Search results for: health care services
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 13449

Search results for: health care services

4839 Association of Clostridium difficile Infection and Bone Cancer

Authors: Daniela Prado, Lexi Frankel, Amalia Ardeljan, Lokesh Manjani, Matthew Cardeiro, Omar Rashid

Abstract:

Background: Clostridium difficile (C. diff) is a gram-positive bacterium that is known to cause life-threatening diarrhea and severe inflammation of the colon. It originates as an alteration of the gut microbiome and can be transmitted through spores. Recent studies have shown a high association between the development of C. diff in cancer patients due to extensive hospitalization. However, research is lacking regarding C. diff’s association in the causation or prevention of cancer. The objective of this study was to therefore assess the correlation between Clostridium difficile infection (CDI) and the incidence of bone cancer. Methods: This retrospective analysis used data provided by a Health Insurance Portability and Accountability Act (HIPAA) compliant national database to evaluate the patients infected versus patients not infected with C. diff using ICD-10 and ICD-9 codes. Access to the database was granted by the Holy Cross Health, Fort Lauderdale, for the purpose of academic research. Standard statistical methods were used. Results: Between January 2010 and December 2019, the query was analyzed and resulted in 78863 patients in both the infected and control group, respectively. The two groups were matched by age range and CCI score. The incidence of bone cancer was 659 patients (0.835%) in the C. diff group compared to 1941 patients (2.461%) in the control group. The difference was statistically significant by a P-value < 2.2x10^-16 with an odds ratio (OR)= 0.33 (0.31-0.37) with a 95% confidence interval (CI). Treatment for CDI was analyzed for both C. diff infected and noninfected populations. 91 out of 16,676 (0.55%) patients with a prior C. diff infection and treated with antibiotics were compared to the control group were 275 out of 16,676 (1.65%) patients with no history of CDI and received antibiotic treatment. Results remained statistically significant by P-value <2.2x10-16 with an OR= 0.42 (0.37, 0.48). and a 95% CI. Conclusion: The study shows a statistically significant correlation between C. diff and a reduced incidence of bone cancer. Further evaluation is recommended to assess the potential of C. difficile in reducing bone cancer incidence.

Keywords: bone cancer, colitis, clostridium difficile, microbiome

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4838 Efficacy of Knowledge Management Practices in Selected Public Libraries in the Province of Kwazulu-Natal, South Africa

Authors: Petros Dlamini, Bethiweli Malambo, Maggie Masenya

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Knowledge management practices are very important in public libraries, especial in the era of the information society. The success of public libraries depends on the recognition and application of knowledge management practices. The study investigates the value and challenges of knowledge management practices in public libraries. Three research objectives informed the study: to identify knowledge management practices in public libraries, understand the value of knowledge management practices in public libraries, and determine the factors hampering knowledge management practices in public libraries. The study was informed by the interpretivism research paradigm, which is associated with qualitative studies. In that light, the study collected data from eight librarians and or library heads, who were purposively selected from public libraries. The study adopted a social anthropological approach, which thoroughly evaluated each participant's response. Data was collected from the respondents through telephonic semi-structured interviews and assessed accordingly. Furthermore, the study used the latest content concept for data interpretation. The chosen data analysis method allowed the study to achieve its main purpose with concrete and valid information. The study's findings showed that all six (100%) selected public libraries apply knowledge management practices. The findings of the study revealed that public libraries have knowledge sharing as the main knowledge management practice. It was noted that public libraries employ many practices, but each library employed its practices of choice depending on their knowledge management practices structure. The findings further showed that knowledge management practices in public libraries are employed through meetings, training, information sessions, and awareness, to mention a few. The findings revealed that knowledge management practices make the libraries usable. Furthermore, it has been asserted that knowledge management practices in public libraries meet users’ needs and expectations and equip them with skills. It was discovered that all participating public libraries from Umkhanyakude district municipality valued their knowledge management practices as the pillar and foundation of services. Noticeably, knowledge management practices improve users ‘standard of living and build an information society. The findings of the study showed that librarians should be responsible for the value of knowledge management practices as they are qualified personnel. The results also showed that 83.35% of public libraries had factors hampering knowledge management practices. The factors are not limited to shortage of funds, resources and space, and political interference. Several suggestions were made to improve knowledge management practices in public libraries. These suggestions include improving the library budget, increasing libraries’ building sizes, and conducting more staff training.

Keywords: knowledge management, knowledge management practices, storage, dissemination

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4837 Transdisciplinary Pedagogy: An Arts-Integrated Approach to Promote Authentic Science, Technology, Engineering, Arts, and Mathematics Education in Initial Teacher Education

Authors: Anne Marie Morrin

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This paper will focus on the design, delivery and assessment of a transdisciplinary STEAM (Science, Technology, Engineering, Arts, and Mathematics) education initiative in a college of education in Ireland. The project explores a transdisciplinary approach to supporting STEAM education where the concepts, methodologies and assessments employed derive from visual art sessions within initial teacher education. The research will demonstrate that the STEAM Education approach is effective when visual art concepts and methods are placed at the core of the teaching and learning experience. Within this study, emphasis is placed on authentic collaboration and transdisciplinary pedagogical approaches with the STEAM subjects. The partners included a combination of teaching expertise in STEM and Visual Arts education, artists, in-service and pre-service teachers and children. The inclusion of all stakeholders mentioned moves towards a more authentic approach where transdisciplinary practice is at the core of the teaching and learning. Qualitative data was collected using a combination of questionnaires (focused and open-ended questions) and focus groups. In addition, the data was collected through video diaries where students reflected on their visual journals and transdisciplinary practice, which gave rich insight into participants' experiences and opinions on their learning. It was found that an effective program of STEAM education integration was informed by co-teaching (continuous professional development), which involved a commitment to adaptable and flexible approaches to teaching, learning, and assessment, as well as the importance of continuous reflection-in-action by all participants. The delivery of a transdisciplinary model of STEAM education was devised to reconceptualizatise how individual subject areas can develop essential skills and tackle critical issues (such as self-care and climate change) through data visualisation and technology. The success of the project can be attributed to the collaboration, which was inclusive, flexible and a willingness between various stakeholders to be involved in the design and implementation of the project from conception to completion. The case study approach taken is particularistic (focusing on the STEAM-ED project), descriptive (providing in-depth descriptions from varied and multiple perspectives), and heuristic (interpreting the participants’ experiences and what meaning they attributed to their experiences).

Keywords: collaboration, transdisciplinary, STEAM, visual arts education

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4836 Challenging Shariah-Compliant Contract: A Latest Insight into the Malaysian Court Cases

Authors: Noor Suhaida Kasri

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In the last three decades, Malaysia has developed fundamental legal and regulatory structures that aim to accommodate and facilitate the growth of Islamic banking and finance industry. Important building blocks have been put in place, to cite a few, the elevation of the position of the Malaysian Central Bank Shariah Advisory Council (SAC) as the apex advisory body and the empowerment of their Shariah resolutions through the Central Bank Act 1958; the promulgation of the Islamic Financial Services Act 2013 that regulate and govern Islamic finance market with a robust statutory requirement of Shariah governance and Shariah compliance. Notwithstanding these achievements, enforceability of Shariah-compliant contract remains a contentious subject. The validity of Al Bai Bithaman Ajil concept that was commonly used by the Islamic financial institutions in their financing facilities structures and documentation has been unabatedly challenged by the customers in courts. The challenge was due to the manner in which the Al Bai Bithaman Ajil transactions were carried out. Due to this legal challenge, Al Bai Bithaman Ajil financing structure seems to no longer be the practitioners’ favourite in Malaysia, though its substitute tawarruq and commodity murabahah financing structure may potentially face similar legal challenges. This paper examines the legal challenges affecting the enforceability of these underlying Shariah contracts. The examination of these cases highlights the manner in which these contracts were being implemented and applied by the Malaysian Islamic financial institutions that triggered Shariah and legal concern. The analysis also highlights the approach adopted by the Malaysian courts in determining the Shariah issues as well as the SAC in ascertaining the rulings on the Shariah issues referred to it by the courts. The paper adopts a qualitative research methodology by using textual and documentary analysis approach. The outcome of this study underlines factors that require consideration by industry stakeholder in order to ameliorate the efficacy of the existing building blocks that would eventually strengthens the validity and enforceability of Shariah-compliant contracts. This, in the long run, will further reinforce financial stability and trust into the Islamic banking and finance industry in Malaysia.

