Search results for: effective%20demand
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9196

Search results for: effective%20demand

8176 A Randomised Simulation Study to Assess the Impact of a Focussed Crew Resource Management Course on UK Medical Students

Authors: S. MacDougall-Davis, S. Wysling, R. Willmore

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Background: The application of good non-technical skills, also known as crew resource management (CRM), is central to the delivery of safe, effective healthcare. The authors have been running remote trauma courses for over 10 years, primarily focussing on developing participants’ CRM in time-critical, high-stress clinical situations. The course has undergone an iterative process over the past 10 years. We employ a number of experiential learning techniques for improving CRM, including small group workshops, military command tasks, high fidelity simulations with reflective debriefs, and a ‘flipped classroom’, where participants are asked to create their own simulations and assess and debrief their colleagues’ CRM. We created a randomised simulation study to assess the impact of our course on UK medical students’ CRM, both at an individual and a teams level. Methods: Sixteen students took part. Four clinical scenarios were devised, designed to be of similar urgency and complexity. Professional moulage effects and experienced clinical actors were used to increase fidelity and to further simulate high-stress environments. Participants were block randomised into teams of 4; each team was randomly assigned to one pre-course simulation. They then underwent our 5 day remote trauma CRM course. Post-course, students were re-randomised into four new teams; each was randomly assigned to a post-course simulation. All simulations were videoed. The footage was reviewed by two independent CRM-trained assessors, who were blinded to the before/after the status of the simulations. Assessors used the internationally validated team emergency assessment measure (TEAM) to evaluate key areas of team performance, as well as a global outcome rating. Prior to the study, assessors had scored two unrelated scenarios using the same assessment tool, demonstrating 89% concordance. Participants also completed pre- and post-course questionnaires. Likert scales were used to rate individuals’ perceived NTS ability and their confidence to work in a team in time-critical, high-stress situations. Results: Following participation in the course, a significant improvement in CRM was observed in all areas of team performance. Furthermore, the global outcome rating for team performance was markedly improved (40-70%; mean 55%), thus demonstrating an impact at Level 4 of Kirkpatrick’s hierarchy. At an individual level, participants’ self-perceived CRM improved markedly after the course (35-70% absolute improvement; mean 55%), as did their confidence to work in a team in high-stress situations. Conclusion: Our study demonstrates that with a short, cost-effective course, using easily reproducible teaching sessions, it is possible to significantly improve participants’ CRM skills, both at an individual and, perhaps more importantly, at a teams level. The successful functioning of multi-disciplinary teams is vital in a healthcare setting, particularly in high-stress, time-critical situations. Good CRM is of paramount importance in these scenarios. The authors believe that these concepts should be introduced from the earliest stages of medical education, thus promoting a culture of effective CRM and embedding an early appreciation of the importance of these skills in enabling safe and effective healthcare.

Keywords: crew resource management, non-technical skills, training, simulation

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8175 Elements of a Culture of Quality in the Implementation of Quality Assurance Systems of Countries in the European Higher Education Area

Authors: Laura Mion

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The implementation of quality management systems in higher education in different countries is determined by national regulatory choices and supranational indications (such as the European Standard Guidelines for Quality Assurance). The effective functioning and transformative capacity of these quality management systems largely depend on the organizational context in which they are applied and, more specifically, on the culture of quality developed in single universities or in single countries. The University's concept of quality culture integrates the structural dimension of QA (quality management manuals, process definitions, tools) with the value dimension of an organization (principles, skills, and attitudes). Within the EHEA (European Higher Education Area), countries such as Portugal, the Netherlands, the UK, and Norway demonstrate a greater integration of QA principles in the various organizational levels and areas of competence of university institutions or have greater experience in implementation or scientific and political debate on the matter. Therefore, the study, through an integrative literature review, of the quality management systems of these countries is aimed at determining a framework of the culture of quality, helpful in defining the elements which, both in structural-organizational terms and in terms of values and skills and attitudes, have proved to be factors of success in the effective implementation of quality assurance systems in universities and in the countries considered in the research. In order for a QA system to effectively aim for continuous improvement in a complex and dynamic context such as the university one, it must embrace a holistic vision of quality from an integrative perspective, focusing on the objective of transforming the reality being evaluated.

Keywords: higher education, quality assurance, quality culture, Portugal, Norway, Netherlands, United Kingdom

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8174 Investigation into the Effectiveness of Bacillus Mucilaginosus in Liberation of Platinum Group Metals Locked in Silicates

Authors: Nokubonga G. Zulu, Bongephiwe M. Thethwayo, Mapilane S. Madiba, Peter A. Olubambi

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In South Africa, PGMs’ metallurgy industry is now leaned on the Upper Group 2 (UG2) reef for the beneficiation of 4PGEs (Platinum, Palladium, Rhodium, and Ruthenium). The current effective beneficiation method is direct froth flotation which uses the hydrophobicity of liberated valuables minerals to carefully float them while hydrophilic gangue minerals report to the residue. PGMs are known to be associated with base metal sulphides which are hydrophobic; however, approximately 25% of PGMs from UG2 are associated with hydrophilic silicates, which results in high PGMs grade in the flotation residue. Further, the smallest size in which UG2 PGMs occur is approximately 9 microns which demands high grinding for liberation, imposing energy and cost implications. The use of Bacillus mucilaginosus to liberate PGMs using Bio-leaching of PGMs bearing Silicates is a promising cost-effective, energy-saving, and green solution to liberate PGMs locked in silicates. This is due to the ability of Bacillus mucilaginosus to generate extracellular polysaccharides (EPS) that are responsible for the leaching of silicate minerals. The bioleaching is done at a laboratory beaker using a cultivated Bacillus mucilaginosus as a lixiviant. The bioleaching residue is expected to have a reduced particle size due to silicate consumption, which reduces the need and cost associated with a secondary milling circuit. Moreover, the grade of the bioleaching product is increased since the silicates (gangue minerals) are consumed by Bacillus mucilaginosus; this serves as a pre-concentration step. This paper discusses an alternative liberation and pre-concentrating technique of PGMs that are associated with silicates using Bacillus mucilaginosus leaching to dissolve silicates.

Keywords: Bacillus mucilaginosus, bio-leaching of PGMs bearing silicates, liberation of PGMs, pre-concentration of PGMs

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8173 Conciliation Bodies as an Effective Tool for the Enforcement of Air Passenger Rights: Examination of an Exemplary Model in Germany

Authors: C. Hipp

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The EU Regulation (EC) No 261/2004 under which air passengers can claim compensation in the event of denied boarding, cancellation or long delay of flights has to be regarded as a substantial progress for the consumer protection in the field of air transport since it went into force in February 2005. Nevertheless, different reviews of its effective functioning demonstrate that most passengers affected by service disruptions do not enforce their complaints and claims towards the airline. The main cause of this is not only the unclear legal situation due to the fact that the regulation itself suffers from many undetermined terms and loopholes it is also attributable to the strategy of the airlines which do not handle the complaints of the passengers or exclude their duty to compensate them. Economically contemplated, reasons like the long duration of a trial and the cost risk in relation to the amount of compensation make it comprehensible that passengers are deterred from enforcing their rights by filing a lawsuit. The paper focusses on the alternative dispute resolution namely the recently established conciliation bodies which deal with air passenger rights. In this paper, the Conciliation Body for Public Transport in Germany (Schlichtungsstelle für den öffentlichen Personenverkehr – SÖP) is examined as a successful example of independent consumer arbitration service. It was founded in 2009 and deals with complaints in the field of air passenger rights since November 2013. According to the current situation one has to admit that due to its structure and operation it meets on the one hand the needs of the airlines by giving them an efficient tool of their customer relation management and on the other hand that it contributes to the enforcement of air passenger rights effectively.

