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Commenced in January 2007
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Paper Count: 10400

Search results for: theatrical show

560 Developing Dynamic Capabilities: The Case of Western Subsidiaries in Emerging Market

Authors: O. A. Adeyemi, M. O. Idris, W. A. Oke, O. T. Olorode, S. O. Alayande, A. E. Adeoye

Abstract:

The purpose of this paper is to investigate the process of capability building at subsidiary level and the challenges to such process. The relevance of external factors for capability development, have not been explicitly addressed in empirical studies. Though, internal factors, acting as enablers, have been more extensively studied. With reference to external factors, subsidiaries are actively influenced by specific characteristics of the host country, implying a need to become fully immersed in local culture and practices. Specifically, in MNCs, there has been a widespread trend in management practice to increase subsidiary autonomy,  with subsidiary managers being encouraged to act entrepreneurially, and to take advantage of host country specificity. As such, it could be proposed that: P1: The degree at which subsidiary management is connected to the host country, will positively influence the capability development process. Dynamic capabilities reside to a large measure with the subsidiary management team, but are impacted by the organizational processes, systems and structures that the MNC headquarter has designed to manage its business. At the subsidiary level, the weight of the subsidiary in the network, its initiative-taking and its profile building increase the supportive attention of the HQs and are relevant to the success of the process of capability building. Therefore, our second proposition is that: P2: Subsidiary role and HQ support are relevant elements in capability development at the subsidiary level. Design/Methodology/Approach: This present study will adopt the multiple case studies approach. That is because a case study research is relevant when addressing issues without known empirical evidences or with little developed prior theory. The key definitions and literature sources directly connected with operations of western subsidiaries in emerging markets, such as China, are well established. A qualitative approach, i.e., case studies of three western subsidiaries, will be adopted. The companies have similar products, they have operations in China, and both of them are mature in their internationalization process. Interviews with key informants, annual reports, press releases, media materials, presentation material to customers and stakeholders, and other company documents will be used as data sources. Findings: Western Subsidiaries in Emerging Market operate in a way substantially different from those in the West. What are the conditions initiating the outsourcing of operations? The paper will discuss and present two relevant propositions guiding that process. Practical Implications: MNCs headquarter should be aware of the potential for capability development at the subsidiary level. This increased awareness could induce consideration in headquarter about the possible ways of encouraging such known capability development and how to leverage these capabilities for better MNC headquarter and/or subsidiary performance. Originality/Value: The paper is expected to contribute on the theme: drivers of subsidiary performance with focus on emerging market. In particular, it will show how some external conditions could promote a capability-building process within subsidiaries.

Keywords: case studies, dynamic capability, emerging market, subsidiary

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559 MOF [(4,4-Bipyridine)₂(O₂CCH₃)₂Zn]N as Heterogeneous Acid Catalysts for the Transesterification of Canola Oil

Authors: H. Arceo, S. Rincon, C. Ben-Youssef, J. Rivera, A. Zepeda

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Biodiesel has emerged as a material with great potential as a renewable energy replacement to current petroleum-based diesel. Recently, biodiesel production is focused on the development of more efficient, sustainable process with lower costs of production. In this sense, a “green” approach to biodiesel production has stimulated the use of sustainable heterogeneous acid catalysts, that are better alternatives to conventional processes because of their simplicity and the simultaneous promotion of esterification and transesterification reactions from low-grade, highly-acidic and water containing oils without the formation of soap. The focus of this methodology is the development of new heterogeneous catalysts that under ordinary reaction conditions could reach yields similar to homogeneous catalysis. In recent years, metal organic frameworks (MOF) have attracted much interest for their potential as heterogeneous acid catalysts. They are crystalline porous solids formed by association of transition metal ions or metal–oxo clusters and polydentate organic ligands. This hybridization confers MOFs unique features such as high thermal stability, larger pore size, high specific area, high selectivity and recycling potential. Thus, MOF application could be a way to improve the biodiesel production processes. In this work, we evaluated the catalytic activity of MOF [(4,4-bipyridine)2(O₂CCH₃)2Zn]n (MOF Zn-I) for the synthesis of biodiesel from canola oil. The reaction conditions were optimized using the response surface methodology with a compound design central with 24. The variables studied were: Reaction temperature, amount of catalyst, molar ratio oil: MetOH and reaction time. The preparation MOF Zn-I was performed by mixing 5 mmol 4´4 dipyridine dissolved in 25 mL methanol with 10 mmol Zn(O₂CCH₃)₂ ∙ 2H₂O in 25 mL water. The crystals were obtained by slow evaporation of the solvents at 60°C for 18 h. The prepared catalyst was characterized using X-ray diffraction (XRD) and Fourier transform infrared spectrometer (FT-IR). The prepared catalyst was characterized using X-ray diffraction (XRD) and Fourier transform infrared spectrometer (FT-IR). Experiments were performed using commercially available canola oil in ace pressure tube under continuous stirring. The reaction was filtered and vacuum distilled to remove the catalyst and excess alcohol, after which it was centrifuged to separate the obtained biodiesel and glycerol. 1H NMR was used to calculate the process yield. GC-MS was used to quantify the fatty acid methyl ester (FAME). The results of this study show that the acid catalyst MOF Zn-I could be used as catalyst for biodiesel production through heterogeneous transesterification of canola oil with FAME yield 82 %. The optimum operating condition for the catalytic reaction were of 142°C, 0.5% catalyst/oil weight ratio, 1:30 oil:MeOH molar ratio and 5 h reaction time.

Keywords: fatty acid methyl ester, heterogeneous acid catalyst, metal organic framework, transesterification

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558 The Distribution and Environmental Behavior of Heavy Metals in Jajarm Bauxite Mine, Northeast Iran

Authors: Hossein Hassani, Ali Rezaei

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Heavy metals are naturally occurring elements that have a high atomic weight and a density at least five times greater than that of water. Their multiple industrial, domestic, agricultural, medical, and technological applications have led to their wide distribution in the environment, raising concerns over their potential effects on human health and the environment. Environmental protection against various pollutants, such as heavy metals formed by industries, mines and modern technologies, is a concern for researchers and industry. In order to assess the contamination of soils the distribution and environmental behavior have been investigated. Jajarm bauxite mine, the most important deposits have been discovered in Iran, which is about 22 million tons of reserve, and is the main mineral of the Diaspora. With a view to estimate the heavy metals ratio of the Jajarm bauxite mine area and to evaluate the pollution level, 50 samples have been collected and have been analyzed for the heavy metals of As, Cd, Cu, Hg, Ni and Pb with the help of Inductively Coupled Plasma-Mass Spectrometer (ICP- MS). In this study, we have dealt with determining evaluation criteria including contamination factor (CF), average concentration (AV), enrichment factor (EF) and geoaccumulation index (GI) to assess the risk of pollution from heavy metals(As, Cd, Cu, Hg, Ni and Pb) in Jajarm bauxite mine. In the samples of the studied, the average of recorded concentration of elements for Arsenic, Cadmium, Copper, Mercury, Nickel and Lead are 18, 0.11, 12, 0.07, 58 and 51 (mg/kg) respectively. The comparison of the heavy metals concentration average and the toxic potential in the samples has shown that an average with respect to the world average of the uncontaminated soil amounts. The average of Pb and As elements shows a higher quantity with respect to the world average quantity. The pollution factor for the study elements has been calculated on the basis of the soil background concentration and has been categorized on the basis of the uncontaminated world soil average with respect to the Hakanson classification. The calculation of the corrected pollutant degree shows the degree of the bulk intermediate pollutant (1.55-2.0) for the average soil sampling of the study area which is on the basis of the background quantity and the world average quantity of the uncontaminated soils. The provided conclusion from calculation of the concentrated factor, for some of the samples show that the average of the lead and arsenic elements stations are more than the background values and the unnatural metal concentration are covered under the study area, That's because the process of mining and mineral extraction. Given conclusion from the calculation of Geoaccumulation index of the soil sampling can explain that the copper, nickel, cadmium, arsenic, lead and mercury elements are Uncontamination. In general, the results indicate that the Jajarm bauxite mine of heavy metal pollution is uncontaminated area and extract the mineral from the mine, not create environmental hazards in the region.

Keywords: enrichment factor, geoaccumulation index, heavy metals, Jajarm bauxite mine, pollution

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557 Exploring the Neural Correlates of Different Interaction Types: A Hyperscanning Investigation Using the Pattern Game

Authors: Beata Spilakova, Daniel J. Shaw, Radek Marecek, Milan Brazdil

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Hyperscanning affords a unique insight into the brain dynamics underlying human interaction by simultaneously scanning two or more individuals’ brain responses while they engage in dyadic exchange. This provides an opportunity to observe dynamic brain activations in all individuals participating in interaction, and possible interbrain effects among them. The present research aims to provide an experimental paradigm for hyperscanning research capable of delineating among different forms of interaction. Specifically, the goal was to distinguish between two dimensions: (1) interaction structure (concurrent vs. turn-based) and (2) goal structure (competition vs cooperation). Dual-fMRI was used to scan 22 pairs of participants - each pair matched on gender, age, education and handedness - as they played the Pattern Game. In this simple interactive task, one player attempts to recreate a pattern of tokens while the second player must either help (cooperation) or prevent the first achieving the pattern (competition). Each pair played the game iteratively, alternating their roles every round. The game was played in two consecutive sessions: first the players took sequential turns (turn-based), but in the second session they placed their tokens concurrently (concurrent). Conventional general linear model (GLM) analyses revealed activations throughout a diffuse collection of brain regions: The cooperative condition engaged medial prefrontal cortex (mPFC) and posterior cingulate cortex (PCC); in the competitive condition, significant activations were observed in frontal and prefrontal areas, insula cortices and the thalamus. Comparisons between the turn-based and concurrent conditions revealed greater precuneus engagement in the former. Interestingly, mPFC, PCC and insulae are linked repeatedly to social cognitive processes. Similarly, the thalamus is often associated with a cognitive empathy, thus its activation may reflect the need to predict the opponent’s upcoming moves. Frontal and prefrontal activation most likely represent the higher attentional and executive demands of the concurrent condition, whereby subjects must simultaneously observe their co-player and place his own tokens accordingly. The activation of precuneus in the turn-based condition may be linked to self-other distinction processes. Finally, by performing intra-pair correlations of brain responses we demonstrate condition-specific patterns of brain-to-brain coupling in mPFC and PCC. Moreover, the degree of synchronicity in these neural signals related to performance on the game. The present results, then, show that different types of interaction recruit different brain systems implicated in social cognition, and the degree of inter-player synchrony within these brain systems is related to nature of the social interaction.