Keywords: enforceability of Shariah compliant contract, legal challenge, legal and regulatory framework, Shariah Advisory Council

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4835 Civic Participation as a Promoter of Active Ageing in Europe

Authors: Andrea Vega-Tinoco, Ana I. Gil-Lacruz, Marta Gil-Lacruz

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The main objective of this research is to acknowledge whether civic participation affects the well-being of the elderly, thus being a key activity of active aging. It is also of interest to recognize any differences among genders, generational cohorts or country of residence. If a positive relationship is found between civic participation and well-being, the actions that promote this participation will benefit the quality of life of senior citizens. Otherwise, independent action must be taken in the improvement of social and human capital. The sample consists of approximately 50.000 individuals from the European Social Survey (2002-2016). Only individuals born before 1965 in 15 European countries were considered. The sample was distributed according to gender, year of birth, country, level of studies and ESS wave to form pseudo-panel data cohorts, leaving a total of 1.318 observations. The data were analyzed through a Cross-Lagged Model using Fixed-Effects. A bidirectional association is observed between the civic participation and well-being variables. However, participating in the past seems to have a higher impact on today’s health, happiness and life satisfaction than the other way around. Furthermore, 26% of the respondents expressed to be satisfied with their life, 27% to be happy and 57% to have good health. On the other hand, 49% have participated civically in the last year, being the most common activities: signing petitions, boycotting products and volunteer work in non-political organizations. A slight trend of BabyBoomers and men towards greater participation can be observed, as well as a higher impact of this participation on their well-being. In addition, international differences exhibit a stronger relation for Nordic, East European and Mediterranean countries. The given results support the hypothesis that civic participation is a promoter of well-being for the elderly. This paper positively highlights the activity of involving in political and non-political organizations, as well as wearing badges. At any rate, almost all forms of civic participation show a positive relationship with well-being and should therefore be promoted, although differences between countries must be taken into consideration.

Keywords: active aging, civic participation, Europe, well-being

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4834 Impact of Intelligent Transportation System on Planning, Operation and Safety of Urban Corridor

Authors: Sourabh Jain, S. S. Jain

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Intelligent transportation system (ITS) is the application of technologies for developing a user–friendly transportation system to extend the safety and efficiency of urban transportation systems in developing countries. These systems involve vehicles, drivers, passengers, road operators, managers of transport services; all interacting with each other and the surroundings to boost the security and capacity of road systems. The goal of urban corridor management using ITS in road transport is to achieve improvements in mobility, safety, and the productivity of the transportation system within the available facilities through the integrated application of advanced monitoring, communications, computer, display, and control process technologies, both in the vehicle and on the road. Intelligent transportation system is a product of the revolution in information and communications technologies that is the hallmark of the digital age. The basic ITS technology is oriented on three main directions: communications, information, integration. Information acquisition (collection), processing, integration, and sorting are the basic activities of ITS. In the paper, attempts have been made to present the endeavor that was made to interpret and evaluate the performance of the 27.4 Km long study corridor having eight intersections and four flyovers. The corridor consisting of six lanes as well as eight lanes divided road network. Two categories of data have been collected such as traffic data (traffic volume, spot speed, delay) and road characteristics data (no. of lanes, lane width, bus stops, mid-block sections, intersections, flyovers). The instruments used for collecting the data were video camera, stop watch, radar gun, and mobile GPS (GPS tracker lite). From the analysis, the performance interpretations incorporated were the identification of peak and off-peak hours, congestion and level of service (LOS) at midblock sections and delay followed by plotting the speed contours. The paper proposed the urban corridor management strategies based on sensors integrated into both vehicles and on the roads that those have to be efficiently executable, cost-effective, and familiar to road users. It will be useful to reduce congestion, fuel consumption, and pollution so as to provide comfort, safety, and efficiency to the users.

Keywords: ITS strategies, congestion, planning, mobility, safety

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4833 Prevalence of Dengue in Sickle Cell Disease in Pre-school Children

Authors: Nikhil A. Gavhane, Sachin Shah, Ishant S. Mahajan, Pawan D. Bahekar

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Introduction: Millions of people are affected with dengue fever every year, which drives up healthcare expenses in many low-income countries. Organ failure and other serious symptoms may result. Another worldwide public health problem is sickle cell anaemia, which is most prevalent in Africa, the Caribbean, and Europe. Dengue epidemics have reportedly occurred in locations with a high frequency of sickle cell disease, compounding the health problems in these areas. Aims and Objectives: This study examines dengue infection in sickle cell disease-afflicted pre-schoolers. Method:This Retrospective cohort study examined paediatric patients. Young people with sickle cell disease (SCD), dengue infection, and a control group without SCD or dengue were studied. Data on demographics, SCD consequences, medical treatments, and laboratory findings were gathered to analyse the influence of SCD on dengue severity and clinical outcomes, classified as severe or non-severe by the 2009 WHO classification. Using fever or admission symptoms, the research estimated acute illness duration. Result: Table 1 compares haemoglobin genotype-based dengue episode features in SS, SC, and controls. Table 2 shows that severe dengue cases are older, have longer admission delays, and have particular symptoms. Table 3's multivariate analysis indicates SS genotype's high connection with severe dengue, multiorgan failure, and acute pulmonary problems. Table 4 relates severe dengue to greater white blood cell counts, anaemia, liver enzymes, and reduced lactate dehydrogenase. Conclusion: This study is valuable but confined to hospitalised dengue patients with sickle cell illness. Small cohorts limit comparisons. Further study is needed since findings contradict predictions.

Keywords: dengue, chills, headache, severe myalgia, vomiting, nausea, prostration

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4832 Development of a 3D Model of Real Estate Properties in Fort Bonifacio, Taguig City, Philippines Using Geographic Information Systems

Authors: Lyka Selene Magnayi, Marcos Vinas, Roseanne Ramos

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As the real estate industry continually grows in the Philippines, Geographic Information Systems (GIS) provide advantages in generating spatial databases for efficient delivery of information and services. The real estate sector is not only providing qualitative data about real estate properties but also utilizes various spatial aspects of these properties for different applications such as hazard mapping and assessment. In this study, a three-dimensional (3D) model and a spatial database of real estate properties in Fort Bonifacio, Taguig City are developed using GIS and SketchUp. Spatial datasets include political boundaries, buildings, road network, digital terrain model (DTM) derived from Interferometric Synthetic Aperture Radar (IFSAR) image, Google Earth satellite imageries, and hazard maps. Multiple model layers were created based on property listings by a partner real estate company, including existing and future property buildings. Actual building dimensions, building facade, and building floorplans are incorporated in these 3D models for geovisualization. Hazard model layers are determined through spatial overlays, and different scenarios of hazards are also presented in the models. Animated maps and walkthrough videos were created for company presentation and evaluation. Model evaluation is conducted through client surveys requiring scores in terms of the appropriateness, information content, and design of the 3D models. Survey results show very satisfactory ratings, with the highest average evaluation score equivalent to 9.21 out of 10. The output maps and videos obtained passing rates based on the criteria and standards set by the intended users of the partner real estate company. The methodologies presented in this study were found useful and have remarkable advantages in the real estate industry. This work may be extended to automated mapping and creation of online spatial databases for better storage, access of real property listings and interactive platform using web-based GIS.

