Search results for: total ownership cost
Commenced in January 2007
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Edition: International
Paper Count: 14189

Search results for: total ownership cost

3959 Hydrological Response of the Glacierised Catchment: Himalayan Perspective

Authors: Sonu Khanal, Mandira Shrestha

Abstract:

Snow and Glaciers are the largest dependable reserved sources of water for the river system originating from the Himalayas so an accurate estimate of the volume of water contained in the snowpack and the rate of release of water from snow and glaciers are, therefore, needed for efficient management of the water resources. This research assess the fusion of energy exchanges between the snowpack, air above and soil below according to mass and energy balance which makes it apposite than the models using simple temperature index for the snow and glacier melt computation. UEBGrid a Distributed energy based model is used to calculate the melt which is then routed by Geo-SFM. The model robustness is maintained by incorporating the albedo generated from the Landsat-7 ETM images on a seasonal basis for the year 2002-2003 and substrate map derived from TM. The Substrate file includes predominantly the 4 major thematic layers viz Snow, clean ice, Glaciers and Barren land. This approach makes use of CPC RFE-2 and MERRA gridded data sets as the source of precipitation and climatic variables. The subsequent model run for the year between 2002-2008 shows a total annual melt of 17.15 meter is generate from the Marshyangdi Basin of which 71% is contributed by the glaciers , 18% by the rain and rest being from the snow melt. The albedo file is decisive in governing the melt dynamics as 30% increase in the generated surface albedo results in the 10% decrease in the simulated discharge. The melt routed with the land cover and soil variables using Geo-SFM shows Nash-Sutcliffe Efficiency of 0.60 with observed discharge for the study period.

Keywords: Glacier, Glacier melt, Snowmelt, Energy balance

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3958 Numerical Analysis for Soil Compaction and Plastic Points Extension in Pile Drivability

Authors: Omid Tavasoli, Mahmoud Ghazavi

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A numerical analysis of drivability of piles in different geometry is presented. In this paper, a three-dimensional finite difference analysis for plastic point extension and soil compaction in the effect of pile driving is analyzed. Four pile configurations such as cylindrical pile, fully tapered pile, T-C pile consists of a top tapered segment and a lower cylindrical segment and C-T pile has a top cylindrical part followed by a tapered part are investigated. All piles which driven up to a total penetration depth of 16 m have the same length with equivalent surface area and approximately with identical material volumes. An idealization for pile-soil system in pile driving is considered for this approach. A linear elastic material is assumed to model the vertical pile behaviors and the soil obeys the elasto-plastic constitutive low and its failure is controlled by the Mohr-Coulomb failure criterion. A slip which occurred at the pile-soil contact surfaces along the shaft and the toe in pile driving procedures is simulated with interface elements. All initial and boundary conditions are the same in all analyses. Quiet boundaries are used to prevent wave reflection in the lateral and vertical directions for the soil. The results obtained from numerical analyses were compared with available other numerical data and laboratory tests, indicating a satisfactory agreement. It will be shown that with increasing the angle of taper, the permanent piles toe settlement increase and therefore, the extension of plastic points increase. These are interesting phenomena in pile driving and are on the safe side for driven piles.

Keywords: pile driving, finite difference method, non-uniform piles, pile geometry, pile set, plastic points, soil compaction

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3957 Performance Evaluation of Production Schedules Based on Process Mining

Authors: Kwan Hee Han

Abstract:

External environment of enterprise is rapidly changing majorly by global competition, cost reduction pressures, and new technology. In these situations, production scheduling function plays a critical role to meet customer requirements and to attain the goal of operational efficiency. It deals with short-term decision making in the production process of the whole supply chain. The major task of production scheduling is to seek a balance between customer orders and limited resources. In manufacturing companies, this task is so difficult because it should efficiently utilize resource capacity under the careful consideration of many interacting constraints. At present, many computerized software solutions have been utilized in many enterprises to generate a realistic production schedule to overcome the complexity of schedule generation. However, most production scheduling systems do not provide sufficient information about the validity of the generated schedule except limited statistics. Process mining only recently emerged as a sub-discipline of both data mining and business process management. Process mining techniques enable the useful analysis of a wide variety of processes such as process discovery, conformance checking, and bottleneck analysis. In this study, the performance of generated production schedule is evaluated by mining event log data of production scheduling software system by using the process mining techniques since every software system generates event logs for the further use such as security investigation, auditing and error bugging. An application of process mining approach is proposed for the validation of the goodness of production schedule generated by scheduling software systems in this study. By using process mining techniques, major evaluation criteria such as utilization of workstation, existence of bottleneck workstations, critical process route patterns, and work load balance of each machine over time are measured, and finally, the goodness of production schedule is evaluated. By using the proposed process mining approach for evaluating the performance of generated production schedule, the quality of production schedule of manufacturing enterprises can be improved.

Keywords: data mining, event log, process mining, production scheduling

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3956 Road Accident Blackspot Analysis: Development of Decision Criteria for Accident Blackspot Safety Strategies

Authors: Tania Viju, Bimal P., Naseer M. A.

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This study aims to develop a conceptual framework for the decision support system (DSS), that helps the decision-makers to dynamically choose appropriate safety measures for each identified accident blackspot. An accident blackspot is a segment of road where the frequency of accident occurrence is disproportionately greater than other sections on roadways. According to a report by the World Bank, India accounts for the highest, that is, eleven percent of the global death in road accidents with just one percent of the world’s vehicles. Hence in 2015, the Ministry of Road Transport and Highways of India gave prime importance to the rectification of accident blackspots. To enhance road traffic safety and reduce the traffic accident rate, effectively identifying and rectifying accident blackspots is of great importance. This study helps to understand and evaluate the existing methods in accident blackspot identification and prediction that are used around the world and their application in Indian roadways. The decision support system, with the help of IoT, ICT and smart systems, acts as a management and planning tool for the government for employing efficient and cost-effective rectification strategies. In order to develop a decision criterion, several factors in terms of quantitative as well as qualitative data that influence the safety conditions of the road are analyzed. Factors include past accident severity data, occurrence time, light, weather and road conditions, visibility, driver conditions, junction type, land use, road markings and signs, road geometry, etc. The framework conceptualizes decision-making by classifying blackspot stretches based on factors like accident occurrence time, different climatic and road conditions and suggesting mitigation measures based on these identified factors. The decision support system will help the public administration dynamically manage and plan the necessary safety interventions required to enhance the safety of the road network.