Keywords: brain-to-brain coupling, hyperscanning, pattern game, social interaction

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556 Insights into Particle Dispersion, Agglomeration and Deposition in Turbulent Channel Flow

Authors: Mohammad Afkhami, Ali Hassanpour, Michael Fairweather

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The work described in this paper was undertaken to gain insight into fundamental aspects of turbulent gas-particle flows with relevance to processes employed in a wide range of applications, such as oil and gas flow assurance in pipes, powder dispersion from dry powder inhalers, and particle resuspension in nuclear waste ponds, to name but a few. In particular, the influence of particle interaction and fluid phase behavior in turbulent flow on particle dispersion in a horizontal channel is investigated. The mathematical modeling technique used is based on the large eddy simulation (LES) methodology embodied in the commercial CFD code FLUENT, with flow solutions provided by this approach coupled to a second commercial code, EDEM, based on the discrete element method (DEM) which is used for the prediction of particle motion and interaction. The results generated by LES for the fluid phase have been validated against direct numerical simulations (DNS) for three different channel flows with shear Reynolds numbers, Reτ = 150, 300 and 590. Overall, the LES shows good agreement, with mean velocities and normal and shear stresses matching those of the DNS in both magnitude and position. The research work has focused on the prediction of those conditions favoring particle aggregation and deposition within turbulent flows. Simulations have been carried out to investigate the effects of particle size, density and concentration on particle agglomeration. Furthermore, particles with different surface properties have been simulated in three channel flows with different levels of flow turbulence, achieved by increasing the Reynolds number of the flow. The simulations mimic the conditions of two-phase, fluid-solid flows frequently encountered in domestic, commercial and industrial applications, for example, air conditioning and refrigeration units, heat exchangers, oil and gas suction and pressure lines. The particle size, density, surface energy and volume fractions selected are 45.6, 102 and 150 µm, 250, 1000 and 2159 kg m-3, 50, 500, and 5000 mJ m-2 and 7.84 × 10-6, 2.8 × 10-5, and 1 × 10-4, respectively; such particle properties are associated with particles found in soil, as well as metals and oxides prevalent in turbulent bounded fluid-solid flows due to erosion and corrosion of inner pipe walls. It has been found that the turbulence structure of the flow dominates the motion of the particles, creating particle-particle interactions, with most of these interactions taking place at locations close to the channel walls and in regions of high turbulence where their agglomeration is aided both by the high levels of turbulence and the high concentration of particles. A positive relationship between particle surface energy, concentration, size and density, and agglomeration was observed. Moreover, the results derived for the three Reynolds numbers considered show that the rate of agglomeration is strongly influenced for high surface energy particles by, and increases with, the intensity of the flow turbulence. In contrast, for lower surface energy particles, the rate of agglomeration diminishes with an increase in flow turbulence intensity.

Keywords: agglomeration, channel flow, DEM, LES, turbulence

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555 The Women’s Empowerment and Children’s Bell-Being in Italy: An Empirical Research Starting From the Capability Approach

Authors: Alba Francesca Canta

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The present is one of those times when what normally seems to constitute a reason for living vanishes, particularly in times of crisis, during which certainties of all times crumble, and critical issues emerge, especially in already problematic areas such as the role of women and children. This paper aims to explore the issue of gender and highlight the importance of education for people’s development and well-being. The study is part of the broader framework of the capability approach, a multidimensional approach based on the need to consider a person’s wealth by virtue of their opportunity and freedom to live a ‘life of worth. The results of empirical research conducted in 2020 will be presented, the main objective of which was to measure, through qualitative (project techniques, focus groups, interviews with key informants) and quantitative (questionnaire) methods, the level of empowerment of women in two Italian territories and the consequent well-being of their children. By means of the relationship study, the present research results show that a higher level of women’s empowerment corresponds to a higher level of children’s well-being in a positive virtuous process. The opportunity structure and education are the main driving guide both to women’s empowerment and children’s well-being, emphasizing the importance of education to gender culture as a key factor for the development of the whole society. Among all the traumatic events that broke the harmony of the world and caused an abrupt turn in all areas of society, the crisis of democracy and education are some of the harshest. Nevertheless, education continues to be a fundamental pillar of Global Development Agendas, and above all, democratic education is the main factor in the development of a generative society, capable of forming people who know how to live in society. In this context, recovering democratic and inclusive education can be the key to a breakthrough. In the capability approach Sen, and other Scholars, point out education from two different perspectives: a. education as a fundamental right capable of influencing other real fields of people’s life (i.e., being educated to prevent illness, to vote, etc.) and b. spread communitarian education, tolerance, inclusive, democratic, and respectful, capable of forming human beings. This kind of educational system can directly lead to a general process of gender education that presupposes respect for essential principles: equality, uniqueness, and the participation of all in the processes of defining a democratic society. Many practices of women and children’s exclusions essentially derive from social factors (norms, values, quality of institutions, relations of power, educational and cultural practices) that can build strong barriers. Respect for these principles and education for gender culture could foster the renewal of society and the acquisition of fundamental skills for a generative and inclusive society, such as critical skills, cosmopolitan skills, and narrative imagination.

Keywords: capability approach, children’s well-being, education, women’s empowerment

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554 Predictors of Motor and Cognitive Domains of Functional Performance after Rehabilitation of Individuals with Acute Stroke

Authors: A. F. Jaber, E. Dean, M. Liu, J. He, D. Sabata, J. Radel

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Background: Stroke is a serious health care concern and a major cause of disability in the United States. This condition impacts the individual’s functional ability to perform daily activities. Predicting functional performance of people with stroke assists health care professionals in optimizing the delivery of health services to the affected individuals. The purpose of this study was to identify significant predictors of Motor FIM and of Cognitive FIM subscores among individuals with stroke after discharge from inpatient rehabilitation (typically 4-6 weeks after stroke onset). A second purpose is to explore the relation among personal characteristics, health status, and functional performance of daily activities within 2 weeks of stroke onset. Methods: This study used a retrospective chart review to conduct a secondary analysis of data obtained from the Healthcare Enterprise Repository for Ontological Narration (HERON) database. The HERON database integrates de-identified clinical data from seven different regional sources including hospital electronic medical record systems of the University of Kansas Health System. The initial HERON data extract encompassed 1192 records and the final sample consisted of 207 participants who were mostly white (74%) males (55%) with a diagnosis of ischemic stroke (77%). The outcome measures collected from HERON included performance scores on the National Institute of Health Stroke Scale (NIHSS), the Glasgow Coma Scale (GCS), and the Functional Independence Measure (FIM). The data analysis plan included descriptive statistics, Pearson correlation analysis, and Stepwise regression analysis. Results: significant predictors of discharge Motor FIM subscores included age, baseline Motor FIM subscores, discharge NIHSS scores, and comorbid electrolyte disorder (R2 = 0.57, p <0.026). Significant predictors of discharge Cognitive FIM subscores were age, baseline cognitive FIM subscores, client cooperative behavior, comorbid obesity, and the total number of comorbidities (R2 = 0.67, p <0.020). Functional performance on admission was significantly associated with age (p < 0.01), stroke severity (p < 0.01), and length of hospital stay (p < 0.05). Conclusions: our findings show that younger age, good motor and cognitive abilities on admission, mild stroke severity, fewer comorbidities, and positive client attitude all predict favorable functional outcomes after inpatient stroke rehabilitation. This study provides health care professionals with evidence to evaluate predictors of favorable functional outcomes early at stroke rehabilitation, to tailor individualized interventions based on their client’s anticipated prognosis, and to educate clients about the benefits of making lifestyle changes to improve their anticipated rate of functional recovery.

