Search results for: 425 OECD guidelines

Authors: Jignasha Derasari, Patel Krishna M, Modi Jignasa G.

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Chemical stability of pharmaceutical molecules is a matter of great concern as it affects the safety and efficacy of the drug product.Stability testing data provides the basis to understand how the quality of a drug substance and drug product changes with time under the influence of various environmental factors. Besides this, it also helps in selecting proper formulation and package as well as providing proper storage conditions and shelf life, which is essential for regulatory documentation. The ICH guideline states that stress testing is intended to identify the likely degradation products which further help in determination of the intrinsic stability of the molecule and establishing degradation pathways, and to validate the stability indicating procedures. A simple, accurate and precise stability indicating RP- HPLC method was developed and validated for simultaneous estimation of Amiloride Hydrochloride and Furosemide in tablet dosage form. Separation was achieved on an Phenomenexluna ODS C18 (250 mm × 4.6 mm i.d., 5 µm particle size) by using a mobile phase consisting of Ortho phosphoric acid: Acetonitrile (50:50 %v/v) at a flow rate of 1.0 ml/min (pH 3.5 adjusted with 0.1 % TEA in Water) isocratic pump mode, Injection volume 20 µl and wavelength of detection was kept at 283 nm. Retention time for Amiloride Hydrochloride and Furosemide was 1.810 min and 4.269 min respectively. Linearity of the proposed method was obtained in the range of 40-60 µg/ml and 320-480 µg/ml and Correlation coefficient was 0.999 and 0.998 for Amiloride hydrochloride and Furosemide, respectively. Forced degradation study was carried out on combined dosage form with various stress conditions like hydrolysis (acid and base hydrolysis), oxidative and thermal conditions as per ICH guideline Q2 (R1). The RP- HPLC method has shown an adequate separation for Amiloride hydrochloride and Furosemide from its degradation products. Proposed method was validated as per ICH guidelines for specificity, linearity, accuracy; precision and robustness for estimation of Amiloride hydrochloride and Furosemide in commercially available tablet dosage form and results were found to be satisfactory and significant. The developed and validated stability indicating RP-HPLC method can be used successfully for marketed formulations. Forced degradation studies help in generating degradants in much shorter span of time, mostly a few weeks can be used to develop the stability indicating method which can be applied later for the analysis of samples generated from accelerated and long term stability studies. Further, kinetic study was also performed for different forced degradation parameters of the same combination, which help in determining order of reaction.

Keywords: amiloride hydrochloride, furosemide, kinetic study, stability indicating RP-HPLC method validation

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Authors: Elena Maria Scalisi

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The increasing production and the use of TiO₂ nanoparticles (NPs) have inevitably led to their release into the environment, thereby posing a threat to organisms and also for human. Human exposure to TiO₂-NPs may occur during both manufacturing and use. TiO₂-NPs are common in consumer products for dermal application, toothpaste, food colorants, and nutritional supplements, then oral exposure may occur during use of such products. Into the body, TiO₂-NPs thanks to their small size (<100 nm), can, through testicular blood barrier inducing effect on testis and then on male reproductive health. The nanoscale size of TiO₂ increase the surface-to-volume ratio making them more reactive in a cell, then TiO₂ NPs increase their ability to produce reactive oxygen species (ROS). In male germ cells, ROS may have important implications in maintaining the normal functions of mature spermatozoa at physiological levels, moreover, in spermatozoa they are important signaling molecules for their hyperactivation and acrosome reaction. Nevertheless, an excess of ROS by external inputs such as NPs can increased the oxidative stress (OS), which results in damage DNA and apoptosis. The aim of our study has been investigate the impact of TiO₂ NPs on human spermatozoa, evaluating DNA damage and the expression of proteins involved in cell stress. According WHO guidelines 2021, we have exposed human spermatozoa in vitro to TiO₂ NP at concentrations 50 ppm, 100 ppm, 250 ppm, and 500 ppm for 1 hour (at 37°C and CO₂ at 5%). DNA damage was evaluated by Sperm Chromatin Dispersion Test (SCD) and TUNEL assay; moreover, we have evaluated the expression of biomarkers of oxidative stress like Heat Shock Protein 70 (HSP70) and Metallothioneins (MTs). Also, sperm parameters as motility viability have been evaluated. Our results not report a significant reduction in motility of spermatozoa at the end of the exposure. On the contrary, the progressive motility was increased at the highest concentration (500 ppm) and was statistically significant compared to control (p <0.05). Also, viability was not changed by exposure to TiO₂-NPs (p <0.05). However, increased DNA damage was observed at all concentrations, and the TUNEL assay highlighted the presence of single strand breaks in the DNA. The spermatozoa responded to the presence of TiO₂-NPs with the expression of Hsp70, which have a protective function because they allow the maintenance of cellular homeostasis in stressful/ lethal conditions. A positivity for MTs was observed mainly for the concentration of 4 mg/L. Although the biological and physiological function of the metallothionein (MTs) in the male genital organs is unclear, our results highlighted that the MTs expressed by spermatozoa maintain their biological role of detoxification from metals. Our results can give additional information to the data in the literature on the toxicity of TiO₂-NPs and reproduction.

Keywords: human spermatozoa, DNA damage, TiO₂-NPs, biomarkers

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Authors: Chandra Shekhar Majumder, Orin Sultana Jamie

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Background: Dacryocystorhinostomy (DCR) has been a widely accepted surgical intervention for nasolacrimal duct obstructions. Some previous studies demonstrated the potential benefits of the peroperative application of agents like Mitomycin-C (MMC) with DCR to improve surgical outcomes. Relevant studies are rare in Bangladesh, and there are controversies about the dose, duration of MMC, and outcome. Therefore, the present study aimed to investigate the comparative efficacy of DCR with and without MMC in a tertiary hospital in Bangladesh. Objective: The study aims to determine the outcome of a dacryocystorhinostomy with preoperative local use of mitomycin–C. Methods: An analytical study was conducted in the Department of Ophthalmology, Sir Salimullah Medical College & Mitford Hospital, Dhaka, from January 2023 to September 2023. Seventy patients who were admitted for DCR operation were included according to the inclusion and exclusion criteria. Patients were divided into two groups: those who underwent DCR with peroperative administration of 0.2 mg/ml Mitomycin-C for 5 minutes (Group I) and those who underwent DCR alone (Group II). All patients were subjected to detailed history taking, clinical examination, and relevant investigations. All patients underwent DCR according to standard guidelines and ensured the highest peroperative and postoperative care. Then, patients were followed up at 7th POD, 1-month POD, 3 months POD, and 6 months POD to observe the success rate between the two groups by assessing tearing condition, irrigation, height of tear meniscus, and FDDT- test. Data was recorded using a pre-structured questionnaire, and collected data were analyzed using SPSS 23. Results: The mean age of the study patients was 42.17±6.7 (SD) years and 42.29±7.1 (SD) years in Groups I and II, respectively, with no significant difference (p=0.945). At the 6th month’s follow-up, group I patients were observed with 94.3% frequency of symptom-free, 85.6% patency of lacrimal drainage system, 68.6% had tear meniscus <0.1mm and 88.6% had positive Fluorescence Dye Disappearance Test (FDDT test). In group II, 91.4% were symptom-free, 68.6% showed patency, 57.1% had a height of tear meniscus < 0.1 mm, and 85.6% had FDDT test positive. But no statistically significant difference was observed (p<.05). Conclusion: The use of Mitomycin-C preoperatively during DCR offers better postoperative outcomes, particularly in maintaining patency and achieving symptom resolution with more FDDT test positive and improvement of tear meniscus in the MMC group than the control group. However, this study didn’t demonstrate a statistically significant difference between the two groups. Further research with larger sample sizes and longer follow-up periods would be beneficial to corroborate these findings.

