Search results for: Customer Experience Management
723 Adaptative Metabolism of Lactic Acid Bacteria during Brewers' Spent Grain Fermentation
Authors: M. Acin-Albiac, P. Filannino, R. Coda, Carlo G. Rizzello, M. Gobbetti, R. Di Cagno
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Demand for smart management of large amounts of agro-food by-products has become an area of major environmental and economic importance worldwide. Brewers' spent grain (BSG), the most abundant by-product generated in the beer-brewing process, represents an example of valuable raw material and source of health-promoting compounds. To the date, the valorization of BSG as a food ingredient has been limited due to poor technological and sensory properties. Tailored bioprocessing through lactic acid bacteria (LAB) fermentation is a versatile and sustainable means for the exploitation of food industry by-products. Indigestible carbohydrates (e.g., hemicelluloses and celluloses), high phenolic content, and mostly lignin make of BSG a hostile environment for microbial survival. Hence, the selection of tailored starters is required for successful fermentation. Our study investigated the metabolic strategies of Leuconostoc pseudomesenteroides and Lactobacillus plantarum strains to exploit BSG as a food ingredient. Two distinctive BSG samples from different breweries (Italian IT- and Finish FL-BSG) were microbially and chemically characterized. Growth kinetics, organic acid profiles, and the evolution of phenolic profiles during the fermentation in two BSG model media were determined. The results were further complemented with gene expression targeting genes involved in the degradation cellulose, hemicelluloses building blocks, and the metabolism of anti-nutritional factors. Overall, the results were LAB genus dependent showing distinctive metabolic capabilities. Leuc. pseudomesenteroides DSM 20193 may degrade BSG xylans while sucrose metabolism could be furtherly exploited for extracellular polymeric substances (EPS) production to enhance BSG pro-technological properties. Although L. plantarum strains may follow the same metabolic strategies during BSG fermentation, the mode of action to pursue such strategies was strain-dependent. L. plantarum PU1 showed a great preference for β-galactans compared to strain WCFS1, while the preference for arabinose occurred at different metabolic phases. Phenolic compounds profiling highlighted a novel metabolic route for lignin metabolism. These findings will allow an improvement of understanding of how lactic acid bacteria transform BSG into economically valuable food ingredients.Keywords: brewery by-product valorization, metabolism of plant phenolics, metabolism of lactic acid bacteria, gene expression
Procedia PDF Downloads 119722 Magnetic Navigation in Underwater Networks
Authors: Kumar Divyendra
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Underwater Sensor Networks (UWSNs) have wide applications in areas such as water quality monitoring, marine wildlife management etc. A typical UWSN system consists of a set of sensors deployed randomly underwater which communicate with each other using acoustic links. RF communication doesn't work underwater, and GPS too isn't available underwater. Additionally Automated Underwater Vehicles (AUVs) are deployed to collect data from some special nodes called Cluster Heads (CHs). These CHs aggregate data from their neighboring nodes and forward them to the AUVs using optical links when an AUV is in range. This helps reduce the number of hops covered by data packets and helps conserve energy. We consider the three-dimensional model of the UWSN. Nodes are initially deployed randomly underwater. They attach themselves to the surface using a rod and can only move upwards or downwards using a pump and bladder mechanism. We use graph theory concepts to maximize the coverage volume while every node maintaining connectivity with at least one surface node. We treat the surface nodes as landmarks and each node finds out its hop distance from every surface node. We treat these hop-distances as coordinates and use them for AUV navigation. An AUV intending to move closer to a node with given coordinates moves hop by hop through nodes that are closest to it in terms of these coordinates. In absence of GPS, multiple different approaches like Inertial Navigation System (INS), Doppler Velocity Log (DVL), computer vision-based navigation, etc., have been proposed. These systems have their own drawbacks. INS accumulates error with time, vision techniques require prior information about the environment. We propose a method that makes use of the earth's magnetic field values for navigation and combines it with other methods that simultaneously increase the coverage volume under the UWSN. The AUVs are fitted with magnetometers that measure the magnetic intensity (I), horizontal inclination (H), and Declination (D). The International Geomagnetic Reference Field (IGRF) is a mathematical model of the earth's magnetic field, which provides the field values for the geographical coordinateson earth. Researchers have developed an inverse deep learning model that takes the magnetic field values and predicts the location coordinates. We make use of this model within our work. We combine this with with the hop-by-hop movement described earlier so that the AUVs move in such a sequence that the deep learning predictor gets trained as quickly and precisely as possible We run simulations in MATLAB to prove the effectiveness of our model with respect to other methods described in the literature.Keywords: clustering, deep learning, network backbone, parallel computing