Keywords: geovisualization, geographic information systems, GIS, real estate, spatial database, three-dimensional model

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4831 Instrumental Neutron Activation Analysis (INAA) and Atomic Absorption Spectroscopy (AAS) for the Elemental Analysis Medicinal Plants from India Used in the Treatment of Heart Diseases

Authors: B. M. Pardeshi

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Introduction: Minerals and trace elements are chemical elements required by our bodies for numerous biological and physiological processes that are necessary for the maintenance of health. Medicinal plants are highly beneficial for the maintenance of good health and prevention of diseases. They are known as potential sources of minerals and vitamins. 30 to 40% of today’s conventional drugs used in the medicinal and curative properties of various plants are employed in herbal supplement botanicals, nutraceuticals and drug. Aim: The authors explored the mineral element content of some herbs, because mineral elements may have significant role in the development and treatment of gastrointestinal diseases, and a close connection between the presence or absence of mineral elements and inflammatory mediators was noted. Methods: Present study deals with the elemental analysis of medicinal plants by Instrumental Neutron activation Analysis and Atomic Absorption Spectroscopy. Medicinal herbals prescribed for skin diseases were purchased from markets and were analyzed by Instrumental Neutron Activation Analysis (INAA) using 252Cf Californium spontaneous fission neutron source (flux* 109 n s-1) and the induced activities were counted by γ-ray spectrometry and Atomic Absorption Spectroscopy (AAS) techniques (Perkin Elmer 3100 Model) available at Department of Chemistry University of Pune, India, was used for the measurement of major, minor and trace elements. Results: 15 elements viz. Al, K, Cl, Na, Mn by INAA and Cu, Co, Pb Ni, Cr, Ca, Fe, Zn, Hg and Cd by AAS were analyzed from different medicinal plants from India. A critical examination of the data shows that the elements Ca , K, Cl, Al, and Fe are found to be present at major levels in most of the samples while the other elements Na, Mn, Cu, Co, Pb, Ni, Cr, Ca, Zn, Hg and Cd are present in minor or trace levels. Conclusion: The beneficial therapeutic effect of the studied herbs may be related to their mineral element content. The elemental concentration in different medicinal plants is discussed.

Keywords: instrumental neutron activation analysis, atomic absorption spectroscopy, medicinal plants, trace elemental analysis, mineral contents

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4830 Evaluation of Information Technology Governance Frameworks for Better Governance in South Africa

Authors: Memory Ranga, Phillip Pretorious

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The South African Government has invested a lot of money in Information Technology Governance (ITG) within the Government departments. The ITG framework was spearheaded by the Department of Public Service and Administration (DPSA). This led to the development of a governing ITG DPSA framework and later the Government Wide Enterprise Architecture (GWEA) Framework for assisting the departments to implement ITG. In addition to this, the government departments have adopted the Information Systems Audit and Control Association (ISACA) Control Objectives for Information and Related Technology (COBIT) for ITG processes. Despite all these available frameworks, departments fail to fully capitalise and improve the ITG processes mainly as these are too generic and difficult to apply for specific governance needs. There has been less research done to evaluate the progress on ITG initiatives within the government departments. This paper aims to evaluate the existing ITG frameworks within selected government departments in South Africa. A quantitative research approach was used in this study. Data was collected through an online questionnaire targeting ICT Managers and Directors from government departments. The study is undertaken within a case study and only the Eastern Cape Province was selected for the research. Document review mainly on ITG framework and best practices was also used. Data was analysed using the Google Analytic tools and SPSS. A one–sample Chi-Squared Test was used to verity the evaluation findings. Findings show that there is evidence that the current guiding National governance framework (DPSA) is out dated and does not accommodate the new changes in other governance frameworks. The Eastern Cape Government Departments have spent huge amount of money on ITG but not yet able to identify the benefits of the ITG initiatives. The guiding framework is rigid and does to address some of the departmental needs making it difficult to be flexible and apply the DPSA framework. Furthermore, despite the large budget on ITG, the departments still find themselves with many challenges and unable to improve some of the processes and services. All the engaged Eastern Cape departments have adopted the COBIT framework, but none has been conducting COBIT maturity Assessment which is a functionality of COBIT. There is evidence of too many the ITG frameworks and underutilisation of these frameworks. The study provides a comprehensive evaluation of the ITG frameworks that have been adopted by the South African Government Departments in the Eastern Cape Province. The evaluation guides and recommends the government departments to rethink and adopt ITG frameworks that could be customised to accommodate their needs. The adoption and application of ITG by government departments should assist in better governance and service delivery to the citizens.

Keywords: information technology governance, COBIT, evaluate, framework, governance, DPSA framework

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4829 A Case Report on Anesthetic Considerations in a Neonate with Isolated Oesophageal Atresia with Radiological Fallacy

Authors: T. Rakhi, Thrivikram Shenoy

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Esophageal atresia is a disorder of maldevelopment of esophagus with or without a connection to the trachea. Radiological reviews are needed in consultation with the pediatric surgeon and neonatologist and we report a rare case of esophageal atresia associated with atrial septal defect-patent ductus arteriosus complex. A 2-day old female baby born at term, weighing 3.010kg, admitted to the Neonatal Intensive Care Unit with respiratory distress and excessive oral secretions. On examination, continuous murmur and cyanosis were seen. Esophageal atresia was suspected, after a failed attempt to pass a nasogastric tube. Chest radiograph showed coiling of the nasogastric tube and absent gas shadow in the abdomen. Echocardiography confirmed Patent Ductus Arteriosus with Atrial Septal Defect not in failure and was diagnosed with esophageal atresia with suspected fistula posted for surgical repair. After preliminary management with oxygenation, suctioning in prone position and antibiotics, investigations revealed Hb 17gms serum biochemistry, coagulation profile and C-Reactive Protein Test normal. The baby was premedicated with 5mcg of fentanyl and 100 mcg of midazolam and a rapid awake laryngoscopy was done to rule out difficult airway followed by induction with o2 air, sevo and atracurium 2 mg. Placement of a 3.5 tube was uneventful at first attempt and after confirming bilateral air entry positioned in the lateral position for Right thoracotomy. A pulse oximeter, Echocardiogram, Non-invasive Blood Pressure, temperature and a precordial stethoscope in left axilla were essential monitors. During thoracotomy, both the ends of the esophagus and the fistula could not be located after thorough search suggesting an on table finding of type A esophageal atresia. The baby was repositioned for gastrostomy, and cervical esophagostomy ventilated overnight and extubated uneventful. Absent gas shadow was overlooked and the purpose of this presentation is to create an awareness between the neonatologist, pediatric surgeons and anesthesiologist regarding variation of typing of Tracheoesophageal fistula pre and intraoperatively. A need for imaging modalities warranted for a definitive diagnosis in the presence of a gasless stomach.

