Search results for: integrated solid waste management plan

Authors: Hamad Albadr

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Joint Commission International (JCI) accreditation process intent to improve the safety and quality of care in the international community through the provision of education, publications, consultation, and evaluation services. These standards apply to the entire organization as well as to each department, unit, or service within the organization. Medical Technology that contains both medical equipment and devices, is an essential part of health care. Appropriate management of equipment maintenance for ensuring medical technology safe, the equipment life is maximized, and the total costs are minimized. JCI medical technology evaluation and accreditation use standards, intents, and measurable elements. The paper focuses on evaluation of JCI standards for medical technology in Saudi Arabian hospitals: a Study Case of PSMMC that define the performance expectation, structures, or functions that must be in place for a hospital to be accredited by JCI through measurable elements that indicate a score during the survey process that identify the requirements for full compliance with the standard specially through Facility Management and Safety (FMS) section that require the hospital establishes and implements a program for inspecting, testing, and maintaining medical technology and documenting the results, to ensure that medical technology is available for use and functioning properly, the hospital performs and documents; an inventory of medical technology; regular inspections of medical technology; testing of medical technology according to its use and manufacturers’ requirements; and performance of preventive maintenance.

Keywords: joint commission international (JCI) accreditation, medical technology, Saudi Arabia, Saudi Arabian hospitals

Procedia PDF Downloads 543

Authors: Mandeep Kaur, Jitendra K. Bera

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The search for atom-economical and green synthetic methods for the synthesis of functionalized molecules has attracted much attention. Metal ligand cooperation (MLC) plays a pivotal role in organometallic catalysis to activate C−H, H−H, O−H, N−H and B−H bonds through reversible bond breaking and bond making process. Towards this goal, a bifunctional N─heterocyclic carbene (NHC) based pyridyl-functionalized amide ligand precursor, and corresponding dearomatized iridium complex was synthesized. The NMR and UV/Vis acid titration study have been done to prove the proton response nature of the iridium complex. Further, the dearomatized iridium complex explored as a catalyst on the platform of MLC via dearomatzation/aromatization mode of action towards atom economical α and β─alkylation of ketones and secondary alcohols by using primary alcohols through hydrogen borrowing methodology. The key features of the catalysis are high turnover frequency (TOF) values, low catalyst loading, low base loading and no waste product. The greener syntheses of quinoline, lactone derivatives and selective alkylation of drug molecules like pregnenolone and testosterone were also achieved successfully. Another structurally similar iridium complex was also synthesized with modified ligand precursor where a pendant amide unit was absent. The inactivity of this analogue iridium complex towards catalysis authenticated the participation of proton responsive imido sidearm of the ligand to accelerate the catalytic reaction. The mechanistic investigation through control experiments, NMR and deuterated labeling study, authenticate the borrowing hydrogen strategy.

Keywords: C-C bond formation, hydrogen borrowing, metal ligand cooperation (MLC), n-heterocyclic carbene

Procedia PDF Downloads 171

Authors: Angel Champion, Sadia Kanwal, Rafat Siddiqui

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Harnessing phytochemicals from plant sources presents a novel opportunity to prevent or treat malignant diseases, including breast cancer. Chemotherapy lacks precision in targeting cancerous cells while sparing normal cells, but a phytopharmaceutical approach may offer a solution. Dandelion, a common weed plant, is rich in phytochemicals and provides a safer, more cost-effective alternative with lower toxicity than traditional pharmaceuticals for conditions such as breast cancer. In this study, an in-vitro experiment will be conducted using the ethanol extract of Dandelion on triple-negative MDA-231 breast cancer cell lines. The polyphenolic analysis revealed that the Dandelion extract, particularly from the root and leaf (both cut and sifted), had the most potent antioxidant properties and exhibited the most potent antioxidation activity from the powdered leaf extract. The extract exhibits prospective promising effects for inducing cell proliferation and apoptosis in breast cancer cells, highlighting its potential for targeted therapeutic interventions. Standardizing methods for Dandelion use is crucial for future clinical applications in cancer treatment. Combining plant-derived compounds with cancer nanotechnology holds the potential for effective strategies in battling malignant diseases. Utilizing liposomes as carriers for phytoconstituent anti-cancer agents offers improved solubility, bioavailability, immunoregulatory effects, advancing anticancer immune function, and reducing toxicity. This integrated approach of natural products and nanotechnology has significant potential to revolutionize healthcare globally, especially in underserved communities where herbal medicine is prevalent.

Keywords: apoptosis, antioxidant activity, cancer nanotechnology, phytopharmaceutical

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Authors: Fatema Akram, Mohammad Golam Rasul, Mohammad Masud Kamal Khan, Md. Sharif Imam Ibne Amir

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A variety of routing techniques are available to develop surface runoff hydrographs from rainfall. The selection of runoff routing method is very vital as it is directly related to the type of watershed and the required degree of accuracy. There are different modelling softwares available to explore the rainfall-runoff process in urban areas. XPSTORM, a link-node based, integrated storm-water modelling software, has been used in this study for developing surface runoff hydrograph for a Golf course area located in Rockhampton in Central Queensland in Australia. Four commonly used methods, namely SWMM runoff, Kinematic wave, Laurenson, and Time-Area are employed to generate runoff hydrograph for design storm of this study area. In runoff mode of XPSTORM, the rainfall, infiltration, evaporation and depression storage for sub-catchments were simulated and the runoff from the sub-catchment to collection node was calculated. The simulation results are presented, discussed and compared. The total surface runoff generated by SWMM runoff, Kinematic wave and Time-Area methods are found to be reasonably close, which indicates any of these methods can be used for developing runoff hydrograph of the study area. Laurenson method produces a comparatively less amount of surface runoff, however, it creates highest peak of surface runoff among all which may be suitable for hilly region. Although the Laurenson hydrograph technique is widely acceptable surface runoff routing technique in Queensland (Australia), extensive investigation is recommended with detailed topographic and hydrologic data in order to assess its suitability for use in the case study area.

