retrain the chat bot with newly configured programs, or new dialog flows for new services. One approach employs semantics analysis to learn the dialogues for new business cases and then establish the necessary ontology for the new service. With the newly learned programs, it completes the understanding of the reaction behavior and finally uses dialog flows to connect all the understanding results and programs, achieving the goal of self-learning process. We have developed a chat bot service mounted on a kiosk, with a camera for facial recognition and a directional microphone array for voice capture. The chat bot serves as a concierge with polite conversation for visitors. As a proof of concept. We have demonstrated to complete 90% of reception services with limited self-learning capability.

Keywords: conversational AI, chatbot, dialog management, semantic analysis

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Authors: Chuan-Ming Tung, Jin-Cheng Fu, Chia-En Feng

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In recent years, the rapid development of urban land in Taiwan has led to the constant increase of the areas of impervious surface, which has increased the risk of waterlogging during heavy rainfall. Therefore, in recent years, promoting runoff allocation responsibilities has often been used as a means of reducing regional flooding. In this study, the single catchment area covering both urban and rural land as the study area is discussed. Based on Storm Water Management Model, urban and rural land in a single catchment area was explored to develop the runoff allocation responsibilities according to their respective control regulation on land use. The impacts of runoff increment and reduction in sub-catchment area were studied to understand the impact of highly developed urban land on the reduction of flood risk of rural land at the back end. The results showed that the rainfall with 1 hour short delay of 2 years, 5 years, 10 years, and 25 years return period. If the study area was fully developed, the peak discharge at the outlet would increase by 24.46% -22.97% without runoff allocation responsibilities. The front-end urban land would increase runoff from back-end of rural land by 76.19% -46.51%. However, if runoff allocation responsibilities were carried out in the study area, the peak discharge could be reduced by 58.38-63.08%, which could make the front-end to reduce 54.05% -23.81% of the peak flow to the back-end. In addition, the researchers found that if it was seen from the perspective of runoff allocation responsibilities of per unit area, the residential area of urban land would benefit from the relevant laws and regulations of the urban system, which would have a better effect of reducing flood than the residential land in rural land. For rural land, the development scale of residential land was generally small, which made the effect of flood reduction better than that of industrial land. Agricultural land requires a large area of land, resulting in the lowest share of the flow per unit area. From the point of the planners, this study suggests that for the rural land around the city, its responsibility should be assigned to share the runoff. And setting up rain water storage facilities in the same way as urban land, can also take stock of agricultural land resources to increase the ridge of field for flood storage, in order to improve regional disaster reduction capacity and resilience.

Keywords: runoff allocation responsibilities, land use, flood mitigation, SWMM

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Authors: Mohammad Arshad Ikram

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We report three cases of challenging fractures in children treated by intramedullary fixation using the Metaizeau method and achieved anatomical reduction with excellent clinical results. Jean-Paul Metaizeau described the centromedullary fixation for the radial neck in 1980 using K-wires Radial neck fractures are uncommon in children. Treatment of severely displaced fractures is always challenging. Closed reduction techniques are more popular as compared to open reduction due to the low risk of complications. Metaizeau technique of closed reduction with centromedullary pinning is a commonly preferred method of treatment. We present two cases with a severely displaced radial neck fracture, treated by this method and achieved sound union; anatomical position of the radial head and full function were observed two months after surgery. Proximal humerus fractures are another uncommon injury in children accounting for less than 5% of all pediatric fractures. Most of these injuries occur through the growth plate because of its relative weakness. Salter-Harris type I is commonly seen in the younger age group, whereas type II & III occurs in older children and adolescents. In contrast to adults, traumatic glenohumeral dislocation is an infrequently observed condition among children. A combination of proximal humerus fracture and glenohumeral dislocation is extremely rare and occurs in less than 2% of the pediatric population. The management of this injury is always challenging. Treatment ranged from closed reduction with and without internal fixation and open reduction with internal fixation. The children who had closed reduction with centromedullary fixation by the Metaizeau method showed excellent results with the return of full movements at the shoulder in a short time without any complication. We present the case of a child with anterior dislocation of the shoulder associated with a complete displaced proximal humerus metaphyseal fracture. The fracture was managed by closed reduction and then fixation by two centromedullary K-wires using the Metaizeau method, achieving the anatomical reduction of the fracture and dislocation. This method of treatment enables us to achieve excellent radiological and clinical results in a short time.