Procedia PDF Downloads 87721 Evaluation of the Pathogenicity Test of Some Entomopathogenic Fungus Isolates against Tomato Leaf Miner Tuta Absoluta (Meyrick) Larvae [Lepidoptera: Gelechiidae])
Authors: Tadesse Kebede, Orkun Baris Kovanci
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Tomatoes leaf minor (Tutaabasoluta) is one of the most economically important insect pest in tomatoes production. The use of biological control such as entomopathogen fungi isolates would be a long-term and cost-effective solution to control insects pest. Therefore, identifying the most virulent and pathogenic entomopathogen fungi is one of the basic requirements for effective management options to combat Tomatoes leaf minor (Tutaabasoluta). Furthermore, the pathogenicity and virulence difference among entomopathogenfungus strains is not widely well investıgated. The current study was therefore initiated to test the pathogenicity of some entomopathogenic fungus isolates against Tutaabsoluta. The experiment was conducted at Bursa Uludag University, Agiculutre faculty, horticulture department glasshouse in 2020/2021. Tutabasoluta adult were collected, and masslarvae were reared in a growth chamber. Then, ten third instar larvae were inoculated with four entomopathogen fungi isolates (Beuaveriabassania Ak-10, Beuaveriabassania Ak-14, Metarhziumanisoplai Ak-11, and Metarhziumanisoplai Ak-12) with different inoculum suspension (0, 1x10⁶, 1x10⁷,,4 × 10⁸, 4× 10⁹ and 1×10¹⁰ conidia /ml) in a factorial experiment arranged in randomized complete block design with three replication. Mortality data assessment was done on the 3rd, 5thand 7th days after treatment and analyzed. The analysis of variance for mortality rate revealed significant variations (p<0.05) among entomoptahogen fungi isolates and conidia concentrations. The results revealed thatMetarhziumanisoplai Ak-12was found to show the lowest mortality percentage80.77%, highest LC50 2.3x108, and the longest incubation period, LT50, 4.9 and LT90, 9.9daysand considered to be less pathogenic fungi. On the other hand, Beuaveriabassania Ak-10 isolate showed the highest mortality percentage, 91%, and the lowest LT50, 4, and LT90, 7.6 values at 1×10¹⁰ conidia /ml, followed by Beuaveriabassania Ak-14 and being considered as the most aggressive bio-agent. Metarhziumanisoplai Ak-11 was determined as moderately virulent, having a mortality rate 27-81%. Results also revealed that among conidia concentrations, 1x10⁹ and 1x10¹⁰ suspensions is the most effective, while 1x10⁶ conidia/ml concentration is the least effective. Hence, results indicated that EPF tested were effective against T. absoluta larvae. As the current work revealed the potential variation among entomopathogen fungi isolates and concentration against third instar larvae.Keywords: tuta absoluta, tomato, metarhizium anisopliae, beauveria bassiana, biological control
Procedia PDF Downloads 120720 Nutrition Transition in Bangladesh: Multisectoral Responsiveness of Health Systems and Innovative Measures to Mobilize Resources Are Required for Preventing This Epidemic in Making
Authors: Shusmita Khan, Shams El Arifeen, Kanta Jamil
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Background: Nutrition transition in Bangladesh has progressed across various relevant socio-demographic contextual issues. For a developing country like Bangladesh, its is believed that, overnutrition is less prevalent than undernutrition. However, recent evidence suggests that a rapid shift is taking place where overweight is subduing underweight. With this rapid increase, for Bangladesh, it will be challenging to achieve the global agenda on halting overweight and obesity. Methods: A secondary analysis was performed from six successive national demographic and health surveys to get the trend on undernutrition and overnutrition for women from reproductive age. In addition, national relevant policy papers were reviewed to determine the countries readiness for whole of the systems approach to tackle this epidemic. Results: Over the last decade, the proportion of women with low body mass index (BMI<18.5), an indicator of undernutrition, has decreased markedly from 34% to 19%. However, the proportion of overweight women (BMI ≥25) increased alarmingly from 9% to 24% over the same period. If the WHO cutoff for public health action (BMI ≥23) is used, the proportion of overweight women has increased from 17% in 2004 to 39% in 2014. The increasing rate of obesity among women is a major challenge to obstetric practice for both women and fetuses. In the long term, overweight women are also at risk of future obesity, diabetes, hyperlipidemia, hypertension, and heart disease. These diseases have serious impact on health care systems. Costs associated with overweight and obesity involves direct and indirect costs. Direct costs include preventive, diagnostic, and treatment services related to obesity. Indirect costs relate to morbidity and mortality costs including productivity. Looking at the Bangladesh Health Facility Survey, it is found that the country is bot prepared for providing nutrition-related health services, regarding prevention, screening, management and treatment. Therefore, if this nutrition transition is not addressed properly, Bangladesh will not be able to achieve the target of the NCD global monitoring framework of the WHO. Conclusion: Addressing this nutrition transition requires contending ‘malnutrition in all its forms’ and addressing it with integrated approaches. Whole of the systems action is required at all levels—starting from improving multi-sectoral coordination to scaling up nutrition-specific and nutrition-sensitive mainstreamed interventions keeping health system in mind.Keywords: nutrition transition, Bangladesh, health system, undernutrition, overnutrition, obesity
