Search results for: symptom control in oncology patients
Commenced in January 2007
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Edition: International
Paper Count: 15398

Search results for: symptom control in oncology patients

3128 Deficits in Perceptual and Musical Memory in Individuals with Major Depressive Disorder

Authors: Toledo-Fernandez Aldebaran

Abstract:

Introduction: One of the least explored cognitive functions in relation with depression is the one related to musical stimuli. Music perception and memory can become impaired as well. The term amusia is used to define a type of agnosia caused by damage to basic processes that creates a general inability to perceive music. Therefore, the main objective is to explore performance-based and self-report deficits in music perception and memory on people with major depressive disorder (MDD). Method: Data was collected through April-October 2021 recruiting people who met the eligibility criteria and using the Montreal Battery of Evaluation of Amusia (MBEA) to evaluate performance-based music perception and memory, along with the module for depression of the Mini International Neuropsychiatric Interview, and the Amusic Dysfunction Inventory (ADI) which evaluates the participants’ self-report concerning their abilities in music perception. Results: 64 participants were evaluated. The main study, referring to analyzing the differences between people with MDD and the control group, only showed one statistical difference on the Interval subtest of the MBEA. No difference was found in the dimensions assessed by the ADI. Conclusion: Deficits in interval perception can be explained by mental fatigue, to which people with depression are more vulnerable, rather than by specific deficits in musical perception and memory associated with depressive disorder. Additionally, significant associations were found between musical deficits as observed by performance-based evidence and music dysfunction according to self-report, which could suggest that some people with depression are capable of detecting these deficits in themselves.

Keywords: depression, amusia, music, perception, memory

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3127 Fear of Crime Among Females on University Campuses

Authors: Shahed, Tala, Ahlam, Marah, Sara, Shaden

Abstract:

Research on fear of crime has shown that there are many influences on it, including gender, age, and geographic location. For example, women are more afraid of crime than men. The campus has a high crime rate and fear of crime due to many hiding places and blind spots; women are more likely than men to be victims of certain types of crime, such as rape and verbal and sexual harassment. And it became clear that older female students have a different perception of the place over time and other knowledge and fear of it, another study at Hashemite University. This study aims to understand better how the environment affects the negative experiences of female students and how their age and familiarity environment affects their sense of safety. This study also examines whether CPTED can be used to help prevent crime. The Broken Windows Theory also states that crime occurs in areas with overt indications of criminal activity, antisocial behavior, and civil unrest. This is related to the principle of CPTED maintenance and monitoring, activity support, regional development, and access control. Given their increased vulnerability to harassment, “sexual harassment” can refer to different behaviors. On campuses, harassment was happening everywhere, but it was most prevalent in "blind spots" that were out of sight and deserted. This study uses a methodology based on quantitative data that depends on putting a number on the amount of a particular phenomenon that exists in the world. The main finding shows how CPTED works in an academic context and what adjustments need to be made.

Keywords: Hashmite University, CPTED, crime prevention, university campus, fear of crime, female faer, broken window theory

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3126 Electrochemical Sensor Based on Poly(Pyrogallol) for the Simultaneous Detection of Phenolic Compounds and Nitrite in Wastewater

Authors: Majid Farsadrooh, Najmeh Sabbaghi, Seyed Mohammad Mostashari, Abolhasan Moradi

Abstract:

Phenolic compounds are chief environmental contaminants on account of their hazardous and toxic nature on human health. The preparation of sensitive and potent chemosensors to monitor emerging pollution in water and effluent samples has received great consideration. A novel and versatile nanocomposite sensor based on poly pyrogallol is presented for the first time in this study, and its electrochemical behavior for simultaneous detection of hydroquinone (HQ), catechol (CT), and resorcinol (RS) in the presence of nitrite is evaluated. The physicochemical characteristics of the fabricated nanocomposite were investigated by emission-scanning electron microscopy (FE-SEM), energy-dispersive X-ray spectroscopy (EDS), and Brunauer-Emmett-Teller (BET). The electrochemical response of the proposed sensor to the detection of HQ, CT, RS, and nitrite is studied using cyclic voltammetry (CV), chronoamperometry (CA), differential pulse voltammetry (DPV), and electrochemical impedance spectroscopy (EIS). The kinetic characterization of the prepared sensor showed that both adsorption and diffusion processes can control reactions at the electrode. In the optimized conditions, the new chemosensor provides a wide linear range of 0.5-236.3, 0.8-236.3, 0.9-236.3, and 1.2-236.3 μM with a low limit of detection of 21.1, 51.4, 98.9, and 110.8 nM (S/N = 3) for HQ, CT and RS, and nitrite, respectively. Remarkably, the electrochemical sensor has outstanding selectivity, repeatability, and stability and is successfully employed for the detection of RS, CT, HQ, and nitrite in real water samples with the recovery of 96.2%–102.4%, 97.8%-102.6%, 98.0%–102.4% and 98.4%–103.2% for RS, CT, HQ, and nitrite, respectively. These outcomes illustrate that poly pyrogallol is a promising candidate for effective electrochemical detection of dihydroxybenzene isomers in the presence of nitrite.

Keywords: electrochemical sensor, poly pyrogallol, phenolic compounds, simultaneous determination

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3125 The Medical Student Perspective on the Role of Doubt in Medical Education

Authors: Madhavi-Priya Singh, Liam Lowe, Farouk Arnaout, Ludmilla Pillay, Giordan Perez, Luke Mischker, Steve Costa

Abstract:

Introduction: An Emergency Department consultant identified the failure of medical students to complete the task of clerking a patient in its entirety. As six medical students on our first clinical placement, we recognised our own failure and endeavored to examine why this failure was consistent among all medical students that had been given this task, despite our best motivations as adult learners. Aim: Our aim is to understand and investigate the elements which impeded our ability to learn and perform as medical students in the clinical environment, with reference to the prescribed task. We also aim to generate a discussion around the delivery of medical education with potential solutions to these barriers. Methods: Six medical students gathered together to have a comprehensive reflective discussion to identify possible factors leading to the failure of the task. First, we thoroughly analysed the delivery of the instructions with reference to the literature to identify potential flaws. We then examined personal, social, ethical, and cultural factors which may have impacted our ability to complete the task in its entirety. Results: Through collation of our shared experiences, with support from discussion in the field of medical education and ethics, we identified two major areas that impacted our ability to complete the set task. First, we experienced an ethical conflict where we believed the inconvenience and potential harm inflicted on patients did not justify the positive impact the patient interaction would have on our medical learning. Second, we identified a lack of confidence stemming from multiple factors, including the conflict between preclinical and clinical learning, perceptions of perfectionism in the culture of medicine, and the influence of upward social comparison. Discussion: After discussions, we found that the various factors we identified exacerbated the fears and doubts we already had about our own abilities and that of the medical education system. This doubt led us to avoid completing certain aspects of the tasks that were prescribed and further reinforced our vulnerability and perceived incompetence. Exploration of philosophical theories identified the importance of the role of doubt in education. We propose the need for further discussion around incorporating both pedagogic and andragogic teaching styles in clinical medical education and the acceptance of doubt as a driver of our learning. Conclusion: Doubt will continue to permeate our thoughts and actions no matter what. The moral or psychological distress that arises from this is the key motivating factor for our avoidance of tasks. If we accept this doubt and education embraces this doubt, it will no longer linger in the shadows as a negative and restrictive emotion but fuel a brighter dialogue and positive learning experience, ultimately assisting us in achieving our full potential.