Keywords: glenohumeral, Metaizeau method, pediatric fractures, radial neck

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Authors: Asiya Rezzouq, Mehdi El Bouchti, Omar Cherkaoui, Sanaa Majid, Souad Zyade

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In recent years, there has been a steady increase in the exploration of new renewable and non-conventional sources for the production of biodegradable nanomaterials. Nature harbours valuable cellulose-rich materials that have so far been under-exploited and can be used to create cellulose derivatives such as cellulose microfibres (CMFs) and cellulose nanocrystals (CNCs). These unconventional sources have considerable potential as alternatives to conventional sources such as wood and cotton. By using agricultural waste to produce these cellulose derivatives, we are responding to the global call for sustainable solutions to environmental and economic challenges. Responsible management of agricultural waste is increasingly crucial to reducing the environmental consequences of its disposal, including soil and water pollution, while making efficient use of these untapped resources. In this study, the main objective was to extract cellulose nanocrystals (CNC) from melon plant residues using methods that are both efficient and sustainable. To achieve this high-quality extraction, we followed a well-defined protocol involving several key steps: pre-treatment of the residues by grinding, filtration and chemical purification to obtain high-quality (CMF) with a yield of 52% relative to the initial mass of the melon plant residue. Acid hydrolysis was then carried out using phosphoric acid and sulphuric acid to convert (CMF) into cellulose nanocrystals. The extracted cellulose nanocrystals were subjected to in-depth characterization using advanced techniques such as transmission electron microscopy (TEM), thermogravimetric analysis (TGA), Fourier transform infrared spectroscopy (FTIR) and X-ray diffraction. The resulting cellulose nanocrystals have exceptional properties, including a large specific surface area, high thermal stability and high mechanical strength, making them suitable for a variety of applications, including as reinforcements for composite materials. In summary, the study highlights the potential for recovering agricultural melon waste to produce high-quality cellulose nanocrystals with promising applications in industry, nanotechnology, and biotechnology, thereby contributing to environmental and economic sustainability.

Keywords: cellulose, melon plant residues, cellulose nanocrystals, properties, applications, composite materials

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Authors: Mahesh Mitra

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Introduction and Purpose: Patellofemoral Pain Syndrome [PFPS] is characterized by pain or discomfort seemingly originating from the contact of posterior surface of Patella with Femur. Given the multifactorial causes and high prevalence there is a need of proper management technique. Also a more comprehensive and best possible Physiotherapy treatment approach has to be devised to enhance the performance of the individual with PFPS. Purpose of the study was to: - Prevalence of PFPS in various sports - To determine if there exists any relationship between the Body Mass Index[BMI] and Pain Intensity in the person playing a sport. - To evaluate the effect of conventional Physiotherapy program, Mobilization and Taping with Proprioceptive training on PFPS. Hypothesis 1. Prevalence is not the same with different sporting activities 2. There is a relationship between BMI and Pain intensity. 3. There is no significant difference in the improvement with the different treatment approaches. Methodology: A sample of 200 sports men were tested for the prevalence of PFPS and their anthropometric measurements were obtained to check for the correlation between BMI vs Pain intensity. Out of which 80 diagnosed cases of PFPS were allotted into three treatment groups and evaluated for Pain at rest and at activity and KUJALA scale. Group I were treated with conventional Physiotherapy that included TENS application and Exercises, Group II were treated with compression mobilization along with exercises, Group III were treated with Taping and Proprioceptive exercises. The variables Pain on rest, activity and KUJALA score were measured initially, at 1 week and at the end of 2 weeks after respective treatment. Data Analysis - Prevalence percentage of PFPS in each sport - Pearsons Correlation coefficient to find the relationship between BMI and Pain during activity. - Repeated measures analysis of variance [ANOVA] to find out the significance during Pre, Mid and Post-test difference among - Newman Kuel Post hoc Test - ANCOVA for the difference amongst group I, II and III. Results and conclusion It was concluded that PFPS was more prevalent in volley ball players [80%] followed by football and basketball [66%] players, then in hand ball and cricket players [46.6%] and 40% in tennis players. There was no relationship between BMI of the individual and Pain intensity. All the three treatment approaches were effective whereas mobilization and taping were more effective than Conventional Physiotherapy program.