Keywords: air passenger rights, alternative dispute resolution, consumer protection, EU law regulation (EC) 261/2004

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8172 Enhancing VR Exposure Therapy for the Treatment of Phobias with the Use of Photorealistic VR Environments and Stimuli, and the Use of Tactile Feedback Suits and Responsive Systems

Authors: Vardan Melkonyan, Arman Azizyan, Astghik Boyajyan

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Virtual reality (VR) exposure therapy is a form of cognitive-behavioral therapy that uses immersive virtual environments to expose individuals to the feared stimuli or situations that trigger their phobia. VR exposure therapy has become an increasingly popular treatment for phobias, including fear of heights, public speaking, and flying, due to its ability to provide a controlled and safe environment for individuals to confront their fears while also allowing therapists to tailor the virtual exposure to the specific needs and goals of each individual. It is also a cost-effective and accessible treatment option, as it can be delivered remotely and does not require the use of drugs. Overall, VR exposure therapy has the potential to be a valuable tool for therapists in the treatment of phobias. But current methods may be improved by incorporating advanced technology such as photorealistic VR environments, tactile feedback suits, and responsive systems. The aim of this study was to identify the most effective approach for enhancing VR exposure therapy for the treatment of phobias. Photorealistic VR environments and stimuli can greatly enhance the effectiveness of VR exposure therapy for the treatment of phobias. By creating immersive, realistic virtual environments that closely mimic the real-life situations that trigger phobia responses, patients are able to more fully engage in the therapeutic process and confront their fears in a controlled and safe manner. This can help to reduce the severity of phobia symptoms and increase treatment outcomes. The use of tactile feedback suits and responsive systems can further enhance the VR exposure therapy experience by adding a physical element to the virtual environment. These suits, which can mimic the sensations of touch, pressure, and movement, allow patients to fully immerse themselves in the virtual world and feel as if they are physically present in the situation. This can help to increase the realism of the virtual environment and make it more effective in reducing phobia symptoms. Additionally, responsive systems can be used to trigger specific events or responses within the virtual environment based on the patient's actions, providing a more interactive and personalized treatment experience. A comprehensive literature review was conducted, including studies on VR exposure therapy for phobias and the use of advanced technology to enhance the therapy. Results indicate that incorporating these enhancements may significantly increase the effectiveness of VR exposure therapy for phobias. Further research is needed to fully understand the potential of these enhancements and to determine the optimal combination and implementation.

Keywords: virtual reality, mental health, phobias, fears, treatment, photorealistic, immersive, phobia

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8171 Smart BIM Documents - the Development of the Ontology-Based Tool for Employer Information Requirements (OntEIR), and its Transformation into SmartEIR

Authors: Shadan Dwairi

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Defining proper requirements is one of the key factors for a successful construction projects. Although there have been many attempts put forward in assist in identifying requirements, but still this area is under developed. In Buildings Information Modelling (BIM) projects. The Employer Information Requirements (EIR) is the fundamental requirements document and a necessary ingredient in achieving a successful BIM project. The provision on full and clear EIR is essential to achieving BIM Level-2. As Defined by PAS 1192-2, EIR is a “pre-tender document that sets out the information to be delivered and the standards and processes to be adopted by the supplier as part of the project delivery process”. It also notes that “EIR should be incorporated into tender documentation to enable suppliers to produce an initial BIM Execution Plan (BEP)”. The importance of effective definition of EIR lies in its contribution to a better productivity during the construction process in terms of cost and time, in addition to improving the quality of the built asset. Proper and clear information is a key aspect of the EIR, in terms of the information it contains and more importantly the information the client receives at the end of the project that will enable the effective management and operation of the asset, where typically about 60%-80% of the cost is spent. This paper reports on the research done in developing the Ontology-based tool for Employer Information Requirements (OntEIR). OntEIR has proven the ability to produce a full and complete set of EIRs, which ensures that the clients’ information needs for the final model delivered by BIM is clearly defined from the beginning of the process. It also reports on the work being done into transforming OntEIR into a smart tool for Defining Employer Information Requirements (smartEIR). smartEIR transforms the OntEIR tool into enabling it to develop custom EIR- tailored for the: Project Type, Project Requirements, and the Client Capabilities. The initial idea behind smartEIR is moving away from the notion “One EIR fits All”. smartEIR utilizes the links made in OntEIR and creating a 3D matrix that transforms it into a smart tool. The OntEIR tool is based on the OntEIR framework that utilizes both Ontology and the Decomposition of Goals to elicit and extract the complete set of requirements needed for a full and comprehensive EIR. A new ctaegorisation system for requirements is also introduced in the framework and tool, which facilitates the understanding and enhances the clarification of the requirements especially for novice clients. Findings of the evaluation of the tool that was done with experts in the industry, showed that the OntEIR tool contributes towards effective and efficient development of EIRs that provide a better understanding of the information requirements as requested by BIM, and support the production of a complete BIM Execution Plan (BEP) and a Master Information Delivery Plan (MIDP).

Keywords: building information modelling, employer information requirements, ontology, web-based, tool

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8170 A Review of Gas Hydrate Rock Physics Models

Authors: Hemin Yuan, Yun Wang, Xiangchun Wang

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Gas hydrate is drawing attention due to the fact that it has an enormous amount all over the world, which is almost twice the conventional hydrocarbon reserves, making it a potential alternative source of energy. It is widely distributed in permafrost and continental ocean shelves, and many countries have launched national programs for investigating the gas hydrate. Gas hydrate is mainly explored through seismic methods, which include bottom simulating reflectors (BSR), amplitude blanking, and polarity reverse. These seismic methods are effective at finding the gas hydrate formations but usually contain large uncertainties when applying to invert the micro-scale petrophysical properties of the formations due to lack of constraints. Rock physics modeling links the micro-scale structures of the rocks to the macro-scale elastic properties and can work as effective constraints for the seismic methods. A number of rock physics models have been proposed for gas hydrate modeling, which addresses different mechanisms and applications. However, these models are generally not well classified, and it is confusing to determine the appropriate model for a specific study. Moreover, since the modeling usually involves multiple models and steps, it is difficult to determine the source of uncertainties. To solve these problems, we summarize the developed models/methods and make four classifications of the models according to the hydrate micro-scale morphology in sediments, the purpose of reservoir characterization, the stage of gas hydrate generation, and the lithology type of hosting sediments. Some sub-categories may overlap each other, but they have different priorities. Besides, we also analyze the priorities of different models, bring up the shortcomings, and explain the appropriate application scenarios. Moreover, by comparing the models, we summarize a general workflow of the modeling procedure, which includes rock matrix forming, dry rock frame generating, pore fluids mixing, and final fluid substitution in the rock frame. These procedures have been widely used in various gas hydrate modeling and have been confirmed to be effective. We also analyze the potential sources of uncertainties in each modeling step, which enables us to clearly recognize the potential uncertainties in the modeling. In the end, we explicate the general problems of the current models, including the influences of pressure and temperature, pore geometry, hydrate morphology, and rock structure change during gas hydrate dissociation and re-generation. We also point out that attenuation is also severely affected by gas hydrate in sediments and may work as an indicator to map gas hydrate concentration. Our work classifies rock physics models of gas hydrate into different categories, generalizes the modeling workflow, analyzes the modeling uncertainties and potential problems, which can facilitate the rock physics characterization of gas hydrate bearding sediments and provide hints for future studies.