Keywords: functional performance, predictors, stroke, recovery

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553 Research Project on Learning Rationality in Strategic Behaviors: Interdisciplinary Educational Activities in Italian High Schools

Authors: Giovanna Bimonte, Luigi Senatore, Francesco Saverio Tortoriello, Ilaria Veronesi

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The education process considers capabilities not only to be seen as a means to a certain end but rather as an effective purpose. Sen's capability approach challenges human capital theory, which sees education as an ordinary investment undertaken by individuals. A complex reality requires complex thinking capable of interpreting the dynamics of society's changes to be able to make decisions that can be rational for private, ethical and social contexts. Education is not something removed from the cultural and social context; it exists and is structured within it. In Italy, the "Mathematical High School Project" is a didactic research project is based on additional laboratory courses in extracurricular hours where mathematics intends to bring itself in a dialectical relationship with other disciplines as a cultural bridge between the two cultures, the humanistic and the scientific ones, with interdisciplinary educational modules on themes of strong impact in younger life. This interdisciplinary mathematics presents topics related to the most advanced technologies and contemporary socio-economic frameworks to demonstrate how mathematics is not only a key to reading but also a key to resolving complex problems. The recent developments in mathematics provide the potential for profound and highly beneficial changes in mathematics education at all levels, such as in socio-economic decisions. The research project is built to investigate whether repeated interactions can successfully promote cooperation among students as rational choice and if the skill, the context and the school background can influence the strategies choice and the rationality. A Laboratory on Game Theory as mathematical theory was conducted in the 4th year of the Mathematical High Schools and in an ordinary scientific high school of the Scientific degree program. Students played two simultaneous games of repeated Prisoner's Dilemma with an indefinite horizon, with two different competitors in each round; even though the competitors in each round will remain the same for the duration of the game. The results highlight that most of the students in the two classes used the two games with an immunization strategy against the risk of losing: in one of the games, they started by playing Cooperate, and in the other by the strategy of Compete. In the literature, theoretical models and experiments show that in the case of repeated interactions with the same adversary, the optimal cooperation strategy can be achieved by tit-for-tat mechanisms. In higher education, individual capacities cannot be examined independently, as conceptual framework presupposes a social construction of individuals interacting and competing, making individual and collective choices. The paper will outline all the results of the experimentation and the future development of the research.

Keywords: game theory, interdisciplinarity, mathematics education, mathematical high school

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552 Contraceptive Uptake among Women in Low Socio-Economic Areas in Kenya: Quantitative Analysis of Secondary Data

Authors: J. Waita, S. Wamuhu, J. Makoyo, M. Rachel, T. Ngangari, W. Christine, M. Zipporah

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Contraceptive use is one of the key global strategies to alleviate maternal mortality. Global efforts through advocating for contraceptive uptake and service provision has led improved contraceptive prevalence. In Kenya maternal mortality rate has remained a challenged despites efforts by government and non-governmental organizations. Objective: To describe the uptake of contraceptives among women in Tunza Clinics, Kenya. Design and Methods: Ps Kenya through health care marketing fund is implementing a family planning program among its 350 Tunza fractional franchise facilities. Through private partnership, private owned facilities in low socio-economic areas are recruited and trained on contraceptive technology update. The providers are supported through facilitative supervision through a mobile based application Health Network Quality Improvement System (HNQIS) and interpersonal communication through 150 community based volunteers. The data analyzed in this paper was collected between January to July 2017 to show the uptake of modern Contraceptives among women in the Tunza franchise, method mix, age and distribution among the age bracket. Further analysis compares two different service delivery strategies; outreach and walk ins. Supportive supervision HNQIS scores was analyzed. Results: During the time period, a total of 132121 family planning clients were attended in 350 facilities. The average age of clients was 29.6 years. The average number of clients attended in the facilities per month was 18874. 73.7 %( n=132121) of the clients attended in the Tunza facilities were aged above 25 years while 22.1% 20-24 years and 4.2% 15-19 years. On contraceptive method mix, intra uterine device insertions clients contributed to 7.5%, implant insertions 15.3%, pills 11.2%, injections 62.7% while condoms and emergency pills had 2.7% and 0.6% respectively. Analysis of service delivery strategy indicated more than 79% of the clients were walk ins while 21% were attended to during outreaches. Uptake of long term contraceptive methods during outreaches was 73% of the clients while short term modern methods were 27%. Health Network Quality Improvement system assessment scores indicated 51% of the facilities scored over 90%, 25% scoring 80-89% while 21% scored below 80%. Conclusion: Preference for short term methods by women is possibly associated to cost as they are cheaper and easy to administer. When the cost of intra uterine device Implants is meant affordable during outreaches, the uptake is observed to increase. Making intra uterine device and implants affordable to women is a key strategy in increasing contraceptive prevalence hence averting maternal mortality.

Keywords: contraceptives, contraceptive uptake, low socio economic, supportive supervision

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551 Influence of Moss Cover and Seasonality on Soil Microbial Biomass and Enzymatic Activity in Different Central Himalayan Temperate Forest Types

Authors: Anshu Siwach, Qianlai Zhuang, Ratul Baishya

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Context: This study focuses on the influence of moss cover and seasonality on soil microbial biomass and enzymatic activity in different Central Himalayan temperate forest types. Soil microbial biomass and enzymes are key indicators of microbial communities in soil and provide information on soil properties, microbial status, and organic matter dynamics. The activity of microorganisms in the soil varies depending on the vegetation type and environmental conditions. Therefore, this study aims to assess the effects of moss cover, seasons, and different forest types on soil microbial biomass carbon (SMBC), soil microbial biomass nitrogen (SMBN), and soil enzymatic activity in the Central Himalayas, Uttarakhand, India. Research Aim: The aim of this study is to evaluate the levels of SMBC, SMBN, and soil enzymatic activity in different temperate forest types under the influence of two ground covers (soil with and without moss cover) during the rainy and winter seasons. Question Addressed: This study addresses the following questions: 1. How does the presence of moss cover and seasonality affect soil microbial biomass and enzymatic activity? 2. What is the influence of different forest types on SMBC, SMBN, and enzymatic activity? Methodology: Soil samples were collected from different forest types during the rainy and winter seasons. The study utilizes the chloroform-fumigation extraction method to determine SMBC and SMBN. Standard methodologies are followed to measure enzymatic activities, including dehydrogenase, acid phosphatase, aryl sulfatase, β-glucosidase, phenol oxidase, and urease. Findings: The study reveals significant variations in SMBC, SMBN, and enzymatic activity under different ground covers, within the rainy and winter seasons, and among the forest types. Moss cover positively influences SMBC and enzymatic activity during the rainy season, while soil without moss cover shows higher values during the winter season. Quercus-dominated forests, as well as Cupressus torulosa forests, exhibit higher levels of SMBC and enzymatic activity, while Pinus roxburghii forests show lower levels. Theoretical Importance: The findings highlight the importance of considering mosses in forest management plans to improve soil microbial diversity, enzymatic activity, soil quality, and health. Additionally, this research contributes to understanding the role of lower plants, such as mosses, in influencing ecosystem dynamics. Conclusion: The study concludes that moss cover during the rainy season significantly influences soil microbial biomass and enzymatic activity. Quercus and Cupressus torulosa dominated forests demonstrate higher levels of SMBC and enzymatic activity, indicating the importance of these forest types in sustaining soil microbial diversity and soil health. Including mosses in forest management plans can improve soil quality and overall ecosystem dynamics.

Keywords: moss cover, seasons, soil enzymes, soil microbial biomass, temperate forest types

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550 The Importance of Development Evaluation to Preterm Children in Remote Area

Authors: Chung-Yuan Wang, Min Hsu, Bo-Ya Juan, Hsiv Ching Lin, Hsveh Min Lin, Hsiu-Fang Yeh

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The success of Taiwan's National Health Insurance (NHI) system attracts widespread praise from the international society. However, the availability of medical care in a emote area is limited. Without the convenient public transportation system and mature social welfare policy, these people are difficult to regain their health and prevent disability. Preterm children have more risk to get development delay. Preterm children in a remote area have the human right to get rehabilitation resources as those in the city area. Therefore, the aim of this study was to show the importance of development screening to preterm children in a remote area and a tract the government to notice the issue. In Pingtung, children who are suspected development delay would be suggested to take a skillful screening evaluation in our hospital. Those preterm children (within 1-year-old) visited our pediatric clinic would also be referred to take the development evaluation. After the physiatrist’s systemic evaluation, the subjects would be scheduled to take the development evaluation. Gross motor, fine motor, speech comprehension/expression and mental study were included. The evaluation was in-charged by a physical therapist, occupational therapy, speech therapist and pediatric psychologist. The tools were Peabody developmental scale, Bayley Scales of Infant and Toddler Development (Bayley-III) and Wechsler Preschool & Primary Scale of Intelligence-Revised (WPPSI-R). In 2013, 459 children received the service in our hospital. Among these children, fifty-seven were noted with preterm baby history (gestation within 37 weeks). Thirty-six of these preterm children, who had never receive development evaluation, were included in this study. Thirty-six subjects (twenty-six male and ten female) were included. Nineteen subjects were found development delay. Six subjects were found suspected development delay. In gross motor, six subjects were development delay and eight were suspected development delay. In fine motor, five subjects were development delay and three were suspected development delay. In speech, sixteen subjects were development delay and six were suspected development delay. In our study, through the provision of development evaluation service, 72.2% preterm baby were found their development delay or suspected delay. They need further early intervention rehabilitation service. We made their parents realize that when development delay was recognized at the early stage, they are often reversible. No only the patients but also their families were improved their health status. The number of the subjects was limited in our study. Further study might be needed. Compared with 770 physical therapist (PT) and 370 occupational therapy (OT) in Taipei, there are only 108 PT and 54 OT in Pingtung. Further, there are much fewer therapists working on the field of pediatric rehabilitation. Living healthy is a human's right, no matter where does he live. For those development delay children in remote area, particularly preterm children, early detection, and early intervention rehabilitation service could play an important role in decreasing their disability and improving their quality of life. Through this study, we suggest the government to add more national resources on the development evaluation to preterm children in a remote area.