Keywords: ethics, medical student, doubt, medical education, faith

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3124 Emotion-Convolutional Neural Network for Perceiving Stress from Audio Signals: A Brain Chemistry Approach

Authors: Anup Anand Deshmukh, Catherine Soladie, Renaud Seguier

Abstract:

Emotion plays a key role in many applications like healthcare, to gather patients’ emotional behavior. Unlike typical ASR (Automated Speech Recognition) problems which focus on 'what was said', it is equally important to understand 'how it was said.' There are certain emotions which are given more importance due to their effectiveness in understanding human feelings. In this paper, we propose an approach that models human stress from audio signals. The research challenge in speech emotion detection is finding the appropriate set of acoustic features corresponding to an emotion. Another difficulty lies in defining the very meaning of emotion and being able to categorize it in a precise manner. Supervised Machine Learning models, including state of the art Deep Learning classification methods, rely on the availability of clean and labelled data. One of the problems in affective computation is the limited amount of annotated data. The existing labelled emotions datasets are highly subjective to the perception of the annotator. We address the first issue of feature selection by exploiting the use of traditional MFCC (Mel-Frequency Cepstral Coefficients) features in Convolutional Neural Network. Our proposed Emo-CNN (Emotion-CNN) architecture treats speech representations in a manner similar to how CNN’s treat images in a vision problem. Our experiments show that Emo-CNN consistently and significantly outperforms the popular existing methods over multiple datasets. It achieves 90.2% categorical accuracy on the Emo-DB dataset. We claim that Emo-CNN is robust to speaker variations and environmental distortions. The proposed approach achieves 85.5% speaker-dependant categorical accuracy for SAVEE (Surrey Audio-Visual Expressed Emotion) dataset, beating the existing CNN based approach by 10.2%. To tackle the second problem of subjectivity in stress labels, we use Lovheim’s cube, which is a 3-dimensional projection of emotions. Monoamine neurotransmitters are a type of chemical messengers in the brain that transmits signals on perceiving emotions. The cube aims at explaining the relationship between these neurotransmitters and the positions of emotions in 3D space. The learnt emotion representations from the Emo-CNN are mapped to the cube using three component PCA (Principal Component Analysis) which is then used to model human stress. This proposed approach not only circumvents the need for labelled stress data but also complies with the psychological theory of emotions given by Lovheim’s cube. We believe that this work is the first step towards creating a connection between Artificial Intelligence and the chemistry of human emotions.

Keywords: deep learning, brain chemistry, emotion perception, Lovheim's cube

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3123 Intestine Characteristics and Blood Profile of Broiler Chickens Treated with Garlic

Authors: Mary Anthony Oguike, Ilouno, Amaduruonye

Abstract:

A completely randomized design experiment with 3 treatments was conducted to study the effects of garlic on intestine characteristics, haematology and serum biochemistry of Marshal broilers. Thirty three (33) broiler chicks were randomly allotted to each treatment designated T1, T2 and T3. The birds in each treatment were replicated 3 times with 11 broilers per replicate. They were fed diets supplemented with garlic at 0, 1.5 and 2.5 % /kg feed for t1, T2 and T3, respectively with T1 as control. Data were collected on intestine parameters, serum biochemical parameters and haematological indices. The results showed significant (P>0.05) dose-dependent decrease in intestine weight and caeca microbial load of the broilers. The intestine of broilers in the treatments showed normal histological architecture in all the treatments. The red blood cell (RBC), white blood cell (WBC), haemoglobin (Hb) and other haematological indices showed no significant differences (P<0.05) among the treatments. Cholesterol, globulin, glucose and alanin aminotransferase (ALT) were significantly different (P<0.05) among the treatment groups. Serum biochemical parameters such as, total protein albumin, bilirubin and others were not significant among the treatments. All the blood parameters studied fall within the normal range for broilers. Garlic supplementation in the diets of broilers did not have any detrimental effects on the treated birds since their serum biochemistry and haematology fall within the normal range for broilers birds. The microbial examination of intestine and caeca, as well as the histopathological studies of the intestine confirmed antimicrobial properties of garlic.

Keywords: broiler, biochemistry and haematology, garlic, intestine

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3122 Comparison of the Effectiveness of Tree Algorithms in Classification of Spongy Tissue Texture

Authors: Roza Dzierzak, Waldemar Wojcik, Piotr Kacejko

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Analysis of the texture of medical images consists of determining the parameters and characteristics of the examined tissue. The main goal is to assign the analyzed area to one of two basic groups: as a healthy tissue or a tissue with pathological changes. The CT images of the thoracic lumbar spine from 15 healthy patients and 15 with confirmed osteoporosis were used for the analysis. As a result, 120 samples with dimensions of 50x50 pixels were obtained. The set of features has been obtained based on the histogram, gradient, run-length matrix, co-occurrence matrix, autoregressive model, and Haar wavelet. As a result of the image analysis, 290 descriptors of textural features were obtained. The dimension of the space of features was reduced by the use of three selection methods: Fisher coefficient (FC), mutual information (MI), minimization of the classification error probability and average correlation coefficients between the chosen features minimization of classification error probability (POE) and average correlation coefficients (ACC). Each of them returned ten features occupying the initial place in the ranking devised according to its own coefficient. As a result of the Fisher coefficient and mutual information selections, the same features arranged in a different order were obtained. In both rankings, the 50% percentile (Perc.50%) was found in the first place. The next selected features come from the co-occurrence matrix. The sets of features selected in the selection process were evaluated using six classification tree methods. These were: decision stump (DS), Hoeffding tree (HT), logistic model trees (LMT), random forest (RF), random tree (RT) and reduced error pruning tree (REPT). In order to assess the accuracy of classifiers, the following parameters were used: overall classification accuracy (ACC), true positive rate (TPR, classification sensitivity), true negative rate (TNR, classification specificity), positive predictive value (PPV) and negative predictive value (NPV). Taking into account the classification results, it should be stated that the best results were obtained for the Hoeffding tree and logistic model trees classifiers, using the set of features selected by the POE + ACC method. In the case of the Hoeffding tree classifier, the highest values of three parameters were obtained: ACC = 90%, TPR = 93.3% and PPV = 93.3%. Additionally, the values of the other two parameters, i.e., TNR = 86.7% and NPV = 86.6% were close to the maximum values obtained for the LMT classifier. In the case of logistic model trees classifier, the same ACC value was obtained ACC=90% and the highest values for TNR=88.3% and NPV= 88.3%. The values of the other two parameters remained at a level close to the highest TPR = 91.7% and PPV = 91.6%. The results obtained in the experiment show that the use of classification trees is an effective method of classification of texture features. This allows identifying the conditions of the spongy tissue for healthy cases and those with the porosis.