Keywords: PFPS, KUJALA score, mobilization, proprioceptive training

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Authors: C. Vogeler

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Change processes such as individualization and digitalization have an impact on higher education. Graduates are expected to cooperate in creative work processes in their professional life. During their studies, they need to be prepared accordingly. This includes modern learning scenarios that integrate the benefits of digital media. Therefore, design thinking and blended learning have been combined in the project-based seminar conception introduced here. The presented seminar conception has been realized and evaluated with students of information sciences since September 2017. Within the seminar, the students learn to work on a project. They apply the methods in a problem-based learning scenario. Task of the case study is to arrange a conference on the topic gaming in libraries. In order to collaborative develop creative possibilities of realization within the group of students the design thinking method has been chosen. Design thinking is a method, used to create user-centric, problem-solving and need-driven innovation through creative collaboration in multidisciplinary teams. Central characteristics are the openness of this approach to work results and the visualization of ideas. This approach is now also accepted in the field of higher education. Especially in problem-based learning scenarios, the method offers clearly defined process steps for creative ideas and their realization. The creative process can be supported by digital media, such as search engines and tools for the documentation of brainstorming, creation of mind maps, project management etc. Because the students have to do two-thirds of the workload in their private study, design thinking has been combined with a blended learning approach. This supports students’ preparation and follow-up of the joint work in workshops (flipped classroom scenario) as well as the communication and collaboration during the entire project work phase. For this purpose, learning materials are provided on a Moodle-based learning platform as well as various tools that supported the design thinking process as described above. In this paper, the seminar conception with a combination of design thinking and blended learning is described and the potentials and limitations of the chosen strategy for the development of a course with a multimedia approach in higher education are reflected.

Keywords: blended learning, design thinking, digital media tools and methods, flipped classroom

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Authors: Igor A. Bessmertny, Bidru C. Enkomaryam

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Active involving patients and communities in health decisions can improve both people’s health and the healthcare system. Adopting artificial intelligence can lead to more accurate and complete patient record management. This review aims to identify the current state of researches conducted using artificial intelligence techniques to improve patient engagement and wellbeing, medical domains used in patient engagement context, and lastly, to assess opportunities and challenges for patient engagement in the wellness process. A search of peer-reviewed publications, reviews, conceptual analyses, white papers, author’s manuscripts and theses was undertaken. English language literature published in 2013– 2022 period and publications, report and guidelines of World Health Organization (WHO) were also assessed. About 281 papers were retrieved. Duplicate papers in the databases were removed. After application of the inclusion and exclusion criteria, 41 papers were included to the analysis. Patient counseling in preventing adverse drug events, in doctor-patient risk communication, surgical, drug development, mental healthcare, hypertension & diabetes, metabolic syndrome and non-communicable chronic diseases are implementation areas in healthcare where patient engagement can be implemented using artificial intelligence, particularly machine learning and deep learning techniques and tools. The five groups of factors that potentially affecting patient engagement in safety are related to: patient, health conditions, health care professionals, tasks and health care setting. Active involvement of patients and families can help accelerate the implementation of healthcare safety initiatives. In sub-Saharan Africa, using digital technologies like artificial intelligence in patient engagement context is low due to poor level of technological development and deployment. The opportunities and challenges available to implement patient engagement strategies vary greatly from country to country and from region to region. Thus, further investigation will be focused on methods and tools using the potential of artificial intelligence to support more simplified care that might be improve communication with patients and train health care professionals.

Keywords: artificial intelligence, patient engagement, machine learning, patient involvement