Keywords: development, early intervention, preterm children, rehabilitation

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549 Personal Data Protection: A Legal Framework for Health Law in Turkey

Authors: Veli Durmus, Mert Uydaci

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Every patient who needs to get a medical treatment should share health-related personal data with healthcare providers. Therefore, personal health data plays an important role to make health decisions and identify health threats during every encounter between a patient and caregivers. In other words, health data can be defined as privacy and sensitive information which is protected by various health laws and regulations. In many cases, the data are an outcome of the confidential relationship between patients and their healthcare providers. Globally, almost all nations have own laws, regulations or rules in order to protect personal data. There is a variety of instruments that allow authorities to use the health data or to set the barriers data sharing across international borders. For instance, Directive 95/46/EC of the European Union (EU) (also known as EU Data Protection Directive) establishes harmonized rules in European borders. In addition, the General Data Protection Regulation (GDPR) will set further common principles in 2018. Because of close policy relationship with EU, this study provides not only information on regulations, directives but also how they play a role during the legislative process in Turkey. Even if the decision is controversial, the Board has recently stated that private or public healthcare institutions are responsible for the patient call system, for doctors to call people waiting outside a consultation room, to prevent unlawful processing of personal data and unlawful access to personal data during the treatment. In Turkey, vast majority private and public health organizations provide a service that ensures personal data (i.e. patient’s name and ID number) to call the patient. According to the Board’s decision, hospital or other healthcare institutions are obliged to take all necessary administrative precautions and provide technical support to protect patient privacy. However, this application does not effectively and efficiently performing in most health services. For this reason, it is important to draw a legal framework of personal health data by stating what is the main purpose of this regulation and how to deal with complicated issues on personal health data in Turkey. The research is descriptive on data protection law for health care setting in Turkey. Primary as well as secondary data has been used for the study. The primary data includes the information collected under current national and international regulations or law. Secondary data include publications, books, journals, empirical legal studies. Consequently, privacy and data protection regimes in health law show there are some obligations, principles and procedures which shall be binding upon natural or legal persons who process health-related personal data. A comparative approach presents there are significant differences in some EU member states due to different legal competencies, policies, and cultural factors. This selected study provides theoretical and practitioner implications by highlighting the need to illustrate the relationship between privacy and confidentiality in Personal Data Protection in Health Law. Furthermore, this paper would help to define the legal framework for the health law case studies on data protection and privacy.

Keywords: data protection, personal data, privacy, healthcare, health law

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548 Exploring Barriers to Quality of Care in South African Midwifery Obstetric Units: The Perspective of Nurses and Midwives

Authors: J. Dutton, L. Knight

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Achieving quality and respectful maternal health care is part of the global agenda to improve reproductive health and achieve universal reproductive rights. Barriers to quality of care in South African maternal health facilities exist at both systemic and individual levels. Addition to this, the normalization of gender violence within South Africa has a large impact on people seeking health care as well as those who provide care within health facilities. The hierarchical environment of South Africa’s public health system penalizes both patients and providers who battle to assume any assessable power. This paper explores how systemic and individual level barriers to quality of care affect the midwifery profession within South African maternal health services and create, at times, an environment of enmity rather than care. This paper analyzes and discusses the data collected from in-depth, semi-structured interviews with nurses and midwives at three maternal health facilities in South Africa. This study has taken a holistic approach to understand the realities of nurses and midwives in order to explore the ways in which experience informs their practice and treatment of pregnant women. Through collecting and analyzing narratives, linkages between nurses and midwives day-to-day and historical experiences and disrespectful care have been made. Findings from this study show that barriers to quality of care take form in complex and interrelated ways. The physical structure of the health facility, human resource shortages, and the current model of maternal health care, which often lacks a person-centered approach, is entangled within personal beliefs and attitudes of what it means to be a midwife to create an environment that is often not conducive to a positive birthing experience. This entanglement sits within a society of high rates of violence, inequality, and poverty. Having teased out the nuances of each of these barriers and the multiple ways they reinforce each other, the findings of this paper demonstrate that birth, and the work of a midwife, are situated in a mode of discipline and punishment within this context. For analytical purposes, this paper has broken down the individual barriers to quality care and discusses the current and historical significance before returning to the interrelated forms in which barriers to quality maternal health care manifest. In conclusion this paper questions the role of agency in the ability to subvert systemic barriers to quality care and ideas around shifting attitudes and beliefs of and about midwives. International and local policies and guidelines have a role to play in realizing such shifts, however, as this paper suggests, when policy does not speak to the local context there is the risk of it contributing to frustrations and impeding the path to quality and respectful maternal health care.

Keywords: disrespect and abuse in childbirth, midwifery, South African maternal health care, quality of care

Procedia PDF Downloads 158
547 Motives for Reshoring from China to Europe: A Hierarchical Classification of Companies

Authors: Fabienne Fel, Eric Griette

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Reshoring, whether concerning back-reshoring or near-reshoring, is a quite recent phenomenon. Despite the economic and political interest of this topic, academic research questioning determinants of reshoring remains rare. Our paper aims at contributing to fill this gap. In order to better understand the reasons for reshoring, we conducted a study among 280 French firms during spring 2016, three-quarters of which sourced, or source, in China. 105 firms in the sample have reshored all or part of their Chinese production or supply in recent years, and we aimed to establish a typology of the motives that drove them to this decision. We asked our respondents about the history of their Chinese supplies, their current reshoring strategies, and their motivations. Statistical analysis was performed with SPSS 22 and SPAD 8. Our results show that change in commercial and financial terms with China is the first motive explaining the current reshoring movement from this country (it applies to 54% of our respondents). A change in corporate strategy is the second motive (30% of our respondents); the reshoring decision follows a change in companies’ strategies (upgrading, implementation of a CSR policy, or a 'lean management' strategy). The third motive (14% of our sample) is a mere correction of the initial offshoring decision, considered as a mistake (under-estimation of hidden costs, non-quality and non-responsiveness problems). Some authors emphasize that developing a short supply chain, involving geographic proximity between design and production, gives a competitive advantage to companies wishing to offer innovative products. Admittedly 40% of our respondents indicate that this motive could have played a part in their decision to reshore, but this reason was not enough for any of them and is not an intrinsic motive leading to leaving Chinese suppliers. Having questioned our respondents about the importance given to various problems leading them to reshore, we then performed a Principal Components Analysis (PCA), associated with an Ascending Hierarchical Classification (AHC), based on Ward criterion, so as to point out more specific motivations. Three main classes of companies should be distinguished: -The 'Cost Killers' (23% of the sample), which reshore their supplies from China only because of higher procurement costs and so as to find lower costs elsewhere. -The 'Realists' (50% of the sample), giving equal weight or importance to increasing procurement costs in China and to the quality of their supplies (to a large extend). Companies being part of this class tend to take advantage of this changing environment to change their procurement strategy, seeking suppliers offering better quality and responsiveness. - The 'Voluntarists' (26% of the sample), which choose to reshore their Chinese supplies regardless of higher Chinese costs, to obtain better quality and greater responsiveness. We emphasize that if the main driver for reshoring from China is indeed higher local costs, it is should not be regarded as an exclusive motivation; 77% of the companies in the sample, are also seeking, sometimes exclusively, more reactive suppliers, liable to quality, respect for the environment and intellectual property.

Keywords: China, procurement, reshoring, strategy, supplies

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546 R&D Diffusion and Productivity in a Globalized World: Country Capabilities in an MRIO Framework

Authors: S. Jimenez, R.Duarte, J.Sanchez-Choliz, I. Villanua

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There is a certain consensus in economic literature about the factors that have influenced in historical differences in growth rates observed between developed and developing countries. However, it is less clear what elements have marked different paths of growth in developed economies in recent decades. R&D has always been seen as one of the major sources of technological progress, and productivity growth, which is directly influenced by technological developments. Following recent literature, we can say that ‘innovation pushes the technological frontier forward’ as well as encourage future innovation through the creation of externalities. In other words, productivity benefits from innovation are not fully appropriated by innovators, but it also spread through the rest of the economies encouraging absorptive capacities, what have become especially important in a context of increasing fragmentation of production This paper aims to contribute to this literature in two ways, first, exploring alternative indexes of R&D flows embodied in inter-country, inter-sectorial flows of good and services (as approximation to technology spillovers) capturing structural and technological characteristic of countries and, second, analyzing the impact of direct and embodied R&D on the evolution of labor productivity at the country/sector level in recent decades. The traditional way of calculation through a multiregional input-output framework assumes that all countries have the same capabilities to absorb technology, but it is not, each one has different structural features and, this implies, different capabilities as part of literature, claim. In order to capture these differences, we propose to use a weight based on specialization structure indexes; one related with the specialization of countries in high-tech sectors and the other one based on a dispersion index. We propose these two measures because, as far as we understood, country capabilities can be captured through different ways; countries specialization in knowledge-intensive sectors, such as Chemicals or Electrical Equipment, or an intermediate technology effort across different sectors. Results suggest the increasing importance of country capabilities while increasing the trade openness. Besides, if we focus in the country rankings, we can observe that with high-tech weighted R&D embodied countries as China, Taiwan and Germany arose the top five despite not having the highest intensities of R&D expenditure, showing the importance of country capabilities. Additionally, through a fixed effects panel data model we show that, in fact, R&D embodied is important to explain labor productivity increases, in fact, even more that direct R&D investments. This is reflecting that globalization is more important than has been said until now. However, it is true that almost all analysis done in relation with that consider the effect of t-1 direct R&D intensity over economic growth. Nevertheless, from our point of view R&D evolve as a delayed flow and it is necessary some time to be able to see its effects on the economy, as some authors have already claimed. Our estimations tend to corroborate this hypothesis obtaining a gap between 4-5 years.