Keywords: gas hydrate, rock physics model, modeling classification, hydrate morphology

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8169 A Qualitative Study of the Effect of Sibling and Parental Relationships on Coping Mechanisms in Families of Children with Autism Spectrum Disorder

Authors: Smriti Gour, Neelam Pandey

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The objective of this study was to describe and analyse the mutual relationship between the coping mechanisms used by the families of a child with Autism Spectrum Disorder (ASD) and family dynamics and the effect sibling interactions have on the dynamics and coping mechanisms in an urban setup. In-depth interviews were conducted for 25 families, with 4 members each in the Delhi NCR area in India. The families who were interviewed had a younger child who had received a diagnosis of ASD between the ages of 5-12. The in-depth questionnaires contained open-ended questions and the interviews were conducted separately for the mother, father and the typically developing sibling. The key findings of the study suggested that lack of communication was a common factor in most families (n=19) leading to other difficulties like stress and relationship dysfunction. It also fostered a fallacious perception of the relationship dynamics in the family in most of the interviewed families and changed depending on the family member being interviewed. In families where the typically developing elder sibling had a good relationship with the autistic child, the family dynamics were found to be more stable, and the overall family well-being was better maintained. The coping mechanisms employed by the families were also more positive and tended to work better if the typically developing sibling maintained a positive and interactive relationship with the parents and the autistic child. The type of coping mechanisms had a major impact on the relationship between the parents and in dictating the dynamics of the family of the child with ASD. Spirituality, professional help, family support and household help emerged to be the most effective coping mechanisms for the families, with spirituality emerging to be the most positive and effective coping mechanism in the families interviewed.

Keywords: autism spectrum disorder, coping mechanism, family dynamics, parental relationships, siblings

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8168 Greenlight Laser Prostatectomy: A Safe and Effective Day Case Option for Bladder Outlet Obstruction in the Elderly Population

Authors: Gordon Weight, Hermione Tsoi, Patrick Cutinha, Sanjay Rajpal

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Aim: Greenlight-laser prostatectomy (GLLP) is becoming a popular treatment option for bladder outlet obstruction and lower urinary tract symptoms (LUTS). In this retrospective study, we aim to explore the patient selection, perioperative morbidity, and functional outcomes of GLLP. Methods: Patients who underwent GLLP at a UK tertiary centre between June 2018 and November 2021 were included in this study. Retrospective data covering patient demographics, perioperative parameters and postoperative outcomes were collected using the electronic records systems. Results: 305 patients were included in this study with a mean age of 73 (range 30-90) years. The most common indication (62.6%) for the procedure was patient’s wish to be free from long-term catheters (LTC) or intermittent catheterisation (ISC), followed by failed medical therapy for LUTS (36.4%). 84.6% of patients had an ASA ≥2, and 32.1% took anticoagulant or antiplatelet therapy. Inpatient stays were minimal, with the majority (68.2%) of patients were performed as day case, and only 10.5% of patients requiring more than a single night admission. The 3-month readmission rate was 10.8%, with the most common causes being haematuria and urinary-tract infection. The successful TWOC rate at follow up was 91.2%. Amongst the 19 patients who failed TWOC, 14 had LTC prior to the procedure and 4 had been performing ISC. Conclusions: Our study shows that GLLP is a safe and effective day case treatment and can be suitable for elderly and comorbid patients. Patients requiring LTC or ISC pre-operatively should be counselled carefully about the risk of not being catheter-free post procedure.

Keywords: urology, endourology, prostate, bladder outlet obstruction, laser

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8167 Numerical Calculation and Analysis of Fine Echo Characteristics of Underwater Hemispherical Cylindrical Shell

Authors: Hongjian Jia

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A finite-length cylindrical shell with a spherical cap is a typical engineering approximation model of actual underwater targets. The research on the omni-directional acoustic scattering characteristics of this target model can provide a favorable basis for the detection and identification of actual underwater targets. The elastic resonance characteristics of the target are the results of the comprehensive effect of the target length, shell-thickness ratio and materials. Under the conditions of different materials and geometric dimensions, the coincidence resonance characteristics of the target have obvious differences. Aiming at this problem, this paper obtains the omni-directional acoustic scattering field of the underwater hemispherical cylindrical shell by numerical calculation and studies the influence of target geometric parameters (length, shell-thickness ratio) and material parameters on the coincidence resonance characteristics of the target in turn. The study found that the formant interval is not a stable value and changes with the incident angle. Among them, the formant interval is less affected by the target length and shell-thickness ratio and is significantly affected by the material properties, which is an effective feature for classifying and identifying targets of different materials. The quadratic polynomial is utilized to fully fit the change relationship between the formant interval and the angle. The results show that the three fitting coefficients of the stainless steel and aluminum targets are significantly different, which can be used as an effective feature parameter to characterize the target materials.

Keywords: hemispherical cylindrical shell;, fine echo characteristics;, geometric and material parameters;, formant interval

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8166 Optimization of a Bioremediation Strategy for an Urban Stream of Matanza-Riachuelo Basin

Authors: María D. Groppa, Andrea Trentini, Myriam Zawoznik, Roxana Bigi, Carlos Nadra, Patricia L. Marconi

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In the present work, a remediation bioprocess based on the use of a local isolate of the microalgae Chlorella vulgaris immobilized in alginate beads is proposed. This process was shown to be effective for the reduction of several chemical and microbial contaminants present in Cildáñez stream, a water course that is part of the Matanza-Riachuelo Basin (Buenos Aires, Argentina). The bioprocess, involving the culture of the microalga in autotrophic conditions in a stirred-tank bioreactor supplied with a marine propeller for 6 days, allowed a significant reduction of Escherichia coli and total coliform numbers (over 95%), as well as of ammoniacal nitrogen (96%), nitrates (86%), nitrites (98%), and total phosphorus (53%) contents. Pb content was also significantly diminished after the bioprocess (95%). Standardized cytotoxicity tests using Allium cepa seeds and Cildáñez water pre- and post-remediation were also performed. Germination rate and mitotic index of onion seeds imbibed in Cildáñez water subjected to the bioprocess was similar to that observed in seeds imbibed in distilled water and significantly superior to that registered when untreated Cildáñez water was used for imbibition. Our results demonstrate the potential of this simple and cost-effective technology to remove urban-water contaminants, offering as an additional advantage the possibility of an easy biomass recovery, which may become a source of alternative energy.