Keywords: decision support system, dynamic management, road accident blackspots, road safety

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3955 Clinical, Demographic and Molecular Characterization of Dengue, Chikungunya and Zika Viruses Causing Hemorrhagic Fever in North India

Authors: Suruchi Shukla, Shantanu Prakash, Amita Jain

Abstract:

Introduction: Arboviral diseases are one of the most common causes of viral hemorrhagic fever (VHF). Of which, Dengue and Chikungunya pose a significant health problem in India. Arbovirus has a tendency to cross the territories and emerge in the new region. Considering the above issues, in the current study active surveillance was conducted among viral hemorrhagic fever (VHF) cases reported from Uttar Pradesh (UP), India. We studied the arboviral etiology of VHF; mainly Dengue, Chikungunya, and ZIKA. Methods: Clinical samples of 465 suspected VHF cases referred to tertiary care referral center of UP, India were enrolled in the study during a period from 15th May 2016 to 9th March 2018. Serum specimens were collected and analyzed for the presence of Dengue, Chikungunya, and ZIKA either by serology and/or by molecular assays. Results: Of all tested, 165 (35.4%) cases were positive for either Dengue or Chikungunya. Dengue (21.2%) was found to be the most prevalent, followed by Chikungunya, (6.6%). None of the cases tested positive for ZIKA virus. Serum samples of 35 (7.5%) cases were positive for both Dengue and Chikungunya. DEN-2 serotype was the most predominant serotype. Phylogenetic and sequence analysis of DEN-2 strains showed 100% clustering with the Cosmopolitan genotype strain. Bleeding from several sites, jaundice, abdominal pain, arthralgia, haemoconcentration, and thrombocytopenia were significantly higher in dengue hemorrhagic cases. However, the rash was significantly more common in Chikungunya patients. Most of the Dengue and Chikungunya positive cases (Age group 6-40 years) were seen in post monsoon season (September to November). Conclusion: Only one-third of total VHF cases are positive for either Dengue/Chikungunya or both. This necessitates the screening of other etiologies capable of causing hemorrhagic manifestations.

Keywords: viral hemorrhagic fever, dengue, chikungunya, zika, India

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3954 Seroprevalence of Bovine Brucellosis and its Public Health Significance in Selected Sites of Central High Land of Ethiopia

Authors: Temesgen Kassa Getahun, Gezahegn Mamo, Beksisa Urge

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A cross-sectional study was conducted from December 2019 to May 2020 with the aim of determining the seroprevalence of brucellosis in dairy cows and their owners in the central highland of Oromia, Ethiopia. A total of 352 blood samples from dairy cattle, 149 from animal owners, and 17 from farm workers were collected and initially screened using the Rose Bengal Plate test and confirmed by the Complement Fixation test. Overall seroprevalence was 0.6% (95% CI: 0.0016–0.0209) in bovines and 1.2% (95% CI: 0.0032–0.0427) in humans. Market-based stock replacement (OR=16.55, p=0.002), breeding by artificial insemination (OR=7.58, p=0.05), and parturition pen (OR = 11.511, p=0.027) were found to be significantly associated with the seropositivity for Brucella infection in dairy cattle. Human housing (OR=1.8, p=0.002), contact with an aborted fetus (OR=21.19, p=0.017), drinking raw milk from non-aborted (OR=24.99, p=0.012), aborted (OR=5.72, p=0.019) and retained fetal membrane (OR=4.22, p=0.029) cows had a significant influence on human brucellosis. A structured interview question was administered to 284 respondents. Accordingly, most respondents had no knowledge of brucellosis (93.3%), and in contrast, 90% of them consumed raw milk. In conclusion, the present seroprevalence study revealed that brucellosis was low among dairy cattle and exposed individuals in the study areas. However, since there were no control strategies implemented in the study areas, there is a potential risk of transmission of brucellosis in dairy cattle and the exposed human population in the study areas. Implementation of a test and slaughter strategy with compensation to farmers is recommended, while in the case of human brucellosis, continuous social training and implementing one health approach framework must be applied.

Keywords: abortion, bovine brucellosis, human brucellosis, risk factors, seroprevalence

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3953 Traditional Correspondence as Reminiscence Therapy for the Elderly

Authors: Paulina Pergoł, Paulina Pergoł, Tomasz Kryczka

Abstract:

Aging of societies is a phenomenon that is visible all over the world. The above has social, economic, and medical consequences. Many methods of pro-health stimulation of the elderly, improving cognitive functions and quality of life, are described in the world literature. The most frequently used method of activating the elderly is physical activity, in which, in addition to standard exercise programs, activities such as dance, tai chi, and yoga are often introduced. The introduction of physical activity may be limited due to the disability that often accompanies people aged 65+. Other activating methods mentioned in the literature are therapies with the participation of animals - animal therapy or plant therapy - hortitherapy, as well as music therapy, which is increasingly popular. All of the above-mentioned therapeutic methods require the involvement of a person who would conduct the so-called occupational therapist, which can be a financial barrier for many nursing homes. Researchers all over the world are trying to find solutions that can be applied in any care institution, even in those where financial support for running such centers is small. One of the forms of therapy that is recommended in the group of elderly people and which does not require large financial outlays is the so-called reminiscence therapy based on recalling personal experiences and experiences. Thanks to reminiscence therapy, seniors can return to happy moments in their lives. Research shows that reminiscence therapy increases self-esteem and reduces symptoms of depression. The method of activating older people with the use of correspondence can be an effective and low-cost form of therapy, as shown by the pilot study conducted in 2019 as part of the Queen Silvia Nursing Award competition, consisting in a systematic exchange of correspondence between volunteers and residents of the Nursing Home. This study was conducted with the participation of a small group of participants, therefore, in order to identify and prove the beneficial effect of this form of activation, it should be carried out on a larger group of respondents using standardized scales assessing various psychological parameters.

Keywords: nursing, elderly care, psychiatry, psychology

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3952 The Counselling Practice of School Social Workers in Swedish Elementary Schools - A Focus Group Study

Authors: Kjellgren Maria, Lilliehorn Sara, Markström Urban

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This article describes the counselling practice of school social workers (SSWs) with individual children. SSWs work in the school system’s pupil health team, whose primary task is health promotion and prevention. The work of SSWs is about helping children and adolescents who, for various reasons, suffer from mental ill-health, school absenteeism, or stress that make them unable to achieve their intended goals. SSWs preferably meet these children in individual counselling sessions. The aim of this article is to describe and analyse SSWs’ experience of counselling with children and to examine the characteristics of counselling practice. The data collection was conducted through four semi-structured focus group interviews with a total of 22 SSWs in four different regions in Sweden. SSWs provide counselling to children in order to bring about improved feelings or behavioural changes. It can be noted that SSWs put emphasis on both the counselling process and the alliance with the child. The interviews showed a common practice among SSWs regarding the structure of the counselling sessions, with certain steps and approaches being employed. However, the specific interventions differed and were characterised by an eclectic standpoint in which SSWs utilise a broad repertoire of therapeutic schools and techniques. Furthermore, a relational perspective emerged as a most prominent focus for the SSWs by re-emerging throughout the material. We believe that SSWs could benefit from theoretical perspectives on ‘contextual model’ and ‘attachment theory’ as ‘models of the mind’. Being emotionally close to the child and being able to follow their development requires a lot from SSWs, as both professional caregivers and as “safe havens”.