Keywords: ARI, design storm, IFD, rainfall temporal pattern, routing techniques, surface runoff, XPSTORM

Procedia PDF Downloads 447

Authors: Abid Hussain, Muhammad Rizwan-ul-Haq, Hassan Al-Ayedh, Ahmed M. Al-Jabr

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Oligonychus afrasiaticus, is an important pest that devastates date palms (Phoenix dactylifera). They caused serious damage to date palm fruits. They start feeding on dates at Kimri stage (greenish color dates with high sugar and moisture level) resulting severe fruit losses and rendering them unfit for human consumption. Currently, acaricides are the only tool available to Saudi growers to prevent O. afrasiaticus damage. Many acaricides are available in the Saudi markets in order to control the mites on date palm trees but their efficacy against O. afrasiaticus is questionable. The intensive use of acaricides has led to resistance in many mite species around the globe and their control becomes exceedingly challenging. The current investigation explored for the first time the acaricidal potential of Elettaria cardamomum essential oil for the environmentally safe management of date mites in the laboratory. E. cardamomum exhibited acaricidal activities in a dose dependent manner. GC-MS fractionation of E. cardamomum detected numerous compounds. Among the identified compounds, Guaniol caused 100% mortality compared to other identified compounds including (+)-α-Pinene, Camphene, (-)-B-Pinene, 3-Carene, (R)-(+)-Limonene, and Citral. Our laboratory results showed that E. cardamomum and its constituents especially Guaniol are promising for the eco-friendly management of date mites, O. afrasiaticus, although their field efficacy remains to be evaluated.

Keywords: cardamom, old world date mite, natural acaricide, toxicity

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Authors: Petar Kurecic, Josipa Penic

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The paper represents a product of mentor-graduate student cooperation, developed at the graduate study of Business Economics, major Tourism. The analysis was made through the anonymous questionnaire filled by the respondents from Croatia. Following the latest threatening events and having in mind those yet to come, it can be concluded that no country can benefit from the tourism industry if at the same time does not develop its security system as an integral part of the standard tourist offer. Analyzing the trends in contemporary tourism, the safety and security issues became the decisive factors for the choice of a certain destination. Consequently, countries must not perceive security systems and measures as an unnecessary expense but as an essential element in organizing their tourist services. All hotels and respectable tourist agencies should have a crisis management, with detailed, thoroughly elaborated procedures for emergency situations. Tourists should be timely informed about the potential dangers and risks and the measures taken to prevent them, as well as on procedures for emergency situations. Additionally, it would be good to have mobile applications that would enable tourists to make direct emergency calls with instructions on behavior in crisis situations. It is also essential to implement and put into effect sophisticated security measures such as using surveillance cameras, controlling access to buildings, information exchange with colleagues and neighbors, reporting the suspicious occurrences to the security services, and training staff for crisis management. The security issue is definitely one of the crucial factors in the development of tourism in a certain country.

Keywords: security, security measures in tourism, tourism, tourist destinations

Procedia PDF Downloads 276

Authors: Alok Kalra

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Consumers and practitioners (medical herbalists, pharmacists, and aromatherapists) with strong and increased awareness about health and environment demand organically grown medicinal and aromatic plants (MAPs) to offer a valued product. As the system does not permit the use of synthetic fertilizers the use of nutrient rich organic manures is extremely important. CSIR-CIMAP has developed a complete recycling package for managing distillation and agro-waste of medicinal and aromatic plants for production of superior quality vermicompost involving microbes capable of producing high amounts of humic acid. The major benefits being faster composting period and nutrient rich vermicompost; a nutrient advantage of about 100-150% over the most commonly used organic manure (FYM). At CSIR-CIMAP, strains of microbial inoculants with multiple activities especially strains useful both as biofertilizers and biofungicide and consortia of microbes possessing diverse functional activities have been developed. CSIR-CIMAP has also initiated a program where a large number of accessions are being screened for identifying organic proficient genotypes in mints, ashwagandha, geranium and safed musli. Some of the natural plant growth promoters like calliterpenones from the plant Callicarpa macrophylla has been tested successfully for induction of rooting in stem cuttings and improving growth and yield of various crops. Some of the microbes especially the endophytes have even been identified improving the active constituents of medicinal and aromatic plants. The above said scientific interventions making organic farming a charming proposition would be discussed in details.

Keywords: organic agriculture, microbial inoculants, organic fertilizers, natural plant growth promoters

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Authors: Naveed Chughtai, Salman Atif, Azhar Ali Taj, Murtaza Asghar Bukhari

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Accessible transport systems play a crucial role in infrastructure management and ease of access to destinations. Thus, the necessity of knowledge of service coverage and service deprived areas is a prerequisite for devising policies. Integration of PTALs model with GIS network analysis models (Service Area Analysis, Closest Facility Analysis) facilitates the analysis of deprived areas. In this research, models presented determine the accessibility. The empirical evidence suggests that current bus network system caters only 18.5% of whole population. Using network analysis results as inputs for PTALs, it is seen that excellent accessibility indexed bands cover a limited areas, while 78.8% of area is totally deprived of any service. To cater the unserved catchment, new route alignments are proposed while keeping in focus the Socio-economic characteristics, land-use type and net population density of the deprived area. Change in accessibility with proposed routes show a 10% increment in service delivery and enhancement in terms of served population is up to 20.4%. PTALs result shows a decrement of 60 Km2 in unserved band. The result of this study can be used for planning, transport infrastructure management, allocation of new route alignments in combination with future land-use development and for adequate spatial distribution of service access points.

Keywords: GIS, public transport accessibility, PTALs, accessibility index, service area analysis, closest facility analysis

Procedia PDF Downloads 428

Authors: Raimoana Frogier, Luc Girard, Pierre Bauduin, Diane Rebiscoul, Olivier Diat

