Search results for: international patient safety goals
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11255

Search results for: international patient safety goals

1115 Determinants of Healthcare Team Effectiveness in Subterranean Settings: A Mixed-Methods Study

Authors: Nasra Idilbi, Jalal Tarabeia, Layalleh Masalha, Heiam Shoufani Kassis, Gizell Green

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Background: Healthcare professionals working in underground facilities face unique challenges affecting their physical and mental health and team effectiveness. We aimed to examine how an underground work environment affects the physical and mental health and effectiveness of a multi-professional medical team in a medical center under continuous war threats and the contribution of various demographic and professional characteristics. Methods: A cross-sectional survey was disseminated electronically. The questionnaire assessed team effectiveness, the quality of the work, and the health symptoms reported by the team while working in the underground complex. Results: In total, 270 healthcare workers (mean age 40 years, 75.6% females, 88.4% nurses) completed the questionnaire. Women reported statistically significantly higher mean scores of physical strain, fatigue, and eye irritation associated with the work environment compared to men. Multiple regression analysis revealed that psychological distress, noise, and lighting in the underground compound significantly influenced team effectiveness. The qualitative analysis revealed two key themes: the mental health impact of working in an underground environment and the effects of noise and lighting on staff performance. Nurses reported feelings of suffocation, claustrophobia, and difficulty concentrating due to the enclosed space, with some expressing heightened stress levels that impaired their ability to work effectively and safely. Female staff reported more pronounced symptoms of physical strain, fatigue, and eye irritation. Additionally, the underground complex’s poor noise absorption created a highly disruptive work environment, while inadequate lighting hindered accurate patient assessments, leading to potential errors. These challenges were exacerbated by physical symptoms like headaches and nausea, which further impacted job performance. The findings underscore the significant role of environmental factors in influencing both mental health and operational effectiveness, aligning with quantitative data on the predictors of team performance. Conclusions: The underground work environment is crucial in influencing healthcare team effectiveness, with psychological distress, noise, and lighting as key factors. The study highlights the importance of creating a comfortable work environment to foster team efficiency. The findings provide valuable insights for managers in underground healthcare facilities to optimize team performance and well-being.

Keywords: team effectiveness, underground settings, healthcare, environmental factors, a mixed-methods study

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1114 Growth and Bone Health in Children following Liver Transplantation

Authors: Faris Alkhalil, Rana Bitar, Amer Azaz, Hisham Natour, Noora Almeraikhi, Mohamad Miqdady

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Background: Children with liver transplantation are achieving very good survival and so there is now a need to concentrate on achieving good health in these patients and preventing disease. Immunosuppressive medications have side effects that need to be monitored and if possible avoided. Glucocorticoids and calcineurin inhibitors are detrimental to bone and mineral homeostasis in addition steroids can also affect linear growth. Steroid sparing regimes in renal transplant children has shown to improve children’s height. Aim: We aim to review the growth and bone health of children post liver transplant by measuring bone mineral density (BMD) using dual energy X-ray absorptiometry (DEXA) scan and assessing if there is a clear link between poor growth and impaired bone health and use of long term steroids. Subjects and Methods: This is a single centre retrospective Cohort study, we reviewed the medical notes of children (0-16 years) who underwent a liver transplantation between November 2000 to November 2016 and currently being followed at our centre. Results: 39 patients were identified (25 males and 14 females), the median transplant age was 2 years (range 9 months - 16 years), and the median follow up was 6 years. Four patients received a combined transplant, 2 kidney and liver transplant and 2 received a liver and small bowel transplant. The indications for transplant included, Biliary Atresia (31%), Acute Liver failure (18%), Progressive Familial Intrahepatic Cholestasis (15%), transplantable metabolic disease (10%), TPN related liver disease (8%), Primary Hyperoxaluria (5%), Hepatocellular carcinoma (3%) and other causes (10%). 36 patients (95%) were on a calcineurin inhibitor (34 patients were on Tacrolimus and 2 on Cyclosporin). The other three patients were on Sirolimus. Low dose long-term steroids was used in 21% of the patients. A considerable proportion of the patients had poor growth. 15% were below the 3rd centile for weight for age and 21% were below the 3rd centile for height for age. Most of our patients with poor growth were not on long term steroids. 49% of patients had a DEXA scan post transplantation. 21% of these children had low bone mineral density, one patient had met osteoporosis criteria with a vertebral fracture. Most of our patients with impaired bone health were not on long term steroids. 20% of the patients who did not undergo a DEXA scan developed long bone fractures and 50% of them were on long term steroid use which may suggest impaired bone health in these patients. Summary and Conclusion: The incidence of impaired bone health, although studied in limited number of patients; was high. Early recognition and treatment should be instituted to avoid fractures and improve bone health. Many of the patients were below the 3rd centile for weight and height however there was no clear relationship between steroid use and impaired bone health, reduced weight and reduced linear height.

Keywords: bone, growth, pediatric, liver, transplantation

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1113 Regional Review of Outcome of Cervical Smears Reported with Cytological Features of Non Cervical Glandular Neoplasia

Authors: Uma Krishnamoorthy, Vivienne Beavers, Janet Marshall

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Introduction: Cervical cytology showing features raising the suspicion of non cervical glandular neoplasia are reported as code 0 under the United Kingdom National Health Service Cervical screening programme ( NHSCSP). As the suspicion is regarding non cervical neoplasia, smear is reported as normal and patient informed that cervical screening result is normal. GP receives copy of results where it states further referral is indicated in small font within text of report. Background: There were several incidents of delayed diagnosis of endometrial cancer in Lancashire which prompted this Northwest Regional review to enable an understanding of underlying pathology outcome of code zero smears to raise awareness and also to review whether further action on wording of smear results was indicated to prevent such delay. Methodology: All Smears reported at the Manchester cytology centre who process cytology for Lancashire population from March 2013 to March 2014 were reviewed and histological diagnosis outcome of women in whom smear was reported as code zero was reviewed retrospectively . Results: Total smears reported by the cytology centre during this period was approximately 109400. Reports issued with result code 0 among this during this time period was 49.Results revealed that among three fourth (37) of women with code zero smear (N=49), evidence of underlying pathology of non cervical origin was confirmed. Of this, 73 % (36) were due to endometrial pathology with 49 % (24) endometrial carcinoma, 12 % (6)polyp, 4 % atypical endometrial hyperplasia (2), 6 % endometrial hyperplasia without atypia (3), and 2 % adenomyosis (1 case) and 2 % ( 1 case) due to ovarian adenocarcinoma. Conclusion: This review demonstrated that more than half (51 %) of women with a code 0 smear report were diagnosed with underlying carcinoma and 75 % had a confirmed underlying pathology contributory to code 0 smear findings. Recommendations and Action Plan: A local rapid access referral and management pathway for this group of women was implemented as a result of this in our unit. The findings and Pathway were shared with other regional units served by the cytology centre through the Pan Lancashire cervical screening board and through the Cytology centre. Locally, the smear report wording was updated to include a rubber stamp/ print in "Red Bold letters" stating that " URGENT REFERRAL TO GYNAECOLOGY IS INDICATED". Findings were also shared through the Pan Lancashire board with National cervical screening programme board, and revisions to wording of code zero smear reports to highlight the need for Urgent referral has now been agreed at National level to be implemented.

Keywords: code zero smears, endometrial cancer, non cervical glandular neoplasia, ovarian cancer

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1112 Oat βeta Glucan Attenuates the Development of Atherosclerosis and Improves the Intestinal Barrier Function by Reducing Bacterial Endotoxin Translocation in APOE-/- MICE

Authors: Dalal Alghawas, Jetty Lee, Kaisa Poutanen, Hani El-Nezami

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Oat β-glucan a water soluble non starch linear polysaccharide has been approved as a cholesterol lowering agent by various food safety administrations and is commonly used to reduce the risk of heart disease. The molecular weight of oat β-glucan can vary depending on the extraction and fractionation methods. It is not clear whether the molecular weight has a significant impact at reducing the acceleration of atherosclerosis. The aim of this study was to investigate three different oat β-glucan fractionations on the development of atherosclerosis in vivo. With special focus on plaque stability and the intestinal barrier function. To test this, ApoE-/- female mice were fed a high fat diet supplemented with oat bran, high molecular weight (HMW) oat β-glucan fractionate and low molecular weight (LMW) oat β-glucan fractionate for 16 weeks. Atherosclerosis risk markers were measured in the plasma, heart and aortic tree. Plaque size was measured in the aortic root and aortic tree. ICAM-1, VCAM-1, E-Selectin, P-Selectin, protein levels were assessed from the aortic tree to determine plaque stability at 16 weeks. The expression of p22phox at the aortic root was evaluated to study the NADPH oxidase complex involved in nitric oxide bioavailability and vascular elasticity. The tight junction proteins E-cadherin and beta-catenin from western blot analyses were analysed as an intestinal barrier function test. Plasma LPS, intestinal D-lactate levels and hepatic FMO gene expression were carried out to confirm whether the compromised intestinal barrier lead to endotoxemia. The oat bran and HMW oat β-glucan diet groups were more effective than the LMW β-glucan diet group at reducing the plaque size and showed marked improvements in plaque stability. The intestinal barrier was compromised for all the experimental groups however the endotoxemia levels were higher in the LMW β-glucan diet group. The oat bran and HMW oat β-glucan diet groups were more effective at attenuating the development of atherosclerosis. Reasons for this could be due to the LMW oat β-glucan diet group’s low viscosity in the gut and the inability to block the reabsorption of cholesterol. Furthermore the low viscosity may allow more bacterial endotoxin translocation through the impaired intestinal barrier. In future food technologists should carefully consider how to incorporate LMW oat β-glucan as a health promoting food.