Keywords: school social conselling, school social workers, contextual model, attachment thory

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3951 A Preliminary Analysis of Sustainable Development in the Belgrade Metropolitan Area

Authors: Slavka Zeković, Miodrag Vujošević, Tamara Maričić

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The paper provides a comprehensive analysis of the sustainable development in the Belgrade Metropolitan Region - BMA (level NUTS 2) preliminary evaluating the three chosen components: 1) economic growth and developmental changes; 2) competitiveness; and 3) territorial concentration and industrial specialization. First, we identified the main results of development changes and economic growth by applying Shift-share analysis on the metropolitan level. Second, the empirical evaluation of competitiveness in the BMA is based on the analysis of absolute and relative values of eight indicators by Spider method. Paper shows that the consideration of the national share, industrial mix and metropolitan/regional share in total Shift share of the BMA, as well as economic/functional specialization of the BMA indicate very strong process of deindustrialization. Allocative component of the BMA economic growth has positive value, reflecting the above-average sector productivity compared to the national average. Third, the important positive role of metropolitan/regional component in decomposition of the BMA economic growth is highlighted as one of the key results. Finally, comparative analysis of the industrial territorial concentration in the BMA in relation to Serbia is based on location quotient (LQ) or Balassa index as a valid measure. The results indicate absolute and relative differences in decrease of industry territorial concentration as well as inefficiency of utilizing territorial capital in the BMA. Results are important for the increase of regional competitiveness and territorial distribution in this area as well as for improvement of sustainable metropolitan and sector policies, planning and governance on this level.

Keywords: Belgrade Metropolitan Area (BMA), comprehensive analysis / evaluation, economic growth, competitiveness, sustainable development

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3950 The Influence of Training and Competition on Cortisol Levels and Sleep in Elite Female Athletes

Authors: Shannon O’Donnell, Matthew Driller, Gregory Jacobson, Steve Bird

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Stress hormone levels in a competition vs. training setting are yet to be evaluated in elite female athletes. The effect that these levels of stress have on subsequent sleep quality and quantity is also yet to be investigated. The aim of the current study was to evaluate different psychophysiological stress markers in competition and training environments and the subsequent effect on sleep indices in an elite female athlete population. The study involved 10 elite female netball athletes (mean ± SD; age = 23 ± 6 yrs) providing multiple salivary hormone measures and having their sleep monitored on two occasions; a match day, and a training day. The training and match were performed at the same time of day and were matched for intensity and duration. Saliva samples were collected immediately pre (5:00 pm) and post session (7:15 pm), and at 10:00 pm and were analysed for cortisol concentrations. Sleep monitoring was performed using wrist actigraphy to assess total sleep time (TST), sleep efficiency (SE%) and sleep latency (SL). Cortisol levels were significantly higher (p < 0.01) immediately post the match vs post training (mean ± SD; 0.925 ± 0.341 μg/dL and 0.239 ± 0.284 μg/dL, respectively) and at 10:00pm (0.143 ± 0.085 μg/dL and 0.072 ± 0.064 μg/dL, respectively, p < 0.01). The difference between trials was associated with a very large effect (ES: 2.23) immediately post (7:15 pm) and a large effect (ES: 1.02) at 10:00 pm. There was a significant reduction in TST (mean ± SD; -117.9 ± 111.9 minutes, p < 0.01, ES: -1.89) and SE% (-7.7 ± 8.5%, p < 0.02, ES: -0.79) on the night following the netball match compared to the training session. Although not significant (p > 0.05), there was an increase in SL following the netball match v the training session (67.0 ± 51.9 minutes and 38.5 ± 29.3 minutes, respectively), which was associated with a moderate effect (ES: 0.80). The current study reports that cortisol levels are significantly higher and subsequent sleep quantity and quality is significantly reduced in elite female athletes following a match compared to a training session.

Keywords: cortisol, netball, performance, recovery

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3949 Leading with Skill Development: A Collaborative and Community Based Approach to Ending Open Defecation in Rural India via Computerized Technical Vocational Education and Training

Authors: Srividya Sheshadri, Christopher Coley, Roa. R. Bhavani

Abstract:

India currently accounts for 60 percent of the open defecation that is practiced globally. While research in the domain of sanitation development makes it apparent that girls and women living in rural India are disproportionately affected, interventions to address this dilemma are lacking. An important but relatively unexplored connection with poor sanitation is that women living in rural India are not only the largest marginalized group without access to adequate sanitation facilities, they also represent a majority of India’s unskilled workers. By training women to build their own toilets, through an approach that has demonstrated success in empowering marginalized communities through technical and vocational education and training (TVET), a collaborative dynamic emerges that can engage entire communities in the movement towards total sanitation. Designed and implemented by Amrita University, this technology-enhanced, community-based approach to skill development, known as Amrita computerized Vocational Education and Training (or Amrita cVET), has begun to show promise in addressing the struggle to end open defecation, and raise sanitation awareness, as well as strengthen personal and community development among women living in rural India. While Amrita cVET project, known as Women Empowerment: Sanitation, is currently in implementation in seven states throughout India, this paper will discuss early stages of the intervention in rural villages within the Indian states of: Karnataka and Goa, where previous sanitation efforts have failed to take hold.

Keywords: community based development, empowerment studies, sanitation in India, computerized vocational training

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3948 The Impact of Gold Mining on Disability: Experiences from the Obuasi Municipal Area

Authors: Mavis Yaa Konadu Agyemang

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Despite provisions to uphold and safeguard the rights of persons with disability in Ghana, there is evidence that they still encounter several challenges which limit their full and effective involvement in mainstream society, including the gold mining sector. The study sought to explore how persons with physical disability (PWPDs) experience gold mining in the Obuasi Municipal Area. A qualitative research design was used to discover and understand the experiences of PWPDs regarding mining. The purposive sampling technique was used to select five key informants for the study with the age range of (24-52 years) while snowball sampling aided the selection of 16 persons with various forms of physical disability with the age range of (24-60 years). In-depth interviews were used to gather data. The interviews lasted from forty-five minutes to an hour. In relation to the setting, the interviews of thirteen (13) of the participants with disability were done in their houses, two (2) were done on the phone, and one (1) was done in the office. Whereas the interviews of the five (5) key informants were all done in their offices. Data were analyzed using Creswell’s (2009) concept of thematic analysis. The findings suggest that even though land degradation affected everyone in the area, persons with mobility and visual impairment experienced many difficulties trekking the undulating land for long distances in search of arable land. Also, although mining activities are mostly labour-intensive, PWPDs were not employed even in areas where they could work. Further, the cost of items, in general, was high, affecting PWPDs more due to their economic immobility and paying for other sources of water due to land degradation and water pollution. The study also discovered that the peculiar conditions of PWPDs were not factored into compensation payments, and neither were females with physical disability engaged in compensation negotiations. Also, although some of the infrastructure provided by the gold mining companies in the area was physically accessible to some extent, it was not accessible in terms of information delivery. There is a need to educate the public on the effects of mining on PWPDs, their needs as well as disability issues in general. The Minerals and Mining Act (703) should be amended to include provisions that would consider the peculiar needs of PWPDs in compensation payment.