Keywords: dacryocystorhinostomy, mitomycin-c, dacryocystitis, nasolacrimal duct obstruction

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Authors: Achiron Anat, Mathilda Mandel, Mayust Sue, Achiron Reuven, Gurevich Michael

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Introduction: As coronavirus disease 2019 (COVID-19) vaccination is currently spreading around the world, it is of importance to assess the ability of multiple sclerosis (MS) patients to mount an appropriate immune response to the vaccine in the context of disease-modifying treatments (DMT’s). Objectives: Evaluate immunity generated following COVID-19 vaccination in MS patients, and assess factors contributing to protective humoral and cellular immune responses in MS patients vaccinated against severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) virus infection. Methods: Review our recent data related to (1) the safety of PfizerBNT162b2 COVID-19 mRNA vaccine in adult MS patients; (2) the humoral post-vaccination SARS-CoV2 IgG response in MS vaccinees using anti-spike protein-based serology; and (3) the cellular immune response of memory B-cells specific for SARS-CoV-2 receptor-binding domain (RBD) and memory T-cells secreting IFN-g and/or IL-2 in response to SARS-CoV2 peptides using ELISpot/Fluorospot assays in MS patients either untreated or under treatment with fingolimod, cladribine, or ocrelizumab; (4) covariate parameters related to mounting protective immune responses. Results: COVID-19 vaccine proved safe in MS patients, and the adverse event profile was mainly characterised by pain at the injection site, fatigue, and headache. Not any increased risk of relapse activity was noted and the rate of patients with acute relapse was comparable to the relapse rate in non-vaccinated patients during the corresponding follow-up period. A mild increase in the rate of adverse events was noted in younger MS patients, among patients with lower disability, and in patients treated with DMTs. Following COVID-19 vaccination protective humoral immune response was significantly decreased in fingolimod- and ocrelizumab- treated MS patients. SARS-CoV2 specific B-cell and T-cell cellular responses were respectively decreased. Untreated MS patients and patients treated with cladribine demonstrated protective humoral and cellular immune responses, similar to healthy vaccinated subjects. Conclusions: COVID-19 BNT162b2 vaccine proved as safe for MS patients. No increased risk of relapse activity was noted post-vaccination. Although COVID-19 vaccination is new, accumulated data demonstrate differences in immune responses under various DMT’s. This knowledge can help to construct appropriate COVID-19 vaccine guidelines to ensure proper immune responses for MS patients.

Keywords: covid-19, vaccination, multiple sclerosis, IgG

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Authors: Carlos M. Goncalves, Luisa Duarte, Teresa Cartaxo

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The aim of this work was to understand the reasons behind the underutilization of electroconvulsive therapy (ECT) in the younger population and raise possible solutions. We conducted a non-systematic review of literature throughout a search on PubMed, using the terms ‘children’, ‘adolescents’ and ‘electroconvulsive’, ‘therapy’. Candidate articles written in languages other than English were excluded. Articles were selected according to title and/or abstract’s content relevance, resulting in a total of 5 articles. ECT is a recognized effective treatment in adults for several psychiatric conditions. As in adults, ECT in children and adolescents is proven most beneficial in the treatment of severe mood disorders, catatonia, and, to a lesser extent, schizophrenia. ECT in adults has also been used to treat autism’s self-injurious behaviours, Tourette’s syndrome and resistant first-episode schizophrenia disorder. Despite growing evidence on its safety and effectiveness in children and adolescents, like those found in adults, ECT remains a controversial and underused treatment in patients this age, even when it is clearly indicated. There are various possible reasons to this; limited awareness among professionals (lack of knowledge and experience among child psychiatrists), stigmatic public opinion (despite positive feedback from patients and families, there is an unfavourable and inaccurate representation in the media, contributing to a negative public opinion), legal restrictions and ethical controversies (restrictive regulations such as a minimum age for administration), lack of randomized trials (the currently available studies are retrospective, with small size samples, and most of the publications are either case reports or case series). This shows the need to raise awareness and knowledge, not only for mental health professionals, but also to the general population, through the media, regarding indications, methods and safety of ECT in order to provide reliable information to the patient and families. Large-scale longitudinal studies are also useful to further demonstrate the efficacy and safety of ECT and can aid in the formulation of algorithms and guidelines as without these changes, the availability of ECT to the younger population will remain restricted by regulations and social stigma. In conclusion, these results highlight that lack of adequate knowledge and accurate information are the most important factors behind the underutilization of ECT in younger population. Mental healthcare professionals occupy a cornerstone position; if data is given by a well-informed healthcare professional instead of the media, general population (including patients and their families) will probably regard the procedure in a more favourable way. So, the starting point should be to improve health care professional’s knowledge and experience on this choice of treatment.

Keywords: adolescents, children, electroconvulsive, therapy

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Authors: Erine van Niekerk, Jason Holland

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In Māori culture water is considered to be the foundation of all life and has its own mana (spiritual power) and mauri (life force). Water classification for cultural values therefore includes categories like waitapu (sacred water), waimanawa-whenua (water from under the land), waipuna (freshwater springs), the relationship between water quantity and quality and the relationship between surface and groundwater. Particular rivers and lakes have special significance to iwi and hapu for their rohe (tribal areas). The Mararoa River, including its freshwater springs and wetlands, is an example of such an area. There is currently little information available about the sources, characteristics and behavior of these important water resources and this study on the water quality of the Mararoa River and adjacent freshwater springs will provide valuable information to be used in informed decisions about water management. The regional council of Southland, Environment Southland, is required to make changes under their water quality policy in order to comply with the requirements for the New National Standards for Freshwater to consult with Maori to determine strategies for decision making. This requires an approach that includes traditional knowledge combined with scientific knowledge in the decision-making process. This study provided the scientific data that can be used in future for decision making on fresh water springs combined with traditional values for this particular area. Several parameters have been tested in situ as well as in a laboratory. Parameters such as temperature, salinity, electrical conductivity, Total Dissolved Solids, Total Kjeldahl Nitrogen, Total Phosphorus, Total Suspended Solids, and Escherichia coli among others show that recorded values of all test parameters fall within recommended ANZECC guidelines and Environment Southland standards and do not raise any concerns for the water quality of the springs and the river at the moment. However, the destruction of natural areas, particularly due to changes in farming practices, and the changes to water quality by the introduction of Didymosphenia geminate (Didymo) means Māori have already lost many of their traditional mahinga kai (food sources). There is a major change from land use such as sheep farming to dairying in Southland which puts freshwater resources under pressure. It is, therefore, important to draw on traditional knowledge and spirituality alongside scientific knowledge to protect the waters of the Mararoa River and waipuna. This study hopes to contribute to scientific knowledge to preserve the cultural values of these significant waters.

Keywords: cultural values, freshwater springs, Maori, water quality

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Authors: Godian Asami Mabindah

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The convergence of knowledge management (KM) and competitive intelligence (CI) has gained significant attention in recent years as organizations seek to enhance their competitive advantage in an increasingly complex and dynamic business environment. This research study aims to explore and understand the synergistic relationship between KM and CI and its impact on organizational performance. By investigating how the integration of KM and CI practices can contribute to decision-making, innovation, and competitive advantage, this study seeks to unlock the potential benefits and challenges associated with this integration. The research employs a mixed-methods approach to gather comprehensive data. A quantitative analysis is conducted using survey data collected from a diverse sample of organizations across different industries. The survey measures the extent of integration between KM and CI practices and examines the perceived benefits and challenges associated with this integration. Additionally, qualitative interviews are conducted with key organizational stakeholders to gain deeper insights into their experiences, perspectives, and best practices regarding the synergistic relationship. The findings of this study are expected to reveal several significant outcomes. Firstly, it is anticipated that organizations that effectively integrate KM and CI practices will outperform those that treat them as independent functions. The study aims to highlight the positive impact of this integration on decision-making, innovation, organizational learning, and competitive advantage. Furthermore, the research aims to identify critical success factors and enablers for achieving constructive interaction between KM and CI, such as leadership support, culture, technology infrastructure, and knowledge-sharing mechanisms. The implications of this research are far-reaching. Organizations can leverage the findings to develop strategies and practices that facilitate the integration of KM and CI, leading to enhanced competitive intelligence capabilities and improved knowledge management processes. Additionally, the research contributes to the academic literature by providing a comprehensive understanding of the synergistic relationship between KM and CI and proposing a conceptual framework that can guide future research in this area. By exploring the synergies between KM and CI, this study seeks to help organizations harness their collective power to gain a competitive edge in today's dynamic business landscape. The research provides practical insights and guidelines for organizations to effectively integrate KM and CI practices, leading to improved decision-making, innovation, and overall organizational performance.