Keywords: Atherosclerosis, beta glucan, endotoxemia, intestinal barrier function

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1111 Assessing the Recycling Potential of Cupriavidus Necator for Space Travel: Production of Single Cell Proteins and Polyhydroxyalkanoates From Organic Waste

Authors: P. Joris, E. Lombard, X. Cameleyre, G. Navarro, A. Paillet, N. Gorret, S. E. Guillouet

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Today, on the international space station, multiple supplies are needed per year to supply food and spare parts and to take out waste. But as it is planned to go longer and further into space these supplies will no longer be possible. The astronaut life support system must be able of continuously transform waste into valuable compounds. Two types of production were identified as critical and could be be supplemented by microorganisms. On the one hand, since microgravity causes rapid muscle loss, single cell proteins (SCPs) could be used as protein rich feed or food. On the other hand, having enough building materials to build an advanced habitat will not be possible only by transporting space goods from earth to mars for example. The bacterium Cupriavidus. necator is well known for its ability to produce a large amount of proteins or of polyhydroxyalkanoate biopolymers (PHAs) depending on its implementation. By coupling the life support system to a 3D-printer, astronauts could be supplied with an unlimited amount of building materials. Additionally, based on the design of the life support system, waste streams have been identified: urea from the crew urine and volatile fatty acids (VFAs) from a first stage of organic waste (excrement and food waste) treatment through anaerobic digestion. Thus, the objective of this, within the Spaceship.Fr project, was to demonstrate the feasibility of producing SCPs and PHAs from VFAs and urea in bioreactor. Because life support systems operate continuously as loops, continuous culture experiments were chosen and the effect of the bioreactor dilution rate on biomass composition was investigated. Total transformation of the carbon source into biomass with high SCP or PHA content was achieved in all cases. We will present the transformation performances of VFAs and urea by the bacteria in bioreactor in terms of titers, yields and productivities but also in terms of the quality of SCP and PHA produced, nucleic acid content. We will further discuss the envisioned integration of our process within life support systems.

Keywords: life support system, space travel, waste treatment, single cell proteins, polyhydroxyalkanoates, bioreactor

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1110 Menopause Hormone Therapy: An Insight into Knowledge and Attitudes of Obstetricians and Gynecologists in Singapore

Authors: Tan Hui Ying Renee, Stella Rizalina Sasha, Farah Safdar Husain

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Introduction: Menopause Hormone Therapy (MHT) is an effective drug indicated for the treatment of menopausal symptoms and as replacement therapy in women who undergo premature menopause. In 2020, less than 8.8% of perimenopausal Singaporean women are on hormonal therapy, as compared to the Western population, where up to 50% may be on MHT. Factors associated with MHT utilization have been studied from patient characteristics, but the impact of locally prescribing physicians resulting in low MHT utilization has yet to be evaluated. The aim of the study is to determine the level of knowledge physicians in the Obstetrics and Gynaecology specialty have and their attitudes toward MHT. We believe that knowledge of MHT is lacking and that negative attitudes towards MHT may influence its use and undermine the benefits MHT may have for women. This paper is a part of a larger study on Singaporean physicians’ knowledge and attitudes towards MHT. Methods: This is a cross-sectional study intended to assess the knowledge and attitudes of physicians toward Menopausal Hormone Therapy. An anonymous questionnaire was disseminated via institutional internal circulations to optimize reach to physicians who may prescribe MHT, particularly in the fields of Gynaecology, Family Medicine and Endocrinology. Responses were completed voluntarily. Physicians had the option for each question to declare that they were ‘unsure’ or that the question was ‘beyond their expertise’. 21 knowledge questions tested factual recall on indications, contraindications, and risks of MHT. The remaining 6 questions were clinical scenarios crafted with the intention of testing specific principles related to the use of MHT. These questions received face validation from experts in the field. 198 responses were collected, 79 of which were from physicians in the Obstetrics and Gynaecology specialty. The data will be statistically analyzed to investigate areas that can be improved to increase the overall benefits of MHT for the Singaporean population. Results: Preliminary results show that the prevailing factors that limit Singaporean gynecologists and obstetricians from prescribing MHT are a lack of knowledge of MHT and a lack of confidence in prescribing MHT. Risks and indications of MHT were not well known by many physicians, with the majority of the questions having more than 25% incorrect and ‘unsure’ as their reply. The clinical scenario questions revealed significant shortcomings in knowledge on how to navigate real-life challenges in MHT use, with 2 of 6 questions with more than 50% incorrect or ‘beyond their expertise’ as their reply. The portion of the questionnaire that investigated the attitudes of physicians showed that though a large majority believed MHT to be an effective drug, only 40.5% were confident in prescribing it. Conclusion: Physicians in the Obstetrics and Gynaecology specialty lack knowledge and confidence in MHT. Therefore, it is imperative to formulate solutions on both the individual and institutional levels to fill these gaps and ensure that MHT is used appropriately and prescribed to the patients who need it.

Keywords: menopause, menopause hormone therapy, physician factors, obstetrics and gynecology, menopausal symptoms, Singapore

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1109 Robust Electrical Segmentation for Zone Coherency Delimitation Base on Multiplex Graph Community Detection

Authors: Noureddine Henka, Sami Tazi, Mohamad Assaad

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The electrical grid is a highly intricate system designed to transfer electricity from production areas to consumption areas. The Transmission System Operator (TSO) is responsible for ensuring the efficient distribution of electricity and maintaining the grid's safety and quality. However, due to the increasing integration of intermittent renewable energy sources, there is a growing level of uncertainty, which requires a faster responsive approach. A potential solution involves the use of electrical segmentation, which involves creating coherence zones where electrical disturbances mainly remain within the zone. Indeed, by means of coherent electrical zones, it becomes possible to focus solely on the sub-zone, reducing the range of possibilities and aiding in managing uncertainty. It allows faster execution of operational processes and easier learning for supervised machine learning algorithms. Electrical segmentation can be applied to various applications, such as electrical control, minimizing electrical loss, and ensuring voltage stability. Since the electrical grid can be modeled as a graph, where the vertices represent electrical buses and the edges represent electrical lines, identifying coherent electrical zones can be seen as a clustering task on graphs, generally called community detection. Nevertheless, a critical criterion for the zones is their ability to remain resilient to the electrical evolution of the grid over time. This evolution is due to the constant changes in electricity generation and consumption, which are reflected in graph structure variations as well as line flow changes. One approach to creating a resilient segmentation is to design robust zones under various circumstances. This issue can be represented through a multiplex graph, where each layer represents a specific situation that may arise on the grid. Consequently, resilient segmentation can be achieved by conducting community detection on this multiplex graph. The multiplex graph is composed of multiple graphs, and all the layers share the same set of vertices. Our proposal involves a model that utilizes a unified representation to compute a flattening of all layers. This unified situation can be penalized to obtain (K) connected components representing the robust electrical segmentation clusters. We compare our robust segmentation to the segmentation based on a single reference situation. The robust segmentation proves its relevance by producing clusters with high intra-electrical perturbation and low variance of electrical perturbation. We saw through the experiences when robust electrical segmentation has a benefit and in which context.