Keywords: classification, feature selection, texture analysis, tree algorithms

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3121 Presence of High Concentrations of Toxic Metals from the Collected Soil Samples Due to Excessive E-Waste Burning in the Various Areas of Moradabad City, U.P India

Authors: Aprajita Singh, Anamika Tripathi, Surya P. Dwivedi

Abstract:

Moradabad is a small town in the Northern area of Uttar Pradesh, India. It is situated on the bank of river Ramganga which is also known as ‘Brass City of India’. There is eventually increase in the environmental pollution due to uncontrolled and inappropriate e-waste burning (recycling) activities which have been reported in many areas of Moradabad. In this paper, analysis of toxic heavy metals, causing pollution to the surrounding environment released from the e-waste burning and much other recycling process. All major e-waste burning sites are situated on the banks of the river which is burned in open environmental conditions. Soil samples were collected from seven (n=3) different sites including control site, after digestion of soil samples using triacid mixture, analysis of different toxic metals (Pb, Ar, Hg, Cd, Cr, Cu, Zn, Fe, and Ni) has been carried out with the help of instrument ICP-AAS. After the study, the outcome is that the soil of those areas contains a relatively high level of the toxic metals in order of Cu>Fe>Pb>Cd>Cr>Zn>Ar>Hg. The concentration of Cd, Pb, Cr, Ar and Zn (the majority of samples experimentally proved) exceeded the maximum standard level of WHO. Sequentially this study showed that uncontrolled e-waste processing operations caused serious pollution to local soil and release of toxic metals in the environment is also causing adverse effect on the health of people living in the nearby areas making them more prone to various harmful diseases.

Keywords: brass city, environment pollution, e-waste, toxic heavy metals

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3120 A Systematic Review of Chronic Neurologic Complications of COVID-19; A Potential Risk Factor for Narcolepsy, Parkinson's Disease, and Multiple Sclerosis.

Authors: Sulemana Saibu, Moses Ikpeme

Abstract:

Background: The severity of the COVID-19 pandemic, brought on by the SARS-CoV-2 coronavirus, has been unprecedented since the 1918 influenza pandemic. SARS-CoV-2 cases of CNS and peripheral nervous system disease, including neurodegenerative disorders and chronic immune-mediated diseases, may be anticipated based on knowledge of past coronaviruses, particularly those that caused the severe acute respiratory syndrome and Middle East respiratory syndrome outbreaks. Although respiratory symptoms are the most common clinical presentation, neurological symptoms are becoming increasingly recognized, raising concerns about their potential role in causing Parkinson's disease, Multiple sclerosis, and Narcolepsy. This systematic review aims to summarize the current evidence by exploring the association between COVID-19 infection and how it may overlap with etiological mechanisms resulting in Narcolepsy, Parkinson's disease, and Multiple sclerosis. Methods: A systematic search was conducted using electronic databases ((PubMed/MedLine, Embase, PsycINFO, ScieLO, Web of Science, ProQuest (Biotechnology, Virology, and AIDS), Scopus, and CINAHL)) to identify studies published between January 2020 and December 2022 that investigated the association between COVID-19 and Parkinson's disease, multiple sclerosis, and Narcolepsy. Per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the review was performed and reported. Study quality was assessed using the Critical Appraisal Skills Programme Checklist and the Joanna Briggs Institute Critical appraisal tools. Results: A total of 21 studies out of 1025 met the inclusion criteria, including 8 studies reporting Parkinson's disease, 11 on multiple sclerosis, and 2 on Narcolepsy. In COVID-19 individuals compared to the general population, Narcolepsy, Parkinson's disease, and multiple sclerosis were shown to have a higher incidence. The findings imply that COVID-19 may worsen the signs or induce multiple sclerosis and Parkinson's disease and may raise the risk of developing Narcolepsy. Further research is required to confirm these connections because the available data is insufficient. Conclusion: According to the existing data, COVID-19 may raise the risk of Narcolepsy and have a causative relationship with Parkinson's disease, multiple sclerosis, and other diseases. More study is required to confirm these correlations and pinpoint probable mechanisms behind these interactions. Clinicians should be aware of how COVID-19 may affect various neurological illnesses and should treat patients who are affected accordingly.

Keywords: COVID-19, parkinson’s disease, multiple sclerosis, narcolepsy, neurological disorders, sars-cov-2, neurodegenerative disorders, chronic immune-mediated diseases

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3119 Effect of Fat Percentage and Prebiotic Composition on Proteolysis, ACE-Inhibitory and Antioxidant Activity of Probiotic Yogurt

Authors: Mohammad B. HabibiNajafi, Saeideh Sadat Fatemizadeh, Maryam Tavakoli

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In recent years, the consumption of functional foods, including foods containing probiotic bacteria, has come to notice. Milk proteins have been identified as a source of angiotensin-I-converting enzyme )ACE( inhibitory peptides and are currently the best-known class of bioactive peptides. In this study, the effects of adding prebiotic ingredients (inulin and wheat fiber) and fat percentage (0%, 2% and 3.5%) in yogurt containing probiotic Lactobacillus casei on physicochemical properties, degree of proteolysis, antioxidant and ACE-inhibitory activity within 21 days of storage at 5 ± 1 °C were evaluated. The results of statistical analysis showed that the application of prebiotic compounds led to a significant increase in water holding capacity, proteolysis and ACE-inhibitory of samples. The degree of proteolysis in yogurt increases as storage time elapses (P < 0.05) but when proteolysis exceeds a certain threshold, this trend begins to decline. Also, during storage time, water holding capacity reduced initially but increased thereafter. Moreover, based on our findings, the survival of Lactobacillus casei in samples treated with inulin and wheat fiber increased significantly in comparison to the control sample (P < 0.05) whereas the effect of fat percentage on the survival of probiotic bacteria was not significant (P = 0.095). Furthermore, the effect of prebiotic ingredients and the presence of probiotic cultures on the antioxidant activity of samples was significant (P < 0.05).

Keywords: probiotic yogurt, proteolysis, ACE-inhibitory, antioxidant activity

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3118 The Need for a Consistent Regulatory Framework for CRISPR Gene-Editing in the European Union

Authors: Andrew Thayer, Courtney Rondeau, Paraskevi Papadopoulou

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The Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) gene-editing technologies have generated considerable discussion about the applications and ethics of their use. However, no consistent guidelines for using CRISPR technologies have been developed -nor common legislation passed related to gene editing, especially as it is connected to genetically modified organisms (GMOs) in the European Union. The recent announcement that the first babies with CRISPR-edited genes were born, along with new studies exploring CRISPR’s applications in treating thalassemia, sickle-cell anemia, cancer, and certain forms of blindness, have demonstrated that the technology is developing faster than the policies needed to control it. Therefore, it can be seen that a reasonable and coherent regulatory framework for the use of CRISPR in human somatic and germline cells is necessary to ensure the ethical use of the technology in future years. The European Union serves as a unique region of interconnected countries without a standard set of regulations or legislation for CRISPR gene-editing. We posit that the EU would serve as a suitable model in comparing the legislations of its affiliated countries in order to understand the practicality and effectiveness of adopting majority-approved practices. Additionally, we present a proposed set of guidelines which could serve as a basis in developing a consistent regulatory framework for the EU countries to implement but also act as a good example for other countries to adhere to. Finally, an additional, multidimensional framework of smart solutions is proposed with which all stakeholders are engaged to become better-informed citizens.