Keywords: bioreactor, bioremediation, Chlorella vulgaris, Matanza-Riachuelo Basin, microalgae

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8165 Improving Efficiency and Effectiveness of FMEA Studies

Authors: Joshua Loiselle

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This paper discusses the challenges engineering teams face in conducting Failure Modes and Effects Analysis (FMEA) studies. This paper focuses on the specific topic of improving the efficiency and effectiveness of FMEA studies. Modern economic needs and increased business competition require engineers to constantly develop newer and better solutions within shorter timeframes and tighter margins. In addition, documentation requirements for meeting standards/regulatory compliance and customer needs are becoming increasingly complex and verbose. Managing open actions and continuous improvement activities across all projects, product variations, and processes in addition to daily engineering tasks is cumbersome, time consuming, and is susceptible to errors, omissions, and non-conformances. FMEA studies are proven methods for improving products and processes while subsequently reducing engineering workload and improving machine and resource availability through a pre-emptive, systematic approach of identifying, analyzing, and improving high-risk components. If implemented correctly, FMEA studies significantly reduce costs and improve productivity. However, the value of an effective FMEA is often shrouded by a lack of clarity and structure, misconceptions, and previous experiences and, as such, FMEA studies are frequently grouped with the other required information and documented retrospectively in preparation of customer requirements or audits. Performing studies in this way only adds cost to a project and perpetuates the misnomer that FMEA studies are not value-added activities. This paper discusses the benefits of effective FMEA studies, the challenges related to conducting FMEA studies, best practices for efficiently overcoming challenges via structure and automation, and the benefits of implementing those practices.

Keywords: FMEA, quality, APQP, PPAP

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8164 The Effects of Incompetence in the Use of Mother Tongue on the Spoken English of Selected Primary School Pupils in Abeokuta South Local Government Ogun State, Nigeria

Authors: K. G. Adeosun, K. Osunaiye, E. C. Chinaguh, M. A. Aliyu, C. A. Onifade

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This study examined the effects of incompetence in the use of the mother tongue on the spoken English of selected Primary School pupils in Abeokuta South Local Government, Ogun State, Nigeria. The study used a structured questionnaire and interview guide as data collection instruments. The target population was 110 respondents. The sample was obtained by the use of simple random and stratified sampling techniques. The study samples were pupils from Government Primary Schools in Abeokuta South Local Government. The result revealed that the majority of pupils exhibited mother tongue interference in their oral production stage and that the local indigenous languages interfered with the pronunciation of English words to a large extent such that they pronounced ‘people’ as ‘fitful.’ The findings also revealed that there is no significant difference between inadequate teaching materials, shortage of funds towards the promotion of the mother tongue (Yoruba) and spoken English of Primary school pupils in the study area. The study recommended, among other things, that government should provide the necessary support for schools in the areas of teaching and learning materials, funds and other related materials that can enhance the effective use of the mother tongue towards spoken English by Primary School pupils. Government should ensure that oral English is taught to the pupils and the examination at the end of Primary school education should be made compulsory for all pupils. More so, the Government should provide language laboratories and other equipment to facilitate good teaching and learning of oral English.

Keywords: education, effective, government, learning, teaching

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8163 Pharmacodynamic Interaction between Tamsulosin and Finasteride Treatment on Induced Benign Prostate Hyperplasia in Mice by Using Chou-Talalay Method

Authors: Firas Rashad Al-Samarai

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Introduction: Benign prostatic hyperplasia (BPH) is a common condition as men get older. An enlarged prostate gland can cause uncomfortable urinary symptoms, such as blocking the flow of urine out of the bladder. It can also cause bladder, urinary tract, or kidney problems. Objective: to evaluate the efficacy and interaction of tamsulosin with finasteride treatment on induced benign prostate hyperplasia (BPH) in mice. Methods: BPH was induced by subcutaneous injection of testosterone propionate (20 mg/kg) for 30 days. Eighty-five mice were divided into five groups. The first group (G1): twenty-five mice induced BPH treated with tamsulosin orally and divided into five equal subgroups with doses (0.017, 0.052, 0.087, 0. 123, and 0.158) mg/kg, the second group (G2): twenty-five mice induced BPH treated with finasteride orally and divided into five equal subgroups with doses (0.175, 0.527, 0.878, 1.23, and 1.580) mg/kg. the third group (G3): twenty-five mice induced BPH treated with a combination of tamsulosin with finasteride orally, and divided into five equal subgroups with doses (0.0085, 0.0875), (0.026, 0.2635), (0.0435, 0.439) , (0.0615, 0.615) and ( 0.079 , 0.790 ) mg/kg respectively. Fourth group (G4): five mice induced BPH and treated distilled water. Fifth group (G5): five mice were not inducing BPH and without any treatment. Results: The results showed a gradual significant increase in prostate weight % and prostate index % Inhibitions until reached saturation in the last two doses of tamsulosin, finasteride, and combination groups, the maximum effective dose of tamsulosin and finasteride were (0.156) and (1.495) mg/kg respectively. Moreover, the effective dose of the combination (tamsulosin and finasteride) was estimated (0.06876, 0.6876) mg/kg, respectively, as well as the type of interaction was synergism and the value of the combination index was 0.046. Conclusions: We concluded that the combination of tamsulosin with finasteride showed a synergistic effect in BPH treatment by minimizing the side effect of each drug as s result of decreasing the dose of each one.

Keywords: Tamsulosin, Finasteride, combination, BPH

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8162 Exploring Knowledge, Attitudes, and Practices toward the Preventive Aspect of the COVID-19 among University Nursing Students at the University of Sunderland 2021, in the United Kingdom: A Cross-Sectional Study

Authors: Sasalanka Chamara Karunanayaka Pathirannehelage, Sarah Connelly

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Background: Knowledge, attitudes, and practices (KAP) toward the preventive aspect of COVID-19 are crucial for effective control and prevention of the disease. Sociodemographic factors can associate with KAP. This study aims to investigate KAP towards the preventive aspect of COVID-19 and associate sociodemographic factors among university nursing students at the University of Sunderland, 2021, United Kingdom. Methods: A cross-sectional online survey was conducted among 63 university nursing students between the 1st of July and the 13th of August 2021. A previously used, validated, self-administered questionnaire was applied to assess nursing students' KAP levels. Cross tabulation and chi-square were used to identify the associated sociodemographic factors with KAP. Results: Good knowledge was shown by 98.4% of respondents. 84.1 % of respondents reported positive attitudes, while 90.5% of respondents reported good practices toward the preventive aspect of COVID-19. The knowledge score of the students was significantly associated (p = 0.03) with the ethnicity of the respondents. Students' attitudes were significantly associated (p<0.05) with students' sex, student status (home student, international student), and course type (undergraduate student, postgraduate student). Student's age, student status, and course type were significantly associated (p < 0.05) with practices toward the preventive aspect of COVID-19. Conclusion: The finding of the study suggested that the university nursing student at the University of Sunderland demonstrate good knowledge, positive attitude, and good practice level towards the preventive aspect of COVID-19. Associated factors like age, sex, student status, and course type should be considered for effective strategies against COVID-19 as well as for future outbreaks.