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Nano-ions (NIs) are ionic species or clusters of nanometric size. Their low charge density and the delocalization of their charges give special properties to some of NIs belonging to chemical classes of polyoxometalates (POMs) or boron clusters. They have the particularity of interacting non-covalently with neutral hydrated surface or interfaces such as assemblies of surface-active molecules (micelles, vesicles, lyotropic liquid crystals), foam bubbles or emulsion droplets. This makes possible to classify those NIs in the Hofmeister series as superchaotropic ions. The mechanism of adsorption is complex, linked to the simultaneous dehydration of the ion and the molecule or supramolecular assembly with which it can interact, all with an enthalpic gain on the free energy of the system. This interaction process is reversible and is sufficiently pronounced to induce changes in molecular and supramolecular shape or conformation, phase transitions in the liquid phase, all at sub-millimolar ionic concentrations. This new property of some NIs opens up new possibilities for applications in fields as varied as biochemistry for solubilization, recovery of metals of interest by foams in the form of NIs... In order to better understand the physico-chemical mechanisms at the origin of this interaction, we use silicon wafers functionalized by non-ionic oligomers (polyethylene glycol chains or PEG) to study in situ by X-ray reflectivity this interaction of NIs with the grafted chains. This study carried out at ESRF (European Synchrotron Radiation Facility) and has shown that the adsorption of the NIs, such as POMs, has a very fast kinetics. Moreover the distribution of the NIs in the grafted PEG chain layer was quantify. These results are very encouraging and confirm what has been observed on soft interfaces such as micelles or foams. The possibility to play on the density, length and chemical nature of the grafted chains makes this system an ideal tool to provide kinetic and thermodynamic information to decipher the complex mechanisms at the origin of this adsorption.

Keywords: adsorption, nano-ions, solid-liquid interface, superchaotropicity

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Authors: Lakshmi, Yakshita Awasthi, Deepika, Lovleen Jha, Archna Kumar

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From the back of centuries, plant-parasitic nematodes (PPN) have been recognized as a major threat to agriculturalists globally. It causes 21.3% global food loss annually. The utilization of harmful chemical pesticides to minimize the nematode population may cause acute and delayed health hazards and harmful impacts on human health. In recent years, a variety of plants have been evaluated for their nematicidal properties and efficacy in the management of plant-parasitic nematodes. Several Phyto-nematicides are available, but most of them are incapable of sustainable management of PPN, especially Meloidogyne spp. Thus, there is a great need for a new eco-friendly, highly efficient, sustainable control measure for this nematode species. Keeping all these facts and after reviewing the literature, aqueous extract of Cymbopogon citratus, Tagetes erecta, and Azadirachta indica were prepared by adding distilled water (1 g sample mixed with 10ml of water). In vitro studies were conducted to evaluate the efficacious nature of targeted botanicals against PPN Meloidogyne spp. The mortality status of PPN was recorded by counting the live and dead individuals after applying 100μl of selected extract. The impact was observed at different time durations, i.e., 24h and 48h. The result showed that the highest 100% mortality was at 48h in all three extracts. Thus, these extracts, with the addition of a suitable shelf-life enhancer, may be exploited in different nematode control programs as an economical, sustainable measure.

Keywords: Meloidogyne, Cymbopogon citratus, Tagetes erecta, Azadirachta indica, nematicidal

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Authors: Kamakshaiah Kolli, R. Seshadri

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Water is a key resource in all economic activities ranging from agriculture to industry. Only a tiny fraction of the planet's abundant water is available to us as fresh water. Assessment of water quality has always been paramount in the field of environmental quality management. It is the foundation for health, hygiene, progress and prosperity. With ever increasing pressure of human population, there is severe stress on water resources. Therefore efficient water management is essential to civil society for betterment of quality of life. The present study emphasizes on the groundwater quality, sources of ground water contamination, variation of groundwater quality and its spatial distribution. The bases for groundwater quality assessment are groundwater bodies and representative monitoring network enabling determination of chemical status of groundwater body. For this study, water samples were collected from various areas of the entire corporation area of Guntur. Water is required for all living organisms of which 1.7% is available as ground water. Water has no calories or any nutrients, but essential for various metabolic activities in our body. Chemical and physical parameters can be tested for identifying the portability of ground water. Electrical conductivity, pH, alkalinity, Total Alkalinity, TDS, Calcium, Magnesium, Sodium, Potassium, Chloride, and Sulphate of the ground water from Guntur district: Different areas of the District were analyzed. Our aim is to check, if the ground water from the above areas are potable or not. As multivariate are present, Data mining technique using JRIP rules was employed for classifying the ground water.

Keywords: groundwater, water quality standards, potability, data mining, JRIP, PCA, classification

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Authors: Magdy Roman, Mostafa Shoeib, Mostafa Rostom

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Global vision, whether provided by overhead fixed cameras, on-board aerial vehicle cameras, or satellite images can always provide detailed information on the environment around mobile robots. In this paper, an intelligent vision-based method of path planning and obstacle avoidance for mobile robots is presented. The method integrates visual perception with a new proposed field-based path-planning method to overcome common path-planning problems such as local minima, unreachable destination and unnecessary lengthy paths around obstacles. The method proposes an exponential angle deviation field around each obstacle that affects the orientation of a close robot. As the robot directs toward, the goal point obstacles are classified into right and left groups, and a deviation angle is exponentially added or subtracted to the orientation of the robot. Exponential field parameters are chosen based on Lyapunov stability criterion to guarantee robot convergence to the destination. The proposed method uses obstacles' shape and location, extracted from global vision system, through a collision prediction mechanism to decide whether to activate or deactivate obstacles field. In addition, a search mechanism is developed in case of robot or goal point is trapped among obstacles to find suitable exit or entrance. The proposed algorithm is validated both in simulation and through experiments. The algorithm shows effectiveness in obstacles' avoidance and destination convergence, overcoming common path planning problems found in classical methods.

Keywords: path planning, collision avoidance, convergence, computer vision, mobile robots