Keywords: Competitive Intelligence, Knowledge Management, Organizational Performance, Incusivity, Optimum Performance

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Authors: Nibal Al-Batsh, Issam Al-Khatib, Subha Ghannam

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Yatta is the study area for this research, located 9 km south of Hebron City in the West Bank in Palestine. It has been connected to a water network since 1974 serving nearly 85% of the households. The water network is old and inadequate to meet the needs of the population. The water supply made available to the area is also very limited, estimated to be around 20 l/c.d. Residents are thus forced to rely on water vendors which supply water with a lower quality compared to municipal water while being 400% more expensive. As a cheaper and more reliable alternative, rainwater harvesting is a common practice in the area, with the majority of the households owning at least one cistern. Rainwater harvesting is of great socio-economic importance in areas where water sources are scarce or polluted. The quality of harvested rainwater used for drinking and domestic purposes in the Yatta area was assessed throughout a year long period. A total of 100 water samples were collected from (50 rainfed cisterns) with an average capacity of 69 m3, adjacent to cement-roof catchment with an average area of 145 m2. Samples were analyzed for a number of parameters including: pH, Alkalinity, Hardness, Turbidity, Total Dissolved Solids (TDS), NO3, NH4, chloride and salinity. Microbiological contents such as Total Coliforms (TC) and Fecal Coliforms (FC) bacteria were also analyzed. Results showed that most of the rainwater samples were within WHO and EPA guidelines set for chemical parameters while revealing biological contamination. The pH values of mixed water ranged from 6.9 to 8.74 with a mean value of 7.6. collected Rainwater had lower pH values than mixed water ranging from 7.00 to 7.57 with a mean of 7.21. Rainwater also had lower average values of conductivity (389.11 µScm-1) compared to that of mixed water (463.74 µScm-1) thus indicating lower values of salinity (0.75%). The largest TDS value measured in rainwater was 316 mg/l with a mean of 199.86 mg /l. As far as microbiological quality is concerned, TC and FC were detected in 99%, 52% of collected rainwater samples, respectively. The research also addressed the impact of different socio-economic attributes on rainwater harvesting using information collected through a survey from the area. Results indicated that the majority of homeowners have the primary knowledge necessary to collect and store water in cisterns. Most of the respondents clean both the cisterns and the catchment areas. However, the research also arrives at a conclusion that cleaning is not done in a proper manner. Results show that cisterns with an operating capacity of 69 m3 would provide sufficient water to get through the dry summer months. However, the catchment area must exceed 146 m2 to produce sufficient water to fill a cistern of this size in a year receiving average precipitation.

Keywords: rainwater harvesting, runoff coefficient, water quality, microbiological contamination

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Authors: Ruchi Sharma, Rajasekhar Balasubramanian

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Motor vehicles emit a number of air pollutants, among which fine particulate matter (PM₂.₅) is of major concern in cities with high population density due to its negative impacts on air quality and human health. Typically, people spend more than 80% of their time indoors. Consequently, human exposure to traffic-related PM₂.₅ in indoor environments has received considerable attention. Most of the public residential buildings in tropical countries are designed for natural ventilation where indoor air quality tends to be strongly affected by the migration of air pollutants of outdoor origin. However, most of the previously reported traffic-related PM₂.₅ exposure assessment studies relied on ambient PM₂.₅ concentrations and thus, the health impact of traffic-related PM₂.₅ on occupants in naturally ventilated buildings remains largely unknown. Therefore, a systematic field study was conducted to assess indoor human exposure to traffic-related PM₂.₅ with and without mitigation measures in a typical naturally ventilated residential apartment situated near a road carrying a large volume of traffic. Three PM₂.₅ exposure scenarios were simulated in this study, i.e., Case 1: keeping all windows open with a ceiling fan on as per the usual practice, Case 2: keeping all windows fully closed as a mitigation measure, and Case 3: keeping all windows fully closed with the operation of a portable indoor air cleaner as an additional mitigation measure. The indoor to outdoor (I/O) ratios for PM₂.₅ mass concentrations were assessed and the effectiveness of using the indoor air cleaner was quantified. Additionally, potential human health risk based on the bioavailable fraction of toxic trace elements was also estimated for the three cases in order to identify a suitable mitigation measure for reducing PM₂.₅ exposure indoors. Traffic-related PM₂.₅ levels indoors exceeded the air quality guidelines (12 µg/m³) in Case 1, i.e., under natural ventilation conditions due to advective flow of outdoor air into the indoor environment. However, while using the indoor air cleaner, a significant reduction (p < 0.05) in the PM₂.₅ exposure levels was noticed indoors. Specifically, the effectiveness of the air cleaner in terms of reducing indoor PM₂.₅ exposure was estimated to be about 74%. Moreover, potential human health risk assessment also indicated a substantial reduction in potential health risk while using the air cleaner. This is the first study of its kind that evaluated the indoor human exposure to traffic-related PM₂.₅ and identified a suitable exposure mitigation measure that can be implemented in densely populated cities to realize health benefits.

Keywords: fine particulate matter, indoor air cleaner, potential human health risk, vehicular emissions

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Authors: Jacklyn Yek, Clara Tong, Shin Yuet Chong, Yee Yian Ong

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Background: While emergency manuals and cognitive aids (CA) have been used in high-hazard industries for decades, this has been a nascent field in healthcare. CAs can potentially offset the large cognitive load involved in crisis resource management and possibly facilitate the efficient performance of key steps in treatment. A crisis manual was developed based on local guidelines and the latest evidence-based information and introduced to a tertiary hospital setting in Singapore. Hence, the objective of this study is to evaluate the effectiveness of the crisis manual in guiding response and management of critical events. Methods: 7 surgical teams were recruited to participate in a series of simulated emergencies in high-fidelity operating room simulator over the period of April to June 2018. All teams consisted of a surgical consultant and medical officer/registrar, anesthesia consultant and medical officer/registrar; as well as a circulating, scrub and anesthetic nurse. Each team performed a simulated operation in which 1 or more of the crisis events occurred. The teams were randomly assigned to a scenario of the crisis manual and all teams were deemed to be equal in experience and knowledge. Before the simulation, teams were instructed on proper checklist use but the use of the checklist was optional. Results: 7 simulation sessions were performed, consisting of the following scenarios: Airway fire, Massive Transfusion Protocol, Malignant Hyperthermia, Eclampsia, and Difficult Airway. Out of the 7 surgical teams, 2 teams made use of the crisis manual – of which both teams had encountered a ‘Malignant Hyperthermia’ scenario. These team members reflected that the crisis manual assisted allowed them to work in a team, especially being able to involve the surgical doctors who were unfamiliar with the condition and management. A run chart plotted showed a possible upward trend, suggesting that with increasing awareness and training, staff would become more likely to initiate the use of the crisis manual. Conclusion: Despite the high volume load in this tertiary hospital, certain crises remain rare and clinicians are often caught unprepared. A crisis manual is an effective tool and easy-to-use repository that can improve patient outcome and encourage teamwork. With training, familiarity would allow clinicians to be increasingly comfortable with reaching out for the crisis manual. More simulation training would need to be conducted to determine its effectiveness.