Keywords: knowledge, attitudes, practices, nursing students

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8161 Role of Indigenous Peoples in Climate Change

Authors: Neelam Kadyan, Pratima Ranga, Yogender

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Indigenous people are the One who are affected by the climate change the most, although there have contributed little to its causes. This is largely a result of their historic dependence on local biological diversity, ecosystem services and cultural landscapes as a source of their sustenance and well-being. Comprising only four percent of the world’s population they utilize 22 percent of the world’s land surface. Despite their high exposure-sensitivity indigenous peoples and local communities are actively responding to changing climatic conditions and have demonstrated their resourcefulness and resilience in the face of climate change. Traditional Indigenous territories encompass up to 22 percent of the world’s land surface and they coincide with areas that hold 80 percent of the planet’s biodiversity. Also, the greatest diversity of indigenous groups coincides with the world’s largest tropical forest wilderness areas in the Americas (including Amazon), Africa, and Asia, and 11 percent of world forest lands are legally owned by Indigenous Peoples and communities. This convergence of biodiversity-significant areas and indigenous territories presents an enormous opportunity to expand efforts to conserve biodiversity beyond parks, which tend to benefit from most of the funding for biodiversity conservation. Tapping on Ancestral Knowledge Indigenous Peoples are carriers of ancestral knowledge and wisdom about this biodiversity. Their effective participation in biodiversity conservation programs as experts in protecting and managing biodiversity and natural resources would result in more comprehensive and cost effective conservation and management of biodiversity worldwide. Addressing the Climate Change Agenda Indigenous Peoples has played a key role in climate change mitigation and adaptation. The territories of indigenous groups who have been given the rights to their lands have been better conserved than the adjacent lands (i.e., Brazil, Colombia, Nicaragua, etc.). Preserving large extensions of forests would not only support the climate change objectives, but it would respect the rights of Indigenous Peoples and conserve biodiversity as well. A climate change agenda fully involving Indigenous Peoples has many more benefits than if only government and/or the private sector are involved. Indigenous peoples are some of the most vulnerable groups to the negative effects of climate change. Also, they are a source of knowledge to the many solutions that will be needed to avoid or ameliorate those effects. For example, ancestral territories often provide excellent examples of a landscape design that can resist the negatives effects of climate change. Over the millennia, Indigenous Peoples have developed adaptation models to climate change. They have also developed genetic varieties of medicinal and useful plants and animal breeds with a wider natural range of resistance to climatic and ecological variability.

Keywords: ancestral knowledge, cost effective conservation, management, indigenous peoples, climate change

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8160 Challenges to Safe and Effective Prescription Writing in the Environment Where Digital Prescribing is Absent

Authors: Prashant Neupane, Asmi Pandey, Mumna Ehsan, Katie Davies, Richard Lowsby

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Introduction/Background & aims: Safe and effective prescribing in hospitals, directly and indirectly, impacts the health of the patients. Even though digital prescribing in the National Health Service (NHS), UK has been used in lots of tertiary centers along with district general hospitals, a significant number of NHS trusts are still using paper prescribing. We came across lots of irregularities in our daily clinical practice when we are doing paper prescribing. The main aim of the study was to assess how safely and effectively are we prescribing at our hospital where there is no access to digital prescribing. Method/Summary of work: We conducted a prospective audit in the critical care department at Mid Cheshire Hopsitals NHS Foundation Trust in which 20 prescription charts from different patients were randomly selected over a period of 1 month. We assessed 16 multiple categories from each prescription chart and compared them to the standard trust guidelines on prescription. Results/Discussion: We collected data from 20 different prescription charts. 16 categories were evaluated within each prescription chart. The results showed there was an urgent need for improvement in 8 different sections. In 85% of the prescription chart, all the prescribers who prescribed the medications were not identified. Name, GMC number and signature were absent in the required prescriber identification section of the prescription chart. In 70% of prescription charts, either indication or review date of the antimicrobials was absent. Units of medication were not documented correctly in 65% and the allergic status of the patient was absent in 30% of the charts. The start date of medications was missing and alternations of the medications were not done properly in 35%of charts. The patient's name was not recorded in all desired sections of the chart in 50% of cases and cancellations of the medication were not done properly in 45% of the prescription charts. Conclusion(s): From the audit and data analysis, we assessed the areas in which we needed improvement in prescription writing in the Critical care department. However, during the meetings and conversations with the experts from the pharmacy department, we realized this audit is just a representation of the specialized department of the hospital where access to prescribing is limited to a certain number of prescribers. But if we consider bigger departments of the hospital where patient turnover is much more, the results could be much worse. The findings were discussed in the Critical care MDT meeting where suggestions regarding digital/electronic prescribing were discussed. A poster and presentation regarding safe and effective prescribing were done, awareness poster was prepared and attached alongside every bedside in critical care where it is visible to prescribers. We consider this as a temporary measure to improve the quality of prescribing, however, we strongly believe digital prescribing will help to a greater extent to control weak areas which are seen in paper prescribing.

Keywords: safe prescribing, NHS, digital prescribing, prescription chart

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8159 A Review of Deep Learning Methods in Computer-Aided Detection and Diagnosis Systems based on Whole Mammogram and Ultrasound Scan Classification

Authors: Ian Omung'a

Abstract:

Breast cancer remains to be one of the deadliest cancers for women worldwide, with the risk of developing tumors being as high as 50 percent in Sub-Saharan African countries like Kenya. With as many as 42 percent of these cases set to be diagnosed late when cancer has metastasized and or the prognosis has become terminal, Full Field Digital [FFD] Mammography remains an effective screening technique that leads to early detection where in most cases, successful interventions can be made to control or eliminate the tumors altogether. FFD Mammograms have been proven to multiply more effective when used together with Computer-Aided Detection and Diagnosis [CADe] systems, relying on algorithmic implementations of Deep Learning techniques in Computer Vision to carry out deep pattern recognition that is comparable to the level of a human radiologist and decipher whether specific areas of interest in the mammogram scan image portray abnormalities if any and whether these abnormalities are indicative of a benign or malignant tumor. Within this paper, we review emergent Deep Learning techniques that will prove relevant to the development of State-of-The-Art FFD Mammogram CADe systems. These techniques will span self-supervised learning for context-encoded occlusion, self-supervised learning for pre-processing and labeling automation, as well as the creation of a standardized large-scale mammography dataset as a benchmark for CADe systems' evaluation. Finally, comparisons are drawn between existing practices that pre-date these techniques and how the development of CADe systems that incorporate them will be different.

Keywords: breast cancer diagnosis, computer aided detection and diagnosis, deep learning, whole mammogram classfication, ultrasound classification, computer vision

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8158 Determination of Optimum Parameters for Thermal Stress Distribution in Composite Plate Containing a Triangular Cutout by Optimization Method

Authors: Mohammad Hossein Bayati Chaleshtari, Hadi Khoramishad

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Minimizing the stress concentration around triangular cutout in infinite perforated plates subjected to a uniform heat flux induces thermal stresses is an important consideration in engineering design. Furthermore, understanding the effective parameters on stress concentration and proper selection of these parameters enables the designer to achieve a reliable design. In the analysis of thermal stress, the effective parameters on stress distribution around cutout include fiber angle, flux angle, bluntness and rotation angle of the cutout for orthotropic materials. This paper was tried to examine effect of these parameters on thermal stress analysis of infinite perforated plates with central triangular cutout. In order to achieve the least amount of thermal stress around a triangular cutout using a novel swarm intelligence optimization technique called dragonfly optimizer that inspired by the life method and hunting behavior of dragonfly in nature. In this study, using the two-dimensional thermoelastic theory and based on the Likhnitskiiʼ complex variable technique, the stress analysis of orthotropic infinite plate with a circular cutout under a uniform heat flux was developed to the plate containing a quasi-triangular cutout in thermal steady state condition. To achieve this goal, a conformal mapping function was used to map an infinite plate containing a quasi- triangular cutout into the outside of a unit circle. The plate is under uniform heat flux at infinity and Neumann boundary conditions and thermal-insulated condition at the edge of the cutout were considered.