Keywords: CRISPR, ethics, regulatory framework, European legislation

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3117 Functional Characteristics of Chemosensory Proteins in the Sawyer Beetle Monochamus alternatus Hope

Authors: Saqib Ali, Man-Qun Wang

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The Japanese pine sawyer, Monochamus alternatus Hope (Coleoptera: Cerambycidae), is a major pest of pines and it is also the key vector of the exotic pinewood nematode in China. In the present study, we cloned, expressed, and purified a chemosensory protein (CSP) in M. alternatus. We surveyed its expression in various developmental stages of male and female adult tissues and determined its binding affinities for different pine volatiles using a competitive binding fluorescence assay. A CSP known as CSP5 in M. alternatus was obtained from an antennal cDNA library and expressed in Escherichia coli. Quantitative reverse transcription polymerase chain reaction results indicated that the CSP5 gene was mainly expressed in male and female antennae. Competitive binding assays were performed to test the binding affinity of recombinant CSP5 to 13 odour molecules of pine volatiles. The results showed that CSP5 showed very strong binding abilities to myrcene, (+)-β-pinene, and (−)-isolongifolene, whereas the volatiles 2-methoxy-4-vinylphenol, p-cymene, and (+)-limonene oxide have relatively weak binding affinity at pH 5.0. Three volatiles myrcene, (+)-β-pinene, and (−)-isolongifolene may play crucial roles in CSP5 binding with ligands, but this needs further study for confirmation. The sensitivity of insect to host plant volatiles can effectively be used to control and monitor the population through mass trapping as part of integrated pest management programs.

Keywords: olfactory-specific protein, volatiles, competitive binding assay, expression characteristics, qPCR

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3116 Menopause Hormone Therapy: An Insight into Knowledge and Attitudes of Obstetricians and Gynecologists in Singapore

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

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

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

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3115 Bacteriological Screening and Antibiotic – Heavy Metal Resistance Profile of the Bacteria Isolated from Some Amphibian and Reptile Species of the Biga Stream in Turkey

Authors: Nurcihan Hacioglu, Cigdem Gul, Murat Tosunoglu

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In this article, the antibiogram and heavy metal resistance profile of the bacteria isolated from total 34 studied animals (Pelophylax ridibundus = 12, Mauremys rivulata = 14, Natrix natrix = 8) captured around the Biga Stream, are described. There was no database information on antibiogram and heavy metal resistance profile of bacteria from these area’s amphibians and reptiles. In this study, a total of 200 bacteria were successfully isolated from cloaca and oral samples of the aquatic amphibians and reptiles as well as from the water sample. According to Jaccard’s similarity index, the degree of similarity in the bacterial flora was quite high among the amphibian and reptile species under examination, whereas it was different from the bacterial diversity in the water sample. The most frequent isolates were A. hydrophila (31.5%), B. pseudomallei (8.5%), and C. freundii (7%). The total numbers of bacteria obtained were as follows: 45 in P. ridibundus, 45 in N. natrix 30 in M. rivulata, and 80 in the water sample. The result showed that cefmetazole was the most effective antibiotic to control the bacteria isolated in this study and that approximately 93.33% of the bacterial isolates were sensitive to this antibiotic. The Multiple Antibiotic Resistances (MAR) index indicated that P. ridibundus (0.95) > N. natrix (0.89) > M. rivulata (0.39). Furthermore, all the tested heavy metals (Pb+2, Cu+2, Cr+3, and Mn+2) inhibit the growth of the bacterial isolates at different rates. Therefore, it indicated that the water source of the animals was contaminated with both antibiotic residues and heavy metals.

Keywords: bacteriological quality, amphibian, reptile, antibiotic, heavy metal resistance

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3114 Frontal Oscillatory Activity and Phase–Amplitude Coupling during Chan Meditation

Authors: Arthur C. Tsai, Chii-Shyang Kuo, Vincent S. C. Chien, Michelle Liou, Philip E. Cheng

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Meditation enhances mental abilities and it is an antidote to anxiety. However, very little is known about brain mechanisms and cortico-subcortical interactions underlying meditation-induced anxiety relief. In this study, the changes of phase-amplitude coupling (PAC) in which the amplitude of the beta frequency band were modulated in phase with delta rhythm were investigated after eight-week of meditation training. The study hypothesized that through a concentrate but relaxed mental training the delta-beta coupling in the frontal regions is attenuated. The delta-beta coupling analysis was applied to within and between maximally-independent component sources returned from the extended infomax independent components analysis (ICA) algorithm on the continuous EEG data during mediation. A unique meditative concentration task through relaxing body and mind was used with a constant level of moderate mental effort, so as to approach an ‘emptiness’ meditative state. A pre-test/post-test control group design was used in this study. To evaluate cross-frequency phase-amplitude coupling of component sources, the modulation index (MI) with statistics to calculate circular phase statistics were estimated. Our findings reveal that a significant delta-beta decoupling was observed in a set of frontal regions bilaterally. In addition, beta frequency band of prefrontal component were amplitude modulated in phase with the delta rhythm of medial frontal component.

Keywords: phase-amplitude coupling, ICA, meditation, EEG

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3113 Effects of Beeswax Coating on the Properties of Cocoa Bean Shell Based Papers

Authors: Sri Rejeki, Tamrin Tamrin, RH. F. Faradilla, Muhammad N. Ibrahim, Mariana M., Irnawati Irnawati

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Cocoa bean shells, despite their antioxidant and antimicrobial properties, are still considered as an underutilized agricultural waste. The functional properties and their lignocelluloses content make cocoa bean shells a potential material for paper-based food packaging. In our previous research, we have successfully produced papers from cocoa bean shells that had antioxidant and antibacterial activities. However, the hydrophilic nature of the lignocelluloses of cocoa bean shells hinders the application of the paper to be used as a food packaging. In this research, we aimed to study the effects of beeswax coating on the wettability and mechanical properties of the paper. The coating was done by dipping the papers in beeswax solution several times and in three different beeswax concentrations. The number of dipping and beeswax concentration significantly (p<0.05) affected the water contact angle of the papers. Results show that the water contact angle increases dramatically due to the coating treatment. The control paper or uncoated paper had a contact angle of 40.50o, while the contact angle of the best-coated paper (D3B3: 3x dipping, 3g/10mL beeswax) reached 96.93o. Both tensile strength and percent elongation were not significantly (p>0.05) affected by the coating treatment. This showed that beeswax was a potential organic material to improve the hydrophobicity of paper from cocoa bean shells without any undesirable effects on the mechanical properties of the paper.