Keywords: community detection, electrical segmentation, multiplex graph, power grid

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1108 A Novel Treatment of the Arthritic Hip: A Prospective, Cross-Sectional Study on Changes Following Bone Marrow Concentrate Injection and Arthroscopic Debridement

Authors: A. Drapeaux, S. Aviles, E. Garfoot

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Stem cell injections are a promising alternative treatment for hip osteoarthritis. Current literature has focused on short-term outcomes for both knee and hip osteoarthritis; however, there is a significant gap for longitudinal benefits for hip OA and limited firm conclusions due to small sample sizes. The purpose of this prospective study was to determine longitudinal changes in pain, function, and radiographs following bone marrow concentrate injection (BMAC) into the osteoarthritic hip joint. Methods: A prospective, cross-sectional study was conducted over the course of 12 months at an orthopedic practice. The study recruited 15 osteoarthritic pre-surgical hips with mild to moderate osteoarthritic severity who were scheduled to undergo hip arthroscopy. Data was collected at both pre-operative and post-operative time frames. Data collected included: hip radiographs, i-HOT-33 questionnaire data, BMAC autologous volume, and demographics. Questionnaire data was captured using Qualtrics XM software, and participants were sent an anonymous link at the following time frames: pre-operative, 2 weeks, 6 weeks, 12 weeks, 6 months, 12 months, and 24 months. Radiographic changes and BMAC volume were collected and reviewed by an orthopedic surgeon and sent to the primary investigator. Data was exported and analyzed in IBM-SPSS. Results: A total of 15 hips from 15 participants (mean age: 49, gender: 50% males, 50% females, BMI: 29.7) were used in the final analysis. Summative i-HOT 33 mean scores significantly changed between pre-operative status and 2-6 weeks post-operative status (p <.001) and pre-operative status and 3-6 months post-operative status (p <.001). There were no significant changes between other post-operative phases or between pre-operative status and 12 months post-operative. Significant improvements were found between summative i-HOT 33 mean (p<.001), daily pain (p<.001), daily sitting (p=.02), daily distance walked (p =.003), and daily limp (p=0.03) and post-operative status (2-6 weeks). No significant differences between demographic variables (gender, age, tobacco use, or diabetes) and i-HOT 33 summative mean scores. Discussion/Implications: The purpose of this study was to determine longitudinal changes in pain and function following a hip joint bone marrow concentrate injection. Results indicate that participants experience a significant improvement in pain and function between pre-operative and 2-6 weeks and 3-6 months post-injection. Participants also self-reported a significant change in average daily pain with sitting and walking between pre-operation and 2-6 weeks post-operative. This study includes a larger sample size of hip osteoarthritis cases; however, future research is warranted to include random controlled trials with a larger sample size.

Keywords: adult stem cell, orthopedics, osteoarthritis (hip), patient outcome assessment

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1107 Cartilage Mimicking Coatings to Increase the Life-Span of Bearing Surfaces in Joint Prosthesis

Authors: L. Sánchez-Abella, I. Loinaz, H-J. Grande, D. Dupin

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Aseptic loosening remains as the principal cause of revision in total hip arthroplasty (THA). For long-term implantations, submicron particles are generated in vivo due to the inherent wear of the prosthesis. When this occurs, macrophages undergo phagocytosis and secretion of bone resorptive cytokines inducing osteolysis, hence loosening of the implanted prosthesis. Therefore, new technologies are required to reduce the wear of the bearing materials and hence increase the life-span of the prosthesis. Our strategy focuses on surface modification of the bearing materials with a hydrophilic coating based on cross-linked water-soluble (meth)acrylic monomers to improve their tribological behavior. These coatings are biocompatible, with high swelling capacity and antifouling properties, mimicking the properties of natural cartilage, i.e. wear resistance with a permanent hydrated layer that prevents prosthesis damage. Cartilage mimicking based coatings may be also used to protect medical device surfaces from damage and scratches that will compromise their integrity and hence their safety. However, there are only a few reports on the mechanical and tribological characteristics of this type of coatings. Clear beneficial advantages of this coating have been demonstrated in different conditions and different materials, such as Ultra-high molecular weight polyethylene (UHMWPE), Polyethylene (XLPE), Carbon-fiber-reinforced polyetheretherketone (CFR-PEEK), cobalt-chromium (CoCr), Stainless steel, Zirconia Toughened Alumina (ZTA) and Alumina. Using routine tribological experiments, the wear for UHMWPE substrate was decreased by 75% against alumina, ZTA and stainless steel. For PEEK-CFR substrate coated, the amount of material lost against ZTA and CrCo was at least 40% lower. Experiments on hip simulator allowed coated ZTA femoral heads and coated UHMWPE cups to be validated with a decrease of 80% of loss material. Further experiments on hip simulator adding abrasive particles (1 micron sized alumina particles) during 3 million cycles, on a total of 6 million, demonstrated a decreased of around 55% of wear compared to uncoated UHMWPE and uncoated XLPE. In conclusion, CIDETEC‘s hydrogel coating technology is versatile and can be adapted to protect a large range of surfaces, even in abrasive conditions.

Keywords: cartilage, hydrogel, hydrophilic coating, joint

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1106 Steps toward the Support Model of Decision-Making in Hungary: The Impact of the Article 12 of the UN Convention on the Rights of Persons with Disabilities on the Hungarian National Legislation

Authors: Szilvia Halmos

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Hungary was one of the first countries to sign and ratify the UN Convention on the Rights of Persons with Disabilities (hereinafter: CRPD). Consequently, Hungary assumed an obligation under international law to review the national law in the light of the Article 12 of the CRPD requiring the States parties to guarantee the equality of persons with disabilities in terms of legal capacity, and to replace the regimes of substitute decision-making by the instruments of supported decision-making. This article is often characterized as one of the key norms of the CRPD, since the legal autonomy of the persons with disabilities is an essential precondition of their participation in the social life on an equal basis with others, envisaged by the social paradigm of disability. This paper examines the impact of the CRPD on the relevant Hungarian national legal norms, with special focus on the relevant rules of the recently codified Civil Code. The employed research methodologies include (1) the specification of the implementation requirements imposed by the Article 12 of the CRPD, (2) the determination of the indicators of the appropriate implementation, (3) the critical analysis of compliance of the relevant Hungarian legal regulation with the indicators, (4) with respect to the relevant case law of the Hungarian Constitutional Court and ordinary courts, the European Court of Human Rights and the Committee of Rights of Persons with Disabilities and (5) to the available empirical figures on the functioning of substitute and supported decision-making regimes. It will be established that the new Civil Code has made large steps toward the equality of persons with disabilities in terms of legal capacity and the support model of decision-making by the introduction of some specific instruments of supported decision-making and the restriction of the application of guardianship. Nevertheless, the regulation currently in effect fails to represent some crucial principles of the Article 12 of the CRPD, such as the non-discrimination of persons with psycho-social disabilities, the support of the articulation of the will and preferences of the individual instead of his/her best interest in the course of decision-making. The changes in the practice of the substitute and the support model brought about by the new legal norms can also be assessed as significant, however, so far unsatisfactory. The number of registered supporters is rather low, and the preconditions of the effective functioning of the support (e.g. the proper training of the supporters) are not ensured.

Keywords: Article 12 of the UN CRPD, Hungarian law on legal capacity, persons with intellectual and psycho-social disabilities, supported decision-making

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1105 Novel EGFR Ectodomain Mutations and Resistance to Anti-EGFR and Radiation Therapy in H&N Cancer

Authors: Markus Bredel, Sindhu Nair, Hoa Q. Trummell, Rajani Rajbhandari, Christopher D. Willey, Lewis Z. Shi, Zhuo Zhang, William J. Placzek, James A. Bonner

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Purpose: EGFR-targeted monoclonal antibodies (mAbs) provide clinical benefit in some patients with H&N squamous cell carcinoma (HNSCC), but others progress with minimal response. Missense mutations in the EGFR ectodomain (ECD) can be acquired under mAb therapy by mimicking the effect of large deletions on receptor untethering and activation. Little is known about the contribution of EGFR ECD mutations to EGFR activation and anti-EGFR response in HNSCC. Methods: We selected patient-derived HNSCC cells (UM-SCC-1) for resistance to mAb Cetuximab (CTX) by repeated, stepwise exposure to mimic what may occur clinically and identified two concurrent EGFR ECD mutations (UM-SCC-1R). We examined the competence of the mutants to bind EGF ligand or CTX. We assessed the potential impact of the mutations through visual analysis of space-filling models of the native sidechains in the original structures vs. their respective side-chain mutations. We performed CRISPR in combination with site-directed mutagenesis to test for the effect of the mutants on ligand-independent EGFR activation and sorting. We determined the effects on receptor internalization, endocytosis, downstream signaling, and radiation sensitivity. Results: UM-SCC-1R cells carried two non-synonymous missense mutations (G33S and N56K) mapping to domain I in or near the EGF binding pocket of the EGFR ECD. Structural modeling predicted that these mutants restrict the adoption of a tethered, inactive EGFR conformation while not permitting association of EGFR with the EGF ligand or CTX. Binding studies confirmed that the mutant, untethered receptor displayed a reduced affinity for both EGF and CTX but demonstrated sustained activation and presence at the cell surface with diminished internalization and sorting for endosomal degradation. Single and double-mutant models demonstrated that the G33S mutant is dominant over the N56K mutant in its effect on EGFR activation and EGF binding. CTX-resistant UM-SCC-1R cells demonstrated cross-resistance to mAb Panitumuab but, paradoxically, remained sensitive to the reversible receptor tyrosine kinase inhibitor Erlotinib. Conclusions: HNSCC cells can select for EGFR ECD mutations under EGFR mAb exposure that converge to trap the receptor in an open, constitutively activated state. These mutants impede the receptor’s competence to bind mAbs and EGF ligand and alter its endosomal trafficking, possibly explaining certain cases of clinical mAb and radiation resistance.