Keywords: economic growth, embodied, input-output, technology

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545 Social and Economic Aspects of Unlikely but Still Possible Welfare to Work Transitions from Long-Term Unemployed

Authors: Andreas Hirseland, Lukas Kerschbaumer

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In Germany, during the past years there constantly are about one million long term unemployed who did not benefit from the prospering labor market while most short term unemployed did. Instead, they are continuously dependent on welfare and sometimes precarious short-term employment, experiencing work poverty. Long term unemployment thus turns into a main obstacle to regular employment, especially if accompanied by other impediments such as low level education (school/vocational), poor health (especially chronical illness), advanced age (older than fifty), immigrant status, motherhood or engagement in care for other relatives. Almost two thirds of all welfare recipients have multiple impediments which hinder a successful transition from welfare back to sustainable and sufficient employment. Hiring them is often considered as an investment too risky for employers. Therefore formal application schemes based on formal qualification certificates and vocational biographies might reduce employers’ risks but at the same time are not helpful for long-term unemployed and welfare recipients. The panel survey ‘Labor market and social security’ (PASS; ~15,000 respondents in ~10,000 households), carried out by the Institute of Employment Research (the research institute of the German Federal Labor Agency), shows that their chance to get back to work tends to fall to nil. Only 66 cases of such unlikely transitions could be observed. In a sequential explanatory mixed-method study, the very scarce ‘success stories’ of unlikely transitions from long term unemployment to work were explored by qualitative inquiry – in-depth interviews with a focus on biography accompanied by qualitative network techniques in order to get a more detailed insight of relevant actors involved in the processes which promote the transition from being a welfare recipient to work. There is strong evidence that sustainable transitions are influenced by biographical resources like habits of network use, a set of informal skills and particularly a resilient way of dealing with obstacles, combined with contextual factors rather than by job-placement procedures promoted by Job-Centers according to activation rules or by following formal paths of application. On the employer’s side small and medium-sized enterprises are often found to give job opportunities to a wider variety of applicants, often based on a slow but steadily increasing relationship leading to employment. According to these results it is possible to show and discuss some limitations of (German) activation policies targeting welfare dependency and long-term unemployment. Based on these findings, indications for more supportive small scale measures in the field of labor-market policies are suggested to help long-term unemployed with multiple impediments to overcome their situation.

Keywords: against-all-odds, economic sociology, long-term unemployment, mixed-methods

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544 Integrating Natural Language Processing (NLP) and Machine Learning in Lung Cancer Diagnosis

Authors: Mehrnaz Mostafavi

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The assessment and categorization of incidental lung nodules present a considerable challenge in healthcare, often necessitating resource-intensive multiple computed tomography (CT) scans for growth confirmation. This research addresses this issue by introducing a distinct computational approach leveraging radiomics and deep-learning methods. However, understanding local services is essential before implementing these advancements. With diverse tracking methods in place, there is a need for efficient and accurate identification approaches, especially in the context of managing lung nodules alongside pre-existing cancer scenarios. This study explores the integration of text-based algorithms in medical data curation, indicating their efficacy in conjunction with machine learning and deep-learning models for identifying lung nodules. Combining medical images with text data has demonstrated superior data retrieval compared to using each modality independently. While deep learning and text analysis show potential in detecting previously missed nodules, challenges persist, such as increased false positives. The presented research introduces a Structured-Query-Language (SQL) algorithm designed for identifying pulmonary nodules in a tertiary cancer center, externally validated at another hospital. Leveraging natural language processing (NLP) and machine learning, the algorithm categorizes lung nodule reports based on sentence features, aiming to facilitate research and assess clinical pathways. The hypothesis posits that the algorithm can accurately identify lung nodule CT scans and predict concerning nodule features using machine-learning classifiers. Through a retrospective observational study spanning a decade, CT scan reports were collected, and an algorithm was developed to extract and classify data. Results underscore the complexity of lung nodule cohorts in cancer centers, emphasizing the importance of careful evaluation before assuming a metastatic origin. The SQL and NLP algorithms demonstrated high accuracy in identifying lung nodule sentences, indicating potential for local service evaluation and research dataset creation. Machine-learning models exhibited strong accuracy in predicting concerning changes in lung nodule scan reports. While limitations include variability in disease group attribution, the potential for correlation rather than causality in clinical findings, and the need for further external validation, the algorithm's accuracy and potential to support clinical decision-making and healthcare automation represent a significant stride in lung nodule management and research.

Keywords: lung cancer diagnosis, structured-query-language (SQL), natural language processing (NLP), machine learning, CT scans

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543 Patterns of Change in Specific Behaviors of Autism Symptoms for Boys and for Girls Across Childhood

Authors: Einat Waizbard, Emilio Ferrer, Meghan Miller, Brianna Heath, Derek S. Andrews, Sally J. Rogers, Christine Wu Nordahl, Marjorie Solomon, David G. Amaral

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Background: Autism symptoms are comprised of social-communication deficits and restricted/repetitive behaviors (RRB). The severity of these symptoms can change during childhood, with differences between boys and girls. From the literature, it was found that young autistic girls show a stronger tendency to decrease and a weaker tendency to increase their overall autism symptom severity levels compared to young autistic boys. It is not clear, however, which symptoms are driving these sex differences across childhood. In the current study, we evaluated the trajectories of independent autism symptoms across childhood and compared the patterns of change in such symptoms between boys and girls. Method: The study included 183 children diagnosed with autism (55 girls) evaluated three times across childhood, at ages 3, 6 and 11. We analyzed 22 independent items from the Autism Diagnostic Observation Scheudule-2 (ADOS-2), the gold-standard assessment tool for autism symptoms, each item representing a specific autism symptom. First, we used latent growth curve models to estimate the trajectories for the 22 ADOS-2 items for each child in the study. Second, we extracted the factor scores representing the individual slopes for each ADOS-2 item (i.e., slope representing that child’s change in that specific item). Third, we used factor analysis to identify common patterns of change among the ADOS-2 items, separately for boys and girls, i.e., which autism symptoms tend to change together and which change independently across childhood. Results: The best-emerging patterns for both boys and girls identified four common factors: three factors representative of changes in social-communication symptoms and one factor describing changes in RRB. Boys and girls showed the same pattern of change in RRB, with four items (e.g., speech abnormalities) changing together across childhood and three items (e.g., mannerisms) changing independently of other items. For social-communication deficits in boys, three factors were identified: the first factor included six items representing initiating and engaging in social-communication (e.g., quality of social overtures, conversation), the second factor included five items describing responsive social-communication (e.g., response to name) and the third factor included three items related to different aspects of social-communication (e.g., level of language). Girls’ social-communications deficits also loaded onto three factors: the first factor included five items (e.g., unusual eye contact), the second factor included six items (e.g., quality of social response), and the third factor included four items (e.g., showing). Some items showed similar patterns of change for both sexes (e.g., responsive joint attention), while other items showed differences (e.g., shared enjoyment). Conclusions: Girls and boys had different patterns of change in autism symptom severity across childhood. For RRB, both sexes showed similar patterns. For social-communication symptoms, however, there were both similarities and differences between boys and girls in the way symptoms changed over time. The strongest patterns of change were identified for initiating and engaging in social communication for boys and responsive social communication for girls.

Keywords: autism spectrum disorder, autism symptom severity, symptom trajectories, sex differences

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542 Sustainability in Space: Material Efficiency in Space Missions

Authors: Hamda M. Al-Ali

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From addressing fundamental questions about the history of the solar system to exploring other planets for any signs of life have always been the core of human space exploration. This triggered humans to explore whether other planets such as Mars could support human life on them. Therefore, many planned space missions to other planets have been designed and conducted to examine the feasibility of human survival on them. However, space missions are expensive and consume a large number of various resources to be successful. To overcome these problems, material efficiency shall be maximized through the use of reusable launch vehicles (RLV) rather than disposable and expendable ones. Material efficiency is defined as a way to achieve service requirements using fewer materials to reduce CO2 emissions from industrial processes. Materials such as aluminum-lithium alloys, steel, Kevlar, and reinforced carbon-carbon composites used in the manufacturing of spacecrafts could be reused in closed-loop cycles directly or by adding a protective coat. Material efficiency is a fundamental principle of a circular economy. The circular economy aims to cutback waste and reduce pollution through maximizing material efficiency so that businesses can succeed and endure. Five strategies have been proposed to improve material efficiency in the space industry, which includes waste minimization, introduce Key Performance Indicators (KPIs) to measure material efficiency, and introduce policies and legislations to improve material efficiency in the space sector. Another strategy to boost material efficiency is through maximizing resource and energy efficiency through material reusability. Furthermore, the environmental effects associated with the rapid growth in the number of space missions include black carbon emissions that lead to climate change. The levels of emissions must be tracked and tackled to ensure the safe utilization of space in the future. The aim of this research paper is to examine and suggest effective methods used to improve material efficiency in space missions so that space and Earth become more environmentally and economically sustainable. The objectives used to fulfill this aim are to identify the materials used in space missions that are suitable to be reused in closed-loop cycles considering material efficiency indicators and circular economy concepts. An explanation of how spacecraft materials could be re-used as well as propose strategies to maximize material efficiency in order to make RLVs possible so that access to space becomes affordable and reliable is provided. Also, the economic viability of the RLVs is examined to show the extent to which the use of RLVs has on the reduction of space mission costs. The environmental and economic implications of the increase in the number of space missions as a result of the use of RLVs are also discussed. These research questions are studied through detailed critical analysis of the literature, such as published reports, books, scientific articles, and journals. A combination of keywords such as material efficiency, circular economy, RLVs, and spacecraft materials were used to search for appropriate literature.