Procedia PDF Downloads 275719 Promoting 'One Health' Surveillance and Response Approach Implementation Capabilities against Emerging Threats and Epidemics Crisis Impact in African Countries
Authors: Ernest Tambo, Ghislaine Madjou, Jeanne Y. Ngogang, Shenglan Tang, Zhou XiaoNong
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Implementing national to community-based 'One Health' surveillance approach for human, animal and environmental consequences mitigation offers great opportunities and value-added in sustainable development and wellbeing. 'One Health' surveillance approach global partnerships, policy commitment and financial investment are much needed in addressing the evolving threats and epidemics crises mitigation in African countries. The paper provides insights onto how China-Africa health development cooperation in promoting “One Health” surveillance approach in response advocacy and mitigation. China-Africa health development initiatives provide new prospects in guiding and moving forward appropriate and evidence-based advocacy and mitigation management approaches and strategies in attaining Universal Health Coverage (UHC) and Sustainable Development Goals (SDGs). Early and continuous quality and timely surveillance data collection and coordinated information sharing practices in malaria and other diseases are demonstrated in Comoros, Zanzibar, Ghana and Cameroon. Improvements of variety of access to contextual sources and network of data sharing platforms are needed in guiding evidence-based and tailored detection and response to unusual hazardous events. Moreover, understanding threats and diseases trends, frontline or point of care response delivery is crucial to promote integrated and sustainable targeted local, national “One Health” surveillance and response approach needs implementation. Importantly, operational guidelines are vital in increasing coherent financing and national workforce capacity development mechanisms. Strengthening participatory partnerships, collaboration and monitoring strategies in achieving global health agenda effectiveness in Africa. At the same enhancing surveillance data information streams reporting and dissemination usefulness in informing policies decisions, health systems programming and financial mobilization and prioritized allocation pre, during and post threats and epidemics crises programs strengths and weaknesses. Thus, capitalizing on “One Health” surveillance and response approach advocacy and mitigation implementation is timely in consolidating Africa Union 2063 agenda and Africa renaissance capabilities and expectations.Keywords: Africa, one health approach, surveillance, response
Procedia PDF Downloads 413718 Comparative Quantitative Study on Learning Outcomes of Major Study Groups of an Information and Communication Technology Bachelor Educational Program
Authors: Kari Björn, Mikael Soini
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Higher Education system reforms, especially Finnish system of Universities of Applied Sciences in 2014 are discussed. The new steering model is based on major legislative changes, output-oriented funding and open information. The governmental steering reform, especially the financial model and the resulting institutional level responses, such as a curriculum reforms are discussed, focusing especially in engineering programs. The paper is motivated by management need to establish objective steering-related performance indicators and to apply them consistently across all educational programs. The close relationship to governmental steering and funding model imply that internally derived indicators can be directly applied. Metropolia University of Applied Sciences (MUAS) as a case institution is briefly introduced, focusing on engineering education in Information and Communications Technology (ICT), and its related programs. The reform forced consolidation of previously separate smaller programs into fewer units of student application. New curriculum ICT students have a common first year before they apply for a Major. A framework of parallel and longitudinal comparisons is introduced and used across Majors in two campuses. The new externally introduced performance criteria are applied internally on ICT Majors using data ex-ante and ex-post of program merger. A comparative performance of the Majors after completion of joint first year is established, focusing on previously omitted Majors for completeness of analysis. Some new research questions resulting from transfer of Majors between campuses and quota setting are discussed. Practical orientation identifies best practices to share or targets needing most attention for improvement. This level of analysis is directly applicable at student group and teaching team level, where corrective actions are possible, when identified. The analysis is quantitative and the nature of the corrective actions are not discussed. Causal relationships and factor analysis are omitted, because campuses, their staff and various pedagogical implementation details contain still too many undetermined factors for our limited data. Such qualitative analysis is left for further research. Further study must, however, be guided by the relevance of the observations.Keywords: engineering education, integrated curriculum, learning outcomes, performance measurement
Procedia PDF Downloads 227717 Sludge Marvel (Densification): The Ultimate Solution For Doing More With Less Effort!