Keywords: crisis resource management, high fidelity simulation training, medical errors, visual aids

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Authors: Amit Zriker, Anat Freund

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The aim of the study was to conduct a thorough examination into the multiple complexities of bringing a foreign caregiver into the home to care for older adults in the Haredi society, by relating to the perspectives of the older adult and his family members. Research questions were: What is the meaning of bringing a foreign caregiver into the home in Haredi society, from the point of view of the older adult’s family members, and what are the implications of these meanings in the context of developing social policies and interventions? The current study was a qualitative-phenomenological study, which relates to “the lived experience” of those involved in the studied phenomenon. In the framework of the study, the participants included 15 adult Haredi sons and daughters of elderly impaired parents who receive homecare from a foreign caregiver. Data collection was carried out using in-depth, semi-structured interviews; the interview guidelines are comprised of the following content worlds: the meanings of aging in Haredi families; the decision-making process in relation to providing home care assistance for elderly impaired parents; making decisions regarding bringing a foreign caregiver into the home to care for an elderly parent; the daily routine after bringing in a foreign caregiver; bringing in a foreign caregiver vs. the society and vs. the Haredi establishment; and more. The issue of bringing a foreign caregiver into the home in the context of a faith-based society has received only scant and partial research attention to date. Nevertheless, in light of the growing elderly population in the Haredi society in Israel, and in closed, faith-based societies, in general; there is a growing need to bring foreign caregivers into the home as a possible solution to the “aging-in-place” problem in these societies. The separatist nature, and the collectivist and faith-based lifestyle of the Haredi society present unique challenges and needs in the process of employing a foreign caregiver. Moreover, the foreign caregiver also brings his/her own cultural world to the encounter, meaning, this process involves the elderly impaired individual, his/her family members, as well as the foreign caregiver. Therefore, it is important to understand their attitudes, perceptions and interactions, in order to create a good fit among all involved parties. The innovation and uniqueness of the current study is in its in-depth exploration of a phenomenon through an emotional-cultural lens. The study findings also contribute to the creation of social policy in the field of nursing, which will be adapted and culturally sensitive to Haredi society, and other faith-based societies.

Keywords: culturally-sensitive intervention, faith-based society, foreign caregiver, Haredi society

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Authors: Eliane G. Tótoli, Hérida Regina N. Salgado

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Daptomycin is an important antimicrobial agent used in clinical practice nowadays, since it is very active against some Gram-positive bacteria that are particularly challenges for the medicine, such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE). The importance of environmental preservation has receiving special attention since last years. Considering the evident need to protect the natural environment and the introduction of strict quality requirements regarding analytical procedures used in pharmaceutical analysis, the industries must seek environmentally friendly alternatives in relation to the analytical methods and other processes that they follow in their routine. In view of these factors, green analytical chemistry is prevalent and encouraged nowadays. In this context, infrared spectroscopy stands out. This is a method that does not use organic solvents and, although it is formally accepted for the identification of individual compounds, also allows the quantitation of substances. Considering that there are few green analytical methods described in literature for the analysis of daptomycin, the aim of this work was the development and validation of a green analytical method for the quantification of this drug in lyophilized powder for injectable solution, by Fourier-transform infrared spectroscopy (FT-IR). Method: Translucent potassium bromide pellets containing predetermined amounts of the drug were prepared and subjected to spectrophotometric analysis in the mid-infrared region. After obtaining the infrared spectrum and with the assistance of the IR Solution software, quantitative analysis was carried out in the spectral region between 1575 and 1700 cm-1, related to a carbonyl band of the daptomycin molecule, and this band had its height analyzed in terms of absorbance. The method was validated according to ICH guidelines regarding linearity, precision (repeatability and intermediate precision), accuracy and robustness. Results and discussion: The method showed to be linear (r = 0.9999), precise (RSD% < 2.0), accurate and robust, over a concentration range from 0.2 to 0.6 mg/pellet. In addition, this technique does not use organic solvents, which is one great advantage over the most common analytical methods. This fact contributes to minimize the generation of organic solvent waste by the industry and thereby reduces the impact of its activities on the environment. Conclusion: The validated method proved to be adequate to quantify daptomycin in lyophilized powder for injectable solution and can be used for its routine analysis in quality control. In addition, the proposed method is environmentally friendly, which is in line with the global trend.

Keywords: daptomycin, Fourier-transform infrared spectroscopy, green analytical chemistry, quality control, spectrometry in IR region

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Authors: Kedar Hardikar, Joe Varghese

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Conductive adhesives have found wide-ranging applications in electronics industry ranging from fixing a defective conductor on printed circuit board (PCB) attaching an electronic component in an assembly to protecting electronics components by the formation of “Faraday Cage.” The reliability requirements for the conductive adhesive vary widely depending on the application and expected product lifetime. While the conductive adhesive is required to maintain the structural integrity, the electrical performance of the associated sub-assembly can be affected by the degradation of conductive adhesive. The degradation of the adhesive is dependent upon the highly varied use case. The conventional approach to assess the reliability of the sub-assembly involves subjecting it to the standard environmental test conditions such as high-temperature high humidity, thermal cycling, high-temperature exposure to name a few. In order to enable projection of test data and observed failures to predict field performance, systematic development of an acceleration factor between the test conditions and field conditions is crucial. Common acceleration factor models such as Arrhenius model are based on rate kinetics and typically rely on an assumption of linear degradation in time for a given condition and test duration. The application of interest in this work involves conductive adhesive used in an electronic circuit of a capacitive sensor. The degradation of conductive adhesive in high temperature and humidity environment is quantified by the capacitance values. Under such conditions, the use of established models such as Hallberg-Peck model or Eyring Model to predict time to failure in the field typically relies on linear degradation rate. In this particular case, it is seen that the degradation is nonlinear in time and exhibits a square root t dependence. It is also shown that for the mechanism of interest, the presence of moisture is essential, and the dominant mechanism driving the degradation is the diffusion of moisture. In this work, a framework is developed to incorporate nonlinear degradation of the conductive adhesive for the development of an acceleration factor. This method can be extended to applications where nonlinearity in degradation rate can be adequately characterized in tests. It is shown that depending on the expected product lifetime, the use of conventional linear degradation approach can overestimate or underestimate the field performance. This work provides guidelines for suitability of linear degradation approximation for such varied applications

Keywords: conductive adhesives, nonlinear degradation, physics of failure, acceleration factor model.

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Authors: Amanda Aliende da Matta, Maria del Pilar Fogueiras Bertomeu, Valeria de Ormaechea Otalora, Maria Paz Sandin Esteban, Miriam Comet Donoso

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This communication presents the preliminary emerging themes in a research on political participation of young women. The study follows a qualitative methodology; in particular, the applied hermeneutic phenomenological method, and the general objective of the research is to give an account of the experience of political participation as young women. The study participants are women aged 18 to 35 who have experience in political participation. The techniques of data collection are the descriptive story and the phenomenological interview. With respect to the first methodological steps, these have been: 1) collect and select stories of lived experience in political participation, 2) select descriptions of lived experience (DLEs) in political participation of the chosen stories, 3) to prepare phenomenological interviews from the selected DLEs, 4) to conduct phenomenological thematic analysis (PTA) of the DLEs. We have so far initiated the PTA on 5 vignettes. Hermeneutic phenomenology as a research approach is based on phenomenological philosophy and applied hermeneutics. Phenomenology is a descriptive philosophy of pure experience and essences, through which we seek to capture an experience at its origins without categorizing, interpreting or theorizing it. Hermeneutics, on the other hand, may be defined as a philosophical current that can be applied to data analysis. Max Van Manen wrote that hermeneutic phenomenology is a method of abstemious reflection on the basic structures of the lived experience of human existence. In hermeneutic phenomenology we focus, then, on the way we experience “things” in the first person, seeking to capture the world exactly as we experience it, not as we categorize or conceptualize it. In this study, the empirical methods used were: Lived experience description (written) and conversational interview. For these short stories, participants were asked: “What was your lived experience of participation in politics as a young woman? Can you tell me any stories or anecdotes that you think exemplify or typify your experience?”. The questions were accompanied by a list of guidelines for writing descriptive vignettes. And the analytical method was PTA. Among the provisional results, we found preliminary emerging themes, which could in the advance of the investigation result in meaning structures of political participation of young women. They are the following: - Complicity may be inherent/essential in political participation as a young woman; - Feelings may be essential/inherent in political participation as a young woman; - Hope may be essential in authentic political participation as a young woman; - Frustration may be essential in authentic political participation as a young woman; - Satisfaction may be essential in authentic political participation as a young woman; - There may be tension between individual/collective inherent/essential in political participation as a young woman; - Political participation as a young woman may include moments of public demonstration.