Keywords: access to space, circular economy, material efficiency, reusable launch vehicles, spacecraft materials

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541 The Effectiveness of Therapeutic Exercise on Motor Skills and Attention of Male Students with Autism Spectrum Disorder

Authors: Masoume Pourmohamadreza-Tajrishi, Parviz Azadfallah

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Autism spectrum disorders (ASD) involve myriad aberrant perceptual, cognitive, linguistic, and social behaviors. The term spectrum emphasizes that the disabilities associated with ASD fall on a continuum from relatively mild to severe. People with ASD may display stereotyped behaviors such as twirling, spinning objects, flapping the hands, and rocking. The individuals with ASD exhibit communication problems due to repetitive/restricted behaviors. Children with ASD who lack the motivation to learn, who do not enjoy physical challenges, or whose sensory perception results in confusing or unpleasant feedback from movement may not become sufficiently motivated to practice motor activities. As a result, they may show both a delay in developing certain motor skills. Additionally, attention is an important component of learning. As far as children with ASD have problems in joint attention, many education-based programs are needed to consider some aspects of attention and motor activities development for students with ASD. These programs focus on the basic movement skills that are crucial for the future development of the more complex skills needed in games, dance, sports, gymnastics, active play, and recreational physical activities. The purpose of the present research was to determine the effectiveness of therapeutic exercise on motor skills and attention of male students with ASD. This was an experimental study with a control group. The population consisted of 8-10 year-old male students with ASD and 30 subjects were selected randomly from an available center suitable for the children with ASD. They were evaluated by the Basic Motor Ability Test (BMAT) and Persian version of computerized Stroop color-word test and randomly assigned to an experimental and control group (15 students in per group). The experimental group participated in 16 therapeutic exercise sessions and received therapeutic exercise program (twice a week; each lasting for 45 minutes) designed based on the Spark motor program while the control group did not. All subjects were evaluated by BMAT and Stroop color-word test after the last session again. The collected data were analyzed by using multivariate analysis of covariance (MANCOVA). The results of MANCOVA showed that experimental and control groups had a significant difference in motor skills and at least one of the components of attention (correct responses, incorrect responses, no responses, the reaction time of congruent words and reaction time of incongruent words in the Stroop test). The findings showed that the therapeutic exercise had a significant effect on motor skills and all components of attention in students with ASD. We can conclude that the therapeutic exercise led to promote the motor skills and attention of students with ASD, so it is necessary to design or plan such programs for ASD students to prevent their communication or academic problems.

Keywords: Attention, autism spectrum disorder, motor skills, therapeutic exercise

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540 Newly Designed Ecological Task to Assess Cognitive Map Reading Ability: Behavioral Neuro-Anatomic Correlates of Mental Navigation

Authors: Igor Faulmann, Arnaud Saj, Roland Maurer

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Spatial cognition consists in a plethora of high level cognitive abilities: among them, the ability to learn and to navigate in large scale environments is probably one of the most complex skills. Navigation is thought to rely on the ability to read a cognitive map, defined as an allocentric representation of ones environment. Those representations are of course intimately related to the two geometrical primitives of the environment: distance and direction. Also, many recent studies point to a predominant hippocampal and para-hippocampal role in spatial cognition, as well as in the more specific cluster of navigational skills. In a previous study in humans, we used a newly validated test assessing cognitive map processing by evaluating the ability to judge relative distances and directions: the CMRT (Cognitive Map Recall Test). This study identified in topographically disorientated patients (1) behavioral differences between the evaluation of distances and of directions, and (2) distinct causality patterns assessed via VLSM (i.e., distinct cerebral lesions cause distinct response patterns depending on the modality (distance vs direction questions). Thus, we hypothesized that: (1) if the CMRT really taps into the same resources as real navigation, there would be hippocampal, parahippocampal, and parietal activation, and (2) there exists underlying neuroanatomical and functional differences between the processing of this two modalities. Aiming toward a better understanding of the neuroanatomical correlates of the CMRT in humans, and more generally toward a better understanding of how the brain processes the cognitive map, we adapted the CMRT as an fMRI procedure. 23 healthy subjects (11 women, 12 men), all living in Geneva for at least 2 years, underwent the CMRT in fMRI. Results show, for distance and direction taken together, than the most active brain regions are the parietal, frontal and cerebellar parts. Additionally, and as expected, patterns of brain activation differ when comparing the two modalities. Furthermore, distance processing seems to rely more on parietal regions (compared to other brain regions in the same modality and also to direction). It is interesting to notice that no significant activity was observed in the hippocampal or parahippocampal areas. Direction processing seems to tap more into frontal and cerebellar brain regions (compared to other brain regions in the same modality and also to distance). Significant hippocampal and parahippocampal activity has been shown only in this modality. This results demonstrated a complex interaction of structures which are compatible with response patterns observed in other navigational tasks, thus showing that the CMRT taps at least partially into the same brain resources as real navigation. Additionally, differences between the processing of distances and directions leads to the conclusion that the human brain processes each modality distinctly. Further research should focus on the dynamics of this processing, allowing a clearer understanding between the two sub-processes.

Keywords: cognitive map, navigation, fMRI, spatial cognition

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539 Arc Plasma Thermochemical Preparation of Coal to Effective Combustion in Thermal Power Plants

Authors: Vladimir Messerle, Alexandr Ustimenko, Oleg Lavrichshev

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This work presents plasma technology for solid fuel ignition and combustion. Plasma activation promotes more effective and environmentally friendly low-rank coal ignition and combustion. To realise this technology at coal fired power plants plasma-fuel systems (PFS) were developed. PFS improve efficiency of power coals combustion and decrease harmful emission. PFS is pulverized coal burner equipped with arc plasma torch. Plasma torch is the main element of the PFS. Plasma forming gas is air. It is blown through the electrodes forming plasma flame. Temperature of this flame is varied from 5000 to 6000 K. Plasma torch power is varied from 100 to 350 kW and geometrical sizes are the following: the height is 0.4-0.5 m and diameter is 0.2-0.25 m. The base of the PFS technology is plasma thermochemical preparation of coal for burning. It consists of heating of the pulverized coal and air mixture by arc plasma up to temperature of coal volatiles release and char carbon partial gasification. In the PFS coal-air mixture is deficient in oxygen and carbon is oxidised mainly to carbon monoxide. As a result, at the PFS exit a highly reactive mixture is formed of combustible gases and partially burned char particles, together with products of combustion, while the temperature of the gaseous mixture is around 1300 K. Further mixing with the air promotes intensive ignition and complete combustion of the prepared fuel. PFS have been tested for boilers start up and pulverized coal flame stabilization in different countries at power boilers of 75 to 950 t/h steam productivity. They were equipped with different types of pulverized coal burners (direct flow, muffle and swirl burners). At PFS testing power coals of all ranks (lignite, bituminous, anthracite and their mixtures) were incinerated. Volatile content of them was from 4 to 50%, ash varied from 15 to 48% and heat of combustion was from 1600 to 6000 kcal/kg. To show the advantages of the plasma technology before conventional technologies of coal combustion numerical investigation of plasma ignition, gasification and thermochemical preparation of a pulverized coal for incineration in an experimental furnace with heat capacity of 3 MW was fulfilled. Two computer-codes were used for the research. The computer simulation experiments were conducted for low-rank bituminous coal of 44% ash content. The boiler operation has been studied at the conventional mode of combustion and with arc plasma activation of coal combustion. The experiments and computer simulation showed ecological efficiency of the plasma technology. When a plasma torch operates in the regime of plasma stabilization of pulverized coal flame, NOX emission is reduced twice and amount of unburned carbon is reduced four times. Acknowledgement: This work was supported by Ministry of Education and Science of the Republic of Kazakhstan and Ministry of Education and Science of the Russian Federation (Agreement on grant No. 14.613.21.0005, project RFMEFI61314X0005).

Keywords: coal, ignition, plasma-fuel system, plasma torch, thermal power plant

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538 Seismic Response of Reinforced Concrete Buildings: Field Challenges and Simplified Code Formulas

Authors: Michel Soto Chalhoub

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Building code-related literature provides recommendations on normalizing approaches to the calculation of the dynamic properties of structures. Most building codes make a distinction among types of structural systems, construction material, and configuration through a numerical coefficient in the expression for the fundamental period. The period is then used in normalized response spectra to compute base shear. The typical parameter used in simplified code formulas for the fundamental period is overall building height raised to a power determined from analytical and experimental results. However, reinforced concrete buildings which constitute the majority of built space in less developed countries pose additional challenges to the ones built with homogeneous material such as steel, or with concrete under stricter quality control. In the present paper, the particularities of reinforced concrete buildings are explored and related to current methods of equivalent static analysis. A comparative study is presented between the Uniform Building Code, commonly used for buildings within and outside the USA, and data from the Middle East used to model 151 reinforced concrete buildings of varying number of bays, number of floors, overall building height, and individual story height. The fundamental period was calculated using eigenvalue matrix computation. The results were also used in a separate regression analysis where the computed period serves as dependent variable, while five building properties serve as independent variables. The statistical analysis shed light on important parameters that simplified code formulas need to account for including individual story height, overall building height, floor plan, number of bays, and concrete properties. Such inclusions are important for reinforced concrete buildings of special conditions due to the level of concrete damage, aging, or materials quality control during construction. Overall results of the present analysis show that simplified code formulas for fundamental period and base shear may be applied but they require revisions to account for multiple parameters. The conclusion above is confirmed by the analytical model where fundamental periods were computed using numerical techniques and eigenvalue solutions. This recommendation is particularly relevant to code upgrades in less developed countries where it is customary to adopt, and mildly adapt international codes. We also note the necessity of further research using empirical data from buildings in Lebanon that were subjected to severe damage due to impulse loading or accelerated aging. However, we excluded this study from the present paper and left it for future research as it has its own peculiarities and requires a different type of analysis.