Keywords: anesthetic, atrial septal defects, esophageal atresia, patent ductus arteriosus, perioperative, chest x-ray

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4828 Descriptive Analysis of Alcohol Abuse and Sexual Behaviour of Adolescent Males in Eastern Cape

Authors: Jabulani Gilford Kheswa, Sinovuyo Takatshana

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Literature documented that the combination of permissive attitudes, sexual experimentation and lack of accurate information from parents to educate male adolescents, poses a threat to the sexual health of adolescent males and exposes them to risky sexual behaviours. Grounded in problem behaviour theory as a theoretical framework for this study in understanding health-related behaviours of adolescent males, the weaker one’s perceived self-efficacy, the more social and affective factors increase the likelihood of risky sexual behaviour, such as alcohol abuse and intimate partner violence. The purpose of this study was to determine the correlation between alcohol use and sexual behaviour among 176 purposively selected Xhosa- speaking adolescent males, from one school in the Nkonkobe Municipality, Eastern Cape Province, South Africa. These learners were in grade ten, eleven and twelve with an age range from a low of 14 to a high of 25 years. The mean age was 18.06 years while the standard deviation was .144. To be ethically bound, the researchers sought permission from the school principal to distribute self-administered questionnaires and assured the participants of confidentiality and anonymity. A survey was conducted by means of self-administered questionnaires. A cross-sectional study was carried out within the quantitative paradigm using the SPSS version 18 and the Chronbach’s alpha of 0.79 were found for alcohol and sexual behaviour of adolescent males. Findings showed that 59.6% (N=105) of the learners indicated that their caregivers talk about safe sex practice as compared to only 40.4% (N=71) who indicated that their caregivers do not talk to them about safe sex practice. A statistically significant association between alcohol and negotiation of safe sex at p-value of 0.05 (chi-square of 34.529, degree of freedom of 16) was reported. In conclusion, as young people in South Africa become sexually active at an early age, schools should initiate psycho-educational programmes to equip adolescents against risk- behaviours (such as HIV/AIDS, substance abuse, crime).

Keywords: adolescent males, alcohol, parents, sex

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4827 Surgical Hip Dislocation of Femoroacetabular Impingement: Survivorship and Functional Outcomes at 10 Years

Authors: L. Hoade, O. O. Onafowokan, K. Anderson, G. E. Bartlett, E. D. Fern, M. R. Norton, R. G. Middleton

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Aims: Femoroacetabular impingement (FAI) was first recognised as a potential driver for hip pain at the turn of the last millennium. While there is an increasing trend towards surgical management of FAI by arthroscopic means, open surgical hip dislocation and debridement (SHD) remains the Gold Standard of care in terms of reported outcome measures. (1) Long-term functional and survivorship outcomes of SHD as a treatment for FAI are yet to be sufficiently reported in the literature. This study sets out to help address this imbalance. Methods: We undertook a retrospective review of our institutional database for all patients who underwent SHD for FAI between January 2003 and December 2008. A total of 223 patients (241 hips) were identified and underwent a ten year review with a standardised radiograph and patient-reported outcome measures questionnaire. The primary outcome measure of interest was survivorship, defined as progression to total hip arthroplasty (THA). Negative predictive factors were analysed. Secondary outcome measures of interest were survivorship to further (non-arthroplasty) surgery, functional outcomes as reflected by patient reported outcome measure scores (PROMS) scores, and whether a learning curve could be identified. Results: The final cohort consisted of 131 females and 110 males, with a mean age of 34 years. There was an overall native hip joint survival rate of 85.4% at ten years. Those who underwent a THA were significantly older at initial surgery, had radiographic evidence of preoperative osteoarthritis and pre- and post-operative acetabular undercoverage. In those whom had not progressed to THA, the average Non-arthritic Hip Score and Oxford Hip Score at ten year follow-up were 72.3% and 36/48, respectively, and 84% still deemed their surgery worthwhile. A learning curve was found to exist that was predicated on case selection rather than surgical technique. Conclusion: This is only the second study to evaluate the long-term outcomes (beyond ten years) of SHD for FAI and the first outside the originating centre. Our results suggest that, with correct patient selection, this remains an operation with worthwhile outcomes at ten years. How the results of open surgery compared to those of arthroscopy remains to be answered. While these results precede the advent of collison software modelling tools, this data helps set a benchmark for future comparison of other techniques effectiveness at the ten year mark.

Keywords: femoroacetabular impingement, hip pain, surgical hip dislocation, hip debridement

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4826 The Changing Landscape of Fire Safety in Covered Car Parks with the Arrival of Electric Vehicles

Authors: Matt Stallwood, Michael Spearpoint

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In 2020, the UK government announced that sales of new petrol and diesel cars would end in 2030, and battery-powered cars made up 1 in 8 new cars sold in 2021 – more than the total from the previous five years. The guidance across the UK for the fire safety design of covered car parks is changing in response to the projected rapid growth in electric vehicle (EV) use. This paper discusses the current knowledge on the fire safety concerns posed by EVs, in particular those powered by lithium-ion batteries, when considering the likelihood of vehicle ignition, fire severity and spread of fire to other vehicles. The paper builds on previous work that has investigated the frequency of fires starting in cars powered by internal combustion engines (ICE), the hazard posed by such fires in covered car parks and the potential for neighboring vehicles to become involved in an incident. Historical data has been used to determine the ignition frequency of ICE car fires, whereas such data is scarce when it comes to EV fires. Should a fire occur, then the fire development has conventionally been assessed to match a ‘medium’ growth rate and to have a 95th percentile peak heat release of 9 MW. The paper examines recent literature in which researchers have measured the burning characteristics of EVs to assess whether these values need to be changed. These findings are used to assess the risk posed by EVs when compared to ICE vehicles. The paper examines what new design guidance is being issued by various organizations across the UK, such as fire and rescue services, insurers, local government bodies and regulators and discusses the impact these are having on the arrangement of parking bays, particularly in residential and mixed-use buildings. For example, the paper illustrates how updated guidance published by the Fire Protection Association (FPA) on the installation of sprinkler systems has increased the hazard classification of parking buildings that can have a considerable impact on the feasibility of a building to meet all its design intents when specifying water supply tanks. Another guidance on the provision of smoke ventilation systems and structural fire resistance is also presented. The paper points to where further research is needed on the fire safety risks posed by EVs in covered car parks. This will ensure that any guidance is commensurate with the need to provide an adequate level of life and property safety in the built environment.

Keywords: covered car parks, electric vehicles, fire safety, risk

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4825 An EEG-Based Scale for Comatose Patients' Vigilance State

Authors: Bechir Hbibi, Lamine Mili

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Understanding the condition of comatose patients can be difficult, but it is crucial to their optimal treatment. Consequently, numerous scoring systems have been developed around the world to categorize patient states based on physiological assessments. Although validated and widely adopted by medical communities, these scores still present numerous limitations and obstacles. Even with the addition of additional tests and extensions, these scoring systems have not been able to overcome certain limitations, and it appears unlikely that they will be able to do so in the future. On the other hand, physiological tests are not the only way to extract ideas about comatose patients. EEG signal analysis has helped extensively to understand the human brain and human consciousness and has been used by researchers in the classification of different levels of disease. The use of EEG in the ICU has become an urgent matter in several cases and has been recommended by medical organizations. In this field, the EEG is used to investigate epilepsy, dementia, brain injuries, and many other neurological disorders. It has recently also been used to detect pain activity in some regions of the brain, for the detection of stress levels, and to evaluate sleep quality. In our recent findings, our aim was to use multifractal analysis, a very successful method of handling multifractal signals and feature extraction, to establish a state of awareness scale for comatose patients based on their electrical brain activity. The results show that this score could be instantaneous and could overcome many limitations with which the physiological scales stock. On the contrary, multifractal analysis stands out as a highly effective tool for characterizing non-stationary and self-similar signals. It demonstrates strong performance in extracting the properties of fractal and multifractal data, including signals and images. As such, we leverage this method, along with other features derived from EEG signal recordings from comatose patients, to develop a scale. This scale aims to accurately depict the vigilance state of patients in intensive care units and to address many of the limitations inherent in physiological scales such as the Glasgow Coma Scale (GCS) and the FOUR score. The results of applying version V0 of this approach to 30 patients with known GCS showed that the EEG-based score similarly describes the states of vigilance but distinguishes between the states of 8 sedated patients where the GCS could not be applied. Therefore, our approach could show promising results with patients with disabilities, injected with painkillers, and other categories where physiological scores could not be applied.