Procedia PDF Downloads 76

Authors: Jean Paul M. Milambo

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Purpose: Aromatase inhibitors (AIs) are indicated in the treatment of hormone-receptive breast cancer in postmenopausal women in various settings. Studies have shown cardiovascular events in some developed countries. To date the data is sparce for evidence-based recommendations in African clinical settings due to lack of cancer registries, capacity building and surveillance systems. Therefore, this study was conducted to assess the feasibility of HyBeacon® probe genotyping adjunctive to standard care for timely prediction and diagnosis of Aromatase inhibitors (AIs) associated adverse events in breast cancer survivors in Africa. Methods: Cross sectional study was conducted to assess the knowledge of POCT among six African countries using online survey and telephonically contacted. Incremental cost effectiveness ratio (ICER) was calculated, using diagnostic accuracy study. This was based on mathematical modeling. Results: One hundred twenty-six participants were considered for analysis (mean age = 61 years; SD = 7.11 years; 95%CI: 60-62 years). Comparison of genotyping from HyBeacon® probe technology to Sanger sequencing showed that sensitivity was reported at 99% (95% CI: 94.55% to 99.97%), specificity at 89.44% (95% CI: 87.25 to 91.38%), PPV at 51% (95%: 43.77 to 58.26%), and NPV at 99.88% (95% CI: 99.31 to 100.00%). Based on the mathematical model, the assumptions revealed that ICER was R7 044.55. Conclusion: POCT using HyBeacon® probe genotyping for AI-associated adverse events maybe cost effective in many African clinical settings. Integration of preventive measures for early detection and prevention guided by different subtype of breast cancer diagnosis with specific clinical, biomedical and genetic screenings may improve cancer survivorship. Feasibility of POCT was demonstrated but the implementation could be achieved by improving the integration of POCT within primary health cares, referral cancer hospitals with capacity building activities at different level of health systems. This finding is pertinent for a future envisioned implementation and global scale-up of POCT-based initiative as part of risk communication strategies with clear management pathways.

Keywords: breast cancer, diagnosis, point of care, South Africa, aromatase inhibitors

Procedia PDF Downloads 75

Authors: A. K. Faizah, G. Vadamalai, S. K. Balasundram, W. L. Lim

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Pineapple (Ananas comosus) is a common crop in tropical and subtropical areas of the world. Malaysia once ranked as one of the top 3 pineapple producers in the world in the 60's and early 70's, after Hawaii and Brazil. Moreover, government’s recognition of the pineapple crop as one of priority commodities to be developed for the domestics and international markets in the National Agriculture Policy. However, pineapple industry in Malaysia still faces numerous challenges, one of which is the management of disease and pest. Red tip disease on pineapple was first recognized about 20 years ago in a commercial pineapple stand located in Simpang Renggam, Johor, Peninsular Malaysia. Since its discovery, there has been no confirmation on its causal agent of this disease. The epidemiology of red tip disease is still not fully understood. Nevertheless, the disease symptoms and the spread within the field seem to point toward viral infection. Bioassay test on nucleic acid extracted from the red tip-affected pineapple was done on Nicotiana tabacum cv. Coker by rubbing the extracted sap. Localised lesions were observed 3 weeks after inoculation. Negative staining of the fresh inoculated Nicotiana tabacum cv. Coker showed the presence of membrane-bound spherical particles with an average diameter of 94.25nm under transmission electron microscope. The shape and size of the particles were similar to tospovirus. SDS-PAGE analysis of partial purified virions from inoculated N. tabacum produced a strong and a faint protein bands with molecular mass of approximately 29 kDa and 55 kDa. Partial purified virions of symptomatic pineapple leaves from field showed bands with molecular mass of approximately 29 kDa, 39 kDa and 55kDa. These bands may indicate the nucleocapsid protein identity of tospovirus. Furthermore, a handheld sensor, Greenseeker, was used to detect red tip symptoms on pineapple non-destructively based on spectral reflectance, measured as Normalized Difference Vegetation Index (NDVI). Red tip severity was estimated and correlated with NDVI. Linear regression models were calibrated and tested developed in order to estimate red tip disease severity based on NDVI. Results showed a strong positive relationship between red tip disease severity and NDVI (r= 0.84).

Keywords: pineapple, diagnosis, virus, NDVI

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Authors: Abdulkarem Qasem Dammag, Basema Qasim Dammag, Jian Dai