Keywords: seismic behaviour, reinforced concrete, simplified code formulas, equivalent static analysis, base shear, response spectra

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537 Combustion Characteristics and Pollutant Emissions in Gasoline/Ethanol Mixed Fuels

Authors: Shin Woo Kim, Eui Ju Lee

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The recent development of biofuel production technology facilitates the use of bioethanol and biodiesel on automobile. Bioethanol, especially, can be used as a fuel for gasoline vehicles because the addition of ethanol has been known to increase octane number and reduce soot emissions. However, the wide application of biofuel has been still limited because of lack of detailed combustion properties such as auto-ignition temperature and pollutant emissions such as NOx and soot, which has been concerned mainly on the vehicle fire safety and environmental safety. In this study, the combustion characteristics of gasoline/ethanol fuel were investigated both numerically and experimentally. For auto-ignition temperature and NOx emission, the numerical simulation was performed on the well-stirred reactor (WSR) to simulate the homogeneous gasoline engine and to clarify the effect of ethanol addition in the gasoline fuel. Also, the response surface method (RSM) was introduced as a design of experiment (DOE), which enables the various combustion properties to be predicted and optimized systematically with respect to three independent variables, i.e., ethanol mole fraction, equivalence ratio and residence time. The results of stoichiometric gasoline surrogate show that the auto-ignition temperature increases but NOx yields decrease with increasing ethanol mole fraction. This implies that the bioethanol added gasoline is an eco-friendly fuel on engine running condition. However, unburned hydrocarbon is increased dramatically with increasing ethanol content, which results from the incomplete combustion and hence needs to adjust combustion itself rather than an after-treatment system. RSM results analyzed with three independent variables predict the auto-ignition temperature accurately. However, NOx emission had a big difference between the calculated values and the predicted values using conventional RSM because NOx emission varies very steeply and hence the obtained second order polynomial cannot follow the rates. To relax the increasing rate of dependent variable, NOx emission is taken as common logarithms and worked again with RSM. NOx emission predicted through logarithm transformation is in a fairly good agreement with the experimental results. For more tangible understanding of gasoline/ethanol fuel on pollutant emissions, experimental measurements of combustion products were performed in gasoline/ethanol pool fires, which is widely used as a fire source of laboratory scale experiments. Three measurement methods were introduced to clarify the pollutant emissions, i.e., various gas concentrations including NOx, gravimetric soot filter sampling for elements analysis and pyrolysis, thermophoretic soot sampling with transmission electron microscopy (TEM). Soot yield by gravimetric sampling was decreased dramatically as ethanol was added, but NOx emission was almost comparable regardless of ethanol mole fraction. The morphology of the soot particle was investigated to address the degree of soot maturing. The incipient soot such as a liquid like PAHs was observed clearly on the soot of higher ethanol containing gasoline, and the soot might be matured under the undiluted gasoline fuel.

Keywords: gasoline/ethanol fuel, NOx, pool fire, soot, well-stirred reactor (WSR)

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536 Photocatalytic Properties of Pt/Er-KTaO3

Authors: Anna Krukowska, Tomasz Klimczuk, Adriana Zaleska-Medynska

Abstract:

Photoactive materials have attracted attention due to their potential application in the degradation of environmental pollutants to non-hazardous compounds in an eco-friendly route. Among semiconductor photocatalysts, tantalates such as potassium tantalate (KTaO3) is one of the excellent functional photomaterial. However, tantalates-based materials are less active under visible-light irradiation, the enhancement in photoactivity could be improved with the modification of opto-eletronic properties of KTaO3 by doping rare earth metal (Er) and further photodeposition of noble metal nanoparticles (Pt). Inclusion of rare earth element in orthorhombic structure of tantalate can generate one high-energy photon by absorbing two or more incident low-energy photons, which convert visible-light and infrared-light into the ultraviolet-light to satisfy the requirement of KTaO3 photocatalysts. On the other hand, depositions of noble metal nanoparticles on the surface of semiconductor strongly absorb visible-light due to their surface plasmon resonance, in which their conducting electrons undergo a collective oscillation induced by electric field of visible-light. Furthermore, the high dispersion of Pt nanoparticles, which will be obtained by photodeposition process is additional important factor to improve the photocatalytic activity. The present work is aimed to study the effect of photocatalytic process of the prepared Er-doped KTaO3 and further incorporation of Pt nanoparticles by photodeposition. Moreover, the research is also studied correlations between photocatalytic activity and physico-chemical properties of obtained Pt/Er-KTaO3 samples. The Er-doped KTaO3 microcomposites were synthesized by a hydrothermal method. Then photodeposition method was used for Pt loading over Er-KTaO3. The structural and optical properties of Pt/Er-KTaO3 photocatalytic were characterized using scanning electron microscope (SEM), X-ray diffraction (XRD), volumetric adsorption method (BET), UV-Vis absorption measurement, Raman spectroscopy and luminescence spectroscopy. The photocatalytic properties of Pt/Er-KTaO3 microcomposites were investigated by degradation of phenol in aqueous phase as model pollutant under visible and ultraviolet-light irradiation. Results of this work show that all the prepared photocatalysis exhibit low BET surface area, although doping of the bare KTaO3 with rare earth element (Er) presents a slight increase in this value. The crystalline structure of Pt/Er-KTaO3 powders exhibited nearly identical positions for the main peak at about 22,8o and the XRD pattern could be assigned to an orthorhombic distorted perovskite structure. The Raman spectra of obtained semiconductors confirmed demonstrating perovskite-like structure. The optical absorption spectra of Pt nanoparticles exhibited plasmon absorption band for main peaks at about 216 and 264 nm. The addition of Pt nanoparticles increased photoactivity compared to Er-KTaO3 and pure KTaO3. Summary optical properties of KTaO3 change with its doping Er-element and further photodeposition of Pt nanoparticles.

Keywords: heterogeneous photocatalytic, KTaO3 photocatalysts, Er3+ ion doping, Pt photodeposition

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535 A Reusable Foundation Solution for Onshore Windmills

Authors: Wael Mohamed, Per-Erik Austrell, Ola Dahlblom

Abstract:

Wind farms repowering is a significant topic nowadays. Wind farms repowering means the complete dismantling of the existing turbine, tower and foundation at an existing site and replacing these units with taller and larger units. Modern wind turbines are designed to withstand approximately for 20~25 years. However, a very long design life of 100 years or more can be expected for high-quality concrete foundations. Based on that there are significant economic and environmental benefits of replacing the out-of-date wind turbine with a new turbine of better power generation capacity and reuse the foundation. The big difference in lifetime shows a potential for new foundation solution to allow wind farms to be updated with taller and larger units in order to increase the energy production. This also means a significant change in the design loads on the foundations. Therefore, the new foundation solution should be able to handle the additional overturning loads. A raft surrounded by an active stabilisation system is proposed in this study. The concept of an active stabilisation system is a novel idea using a movable load to stabilise against the overturning moment. The active stabilisation system consists of a water tank being divided into eight compartments. The system uses the water as a movable load by pumping it into two compartments to stabilise against the overturning moment. The position of the water will rely on the wind direction and a water movement system depending on a number of electric motors and pipes with electric valves is used. One of the advantages of this active foundation solution is that some cost-efficient adjustment could be done to make this foundation able to support larger and taller units. After the end of the first turbine lifetime, an option is presented here to reuse this foundation and make it able to support taller and larger units. This option is considered using extra water volume to fill four compartments instead of two compartments. This extra water volume will increase the stability moment by 41% compared to using water in two compartments. The geotechnical performance of the new foundation solution is investigated using two existing weak soil profiles in Egypt and Sweden. A comparative study of the new solution and a piled raft with long friction piles is performed using finite element simulations. The results show that using a raft surrounded by an active stabilisation system decreases the tilting compared to a piled raft with friction piles. Moreover, it is found that using a raft surrounded by an active stabilisation system decreases the foundation costs compared to a piled raft with friction piles. In term of the environmental impact, it is found that the new foundation has a beneficial impact on the CO2 emissions. It saves roughly from 296.1 tonnes-CO2 to 518.21 tonnes-CO2 from the manufacture of concrete if the new foundation solution is used for another turbine-lifetime.

Keywords: active stabilisation system, CO2 emissions, FE analysis, reusable, weak soils

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534 Mental Health Surveys on Community and Organizational Levels: Challenges, Issues, Conclusions and Possibilities

Authors: László L. Lippai

Abstract:

In addition to the fact that mental health bears great significance to a particular individual, it can also be regarded as an organizational, community and societal resource. Within the Szeged Health Promotion Research Group, we conducted mental health surveys on two levels: The inhabitants of a medium-sized Hungarian town and students of a Hungarian university with a relatively big headcount were requested to participate in surveys whose goals were to define local government priorities and organization-level health promotion programmes, respectively. To facilitate professional decision-making, we defined three, pragmatically relevant, groups of the target population: the mentally healthy, the vulnerable and the endangered. In order to determine which group a person actually belongs to, we designed a simple and quick measurement tool, which could even be utilised as a smoothing method, the Mental State Questionnaire validity of the above three categories was verified by analysis of variance against psychological quality of life variables. We demonstrate the pragmatic significance of our method via the analyses of the scores of our two mental health surveys. On town level, during our representative survey in Hódmezővásárhely (N=1839), we found that 38.7% of the participants was mentally healthy, 35.3% was vulnerable, while 16.3% was considered as endangered. We were able to identify groups that were in a dramatic state in terms of mental health. For example, such a group consisted of men aged 45 to 64 with only primary education qualification and the ratios of the mentally healthy, vulnerable and endangered were 4.5, 45.5 and 50%, respectively. It was also astonishing to see to what a little extent qualification prevailed as a protective factor in the case of women. Based on our data, the female group aged 18 to 44 with primary education—of whom 20.3% was mentally healthy, 42.4% vulnerable and 37.3% was endangered—as well as the female group aged 45 to 64 with university or college degree—of whom 25% was mentally healthy, 51.3 vulnerable and 23.8% endangered—are to be handled as priority intervention target groups in a similarly difficult position. On organizational level, our survey involving the students of the University of Szeged, N=1565, provided data to prepare a strategy of mental health promotion for a university with a headcount exceeding 20,000. When developing an organizational strategy, it was important to gather information to estimate the proportions of target groups in which mental health promotion methods; for example, life management skills development, detection, psychological consultancy, psychotherapy, would be applied. Our scores show that 46.8% of the student participants were mentally healthy, 42.1% were vulnerable and 11.1% were endangered. These data convey relevant information as to the allocation of organizational resources within a university with a considerable headcount. In conclusion, The Mental State Questionnaire, as a valid smoothing method, is adequate to describe a community in a plain and informative way in the terms of mental health. The application of the method can promote the preparation, design and implementation of mental health promotion interventions. 