Authors: Raj Chavan
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At present, the United States is home to more than 14,000 Water Resource Recovery Facilities (WRRFs), of which approximately 35% have implemented nutrient limits of some kind. These WRRFs contribute 10 to 15% of the total nutrient burden to surface rivers in the United States and account for approximately 1% of total power demand and 2% of total greenhouse gas emissions (GHG). There are several factors that have influenced the development of densification technologies in the direction of more compact and energy-efficient nutrient removal processes. Prior to surface water discharge, existing facilities that necessitate capacity expansion or biomass densification for greater treatability within the same footprint are being subjected to stricter nutrient removal requirements. Densification of activated sludge as a method for nutrient removal and process intensification at WRRFs has garnered considerable attention in recent times. The biological processes take place within the aerobic sediment granules, which form the basis of the technology. The possibility of generating granular sludge through continuous (or conventional) activated sludge processes (CAS) or densification of biomass through the transfer of activated sludge flocs to a denser biomass aggregate as an exceptionally efficient intensification technique has generated considerable interest. This presentation aims to furnish attendees with a foundational comprehension of densification through the illustration of practical concerns and insights. The subsequent subjects will be deliberated upon. What are some potential techniques for producing and preserving densified granules? What processes are responsible for the densification of biological flocs? How do physical selectors contribute to the process of biological flocs becoming denser? What viable strategies exist for the management of densified biological flocs, and which design parameters of physical selection influence the retention of densified biological flocs? determining operational solutions for floc and granule customization in order to meet capacity and performance objectives? The answers to these pivotal questions will be derived from existing full-scale treatment facilities, bench-scale and pilot-scale investigations, and existing literature data. By the conclusion of the presentation, the audience will possess a fundamental comprehension of the densification concept and its significance in attaining effective effluent treatment. Additionally, case studies pertaining to the design and operation of densification procedures will be incorporated into the presentation.Keywords: densification, intensification, nutrient removal, granular sludge
Procedia PDF Downloads 64716 Rural Tourism in Indian Himalayan Region: A Scope for Sustainable Livelihood
Authors: Rommila Chandra, Harshika Choudhary
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The present-day tourism sector is globally developing at a fast pace, searching for new ideas and new venues. In the Indian Himalayan Region (IHR), tourism has experienced a vast growth and continuous diversification over the last few years, thus becoming one of the fastest-growing economic sectors in India. With its majestic landscape, high peaks, rich floral and faunal diversity, and cultural history, the IHR has continuously attracted tourists and pilgrims from across the globe. The IHR has attracted a vast range of visitors who seek adventure sports, natural and spiritual solace, peace, cultural assets, food, and festivals, etc. Thus, the multi-functionality of the region has turned tourism into a key component of economic growth for the rural communities in the hills. For the local mountain people, it means valuable economic opportunity for income generation, and for the government and entrepreneurs, it brings profits. As the urban cities gain attention and investment in India, efforts have to be made to protect, safeguard, and strengthen the cultural, spiritual, and natural heritage of IHR for sustainable livelihood development. Furthermore, the socio-economic and environmental insecurities, along with geographical isolation, adds to the challenging survival in the tough terrains of IHR, creating a major threat of outmigration, land abandonment, and degradation. The question the paper intends to answer is: whether the rural community of IHR is aware of the new global trends in rural tourism and the extent of their willingness to adapt to the evolving tourism industry, which impacts the rural economy, including sustainable livelihood opportunity. The objective of the paper is to discuss the integrated nature of rural tourism, which widely depends upon natural resources, cultural heritage, agriculture/horticulture, infrastructural development, education, social awareness, and willingness of the locals. The sustainable management of all these different rural activities can lead to long-term livelihood development and social upliftment. It highlights some gap areas and recommends fewcommunity-based coping measures which the local people can adopt amidst the disorganized sector of rural tourism. Lastly, the main contribution is the exploratory research of the rural tourism vulnerability in the IHR, which would further help in studying the resilience of the tourism sector in the rural parts of a developing nation.Keywords: community-based approach, sustainable livelihood development, Indian Himalayan region, rural tourism
Procedia PDF Downloads 136715 Development of Earthquake and Typhoon Loss Models for Japan, Specifically Designed for Underwriting and Enterprise Risk Management Cycles
Authors: Nozar Kishi, Babak Kamrani, Filmon Habte
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Natural hazards such as earthquakes and tropical storms, are very frequent and highly destructive in Japan. Japan experiences, every year on average, more than 10 tropical cyclones that come within damaging reach, and earthquakes of moment magnitude 6 or greater. We have developed stochastic catastrophe models to address the risk associated with the entire suite of damaging events in Japan, for use by insurance, reinsurance, NGOs and governmental institutions. KCC’s (Karen Clark and Company) catastrophe models are procedures constituted of four modular segments: 1) stochastic events sets that would represent the statistics of the past events, hazard attenuation functions that could model the local intensity, vulnerability functions that would address the repair need for local buildings exposed to the hazard, and financial module addressing policy conditions that could estimates the losses incurring as result of. The events module is comprised of events (faults or tracks) with different intensities