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Change in Land use and Land cover (LU/LC) has a profound impact on the area's natural, economic, and ecological development, and the search for drivers of land cover change is one of the fundamental issues of LU/LC change. The study aimed to assess the temporal and Spatio-temporal dynamics of LU/LC in the past and to predict the future using Landsat images by exploring the characteristics of different LU/LC types. Spatio-temporal patterns of LU/LC change in Ibb Governorate, Yemen, were analyzed based on RS and GIS from 1990, 2005, and 2020. A socioeconomic survey and key informant interviews were used to assess potential drivers of LU/LC. The results showed that from 1990 to 2020, the total area of vegetation land decreased by 5.3%, while the area of barren land, grassland, built-up area, and waterbody increased by 2.7%, 1.6%, 1.04%, and 0.06%, respectively. Based on socio-economic surveys and key informant interviews, natural factors had a significant and long-term impact on land change. In contrast, site construction and socio-economic factors were the main driving forces affecting land change in a short time scale. The analysis results have been linked to the CA-Markov Land Use simulation and forecasting model for the years 2035 and 2050. The simulation results revealed from the period 2020 to 2050, the trend of dynamic changes in land use, where the total area of barren land decreased by 7.0% and grassland by 0.2%, while the vegetation land, built-up area, and waterbody increased by 4.6%, 2.6%, and 0.1 %, respectively. Overall, these findings provide LULC's past and future trends and identify drivers, which can play an important role in sustainable land use planning and management by balancing and coordinating urban growth and land use and can also be used at the regional level in different levels to provide as a reference. In addition, the results provide scientific guidance to government departments and local decision-makers in future land-use planning through dynamic monitoring of LU/LC change.

Keywords: LU/LC change, CA-Markov model, driving forces, change detection, LU/LC change simulation

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Authors: Awole Seid, Yosef Zenebe, Hadgu Gerensea, Kebede Haile Misgina

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Background: Clinical competence is one of the ultimate goals of nursing education. Clinical skills are more than successfully performing tasks; it incorporates client assessment, identification of deficits and the ability to critically think to provide solutions. Assessment of clinical competence, particularly identifying gaps that need improvement and determining the educational needs of nursing students have great importance in nursing education. Thus this study aims determining clinical self-efficacy of final year school of nursing students in three universities of Tigray Region. Methods: A cross-sectional study was conducted on 224 final year school of nursing students from department of nursing, psychiatric nursing, and midwifery on three universities of Tigray region. Anonymous self-administered questionnaire was administered to generate data collected on June, 2017. The data were analyzed using SPSS version 20. The result is described using tables and charts as required. Logistic regression was employed to test associations. Result: The mean age of students was 22.94 + 1.44. Generally, 21% of students have been graduated in the department in which they are not interested. The study demonstrated 28.6% had poor and 71.4% had good perceived clinical self-efficacy. Beside this, 43.8% of psychiatric nursing and 32.6% of comprehensive nursing students have poor clinical self-efficacy. Among the four domains, 39.3% and 37.9% have poor clinical self- efficacy with regard to ‘Professional development’ and ‘Management of care’. Place of the institution [AOR=3.480 (1.333 - 9.088), p=0.011], interest during department selection [AOR=2.202 (1.045 - 4.642), p=.038], and theory-practice gap [AOR=0.224 (0.110 - 0.457), p=0.000] were significantly associated with perceived clinical self-efficacy. Conclusion: The magnitude of students with poor clinically self efficacy was high. Place of institution, theory-practice gap, students interest to the discipline were the significant predictors of clinical self-efficacy. Students from youngest universities have good clinical self-efficacy. During department selection, student’s interest should be respected. The universities and other stakeholders should improve the capacity of surrounding affiliate teaching hospitals to set and improve care standards in order to narrow the theory-practice gap. School faculties should provide trainings to hospital staffs and monitor standards of clinical procedures.

Keywords: clinical self-efficacy, nursing students, Tigray, northern Ethiopia

Procedia PDF Downloads 169

Authors: Aldona Kluczek

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Energy efficient process have become a pressing research field in manufacturing. The arguments for having an effective industrial energy efficiency processes are interacted with factors: economic and environmental impact, and energy security. Improvements in energy efficiency are most often achieved by implementation of more efficient technology or manufacturing process. Current processes of electricity production represents the biggest consumption of energy and the greatest amount of emissions to the environment. The goal of this study is to improve the potential energy-savings and reduce greenhouse emissions related to improvement scenarios for the treatment of hardwood lumber produced by an industrial plant operating in the U.S. through the application of green balancing procedure, in order to find the preferable efficient technology. The green procedure for energy is based on analysis of energy efficiency data. Three alternative scenarios of the cogeneration systems plant (CHP) construction are considered: generation of fresh steam, the purchase of a new boiler with the operating pressure 300 pounds per square inch gauge (PSIG), an installation of a new boiler with a 600 PSIG pressure. In this paper, the application of a bottom-down modelling for energy flow to devise a streamlined Energy and Emission Flow Analyze method for the technology of producing electricity is illustrated. It will identify efficiency or technology of a given process to be reached, through the effective use of energy, or energy management. Results have shown that the third scenario seem to be the efficient alternative scenario considered from the environmental and economic concerns for treating hardwood lumber. The energy conservation evaluation options could save an estimated 6,215.78 MMBtu/yr in each year, which represents 9.5% of the total annual energy usage. The total annual potential cost savings from all recommendations is $143,523/yr, which represents 30.1% of the total annual energy costs. Estimation have presented that energy cost savings are possible up to 43% (US$ 143,337.85), representing 18.6% of the total annual energy costs.