Procedia PDF Downloads 181

Authors: T. Mcgraw, F. N. Morin, N. Desai

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Background: Antimicrobial resistance is a critical issue in global health care and a significant contributor to increased patient morbidity and mortality. Suspected urinary tract infection (UTI) is a key area of inappropriate antibiotic prescription in pediatrics. Management patterns of infectious diseases have been shown to vary by provider type within a single setting. The aim of this study was to assess compliance with national UTI management guidelines by nurse practitioners in a pediatric emergency department (ED). Methods: This was a post-hoc analysis of a retrospective cohort study to review and evaluate visits to a tertiary care freestanding pediatric emergency department. Patients were included if they were 60 days to 36 months old and discharged with a diagnosis of UTI or ‘rule-out UTI’ between July 2015 and July 2020. Primary outcome measure was proportion of visits seen by Nurse Practitioners (NP) which were associated with national guideline compliance in the diagnosis and treatment of suspected UTI. We performed descriptive statistics and comparative analyses to determine differences in practice patterns between NPs, and physicians. Results: A total of 636 charts were reviewed, of which 402 patients met inclusion criteria. 17 patients were treated by NPs, 385 were treated by either Pediatric Emergency Medicine physicians (PEM) or non-PEM physicians. Overall, the proportion of infants receiving guideline-compliant care was 25.9% (21.8-30.4%). Of those who were prescribed antibiotics, 79.6% (74.7-83.8%) received first line guideline recommended therapy and 58.9% (53.8-63.8%) received fully compliant therapy with respect to age, dose, duration, and frequency. In patients treated by NPs, 16/17 (94%(95% CI:73.0-99.0)) required antibiotics, 15/16 (93%(95% CI: 71.7-98.9)) were treated with first line agent (cephalexin), 8/16 (50%(95% CI:28-72)) were guideline compliant of dose and duration. 5/8 (63%(95% CI:30.6-86.3)) were noncompliant for dose being too high. There was no difference in receiving guideline compliant empiric antibiotic therapy between physicians and nurse practitioners (OR: 0.837 CI: 0.302-2.69). Conclusion: In this post-hoc analysis, guideline noncompliance by nurse practitioners is common in children tested and treated for UTIs in a pediatric emergency department. Care by a Nurse Practitioner was not associated with greater rate of noncompliance than care by a Pediatric Emergency Medicine physician. Future appropriately powered studies may focus on confirming these results.

Keywords: antibiotic stewardship, infectious disease, nurse practitioner, urinary tract infection

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Authors: Roberto Machado

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We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology, analyzing 2,996 studies and synthesizing 41 of them to explore the evolution of data science and its integration into geography. By employing optimization algorithms, we accelerated the review process, significantly enhancing the efficiency and precision of literature selection. Our findings indicate that data science has developed over five decades, facing challenges such as the diversified integration of data and the need for advanced statistical and computational skills. In geography, the integration of data science underscores the importance of interdisciplinary collaboration and methodological innovation. Techniques like large-scale spatial data analysis and predictive algorithms show promise in natural disaster management and transportation route optimization, enabling faster and more effective responses. These advancements highlight the transformative potential of data science in geography, providing tools and methodologies to address complex spatial problems. The relevance of this study lies in the use of optimization algorithms in systematic reviews and the demonstrated need for deeper integration of data science into geography. Key contributions include identifying specific challenges in combining diverse spatial data and the necessity for advanced computational skills. Examples of connections between these two fields encompass significant improvements in natural disaster management and transportation efficiency, promoting more effective and sustainable environmental solutions with a positive societal impact.

Keywords: data science, geography, systematic review, optimization algorithms, supervised learning

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Authors: Mehdi Rezai, Asghar Zamani

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Virtual teams are a reality in today’s fast-paced world. With the possibility of commonly using common resources, an increase of inter-organizational projects, cooperation, outsourcing, and the increase in the number of people who work remotely or flexitime, an extensive and active presence of high-performance teams is a must. Virtual teams are a challenge by themselves. Their members remove the barriers of cultures, time regions and organizations, and they often communicate through electronic devices over considerable distances. Firstly, we examine the management of virtual teams by considering different issues such as cultural and personal diversities, communications and arrangement issues. Then we will examine individuals, processes and the existing tools in a team. The main challenge is managing high-performance virtual teams. First of all, we must examine the concept of performance. Then, we must focus on teams and the best methods of managing them. Constant improvement of performance, together with precisely regulating every individual’s method of working, increases the levels of performance in the course of time. High-performance teams exploit every issue as an opportunity for achieving high performance. And we know that doing projects with high performance is among every organization or team’s objectives. Performance could be measured using many criteria, among which carrying out projects in time, the satisfaction of stakeholders, and not exceeding budgets could be named. Elements such as clear objectives, clearly-defined roles and responsibilities, effective communications, and commitment to collaboration are essential to a team’s effectiveness. Finally, we will examine roles, systems, processes and will carry out a cause-and-effect analysis of different criteria in improving a team’s performance.

Keywords: virtual teams, performance, management, process, improvement, effectiveness

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Authors: Bulcha Belay Etana, Benny Malengier, Janarthanan Krishnamoorthy, Timothy Kwa, Lieva VanLangenhove

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Electromyography measures the electrical activity of muscles using surface electrodes or needle electrodes to monitor various disease conditions. Recent developments in the signal acquisition of electromyograms using textile electrodes facilitate wearable devices, enabling patients to monitor and control their health status outside of healthcare facilities. Here, we have developed and tested wearable textile electrodes to acquire electromyography signals from patients suffering from Parkinson’s disease and incorporated a feedback-control system to relieve muscle cramping through thermal stimulus. In brief, the textile electrodes made of stainless steel was knitted into a textile fabric as a sleeve, and their electrical characteristic, such as signal-to-noise ratio, was compared with traditional electrodes. To relieve muscle cramping, a heating element made of stainless-steel conductive yarn sewn onto cotton fabric, coupled with a vibration system, was developed. The system integrated a microcontroller and a Myoware muscle sensor to activate the heating element as well as the vibration motor when cramping occurs, and at the same time, the element gets deactivated when the muscle cramping subsides. An optimum therapeutic temperature of 35.5 °C is regulated by continuous temperature monitoring to deactivate the heating system when this threshold value is reached. The textile electrode exhibited a signal-to-noise ratio of 6.38dB, comparable to that of the traditional electrode’s value of 7.05 dB. For a given 9 V power supply, the rise time was about 6 minutes for the developed heating element to reach an optimum temperature.