Keywords: applied hermeneutic phenomenology, hermeneutics, phenomenology, political participation

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Authors: Muhammad Kashif Fida

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In the bank, teller’s job (cash officer) is highly important and critical as at one end it requires soft and brisk customer services and on the other side, handling cash with integrity. It is always challenging for recruiters to hire competent and trustworthy tellers. According to author’s knowledge, there is no comprehensive test available that may provide assistance in recruitment in Pakistan. So there is a dire need of a psychometric battery that could provide support in recruitment of potential candidates for the teller’ position. So, the aim of the present study was to construct ABL-Teller Aptitude Test (ABL-TApT). Three major phases have been designed by following American Psychological Association’s guidelines. The first phase was qualitative, indicators of the test have been explored by content analysis of the a) teller’s job descriptions (n=3), b) interview with senior tellers (n=6) and c) interview with HR personals (n=4). Content analysis of above yielded three border constructs; i). Personality, ii). Integrity/honesty, iii). Professional Work Aptitude. Identified indicators operationalized and statements (k=170) were generated using verbatim. It was then forwarded to the five experts for review of content validity. They finalized 156 items. In the second phase; ABL-TApT (k=156) administered on 323 participants through a computer application. The overall reliability of the test shows significant alpha coefficient (α=.81). Reliability of subscales have also significant alpha coefficients. Confirmatory Factor Analysis (CFA) performed to estimate the construct validity, confirms four main factors comprising of eight personality traits (Confidence, Organized, Compliance, Goal-oriented, Persistent, Forecasting, Patience, Caution), one Integrity/honesty factor, four factors of professional work aptitude (basic numerical ability and perceptual accuracy of letters, numbers and signature) and two factors for customer services (customer services, emotional maturity). Values of GFI, AGFI, NNFI, CFI, RFI and RMSEA are in recommended range depicting significant model fit. In third phase concurrent validity evidences have been pursued. Personality and integrity part of this scale has significant correlations with ‘conscientiousness’ factor of NEO-PI-R, reflecting strong concurrent validity. Customer services and emotional maturity have significant correlations with ‘Bar-On EQI’ showing another evidence of strong concurrent validity. It is concluded that ABL-TAPT is significantly reliable and valid battery of tests, will assist in objective recruitment of tellers and help recruiters in finding a more suitable human resource.

Keywords: concurrent validity, construct validity, content validity, reliability, teller aptitude test, objective recruitment

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Authors: Till Gramberg

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In the dynamic world of machine and plant engineering, stagnation in the growth of new product sales compels companies to reconsider their business models. The increasing shift toward service orientation, known as "servitization," along with challenges posed by digitalization and sustainability, necessitates an adaptation of product portfolio management (PPM). Against this backdrop, this study investigates the current challenges and requirements of PPM in this industrial context and develops a framework for the application of generative artificial intelligence (AI) to enhance agility and efficiency in PPM processes. The research approach of this study is based on a mixed-method design. Initially, qualitative interviews with industry experts were conducted to gain a deep understanding of the specific challenges and requirements in PPM. These interviews were analyzed using the Gioia method, painting a detailed picture of the existing issues and needs within the sector. This was complemented by a quantitative online survey. The combination of qualitative and quantitative research enabled a comprehensive understanding of the current challenges in the practical application of machine and plant engineering PPM. Based on these insights, a specific framework for the application of generative AI in PPM was developed. This framework aims to assist companies in implementing faster and more agile processes, systematically integrating dynamic requirements from trends such as digitalization and sustainability into their PPM process. Utilizing generative AI technologies, companies can more quickly identify and respond to trends and market changes, allowing for a more efficient and targeted adaptation of the product portfolio. The study emphasizes the importance of an agile and reactive approach to PPM in a rapidly changing environment. It demonstrates how generative AI can serve as a powerful tool to manage the complexity of a diversified and continually evolving product portfolio. The developed framework offers practical guidelines and strategies for companies to improve their PPM processes by leveraging the latest technological advancements while maintaining ecological and social responsibility. This paper significantly contributes to deepening the understanding of the application of generative AI in PPM and provides a framework for companies to manage their product portfolios more effectively and adapt to changing market conditions. The findings underscore the relevance of continuous adaptation and innovation in PPM strategies and demonstrate the potential of generative AI for proactive and future-oriented business management.

Keywords: servitization, product portfolio management, generative AI, disruptive innovation, machine and plant engineering

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Authors: Habib Alshuwaikhat, Nahid Hossain

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Residential sector consumes more than half of the produced electricity in Saudi Arabia, and fossil fuel is the main source of energy to meet growing household electricity demand in the Kingdom. Several studies forecasted and expressed concern that unless the domestic energy demand growth is controlled, it will reduce Saudi Arabia’s crude oil export capacity within a decade and the Kingdom is likely to be incapable of exporting crude oil within next three decades. Though the Saudi government has initiated to address the domestic energy demand growth issue, the demand side energy management policies and programs are focused on industrial and commercial sectors. It is apparent that there is an urgent need to develop a comprehensive energy efficiency strategy for addressing efficient energy use in residential sector in the Kingdom. Then again as Saudi Arabia is at its primary stage in addressing energy efficiency issues in its residential sector, there is a scope for the Kingdom to learn from global energy efficiency practices and design its own energy efficiency policies and programs. However, in order to do that sustainable, it is essential to address local contexts of energy efficiency. It is also necessary to find out the policies and programs that will fit to the local contexts. Thus the objective of this study was set to identify globally best practice energy efficiency policies and programs in residential sector that have replication potential in Saudi Arabia. In this regard two sets of multi-criteria decision analysis matrices were developed to evaluate the energy efficiency policies and programs. The first matrix was used to evaluate the global energy efficiency policies and programs, and the second matrix was used to evaluate the replication potential of global best practice energy efficiency policies and programs for Saudi Arabia. Wuppertal Institute’s guidelines for energy efficiency policy evaluation were used to develop the matrices, and the different attributes of the matrices were set through available literature review. The study reveals that the best practice energy efficiency policies and programs with good replication potential for Saudi Arabia are those which have multiple components to address energy efficiency and are diversified in their characteristics. The study also indicates the more diversified components are included in a policy and program, the more replication potential it has for the Kingdom. This finding is consistent with other studies, where it is observed that in order to be successful in energy efficiency practices, it is required to introduce multiple policy components in a cluster rather than concentrate on a single policy measure. The developed multi-criteria decision analysis matrices for energy efficiency policy and program evaluation could be utilized to assess the replication potential of other globally best practice energy efficiency policies and programs for the residential sector of the Kingdom. In addition it has potential to guide Saudi policy makers to adopt and formulate its own energy efficiency policies and programs for Saudi Arabia.

Keywords: Saudi Arabia, residential sector, energy efficiency, policy evaluation

Procedia PDF Downloads 496

Authors: Farahnaz Amini, Woo Yun Kin, Lazwani Kolandaiveloo

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Availability of different genetic tests after completion of Human Genome Project increases the physicians’ responsibility to keep themselves update on the potential implementation of these genetic tests in their daily practice. However, due to numbers of barriers, still many of physicians are not either aware of these tests or are not willing to offer or refer their patients for genetic tests. This study was conducted an anonymous, cross-sectional, mailed-based survey to develop a primary data of Malaysian physicians’ level of knowledge and perception of gene profiling. Questionnaire had 29 questions. Total scores on selected questions were used to assess the level of knowledge. The highest possible score was 11. Descriptive statistics, one way ANOVA and chi-squared test was used for statistical analysis. Sixty three completed questionnaires was returned by 27 general practitioners (GPs) and 36 medical specialists. Responders’ age range from 24 to 55 years old (mean 30.2 ± 6.4). About 40% of the participants rated themselves as having poor level of knowledge in genetics in general whilst 60% believed that they have fair level of knowledge. However, almost half (46%) of the respondents felt that they were not knowledgeable about available genetic tests. A majority (94%) of the responders were not aware of any lab or company which is offering gene profiling services in Malaysia. Only 4% of participants were aware of using gene profiling for detection of dosage of some drugs. Respondents perceived greater utility of gene profiling for breast cancer (38%) compared to the colorectal familial cancer (3%). The score of knowledge ranged from 2 to 8 (mean 4.38 ± 1.67). Non-significant differences between score of knowledge of GPs and specialists were observed, with score of 4.19 and 4.58 respectively. There was no significant association between any demographic factors and level of knowledge. However, those who graduated between years 2001 to 2005 had higher level of knowledge. Overall, 83% of participants showed relatively high level of perception on value of gene profiling to detect patient’s risk of disease. However, low perception was observed for both statements of using gene profiling for general population in order to alter their lifestyle (25%) as well as having the full sequence of a patient genome for the purpose of determining a patient’s best match for treatment (18%). The lack of clinical guidelines, limited provider knowledge and awareness, lack of time and resources to educate patients, lack of evidence-based clinical information and cost of tests were the most barriers of ordering gene profiling mentioned by physicians. In conclusion Malaysian physicians who participate in this study had mediocre level of knowledge and awareness in gene profiling. The low exposure to the genetic questions and problems might be a key predictor of lack of awareness and knowledge on available genetic tests. Educational and training workshop might be useful in helping Malaysian physicians incorporate genetic profiling into practice for eligible patients.