Keywords: mining, resettlement, compensation, environmental, social, disability

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3947 Effect of Tree Age on Fruit Quality of Different Cultivars of Sweet Orange

Authors: Muhammad Imran, Faheem Khadija, Zahoor Hussain, Raheel Anwar, M. Nawaz Khan, M. Raza Salik

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Amongst citrus species, sweet orange (Citrus sinensis L. Osbeck) occupies a dominant position in the orange producing countries in the world. Sweet orange is widely consumed both as fresh fruit as well as juice and its global demand is attributed due to higher vitamin C and antioxidants. Fruit quality is most important for the external appearance and marketability of sweet orange fruit, especially for fresh consumption. There are so many factors affecting fruit quality, tree age is the most important one, but remains unexplored so far. The present study, we investigated the role of tree age on fruit quality of different cultivars of sweet oranges. The difference between fruit quality of 5-year young and 15-year old trees was discussed in the current study. In case of fruit weight, maximum fruit weight (238g) was recorded in 15-year old sweet orange cv. Sallustiana cultivar while minimum fruit weight (142g) was recorded in 5-year young tree of Succari sweet orange fruit. The results of the fruit diameter showed that the maximum fruit diameter (77.142mm) was recorded in 15-year old Sallustiana orange but the minimum fruit diameter (66.046mm) was observed in 5-year young tree of sweet orange cv. Succari. The minimum value of rind thickness (4.142mm) was noted in 15-year old tree of cv. Red blood. On the other hand maximum value of rind thickness was observed in 5-year young tree of cv. Sallustiana. The data regarding total soluble solids (TSS), acidity (TA), TSS/TA, juice content, rind, flavedo thickness, pH and fruit diameter have also been discussed.

Keywords: age, cultivars, fruit, quality, sweet orange (Citrus Sinensis L. Osbeck)

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3946 Enhancing Healthcare Delivery in Low-Income Markets: An Exploration of Wireless Sensor Network Applications

Authors: Innocent Uzougbo Onwuegbuzie

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Healthcare delivery in low-income markets is fraught with numerous challenges, including limited access to essential medical resources, inadequate healthcare infrastructure, and a significant shortage of trained healthcare professionals. These constraints lead to suboptimal health outcomes and a higher incidence of preventable diseases. This paper explores the application of Wireless Sensor Networks (WSNs) as a transformative solution to enhance healthcare delivery in these underserved regions. WSNs, comprising spatially distributed sensor nodes that collect and transmit health-related data, present opportunities to address critical healthcare needs. Leveraging WSN technology facilitates real-time health monitoring and remote diagnostics, enabling continuous patient observation and early detection of medical issues, especially in areas with limited healthcare facilities and professionals. The implementation of WSNs can enhance the overall efficiency of healthcare systems by enabling timely interventions, reducing the strain on healthcare facilities, and optimizing resource allocation. This paper highlights the potential benefits of WSNs in low-income markets, such as cost-effectiveness, increased accessibility, and data-driven decision-making. However, deploying WSNs involves significant challenges, including technical barriers like limited internet connectivity and power supply, alongside concerns about data privacy and security. Moreover, robust infrastructure and adequate training for local healthcare providers are essential for successful implementation. It further examines future directions for WSNs, emphasizing innovation, scalable solutions, and public-private partnerships. By addressing these challenges and harnessing the potential of WSNs, it is possible to revolutionize healthcare delivery and improve health outcomes in low-income markets.

Keywords: wireless sensor networks (WSNs), healthcare delivery, low-Income markets, remote patient monitoring, health data security

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3945 Palliative Performance Scale Differences between Patients Referred by Specialized Cancer Center and General Hospitals to the Palliative Care Center in Kuwait

Authors: Khalid Al Saleh, Najlaa AlSayed

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Background: Palliative care is changing from just ‘end of life care’ to care delivered earlier in the disease course. Metanalysis showed that Palliative Performance Scale (PPS) is associated with increased length of survival. The Palliative Care Center (PCC) in Kuwait is the only stand-alone center in Eastern Mediterranean Region with a capacity of 92 beds. We compared clinical characteristics between patients referred from the Specialized Cancer Center and general hospitals in Kuwait to PCC. Method: A cross Sectional survey was conducted since the opening of PCC in January 2011 to June 2013. Patients’ data on demographics, type of the cancer, PPS score and referring hospital were collected and analyzed. Results: Total number of the patients was 142. Mean age was 61.05±14.79 years, 66 patients (47.1%) were males and 74 (52.9%) were females. The most common cancers in males were lung (n=18, 27.3%) followed by head and neck cancers (n=8, 12.1%) and brain tumors (n=7, 10.6%) while in females, the most common cancers were breast cancer (n=12, 16.7%) followed by ovarian cancer (n=10, 13.9%) and Cancer Colon (n=8, 11.1%). Patients with PPS score 30% were 27.9% (n=39), 40% in 40.7% (n=57), and 50% in 17.1% (n=24) respectively. Patients referred from the Specialized Cancer Center had significantly higher portion of patients with PPS score > 30% (73.4%, n=94), compared to patients coming from general hospitals (33.3%, n=4), P value= 0.007. Conclusion: There is significant difference in PPS scores between patients referred from the Specialized Cancer Center compared to patients referred from general hospitals. We encourage that all cancer patients should be treated in Specialized Cancer Centers and earlier involvement of Palliative Care Centers to achieve better survival. Training workshops are needed for health care professionals working in general hospitals to raise awareness about earlier referral of patients to palliative care services.

Keywords: palliative care, kuwait, performance scale differences, pps score, specialized hospitals

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3944 Advancing Environmental Remediation Through the Production of Functional Porous Materials from Phosphorite Residue Tailings

Authors: Ali Mohammed Yimer, Ayalew Assen, Youssef Belmabkhout

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Environmental remediation is a pressing global concern, necessitating innovative strategies to address the challenges posed by industrial waste and pollution. This study aims to advance environmental remediation by developing cutting-edge functional porous materials from phosphorite residue tailings. Phosphorite mining activities generate vast amounts of waste, which pose significant environmental risks due to their contaminants. The proposed approach involved transforming these phosphorite residue tailings into valuable porous materials through a series of physico-chemical processes including milling, acid-base leaching, designing or templating as well as formation processes. The key components of the tailings were extracted and processed to produce porous arrays with high surface area and porosity. These materials were engineered to possess specific properties suitable for environmental remediation applications, such as enhanced adsorption capacity and selectivity for target contaminants. The synthesized porous materials were thoroughly characterized using advanced analytical techniques (XRD, SEM-EDX, N2 sorption, TGA, FTIR) to assess their structural, morphological, and chemical properties. The performance of the materials in removing various pollutants, including heavy metals and organic compounds, were evaluated through batch adsorption experiments. Additionally, the potential for material regeneration and reusability was investigated to enhance the sustainability of the proposed remediation approach. The outdoors of this research holds significant promise for addressing the environmental challenges associated with phosphorite residue tailings. By valorizing these waste materials into porous materials with exceptional remediation capabilities, this study contributes to the development of sustainable and cost-effective solutions for environmental cleanup. Furthermore, the utilization of phosphorite residue tailings in this manner offers a potential avenue for the remediation of other contaminated sites, thereby fostering a circular economy approach to waste management.