Keywords: head and neck cancer, EGFR mutation, resistance, cetuximab

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1104 Evidence-Triggers for Care of Patients with Cleft Lip and Palate in Srinagarind Hospital: The Tawanchai Center and Out-Patients Surgical Room

Authors: Suteera Pradubwong, Pattama Surit, Sumalee Pongpagatip, Tharinee Pethchara, Bowornsilp Chowchuen

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Background: Cleft lip and palate (CLP) is a congenital anomaly of the lip and palate that is caused by several factors. It was found in approximately one per 500 to 550 live births depending on nationality and socioeconomic status. The Tawanchai Center and out-patients surgical room of Srinagarind Hospital are responsible for providing care to patients with CLP (starting from birth to adolescent) and their caregivers. From the observations and interviews with nurses working in these units, they reported that both patients and their caregivers confronted many problems which affected their physical and mental health. Based on the Soukup’s model (2000), the researchers used evidence triggers from clinical practice (practice triggers) and related literature (knowledge triggers) to investigate the problems. Objective: The purpose of this study was to investigate the problems of care for patients with CLP in the Tawanchai Center and out-patient surgical room of Srinagarind Hospital. Material and Method: The descriptive method was used in this study. For practice triggers, the researchers obtained the data from medical records of ten patients with CLP and from interviewing two patients with CLP, eight caregivers, two nurses, and two assistant workers. Instruments for the interview consisted of a demographic data form and a semi-structured questionnaire. For knowledge triggers, the researchers used a literature search. The data from both practice and knowledge triggers were collected between February and May 2016. The quantitative data were analyzed through frequency and percentage distributions, and the qualitative data were analyzed through a content analysis. Results: The problems of care gained from practice and knowledge triggers were consistent and were identified as holistic issues, including 1) insufficient feeding, 2) risks of respiratory tract infections and physical disorders, 3) psychological problems, such as anxiety, stress, and distress, 4) socioeconomic problems, such as stigmatization, isolation, and loss of income, 5)spiritual problems, such as low self-esteem and low quality of life, 6) school absence and learning limitation, 7) lack of knowledge about CLP and its treatments, 8) misunderstanding towards roles among the multidisciplinary team, 9) no available services, and 10) shortage of healthcare professionals, especially speech-language pathologists (SLPs). Conclusion: From evidence-triggers, the problems of care affect the patients and their caregivers holistically. Integrated long-term care by the multidisciplinary team is needed for children with CLP starting from birth to adolescent. Nurses should provide effective care to these patients and their caregivers by using a holistic approach and working collaboratively with other healthcare providers in the multidisciplinary team.

Keywords: evidence-triggers, cleft lip, cleft palate, problems of care

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1103 Combination Therapies Targeting Apoptosis Pathways in Pediatric Acute Myeloid Leukemia (AML)

Authors: Ahlam Ali, Katrina Lappin, Jaine Blayney, Ken Mills

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Leukaemia is the most frequently (30%) occurring type of paediatric cancer. Of these, approximately 80% are acute lymphoblastic leukaemia (ALL) with acute myeloid leukaemia (AML) cases making up the remaining 20% alongside other leukaemias. Unfortunately, children with AML do not have promising prognosis with only 60% surviving 5 years or longer. It has been highlighted recently the need for age-specific therapies for AML patients, with paediatric AML cases having a different mutational landscape compared with AML diagnosed in adult patients. Drug Repurposing is a recognized strategy in drug discovery and development where an already approved drug is used for diseases other than originally indicated. We aim to identify novel combination therapies with the promise of providing alternative more effective and less toxic induction therapy options. Our in-silico analysis highlighted ‘cell death and survival’ as an aberrant, potentially targetable pathway in paediatric AML patients. On this basis, 83 apoptotic inducing compounds were screened. A preliminary single agent screen was also performed to eliminate potentially toxic chemicals, then drugs were constructed into a pooled library with 10 drugs per well over 160 wells, with 45 possible pairs and 120 triples in each well. Seven cell lines were used during this study to represent the clonality of AML in paediatric patients (Kasumi-1, CMK, CMS, MV11-14, PL21, THP1, MOLM-13). Cytotoxicity was assessed up to 72 hours using CellTox™ Green reagent. Fluorescence readings were normalized to a DMSO control. Z-Score was assigned to each well based on the mean and standard deviation of all the data. Combinations with a Z-Score <2 were eliminated and the remaining wells were taken forward for further analysis. A well was considered ‘successful’ if each drug individually demonstrated a Z-Score <2, while the combination exhibited a Z-Score >2. Each of the ten compounds in one well (155) had minimal or no effect as single agents on cell viability however, a combination of two or more of the compounds resulted in a substantial increase in cell death, therefore the ten compounds were de-convoluted to identify a possible synergistic pair/triple combinations. The screen identified two possible ‘novel’ drug pairing, with BCL2 inhibitor ABT-737, combined with either a CDK inhibitor Purvalanol A, or AKT/ PI3K inhibitor LY294002. (ABT-737- 100 nM+ Purvalanol A- 1 µM) (ABT-737- 100 nM+ LY294002- 2 µM). Three possible triple combinations were identified (LY2409881+Akti-1/2+Purvalanol A, SU9516+Akti-1/2+Purvalanol A, and ABT-737+LY2409881+Purvalanol A), which will be taken forward for examining their efficacy at varying concentrations and dosing schedules, across multiple paediatric AML cell lines for optimisation of maximum synergy. We believe that our combination screening approach has potential for future use with a larger cohort of drugs including FDA approved compounds and patient material.

Keywords: AML, drug repurposing, ABT-737, apoptosis

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1102 Islamic Finance and Trade Promotion in the African Continental Free Trade Area: An Exploratory Study

Authors: Shehu Usman Rano Aliyu

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Despite the significance of finance as a major trade lubricant, evidence in the literature alludes to its scarcity and increasing cost, especially in developing countries where small and medium-scale enterprises are worst affected. The creation of the African Continental Free Trade Area (AFCFTA) in 2018, an organ of the African Union (AU), was meant to serve as a beacon for deepening economic integration through the removal of trade barriers inhibiting intra-African trade and movement of persons, among others. Hence, this research explores the role Islamic trade finance (ITF) could play in spurring intra- and inter-African trade. The study involves six countries; Egypt, Kenya, Malaysia, Morocco, Nigeria, and Saudi Arabia, and employs survey research, a total of 430 sample data, and SmartPLS Structural Equation Modelling (SEM) techniques in its analyses. We find strong evidence that Shari’ah, legal and regulatory compliance issues of the ITF institutions rhythm with the internal, national, and international compliance requirements equally as the unique instruments applied in ITF. In addition, ITF was found to be largely driven by global economic and political stability, socially responsible finance, ethical and moral considerations, risk-sharing, and resilience of the global Islamic finance industry. Further, SMEs, Governments, and Importers are the major beneficiary sectors. By and large, AfCFTA’s protocols align with the principles of ITF and are therefore suited for the proliferation of Islamic finance in the continent. And, while AML/KYC and BASEL requirements, compliance to AAOIFI and IFSB standards, paucity of Shari'ah experts, threats to global security, and increasing global economic uncertainty pose as major impediments, the future of ITF would be shaped by a greater need for institutional and policy support, global economic cum political stability, robust regulatory framework, and digital technology/fintech. The study calls for the licensing of more ITF institutions in the continent, participation of multilateral institutions in ITF, and harmonization of Shariah standards.