Keywords: coma, vigilance state, EEG, multifractal analysis, feature extraction

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4824 The Role of Public Representatives and Legislatures in Strengthening HIV and AIDS Prevention Strategies: The Case of South Africa

Authors: Moses Mncwabe

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Both Public Representatives and Legislatures have an imperative role towards strengthening interventions to reduce and cease Sexual Transmitted Infections (STIs) specifically the Human Immunodeficiency Virus (HIV). Scaling-up constituency work in support of interventions earmarked for mitigating the compromising socio-economic impacts of advanced HIV is extremely essential. Though the antiretroviral treatment (ART) has saved million lives that would have perished without it, the Joint United Nations Programme on HIV/AIDS (2012) states that more efforts should be redirected to prevention strategies to close the tap of new infections. It is against this backdrop that Legislatures as law making institutions have undisputed role to play in HIV alleviation because of the position they occupy in the society. Furthermore, Public Representatives are arguably idolised by young people for the role they play hence it is incumbent upon them to use their moral and political responsibility to aid the interventions for HIV prevention (Inter-Parliamentary Union, Joint United Nations Programme on HIV/AIDS & United Nations Development Programme, 2007). Moreover, the continuous HIV infection and its devastating effects specifically in Southern African region has brought closer the disease to public representatives and demanded calculated interventions warranting both public representatives and legislatures to be more visible in various ways such as taking HIV counselling and testing publicly, oversight, reducing stigma and discrimination, partnering with civil society organisations (CSOs) and facilitating debates on HIV across parliamentary and social platforms. The effects of advanced HIV yearn for public representatives to be seen, accessed, felt, engaged, partnered and lobbied for pro-human rights legislations and ideal oversight to coerce the executive to deliver on their core responsibilities like providing basic services to the electorates (AIDS Law Project (2003). The National Democratic Institute for International Affairs and the Southern African Development Community Parliamentary Forum (2004) assert that the omission of Public Representatives and Legislatures in the HIV prevention agenda is a serious deficiency in the fight against HIV and AIDS. In light of this, this paper argues the innovative and legislative ways in which both the Public Representative and the Legislatures should play in HIV prevention.

Keywords: legislature, public representative, oversight, HIV and AIDS, constituency, service delivery

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4823 Ecodesign of Bioplastic Films for Food Packaging and Shelf-life Extension

Authors: Sónia Ribeiro, Diana Farinha, Elsa Pereira, Hélia Sales, Filipa Figueiredo, Rita Pontes, João Nunes

Abstract:

Conventional plastic impacts on Planet, natural resources contamination, human health as well as animals are the most attractive environmental and health attention. The lack of treatment in the end-of-life (EOL) phase and uncontrolled discard allows plastic to be found everywhere in the world. Food waste is increasing significantly, with a final destination to landfills. To face these difficulties, new packaging solutions are needed with the objective of prolonging the shelf-life of products as well as equipment solutions for the development of the mentioned packaging. FLUI project thus presents relevance and innovation to reach a new level of knowledge and industrial development focused in Ecodesign. Industrial equipment field for the manufacture of new packaging solutions based on biodegradable plastics films to apply in the food sector. With lesser environmental impacts and new solutions that make it possible to prevent food waste, reduce the production e consequent poor disposal of plastic of fossil origin. It will be a paradigm shift at different levels, from industry to waste treatment stations, passing through commercial agents and consumers. It can be achieved through the life cycle assessment (LCA) and ecodesign of the products, which integrates the environmental concerns in the design of the product as well as through the entire life cycle. The FLUI project aims to build a piece of new bio-PLA extrusion equipment with the incorporation of bioactive extracts through the production of flexible mono- and multi-layer functional films (FLUI systems). The biofunctional and biodegradable films will prompt the extension of packaged products’ shelf-life, reduce food waste and contribute to reducing the consumption of non-degradable fossil plastics, as well as the use of raw material from renewable sources.

Keywords: food packing, bioplastics, ecodesign, circular economy

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4822 LaeA/1-Velvet Interplay in Aspergillus and Trichoderma: Regulation of Secondary Metabolites and Cellulases

Authors: Razieh Karimi Aghcheh, Christian Kubicek, Joseph Strauss, Gerhard Braus

Abstract:

Filamentous fungi are of considerable economic and social significance for human health, nutrition and in white biotechnology. These organisms are dominant producers of a range of primary metabolites such as citric acid, microbial lipids (biodiesel) and higher unsaturated fatty acids (HUFAs). In particular, they produce also important but structurally complex secondary metabolites with enormous therapeutic applications in pharmaceutical industry, for example: cephalosporin, penicillin, taxol, zeranol and ergot alkaloids. Several fungal secondary metabolites, which are significantly relevant to human health do not only include antibiotics, but also e.g. lovastatin, a well-known antihypercholesterolemic agent produced by Aspergillus. terreus, or aflatoxin, a carcinogen produced by A. flavus. In addition to their roles for human health and agriculture, some fungi are industrially and commercially important: Species of the ascomycete genus Hypocrea spp. (teleomorph of Trichoderma) have been demonstrated as efficient producer of highly active cellulolytic enzymes. This trait makes them effective in disrupting and depolymerization of lignocellulosic materials and thus applicable tools in number of biotechnological areas as diverse as clothes-washing detergent, animal feed, and pulp and fuel productions. Fungal LaeA/LAE1 (Loss of aflR Expression A) homologs their gene products act at the interphase between secondary metabolisms, cellulase production and development. Lack of the corresponding genes results in significant physiological changes including loss of secondary metabolite and lignocellulose degrading enzymes production. At the molecular level, the encoded proteins are presumably methyltransferases or demethylases which act directly or indirectly at heterochromatin and interact with velvet domain proteins. Velvet proteins bind to DNA and affect expression of secondary metabolites (SMs) genes and cellulases. The dynamic interplay between LaeA/LAE1, velvet proteins and additional interaction partners is the key for an understanding of the coordination of metabolic and morphological functions of fungi and is required for a biotechnological control of the formation of desired bioactive products. Aspergilli and Trichoderma represent different biotechnologically significant species with significant differences in the LaeA/LAE1-Velvet protein machinery and their target proteins. We, therefore, performed a comparative study of the interaction partners of this machinery and the dynamics of the various protein-protein interactions using our robust proteomic and mass spectrometry techniques. This enhances our knowledge about the fungal coordination of secondary metabolism, cellulase production and development and thereby will certainly improve recombinant fungal strain construction for the production of industrial secondary metabolite or lignocellulose hydrolytic enzymes.