Keywords: functional porous materials, phosphorite residue tailings, adsorption, environmental remediation, sustainable solutions

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3943 Interfacial Adhesion and Properties Improvement of Polyethylene/Thermoplastic Starch Blend Compatibilized by Stearic Acid-Grafted-Starch

Authors: Nattaporn Khanoonkon, Rangrong Yoksan, Amod A. Ogale

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Polyethylene (PE) is one of the most petroleum-based thermoplastic materials used in many applications including packaging due to its cheap, light-weight, chemically inert and capable to be converted into various shapes and sizes of products. Although PE is a commercially potential material, its non-biodegradability caused environmental problems. At present, bio-based polymers become more interesting owing to its bio-degradability, non-toxicity, and renewability as well as being eco-friendly. Thermoplastic starch (TPS) is a bio-based and biodegradable plastic produced from the plasticization of starch under applying heat and shear force. In many researches, TPS was blended with petroleum-based polymers including PE in order to reduce the cost and the use of those polymers. However, the phase separation between hydrophobic PE and hydrophilic TPS limited the amount of TPS incorporated. The immiscibility of two different polarity polymers can be diminished by adding compatibilizer. PE-based compatibilizers, e.g. polyethylene-grafted-maleic anhydride, polyethylene-co-vinyl alcohol, etc. have been applied for the PE/TPS blend system in order to improve their miscibility. Until now, there is no report about the utilization of starch-based compatibilizer for PE/TPS blend system. The aims of the present research were therefore to synthesize a new starch-based compatibilizer, i.e. stearic acid-grafted starch (SA-g-starch) and to study the effect of SA-g-starch on chemical interaction, morphological properties, tensile properties and water vapor as well as oxygen barrier properties of the PE/TPS blend films. PE/TPS blends without and with incorporating SA-g-starch with a content of 1, 3 and 5 part(s) per hundred parts of starch (phr) were prepared using a twin screw extruder and then blown into films using a film blowing machine. Incorporating 1 phr and 3 phr of SA-g-starch could improve miscibility of the two polymers as confirmed from the reduction of TPS phase size and the good dispersion of TPS phase in PE matrix. In addition, the blend containing SA-g-starch with contents of 1 phr and 3 phr exhibited higher tensile strength and extensibility, as well as lower water vapor and oxygen permeabilities than the naked blend. The above results suggested that SA-g-starch could be potentially applied as a compatibilizer for the PE/TPS blend system.

Keywords: blend, compatibilizer, polyethylene, thermoplastic starch

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3942 The Analysis of Personalized Low-Dose Computed Tomography Protocol Based on Cumulative Effective Radiation Dose and Cumulative Organ Dose for Patients with Breast Cancer with Regular Chest Computed Tomography Follow up

Authors: Okhee Woo

Abstract:

Purpose: The aim of this study is to evaluate 2-year cumulative effective radiation dose and cumulative organ dose on regular follow-up computed tomography (CT) scans in patients with breast cancer and to establish personalized low-dose CT protocol. Methods and Materials: A retrospective study was performed on the patients with breast cancer who were diagnosed and managed consistently on the basis of routine breast cancer follow-up protocol between 2012-01 and 2016-06. Based on ICRP (International Commission on Radiological Protection) 103, the cumulative effective radiation doses of each patient for 2-year follow-up were analyzed using the commercial radiation management software (Radimetrics, Bayer healthcare). The personalized effective doses on each organ were analyzed in detail by the software-providing Monte Carlo simulation. Results: A total of 3822 CT scans on 490 patients was evaluated (age: 52.32±10.69). The mean scan number for each patient was 7.8±4.54. Each patient was exposed 95.54±63.24 mSv of radiation for 2 years. The cumulative CT radiation dose was significantly higher in patients with lymph node metastasis (p = 0.00). The HER-2 positive patients were more exposed to radiation compared to estrogen or progesterone receptor positive patient (p = 0.00). There was no difference in the cumulative effective radiation dose with different age groups. Conclusion: To acknowledge how much radiation exposed to a patient is a starting point of management of radiation exposure for patients with long-term CT follow-up. The precise and personalized protocol, as well as iterative reconstruction, may reduce hazard from unnecessary radiation exposure.

Keywords: computed tomography, breast cancer, effective radiation dose, cumulative organ dose

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3941 Conservation Agriculture Practice in Bangladesh: Farmers’ Socioeconomic Status and Soil Environment Perspective

Authors: Mohammad T. Uddin, Aurup R. Dhar

Abstract:

The study was conducted to assess the impact of conservation agriculture practice on farmers’ socioeconomic condition and soil environmental quality in Bangladesh. A total of 450 (i.e., 50 focal, 150 proximal and 250 control) farmers from five districts were selected for this study. Descriptive statistics like sum, averages, percentages, etc. were calculated to evaluate the socioeconomic data. Using Enyedi’s crop productivity index, it was found that the crop productivity of focal, proximal and control farmers was increased by 0.9, 1.2 and 1.3 percent, respectively. The result of DID (Difference-in-difference) analysis indicated that the impact of conservation agriculture practice on farmers’ average annual income was significant. Multidimensional poverty index (MPI) indicates that poverty in terms of deprivation of health, education and living standards was decreased; and a remarkable improvement in farmers’ socioeconomic status was found after adopting conservation agriculture practice. Most of the focal and proximal farmers stated about increased soil environmental condition where majority of control farmers stated about constant environmental condition in this regard. The Probit model reveals that minimum tillage operation, permanent organic soil cover, and application of compost and vermicompost were found significant factors affecting soil environmental quality under conservation agriculture. Input support, motivation, training programmes and extension services are recommended to implement in order to raise the awareness and enrich the knowledge of the farmers on conservation agriculture practice.