Keywords: smart textile system, wearable electronic textile, electromyography, heating textile, vibration therapy, Parkinson’s disease

Procedia PDF Downloads 96

Authors: W. L. Tsang, H. Y. Li, S. L. Wong, T. Y. Kwok, S. C. Yuen, S. S. Kwok, P. S. Ko, S. Y. Lau

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Introduction: Palliative care is no doubt necessary in surgery. When one looks at studies of what patients with life-threatening illness want and compares to what they experience in surgical units, the gap is huge. Surgical nurses, being patient advocates, should engage with patients and families sooner rather than later in their illness trajectories to consider how to manage the illness, not just their capacity to survive. Objective: This clinical practice guide aims to fill the service gap of palliative care in surgery by producing a quality-driven, evidence-based yet straightforward clinical practice guide based on a focus strategy. Methodology: In line with Guide to Good Nursing Practice: End-of-Life Care recommended by Nursing Council of Hong Kong and the strategic goal of improving quality of palliative care proposed in HA Strategic Plan 2017-2022, multiple phases of work were undertaken from July 2015 to December 2017. A pragmatic clinical practice guide for surgical patients facing life-threatening conditions was developed based on assessments on knowledge of and attitudes towards end-of-life care of surgical nurses. Key domains, including preparation for bereavement, nursing care for imminently dying patients and at the dying scene were crystallized according to the results of the assessments and the palliative care checklist formulated by UCH Palliative Care Team. After a year of rollout, its content was refined through analyses of implementation in routine practice and consensus opinions from frontline nurses. Results and Outcomes: This clinical practice guide inspires surgical nurses with the art of care to provide for patients’ comfort, function, and longevity. It provides practical directions and assists nurses to master the skills on advance care planning and learn how to be clear with patients, families and themselves about the realities of the disease pictures. Through the implementation, patients and families are included in the decision process, and their wishes are honored. The delivery of explicit and high-quality palliative care maintains good nurse-to-patient relations and enhances satisfaction of hospital care of patients and families. Conclusion: Surgical nursing has always been up to the unique challenges of the era. This clinical practice guide has become an island of credibility for our nurses as they traverse the often stormy waters of life-limiting illness.

Keywords: palliative care delivery, palliative care in surgery, hospice care, end-of-life care

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Authors: Xiaoxian Zhang

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Guidelines of ecological risk assessment (ERA) and food safety assessment (FSA) used nowadays, based on an S-shaped threshold dose-response curve (SDR), fail to consider hormesis, a reproducible biphasic dose-response model represented as a J-shaped or an inverted U-shaped curve, that occurs in the real-life environment across multitudinous compounds on cells, organisms, populations, and even the ecosystem. Specifically, in SDR-based ERA and FSA practice, predicted no effect concentration (PNEC) is calculated separately for individual substances from no observed effect concentration (NOEC, usually equivalent to 10% effect concentration (EC10) of a contaminant or food condiment) over an assessment coefficient that is bigger than 1. Experienced researchers doubted that hormesis in the real-life environment might lead to a waste of limited human and material resources in ERA and FSA practice, but related data are scarce. In this study, hormetic effects on bioluminescence of Aliivibrio fischeri (A. f) induced by sulfachloropyridazine (SCP) under 40 conditions to simulate the real-life scenario were investigated, and hormetic effects on growth of human MCF-7 cells caused by brown sugar and mascavado sugar were found likewise. After comparison of related parameters, it has for the first time been proved that there is a 50% probability for safe concentration (SC) of contaminants and food condiments to fall within the hormetic-stimulatory range (HSR) or left to HSR, revealing the unreliability of traditional parameters in standardized (eco)toxicological studies, and supporting qualitatively and quantitatively the over-strictness of ERA and FSA resulted from misuse of SDR. This study provides a novel perspective for ERA and FSA practitioners that hormesis should dominate and conditions where SDR works should only be singled out on a specific basis.

Keywords: dose-response relationship, food safety, ecological risk assessment, hormesis

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Authors: Zahra Mila Elmi, Mahsa Khanekheshi

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Almost half of the population and potential manpower in the country and rural areas are women. Manpower especially educated people, plays an important role in the production and economic growth. Also, the potential of rural areas to create employment should not be overlooked. In this research, the effects of socio-economic and demographic factors on women's economic participation in rural areas of Iran's provinces will be studied. Therefore, this study was performed by using the results of the rural households income and expenditure surveys -has been taken in 2016- in the framework of pseudo panel data. This study used the logit model and the maximum likelihood method to study the rural women's participation, with 28,265 observations. Results show the inverted U-shaped relationship between age and the probability of female participation; In other words, young women are more likely to participate in labor markets more than the other groups. Divorced and single woman has more chance of participation in comparison with who was being married. With increasing the divorce rate and singleness in Iran, economic policymakers must provide appropriate solutions for this challenge in the coming years. On the base of the results, being a student and the presence of an infant under the age of 6 in the household has a negative effect on the possibility of women's participation in the labor market. The women's education level has a U-shaped relationship with their participation rate. Illiteracy and high education have a strong positive effect on the economic participation of rural women. This shows the dual labor market for women in Iran. Illiterate women are attracted to service jobs, and educated woman are more attracted to education and health jobs. Increasing household income has a small but positive and significant effect on the probability of rural female participation. In the overlook, due to the frequency of the women population in the age group of 25 to 35 years, and more willingness of women in the age 35 to 44 years to participate in the labor market, and studying ofa significant portion of the rural women, the increase of rural female participation is expected in the years ahead. Thus, it is expected policy maker to create new job opportunities for the employment of educated women and take the necessary plan to improve the current situation for women.

Keywords: female participation rate, rural area, provincial data, pseudo-panel data method

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Authors: Rowena R. De Guzman

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Association of Southeast Asian Nations (ASEAN) integration requires that higher education institutions (HEIs) must adjust the quality of their educational services and develop a global mindset, through various quality assurance (QA) activities to a level producing global graduates and encouraging human resource mobility. For Philippine HEIs, QA involves enormous tasks and responsibilities, whereby the implementation of which involves various parties, agencies and stakeholders; and in that case innovations have to be installed to engage the whole system in the QA process. In this study, collaborative governance (CG), a concept from the field of public administration, is introduced in educational management, particularly in the area of QA management. The paper suggests that the exercise of and attitude toward CG in QA is relevant to the practice of activities across QA indicators in higher educational services among stakeholders from participating HEIs. Participants representing different interests are collectively empowered, and this compelled them to participate and support the QA activities of the HEIs. It is recommended to embed CG model in the system for HEIs undergoing or intending to undergo QA achieve their desired QA outcomes. The study supports the commitment of the Philippine government to the evolving policy and efforts to achieve comparable qualifications across the Asia-Pacific region under the auspices of the UNESCO.