Keywords: cellulases, LaeA/1, proteomics, secondary metabolites

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4821 Intrathecal: Not Intravenous Administration of Evans Blue Reduces Pain Behavior in Neuropathic Rats

Authors: Kun Hua O., Dong Woon Kim, Won Hyung Lee

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Introduction: Neuropathic pain induced by spinal or peripheral nerve injury is highly resistant to common painkillers, nerve blocks, and other pain management approaches. Recently, several new therapeutic drug candidates have been developed to control neuropathic pain. In this study, we used the spinal nerve L5 ligation (SNL) model to investigate the ability of intrathecal or intravenous Evans blue to decrease pain behavior and to study the relationship between Evans blue and the neural structure of pain transmission. Method: Neuropathic pain (allodynia) of the left hind paw was induced by unilateral SNL in Sprague-Dawley rats(n=10) in each group. Evans blue (5, 15, 50μg/10μl) or phosphate buffer saline(PBS,10μl) was injected intrathecally at 3days post-ligation or intravenously(1mg/200 μl) 3days and 5days post-ligation . Mechanical sensitivity was assessed using Von Frey filaments at 3 days post-ligation and at 2 hours, days 1, 2, 3, 5,7 after intrathecal Evans blue injection, and on days 2, 4, 7, and 11 at 14 days after intravenous injection. In the intrathecal group, microglia and glutaminergic neurons in the dorsal horn and VNUT(vesicular nucleotide transporter) in the dorsal root ganglia were tested to evaluate co-staining with Evans blue. The experimental procedures were performed in accordance with the animal care guideline of the Korean Academy of Medical Science(Animal ethic committee of Chungnam National University Hospital: CNUH-014-A0005-1). Results: Tight ligation of the L5 spinal nerve induced allodynia in the left hind paw 3 days post-ligation. Intrathecal Evans blue most significantly(P<0.001) alleviated allodynia at 2 days after intrathecal, but not an intravenous injection. Glutaminergic neurons in the dorsal horn and VNUT in the dorsal root ganglia were co-stained with Evans blue. On the other hand, microglia in the dorsal horn were partially co-stained with Evans blue. Conclusion: We confirmed that Evans blue might have an analgesic effect through the central nervous system, not another system in neuropathic pain of the SNL animal model. These results suggest Evans blue may be a potential new drug for the treatment of chronic pain. This research was supported by the National Research Foundation of Korea (NRF-2020R1A2C100757512), funded by the Ministry of Education.

Keywords: neuropathic pain, Evas blue, intrathecal, intravenous

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4820 Patterns of Eosinophilia in Cardiac Patients and its Association with Endomyocardial Disease Presenting to Tertiary Care Hospital in Peshawar

Authors: Rashid Azeem

Abstract:

Introduction: Eosinophilia, which can be categorized as mild, moderate, and severe form on the basis of increasing eosinophil counts, might be responsible for a wide range of cardiac manifestations, varying from a simple myocarditis to a severe state like endomyocardial fibrosis. Eosinophils are involved in the pathogenesis of a variety of cardiovascular disorder like Loffler endocarditis, eosinophilic granulomatosis with polyangitis (EGPH), and hyper eosinophilic (HES). Among them HES carries and incidence rate b/w 48% and 75% and is the main causes of cardiac motility and mobility due to eosinophilia involvement. Aims and objectives: The aim of this study is to determine the frequency of eosinophilia in cardiac patients and to ascertain the evidence of endomyocardial diseases in eosinophilic patients in a cardiology institution Material and Methods: This cross sectional analytical study was conducted in hematology Department of Peshawar institute of Cardiology after approval from hospital ethical and research committee. All 70 patients were subjected to detailed history and clinical examination. Investigation like CBC, Chest X-ray, ECG, Echo, Angiography findings were used to monitor patient’s clinical status. Data is analyzed using SPSS version 25 and MS Excel. Results: Out of 70 patients in our study, a total of 66 patients(94 %) shows evidence of cardiac manifestations. In our study, we have observed a number of abnormal ECG patterns in cardiac patients presenting with eosinophilia, like T wave changes, loss of R wave, sinus bradycardia with LVH strain, and ST wave abnormality. abnormal echocardiographic findings were observed in our patients, like valvular abnormalities (in 45.7%), RWMA abnormalities (in 2.8%), isolated ventricular dysfunction (in 21.4%), and in 10% patients, normal echocardiography. We further noted abnormal coronary angiography findings in cardiac patients with eosinophilia ranging from single vessel to multi vessel occlusions. Conclusions: Eosinophils are involved in the pathogenesis of a variety of cardiovascular disorders which can be detected by various diagnostic means, and the severity of the disease increases with time and with increasing eosinophil count ranging from simple myocarditis to a fatal condition like endomyocardial fibrosis. Thus, increased eosinophilic count as a laboratory parameter in cardiac patients may be a sign of endomyocardial damage which will further help cardiologist to intervene more aggressively then routine approach to a cardiac patient.

Keywords: eosinophilia, endomyocardial fibrosis, cardiac, hypereosinophilic syndrome

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4819 Racial Distress in the Digital Age: A Mixed-Methods Exploration of the Effects of Social Media Exposure to Police Brutality on Black Students

Authors: Amanda M. McLeroy, Tiera Tanksley

Abstract:

The 2020 movement for Black Lives, ignited by anti-Black police brutality and exemplified by the public execution of George Floyd, underscored the dual potential of social media for political activism and perilous exposure to traumatic content for Black students. This study employs Critical Race Technology Theory (CRTT) to scrutinize algorithmic anti-blackness and its impact on Black youth's lives and educational experiences. The research investigates the consequences of vicarious exposure to police brutality on social media among Black adolescents through qualitative interviews and quantitative scale data. The findings reveal an unprecedented surge in exposure to viral police killings since 2020, resulting in profound physical, socioemotional, and educational effects on Black youth. CRTT forms the theoretical basis, challenging the notion of digital technologies as post-racial and neutral, aiming to dismantle systemic biases within digital systems. Black youth, averaging over 13 hours of daily social media use, face constant exposure to graphic images of Black individuals dying. The study connects this exposure to a range of physical, socioemotional, and mental health consequences, emphasizing the urgent need for understanding and support. The research proposes questions to explore the extent of police brutality exposure and its effects on Black youth. Qualitative interviews with high school and college students and quantitative scale data from undergraduates contribute to a nuanced understanding of the impact of police brutality exposure on Black youth. Themes of unprecedented exposure to viral police killings, physical and socioemotional effects, and educational consequences emerge from the analysis. The study uncovers how vicarious experiences of negative police encounters via social media lead to mistrust, fear, and psychosomatic symptoms among Black adolescents. Implications for educators and counselors are profound, emphasizing the cultivation of empathy, provision of mental health support, integration of media literacy education, and encouragement of activism. Recognizing family and community influences is crucial for comprehensive support. Professional development opportunities in culturally responsive teaching and trauma-informed approaches are recommended for educators. In conclusion, creating a supportive educational environment that addresses the emotional impact of social media exposure to police brutality is crucial for the well-being and development of Black adolescents. Counselors, through safe spaces and collaboration, play a vital role in supporting Black youth facing the distressing effects of social media exposure to police brutality.

Keywords: black youth, mental health, police brutality, social media

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4818 Evaluation of Main Factors Affecting the Choice of a Freight Forwarder: A Sri Lankan Exporter’s Perspective

Authors: Ishani Maheshika

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The intermediary role performed by freight forwarders in exportation has become significant in fulfilling businesses’ supply chain needs in this dynamic world. Since the success of exporter’s business is at present, highly reliant on supply chain optimization, cost efficiency, profitability, consistent service and responsiveness, the decision of selecting the most beneficial freight forwarder has become crucial for exporters. Although there are similar foreign researches, prior researches covering Sri Lankan setting are not in existence. Moreover, results vary with time, nature of industry and business environment factors. Therefore, a study from the perspective of Sri Lankan exporters was identified as a requisite to be researched. In order to identify and prioritize key factors which have affected the exporter’s decision in selecting freight forwarders in Sri Lankan context, Sri Lankan export industry was stratified into 22 sectors based on commodity using stratified sampling technique. One exporter from each sector was then selected using judgmental sampling to have a sample of 22. Factors which were identified through a pilot survey, was organized under 6 main criteria. A questionnaire was basically developed as pairwise comparisons using 9-point semantic differential scale and comparisons were done within main criteria and subcriteria. After a pre-testing, interviews and e-mail questionnaire survey were conducted. Data were analyzed using Analytic Hierarchy Process to determine priority vectors of criteria. Customer service was found to be the most important main criterion for Sri Lankan exporters. It was followed by reliability and operational efficiency respectively. The criterion of the least importance is company background and reputation. Whereas small sized exporters pay more attention to rate, reliability is the major concern among medium and large scale exporters. Irrespective of seniority of the exporter, reliability is given the prominence. Responsiveness is the most important sub criterion among Sri Lankan exporters. Consistency of judgments with respect to main criteria was verified through consistency ratio, which was less than 10%. Being more competitive, freight forwarders should come up with customized marketing strategies based on each target group’s requirements and expectations in offering services to retain existing exporters and attract new exporters.