Keywords: alternative scenario improvements, cogeneration system, energy and emission flow analyze, energy balancing, green procedure, hardwood lumber manufacturing process

Procedia PDF Downloads 207

Authors: Szymon Kuczynski, Krystian Liszka, Mariusz Laciak, Andrii Oliinyk, Adam Szurlej

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Compressed natural gas (CNG) represents an excellent compromise between the availability of a technology that is proven and relatively easy to use in many areas of the automotive industry and incurred costs. This fuel causes a lower corrosion effect due to the lower content of products causing the potential difference on the walls of the engine system. Natural gas powered vehicles (NGVs) do not emit any substances that can contaminate water or land. The absence of carcinogenic substances in gaseous fuel extends the life of the engine. In the longer term, it contributes positively to waste management as well as waste disposal. Popularization of propulsion systems powered by natural gas CNG positively affects the reduction of heavy duty transport. For these reasons, CNG as a fuel stimulates considerable interest around the world. Over the last few years, technologies related to use of natural gas as an engine fuel have been developed and improved. These solutions have evolved from the prototype phase to the industrial scale implementation. The widespread availability of gaseous fuels has led to the development of a technology that allows the CNG fuel to be refueled directly from the urban gas network to the vehicle tank (ie. HYGEN - CNGHRS). Home refueling installations, although they have been known for many years, are becoming increasingly important in the present day. The major obstacle in the sale of this technology was, until recently, quite high capital expenditure compared to the later benefits. Home refueling systems allow refueling vehicle tank, with full control of fuel costs and refueling time. CNG Home Refueling Stations (such as HYGEN) allow gas value chain to overcome the dogma that there is a lack of refueling infrastructure allowing companies in gas value chain to participate in transportation market. Technology is based on one stage hydraulic compressor (instead of multistage mechanical compressor technology) which provides the possibility to compress low pressure gas from distribution gas network to 200 bar for its further usage as a fuel for NGVs. This boosts revenues and profits of gas companies by expanding its presence in higher margin of energy sector.

Keywords: alternative fuels, CNG (compressed natural gas), CNG stations, NGVs (natural gas vehicles), gas value chain

Procedia PDF Downloads 199

Authors: Asma Rashid, Shazia Iram, Iftikhar Ahmad

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Mango sudden death is an emerging problem in Pakistan. As its prevalence is observed in almost all mango growing areas and severity varied from 2-5% in Punjab and 5-10% in Sindh. Symptoms on affected trees include bark splitting, discoloration of the vascular tissue, wilting, gummosis and at the end rapid death. Total of n= 45 isolates were isolated from different mango growing areas of Punjab and Sindh. Pathogenicity of these fungal isolates was tested through artificial inoculation method on different hosts (potato tubers, detached mango leaves, detached mango twigs and mango plants) under controlled conditions and all were proved pathogenic with varying degree of aggressiveness in reference to control. The findings of the present study proved that out of these four methods, potato tubers inoculation method was the most ideal as this fix the inoculums on the target site. Increased fungal growth and spore numbers may be due to soft tissues of potato tubers from which Ceratocystis isolates can easily pass. Lesion area on potato tubers was in the range of 7.09-0.14 cm2 followed by detached mango twigs which were ranged from 0.48-0.09 cm2). All pathological results were proved highly significant at P<0.05 through ANOVA but isolate to isolate showed non-significant behaviour but they have the positive effect on lesion area. Re-isolation of respective fungi was achieved with 100 percent success which results in the verification of Koch’s postulates. DNA of fungal pathogens was successfully extracted through phenol chloroform method. Amplification was done through ITS, b-tubulin gene, and Transcription Elongation Factor (EF1-a) gene primers and the amplified amplicons were sequenced and compared from NCBI which showed 99-100 % similarity with Ceratocystis manginecans. Fungus Ceratocystis manginecans formed one of strongly supported sub-clades through phylogenetic tree. Results obtained through this work would be supportive in establishment of relation of isolates with their region and will give information about pathogenicity level of isolates that would be useful to develop the management policies to reduce the afflictions in orchards caused by mango sudden death.