Keywords: health promotion, mental health promotion, mental state questionnaire, psychological well-being

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533 Compass Bar: A Visualization Technique for Out-of-View-Objects in Head-Mounted Displays

Authors: Alessandro Evangelista, Vito M. Manghisi, Michele Gattullo, Enricoandrea Laviola

Abstract:

In this work, we propose a custom visualization technique for Out-Of-View-Objects in Virtual and Augmented Reality applications using Head Mounted Displays. In the last two decades, Augmented Reality (AR) and Virtual Reality (VR) technologies experienced a remarkable growth of applications for navigation, interaction, and collaboration in different types of environments, real or virtual. Both environments can be potentially very complex, as they can include many virtual objects located in different places. Given the natural limitation of the human Field of View (about 210° horizontal and 150° vertical), humans cannot perceive objects outside this angular range. Moreover, despite recent technological advances in AR e VR Head-Mounted Displays (HMDs), these devices still suffer from a limited Field of View, especially regarding Optical See-Through displays, thus greatly amplifying the challenge of visualizing out-of-view objects. This problem is not negligible when the user needs to be aware of the number and the position of the out-of-view objects in the environment. For instance, during a maintenance operation on a construction site where virtual objects serve to improve the dangers' awareness. Providing such information can enhance the comprehension of the scene, enable fast navigation and focused search, and improve users' safety. In our research, we investigated how to represent out-of-view-objects in HMD User Interfaces (UI). Inspired by commercial video games such as Call of Duty Modern Warfare, we designed a customized Compass. By exploiting the Unity 3D graphics engine, we implemented our custom solution that can be used both in AR and VR environments. The Compass Bar consists of a graduated bar (in degrees) at the top center of the UI. The values of the bar range from -180 (far left) to +180 (far right), the zero is placed in front of the user. Two vertical lines on the bar show the amplitude of the user's field of view. Every virtual object within the scene is represented onto the compass bar as a specific color-coded proxy icon (a circular ring with a colored dot at its center). To provide the user with information about the distance, we implemented a specific algorithm that increases the size of the inner dot as the user approaches the virtual object (i.e., when the user reaches the object, the dot fills the ring). This visualization technique for out-of-view objects has some advantages. It allows users to be quickly aware of the number and the position of the virtual objects in the environment. For instance, if the compass bar displays the proxy icon at about +90, users will immediately know that the virtual object is to their right and so on. Furthermore, by having qualitative information about the distance, users can optimize their speed, thus gaining effectiveness in their work. Given the small size and position of the Compass Bar, our solution also helps lessening the occlusion problem thus increasing user acceptance and engagement. As soon as the lockdown measures will allow, we will carry out user-tests comparing this solution with other state-of-the-art existing ones such as 3D Radar, SidebARs and EyeSee360.

Keywords: augmented reality, situation awareness, virtual reality, visualization design

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532 Role of ASHA in Utilizing Maternal Health Care Services India, Evidences from National Rural Health Mission (NRHM)

Authors: Dolly Kumari, H. Lhungdim

Abstract:

Maternal health is one of the crucial health indicators for any country. 5th goal of Millennium Development Goals is also emphasising on improvement of maternal health. Soon after Independence government of India realizing the importance of maternal and child health care services, and took steps to strengthen in 1st and 2nd five year plans. In past decade the other health indicator which is life expectancy at birth has been observed remarkable improvement. But still maternal mortality is high in India and in some states it is observe much higher than national average. Government of India pour lots of fund and initiate National Rural Health Mission (NRHM) in 2005 to improve maternal health in country by providing affordable and accessible health care services. Accredited Social Heath Activist (ASHA) is one of the key components of the NRHM. Mainly ASHAs are selected female aged 25-45 years from village itself and accountable for the monitoring of maternal health care for the same village. ASHA are trained to works as an interface between the community and public health system. This study tries to assess the role of ASHA in utilizing maternal health care services and to see the level of awareness about benefits given under JSY scheme and utilization of those benefits by eligible women. For the study concurrent evaluation data from National Rural health Mission (NRHM), initiated by government of India in 2005 has been used. This study is based on 78205 currently married women from 70 different districts of India. Descriptive statistics, chi2 test and binary logistic regression have been used for analysis. The probability of institutional delivery increases by 2.03 times (p<0.001) while if ASHA arranged or helped in arranging transport facility the probability of institutional delivery is increased by 1.67 times (p<0.01) than if she is not arranging transport facility. Further if ASHA facilitated to get JSY card to the pregnant women probability of going for full ANC is increases by 1.36 times (p<0.05) than reference. However if ASHA discuses about institutional delivery and approaches to get register than probability of getting TT injection is 1.88 and 1.64 times (p<0.01) higher than that if she did not discus. Further, Probability of benefits from JSY schemes is 1.25 times (p<0.001) higher among women who get married after 18 years. The probability of benefits from JSY schemes is 1.25 times (p<0.001) higher among women who get married after 18 year of age than before 18 years, it is also 1.28 times (p<0.001) and 1.32 times (p<0.001) higher among women have 1 to 8 year of schooling and with 9 and above years of schooling respectively than the women who never attended school. Those women who are working have 1.13 times (p<0.001) higher probability of getting benefits from JSY scheme than not working women. Surprisingly women belongs to wealthiest quintile are .53times (P<0.001) less aware about JSY scheme. Results conclude that work done by ASHA has great influence on maternal health care utilization in India. But results also show that still substantial numbers of needed population are far from utilization of these services. Place of delivery is significantly influenced by referral and transport facility arranged by ASHA.

Keywords: institutional delivery, JSY beneficiaries, referral faculty, public health

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531 The Incidence of Inferior Alveolar Nerve Dysfunction Following Bilateral Sagittal Split Osteotomies: A Single Centre Retrospective Audit in the United Kingdom

Authors: Krupali Mukeshkumar, Jinesh Shah

Abstract:

Background: Bilateral Sagittal Split Osteotomy (BSSO), used for the correction of mandibular deformities, is a common oral and maxillofacial surgical procedure. Inferior alveolar nerve dysfunction is commonly reported post-operatively by patients as paresthesia or anesthesia. The current literature lacks a consensus on the incidence of inferior alveolar nerve dysfunction as patients are not routinely assessed pre and post-operatively with an objective assessment. The range of incidence varies from 9% to 85% of patients, with some authors arguing that 100% of patients experience nerve dysfunction immediately post-surgery. Systematic reviews have shown a difference between incidence rates at different follow-up periods using objective and subjective methods. Aim: To identify the incidence of inferior alveolar nerve dysfunction following BSSO. Gold standard: Nerve dysfunction incidence rates similar or lower than current literature of 83% day one post-operatively and 18.4% at one year follow up. Setting: A retrospective cross-sectional audit of patients treated between 2017-2019 at the Royal Stoke University Hospital, Maxillofacial and Orthodontic departments. Sample: All patients who underwent a BSSO (with or without le fort one osteotomy) between 2017–2019 were identified from the database. Patients with pre-existing neurosensory disturbance, those who had a genioplasty at the same time and those with no follow-up were excluded. The sample consisted of 121 patients, 37 males and 84 females between the ages of 17-50 years at the time of surgery. Methods: Clinical records of 121 cases were reviewed to assess the age, sex, type of mandibular osteotomy, status of the nerve during the surgical procedure, type of bony split and incidence of nerve dysfunction at follow-up appointments. The surgical procedure was carried out by three Maxillo-facial surgeons and follow-up appointments were carried out in the Orthodontic and Oral and Maxillo-facial departments. Results: 120 patients were treated to correct the mandibular facial deformity and 1 patient was treated for sleep apnoea. Seventeen patients had a mandibular setback and 104 patients had mandibular advancement. 68 patients reported inferior alveolar nerve dysfunction at one week following their surgery. Seventy-six patients had temporary paresthesia present between 2 weeks and 12 months post-surgery. 13 patients had persistent nerve dysfunction at 12 months, of which 1 had a bad bony split during the BSSO. The incidence of nerve dysfunction postoperatively was 6.6% after 1 day, 56.1% at 1 week, 62.8% at 2 weeks, 59.5% between 3-6 weeks, 43.0% between 8-16 weeks and 10.7% at 1 year. Conclusions: The results of this audit show a similar incidence rate to the research gold standard at the one-year follow-up. Future Recommendations: No changes to surgical procedure or technique are indicated, but a need for improved documentation and a standardized approach for assessment of post-operative nerve dysfunction would be beneficial.

Keywords: bilateral sagittal split osteotomy, inferior alveolar nerve, mandible, nerve dysfunction

Procedia PDF Downloads 219