Keywords: AfCFTA, islamic trade finance, murabaha, letter of credit, forwarding

Procedia PDF Downloads 56
1101 Innovation Eco-Systems and Cities: Sustainable Innovation and Urban Form

Authors: Claudia Trillo

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Regional innovation eco-ecosystems are composed of a variety of interconnected urban innovation eco-systems, mutually reinforcing each other and making the whole territorial system successful. Combining principles drawn from the new economic growth theory and from the socio-constructivist approach to the economic growth, with the new geography of innovation emerging from the networked nature of innovation districts, this paper explores the spatial configuration of urban innovation districts, with the aim of unveiling replicable spatial patterns and transferable portfolios of urban policies. While some authors suggest that cities should be considered ideal natural clusters, supporting cross-fertilization and innovation thanks to the physical setting they provide to the construction of collective knowledge, still a considerable distance persists between regional development strategies and urban policies. Moreover, while public and private policies supporting entrepreneurship normally consider innovation as the cornerstone of any action aimed at uplifting the competitiveness and economic success of a certain area, a growing body of literature suggests that innovation is non-neutral, hence, it should be constantly assessed against equity and social inclusion. This paper draws from a robust qualitative empirical dataset gathered through 4-years research conducted in Boston to provide readers with an evidence-based set of recommendations drawn from the lessons learned through the investigation of the chosen innovation districts in the Boston area. The evaluative framework used for assessing the overall performance of the chosen case studies stems from the Habitat III Sustainable Development Goals rationale. The concept of inclusive growth has been considered essential to assess the social innovation domain in each of the chosen cases. The key success factors for the development of the Boston innovation ecosystem can be generalized as follows: 1) a quadruple helix model embedded in the physical structure of the two cities (Boston and Cambridge), in which anchor Higher Education (HE) institutions continuously nurture the Entrepreneurial Environment. 2) an entrepreneurial approach emerging from the local governments, eliciting risk-taking and bottom-up civic participation in tackling key issues in the city. 3) a networking structure of some intermediary actors supporting entrepreneurial collaboration, cross-fertilization and co-creation, which collaborate at multiple-scales thus enabling positive spillovers from the stronger to the weaker contexts. 4) awareness of the socio-economic value of the built environment as enabler of cognitive networks allowing activation of the collective intelligence. 5) creation of civic-led spaces enabling grassroot collaboration and cooperation. Evidence shows that there is not a single magic recipe for the successful implementation of place-based and social innovation-driven strategies. On the contrary, the variety of place-grounded combinations of micro and macro initiatives, embedded in the social and spatial fine grain of places and encompassing a diversity of actors, can create the conditions enabling places to thrive and local economic activities to grow in a sustainable way.

Keywords: innovation-driven sustainable Eco-systems , place-based sustainable urban development, sustainable innovation districts, social innovation, urban policie

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1100 Considerations for Effectively Using Probability of Failure as a Means of Slope Design Appraisal for Homogeneous and Heterogeneous Rock Masses

Authors: Neil Bar, Andrew Heweston

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Probability of failure (PF) often appears alongside factor of safety (FS) in design acceptance criteria for rock slope, underground excavation and open pit mine designs. However, the design acceptance criteria generally provide no guidance relating to how PF should be calculated for homogeneous and heterogeneous rock masses, or what qualifies a ‘reasonable’ PF assessment for a given slope design. Observational and kinematic methods were widely used in the 1990s until advances in computing permitted the routine use of numerical modelling. In the 2000s and early 2010s, PF in numerical models was generally calculated using the point estimate method. More recently, some limit equilibrium analysis software offer statistical parameter inputs along with Monte-Carlo or Latin-Hypercube sampling methods to automatically calculate PF. Factors including rock type and density, weathering and alteration, intact rock strength, rock mass quality and shear strength, the location and orientation of geologic structure, shear strength of geologic structure and groundwater pore pressure influence the stability of rock slopes. Significant engineering and geological judgment, interpretation and data interpolation is usually applied in determining these factors and amalgamating them into a geotechnical model which can then be analysed. Most factors are estimated ‘approximately’ or with allowances for some variability rather than ‘exactly’. When it comes to numerical modelling, some of these factors are then treated deterministically (i.e. as exact values), while others have probabilistic inputs based on the user’s discretion and understanding of the problem being analysed. This paper discusses the importance of understanding the key aspects of slope design for homogeneous and heterogeneous rock masses and how they can be translated into reasonable PF assessments where the data permits. A case study from a large open pit gold mine in a complex geological setting in Western Australia is presented to illustrate how PF can be calculated using different methods and obtain markedly different results. Ultimately sound engineering judgement and logic is often required to decipher the true meaning and significance (if any) of some PF results.

Keywords: probability of failure, point estimate method, Monte-Carlo simulations, sensitivity analysis, slope stability

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1099 From Modelled Design to Reality through Material and Machinery Lab and Field Tests: Porous Concrete Carparks at the Wanda Metropolitano Stadium in Madrid

Authors: Manuel de Pazos-Liano, Manuel Cifuentes-Antonio, Juan Fisac-Gozalo, Sara Perales-Momparler, Carlos Martinez-Montero

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The first-ever game in the Wanda Metropolitano Stadium, the new home of the Club Atletico de Madrid, was played on September 16, 2017, thanks to the work of a multidisciplinary team that made it possible to combine urban development with sustainability goals. The new football ground sits on a 1.2 km² land owned by the city of Madrid. Its construction has dramatically increased the sealed area of the site (transforming the runoff coefficient from 0.35 to 0.9), and the surrounding sewer network has no capacity for that extra flow. As an alternative to enlarge the existing 2.5 m diameter pipes, it was decided to detain runoff on site by means of an integrated and durable infrastructure that would not blow up the construction cost nor represent a burden on the municipality’s maintenance tasks. Instead of the more conventional option of building a large concrete detention tank, the decision was taken on the use of pervious pavement on the 3013 car parking spaces for sub-surface water storage, a solution aligned with the city water ordinance and the Madrid + Natural project. Making the idea a reality, in only five months and during the summer season (which forced to pour the porous concrete only overnight), was a challenge never faced before in Spain, that required of innovation both at the material as well as the machinery side. The process consisted on: a) defining the characteristics required for the porous concrete (compressive strength of 15 N/mm2 and 20% voids); b) testing of different porous concrete dosages at the construction company laboratory; c) stablishing the cross section in order to provide structural strength and sufficient water detention capacity (20 cm porous concrete over a 5 cm 5/10 gravel, that sits on a 50 cm coarse 40/50 aggregate sub-base separated by a virgin fiber polypropylene geotextile fabric); d) hydraulic computer modelling (using the Full Hydrograph Method based on the Wallingford Procedure) to estimate design peak flows decrease (an average of 69% at the three car parking lots); e) use of a variety of machinery for the application of the porous concrete to achieve both structural strength and permeable surface (including an inverse rotating rolling imported from USA, and the so-called CMI, a sliding concrete paver used in the construction of motorways with rigid pavements); f) full-scale pilots and final construction testing by an accredited laboratory (pavement compressive strength average value of 15 N/mm2 and 0,0032 m/s permeability). The continuous testing and innovating construction process explained in detail within this article, allowed for a growing performance with time, finally proving the use of the CMI valid also for large porous car park applications. All this process resulted in a successful story that converts the Wanda Metropolitano Stadium into a great demonstration site that will help the application of the Spanish Royal Decree 638/2016 (it also counts with rainwater harvesting for grass irrigation).

Keywords: construction machinery, permeable carpark, porous concrete, SUDS, sustainable develpoment

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1098 Consumer Reactions to Hospitality Social Robots Across Cultures

Authors: Lisa C. Wan

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To address customers’ safety concerns, more and more hospitality companies are using service robots to provide contactless services. For many companies, the switch from human employees to service robots to lower the contagion risk during and after the pandemic may be permanent. The market size for hospitality service robots is estimated to reach US$3,083 million by 2030, registering a CAGR of 25.5% from 2021 to 2030. While service robots may effectively reduce interpersonal contacts and health risk, it also eliminates the social interactions desired by customers. A recent survey revealed that more than 60% of Americans feel lonely during the pandemic. People who are traveling can also feel isolated when they are at a hotel far away from home. It is therefore important for the hospitality companies to understand whether and how social robots can remedy deprived social connection not only due to a pandemic but also for a trip away from home in the post-pandemic future. This study complements extant hospitality literature regarding service robots by examining how service robots can forge social connections with customers. The service robots we are concerned with are those that can interact and communicate with humans; we broadly refer to them as social robots. We define a social robot as one that is equipped with interaction capabilities – it can either be one that directly interacts with the consumer or one through which the consumer can interact with other humans. Drawing on the theories of mind perception, we propose that service robots can foster social connectedness and increase the perception of social competence of the robot, but these effects will vary across cultures. By applying theories of mind perception and cultural dimension to the hospitality setting, this study shows that service robots that are equipped with social connection function will receive a more favorable evaluation from the consumers and enhance their intention to visit a hotel. The more favorable reaction to social robots is stronger for collectivists (i.e., Asians) than individualists (i.e., Westerners). To our knowledge, this is among the first studies to investigate the impact of culture on consumer reactions to social robots in the hospitality and tourism context. Moreover, this research extends the literature by examining whether people imbue non-human entities (i.e., telepresence social robots) with social competence. Because social robots that foster social connection with humans are still rare in hospitality and tourism, this aspect is an underexplored research area. Our study is the first to propose that, just like their human counterparts that possess relevant social skills, social robots’ interaction capabilities (e.g., telepresence robots) are used to infer social competence. More studies will be conducted to examine consumer reactions to humanoid (vs. non-humanoid) robot in the hospitality settings to generalize our research findings.