Keywords: artificial inoculation, mango, Ceratocystis manginecans, phylogenetic, screening

Procedia PDF Downloads 244

Authors: Edna Gnomblerou

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Given the current scale of corruption epidemic in West African economies, governments are seeking for immediate and effective measures to reduce the likelihood of the plague within the region. Generally, accountants and auditors are expected to help organizations in detecting illegal practices. However, their role in the fight against corruption is sometimes limited due to the collusive nature of corruption. The Denmark anti-corruption model shows that the implementation of additional controls over public accounts and independent efficient audits improve transparency and increase the probability of detection. This study is aimed at reviewing the existing anti-corruption policies of the Economic Commission of West African States (ECOWAS) as to observe the role attributed to accounting, auditing and other managerial practices in their anti-corruption drive. It further discusses the usefulness of accounting and auditing in helping anti-corruption commissions in controlling misconduct and increasing the perception to detect irregularities within public administration. The purpose of this initiative is to identify and assess the relevance of accounting and auditing in curbing corruption. To meet this purpose, the study was designed to answer the questions of whether accounting and auditing processes were included in the reviewed anti-corruption strategies, and if yes, whether they were effective in the detection process. A descriptive research method was adopted in examining the role of accounting and auditing in West African anti-corruption strategies. The analysis reveals that proper recognition of accounting standards and implementation of financial audits are viewed as strategic mechanisms in tackling corruption. Additionally, codes of conduct, whistle-blowing and information disclosure to the public are among the most common managerial practices used throughout anti-corruption policies to effectively and efficiently address the problem. These observations imply that sound anti-corruption strategies cannot ignore the values of including accounting and auditing processes. On one hand, this suggests that governments should employ all resources possible to improve accounting and auditing practices in the management of public sector organizations. On the other hand, governments must ensure that accounting and auditing practices are not limited to the private sector, but when properly implemented constitute crucial mechanisms to control and reduce corrupt incentives in public sector.

Keywords: accounting, anti-corruption strategy, auditing, ECOWAS

Procedia PDF Downloads 254

Authors: Geetha Jayapathy, Lakshmi Muthukrishnan, Manoj Kumar Reddy Pulim , Radhika Raman

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Introduction: Ketones are the end products of fatty acid metabolism and a source of energy for vital organs such as the brain, heart and skeletal muscles. Ketones are produced in excess when glucose is not available as a source of energy or it cannot be utilized as in diabetic ketoacidosis. Children admitted in the emergency department often have starvation ketosis which is not clinically manifested. Decision on admission of children to the emergency room with subtle signs can be difficult at times. Point of care blood ketone testing can be done at the bedside even in a primary level care setting to supplement and guide us in our management decisions. Hence this study was done to explore the utility of this simple bedside parameter as a supplement in assessing pediatric patients presenting to the emergency department. Objectives: To estimate blood ketones of children admitted in the emergency department. To analyze the significance of blood ketones in various disease conditions. Methods: Blood ketones using point of care testing instrument (ABOTTprecision Xceed Pro meters) was done in patients getting admitted in emergency room and in out-patients (through sample collection centre). Study population: Children aged 1 month to 18 years were included in the study. 250 cases (In-patients) and 250 controls (out-patients) were collected. Study design: Prospective observational study. Data on details of illness and physiological status were documented. Blood ketones were compared between the two groups and all in patients were categorized into various system groups and analysed. Results: Mean blood ketones were high in in-patients ranging from 0 to 7.2, with a mean of 1.28 compared to out-patients ranging from 0 to 1.9 with a mean of 0.35. This difference was statistically significant with a p value < 0.001. In-patients with shock (mean of 4.15) and diarrheal dehydration (mean of 1.85) had a significantly higher blood ketone values compared to patients with other system involvement. Conclusion: Blood ketones were significantly high (above the normal range) in pediatric patients who are sick requiring admission. Patients with various forms of shock had very high blood ketone values as found in diabetic ketoacidosis. Ketone values in diarrheal dehydration were moderately high correlating to the degree of dehydration.