Keywords: cocoa bean shell, paper, beeswax, coating, contact angle

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3112 Paraoxonase 1 (PON 1) Arylesterase Activity and Apolipoprotein B: Predictors of Myocardial Infarction

Authors: Mukund Ramchandra Mogarekar, Pankaj Kumar, Shraddha Vilas More

Abstract:

Background: Myocardial infarction (MI) is defined as myocardial cell death due to prolonged ischemia as a consequence of atherosclerosis. TC, low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C), Apo B, and lipoprotein(a) was found as atherogenic factors while high-density lipoprotein cholesterol (HDL-C) was anti-atherogenic. Methods and Results: The study group consists of 40, MI subjects and 40 healthy individuals in control group. PON 1 Arylesterase activity (ARE) was measured by using phenylacetate. Phenotyping was done by double substrate method, serum AOPP by using chloramine T and Apo B by Turbidimetric immunoassay. PON 1 ARE activities were significantly lower (p< 0.05) and AOPPs & Apo B were higher in MI subjects (p> 0.05). Trimodal distribution of QQ, QR, and RR phenotypes of study population showed no significant difference among cases and controls (p> 0.05). Univariate binary logistic regression analysis showed independent association of TC, HDL, LDL, AOPP, Apo B, and PON 1 ARE activity with MI and multiple forward binary logistic regression showed PON 1 ARE activity and serum Apo B as an independent predictor of MI. Conclusions: Decrease in PON 1 ARE activity in MI subjects than in controls suggests increased oxidative stress in MI which is reflected by significantly increased AOPP and Apo B. PON1 polymorphism of QQ, QR and RR showed no significant difference in protection against MI. Univariate and multiple binary logistic regression showed PON1 ARE activity and serum Apo B as an independent predictor of MI.

Keywords: advanced oxidation protein product, apolipoprotein B, PON 1 arylesterase activity, myocardial infarction

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3111 Non-Invasive Pre-Implantation Genetic Assessment Using NGS in IVF Clinical Routine

Authors: Katalin Gombos, Bence Gálik, Krisztina Ildikó Kalács, Krisztina Gödöny, Ákos Várnagy, József Bódis, Attila Gyenesei, Gábor L. Kovács

Abstract:

Although non-invasive pre-implantation genetic testing for aneuploidy (NIPGT-A) is potentially appropriate to assess chromosomal ploidy of the embryo, practical application of it in a routine IVF center has not been started in the absence of a recommendation. We developed a comprehensive workflow for a clinically applicable strategy for NIPGT-A based on next-generation sequencing (NGS) technology. We performed MALBAC whole genome amplification and NGS on spent blastocyst culture media of Day 3 embryos fertilized with intra-cytoplasmic sperm injection (ICSI). Spent embryonic culture media of morphologically good quality score embryos were enrolled in further analysis with the blank culture media as background control. Chromosomal abnormalities were identified by an optimized bioinformatics pipeline applying a copy number variation (CNV) detecting algorithm. We demonstrate a comprehensive workflow covering both wet- and dry-lab procedures supporting a clinically applicable strategy for NIPGT-A. It can be carried out within 48 h which is critical for the same-cycle blastocyst transfer, but also suitable for “freeze all” and “elective frozen embryo” strategies. The described integrated approach of non-invasive evaluation of embryonic DNA content of the culture media can potentially supplement existing pre-implantation genetic screening methods.

Keywords: next generation sequencing, in vitro fertilization, embryo assessment, non-invasive pre-implantation genetic testing

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3110 Knowledge of the Doctors Regarding International Patient Safety Goal

Authors: Fatima Saeed, Abdullah Mudassar

Abstract:

Introduction: Patient safety remains a global priority in the ever-evolving healthcare landscape. At the forefront of this endeavor are the International Patient Safety Goals (IPSGs), a standardized framework designed to mitigate risks and elevate the quality of care. Doctors, positioned as primary caregivers, wield a pivotal role in upholding and adhering to IPSGs, underscoring the critical significance of their knowledge and understanding of these goals. This research embarks on a comprehensive exploration into the depth of Doctors ' comprehension of IPSGs, aiming to unearth potential gaps and provide insights for targeted educational interventions. Established by influential healthcare bodies, including the World Health Organization (WHO), IPSGs represent a universally applicable set of objectives spanning crucial domains such as medication safety, infection control, surgical site safety, and patient identification. Adherence to these goals has exhibited substantial reductions in adverse events, fostering an overall enhancement in the quality of care. This study operates on the fundamental premise that an informed Doctors workforce is indispensable for effectively implementing IPSGs. A nuanced understanding of these goals empowers Doctors to identify potential risks, advocate for necessary changes, and actively contribute to a safety-centric culture within healthcare institutions. Despite the acknowledged importance of IPSGs, there is a growing concern that nurses may need more knowledge to integrate these goals into their practice seamlessly. Methodology: A Comprehensive research methodology covering study design, setting, duration, sample size determination, sampling technique, and data analysis. It introduces the philosophical framework guiding the research and details material, methods, and the analysis framework. The descriptive quantitative cross-sectional study in teaching care hospitals utilized convenient sampling over six months. Data collection involved written informed consent and questionnaires, analyzed with SPSS version 23, presenting results graphically and descriptively. The chapter ensures a clear understanding of the study's design, execution, and analytical processes. Result: The survey results reveal a substantial distribution across hospitals, with 34.52% in MTIKTH and 65.48% in HMC MTI. There is a notable prevalence of patient safety incidents, emphasizing the significance of adherence to IPSGs. Positive trends are observed, including 77.0% affirming the "time-out" procedure, 81.6% acknowledging effective healthcare provider communication, and high recognition (82.7%) of the purpose of IPSGs to improve patient safety. While the survey reflects a good understanding of IPSGs, areas for improvement are identified, suggesting opportunities for targeted interventions. Discussion: The study underscores the need for tailored care approaches and highlights the bio-socio-cultural context of 'contagion,' suggesting areas for further research amid antimicrobial resistance. Shifting the focus to patient safety practices, the survey chapter provides a detailed overview of results, emphasizing workplace distribution, patient safety incidents, and positive reflections on IPSGs. The findings indicate a positive trend in patient safety practices with areas for improvement, emphasizing the ongoing need for reinforcing safety protocols and cultivating a safety-centric culture in healthcare. Conclusion: In summary, the survey indicates a positive trend in patient safety practices with a good understanding of IPSGs among participants. However, identifying areas for potential improvement suggests opportunities for targeted interventions to enhance patient safety further. Ongoing efforts to reinforce adherence to safety protocols, address identified gaps, and foster a safety culture will contribute to continuous improvements in patient care and outcomes.