Keywords: ASEAN integration, collaborative governance, global education, government policy, higher education, international demands, quality assurance

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Authors: Mbonigaba Swale

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Malaria is an infection or disease caused by parasites (Plasmodium Falciparum — causes severe Malaria, plasmodium Vivax, Plasmodium Ovale, and Plasmodium Malariae), transmitted by bites of infected anopheles (female) mosquitoes to humans. These vectors comprise of two types in Africa, particularly in Uganda, i.e. anopheles fenestus and Anopheles gambaie (‘example Anopheles arabiensis,,); feeds on man inside the house mainly at dusk, mid-night and dawn and rests indoors and makes them effective transmitters (vectors) of the disease. People in both urban and rural areas have consistently become prone to repetitive attacks of malaria, causing a lot of deaths and significantly increasing the poverty levels of the rural poor. Malaria is a national problem; it causes a lot of maternal pre-natal and antenatal disorders, anemia in pregnant mothers, low birth weights for the newly born, convulsions and epilepsy among the infants. Cumulatively, it kills about one million children every year in sub-Saharan Africa. It has been estimated to account for 25-35% of all outpatient visits, 20-45% of acute hospital admissions and 15-35% of hospital deaths. Uganda is the leading victim country, for which Rakai and Masaka districts are the most affected. So, it is not clear whether these abhorrent situations and episodes of recurrences and failure to cure from the disease are a result of poor diagnosis, prescription and dosing, treatment habits and compliance of the patients to the drugs or the ethical domain of the stake holders in relation to the main stream methodology of malaria management. The research is aimed at offering an alternative approach to manage and deal absolutely with problem by using a knowledge based software model of Artificial Intelligence (Al) that is capable of performing common-sense and cognitive reasoning so as to take decisions like the human brain would do to provide instantaneous expert solutions so as to avoid speculative simulation of the problem during differential diagnosis in the most accurate and literal inferential aspect. This system will assist physicians in many kinds of medical diagnosis, prescribing treatments and doses, and in monitoring patient responses, basing on the body weight and age group of the patient, it will be able to provide instantaneous and timely information options, alternative ways and approaches to influence decision making during case analysis. The computerized system approach, a new model in Uganda termed as “Software Aided Treatment” (SAT) will try to change the moral and ethical approach and influence conduct so as to improve the skills, experience and values (social and ethical) in the administration and management of the disease and drugs (combination therapy and generics) by both the patient and the health worker.

Keywords: knowledge based software, management, treatment, diagnosis

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Authors: Ying-Ming Su, Mei-Shu Huang

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To mitigate the urban heat island effect has become a global issue facing the challenge of climate change. Through literature reviews, plant photosynthesis can reduce the carbon dioxide and mitigate the urban heat island effect relatively. Because there are not enough open space and park, green roof has become an important policy in Taiwan. We selected elementary school buildings in northern New Taipei City as research subjects since elementary school is asked priority to build green roof and important educational place to promote green roof concept. Testo 175-H1 recording device was used to record the temperature and humidity difference between roof surface and interior space below roof with and without green roof for the long-term. We also use questionnaire to investigate the awareness of comfort level of green roof and sensation of teachers and students of the elementary school. The results indicated the temperature of roof without greening was higher than that with greening about 2°C. But sometimes during noontime, the temperature of green roof was higher than that of non-green roof related to the character of the accumulation and dissipation of heat of greening probably. The temperature of interior space below green roof was normally lower than that without green roof about 1°C showed that green roof could lower the temperature. The humidity of the green roof was higher than the one without greening also indicated that green roof retained water better. Teachers liked to combine green roof concept in the curriculum, students wished all classes can take turns to maintain the green roof. Teachers and students that school had integrated green roof concept in the curriculum were more willing to participate in the maintenance work of green roof. Teachers and students who may access and touch the green roof can be more aware of the green roof benefit. We suggest architect to increase the accessibility and visibility of green roof, such as a part of the activity space. This idea can be a reference of the green roof curriculum design.

Keywords: comfort level, elementary school, green roof, heat island effect

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Authors: Evelyn Osehontue Uroro, Richard Bright, Jing Yang Quek, Krasimir Vasilev

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Bacterial infections have been a challenge both in the public and private sectors. The colonization of bacteria often occurs in medical devices such as catheters, heart valves, respirators, and orthopaedic implants. When biomedical devices are inserted into patients, the deposition of macromolecules such as fibrinogen and immunoglobin on their surfaces makes it easier for them to be prone to bacteria colonization leading to the formation of biofilms. The formation of biofilms on medical devices has led to a series of device-related infections which are usually difficult to eradicate and sometimes cause the death of patients. These infections require surgical replacements along with prolonged antibiotic therapy, which would incur additional health costs. It is, therefore, necessary to prevent device-related infections by inhibiting the formation of biofilms using intelligent technology. Antibiotic resistance of bacteria is also a major threat due to overuse. Different antimicrobial agents have been applied to microbial infections. They include conventional antibiotics like rifampicin. The use of conventional antibiotics like rifampicin has raised concerns as some have been found to have hepatic and nephrotoxic effects due to overuse. Hence, there is also a need for proper delivery of these antibiotics. Different techniques have been developed to encapsulate and slowly release antimicrobial agents, thus reducing host cytotoxicity. Examples of delivery systems are solid lipid nanoparticles, hydrogels, micelles, and polymeric nanoparticles. The different ways by which drugs are released from polymeric nanoparticles include diffusion-based release, elution-based release, and chemical/stimuli-responsive release. Polymeric nanoparticles have gained a lot of research interest as they are basically made from biodegradable polymers. An example of such a biodegradable polymer is polycaprolactone (PCL). PCL degrades slowly by hydrolysis but is often sensitive and responsive to stimuli like enzymes to release encapsulants for antimicrobial therapy. This study presents the synthesis of PCL nanoparticles loaded with rifampicin and the on-demand release of rifampicin for treating staphylococcus aureus infections.