Keywords: gene profiling, knowledge, Malaysia, physician

Procedia PDF Downloads 326

Authors: Camilla Marini, Deborah Agostino

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Cultural institutions provide more than service-based offers; indeed, they are experience-based contexts. A cultural experience is a special event that encompasses a wide range of values which, for visitors, are primarily cultural rather than economic and financial. Cultural institutions have always been characterized by inclusivity and participatory practices, but the upcoming of digital technologies has put forward their interest in collaborative practices and the relationship with their audience. Indeed, digital technologies highly affected the cultural experience as it was conceived. Especially, museums, as traditional and authoritative cultural institutions, have been highly challenged by digital technologies. They shifted by a collection-oriented toward a visitor-centered approach, and digital technologies generated a highly interactive ecosystem in which visitors have an active role, shaping their own cultural experience. Most of the studies that investigate value co-creation in museums adopt a single perspective which is separately one of the museums or one of the users, but the analysis of the convergence/divergence of these perspectives is still emphasized. Additionally, many contributions focus on digital value co-creation as an outcome rather than as a process. The study aims to provide a joint perspective on digital value co-creation which include both museum and visitors. Also, it deepens the contribution of digital technologies in the value co-creation process, addressing the following research questions: (i) what are the convergence/divergence drivers on digital value co-creation and (ii) how digital technologies can be means of value co-creation? The study adopts an action research methodology that is based on the case of WORTHY, an educational project which involves cultural institutions and schools all around Europe, creating a virtual collaborative museum. It represents a valuable case for the aim of the study since it has digital technologies at its core, and the interaction through digital technologies is fundamental, all along with the experience. Action research has been identified as the most appropriate methodology for researchers to have direct contact with the field. Data have been collected through primary and secondary sources. Cultural mediators such as museums, teachers and students’ families have been interviewed, while a focus group has been designed to interact with students, investigating all the aspects of the cultural experience. Secondary sources encompassed project reports and website contents in order to deepen the perspective of cultural institutions. Preliminary findings highlight the dimensions of digital value co-creation in cultural institutions from a museum-visitor integrated perspective and the contribution of digital technologies in the value co-creation process. The study outlines a two-folded contribution that encompasses both an academic and a practitioner level. Indeed, it contributes to fulfilling the gap in cultural management literature about the convergence/divergence of service provider-user perspectives but it also provides cultural professionals with guidelines on how to evaluate the digital value co-creation process.

Keywords: co-creation, digital technologies, museum, value

Procedia PDF Downloads 147

Authors: Jose A. Diaz-Olivares, Nafise Mahdavian, Farhad Abtahi, Kaj Lindecrantz, Abdelakram Hafid, Fernando Seoane

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Despite new recommendations and guidelines for the evaluation of occupational risk assessments and their prevention, work-related musculoskeletal disorders are still one of the biggest causes of work activity disruption, productivity loss, sick leave and chronic work disability. It affects millions of workers throughout Europe, with a large-scale economic and social burden. These specific efforts have failed to produce significant results yet, probably due to the limited availability and high costs of occupational risk assessment at work, especially when the methods are complex, consume excessive resources or depend on self-evaluations and observations of poor accuracy. To overcome these limitations, a pervasive system of risk assessment tools in real time has been developed, which has the characteristics of a systematic approach, with good precision, usability and resource efficiency, essential to facilitate the prevention of musculoskeletal disorders in the long term. The system allows the combination of different wearable sensors, placed on different limbs, to be used for data collection and evaluation by a software solution, according to the needs and requirements in each individual working environment. This is done in a non-disruptive manner for both the occupational health expert and the workers. The creation of this solution allows us to attend different research activities that require, as an essential starting point, the recording of data with ergonomic value of very diverse origin, especially in real work environments. The software platform is here presented with a complimentary smart clothing system for data acquisition, comprised of a T-shirt containing inertial measurement units (IMU), a vest sensorized with textile electronics, a wireless electrocardiogram (ECG) and thoracic electrical bio-impedance (TEB) recorder and a glove sensorized with variable resistors, dependent on the angular position of the wrist. The collected data is processed in real-time through a mobile application software solution, implemented in commercially available Android-based smartphones and tablet platforms. Based on the collection of this information and its analysis, real-time risk assessment and feedback about postural improvement is possible, adapted to different contexts. The result is a tool which provides added value to ergonomists and occupational health agents, as in situ analysis of postural behavior can assist in a quantitative manner in the evaluation of work techniques and the occupational environment.

Keywords: ergonomics, mobile technologies, risk assessment, smart textiles

Procedia PDF Downloads 117

Authors: Abdul Haq

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The goal of this research is to better understand how wind loads affect bridges and develop strategies for designing bridges that are more stable and resistant to wind. The effect of wind on bridges is essential to their safety and functionality, especially in areas that are prone to high wind speeds or violent wind conditions. The study looks at the aerodynamic forces and vibrations caused by wind and how they affect bridge construction. Part of the research method involves first understanding the underlying ideas influencing wind flow near bridges. Computational fluid dynamics (CFD) simulations are used to model and forecast the aerodynamic behaviour of bridges under different wind conditions. These models incorporate several factors, such as wind directionality, wind speed, turbulence intensity, and the influence of nearby structures or topography. The results provide significant new insights into the loads and pressures that wind places on different bridge elements, such as decks, pylons, and connections. Following the determination of the wind loads, the structural response of bridges is assessed. By simulating their dynamic behavior under wind-induced forces, Finite Element Analysis (FEA) is used to model the bridge's component parts. This work contributes to the understanding of which areas are at risk of experiencing excessive stresses, vibrations, or oscillations due to wind excitations. Because the bridge has inherent modes and frequencies, the study considers both static and dynamic responses. Various strategies are examined to maximize the design of bridges to withstand wind. It is possible to alter the bridge's geometry, add aerodynamic components, add dampers or tuned mass dampers to lessen vibrations, and boost structural rigidity. Through an analysis of several design modifications and their effectiveness, the study aims to offer guidelines and recommendations for wind-resistant bridge design. In addition to the numerical simulations and analyses, there are experimental studies. In order to assess the computational models and validate the practicality of proposed design strategies, scaled bridge models are tested in a wind tunnel. These investigations help to improve numerical models and prediction precision by providing valuable information on wind-induced forces, pressures, and flow patterns. Using a combination of numerical models, actual testing, and long-term performance evaluation, the project aims to offer practical insights and recommendations for building wind-resistant bridges that are secure, long-lasting, and comfortable for users.

Keywords: wind effects, aerodynamic forces, computational fluid dynamics, finite element analysis

Procedia PDF Downloads 66

Authors: Ruchirat Patanathabutr

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This applied research has adopted descriptive social science research methodology to interpret, analyze and assess the data and used descriptive analysis to present the research results. The objective of this research is to investigate the behaviors and opinions on the service and construction of cable car system at the Upper Esaan Wild Animal Adventure Park (Khon Kaen – Udon Thani) in Khao Suan Kwang District, Khon Kaen Province (Khon Kaen Zoo) of people in the local and distant communities as well as the service users. The research results have revealed that the main target group is the residents in the upper northeastern region of Thailand, especially those who have resided in the immediate vicinity of the cable car project and in nearby districts for more than 10 years. They are men and women at the age of 20-60 with high school diploma and higher levels of education, working as traders/entrepreneurs, government officers/state enterprise employees, and freelancers/self-employed, with the average monthly income of no more than 30,000 baht. Khon Kaen Zoo should improve its 4 organizational images as a tourist attraction, an animal display enclosure, an educational institution and as a provincial symbol; however, the zoo should mainly be presented as an important tourist attraction. The service should focus on maintaining the service standards in both the animal display area and the ocean park. The attention should also be directed at the types and numbers of animals, service quality, service fee, convenient access and transportation, promotions and the standards of other services. Regarding the community involvement in the cable car system construction project, it is strongly agreed that there should be a cable car service between the animal display area and the ocean park and a round-trip ticket should cost 20 baht, 50 baht or 100 baht, respectively. Khon Kaen Zoo or responsible entity must provide related groups of people, such as people in the local and distant communities as well as the service users, with accurate information about the community management guidelines. This is because the community opinions have showed the uncertainty about the cable car system construction at Khon Kaen Zoo and the 4 principles of management, including planning, organizing, leading and controlling, are indicated as uncertain as there is no statistically significant difference at 0.05. In addition, the social, economic, and environmental impacts of the cable car system construction at Khon Kaen Zoo on the communities must be considered carefully.