Keywords: analytic hierarchy process, freight forwarders, main criteria, Sri Lankan exporters, subcriteria

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4817 Soft Skills: Expectations and Needs in Tourism

Authors: Susana Silva, Dora Martins

Abstract:

The recent political, economic, social technological and employment changes significantly affect the tourism organizations and consequently the changing nature of the employment experience of the tourism workforce. Such scene leads several researchers and labor analysts to reflect about what kinds of jobs, knowledge and competences are need to ensure the success to teach, to learning and to work on this sector. In recent years the competency-based approach in high education level has become of significant interest. On the one hand, this approach could leads to the forming of the key students’ competences which contribute their better preparation to the professional future and on the other hand could answer better to practical demands from tourism job market. The goals of this paper are (1) to understand the expectations of university tourism students in relation to the present and future tourism competences demands, (2) to identify the importance put on the soft skills, (3) to know the importance of high qualification to their future professional activity and (4) to explore the students perception about present and future tourist sector specificities. To this proposal, a questionnaire was designed and distributed to every students who participate on classes of Hospitality Management under degree and master from one public Portuguese university. All participants were invited, during December 2014 and September 2015, to answer the questionnaire at the moment and on presence of one researcher of this study. Fulfilled the questionnaire 202 students (72, 35,6% male and 130, 64.4% female), the mean age was 21,64 (SD=5,27), 91% (n=86) were undergraduate and 18 (9%) were master students. 80% (n=162) of our participants refers as a possibility to look for a job outside the country.42% (n=85) prefers to work in a medium-sized tourism units (with 50-249 employees). According to our participants the most valued skills in tourism are the domain of foreign languages (87.6%, n=177), the ability to work as a team (85%), the personal persistence (83%, n=168), the knowledge of the product/services provided (73.8%, n=149), and assertiveness (66.3%, n=134). 65% (n=131) refers the availability to look for a job in a home distance of 1000 kilometers and 59% (n=119) do not consider the possibility to work in another area than tourism. From the results of this study we are in the position of confirming the need for universities to maintain a better link with the professional tourism companies and to rethink some competences into their learning course model. Based on our results students, universities and companies could understand more deeply the motivations, expectations and competences need to build the future career who study and work on the tourism sector.

Keywords: human capital, employability, students’ competencies perceptions, soft skills, tourism

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4816 Meat Consumption for Family Health in Nigeria

Authors: Chigbu Ruth Nnena

Abstract:

This paper discussed the concept of meat its nutritive value in family meals. The paper further discussed the selection, storage and preparation of meat in family meal the Nigerian way. The paper made the following recommendations among others; that families in Nigeria should rear cow meat for easy access to the meant and that family should purchase meat that are fresh from chain shops in the market to avoid meat contamination among others.

Keywords: meat, selection, storage meals, concept and preparation

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4815 Beliefs about the Use of Extemporaneous Compounding for Paediatric Outpatients among Physicians in Yogyakarta, Indonesia

Authors: Chairun Wiedyaningsih, Sri Suryawati, Yati Soenarto, Muhammad Hakimi

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Background: Many drugs used in paediatrics are not commercially available in suitable dosage forms. Therefore, the drugs often prescribed in extemporaneous compounding dosage form. Compounding can pose health risks include poor quality and unsafe products. Studies of compounding dosage form have primarily focused on prescription profiles, reasons of prescribing never be explored. Objectives: The study was conducted to identify factors influencing physicians’ decision to prescribe extemporaneous compounding dosage form for paediatric outpatients. Setting: Daerah Istimewa Yogyakarta (DIY) province, Indonesia. Method: Qualitative semi-structured interviews were conducted with 15 general physicians and 7 paediatricians to identify the reason of prescribing extemporaneous compounding dosage form. The interviews were transcribed and analysed using thematic analysis. Results: Factors underlying prescribing of compounding could be categorized to therapy, healthcare system, patient and past experience. The primary reasons of therapy factors were limited availability of drug compositions, dosages or formulas specific for children. Beliefs in efficacy of the compounding forms were higher when the drugs used primarily to overcome complex cases. Physicians did not concern about compounding form containing several active substances because manufactured syrups may also contain several active substances. Although medicines were available in manufactured syrups, limited institutional budget was healthcare system factor of compounding prescribing. The prescribing factors related to patients include easy to use, efficient and lower price. The prescribing factors related to past experience were physicians’ beliefs to the progress of patient's health status. Conclusions: Compounding was prescribed based on therapy-related factors, healthcare system factors, patient factors and past experience.

Keywords: compounding dosage form, interview, physician, prescription

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4814 Detection Kit of Type 1 Diabetes Mellitus with Autoimmune Marker GAD65 (Glutamic Acid Decarboxylase)

Authors: Aulanni’am Aulanni’am

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Incidence of Diabetes Mellitus (DM) progressively increasing it became a serious problem in Indonesia and it is a disease that government is priority to be addressed. The longer a person is suffering from diabetes the more likely to develop complications particularly diabetic patients who are not well maintained. Therefore, Incidence of Diabetes Mellitus needs to be done in the early diagnosis of pre-phase of the disease. In this pre-phase disease, already happening destruction of pancreatic beta cells and declining in beta cell function and the sign autoimmunity reactions associated with beta cell destruction. Type 1 DM is a multifactorial disease triggered by genetic and environmental factors, which leads to the destruction of pancreatic beta cells. Early marker of "beta cell autoreactivity" is the synthesis of autoantibodies against 65-kDa protein, which can be a molecule that can be detected early in the disease pathomechanism. The importance of early diagnosis of diabetic patients held in the phase of pre-disease is to determine the progression towards the onset of pancreatic beta cell destruction and take precautions. However, the price for this examination is very expensive ($ 150/ test), the anti-GAD65 abs examination cannot be carried out routinely in most or even in all laboratories in Indonesia. Therefore, production-based Rapid Test Recombinant Human Protein GAD65 with "Reverse Flow Immunchromatography Technique" in Indonesia is believed to reduce costs and improve the quality of care of patients with diabetes in Indonesia. Rapid Test Product innovation is very simple and suitable for screening and routine inspection of GAD65 autoantibodies. In the blood serum of patients with diabetes caused by autoimmunity, autoantibody-GAD65 is a major serologic marker to detect autoimmune reaction because their concentration level of stability.GAD65 autoantibodies can be found 10 years before clinical symptoms of diabetes. Early diagnosis is more focused to detect the presence autontibodi-GAD65 given specification and high sensitivity. Autoantibodies- GAD65 that circulates in the blood is a major indicator of the destruction of the islet cells of the pancreas. Results of research in collaboration with Biofarma has produced GAD65 autoantibodies based Rapid Test had conducted the soft launch of products and has been tested with the results of a sensitivity of 100 percent and a specificity between 90 and 96% compared with the gold standard (import product) which worked based on ELISA method.