Keywords: enzyme, Staphylococcus aureus, PCL, rifampicin

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Authors: Lim Chen Kim, Tan Kian Lam, Chan Yi Chee

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This research presents a multi-modal simulation in the reconstruction of the past and the construction of present in digital cultural heritage on mobile platform. In bringing the present life, the virtual environment is generated through a presented scheme for rapid and efficient construction of 360° panoramic view. Then, acoustical heritage model and crowd model are presented and improvised into the 360° panoramic view. For the reconstruction of past life, the crowd is simulated and rendered in an old trading port. However, the keystone of this research is in a virtual walkthrough that shows the virtual present life in 2D and virtual past life in 3D, both in an environment of virtual heritage sites in George Town through mobile device. Firstly, the 2D crowd is modelled and simulated using OpenGL ES 1.1 on mobile platform. The 2D crowd is used to portray the present life in 360° panoramic view of a virtual heritage environment based on the extension of Newtonian Laws. Secondly, the 2D crowd is animated and rendered into 3D with improved variety and incorporated into the virtual past life using Unity3D Game Engine. The behaviours of the 3D models are then simulated based on the enhancement of the classical model of Boid algorithm. Finally, a demonstration system is developed and integrated with the models, techniques and algorithms of this research. The virtual walkthrough is demonstrated to a group of respondents and is evaluated through the user-centred evaluation by navigating around the demonstration system. The results of the evaluation based on the questionnaires have shown that the presented virtual walkthrough has been successfully deployed through a multi-modal simulation and such a virtual walkthrough would be particularly useful in a virtual tour and virtual museum applications.

Keywords: Boid Algorithm, Crowd Simulation, Mobile Platform, Newtonian Laws, Virtual Heritage

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Authors: Prasamsha Panta, Da Yeon Kim, Ja Yong Jang, Min Jae Kim, Jae Ho Kim, Moon Suk Kim

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Introduction: Among the many anticancer drugs used clinically, doxorubicin (Dox), was one of widely used drugs to treat many types of solid tumors such as liver, colon, breast, or lung. Intratumoral injection of chemotherapeutic agents is a potentially more effective alternative to systemic administration because direct delivery of the anticancer drug to the target may improve both the stability and efficacy of anticancer drugs. Injectable in situ-forming gels have attracted considerable attention because they can achieve site specific drug delivery, long term action periods, and improved patient compliance. Objective: Objective of present study is to confirm clinical benefit of intratumoral chemotherapy using injectable in situ-forming poly(ethylene glycol)-b-polycaprolactone diblock copolymer (MP) and Dox with increase in efficacy and reducing the toxicity in patients with cancer diseases. Methods and methodology: We prepared biodegradable MP hydrogel and measured viscosity for the evaluation of thermo-sensitive property. In vivo antitumor activity was performed with normal saline, MP only, single free Dox, repeat free Dox, and Dox-loaded MP gel. The remaining amount of Dox drug was measured using HPLC after the mouse was sacrified. For cytotoxicity studies WST-1 assay was performed. Histological analysis was done with H&E and TUNEL processes respectively. Results: The works in this experiment showed that Dox-loaded MP have biodegradable drug depot property. Dox-loaded MP gels showed remarkable in vitro cytotoxicity activities against cancer cells. Finally, this work indicates that injection of Dox-loaded MP allowed Dox to act effectively in the tumor and induced long-lasting supression of tumor growth. Conclusion: This work has examined the potential clinical utility of intratumorally injected Dox-loaded MP gel, which shows significant effect of higher local Dox retention compared with systemically administered Dox.

Keywords: injectable in-situ forming hydrogel, anticancer, doxorubicin, intratumoral injection

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Authors: Azeem Tariq, Stephane De Tourdonnet, Lars Stoumann Jensen, Reiner Wassmann, Bjoern Ole Sander, Quynh Duong Vu, Trinh Van Mai, Andreas De Neergaard

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Rice growing area is increasing to meet the food demand of increasing population. Mostly, rice is growing on lowland, small landholder fields in most part of the world, which is one of the major sources of greenhouse gases (GHG) emissions from agriculture fields. The strategies such as, altering water and residues (carbon) management practices are assumed to be essential to mitigate the GHG emissions from flooded rice system. The actual implementation and potential of these measures on small farmer fields is still challenging. A field study was conducted on red river delta in Northern Vietnam to identify the potential challenges and barriers to the small rice farmers for implementation of climate smart rice practices. The objective of this study was to develop and access the feasibility of climate smart rice prototypes under actual farmer conditions. Field and scientific oriented framework was used to meet our objective. The methodological framework composed of six steps: i) identification of stakeholders and possible options, ii) assessment of barrios, drawbacks/advantages of new technologies, iii) prototype design, iv) assessment of mitigation potential of each prototype, v) scenario building and vi) scenario assessment. A farm survey was conducted to identify the existing farm practices and major constraints of small rice farmers. We proposed the two water (pre transplant+midseason drainage and early+midseason drainage) and one straw (full residue incorporation) management option keeping in views the farmers constraints and barriers for implementation. To test new typologies with existing prototypes (midseason drainage, partial residue incorporation) at farmer local conditions, a participatory field experiment was conducted for two consecutive rice seasons at farmer fields. Following the results of each season a workshop was conducted with stakeholders (farmers, village leaders, cooperatives, irrigation staff, extensionists, agricultural officers) at local and district level to get feedbacks on new tested prototypes and to develop possible scenarios for climate smart rice production practices. The farm analysis survey showed that non-availability of cheap labor and lacks of alternatives for straw management influence the small farmers to burn the residues in the fields except to use for composting or other purposes. Our field results revealed that application of early season drainage significantly mitigates (40-60%) the methane emissions from residue incorporation. Early season drainage was more efficient and easy to control under cooperate manage system than individually managed water system, and it leads to both economic (9-11% high rice yield, low cost of production, reduced nutrient loses) and environmental (mitigate methane emissions) benefits. The participatory field study allows the assessment of adaptation potential and possible benefits of climate smart practices on small farmer fields. If farmers have no other residue management option, full residue incorporation with early plus midseason drainage is adaptable and beneficial (both environmentally and economically) management option for small rice farmers.