Keywords: infection control, international patient safety, patient safety practices, proper medication

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3109 The Effect of Power of Isolation Transformer on the Lamps in Airfield Ground Lighting Systems

Authors: Hossein Edrisi

Abstract:

To study the impact of the amount and volume of power of isolation transformer on the lamps in airfield Ground Lighting Systems. A test was conducted in Persian Gulf International Airport, This airport is situated in the south of Iran and it is one of the most cutting-edge airports, the same one that owns modern devices. Iran uses materials and auxiliary equipment which are made by ADB Company from Belgium. Airfield ground lighting (AGL) systems are responsible for providing visual issue to aircrafts and helicopters in the runways. In an AGL system a great deal of lamps are connected in serial circuits to each other and each ring has its individual constant current regulators (CCR), which through that provide energy to the lamps. Control of lamps is crucial for maintenance and operation in the AGL systems. Thanks to the Programmable Logic Controller (PLC) that is a cutting-edge technology can help the system to connect the elements from substations and ATC (TOWER). For this purpose, a test in real conditions of the airport done for all element that used in the airport such as isolation transformer in different power capacity and different consuming power and brightness of the lamps. The data were analyzed with Lux meter and Multimeter. The results had shown that the increase in the power of transformer caused a significant increase in brightness. According to the Ohm’s law and voltage division, without changing the characteristics of the light bulb, it is not possible to change the voltage, just need to change the amount of transformer with which it connects to the lamps. When the voltage is increased, the current through the bulb has to increase as well, because of Ohm's law: I=V/R and I=V/R which means that if V increases, so do I increase. The output voltage on the constant current regulator emerges between the lamps and the transformers.

Keywords: AGL, CCR, lamps, transformer, Ohm’s law

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3108 Traditional Medicine in Children: A Significant Cause of Morbidity and Mortality

Authors: Atitallah Sofien, Bouyahia Olfa, Romdhani Meriam, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

Abstract:

Introduction: Traditional medicine refers to a diverse range of therapeutic practices and knowledge systems that have been employed by different cultures over an extended period to uphold and rejuvenate health. These practices can involve herbal remedies, acupuncture, massage, and alternative healing methods that deviate from conventional medical approaches. In Tunisia, we often use unidentified utensils to scratch the oral cavity internally in infants in order to widen the oral cavity for better breathing and swallowing. However, these practices can be risky and may jeopardize the patients' prognosis or even their lives. Aim: This is the case of a nine-month-old infant, admitted to the pediatric department and subsequently to the intensive care unit due to a peritonsillar abscess following the utilization of an unidentifiable tool to scrape the interior of the oral cavity. Case Report: This is a 9-month-old infant with no particular medical history, admitted for high respiratory distress and a fever persisting for 4 days. On clinical examination, he had a respiratory rate of 70 cycles per minute with an oxygen saturation of 97% and subcostal retractions, along with a heart rate of 175 beats per minute. His white blood cell count was 40,960/mm³, and his C-reactive protein was 250 mg/L. Given the severity of the clinical presentation, the infant was transferred to the intensive care unit, intubated, and mechanically ventilated. A cervical-thoracic CT scan was performed, revealing a ruptured 18 mm left peritonsillar abscess in the oropharynx associated with cellulitis of the retropharyngeal space. The oto-rhino-laryngoscopic examination revealed an asymmetry involving the left lateral wall of the oropharynx with the presence of a fistula behind the posterior pillar. Dissection of the collection cavity was performed, allowing the drainage of 2 ml of pus. The culture was negative. The patient received cefotaxime in combination with metronidazole and gentamicin for a duration of 10 days, followed by a switch to amoxicillin-clavulanic acid for 7 days. The patient was extubated after 4 days of treatment, and the clinical and radiological progress was favorable. Conclusions: Traditional medicine remains risky due to the lack of scientific evidence and the potential for injuries and transmission of infectious diseases, especially in children, who constitute a vulnerable population. Therefore, parents should consult healthcare professionals and rely on evidence-based care.

Keywords: children, peritonsillar abscess, traditional medicine, respiratory distress

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3107 Novel EGFR Ectodomain Mutations and Resistance to Anti-EGFR and Radiation Therapy in H&N Cancer

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

Abstract:

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

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

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3106 The Methodology of System Modeling of Mechatronic Systems

Authors: Lakhoua Najeh

Abstract:

Aims of the work: After a presentation of the functionality of an example of a mechatronic system which is a paint mixer system, we present the concepts of modeling and safe operation. This paper briefly discusses how to model and protect the functioning of a mechatronic system relying mainly on functional analysis and safe operation techniques. Methods: For the study of an example of a mechatronic system, we use methods for external functional analysis that illustrate the relationships between a mechatronic system and its external environment. Thus, we present the Safe-Structured Analysis Design Technique method (Safe-SADT) which allows the representation of a mechatronic system. A model of operating safety and automation is proposed. This model enables us to use a functional analysis technique of the mechatronic system based on the GRAFCET (Graphe Fonctionnel de Commande des Etapes et Transitions: Step Transition Function Chart) method; study of the safe operation of the mechatronic system based on the Safe-SADT method; automation of the mechatronic system based on a software tool. Results: The expected results are to propose a model and safe operation of a mechatronic system. This methodology enables us to analyze the relevance of the different models based on Safe-SADT and GRAFCET in relation to the control and monitoring functions and to study the means allowing exploiting their synergy. Conclusion: In order to propose a general model of a mechatronic system, a model of analysis, safety operation and automation of a mechatronic system has been developed. This is how we propose to validate this methodology through a case study of a paint mixer system.

Keywords: mechatronic systems, system modeling, safe operation, Safe-SADT

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3105 Prediction of Compressive Strength of Concrete from Early Age Test Result Using Design of Experiments (Rsm)

Authors: Salem Alsanusi, Loubna Bentaher

Abstract:

Response Surface Methods (RSM) provide statistically validated predictive models that can then be manipulated for finding optimal process configurations. Variation transmitted to responses from poorly controlled process factors can be accounted for by the mathematical technique of propagation of error (POE), which facilitates ‘finding the flats’ on the surfaces generated by RSM. The dual response approach to RSM captures the standard deviation of the output as well as the average. It accounts for unknown sources of variation. Dual response plus propagation of error (POE) provides a more useful model of overall response variation. In our case, we implemented this technique in predicting compressive strength of concrete of 28 days in age. Since 28 days is quite time consuming, while it is important to ensure the quality control process. This paper investigates the potential of using design of experiments (DOE-RSM) to predict the compressive strength of concrete at 28th day. Data used for this study was carried out from experiment schemes at university of Benghazi, civil engineering department. A total of 114 sets of data were implemented. ACI mix design method was utilized for the mix design. No admixtures were used, only the main concrete mix constituents such as cement, coarse-aggregate, fine aggregate and water were utilized in all mixes. Different mix proportions of the ingredients and different water cement ratio were used. The proposed mathematical models are capable of predicting the required concrete compressive strength of concrete from early ages.

Keywords: mix proportioning, response surface methodology, compressive strength, optimal design

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3104 Tomato-Weed Classification by RetinaNet One-Step Neural Network

Authors: Dionisio Andujar, Juan lópez-Correa, Hugo Moreno, Angela Ri

Abstract:

The increased number of weeds in tomato crops highly lower yields. Weed identification with the aim of machine learning is important to carry out site-specific control. The last advances in computer vision are a powerful tool to face the problem. The analysis of RGB (Red, Green, Blue) images through Artificial Neural Networks had been rapidly developed in the past few years, providing new methods for weed classification. The development of the algorithms for crop and weed species classification looks for a real-time classification system using Object Detection algorithms based on Convolutional Neural Networks. The site study was located in commercial corn fields. The classification system has been tested. The procedure can detect and classify weed seedlings in tomato fields. The input to the Neural Network was a set of 10,000 RGB images with a natural infestation of Cyperus rotundus l., Echinochloa crus galli L., Setaria italica L., Portulaca oeracea L., and Solanum nigrum L. The validation process was done with a random selection of RGB images containing the aforementioned species. The mean average precision (mAP) was established as the metric for object detection. The results showed agreements higher than 95 %. The system will provide the input for an online spraying system. Thus, this work plays an important role in Site Specific Weed Management by reducing herbicide use in a single step.