Keywords: service robots, COVID-19, social connection, cultures

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1097 Developing Improvements to Multi-Hazard Risk Assessments

Authors: A. Fathianpour, M. B. Jelodar, S. Wilkinson

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This paper outlines the approaches taken to assess multi-hazard assessments. There is currently confusion in assessing multi-hazard impacts, and so this study aims to determine which of the available options are the most useful. The paper uses an international literature search, and analysis of current multi-hazard assessments and a case study to illustrate the effectiveness of the chosen method. Findings from this study will help those wanting to assess multi-hazards to undertake a straightforward approach. The paper is significant as it helps to interpret the various approaches and concludes with the preferred method. Many people in the world live in hazardous environments and are susceptible to disasters. Unfortunately, when a disaster strikes it is often compounded by additional cascading hazards, thus people would confront more than one hazard simultaneously. Hazards include natural hazards (earthquakes, floods, etc.) or cascading human-made hazards (for example, Natural Hazard Triggering Technological disasters (Natech) such as fire, explosion, toxic release). Multi-hazards have a more destructive impact on urban areas than one hazard alone. In addition, climate change is creating links between different disasters such as causing landslide dams and debris flows leading to more destructive incidents. Much of the prevailing literature deals with only one hazard at a time. However, recently sophisticated multi-hazard assessments have started to appear. Given that multi-hazards occur, it is essential to take multi-hazard risk assessment under consideration. This paper aims to review the multi-hazard assessment methods through articles published to date and categorize the strengths and disadvantages of using these methods in risk assessment. Napier City is selected as a case study to demonstrate the necessity of using multi-hazard risk assessments. In order to assess multi-hazard risk assessments, first, the current multi-hazard risk assessment methods were described. Next, the drawbacks of these multi-hazard risk assessments were outlined. Finally, the improvements to current multi-hazard risk assessments to date were summarised. Generally, the main problem of multi-hazard risk assessment is to make a valid assumption of risk from the interactions of different hazards. Currently, risk assessment studies have started to assess multi-hazard situations, but drawbacks such as uncertainty and lack of data show the necessity for more precise risk assessment. It should be noted that ignoring or partial considering multi-hazards in risk assessment will lead to an overestimate or overlook in resilient and recovery action managements.

Keywords: cascading hazards, disaster assessment, mullti-hazards, risk assessment

Procedia PDF Downloads 112
1096 Volunteered Geographic Information Coupled with Wildfire Fire Progression Maps: A Spatial and Temporal Tool for Incident Storytelling

Authors: Cassandra Hansen, Paul Doherty, Chris Ferner, German Whitley, Holly Torpey

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Wildfire is a natural and inevitable occurrence, yet changing climatic conditions have increased the severity, frequency, and risk to human populations in the wildland/urban interface (WUI) of the Western United States. Rapid dissemination of accurate wildfire information is critical to both the Incident Management Team (IMT) and the affected community. With the advent of increasingly sophisticated information systems, GIS can now be used as a web platform for sharing geographic information in new and innovative ways, such as virtual story map applications. Crowdsourced information can be extraordinarily useful when coupled with authoritative information. Information abounds in the form of social media, emergency alerts, radio, and news outlets, yet many of these resources lack a spatial component when first distributed. In this study, we describe how twenty-eight volunteer GIS professionals across nine Geographic Area Coordination Centers (GACC) sourced, curated, and distributed Volunteered Geographic Information (VGI) from authoritative social media accounts focused on disseminating information about wildfires and public safety. The combination of fire progression maps with VGI incident information helps answer three critical questions about an incident, such as: where the first started. How and why the fire behaved in an extreme manner and how we can learn from the fire incident's story to respond and prepare for future fires in this area. By adding a spatial component to that shared information, this team has been able to visualize shared information about wildfire starts in an interactive map that answers three critical questions in a more intuitive way. Additionally, long-term social and technical impacts on communities are examined in relation to situational awareness of the disaster through map layers and agency links, the number of views in a particular region of a disaster, community involvement and sharing of this critical resource. Combined with a GIS platform and disaster VGI applications, this workflow and information become invaluable to communities within the WUI and bring spatial awareness for disaster preparedness, response, mitigation, and recovery. This study highlights progression maps as the ultimate storytelling mechanism through incident case studies and demonstrates the impact of VGI and sophisticated applied cartographic methodology make this an indispensable resource for authoritative information sharing.

Keywords: storytelling, wildfire progression maps, volunteered geographic information, spatial and temporal

Procedia PDF Downloads 176
1095 Politics in Academia: How the Diffusion of Innovation Relates to Professional Capital

Authors: Autumn Rooms Cypres, Barbara Driver

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The purpose of this study is to extend discussions about innovations and career politics. Research questions that grounded this effort were: How does an academic learn the unspoken rules of the academy? What happens politically to an academic’s career when their research speaks against the grain of society? Do professors perceive signals that it is time to move on to another institution or even to another career? Epistemology and Methods: This qualitative investigation was focused on examining perceptions of academics. Therefore an open-ended field study, based on Grounded Theory, was used. This naturalistic paradigm (Lincoln & Guba,1985) was selected because it tends to understand information in terms of whole, of patterns, and in relations to the context of the environment. The technique for gathering data was the process of semi-structured, in-depth interviewing. Twenty five academics across the United States were interviewed relative to their career trajectories and the politics and opportunities they have encountered in relation to their research efforts. Findings: The analysis of interviews revealed four themes: Academics are beholden to 2 specific networks of power that influence their sense of job security; the local network based on their employing university and the national network of scholars who share the same field of research. The fights over what counts as research can and does drift from the intellectual to the political, and personal. Academic were able to identify specific instances of shunning and or punishment from their colleagues related directly to the dissemination of research that spoke against the grain of the local or national networks. Academics identified specific signals from both of these networks indicating that their career was flourishing or withering. Implications: This research examined insights from those who persevered when the fights over what and who counts drifted from the intellectual to the political, and the personal. Considerations of why such drifts happen were offered in the form of a socio-political construct called Fit, which included thoughts on hegemony, discourse, and identity. This effort reveals the importance of understanding what professional capital is relative to job security. It also reveals that fear is an enmeshed and often unspoken part of the culture of Academia. Further research to triangulate these findings would be helpful within international contexts.

Keywords: politics, academia, job security, context

Procedia PDF Downloads 321
1094 Implementing Critical Friends Groups in Schools

Authors: S. Odabasi Cimer, A. Cimer

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Recently, the poor quality of education, low achieving students, low international exam performances and little or no effect of the education reforms on the teaching in the classrooms are the main problems of education discussed in Turkey. Research showed that the quality of an education system can not exceed the quality of its teachers and teaching. Therefore, in-service training (INSET) courses are important to improve teacher quality, thereby, the quality of education. However, according to the research conducted on the evaluation of the INSET courses in Turkey, they are not effective in improving the quality of teaching in the classroom. The main reason for this result is because INSET courses are conducted and delivered in limited time and presented theoretically, which does not meet the needs of teachers and as a result, the knowledge and skills taught are not used in the classrooms. Recently, developed countries have been using Critical Friends Groups (CFGs) successfully for the purpose of school-based training of teachers. CFGs are the learning groups which contain 6-10 teachers aimed at fostering their capacities to undertake instructional and personal improvement and schoolwide reform. CFGs have been recognized as a critical feature in school reform, improving teaching practice and improving student achievement. In addition, in the USA, teachers have named CFGs one of the most powerful professional development activities in which they have ever participated. Whereas, in Turkey, the concept is new. This study aimed to investigate the implications of application, evaluation, and promotion of CFGs which has the potential to contribute to teacher development and student learning in schools in Turkey. For this purpose, the study employed a qualitative approach and case study methodology to implement the model in high schools. The research was conducted in two schools and 13 teachers working in these schools participated. The study lasted two years and the data were collected through various data collection tools including interviews, meeting transcripts, questionnaires, portfolios, and diaries. The results of the study showed that CFGs contributed professional development of teachers and their students’ learning. It also contributed to a culture of collaborative work in schools. A number of barriers and challenges which prevent effective implementation were also determined.