Keywords: infinite perforated plate, complex variable method, thermal stress, optimization method

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8157 An Effective Synthesis Method of Microwave Solution Combustion with the Application of Visible Light-Responsive Photocatalyst of Rb21 Dye

Authors: Rahul Jarariya

Abstract:

The textile industry uses various types of dyes and discharges a lot of highly coloured wastewater. It impacts the environment like allergic reaction, respiratory, skin problems, irritation to a mucous membrane, the upper respiratory tract has to the fore, Intoxicated dye discharges 40 to 50,000 tons with great concern. Spinel ferrites gained a lot of attention due to their wide application area from biomedical to wastewater treatment. Generally, spinel ferrite is known as M-Fe2O4. Spinel type nanoparticles possess high suspension stability. The synthesis method of Microwave solution combustion (MC) method is effective for nanoscale materials, including oxides, metals, alloys, and sulfides, works as fast and energy-efficient during the process. The review focuses on controlling, nanostructure and doping. The influence of the fuel concentration and the post-treatment temperature on the structural and magnetic properties. The effects of amounts of fuel and phase changes, particle size and shape, and magnetic properties can be characterized by various techniques. Urea is the most commonly used fuel. Ethanol or n-butanol is apt for removing impurities. As a result of the materials gives fine purity. Photocatalysis phenomena act with catalyst dosage to degrade dye from wastewater. Visible light responsive produces a large amount of hydroxyl (•OH) radical made the degradation efficiency of Rh21 type dye. It develops a narrow bandgap to make it suitable for enhanced photocatalytic activity.

Keywords: microwave solution combustion method, normal spinel, doped spinels, magnetic property, Rb21

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8156 Enhancing Inservice Education Training Effectiveness Using a Mobile Based E-Learning Model

Authors: Richard Patrick Kabuye

Abstract:

This study focuses on the addressing the enhancement of in-service training programs as a tool of transforming the existing traditional approaches of formal lectures/contact hours. This will be supported with a more versatile, robust, and remotely accessible means of mobile based e-learning, as a support tool for the traditional means. A combination of various factors in education and incorporation of the eLearning strategy proves to be a key factor in effective in-service education. Key factor needs to be factored in so as to maintain a credible co-existence of the programs, with the prevailing social, economic and political environments. Effective in-service education focuses on having immediate transformation of knowledge into practice for a good time period, active participation of attendees, enable before training planning, in training assessment and post training feedback training analysis which will yield knowledge to the trainers of the applicability of knowledge given out. All the above require a more robust approach to attain success in implementation. Incorporating mobile technology in eLearning will enable the above to be factored together in a more coherent manner, as it is evident that participants have to take time off their duties and attend to these training programs. Making it mobile, will save a lot of time since participants would be in position to follow certain modules while away from lecture rooms, get continuous program updates after completing the program, send feedback to instructors on knowledge gaps, and a wholly conclusive evaluation of the entire program on a learn as you work platform. This study will follow both qualitative and quantitative approaches in data collection, and this will be compounded incorporating a mobile eLearning application using Android.

Keywords: in service, training, mobile, e- learning, model

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8155 The Effects of Branding on Profitability of Banks in Ghana

Authors: Evans Oteng, Clement Yeboah, Alexander Otechere-Fianko

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In today’s economy, despite achievements and advances in the banking and financial institutions, there are challenges that will require intensive attempts on the portion of the banks in Ghana. The perceived decline in profitability of banks seems to have emanated from ineffective branding. Hence, the purpose of this quantitative descriptive-correlational study was to examine the effects of branding on the profitability of banks in Ghana. The researchers purposively sampled some 116 banks in Ghana. Self-developed Likert scale questionnaires were administered to the finance officers of the financial institutions. The results were found to be statistically significant, F (1, 114) = 4. 50, p = .036. This indicates that those banks in Ghana with good branding practices have strong marketing tools to identify and sell their products and services and, as such, have a big market share. The correlation coefficients indicate that branding has a positive correlation with profitability and are statistically significant (r=.207, p<0.05), which signifies that as branding increases, the return on equity’s profitability indicator improves and vice versa. Future researchers can consider other factors beyond branding, such as online banking. The study has significant implications for the success and competitive advantage of those banks that effective branding allows them to differentiate themselves from their competitors. A strong and unique brand identity can help a bank stand out in a crowded market, attract customers, and build customer loyalty. This can lead to increased market share and profitability. Branding influences customer perception and trust. A well-established and reputable brand can create a positive image in the minds of customers, enhancing their confidence in the bank's products and services. This can result in increased customer acquisition, customer retention and a positive impact on profitability. Banks with strong brands can leverage their reputation and customer trust to cross-sell additional products and services. When customers have confidence in the brand, they are more likely to explore and purchase other offerings from the same institution. Cross-selling can boost revenue streams and profitability. Successful branding can open up opportunities for brand extensions and diversification into new products or markets. Banks can leverage their trusted brand to introduce new financial products or expand their presence into related areas, such as insurance or investment services. This can lead to additional revenue streams and improved profitability. This study can have implications for education. Thus, increased profitability of banks due to effective branding can result in higher financial resources available for corporate social responsibility (CSR) activities. Banks may invest in educational initiatives, such as scholarships, grants, research projects, and sponsorships, to support the education sector in Ghana. Also, this study can have implications for logistics and supply chain management. Thus, strong branding can create trust and credibility among customers, leading to increased customer loyalty. This loyalty can positively impact the bank's relationships with its suppliers and logistics partners. It can result in better negotiation power, improved supplier relationships, and enhanced supply chain coordination, ultimately leading to more efficient and cost-effective logistics operations.