with corresponding probabilities. They are based on the same statistics as observed through the historical catalog. The hazard module delivers the hazard intensity (ground motion or wind speed) at location of each building. The vulnerability module provides library of damage functions that would relate the hazard intensity to repair need as percentage of the replacement value. The financial module reports the expected loss, given the payoff policies and regulations. We have divided Japan into regions with similar typhoon climatology, and earthquake micro-zones, within each the characteristics of events are similar enough for stochastic modeling. For each region, then, a set of stochastic events is developed that results in events with intensities corresponding to annual occurrence probabilities that are of interest to financial communities; such as 0.01, 0.004, etc. The intensities, corresponding to these probabilities (called CE, Characteristics Events) are selected through a superstratified sampling approach that is based on the primary uncertainty. Region specific hazard intensity attenuation functions followed by vulnerability models leads to estimation of repair costs. Extensive economic exposure model addresses all local construction and occupancy types, such as post-linter Shinand Okabe wood, as well as concrete confined in steel, SRC (Steel-Reinforced Concrete), high-rise.Keywords: typhoon, earthquake, Japan, catastrophe modelling, stochastic modeling, stratified sampling, loss model, ERM
Procedia PDF Downloads 259714 Bank Internal Controls and Credit Risk in Europe: A Quantitative Measurement Approach
Authors: Ellis Kofi Akwaa-Sekyi, Jordi Moreno Gené
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Managerial actions which negatively profile banks and impair corporate reputation are addressed through effective internal control systems. Disregard for acceptable standards and procedures for granting credit have affected bank loan portfolios and could be cited for the crises in some European countries. The study intends to determine the effectiveness of internal control systems, investigate whether perceived agency problems exist on the part of board members and to establish the relationship between internal controls and credit risk among listed banks in the European Union. Drawing theoretical support from the behavioural compliance and agency theories, about seventeen internal control variables (drawn from the revised COSO framework), bank-specific, country, stock market and macro-economic variables will be involved in the study. A purely quantitative approach will be employed to model internal control variables covering the control environment, risk management, control activities, information and communication and monitoring. Panel data from 2005-2014 on listed banks from 28 European Union countries will be used for the study. Hypotheses will be tested and the Generalized Least Squares (GLS) regression will be run to establish the relationship between dependent and independent variables. The Hausman test will be used to select whether random or fixed effect model will be used. It is expected that listed banks will have sound internal control systems but their effectiveness cannot be confirmed. A perceived agency problem on the part of the board of directors is expected to be confirmed. The study expects significant effect of internal controls on credit risk. The study will uncover another perspective of internal controls as not only an operational risk issue but credit risk too. Banks will be cautious that observing effective internal control systems is an ethical and socially responsible act since the collapse (crisis) of financial institutions as a result of excessive default is a major contagion. This study deviates from the usual primary data approach to measuring internal control variables and rather models internal control variables in a quantitative approach for the panel data. Thus a grey area in approaching the revised COSO framework for internal controls is opened for further research. Most bank failures and crises could be averted if effective internal control systems are religiously adhered to.Keywords: agency theory, credit risk, internal controls, revised COSO framework
Procedia PDF Downloads 300713 The Role of High-Intensity Focused Ultrasound (HIFU) in the Treatment of Fibroadenomas: A Systematic Review
Authors: Ahmed Gonnah, Omar Masoud, Mohamed Abdel-Wahab, Ahmed ElMosalamy, Abdulrahman Al-Naseem
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Introduction: Fibroadenomas are solid, mobile, and non-tender benign breast lumps, with the highest prevalence amongst young women aged between 15 and 35. Symptoms can include discomfort, and they can become problematic, particularly when they enlarge, resulting in many referrals for biopsies, with fibroadenomas accounting for 30-75% of the cases. Diagnosis is based on triple assessment that involves a clinical examination, ultrasound imaging and mammography, as well as core needle biopsies. Current management includes observation for 6-12 months, with the indication of definitive surgery, in cases that are older than 35 years or with fibroadenoma persistence. Serious adverse effects of surgery might include nipple-areolar distortion, scarring and damage to the breast tissue, as well as the risks associated with surgery and anesthesia, making it a non-feasible option. Methods: A literature search was performed on the databases EMBASE. MEDLINE/PubMed, Google scholar and Ovid, for English language papers published between 1st of January 2000 and 17th of March 2021. A structured protocol was employed to devise a comprehensive search strategy with keywords and Boolean operators defined by the research question. The keywords used for the search were ‘HIFU’, ‘High-Intensity Focused Ultrasound’, ‘Fibroadenoma’, ‘Breast’, ‘Lesion’. This review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Recently, a thermal ablative technique, High Intensity Focused Ultrasound (HIFU), was found to be a safe, non-invasive, and technically successful alternative, having displayed promising outcomes in reducing the volume of fibroadenomas, pain experienced by patients, and the length of hospitalization. Quality of life improvement was also evidenced, exhibited by the disappearance of symptoms, and enhanced physical activity post-intervention, in addition to patients’ satisfaction with the cosmetic results and future recommendation of the procedure to other patients. Conclusion: Overall, HIFU is a well-tolerated treatment associated with a low risk of complications that can potentially include erythema, skin discoloration and bruising, with the majority of this self-resolving shortly after the procedure.Keywords: ultrasound, HIFU, breast, efficacy, side effects, fibroadenoma