Keywords: conservation agriculture, crop productivity, socioeconomic status, soil environment quality

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3940 On Cloud Computing: A Review of the Features

Authors: Assem Abdel Hamed Mousa

Abstract:

The Internet of Things probably already influences your life. And if it doesn’t, it soon will, say computer scientists; Ubiquitous computing names the third wave in computing, just now beginning. First were mainframes, each shared by lots of people. Now we are in the personal computing era, person and machine staring uneasily at each other across the desktop. Next comes ubiquitous computing, or the age of calm technology, when technology recedes into the background of our lives. Alan Kay of Apple calls this "Third Paradigm" computing. Ubiquitous computing is essentially the term for human interaction with computers in virtually everything. Ubiquitous computing is roughly the opposite of virtual reality. Where virtual reality puts people inside a computer-generated world, ubiquitous computing forces the computer to live out here in the world with people. Virtual reality is primarily a horse power problem; ubiquitous computing is a very difficult integration of human factors, computer science, engineering, and social sciences. The approach: Activate the world. Provide hundreds of wireless computing devices per person per office, of all scales (from 1" displays to wall sized). This has required new work in operating systems, user interfaces, networks, wireless, displays, and many other areas. We call our work "ubiquitous computing". This is different from PDA's, dynabooks, or information at your fingertips. It is invisible; everywhere computing that does not live on a personal device of any sort, but is in the woodwork everywhere. The initial incarnation of ubiquitous computing was in the form of "tabs", "pads", and "boards" built at Xerox PARC, 1988-1994. Several papers describe this work, and there are web pages for the Tabs and for the Boards (which are a commercial product now): Ubiquitous computing will drastically reduce the cost of digital devices and tasks for the average consumer. With labor intensive components such as processors and hard drives stored in the remote data centers powering the cloud , and with pooled resources giving individual consumers the benefits of economies of scale, monthly fees similar to a cable bill for services that feed into a consumer’s phone.

Keywords: internet, cloud computing, ubiquitous computing, big data

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3939 The Influence of Caregivers’ Preparedness and Role Burden on Quality of Life among Stroke Patients

Authors: Yeaji Seok, Myung Kyung Lee

Abstract:

Background: Even if patients survive after a stroke, stroke patients may experience disability in mobility, sensation, cognition, and speech and language. Stroke patients require rehabilitation for functional recovery and daily life for a considerable time. During rehabilitation, the role of caregivers is important. However, the stroke patients’ quality of life may deteriorate due to family caregivers’ non-preparedness and increased role burden. Purpose: To investigate the prediction of caregivers' preparedness and role burden on stroke patients’ quality of life. Methods: The target population was stroke patients who were hospitalized for rehabilitation and their family care providers. A total of 153 patient-family caregiver dyads were recruited from June to August 2021. Data were collected from self-reported questionnaires and analyzed using descriptive statistics, t-tests, chi-squared test, one-way analysis of variance, Pearson’s correlation coefficients, and multiple regression with SPSS statistics 28 programs. Results: Family caregivers’ preparedness affected stroke patients’ mobility (β = .20, p < 0.05) and character (β = -.084, p < 0.05) and production activities (β = -.197, p < 0.05) in quality of life. The role burden of family caregivers affected language skills (β = .310, p<0.05), visual functions (β=-.357, p < 0.05), thinking skills (β = 0.443, p = 0.05), mood conditions (β = 0.565, p < 0.001), family roles (β = -0.361, p < 0.001), and social roles (β = -0.304, p < 0.001), while the caregivers’ burden of performing self-protection negatively affected patients’ social roles (β = .180, p=.048). In addition, caregivers’ role burden of personal life sacrifice affected patients’ mobility (β = .311, p < 0.05), self-care (β =.232, p < 0.05) and energy (β = .239, p < 0.05). Conclusion: This study indicated that family caregivers' preparedness and role burden affected stroke patients’ quality of life. The results of this study suggested that intervention to improve family caregivers’ preparedness and to reduce role burden should be required for quality of life in stroke patients.

Keywords: quality of life, preparedness, role burden, caregivers, stroke

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3938 Preparation and Properties of Polylactic Acid/MDI Modified Thermoplastic Starch Blends

Authors: Sukhila Krishnan, Smita Mohanty, Sanjay K. Nayak

Abstract:

Polylactide (PLA) and thermoplastic starch (TPS) are the most promising bio-based materials presently available on the market. Polylactic acid is one of the versatile biodegradable polyester showing wide range of applications in various fields and starch is a biopolymer which is renewable, cheap as well as extensively available. The usual increase in the cost of petroleum-based commodities in the next decades opens bright future for these materials. Their biodegradability and compostability was an added advantage in applications that are difficult to recycle. Currently, thermoplastic starch (TPS) has been used as a substitute for synthetic plastic in several commercial products. But, TPS shows some limitations mainly due to its brittle and hydrophilic nature, which has to be resolved to widen its application.The objective of the work we report here was to initiate chemical modifications on TPS and to build up a process to control its chemical structure using a solution process which can reduce its water sensitive properties and then blended it with PLA to improve compatibility between PLA and TPS. The method involves in cleavage of starch amylose and amylopectin chain backbone to plasticize with glycerol and water in batch mixer and then the prepared TPS was reacted in solution with diisocyanates i.e, 4,4'-Methylenediphenyl Diisocyanate (MDI).This diisocyanate was used before with great success for the chemical modification of TPS surface. The method utilized here will form an urethane-linkages between reactive isocyanate groups (–NCO) and hydroxyl groups (-OH) of starch as well as of glycerol. New polymer synthesised shows a reduced crystallinity, less hydrophilic and enhanced compatibility with other polymers. The TPS was prepared by Haake Rheomix 600 batch mixer with roller rotors operating at 50 rpm. The produced material is then refluxed for 5hrs with MDI in toluene with constant stirring. Finally, the modified TPS was melt blended with PLA in different compositions. Blends obtained shows an improved mechanical properties. These materials produced are characterized by Fourier Transform Infrared Spectra (FTIR), DSC, X-Ray diffraction and mechanical tests.

Keywords: polylactic acid, thermoplastic starch, Methylenediphenyl Diisocyanate, Polylactide (PLA)

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3937 International Tourists’ Travel Motivation by Push-Pull Factors and Decision Making for Selecting Thailand as Destination Choice

Authors: Siripen Yiamjanya, Kevin Wongleedee

Abstract:

This research paper aims to identify travel motivation by push and pull factors that affected decision making of international tourists in selecting Thailand as their destination choice. A total of 200 international tourists who traveled to Thailand during January and February, 2014 were used as the sample in this study. A questionnaire was employed as a tool in collecting the data, conducted in Bangkok. The list consisted of 30 attributes representing both psychological factors as “push- based factors” and destination factors as “pull-based factors”. Mean and standard deviation were used in order to find the top ten travel motives that were important determinants in the respondents’ decision making process to select Thailand as their destination choice. The finding revealed the top ten travel motivations influencing international tourists to select Thailand as their destination choice included [i] getting experience in foreign land; [ii] Thai food; [iii] learning new culture; [iv] relaxing in foreign land; [v] wanting to learn new things; [vi] being interested in Thai culture, and traditional markets; [vii] escaping from same daily life; [viii] enjoying activities; [ix] adventure; and [x] good weather. Classification of push- based and pull- based motives suggested that getting experience in foreign land was the most important push motive for international tourists to travel, while Thai food portrayed its highest significance as pull motive. Discussion and suggestions were also made for tourism industry of Thailand.