Keywords: admission, blood ketones, paediatric emergencies, point of care testing

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Authors: Lakmali Anthony, Madeline Gillies

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Background Breast cancer (BC) is usually managed with surgical resection. Many outcomes traditionally used to define successful operative management, such as resection margin, do not adequately reflect patients’ experience. Patient-reported outcomes (PRO) such as Health-Related Quality of life (HRQoL) provide a means by which the impact of surgery for cancer can be reported in a patient-centered way. This exploratory cross-sectional study aims to; (1) describe postoperative HRQoL in patients who underwent primary resection in a regional Australian hospital; (2) describe the prevalence of anxiety, depression and clinically significant fear of cancer recurrence (FCR) in this population; and (3) identify demographic, psychosocial, disease and treatment factors associated with poorer self-reported HRQoL. Methods Patients who had resection of BC in a regional Australian hospital between 2015 and 2022 were eligible. Participants were asked to complete a survey designed to assess HRQoL, as well as validated instruments that assess several other psychosocial PROs hypothesized to be associated with HRQoL; emotional distress, fear of cancer recurrence, social support, dispositional optimism, body image and spirituality. Results Forty-six patients completed the survey. Clinically significant levels of FCR and emotional distress were present in this group. Many domains of HRQoL were significantly worse than an Australian reference population for BC. Demographic and disease factors associated with poor HRQoL included smoking and ongoing adjuvant systemic therapy. The primary operation was not associated with HRQoL for breast cancer. All psychosocial factors measured were associated with HRQoL. Conclusion HRQoL is an important outcome in surgery for both research and clinical practice. This study provides an overview of the quality of life in a regional Australian population of postoperative breast cancer patients and the factors that affect it. Understanding HRQoL and awareness of patients particularly vulnerable to poor outcomes should be used to aid the informed consent and shared decision-making process between surgeon and patient.

Keywords: breast cancer, surgery, quality of life, regional population

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Authors: Tiisetso Mpai, Sanjay K. Jaiswal, Felix D. Dakora

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The South African Cape fynbos biome is a global biodiversity hotspot. This biome contains a diversity of endemic shrub legumes, including Polhillia, Wiborgia, and Wiborgiella species, which are important for ecotourism as well as for improving soil fertility status. This is due to their proven N₂-fixing abilities when in association with compatible soil bacteria. In fact, Polhillia, Wiborgia, and Wiborgiella species have been reported to derive over 61% of their needed nitrogen through biological nitrogen fixation and to exhibit acid and alkaline phosphatase activity in their rhizospheres. Thus, their interactions with soil microbes may explain their survival mechanisms under the continued summer droughts and acidic, nutrient-poor soils in this region. However, information regarding their rhizosphere microbiome is still unavailable, yet it is important for Fynbos biodiversity management. Therefore, the aim of this study was to assess the microbial community structures associated with rhizosphere soils of Polhillia pallens, Polhillia brevicalyx, Wiborgia obcordata, Wiborgia sericea, and Wiborgiella sessilifolia growing at different locations of the South African Cape fynbos, during the wet and dry seasons. The hypothesis is that the microbial communities in these legume rhizospheres are the same type and are not affected by the growing season due to the restricted habitat of these wild fynbos legumes. To obtain the results, DNA was extracted from 0.5 g of each rhizosphere soil using PowerSoil™ DNA Isolation Kit, and sequences were obtained using the 16S rDNA Miseq Illumina technology. The results showed that in both seasons, bacteria were the most abundant microbial taxa in the rhizosphere soils of all five legume species, with Actinobacteria showing the highest number of sequences (about 30%). However, over 19.91% of the inhabitants in all five legume rhizospheres were unclassified. In terms of genera, Mycobacterium and Conexibacter were common in rhizosphere soils of all legumes in both seasons except for W. obcordata soils sampled during the dry season, which had Dehalogenimonas as the major inhabitant (6.08%). In conclusion, plant species and season were found to be the main drivers of microbial community structure in Cape fynbos, with the wet season being more dominant in shaping microbial diversity relative to the dry season. Wiborgia obcordata had a greater influence on microbial community structure than the other four legume species.

Keywords: 16S rDNA, Cape fynbos, endemic legumes, microbiome, rhizosphere

Procedia PDF Downloads 150