Procedia PDF Downloads 207712 Nimart-trained Nurses' Perspectives Regarding Virally Unsuppressed Children HIV-positive on Antiretroviral Therapy and Missing Scheduled Clinic Visits: Mopani District, Limpopo Province
Authors: Linneth Nkateko Mabila, Patrick Hulisani Demana, Tebogo Maria Mothiba
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Background: Sustaining adherence to antiretroviral therapy (ART) over the long term by people, especially children living with Human-Immunodeficiency Virus (HIV), requires accurate and consistent monitoring, and this is a particular challenge for countries in sub-Saharan Africa. However, the regularity and punctuality in monthly antiretroviral treatment collections indicate medication adherence to a certain extent since it has been revealed to be a significant determinant of the outcome of ART. Aim: This study assessed and described the pattern of monthly antiretroviral treatment collections among a cohort of virally unsuppressed HIV-positive children initiated and managed on ART in the rural public clinics of Mopani District, Limpopo, and explored the nurses' perceptions and views of the findings. Methods: A facility-based mixed-methods study was conducted to assess the honoring of scheduled monthly treatment collection practices by a cohort of HIV-positive children under 15 years initiated and managed on ART by Nurse Initiated Management of Antiretroviral Treatment (NIMART)-trained professional nurses (PNs) from 01 January 2015 to 31 December 2015 in public PHC clinics of Mopani District Municipality. This was followed by the exploration of the nurses' perceptions and views regarding this issue to share their experiences and knowledge acquired through managing these children on ART. Results: From a total of 7105 analysable visits, only 44% (3134) were honored as scheduled, with 40% (2828) of children presenting to the clinics after the scheduled appointment date – they missed their appointments, and 11% (768) of treatment collections that took place before the scheduled appointment date. This finding was further confirmed by 90% (97) of the nurses, who reported that they have children who miss scheduled appointments in their public clinics. The primary reasons for children missing appointments were related to caregivers' forgetfulness and conflict between the school schedule and the dates of clinic visits. Conclusion: We confirmed a high prevalence of non-adherence to scheduled monthly ART collections and the existence of health system, social, and caregiver-related factors that threaten treatment adherence and proper clinical outcomes. These findings suggest an urgent need for intervention since non-adherence to ARV therapy can be life-threatening to the child and poses the danger of reduced life expectancy.Keywords: antiretroviral therapy (art), nimart, virally unsuppressed children, missed appointments
Procedia PDF Downloads 92711 Land Use Influence on the 2014 Catastrophic Flood in the Northeast of Peninsular Malaysia
Authors: Zulkifli Yusop
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The severity of December 2014 flood on the east coast of Peninsular Malaysia has raised concern over the adequacy of existing land use practices and policies. This article assesses flood responses to selective logging, plantation establishment (oil palm and rubber) and their subsequent management regimes. The hydrological impacts were evaluated on two levels: on-site (mostly in the upstream) and off-site to reflect the cumulative impact at downstream. Results of experimental catchment studies suggest that on-site impact of flood could be kept to a minimum when selecting logging strictly adhere to the existing guidelines. However, increases in flood potential and sedimentation rate were observed with logging intensity and slope steepness. Forest conversion to plantation show the highest impacts. Except on the heavily compacted surfaces, the ground revegetation is usually rapid within two years upon the cessation of the logging operation. The hydrological impacts of plantation opening and replanting could be significantly reduced once the cover crop has fully established which normally takes between three to six months after sowing. However, as oil palms become taller and the canopy gets closer, the cover crop tends to die off due to light competition, and its protecting function gradually diminishes. The exposed soil is further compacted by harvesting machinery which subsequently leads to greater overland flow and erosion rates. As such, the hydrological properties of matured oil palm plantations are generally poorer than in young plantation. In hilly area, the undergrowth in rubber plantation is usually denser compared to under oil palm. The soil under rubber trees is also less compacted as latex collection is done manually. By considering the cumulative effects of land-use over space and time, selective logging seems to pose the least impact on flood potential, followed by planting rubber for latex, oil palm and Latex Timber Clone (LTC). The cumulative hydrological impact of LTC plantation is the most severe because of its shortest replanting rotation (12 to 15 years) compared to oil palm (25 years) and rubber for latex (35 years). Furthermore, the areas gazetted for LTC are mostly located on steeper slopes which are more susceptible to landslide and erosion. Forest has limited capability to store excess rainfall and is only effective in attenuating regular floods. Once the hydrologic storage is exceeded, the excess rainfall will appear as flood water. Therefore, for big floods, rainfall regime has a much bigger influence than land use.Keywords: selective logging, plantation, extreme rainfall, debris flow
Procedia PDF Downloads 339710 The Influence of Absorptive Capacity on Process Innovation: An Exploratory Study in Seven Leading and Emerging Countries
Authors: Raphael M. Rettig, Tessa C. Flatten