Keywords: decision making, destination choice, international tourist, pull factor, push factor, Thailand, travel motivation

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3936 Tax Criminal Case Settlement Through Obligative Justice Approach to Increase the State Revenue

Authors: Pujiyono, Reda Manthovani, Deny Tri Ardianto, Rabani Halawa, Isharyanto

Abstract:

This research has background that the taxpayer (defendant) who has paid off the tax payable and the tax penalty payable after the tax case file has been transferred to the court, while the legality of stopping the prosecution of tax cases on the grounds that in the interest of state revenue is not regulated in the provisions of Law Number 8 of 1981 concerning The Criminal Procedure Code and Law Number 28 of 2007 concerning the Third Amendment to Law Number 6 of 1983 concerning General Provisions and Tax Procedures as amended several times, most recently by Law Number 16 of 2009 concerning Stipulation of Government Regulation in Lieu of Law Number 5 of 2008 concerning Fourth Amendment to Law Number 6 0f 1983 concerning General Provisions and Tax Procedures to become Law, even though at the investigation stage it regulates the mechanism for stopping the investigation for the sake of the interest of acceptance ne this is because before the case file is transferred to the court where at the request of the Minister of Finance of The Republic of Indonesia can stop the investigation in the interest of state revenue so that based on this phenomenon a legal vacuum is found. Therefore, a non-penal policy is needed from the public prosecutor to resolve tax crime cases without going through litigation in court through the penal mediation method using the Plea Bargaining System which adheres to the principles of restorative justice and obligative justice based on the ultimum remedium principle and the principle of opportunity in order to realize the principle of fast, simple and low cost justice (content principle). This research is a normative legal research, using a statutory approach, conceptual approach, and comparative law approach. Regulations that is used in many countries, include America, The Netherlands and Singapore. The results of this study indicate that there is a reformulation of the tax criminal justice system which regulates the mechanism, qualifications and authority to terminate the prosecution of tax cases in the interest of state revenues in order to achieve legal goals which are not only for legal certainty but more that, namely providing benefits and legal justice for people seeking justice.

Keywords: obligative justice, regulation, state reveneus, tax criminal

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3935 Formal Stress Management Teaching Incorporated into the First Year of a Doctor's Practice: A Career Transition Study of British Foundation Year 1 Doctors

Authors: Edward Ridyard, Vinary Varadarajan

Abstract:

Background and Aims: The first year as a doctor in any country represents a major career transition in any physician's life. During this period, many physicians concentrate on obtaining clinical skills but may not obtain the important skills necessary to cope with stress. In this study we elucidate stress levels amongst FY1 doctors regarding the transitioning into specialty career choices, working in the NHS and anxiety about future career success. Methods: A prospective single blinded analysis of Foundation Year one (FY1) trainees using a non-mandatory online questionnaire was distributed. No exclusion criteria were applied. The only inclusion criteria was the doctor was in a full-time FY1 post and this was their first job in the UK. A total of n= 22 doctors were included in the study. After data collection, statistical analysis using chi-squared testing was applied. Results: The large majority of FY1 doctors (72.7%) already knew what specialty they wished to pursue (p=0.0001). With regards to their future careers 45.5% of FY1 doctors stated "above average" stress levels. The majority of FY1 doctors (64.3%) stated their stress levels working in the NHS were either "above average" or "high". Finally, 81.8% of respondents know colleagues who have been put off from pursuing specialties due to the stress of competition. Conclusions: A large majority of FY1 doctors already know at this early stage what area they would like to specialise in. With this in mind, a large proportion have above "average" levels of stress with regards to securing this future career path. The most worrying finding is that 64.3% of FY1s stated they had "above average" or "high" stress levels working in the NHS. We therefore recommend formal stress management education to be incorporated into the foundation programme curriculum.

Keywords: stress, anxiety, junior doctor, education

Procedia PDF Downloads 358
3934 Re-Evaluation of Functional Assessment of Anorexia/Cachexia Therapy (Appetite Scale) with Nutritional Intake of Cancer Patients

Authors: Amena Omer Syeda, Harita Shyam

Abstract:

Background: Anorexia a common symptom among patients with prolonged illness leading to anorexia-cachexia syndrome with a prevalence rate of 70%. In order to provide effective health care and better response to treatment, appetite should be assessed on admission and then periodically for earlier nutrition intervention. Functional Assessment of Anorexia/Cachexia Therapy (FAACT) appetite scale is 12 questions, patient-rated, symptom specific measure for appetite, and distress from anorexia. It assigns a score ranging from 0 (worst response) to 4 (best response). Therefore, proposing a total score of ≤24 may be sufficient to make a diagnosis of anorexia. Objectives: To assess the FAACT scale by co-relating the scores with the Nutritional intake and BMI of Cancer Patients. Methods: The FAACT scores of 100 cancer in-patients receiving chemotherapy or radiation as treatment, their 24-hour calorie and protein intake and BMI were recorded. The data was then statistically analyzed. Results: The calorie and protein intake and FAACT scores both showed a significant positive co-relation (p<0.001), inferring that the patients with a FAACT score of ≤24 where not meeting their calorie as well as protein requirements, hence rightly categorizing them as anorexic. The co-relation between BMI and FAACT scores showed a weak co-relation and was not statistically significant (p > 0.05).The FAACT scale thus is not sensitive to distinguish patients being under-weight, normal weight or obese. Conclusion: The FAACT scale helps in providing better palliative and nutritional care as it correctly assessed anorexia /cachexia in cancer patients and co-related significantly with their nutrient intake.

Keywords: appetite, cachexia, cancer, malnutrition

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3933 The Influence of Service Quality on Customer Satisfaction and Customer Loyalty at a Telecommunication Company in Malaysia

Authors: Noor Azlina Mohamed Yunus, Baharom Abd Rahman, Abdul Kadir Othman, Narehan Hassan, Rohana Mat Som, Ibhrahim Zakaria

Abstract:

Customer satisfaction and customer loyalty are the most important outcomes of marketing in which both elements serve various stages of consumer buying behavior. Excellent service quality has become a major corporate goal as more companies gradually struggle for quality for their products and services. Therefore, the main purpose of this study is to investigate the influence of service quality on customer satisfaction and customer loyalty at one telecommunication company in Malaysia which is Telekom Malaysia. The scope of this research is to evaluate satisfaction on the products or services at TMpoint Bukit Raja, Malaysia. The data are gathered through the distribution of questionnaires to a total of 306 respondents who visited and used the products or services. By using correlation and multiple regression analyses, the result revealed that there was a positive and significant relationship between service quality and customer satisfaction. The most influential factor on customer satisfaction was empathy followed by reliability, assurance and tangibles. However, there was no significant influence between responsiveness and customer satisfaction. The result also showed there was a positive and significant relationship between service quality and customer loyalty. The most influential factor on customer loyalty was assurance followed by reliability and tangibles. TMpoint Bukit Raja is recommended to device excellent strategies to satisfy customers’ needs and to adopt action-oriented approach by focusing on what the customers wanted. It is also recommended that similar study can be carried out in other industries using different methodologies such as longitudinal method, enlarge the sample size and use a qualitative approach.