Keywords: deep learning, object detection, cnn, tomato, weeds

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3103 Relationshiop Between Occupants' Behaviour And Indoor Air Quality In Malaysian Public Hospital Outpatient Department

Authors: Farha Ibrahim, Ely Zarina Samsudin, Ahmad Razali Ishak, Jeyanthini Sathasivam

Abstract:

Introduction: Indoor air quality (IAQ) has recently gained substantial traction as the airborne transmission of infectious respiratory disease has become an increasing public health concern. Public hospital outpatient department (OPD). IAQ warrants special consideration as it is the most visited department in which patients and staff are all directly impacted by poor IAQ. However, there is limited evidence on IAQ in these settings. Moreover, occupants’ behavior like occupant’s movement and operation of door, windows and appliances, have been shown to significantly affect IAQ, yet the influence of these determinants on IAQ in such settings have not been established. Objectives: This study aims to examine IAQ in Malaysian public hospitals OPD and assess its relationships with occupants’ behavior. Methodology: A multicenter cross-sectional study in which stratified random sampling of Johor public hospitals OPD (n=6) according to building age was conducted. IAQ measurements include indoor air temperature, relative humidity (RH), air velocity (AV), carbon dioxide (CO2), total bacterial count (TBC) and total fungal count (TFC). Occupants’ behaviors in Malaysian public hospital OPD are assessed using observation forms, and results were analyzed. Descriptive statistics were performed to characterize all study variables, whereas non-parametric Spearman Rank correlation analysis was used to assess the correlation between IAQ and occupants’ behavior. Results: After adjusting for potential cofounder, the study has suggested that occupants’ movement in new building, like seated quietly, is significantly correlated with AV in new building (r 0.642, p-value 0.010), CO2 in new (r 0.772, p-value <0.001) and old building (r -0.559, p-value 0.020), TBC in new (r 0.747, p-value 0.001) and old building (r -0.559, p-value 0.020), and TFC in new (r 0.777, p-value <0.001) and old building (r -0.485, p-value 0.049). In addition, standing relaxed movement is correlated with indoor air temperature (r 0.823, p-value <0.001) in new building, CO2 (r 0.559, p-value 0.020), TBC (r 0.559, p-value 0.020), and TFC (r -0.485, p-value 0.049) in old building, while walking is correlated with AV in new building (r -0.642, p-value 0.001), CO2 in new (r -0.772, p-value <0.001) and old building (r 0.559, p-value 0.020), TBC in new (r -0.747, p-value 0.001) and old building (r 0.559, p-value 0.020), and TFC in old building (r -0.485, p-value 0.049). The indoor air temperature is significantly correlated with number of doors kept opened (r 0.522, p-value 0.046), frequency of door adjustments (r 0.753, p-value 0.001), number of windows kept opened (r 0.522, p-value 0.046), number of air-conditioned (AC) switched on (r 0.698, p-value 0.004) and frequency of AC adjustment (r 0.753, p-value 0.001) in new hospital OPD building. AV is found to be significantly correlated with number of doors kept opened (r 0.642, p-value 0.01), frequency of door adjustments (r 0.553, p-value 0.032), number of windows kept opened (r 0.642, p-value 0.01), and frequency of AC adjustment, number of fans switched on, and frequency of fans adjustment(all with r 0.553, p-value 0.032) in new building. In old hospital OPD building, the number of doors kept opened is significantly correlated with CO₂, TBC (both r -0.559, p-value 0.020) and TFC (r -0.495, p-value 0.049), frequency of door adjustment is significantly correlated with CO₂, TBC (both r-0.559, p-value 0.020) and TFC (r -0.495, p-value 0.049), number of windows kept opened is significantly correlated with CO₂, TBC (both r 0.559, p-value 0.020) and TFC (r 0.495, p-value 0.049), frequency of window adjustment is significantly correlated with CO₂,TBC (both r -0.559, p-value 0.020) and TFC (r -0.495, p-value 0.049), number of AC switched on is significantly correlated with CO₂, TBC (both r -0.559, p-value 0.020) and TFC (r -0.495, p-value 0.049),, frequency of AC adjustment is significantly correlated with CO2 (r 0.559, p-value 0.020), TBC (0.559, p-value 0.020) and TFC (r -0.495, p-value 0.049), number of fans switched on is significantly correlated with CO2, TBC (both r 0.559, p-value 0.020) and TFC (r 0.495, p-value 0.049), and frequency of fans adjustment is significantly correlated with CO2, TBC (both r -0.559, p-value 0.020) and TFC (r -0.495, p-value 0.049). Conclusion: This study provided evidence on IAQ parameters in Malaysian public hospitals OPD and significant factors that may be effective targets of prospective intervention, thus enabling stakeholders to develop appropriate policies and programs to mitigate IAQ issues in Malaysian public hospitals OPD.

Keywords: outpatient department, iaq, occupants practice, public hospital

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3102 The Effect of Development of Two-Phase Flow Regimes on the Stability of Gas Lift Systems

Authors: Khalid. M. O. Elmabrok, M. L. Burby, G. G. Nasr

Abstract:

Flow instability during gas lift operation is caused by three major phenomena – the density wave oscillation, the casing heading pressure and the flow perturbation within the two-phase flow region. This paper focuses on the causes and the effect of flow instability during gas lift operation and suggests ways to control it in order to maximise productivity during gas lift operations. A laboratory-scale two-phase flow system to study the effects of flow perturbation was designed and built. The apparatus is comprised of a 2 m long by 66 mm ID transparent PVC pipe with air injection point situated at 0.1 m above the base of the pipe. This is the point where stabilised bubbles were visibly clear after injection. Air is injected into the water filled transparent pipe at different flow rates and pressures. The behavior of the different sizes of the bubbles generated within the two-phase region was captured using a digital camera and the images were analysed using the advanced image processing package. It was observed that the average maximum bubbles sizes increased with the increase in the length of the vertical pipe column from 29.72 to 47 mm. The increase in air injection pressure from 0.5 to 3 bars increased the bubble sizes from 29.72 mm to 44.17 mm and then decreasing when the pressure reaches 4 bars. It was observed that at higher bubble velocity of 6.7 m/s, larger diameter bubbles coalesce and burst due to high agitation and collision with each other. This collapse of the bubbles causes pressure drop and reverse flow within two phase flow and is the main cause of the flow instability phenomena.

Keywords: gas lift instability, bubbles forming, bubbles collapsing, image processing

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3101 A 20 Year Comparison of Australian Childhood Bicycle Injuries – Have We Made a Difference?