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This empirical study answer calls for research on Absorptive Capacity and Process Innovation. Due to the fourth industrial revolution, manufacturing companies face the biggest disruption of their production processes since the rise of advanced manufacturing technologies in the last century. Therefore, process innovation will become a critical task to master in the future for many manufacturing firms around the world. The general ability of organizations to acquire, assimilate, transform, and exploit external knowledge, known as Absorptive Capacity, was proven to positively influence product innovation and is already conceptually associated with process innovation. The presented research provides empirical evidence for this influence. The findings are based on an empirical analysis of 732 companies from seven leading and emerging countries: Brazil, China, France, Germany, India, Japan, and the United States of America. The answers to the survey were collected in February and March 2018 and addressed senior- and top-level management with a focus on operations departments. The statistical analysis reveals the positive influence of potential and Realized Absorptive Capacity on successful process innovation taking the implementation of new digital manufacturing processes as an example. Potential Absorptive Capacity covering the acquisition and assimilation capabilities of an organization showed a significant positive influence (β = .304, p < .05) on digital manufacturing implementation success and therefore on process innovation. Realized Absorptive Capacity proved to have significant positive influence on process innovation as well (β = .461, p < .01). The presented study builds on prior conceptual work in the field of Absorptive Capacity and process innovation and contributes theoretically to ongoing research in two dimensions. First, the already conceptually associated influence of Absorptive Capacity on process innovation is backed by empirical evidence in a broad international context. Second, since Absorptive Capacity was measured with a focus on new product development, prior empirical research on Absorptive Capacity was tailored to the research and development departments of organizations. The results of this study highlight the importance of Absorptive Capacity as a capability in mechanical engineering and operations departments of organizations. The findings give managers an indication of the importance of implementing new innovative processes into their production system and fostering the right mindset of employees to identify new external knowledge. Through the ability to transform and exploit external knowledge, own production processes can be innovated successfully and therefore have a positive influence on firm performance and the competitive position of their organizations.Keywords: absorptive capacity, digital manufacturing, dynamic capabilities, process innovation
Procedia PDF Downloads 137709 A Risk-Based Modeling Approach for Successful Adoption of CAATTs in Audits: An Exploratory Study Applied to Israeli Accountancy Firms
Authors: Alon Cohen, Jeffrey Kantor, Shalom Levy
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Technology adoption models are extensively used in the literature to explore drivers and inhibitors affecting the adoption of Computer Assisted Audit Techniques and Tools (CAATTs). Further studies from recent years suggested additional factors that may affect technology adoption by CPA firms. However, the adoption of CAATTs by financial auditors differs from the adoption of technologies in other industries. This is a result of the unique characteristics of the auditing process, which are expressed in the audit risk elements and the risk-based auditing approach, as encoded in the auditing standards. Since these audit risk factors are not part of the existing models that are used to explain technology adoption, these models do not fully correspond to the specific needs and requirements of the auditing domain. The overarching objective of this qualitative research is to fill the gap in the literature, which exists as a result of using generic technology adoption models. Followed by a pretest and based on semi-structured in-depth interviews with 16 Israeli CPA firms of different sizes, this study aims to reveal determinants related to audit risk factors that influence the adoption of CAATTs in audits and proposes a new modeling approach for the successful adoption of CAATTs. The findings emphasize several important aspects: (1) while large CPA firms developed their own inner guidelines to assess the audit risk components, other CPA firms do not follow a formal and validated methodology to evaluate these risks; (2) large firms incorporate a variety of CAATTs, including self-developed advanced tools. On the other hand, small and mid-sized CPA firms incorporate standard CAATTs and still need to catch up to better understand what CAATTs can offer and how they can contribute to the quality of the audit; (3) the top management of mid-sized and small CPA firms should be more proactive and updated about CAATTs capabilities and contributions to audits; and (4) All CPA firms consider professionalism as a major challenge that must be constantly managed to ensure an optimal CAATTs operation. The study extends the existing knowledge of CAATTs adoption by looking at it from a risk-based auditing approach. It suggests a new model for CAATTs adoption by incorporating influencing audit risk factors that auditors should examine when considering CAATTs adoption. Since the model can be used in various audited scenarios and supports strategic, risk-based decisions, it maximizes the great potential of CAATTs on the quality of the audits. The results and insights can be useful to CPA firms, internal auditors, CAATTs developers and regulators. Moreover, it may motivate audit standard-setters to issue updated guidelines regarding CAATTs adoption in audits.Keywords: audit risk, CAATTs, financial auditing, information technology, technology adoption models
Procedia PDF Downloads 59708 Enhancing Intra-Organizational Supply Chain Relationships in Manufacturing Companies: A Case Study in Tigray, Ethiopia
Authors: Weldeabrha Kiros Kidanemaryam
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The investigation is to examine intra-organizational supply chain relationships of firms, which will help to look at and give an emphasis on internal processes and operations strength and achievements to make an influence even for external relationship management and outstanding performances of organizations. The purpose of the study is to scrutinize the internal supply chain relationships within manufacturing companies located in Tigray. The qualitative and quantitative data analysis methods were employed during the study by applying the primary data sources (questionnaires & interviews) and secondary data sources (organizational reports and documents) with the purposive sampling method. Thus, a descriptive research design was also applied in the research project in line with the cross-sectional research design which portrays simply the magnitude of the issues and problems by collecting the required and necessary data once from the sample respondents. This is because the study variables don’t have any cause-and-effect relationship in the research project that requires other types of research design than a descriptive research design; it already needs to be assessed and analyzed with a detailed description of the results after quantifying the outcomes and degree of the issues and problems