Keywords: customer satisfaction, customer loyalty, service quality, telecommunication company

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3932 Reducing Tobacco Consumption in a Rural Village of Sri Lanka Though a Community Based Health Promotion Intervention

Authors: B. A. N. Madubashini, S. Anojan, S. Thurka, N. M. C. J. Nawasinghe, G. A. S. Milanga, W. M. I. S. Weerakoon, I. D. N. Ihalahewage

Abstract:

Evidence-based health promotional approaches are known to be successful ways of reducing tobacco consumption in a rural village. Hence tobacco prevention is essential in improving lives of people, and community-based approaches are considered as effective. This community-based health promotion intervention implemented to reduce high consumption of tobacco in a rural area in Sri Lanka. This intervention was conducted in a rural village of Sri Lanka. In the beginning, facilitation discussions conducted with community members to identify determinants leading to tobacco consumption among villagers. Intervention was planed based on those determinants. Community actions through small active groups to demote smoking were generated. Children groups displayed cigarette buds collected around common places such as temple to community gatherings including funeral welfare society elaborating the cost and the money spent on cigarettes. A till (expenditure box) was introduced, and smokers in family were encouraged to put money on a cigarette to it when they decide to smoke instead. This way they could monitor potential savings if quit. Children groups introduced a tool 'Engalanthe puthata (for overseas son)' to shops. Shop owners agreed to add a pebble to a box whenever they sell a cigarette. The money spent on cigarettes in that shop was calculated regularly, and that was considered as money sent to tobacco company overseas, so to the son of the company owner. This was useful to encourage quitting and to stop selling cigarette in the shops. All four shops in the community volunteered to stop selling cigarettes. Eleven percent of users quitted smoking and 37% users reduced smoking. Child empowerment was high, and 60% of children had shown their disapproval on smoking publicly at least once. Similar community-based health promotion intervention can be used to generate community actions leading to reduction of tobacco consumption.

Keywords: cigarette, community, empowerment, health promotion, intervention

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3931 Enhancement in Bactericidal Activity of Hydantoin Based Microsphere from Smooth to Rough

Authors: Rajani Kant Rai, Jayakrishnan Athipet

Abstract:

There have been several attempts to prepare polymers with antimicrobial properties by doping with various N-halamines. Hydantoins (Cyclic N-halamine) is of importance due to their stability rechargeable chloroamide function, broad-spectrum anti-microbial action and ability to prevent resistance to the organisms. Polymerizable hydantoins are synthesized by tethering vinyl moieties to 5,5,-dialkyl hydantoin sacrificing the imide hydrogen in the molecule thereby restricting the halogen capture only to the amide nitrogen that results in compromised antibacterial activity. In order to increase the activity of the antimicrobial polymer, we have developed a scheme to maximize the attachment of chlorine to the amide and the imide moieties of hydantoin. Vinyl hydantoin monomer, (Z)-5-(4-((3-methylbuta-1,3-dien-2-yl)oxy)benzylidene)imidazolidine-2,4-dione (MBBID) was synthesized and copolymerized with a commercially available monomer, methyl methacrylate, by free radical polymerization. The antimicrobial activity of hydantoin is strongly dependent on their surface area and hence their microbial activity increases when incorporated in microspheres or nanoparticles as compared to their bulk counterpart. In this regard, smooth and rough surface microsphere of the vinyl monomer (MBBID) with commercial monomer was synthesized. The oxidative chlorine content of the copolymer ranged from 1.5 to 2.45 %. Further, to demonstrate the water purification potential, the thin column was packed with smooth or rough microspheres and challenged with simulated contaminated water that exhibited 6 log kill (total kill) of the bacteria in 20 minutes of exposure with smooth (25 mg/ml) and rough microsphere (15.0 mg/ml).

Keywords: cyclic N-halamine, vinyl hydantoin monomer, rough surface microsphere, simulated contaminated water

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3930 Validity of Clinical Disease Activity Index (CDAI) to Evaluate the Disease Activity of Rheumatoid Arthritis Patients in Sri Lanka: A Prospective Follow up Study Based on Newly Diagnosed Patients

Authors: Keerthie Dissanayake, Chandrika Jayasinghe, Priyani Wanigasekara, Jayampathy Dissanayake, Ajith Sominanda

Abstract:

The routine use of Disease Activity Score-28 (DAS28) to assess the disease activity in rheumatoid arthritis (RA) is limited due to its dependency on laboratory investigations and the complex calculations involved. In contrast, the clinical disease activity index (CDAI) is simple to calculate, which makes the "treat to target" strategy for the management of RA more practical. We aimed to assess the validity of CDAI compared to DAS28 in RA patients in Sri Lanka. A total of 103 newly diagnosed RA patients were recruited, and their disease activity was calculated using DAS 28 and CDAI during the first visit to the clinic (0 months) and re-assessed at 4 and 9 months of the follow-up visits. The validity of the CDAI, compared to DAS 28, was evaluated. Patients had a female preponderance (6:1) and a short symptom duration (mean = 6.33 months). The construct validity of CDAI, as assessed by Cronbach's α test, was 0.868. Convergent validity was assessed by correlation and Kappa statistics. Strong positive correlations were observed between CDAI and DAS 28 at the baseline (0 months), 4, and 9 months of evaluation (Spearman's r = 0.9357, 0.9354, 0.9106, respectively). Moderate-good inter-rater agreements between the DAS-28 and CDAI were observed (Weighted kappa of 0.660, 0.519, and 0.741 at 0, 4, and 9 months respectively). Discriminant validity, as assessed by ROC curves at 0, 4th, and 9th months of the evaluation, showed the area under the curve (AUC) of 0.958, 0.985, and 0.914, respectively. The suggested cut-off points for different CDAI disease activity categories according to ROC curves were ≤ 2 (Remission), >2 to ≤ 5 (low), >5 to ≤ 18 (moderate), > 18 (high). These findings indicate that the CDAI has good concordance with DAS 28 in assessing the disease activity in RA patients in this study sample.

Keywords: rheumatoid arthritis, CDAI, disease activity, Sri Lanka, validation

Procedia PDF Downloads 134