Authors: Bronwyn Griffin, Caroline Acton, Tona Gillen, Roy Kimble

Abstract:

Background: Bicycle riding is a common recreational activity enjoyed by many children throughout Australia that has been associated with the usual caveat of benefits related to exercise and recreation. Given Australia was the first country in the world to introduce cyclist helmet laws in 1991, very few publications have reviewed paediatric cycling injuries (fatal or non-fatal) since. Objectives: To identify trends in children (0-16 years) who required admission for greater than 24 hours following a bicycle-related injury (fatal and non-fatal) in Queensland. Further, to discuss changes that have occurred in paediatric cycling injury trends in Queensland since a prominent local study/publication in 1995. This paper aims to establish evidence to inform interventions promoting safer riding to parents, children and communities. Methods: Data on paediatric (0-16 years) cycling injuries in Queensland resulting in hospital admission more than 24 hours across three tertiary paediatric hospitals in Brisbane between November 2008-June 2015 was compiled by the Paediatric Trauma Data Registry for non-fatal injuries. The Child Death Review Team at the Queensland Families and Childhood Commission provided data on fatalities in children <17years from (June 2004 –June 2015). Comparing trends to a local study published in 1995 Results: Between 2008-2015 there were 197 patients admitted for greater than 24 hours following a cycling injury. The median age was 11 years, with males more frequently involved (n=139, 87%) compared to females. Mean length of stay was three days, with 47 (28%) children admitted to PICU, location of injury was most often the street (n=63, 37%). Between 2004 –2015 there were 15 fatalities (Incidence rate 0.25/100,000); all were male, 14/15 occurred on the street, with eight stated to have not been wearing a helmet, 11/15 children came from the least advantaged socio-economic group (SEIFA) compared to a local publication in 1995, finding of 94 fatalities between (1981-1992). Conclusions: There has been a notable decrease in incidence of fatalities between the two time periods with incidence rates dropping from 1.75-0.25/100,000. More statistics need to be run to ascertain if this is a true reduction or perhaps a decrease in children riding bicycles. Injuries that occur on the street that come in contact with a car remain of serious concern. The purpose of this paper is not to discourage bicycle riding among child and adolescent populations, rather, inform parents and the wider community about the risks associated with cycling in order to reduce injuries associated with this sport, whilst promoting safe cycling.

Keywords: paediatric, cycling, trauma, prevention, emergency

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3100 Supply Side Readiness for Universal Health Coverage: Assessing the Availability and Depth of Essential Health Package in Rural, Remote and Conflict Prone District

Authors: Veenapani Rajeev Verma

Abstract:

Context: Assessing facility readiness is paramount as it can indicate capacity of facilities to provide essential care for resilience to health challenges. In the context of decentralization, estimation of supply side readiness indices at sub national level is imperative for effective evidence based policy but remains a colossal challenge due to lack of dependable and representative data sources. Setting: District Poonch of Jammu and Kashmir was selected for this study. It is remote, rural district with unprecedented topographical barriers and is identified as high priority by government. It is also a fragile area as is bounded by Line of Control with Pakistan bearing the brunt of cease fire violations, military skirmishes and sporadic militant attacks. Hilly geographical terrain, rudimentary/absence of road network and impoverishment are quintessential to this area. Objectives: Objective of the study is to a) Evaluate the service readiness of health facilities and create a concise index subsuming plethora of discrete indicators and b) Ascertain supply side barriers in service provisioning via stakeholder’s analysis. Study also strives to expand analytical domain unravelling context and area specific intricacies associated with service delivery. Methodology: Mixed method approach was employed to triangulate quantitative analysis with qualitative nuances. Facility survey encompassing 90 Subcentres, 44 Primary health centres, 3 Community health centres and 1 District hospital was conducted to gauge general service availability and service specific availability (depth of coverage). Compendium of checklist was designed using Indian Public Health Standards (IPHS) in form of standard core questionnaire and scorecard generated for each facility. Information was collected across dimensions of amenities, equipment, medicines, laboratory and infection control protocols as proposed in WHO’s Service Availability and Readiness Assesment (SARA). Two stage polychoric principal component analysis employed to generate a parsimonious index by coalescing an array of tracer indicators. OLS regression method used to determine factors explaining composite index generated from PCA. Stakeholder analysis was conducted to discern qualitative information. Myriad of techniques like observations, key informant interviews and focus group discussions using semi structured questionnaires on both leaders and laggards were administered for critical stakeholder’s analysis. Results: General readiness score of health facilities was found to be 0.48. Results indicated poorest readiness for subcentres and PHC’s (first point of contact) with composite score of 0.47 and 0.41 respectively. For primary care facilities; principal component was characterized by basic newborn care as well as preparedness for delivery. Results revealed availability of equipment and surgical preparedness having lowest score (0.46 and 0.47) for facilities providing secondary care. Presence of contractual staff, more than 1 hr walk to facility, facilities in zone A (most vulnerable) to cross border shelling and facilities inaccessible due to snowfall and thick jungles was negatively associated with readiness index. Nonchalant staff attitude, unavailability of staff quarters, leakages and constraint in supply chain of drugs and consumables were other impediments identified. Conclusions/Policy Implications: It is pertinent to first strengthen primary care facilities in this setting. Complex dimensions such as geographic barriers, user and provider behavior is not under precinct of this methodology.

Keywords: effective coverage, principal component analysis, readiness index, universal health coverage

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3099 Effect of Permeability Reducing Admixture Utilization on Sulfate Resistance of Self-Consolidating Concrete Mixture

Authors: Ali Mardani-Aghabaglou, Zia Ahmad Faqiri, Semsi Yazici

Abstract:

In this study, the effect of permeability reducing admixture (PRA) utilization on fresh properties, compressive strength and sulfate resistance of self-consolidating concrete (SSC) were investigated. For this aim, two different commercial PRA were used at two utilization ratios as %0.1 and %0.2 wt. CEM I 42.5 R type cement and crushed limestone aggregate having Dmax of 15 mm were used for preparing of SCC mixtures. In all mixtures, cement content, water/cement ratio, and flow value were kept constant as 450 kg, 0.40 and 65 ± 2 cm, respectively. In order to obtain desired flow value, a polycarboxylate ether-based high range water reducing admixture was used at different content. T50 flow time, flow value, L-box, and U-funnel of SCC mixture were measured as fresh properties. 1, 3, 7 and 28-day compressive strength of SCC mixture were obtained on 150 mm cubic specimens. To investigate the sulfate resistance of SCC mixture 75x75x285 mm prismatic specimens were produced. After 28-day water curing, specimens were immersed in %5 sodium sulfate solution during 210 days. The length change of specimens was measured at 5-day time intervals up to 210 days. According to the test results, all fresh properties of SCC mixtures were in accordance with the European federation of specialist construction chemicals and concrete systems (EFNARC) critter for SCC mixtures. The utilization of PRA had no significant effect on compressive strength and fresh properties of SCC mixtures. Regardless of PRA type, sulfate resistance of SCC mixture increased by adding of PRA into the SCC mixtures. The length changes of the SCC mixtures containing %1 and %2 PRA were measured as %8 and %14 less than that of control mixture containing no PRA, respectively.

Keywords: permeability reducing admixture, self-consolidating concrete, fresh properties, sulfate resistance

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