Keywords: critical friends group, education reform, science learning, teacher education

Procedia PDF Downloads 127
1093 Polyvinyl Alcohol Incorporated with Hibiscus Extract Microcapsules as Combined Active and Intelligent Composite Film for Meat Preservation: Antimicrobial, Antioxidant, and Physicochemical Investigations

Authors: Ahmed F. Ghanem, Marwa I. Wahba, Asmaa N. El-Dein, Mohamed A. EL-Raey, Ghada E. A. Awad

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Numerous attempts are being performed in order to formulate suitable packaging materials for the meat products. However, to the best of our knowledge, the incorporation of the free hibiscus extract or its microcapsules in the pure polyvinyl alcohol (PVA) matrix as packaging materials for the meats is seldom reported. Therefore, this study aims at the protection of the aqueous crude extract of the hibiscus flowers utilizing the spry drying encapsulation technique. Results of the Fourier transform infrared (FTIR), the scanning electron microscope (SEM), and the particle size analyzer confirmed the successful formation of the assembled capsules via strong interactions, the spherical rough microparticles, and the particle size of ~ 235 nm, respectively. Also, the obtained microcapsules enjoy higher thermal stability than the free extract. Then, the obtained spray-dried particles were incorporated into the casting solution of the pure PVA film with a concentration of 10 wt. %. The segregated free-standing composite films were investigated, compared to the neat matrix, with several characterization techniques such as FTIR, SEM, thermal gravimetric analysis (TGA), mechanical tester, contact angle, water vapor permeability, and oxygen transmission. The results demonstrated variations in the physicochemical properties of the PVA film after the inclusion of the free and the extract microcapsules. Moreover, biological studies emphasized the biocidal potential of the hybrid films against the microorganisms contaminating the meat. Specifically, the microcapsules imparted not only antimicrobial but also antioxidant activities to the PVA matrix. Application of the prepared films on the real meat samples displayed a low bacterial growth with a slight increase in the pH over the storage time which continued up to 10 days at 4 oC, as further evidence to the meat safety. Moreover, the colors of the films did not significantly changed except after 21 days indicating the spoilage of the meat samples. No doubt, the dual-functional of the prepared composite films pave the way towards combined active and smart food packaging applications. This would play a vital role in the food hygiene, including also the quality control and the assurance.

Keywords: PVA, hibiscus, extraction, encapsulation, active packaging, smart and intelligent packaging, meat spoilage

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1092 Translation and Validation of the Pain Resilience Scale in a French Population Suffering from Chronic Pain

Authors: Angeliki Gkiouzeli, Christine Rotonda, Elise Eby, Claire Touchet, Marie-Jo Brennstuhl, Cyril Tarquinio

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Resilience is a psychological concept of possible relevance to the development and maintenance of chronic pain (CP). It refers to the ability of individuals to maintain reasonably healthy levels of physical and psychological functioning when exposed to an isolated and potentially highly disruptive event. Extensive research in recent years has supported the importance of this concept in the CP literature. Increased levels of resilience were associated with lower levels of perceived pain intensity and better mental health outcomes in adults with persistent pain. The ongoing project seeks to include the concept of pain-specific resilience in the French literature in order to provide more appropriate measures for assessing and understanding the complexities of CP in the near future. To the best of our knowledge, there is currently no validated version of the pain-specific resilience measure, the Pain Resilience scale (PRS), for French-speaking populations. Therefore, the present work aims to address this gap, firstly by performing a linguistic and cultural translation of the scale into French and secondly by studying the internal validity and reliability of the PRS for French CP populations. The forward-translation-back translation methodology was used to achieve as perfect a cultural and linguistic translation as possible according to the recommendations of the COSMIN (Consensus-based Standards for the selection of health Measurement Instruments) group, and an online survey is currently conducted among a representative sample of the French population suffering from CP. To date, the survey has involved one hundred respondents, with a total target of around three hundred participants at its completion. We further seek to study the metric properties of the French version of the PRS, ''L’Echelle de Résilience à la Douleur spécifique pour les Douleurs Chroniques'' (ERD-DC), in French patients suffering from CP, assessing the level of pain resilience in the context of CP. Finally, we will explore the relationship between the level of pain resilience in the context of CP and other variables of interest commonly assessed in pain research and treatment (i.e., general resilience, self-efficacy, pain catastrophising, and quality of life). This study will provide an overview of the methodology used to address our research objectives. We will also present for the first time the main findings and further discuss the validity of the scale in the field of CP research and pain management. We hope that this tool will provide a better understanding of how CP-specific resilience processes can influence the development and maintenance of this disease. This could ultimately result in better treatment strategies specifically tailored to individual needs, thus leading to reduced healthcare costs and improved patient well-being.

Keywords: chronic pain, pain measure, pain resilience, questionnaire adaptation

Procedia PDF Downloads 90
1091 Mechanical Behavior of Sandwiches with Various Glass Fiber/Epoxy Skins under Bending Load

Authors: Emre Kara, Metehan Demir, Şura Karakuzu, Kadir Koç, Ahmet F. Geylan, Halil Aykul

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While the polymeric foam cored sandwiches have been realized for many years, recently there is a growing and outstanding interest on the use of sandwiches consisting of aluminum foam core because of their some of the distinct mechanical properties such as high bending stiffness, high load carrying and energy absorption capacities. These properties make them very useful in the transportation industry (automotive, aerospace, shipbuilding industry), where the "lightweight design" philosophy and the safety of vehicles are very important aspects. Therefore, in this study, the sandwich panels with aluminum alloy foam core and various types and thicknesses of glass fiber reinforced polymer (GFRP) skins produced via Vacuum Assisted Resin Transfer Molding (VARTM) technique were obtained by using a commercial toughened epoxy based adhesive with two components. The aim of this contribution was the analysis of the bending response of sandwiches with various glass fiber reinforced polymer skins. The three point bending tests were performed on sandwich panels at different values of support span distance using a universal static testing machine in order to clarify the effects of the type and thickness of the GFRP skins in terms of peak load, energy efficiency and absorbed energy values. The GFRP skins were easily bonded to the aluminum alloy foam core under press machine with a very low pressure. The main results of the bending tests are: force-displacement curves, peak force values, absorbed energy, collapse mechanisms and the influence of the support span length and GFRP skins. The obtained results of the experimental investigation presented that the sandwich with the skin made of thicker S-Glass fabric failed at the highest load and absorbed the highest amount of energy compared to the other sandwich specimens. The increment of the support span distance made the decrease of the peak force and absorbed energy values for each type of panels. The common collapse mechanism of the panels was obtained as core shear failure which was not affected by the skin materials and the support span distance.

Keywords: aluminum foam, collapse mechanisms, light-weight structures, transport application

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1090 Control of Asthma in Children with Asthma during the Containment Period following the Covid-19 Pandemic

Authors: Meryam Labyad, Karima Fakiri, Widad Lahmini, Ghizlane Draiss, Mohamed Bouskraoui, Nadia Ouzennou

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Background: Asthma is the most common chronic disease in children, affecting nearly 235 million people worldwide (OMS). In Morocco, asthma is much more common in children than in adults; the prevalence rate in children between 13 and 14 years of age is 20%.1 This pathology is marked by high morbidity, a significant impact on the quality of life and development of children 2 This requires a rigorous management strategy in order to achieve clinical control and reduce any risk to the patient 3 A search for aggravating factors is mandatory if a child has difficulty maintaining good asthma control. The objective of the present study is to describe asthma control during this confinement period in children aged 4 to 11 years followed by a pneumo-paediatric consultation. For children whose asthma is not controlled, a search for associations with promoting factors and adherence to treatment is also among the objectives of the study. Knowing the level of asthma control and influencing factors is a therapeutic priority in order to reduce hospitalizations and emergency care use. Objective: To assess asthma control and determine the factors influencing asthma levels in children with asthma during confinement following the COVID 19 pandemic. Method: Prospective cross-sectional study by questionnaire and structured interview among 66 asthmatic children followed in pediatric pneumology consultation at the CHU MED VI of Marrakech from 13/06/2020 to 13/07/2020, asthma control was assessed by the Childhood Asthma Control Test (C-ACT). Results: 66 children and their parents were included (mean age is 7.5 years), asthma was associated with allergic rhinitis (13.5% of cases), conjunctivitis (9% of cases), eczema (12% of cases), occurrence of infection (10.5% of cases). The period of confinement was marked by a decrease in the number of asthma attacks translated by a decrease in the number of emergency room visits (7.5%) of these asthmatic children, control was well controlled in 71% of the children, this control was significantly associated with good adherence to treatment (p<0.001), no infection (p<0.001) and no conjunctivitis (p=002) or rhinitis (p<0.001). This improvement in asthma control during confinement can be explained by the measures taken in the Kingdom to prevent the spread of COVID 19 (school closures, reduction in industrial activity, fewer means of transport, etc.), leading to a decrease in children's exposure to triggers, which justifies the decrease in the number of children having had an infection, allergic rhinitis or conjunctivitis during this period. In addition, the close monitoring of parents resulted in better therapeutic adherence (42.4% were fully observant). Confinement was positively perceived by 68% of the parents; this perception is significantly associated with the level of asthma control (p<0.001). Conclusion: Maintaining good control can be achieved through improved therapeutic adherence and avoidance of triggers, both of which were achieved during the containment period following the VIDOC pandemic 19.