Keywords: diabetes mellitus, GAD65 autoantibodies, rapid test, sensitivity, specificity

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4813 A Radiofrequency Based Navigation Method for Cooperative Robotic Communities in Surface Exploration Missions

Authors: Francisco J. García-de-Quirós, Gianmarco Radice

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When considering small robots working in a cooperative community for Moon surface exploration, navigation and inter-nodes communication aspects become a critical issue for the mission success. For this approach to succeed, it is necessary however to deploy the required infrastructure for the robotic community to achieve efficient self-localization as well as relative positioning and communications between nodes. In this paper, an exploration mission concept in which two cooperative robotic systems co-exist is presented. This paradigm hinges on a community of reference agents that provide support in terms of communication and navigation to a second agent community tasked with exploration goals. The work focuses on the role of the agent community in charge of the overall support and, more specifically, will focus on the positioning and navigation methods implemented in RF microwave bands, which are combined with the communication services. An analysis of the different methods for range and position calculation are presented, as well as the main limiting factors for precision and resolution, such as phase and frequency noise in RF reference carriers and drift mechanisms such as thermal drift and random walk. The effects of carrier frequency instability due to phase noise are categorized in different contributing bands, and the impact of these spectrum regions are considered both in terms of the absolute position and the relative speed. A mission scenario is finally proposed, and key metrics in terms of mass and power consumption for the required payload hardware are also assessed. For this purpose, an application case involving an RF communication network in UHF Band is described, in coexistence with a communications network used for the single agents to communicate within the both the exploring agents as well as the community and with the mission support agents. The proposed approach implements a substantial improvement in planetary navigation since it provides self-localization capabilities for robotic agents characterized by very low mass, volume and power budgets, thus enabling precise navigation capabilities to agents of reduced dimensions. Furthermore, a common and shared localization radiofrequency infrastructure enables new interaction mechanisms such as spatial arrangement of agents over the area of interest for distributed sensing.

Keywords: cooperative robotics, localization, robot navigation, surface exploration

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4812 Psychological Stressors Caused by Urban Expansion in Algeria

Authors: Laid Fekih

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Background: The purpose of this paper is to examine the psychological stressors caused by urbanization, a field study conducted on a sample range of youth who live in urban areas. Some of them reside in areas with green surroundings while others reside in lack of green areas, which saw the terrible expansion of urban. The study included the impact of urbanization on the mental health of youths; select the psychological problems most commonly caused by urbanization, and the impact of green spaces in alleviating stress. Method: The method used in this research is descriptive, as the data collected from a sample of 160 young men were analyzed. The tool used is the psychological distress test. We proceeded with some statistical techniques, which provided percentages, analysis of variance, and t-tests. Results: The findings of this research were: (i) The psychological stressors caused by urban expansion are mainly in the intensity of stress, incompetence, emotional, and psychosomatic problems. (ii) There was a statistically significant difference at the level of significance 0.02 among young people who live in places in green spaces and without green space in terms of psychological stressors, in favor of young people who live in places free of greenery. (iii) The quality of this primary variable effect of housing (rental or ownership) is statistically significant in favor of young people living in rented accommodation. Conclusion: The green spaces provided by Tlemcen city are inadequate and insufficient to fulfill the population's requirements for contact with nature, leading to such effects that may negatively affect mental health, which makes it a prominent process that should not be neglected. Incorporating green spaces into the design of buildings, homes, and communities to create shared spaces, which facilitate interaction and foster well-being, becomes the main purpose. We think this approach can support the reconstruction of the built environment with green spaces by facilitating the link between psychological stress perception studies and technologies.

Keywords: psychological stressors, urbanization, psychological problems, green spaces

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4811 Dual Challenges in Host State Regulation on Transnational Corporate Damages: China's Dilemma and Breakthrough

Authors: Xinchao Liu

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Regulating environmental and human rights damages caused by transnational corporations in host States is a core issue in the business and human rights discourse. In current regulatory practices, host States, which are territorially based and should bear primary regulation responsibility, face dual challenges at both domestic and international levels, leading to their continued marginalization. Specifically, host States as TNC damage regulators are constrained domestically by territorial jurisdiction limitations and internationally by the neoliberal international economic order exemplified by investment protection mechanisms. Taking China as a sample, it currently lacks a comprehensive regulation system to address TNC damages; while domestic constraints manifest as the marginalization of judicial regulation, the absence of corporate duty of care, and inadequate extraterritorial regulation effectiveness, international constraints are reflected in the absence of foreign investor obligations in investment agreements and the asymmetry of dispute resolution clauses, challenging regulatory sovereignty. As China continues to advance its policy of high-quality opening up, the risks of negative externalities from transnational capital will continue to increase, necessitating a focus on building and perfecting a regulation mechanism for TNC damages within the framework of international law. To address domestic constraints, it is essential to clarify the division of regulation responsibilities between judicial and administrative bodies, promote the normalization of judicial regulation, and enhance judicial oversight of governmental settlements. Improving the choice of law rules for cross-border torts and the standards for parent company liability for omissions, and enhancing extraterritorial judicial effectiveness through transnational judicial dialogue and cooperation mechanisms are also crucial. To counteract international constraints, specifying investor obligations in investment treaties and designing symmetrical dispute resolution clauses are indispensable to eliminate regulatory chill. Additionally, actively advancing the implementation of TNC obligations in business and human rights treaty negotiations will lay an international legal foundation for the regulation sovereignty of host States.

Keywords: transnational corporate damages, home state litigation, optimization limit, investor-state dispute settlement

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4810 Reducing Later Life Loneliness: A Systematic Literature Review of Loneliness Interventions

Authors: Dhruv Sharma, Lynne Blair, Stephen Clune

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Later life loneliness is a social issue that is increasing alongside an upward global population trend. As a society, one way that we have responded to this social challenge is through developing non-pharmacological interventions such as befriending services, activity clubs, meet-ups, etc. Through a systematic literature review, this paper suggests that currently there is an underrepresentation of radical innovation, and underutilization of digital technologies in developing loneliness interventions for older adults. This paper examines intervention studies that were published in English language, within peer reviewed journals between January 2005 and December 2014 across 4 electronic databases. In addition to academic databases, interventions found in grey literature in the form of websites, blogs, and Twitter were also included in the overall review. This approach yielded 129 interventions that were included in the study. A systematic approach allowed the minimization of any bias dictating the selection of interventions to study. A coding strategy based on a pattern analysis approach was devised to be able to compare and contrast the loneliness interventions. Firstly, interventions were categorized on the basis of their objective to identify whether they were preventative, supportive, or remedial in nature. Secondly, depending on their scope, they were categorized as one-to-one, community-based, or group based. It was also ascertained whether interventions represented an improvement, an incremental innovation, a major advance or a radical departure, in comparison to the most basic form of a loneliness intervention. Finally, interventions were also assessed on the basis of the extent to which they utilized digital technologies. Individual visualizations representing the four levels of coding were created for each intervention, followed by an aggregated visual to facilitate analysis. To keep the inquiry within scope and to present a coherent view of the findings, the analysis was primarily concerned the level of innovation, and the use of digital technologies. This analysis highlights a weak but positive correlation between the level of innovation and the use of digital technologies in designing and deploying loneliness interventions, and also emphasizes how certain existing interventions could be tweaked to enable their migration from representing incremental innovation to radical innovation for example. This analysis also points out the value of including grey literature, especially from Twitter, in systematic literature reviews to get a contemporary view of latest work in the area under investigation.

Keywords: ageing, loneliness, innovation, digital

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