Keywords: branding, profitability, competitors, customer loyalty, customer retention, corporate social responsibility, cost-effective, logistics operations

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8154 Biological Treatment of Corn Stover with Pleurotus ostreatus, Pleurotus eryngii and Lentinula edudes to Improve Digestibility

Authors: Aydan Atalar, Nurcan Cetinkaya

Abstract:

Corn stover is leftover of the leaves, stalk, husks and tassels in the field after harvesting the grain combined. Corn stover is a low-quality roughage but has mostly been used as roughage source for feeding ruminant animals in developing countries including Turkey; however, it can also be used to make biofuels as in developed countries. The objectives of the present study were to improve the digestibility of corn stover by the treatment of white rod fungus mainly Pleurotus osteritus (PO), Pleurotus eryingii (PE) and Lantinula edudes (LE) at different incubation times and also to determine the most effective fungus and incubation time to prepare fermeted corn stover for ruminant nutrition. The choped corn stover was treated with PO, PE and LE and incubated for 10, 20, 30 and 40 days in incubator at 26 0C. After each incubation time dry matter(DM), organic matter(OM), crude protein (CP), neutral detergent fiber (NDF), acid detergent fiber (ADF), neutral detergent lignin (ADL), in-vitro true dry matter digestibility (IVTDMD) and organic matter digestibility (IVTOMD) were determined. The mean IVTDMD and IVTOMD levels were increased by PO, PE and LE treatments in increasing order of incubation times. The obtained IVTDM values were 59.45, 60.51, 60.82 and 60.18 %; 59.45, 70.55, 67.18 and 66.96 %; 59.45, 70.55, 67.18 and 66,96 %; 59.45, 74.90, 69.18 % ; 59.45, 76.50, 71.24 and 73.04 for control, PO, PE and LE treatments at 0, 10, 20, 30 and 40 days incubation times respectively. The obtained IVTOMD values were 56.45,60.26,60.82and 60.18 %; 56.45, 68.70, 67.18 and 66.96 %; 56.45, 71.26, 69.18 and 69.28 %; 56.45, 73.23, 71.24 and 73.04 % for control, PO, PE and LE treatments at 0, 10, 20, 30 and 40 days incubation times respectively. The most effective fungus was PO and the incubation time was 30 days. In conclusion, PO treatment of corn stover with 30 days incubation may be used to prepare fermented corn stover for ruminant nutrition.

Keywords: biological treatment, corn stover, digestibility, Lantinula edudes, Pleurotus eryingii, Pleurotus osteritus

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8153 A Transformational Ecology Model of School Based Universal Mental Health Development

Authors: Cheryl M. Bowen

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Understanding that children thrive in a multi-systems approach to mental health development, a growing number of schools often promote school-based positive youth development however, there is scant empirical evidence investigating effective school-based “wraparound” mental health services for low income, Latinx children and their families. This 10-month case study utilizes a sample of 281 low-income, Latinx parents and their children, and 23 K-5th grade teachers living in northern California to test the hypothesis that a school-based mental health program can strengthen students’ developmental asset attainment and positively impact the school environment. The study utilized triangulated data to ascertain the effects of two program levels - (a) mental health and (b) positive child development services. All services were site-based and meant to target a wide variety of families. Findings from the study report that the universal mental health program increased the developmental asset attainment in 5 out of 8 thriving indicators thus transforming the child within his/her environment. Data collected from the administrative referral report demonstrate that the project also positively impacted the school climate. Parents and teachers felt more connected to the school, and referrals were down for discipline (35%), academics (66%), and suspensions (51%). The study concludes that a transformational ecology model of positive child development is the most effective means to nurture connections to all socializing agencies in a child’s ecosystem.

Keywords: case study, child development, positive youth development, developmental assets, ecological systems theory

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8152 Transcranial and Sacral Magnetic Stimulation as a Therapeutic Resource for Urinary Incontinence – A Brief Bibliographic Review

Authors: Ana Lucia Molina

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Transcranial magnetic stimulation (TMS) is a non-invasive neuromodulation technique for the investigation and modulation of cortical excitability in humans. The modulation of the processing of different cortical areas can result in several areas for rehabilitation, showing great potential in the treatment of motor disorders. In the human brain, the supplementary motor area (SMA) is involved in the control of the pelvic floor muscles (MAP), where dysfunctions of these muscles can lead to urinary incontinence. Peripheral magnetic stimulation, specifically sacral magnetic stimulation, has been used as a safe and effective treatment option for patients with lower urinary tract dysfunction. A systematic literature review was carried out (Pubmed, Medline and Google academic database) without a time limit using the keywords: "transcranial magnetic stimulation", "sacral neuromodulation", and "urinary incontinence", where 11 articles attended to the inclusion criteria. Results: Thirteen articles were selected. Magnetic stimulation is a non-invasive neuromodulation technique widely used in the evaluation of cortical areas and their respective peripheral areas, as well as in the treatment of lesions of brain origin. With regard to pelvic-perineal disorders, repetitive transcranial stimulation showed significant effects in controlling urinary incontinence, as well as sacral peripheral magnetic stimulation, in addition to exerting the potential to restore bladder sphincter function. Conclusion: Data from the literature suggest that both transcranial stimulation and peripheral stimulation are non-invasive references that can be promising and effective means of treatment in pelvic and perineal disorders. More prospective and randomized studies on a larger scale are needed, adapting the most appropriate and resolving parameters.

Keywords: urinary incontinence, non-invasive neuromodulation, sacral neuromodulation, transcranial magnetic stimulation.

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8151 Teachers' Knowledge, Perceptions, and Attitudes towards Renewable Energy Policy in Malaysia

Authors: Kazi Enamul Hoque

Abstract:

Initiatives on sustainable development are currently aggressively pursued throughout the world. The Malaysian government has developed key policies and strategies for over 30 years to achieve the nation’s policy objectives which are designed to mitigate the issues of security, energy efficiency and environmental impact to meet the rising energy demand. Malaysia’s current focus is on developing effective policies on renewable energy (RE) in order to reduce dependency on fossil fuel and contribute towards mitigating the effects of climate change. In this light mass awareness should be considered as the highest priority to protect the environment and to escape disaster due to climate change. Schools can be the reliable and effective foundation to prepare students to get familiar with environmental issues such as renewable and non-renewable energy sources. Teachers can play a vital role to create awareness among students about the advantages and disadvantages of using different renewable and nonrenewable energy resources. Thus, this study aims to investigate teachers’ knowledge, perceptions and attitudes towards renewable energy through a survey aiming a sustainable energy future. Five hundred sets of questionnaires were distributed to the school teachers in Malaysia. Total 420 questionnaires were returned of which 410 were complete to analyze. Finding shows that teachers are very familiar with the renewable energy like solar, wind and also geothermal. Most teachers were not sure about the Photovoltaics and biodiesel. Furthermore, teachers are also aware that primary energy in Malaysia is imported fossil fuels. Most teachers heard about the renewable energy in Malaysia and only few claims that they did not hear of such things and the others said that they never heard of it. The outcomes of the study will assist the energy policy makers to use teachers to create mass awareness of energy usages for future planning.