Keywords: community opinion, cable car system, Khon Kaen Zoo, Thailand

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Authors: Kitty Kioskli, Theofanis Fotis, Nineta Polemi

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The European Union (EU) directive Artificial Intelligence (AI) Act in Article 9 requires that risk management of AI systems includes both technical and human oversight, while according to NIST_AI_RFM (Appendix C) and ENISA AI Framework recommendations, claim that further research is needed to understand the current limitations of social threats and human-AI interaction. AI threats within social contexts significantly affect the security and trustworthiness of the AI systems; they are interrelated and trigger technical threats as well. For example, lack of explainability (e.g. the complexity of models can be challenging for stakeholders to grasp) leads to misunderstandings, biases, and erroneous decisions. Which in turn impact the privacy, security, accountability of the AI systems. Based on the NIST four fundamental criteria for explainability it can also classify the explainability threats into four (4) sub-categories: a) Lack of supporting evidence: AI systems must provide supporting evidence or reasons for all their outputs. b) Lack of Understandability: Explanations offered by systems should be comprehensible to individual users. c) Lack of Accuracy: The provided explanation should accurately represent the system's process of generating outputs. d) Out of scope: The system should only function within its designated conditions or when it possesses sufficient confidence in its outputs. Biases may also stem from historical data reflecting undesired behaviors. When present in the data, biases can permeate the models trained on them, thereby influencing the security and trustworthiness of the of AI systems. Social related AI threats are recognized by various initiatives (e.g., EU Ethics Guidelines for Trustworthy AI), standards (e.g. ISO/IEC TR 24368:2022 on AI ethical concerns, ISO/IEC AWI 42105 on guidance for human oversight of AI systems) and EU legislation (e.g. the General Data Protection Regulation 2016/679, the NIS 2 Directive 2022/2555, the Directive on the Resilience of Critical Entities 2022/2557, the EU AI Act, the Cyber Resilience Act). Measuring social threats, estimating the risks to AI systems associated to these threats and mitigating them is a research challenge. In this paper it will present the efforts of two European Commission Projects (FAITH and THEMIS) from the HorizonEurope programme that analyse the social threats by building cyber-social exercises in order to study human behaviour, traits, cognitive ability, personality, attitudes, interests, and other socio-technical profile characteristics. The research in these projects also include the development of measurements and scales (psychometrics) for human-related vulnerabilities that can be used in estimating more realistically the vulnerability severity, enhancing the CVSS4.0 measurement.

Keywords: social threats, artificial Intelligence, mitigation, social experiment

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Authors: Anastasia Constantinou, Panayiotis Laouris, Stephen Morris

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Background: Climate change has been reported as one of the worst threats to healthcare. The healthcare sector is a significant contributor to greenhouse gas emissions with primary care being responsible for 23% of the NHS’ total carbon footprint. Digital interventions, primarily focusing on telemedicine, offer a route to change. This systematic review aims to quantify and characterize the carbon footprint savings associated with the implementation of digital interventions in the setting of primary care. Methods: A systematic review of published literature was conducted according to PRISMA (Preferred Reporting Item for Systematic Reviews and Meta-Analyses) guidelines. MEDLINE, PubMed, and Scopus databases as well as Google scholar were searched using key terms relating to “carbon footprint,” “environmental impact,” “sustainability”, “green care”, “primary care,”, and “general practice,” using citation tracking to identify additional articles. Data was extracted and analyzed in Microsoft Excel. Results: Eight studies were identified conducted in four different countries between 2010 and 2023. Four studies used interventions to address primary care services, three studies focused on the interface between primary and specialist care, and one study addressed both. Digital interventions included the use of mobile applications, online portals, access to electronic medical records, electronic referrals, electronic prescribing, video-consultations and use of autonomous artificial intelligence. Only one study carried out a complete life cycle assessment to determine the carbon footprint of the intervention. It estimate that digital interventions reduced the carbon footprint at primary care level by 5.1 kgCO2/visit, and at the interface with specialist care by 13.4 kg CO₂/visit. When assessing the relationship between travel-distance saved and savings in emissions, we identified a strong correlation, suggesting that most of the carbon footprint reduction is attributed to reduced travel. However, two studies also commented on environmental savings associated with reduced use of paper. Patient savings in the form of reduced fuel cost and reduced travel time were also identified. Conclusion: All studies identified significant reductions in carbon footprint following implementation of digital interventions. In the future, controlled, prospective studies incorporating complete life cycle assessments and accounting for double-consulting effects, use of additional resources, technical failures, quality of care and cost-effectiveness are needed to fully appreciate the sustainable benefit of these interventions

Keywords: carbon footprint, environmental impact, primary care, sustainable healthcare

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Authors: Mohsen Rabbani, Trista McLaughlin, Ehsan Vahidi

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the remediation of polluted sites with heavy metals, such as rare earth elements (REEs), has been a primary concern of researchers to decontaminate the soil. Among all developed methods to address this concern, phytoremediation has been established as efficient, cost-effective, easy-to-use, and environmentally friendly way, providing a long-term solution for addressing this global concern. Furthermore, this technology has another great potential application in the metals production sector through returning metals buried in soil via metals cropping. Considering the significant metal concentration in hyper-accumulators, the utilization of bioaccumulated metals to extract metals from plant matter has been proposed as a sub-economic area called phytomining. As a recent, more advanced technology to eliminate such pollutants from the soil and produce critical metals, bioharvesting (phytomining/agromining) has been considered another compromising way to produce metals and meet the global demand for critical/target metals. The bio-ore obtained from phytomining can be safely disposed of or introduced to metal production pathways to obtain the most demanded metals, such as REEs. It is well-known that some hyperaccumulators, e.g., fern Dicranopteris linearis, can be used to absorb REE metals from the polluted soils and accumulate them in plant organs, such as leaves and stems. After soil remediation, the plant species can be harvested and introduced to the downstream steps, namely crushing/grinding, leaching, and purification processes, to extract REEs from plant matter. This novel interdisciplinary field can fill the gap between agriculture, mining, metallurgy, and the environment. Despite the advantages of agromining for the REEs production industry, key issues related to the environmental sustainability of the entire life cycle of this new concept have not been assessed yet. Hence, a comparative life cycle assessment (LCA) study was conducted to quantify the environmental footprints of REEs phytomining. The current LCA study aims to estimate and calculate environmental effects associated with phytomining by considering critical factors, such as climate change, land use, and ozone depletion. The results revealed that phytomining is an easy-to-use and environmentally sustainable approach to either eliminate REEs from polluted sites or produce REEs, offering a new source of such metals production. This LCA research provides guidelines for researchers active in developing a reliable relationship between agriculture, mining, metallurgy, and the environment to encounter soil pollution and keep the earth green and clean.