Keywords: adaptation, climate smart agriculture, constrainsts, smallholders

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Authors: Elvin Çomo, Edlira Tako, Albana Hasimi, Rrapo Ormeni, Olger Gjuzi, Mirela Ndrita

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In Albania, only low enthalpy geothermal springs and wells are known, the temperatures of some of them are almost at the upper limits of low enthalpy, reaching over 60°C. These resources can be used to improve the country's energy balance, as well as for profitable economic purposes. The region of Elbasan has the greatest geothermal energy potential in Albania. This bass is one of the most popular and used in our country. This area is a surface with a number of sources, located in the form of a chain, in the sector between Llixha and Hidraj and constitutes a thermo-mineral basin with stable discharge and high temperature. The sources of Elbasan Springs, with the current average flow of thermo mineral water of 12-18 l/s and its temperature 55-65oC, have specific reserves of 39.6 GJ/m2 and potential power to install 2760 kW. For the assessment of physico-chemical parameters and heavy metals, water samples were taken at 5 monitoring stations throughout the year 2022. The levels of basic parameters were analyzed using ISO, EU and APHA 21-th edition standard methods. This study presents the current state of the physico-chemical parameters of this thermal basin, the evaluation of these parameters for curative activities and for industrial processes, as well as the integrated utilization of geothermal energy. Possibilities for using thermomineral waters for heating homes in the area around them or even further, depending on the flow from the source or geothermal well. Sensitization of Albanian investors, medical research and the community for the high economic and curative effectiveness, for the integral use of geothermal energy in this area and the development of the tourist sector. An analysis of the negative environmental impact from the use of thermal water is also provided.

Keywords: geothermal energy, Llixha, physic-chemical parameters, thermal water

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Authors: Fatemeh Rezaei, Mohammad H. Yarmohammadian, Masoud Ferdosi, Abbas Haghshnas

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Background: Failure Modes and Effect Analysis is now having known as the main methods of risk assessment and the accreditation requirements for many organizations. The Risk Priority Number (RPN) approach is generally preferred, especially for its easiness of use. Indeed it does not require statistical data, but it is based on subjective evaluations given by the experts about the Occurrence (O i), the Severity (Si) and the Detectability (D i) of each cause of failure. Methods: This study is a quantitative – qualitative research. In terms of qualitative dimension, method of focus groups with inductive approach is used. To evaluate the results of the qualitative study, quantitative assessment was conducted to calculate RPN score. Results; We have studied patient’s journey process in surgery ward and the most important phase of the process determined Transport of the patient from the holding area to the operating room. Failures of the phase with the highest priority determined by defining inclusion criteria included severity (clinical effect, claim consequence, waste of time and financial loss), occurrence (time- unit occurrence and degree of exposure to risk) and preventability (degree of preventability and defensive barriers) and quantifying risks priority criteria in the context of RPN index. Ability of improved RPN reassess by root cause (RCA) analysis showed some variations. Conclusions: Finally, It could be concluded that understandable criteria should have been developed according to personnel specialized language and communication field. Therefore, participation of both technical and clinical groups is necessary to modify and apply these models.

Keywords: failure mode, effects analysis, risk priority number(RPN), health system, risk assessment

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Authors: Angesom Gebrezgabiher Tesfay, Afafaw Hailesilasie Tesfay, Muyiwa Samuel Adaramola

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The energy demand boost in Ethiopia urges sustainable fuel options while it is mainly supplemented by traditional biomass and imported conventional fuels. To satisfy the deficiency it has to be sourced from all renewables. Thus identifying resources and estimating potential is vital to the sector. This study aims at an in-depth assessment to quantify, prioritize, and analyze agricultural residue biomass energy and related characteristic forms. Biomass use management and modernization seeks successive information and a clue about the resource quantity and characteristic. Five years of crop yield data for thirteen crops were collected. Conversion factors for their 20 residues are surveyed from the literature. Then residues amount potentially available for energy and their energy is estimated regional, crop-wise, residue-wise, and shares compared. Their potential value for energy is analyzed from two perspectives and prioritized. The gross potential is estimated to be 495PJ, equivalent to 12/17 million tons of oil/coal. At 30% collection efficiency, it is the same as conventional fuel import in 2018. Maize and sorghum potential and spatial availability are preeminent. Cotton and maize presented the highest potential values for energy from application and resource perspectives. Oromia and Amhara regions' contributions are the highest. The resource collection and application trends are required for future management that implicates a prospective study.

Keywords: crop residue, biomass potential, biomass resource, Ethiopian energy

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Authors: Elzbieta Sikorska-Simmons

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Dementia is a progressive terminal disease. Despite this recognition, research shows that most family caregivers do not know it, and it is unclear how this knowledge affects the quality of patient care. The aim of this qualitative study of 20 family caregivers for patients with advanced dementia is to examine how the caregiver's knowledge about dementia affects the quality of patient care in the context of healthcare decision-making, advanced care planning, and access to adequate support systems. Knowledge about dementia implies family caregivers' understanding of dementia trajectories, common symptoms/complications, and alternative treatment options (e.g., comfort feeding versus tube feeding). Data were collected in semi-structured interviews with 20 family caregivers. The interviews were conducted in person by the author and designed to elicit rich descriptions of family caregivers' experiences with healthcare decision-making and the management of common symptoms/complications of end-stage dementia as patient healthcare proxies. The study findings suggest that caregivers who recognize that dementia is a terminal disease are less likely to opt for life-extending treatments during the advanced stages. They are also more likely to seek palliative/hospice care, and consequently, they are better able to avoid unnecessary hospitalizations or medical procedures. For example, those who know that dementia is a terminal disease tend to opt for "comfort feeding" rather than "tube feeding" in managing the swallowing difficulties that accompany advanced dementia. In the context of advance care planning, family caregivers who know that dementia is a terminal disease tend to have more meaningful advance directives (e.g., Power of Attorney and Do Not Resuscitate orders). They are better prepared to anticipate common problems and pursue treatments that foster the best quality of patient life and care. Greater knowledge about advanced dementia helps them make more informed decisions that focus on enhancing the quality of patient life rather than just survival. In addition, those who know that dementia is a terminal disease are more likely to establish adequate support systems to help them cope with the complex demands of caregiving. For example, they are more likely to seek dementia-oriented primary care programs that offer house visits or respite services. Based on the study findings, knowledge about dementia as a terminal disease is critical in the optimal management of patient care needs and the establishment of adequate support systems. More research is needed to better understand what caregivers need to know to better prepare them for the complex demands of dementia caregiving.

Keywords: dementia education, family caregiver, management of dementia, quality of care

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