Keywords: Malaysia, non-renewable energy, renewable energy, school teacher

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8150 Socioeconomic Burden of Life Long Disease: A Case of Diabetes Care in Bangladesh

Authors: Samira Humaira Habib

Abstract:

Diabetes has profound effects on individuals and their families. If diabetes is not well monitored and managed, then it leads to long-term complications and a large and growing cost to the health care system. Prevalence and socioeconomic burden of diabetes and relative return of investment for the elimination or the reduction of the burden are much more important regarding its cost burden. Various studies regarding the socioeconomic cost burden of diabetes are well explored in developed countries but almost absent in developing countries like Bangladesh. The main objective of the study is to estimate the total socioeconomic burden of diabetes. It is a prospective longitudinal follow up study which is analytical in nature. Primary and secondary data are collected from patients who are undergoing treatment for diabetes at the out-patient department of Bangladesh Institute of Research & Rehabilitation in Diabetes, Endocrine & Metabolic Disorders (BIRDEM). Of the 2115 diabetic subjects, females constitute around 50.35% of the study subject, and the rest are male (49.65%). Among the subjects, 1323 are controlled, and 792 are uncontrolled diabetes. Cost analysis of 2115 diabetic patients shows that the total cost of diabetes management and treatment is US$ 903018 with an average of US$ 426.95 per patient. In direct cost, the investigation and medical treatment at hospital along with investigation constitute most of the cost in diabetes. The average cost of a hospital is US$ 311.79, which indicates an alarming warn for diabetic patients. The indirect cost shows that cost of productivity loss (US$ 51110.1) is higher among the all indirect item. All constitute total indirect cost as US$ 69215.7. The incremental cost of intensive management of uncontrolled diabetes is US$ 101.54 per patient and event-free time gained in this group is 0.55 years and the life years gain is 1.19 years. The incremental cost per event-free year gained is US$ 198.12. The incremental cost of intensive management of the controlled group is US$ 89.54 per patient and event-free time gained is 0.68 years, and the life year gain is 1.12 years. The incremental cost per event-free year gained is US$ 223.34. The EuroQoL difference between the groups is found to be 64.04. The cost-effective ratio is found to be US$ 1.64 cost per effect in case of controlled diabetes and US$ 1.69 cost per effect in case of uncontrolled diabetes. So management of diabetes is much more cost-effective. Cost of young type 1 diabetic patient showed upper socioeconomic class, and with the increase of the duration of diabetes, the cost increased also. The dietary pattern showed macronutrients intake and cost are significantly higher in the uncontrolled group than their counterparts. Proper management and control of diabetes can decrease the cost of care for the long term.

Keywords: cost, cost-effective, chronic diseases, diabetes care, burden, Bangladesh

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8149 System for Mechanical Stimulation of the Mesenchymal Stem Cells Supporting Differentiation into Osteogenic Cells

Authors: Jana Stepanovska, Roman Matejka, Jozef Rosina, Marta Vandrovcova, Lucie Bacakova

Abstract:

The aim of this study was to develop a system for mechanical and also electrical stimulation controlling in vitro osteogenesis under conditions more similar to the in vivo bone microenvironment than traditional static cultivation, which would achieve good adhesion, growth and other specific behaviors of osteogenic cells in cultures. An engineered culture system for mechanical stimulation of the mesenchymal stem cells on the charged surface was designed. The bioreactor allows efficient mechanical loading inducing an electrical response and perfusion of the culture chamber with seeded cells. The mesenchymal stem cells were seeded to specific charged materials, like polarized hydroxyapatite (Hap) or other materials with piezoelectric and ferroelectric features, to create electrical potentials for stimulating of the cells. The material of the matrix was TiNb alloy designed for these purposes, and it was covered by BaTiO3 film, like a kind of piezoelectric material. The process of mechanical stimulation inducing electrical response is controlled by measuring electrical potential in the chamber. It was performed a series of experiments, where the cells were seeded, perfused and stimulated up to 48 hours under different conditions, especially pressure and perfusion. The analysis of the proteins expression was done, which demonstrated the effective mechanical and electrical stimulation. The experiments demonstrated effective stimulation of the cells in comparison with the static culture. This work was supported by the Ministry of Health, grant No. 15-29153A and the Grant Agency of the Czech Republic grant No. GA15-01558S.

Keywords: charged surface, dynamic cultivation, electrical stimulation, ferroelectric layers, mechanical stimulation, piezoelectric layers

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8148 Sun-Light Driven Photocatalytic Degradation of Tetracycline Antibiotics Employing Hydrothermally Synthesized sno₂/mnv₂o₆ Heterojunction

Authors: Sandeep Kaushal

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Tetracycline (TC) is a widespread antibiotic that is utilised in a multitude of countries, particularly China, India, and the United States of America, due to its low cost and potency in boosting livestock production. Unfortunately, certain antibiotics can be hazardous to living beings due to metal complexation and aggregation, which can lead to teratogenicity and carcinogenicity. Heterojunction photocatalysts are promising for the effective removal of pollutants like antibiotics. Herein, a simple, economical, and pollution-less hydrothermal technique was used to construct SnO₂/MnV₂O₆heterojunction with varying amounts of tin dioxide (SO₂). Various sophisticated techniques like XRD, FTIR, XPS, FESEM, HRTEM, and PLand Raman spectroscopy demonstrated the successful synthesis of SnO₂/MnV₂O₆ heterojunction photocatalysts.BET surface area analysis revealed that the as-synthesized heterojunction has a favorable surface area and surface properties for efficacious degradation of tetracycline. Under the direct sunlight exposure, the SnO₂/MnV₂O₆ heterojunction possessed superior photodegradation activity toward TC than the pristine SnO₂ and MnV2O6owing to their excellent adsorption abilities suitable band positions, large surface areas along with the effective charge-transfer ability of the heterojunction. The SnO₂/MnV₂O₆ heterojunction possessed extraordinary efficiency for the photocatalytic degradation of TC antibiotic (98% in 60 min) with an apparent rate constant of 0.092 min–1. In the degradation experiments, photocatalytic activities of as-synthesized heterojunction were studied by varying different factors such as time contact, catalyst dose, and solution pH. The role of reactive species in antibiotics was validated by radical scavenging studies, which indicated that.OH, radical has a critical role in photocatalytic degradation. Moreover, liquid chromatography-mass spectrometry (LC-MS) investigations were employed to anticipate a plausible mechanism for TC degradation.

Keywords: photocatalytic degradation, tetracycline, heterojunction, LC-MS

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8147 Nutritionists' Perspective on the Conception of a Telenutrition Platform for Diabetes Care: Qualitative Study

Authors: Choumous Mannoubi, Dahlia Kairy, Brigitte Vachon

Abstract:

The use of technology allows clinicians to provide an individualized approach in a cost-effective manner and to reach a broader client base more easily. Such interventions can be effective in ensuring self-management and follow-up of people with diabetes, reducing the risk of complications by improving accessibility to care services, and better adherence to health recommendations. Consideration of users' opinions and fears to inform the design and implementation stages of these telehealth services seems to be essential to improve their acceptance and usability. The objective of this study is to describe the telepractice of nutritionists supporting the therapeutic management of diabetic patients and document the functional requirements of nutritionists for the design of a tele-nutrition platform. To best identify the requirements and constraints of nutritionists, we conducted individual semi-structured interviews with 10 nutritionists who offered tele-nutrition services. Using a qualitative design with a descriptive approach based on the Nutrition Care Process Model (mNCP) framework, we explored in depth the state of nutritionists' telepractice in public and private health care settings, as well as their requirements for teleconsultation. Qualitative analyses revealed that nutritionists primarily used telephone calls during the COVID 19 pandemic to provide teleconsultations. Nutritionists identified the following important features for the design of a tele-nutrition platform: it should support interprofessional collaboration, allow for the development and monitoring of a care plan, integrate with the existing IT environment, be easy to use, accommodate different levels of patient literacy, and allow for easy sharing of educational materials to support nutrition education.

Keywords: telehealth, nutrition, diabetes, telenutrition, teleconsultation, telemonitoring

Procedia PDF Downloads 114