Keywords: phytoremediation, phytomining, life cycle assessment, environmental impacts, rare earth elements, hyperaccumulator

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Authors: Tania Chalton

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In June 2013, an independent review of the Liverpool Care Pathway (LCP) identified a number of problems with the implementation of the LCP in the UK and recommended that it be replaced by individual care plans for each patient. As a result of the UK findings, in November 2013 the Ministry of Health (MOH) commissioned the Palliative Care Council to initiate a programme of work to investigate an appropriate approach for the care of people in their last days of life in New Zealand (NZ). The Last Days of Life Working Group commenced a process to develop national consensus on the care of people in their last days of life in April 2014. In order to develop its advice for the future provision of care to people in their last days of life, the Working Group (WG) established a comprehensive work programme and as a result has developed a series of working papers. Specific areas of focus included: An analysis of the UK Independent Review findings and an assessment of these findings to the NZ context. A stocktake of services providing care to people in their last days of life, including aged residential care (ARC); hospices; hospitals; and primary care. International and NZ literature reviews of evidence and best practice. Survey of family to understand the consumer perspective on the care of people in their last days of life. Key aspects of care that required further considerations for NZ were: Terminology: clarify terminology used in the last days of life and in relation to death and dying. Evidenced based: including specific review of evidence regarding, spiritual, culturally appropriate care as well as dementia care. Diagnosis of dying: need for both guidance around the diagnosis of dying and communication with family. Workforce issues: access to an appropriate workforce after hours. Nutrition and hydration: guidance around appropriate approaches to nutrition and hydration. Symptom and pain management: guidance around symptom management. Documentation: documentation of the person’s care which is robust enough for data collection and auditing requirements, not ‘tick box’ approach to care. Education and training: improved consistency and access to appropriate education and training. Leadership: A dedicated team or person to support and coordinate the introduction and implementation of any last days of life model of care. Quality indicators and data collection: model of care to enable auditing and regular reviews to ensure on-going quality improvement. Cultural and spiritual: address and incorporate any cultural and spiritual aspects. A final document was developed incorporating all the evidence which provides guidance to the health sector on best practice for people at end of life: “Principles and guidance for the last days of life: Te Ara Whakapiri”.

Keywords: end of life, guidelines, New Zealand, palliative care

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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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Authors: Arul Aram, Vishnu Priya, Monicka Karunanithi

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In India, in particular, festivals are the occasions of celebrations. They create beautiful moments to cherish. Mostly, people pay a visit to their native places to celebrate with their loved ones. So are wedding celebrations. The Covid-19 pandemic came upon us unexpectedly, and to fight it, the festivals and weddings are celebrated unusually. Crowded places are deserted. Mass gatherings are avoided, changes and alterations are made in our rituals and celebrations. The warmth usually people have at their heart during any festival and wedding has disappeared. Some aspects of the celebrations become virtual/digital rather than real -- for instance, digital greetings/invitations, digital conduct of ceremonies by priests, YouTube worship, online/digital cash gifts, and digital audience for weddings. Each festival has different rituals which are followed with the divine nature in every family, but the pandemic warranted some compromises on the traditions. Likewise, a marriage is a beautiful bond between two families where a lot of traditional customs are followed. The wedding ceremonies are colorful and celebrations may extend for several days. People in India spend financial resources to prepare and celebrate weddings. The bride's and the groom's homes are fully decorated with colors, balloons and other decorations. The wedding rituals and celebrations vary by religion, region, preference and the resources of the groom, bride and their families. They can range from one day to multiple-days events. But the Covid-19 pandemic situation changes the mindset of people over ceremonies. This lockdown has affected those weddings and industries that support them and make the people postpone or at times advance without fanfare their 'big day.' People now adopt the protocols, guidelines and safety measures to reduce the risk and minimize the fear during celebrations. The study shall look into: how the pandemic shattered the expectations of people celebrating; problems faced economically by people/service providers who are benefited by the celebrations; and identify the alterations made in the rituals or the practices of our culture for the safety of families. The study shall employ questionnaires, interviews and visual ethnography to collect data. The study found that during a complete lockdown, people have not bought new clothes, sweets, or snacks, as they generally do before a pandemic. Almost all of them kept their celebrations low-key, and some did not celebrate at all. Digital media played a role in keeping the celebration alive, as people used it to wish their friends and families virtually. During partial unlock, the situation was under control, and people began to go out and see a few family and friends. They went shopping and bought new clothes and needs, but they did it while following safety precautions. There is also an equal percentage of people who shopped online. Although people continue to remain disappointed, they were less stressed up as life was returning to normal.

Keywords: covid-19, digital, festivals, India, wedding

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Authors: Adam Aboalkaz, Rana Shamoon, Duncan Meikle, James Lewis

Abstract:

Background and aims: In orthopaedic theatres, radiological screening during operations is a commonly used and useful technique to visualise and guide the operating surgeon. Within any theatre using ionising radiation, it is imperative that the use of protective equipment and the wearing of a dosimeter at all times. 1. To assess compliance with use of protective equipment during orthopaedic procedures involving ionising radiation. 2. To assess the radiation risk knowledge of staff members regularly present in an orthopaedic theatre of a national major trauma centre, in accordance to the ionising radiation regulation (2000) guidelines. Method: We conducted an Observational study of 21 operations at the University Hospital of Wales, which is a major trauma centre, recording the compliance with use of protective equipment (lead aprons and thyroid shields) and dosimeters. The observations were performed sporadically over a two week period to ensure that all staff in monitored operating theatres were not aware of the ongoing study, as to avoid bias. A questionnaire testing the knowledge of trainees and staff within the orthopaedic department was given following completion of the initial phase of the study, with 19 responses. The questions were based on knowledge of ionising radiation exposure and monitoring. The questions also tested the general staff knowledge of what equipment should be worn and where to locate such equipment. Results: This study found that only 25% of staff members were wearing thyroid protectors when less than 1 meter from the radiation source and only 50% were wearing appropriate lead aprons whilst in this same vicinity. The study also showed that 0% of all staff members used a dosimeter whilst in an area of radiation exposure. From the distributed questionnaires, only 40% of staff understood where to stand whilst radiation was being used, and only 25% of staff knew where to find protective equipment. Conclusion: Overall our audit showed poor compliance with regards to the National and local policies, due to lack of awareness of the policy and lack of basic ionising radiation exposure knowledge. It was evident from the observational study and questionnaire that staff were not fully aware of what equipment should be worn, where to find such equipment and did not appreciate that the distance from the ionising radiation source altered its exposure effect. This lack of knowledge may affect the staff health and safety after long term exposure. Changes to clinical practice: From the outcome of this study, we managed to drastically increase awareness of ionising radiation within the orthopaedic department. A mandatory teaching session on the safety of ionising radiation has been incorporated into the orthopaedic induction week for all staff. The dosimeters have been moved to a visible location within the trauma operating theatre and all staff made aware of where to find protective equipment.

Keywords: audit, ionising radiation, observational study, protection

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Authors: Le Jiang, Chua Jinxing

Abstract:

Introduction: The recent outbreak of Ebola virus disease in the west Africa has drawn global concern. With a high fatality rate and direct human-to-human transmission, it has spread between countries and caused great damages for patients and family who are affected. Being the designated hospital to manage epidemic outbreak in Singapore, Tan Tock Seng Hospital (TTSH) is facing great challenges in preparation and managing of potential outbreak of emerging infectious disease such as Ebola virus disease. Aim: We conducted an infection control drill in TTSH emergency department to assess the readiness of healthcare and allied health workers in managing suspected Ebola patients. It also helps to review current Ebola clinical protocol and work instruction to ensure more smooth and safe practice in managing Ebola patients in TTSH emergency department. Result: General preparedness level of staffs involved in managing Ebola virus disease in TTSH emergency department is not adequate. Knowledge deficits of staffs on Ebola personal protective equipment gowning and degowning process increase the risk of potential cross contamination in patient care. Loopholes are also found in current clinical protocol, such as unclear instructions and inaccurate information, which need to be revised to promote better staff performance in patient management. Logistic issues such as equipment dysfunction and inadequate supplies can lead to ineffective communication among teams and causing harm to patients in emergency situation. Conclusion: The infection control drill identified the need for more well-structured and clear clinical protocols to be in place to promote participants performance. In addition to quality protocols and guidelines, systemic training and annual refresher for all staffs in the emergency department are essential to prepare staffs for the outbreak of Ebola virus disease. Collaboration and communication with allied health staffs are also crucial for smooth delivery of patient care and minimising the potential human suffering, properties loss or injuries caused by disease. Therefore, more clinical drills with collaboration among various departments involved are recommended to be conducted in the future to monitor and assess readiness of TTSH emergency department in managing Ebola virus disease.

Keywords: ebola, emergency department, infection control drill, Tan Tock Seng Hospital

Procedia PDF Downloads 121