Keywords: Asthma, control , COVID-19 , children

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1089 Quality of Education in Dilla Zone

Authors: Gezahegn Bekele Welldgiyorgise

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It is obvious that the economics, politics and social conditions of a country are determined by the quality and standard of its education. Indeed, education plays a vital role in changing the consciousness and awareness of society and transforming it on a large scale. Moreover, education contributes a lot to the advancement of science and technology, information and communication, and above all, it speeds up its progress in no time if it focuses mainly on the qualitative approach to education. Education brings about universal change and transformation and lightens mankind in all dimensions. It creates an educated, enlightened and brightened generation in society. The generation will be sharped, sharpened and well-oriented if it gets modern, sophisticated and standardized education in its field of study. The main goal of education is to produce well-qualified, well-trained and disciplined young offers in a given community. If the youth is well trained and well-mannered, he will certainly be enlightened, problem solvers and solution seekers, researchers, and innovators. In this respect, we have to provide the youth with modern education, a teaching-learning process led by active learning and a participatory approach with a new curriculum preparation for the age of children supported by modern facilities (ICT).In addition to that, the curriculum should have to give attention to mathematics and science lessons that include international experience in a comfortable school and classrooms. Therefore, the generation that will be created through such kinds of the guided education system will make the students active participants, self-confident, researchers and problem solvers, besides that result in changed life standards and a developed country. Similarly, our country, Ethiopia, has aimed to get such change in youth (generation) through modern education, designing a new educational policy and curriculum which was implemented for many years, although the goal of education has not reached the required level. To get the main idea of the article, I should have answered the question of why our country's educational goal had not reached the desired level because it is necessary to lay the foundation for research in finding out problems seen through students learning performance, the first task is selecting primary-school as a sample. Therefore, we selected “Dilla primary school (5-8)” which is a workplace for a teacher and gives me a chance to recognize students’ learning performance to recognize their learning grades (internal and external) and measure performance (achievement) of students easily’.

Keywords: curriculum, performance, innovation, learning

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1088 Standardization of Solar Water Pumping System for Remote Areas in Indonesia

Authors: Danar Agus Susanto, Hermawan Febriansyah, Meilinda Ayundyahrini

Abstract:

The availability of spring water to meet people demand is often a problem, especially in tropical areas with very limited surface water sources, or very deep underground water. Although the technology and equipment of pumping system are available and easy to obtain, but in remote areas, the availability of pumping system is difficult, due to the unavailability of fuel or the lack of electricity. Solar Water Pumping System (SWPS) became one of the alternatives that can overcome these obstacles. In the tropical country, sunlight can be obtained throughout the year, even in remote areas. SWPS were already widely built in Indonesia, but many encounter problems during operations, such as decreased of efficiency; pump damaged, damaged of controllers or inverters, and inappropriate photovoltaic performance. In 2011, International Electrotechnical Commission (IEC) issued the IEC standard 62253:2011 titled Photovoltaic pumping systems - Design qualification and performance measurements. This standard establishes design qualifications and performance measurements related to the product of a solar water pumping system. National Standardization Agency of Indonesia (BSN) as the national standardization body in Indonesia, has not set the standard related to solar water pumping system. This research to study operational procedures of SWPS by adopting of IEC Standard 62253:2011 to be Indonesia Standard (SNI). This research used literature study and field observation for installed SWPS in Indonesia. Based on the results of research on SWPS already installed in Indonesia, IEC 62253: 2011 standard can improve efficiency and reduce operational failure of SWPS. SWPS installed in Indonesia still has GAP of 51% against parameters in IEC standard 62253: 2011. The biggest factor not being met is related to operating and maintenance handbooks for personnel that included operation and repair procedures. This may result in operator ignorance in installing, operating and maintaining the system. The Photovoltaic (PV) was also the most non-compliance factor of 71%, although there are 22 Indonesia Standard (SNI) for PV (modules, installation, testing, and construction). These research samples (installers, manufacturers/distributors, and experts) agreed on the parameter in the IEC standard 62253: 2011 able to improve the quality of SWPS in Indonesia. Recommendations of this study, that is required the adoption of IEC standard 62253:2011 into SNI to support the development of SWPS for remote areas in Indonesia.

Keywords: efficiency, inappropriate installation, remote areas, solar water pumping system, standard

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1087 The Feminism of Data Privacy and Protection in Africa

Authors: Olayinka Adeniyi, Melissa Omino

Abstract:

The field of data privacy and data protection in Africa is still an evolving area, with many African countries yet to enact legislation on the subject. While African Governments are bringing their legislation to speed in this field, how patriarchy pervades every sector of African thought and manifests in society needs to be considered. Moreover, the laws enacted ought to be inclusive, especially towards women. This, in a nutshell, is the essence of data feminism. Data feminism is a new way of thinking about data science and data ethics that is informed by the ideas of intersectional feminism. Feminising data privacy and protection will involve thinking women, considering women in the issues of data privacy and protection, particularly in legislation, as is the case in this paper. The line of thought of women inclusion is not uncommon when even international and regional human rights specific for women only came long after the general human rights. The consideration is that these should have been inserted or rather included in the original general instruments in the first instance. Since legislation on data privacy is coming in this century, having seen the rights and shortcomings of earlier instruments, then the cue should be taken to ensure inclusive wholistic legislation for data privacy and protection in the first instance. Data feminism is arguably an area that has been scantily researched, albeit a needful one. With the spate of increase in the violence against women spiraling in the cyber world, compounding the issue of COVID-19 and the needful response of governments, and the effect of these on women and their rights, fast forward, the research on the feminism of data privacy and protection in Africa becomes inevitable. This paper seeks to answer the questions, what is data feminism in the African context, why is it important in the issue of data privacy and protection legislation; what are the laws, if any, existing on data privacy and protection in Africa, are they women inclusive, if not, why; what are the measures put in place for the privacy and protection of women in Africa, and how can this be made possible. The paper aims to investigate the issue of data privacy and protection in Africa, the legal framework, and the protection or provision that it has for women if any. It further aims to research the importance and necessity of feminizing data privacy and protection, the effect of lack of it, the challenges or bottlenecks in attaining this feat and the possibilities of accessing data privacy and protection for African women. The paper also researches the emerging practices of data privacy and protection of women in other jurisprudences. It approaches the research through the methodology of review of papers, analysis of laws, and reports. It seeks to contribute to the existing literature in the field and is explorative in its suggestion. It suggests a draft of some clauses to make any data privacy and protection legislation women inclusive. It would be useful for policymaking, academic, and public enlightenment.

Keywords: feminism, women, law, data, Africa

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1086 The Effect of Artificial Intelligence on Banking Development and Progress

Authors: Mina Malak Hanna Saad

Abstract:

New strategies for supplying banking services to the customer have been brought, which include online banking. Banks have begun to recall electronic banking (e-banking) as a manner to replace some conventional department features by means of the usage of the internet as a brand-new distribution channel. A few clients have at least one account at multiple banks and get admission to those debts through online banking. To test their present-day internet worth, customers need to log into each of their debts, get particular statistics, and paint closer to consolidation. Not only is it time-ingesting; however, but it is also a repeatable activity with a certain frequency. To solve this problem, the idea of account aggregation was delivered as a solution. Account consolidation in e-banking as a form of digital banking appears to build stronger dating with clients. An account linking service is usually known as a service that permits customers to manipulate their bank accounts held at exceptional institutions through a common online banking platform that places a high priority on safety and statistics protection. The object affords an outline of the account aggregation approach in e-banking as a distinct carrier in the area of e-banking. The advanced facts generation is becoming a vital thing in the improvement of financial services enterprise, specifically the banking enterprise. It has brought different ways of delivering banking to the purchaser, which includes net Banking. Banks began to study electronic banking (e-banking) as a means to update some of their traditional branch functions and the use of the net as a distribution channel. Some clients have at least multiple accounts throughout banks and get the right of entry to that money owed through the usage of e-banking offerings. To examine the contemporary internet's well-worth position, customers have to log in to each of their money owed, get the information and work on consolidation. This no longer takes sufficient time; however, it is a repetitive interest at a specified frequency. To address this point, an account aggregation idea is brought as an answer. E-banking account aggregation, as one of the e-banking kinds, appeared to construct a more potent dating with clients. Account Aggregation carrier usually refers to a service that allows clients to control their bank bills maintained in one-of-a-kind institutions via a common Internet banking working platform, with an excessive subject to protection and privateness. This paper offers an overview of an e-banking account aggregation technique as a new provider in the e-banking field.

Keywords: compatibility, complexity, mobile banking, observation, risk banking technology, Internet banks, modernization of banks, banks, account aggregation, security, enterprise developmente-banking, enterprise development

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