based on the data gathered from respondents. The collected data was also analyzed by using the statistical package for social sciences (SPSS Version 20). The intra-organizational relationships of the companies are moderately accomplished, which requires an improvement for enhancing the performances of each unit or department within the firms so as to upgrade and ensure the progress of the companies’ effectiveness and efficiency. Moreover, the manufacturing companies have low industrial discipline and working culture, weak supervision of manpower, delayed delivery in the process within the companies, unsatisfactory quality of products, underutilization of capacity, and low productivity and profitability, which in turn results in minimizing the performance of intra-organizational supply chain relationships and to reduce the companies’ organizational efficiency, effectiveness and sustainability. Hence, the companies should have to give emphasize building and managing the intra-organizational supply chain relationships effectively because nothing can be done without creating successful and progressive relationships with internal units or functional areas and individuals for the production and provision of the required and qualified products that permits to meet the intended customers’ desires. The study contributes to improving the practical applications and gives an emphasis on the policy measurements and implications of the manufacturing companies with regard to intra-organizational supply chain relationships.Keywords: supply chain, supply chain relationships, intra-organizational relationships, manufacturing companies
Procedia PDF Downloads 10707 Applicable Law to Intellectual and Industrial Property Agreements According to Turkish Private International Law and Rome I Regulation
Authors: Sema Cortoglu Koca
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Intellectual and industrial property rules, have a substantial effect on the sustainable development. Intellectual and industrial property rights, as temporary privileges over the products of intellectual activity, determine the supervision of information and technology. The level and scope of intellectual property protection thus influence the flow of technology between developed and developing countries. In addition, intellectual and industrial property rights are based on the notion of balance. Since they are time-limited rights, they reconcile private and public benefits. That is, intellectual and industrial property rights respond to both private interests and public interests by rewarding innovators and by promoting the dissemination of ideas, respectively. Intellectual and industrial property rights can, therefore, be a tool for sustainable development. If countries can balance their private and public interests according to their particular context and circumstances, they can ensure the intellectual and industrial property which promotes innovation and technology transfer relevant for them. People, enterprises and countries who need technology, can transfer developed technology which is acquired by people, enterprises and countries so as to decrease their technological necessity and improve their technology. Because of the significance of intellectual and industrial property rights on the technology transfer law as mentioned above, this paper is confined to intellectual and industrial property agreements especially technology transfer contracts. These are license contract, know-how contract, franchise agreement, joint venture agreement, management agreement, research and development agreement. In Turkey, technology transfer law is still a developing subject. For developing countries, technology transfer regulations are very important for their private international law because these countries do not know which technology transfer law is applicable when conflicts arise. In most technology transfer contracts having international elements, the parties choose a law to govern their contracts. Where the parties do not choose a law, either expressly or impliedly, and matters which is not excluded in party autonomy, the court has to determine the applicable law to contracts in a matter of capacity, material, the formal and essential validity of contracts. For determining the proper law of technology transfer contracts, it is tried to build a rule for applying all technology transfer contracts. This paper is confined to the applicable law to intellectual and industrial property agreements according to ‘5718 Turkish Act on Private International Law and Civil Procedure’ and ‘Regulation (EC) No 593/2008 of the European Parliament and of the Council of 17 June 2008 on the law applicable to contractual obligations (Rome I)’. Like these complex contracts, to find a rule can be really difficult. We can arrange technology transfer contracts in groups, and we can determine the rule and connecting factors to these groups. For the contracts which are not included in these groups, we can determine a special rule considering the characteristics of the contract.Keywords: intellectual and industrial property agreements, Rome I regulation, technology transfer, Turkish act on private international law and civil procedure
Procedia PDF Downloads 146706 The Residential Subdivision under the Influence of the Unfinished Densification, Case Study for Subdivisions in Setif, Algeria
Authors: Lacheheb Dhia Eddine Zakaria, Ballout Amor
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Today, it is necessary to be thrifty for its planet, on one hand the space being a rare, nonrenewable resource, and on the other hand the ecological, economic and social cost of the urban sprawl. It is commonly asserted that the promotion of a more compact and dense city has a positive effect in terms of public costs of investment, functioning and costs for the citizens and the users of the city. It is clear that the modes urban development management have to evolve profoundly, in particular towards a densification favourable to the raising of the urban quality through an ideal urban density on the scale of the individual housing estate. The lot as an individual housing estate was adopted as an alternative development model to the collective housing, thought in an anthropocentric perspective to emerge as a quality model where the density plays an important role, by being included in operations of a global coherence, in an optimal organization without forgetting the main importance of the deadlines of construction and the finalization of the works. The image of eternal construction site inflicted to our cities explains the renewed interest for the application of the regulatory framework and the completion of these limited operations without global coherence, which are summed up in our case to a ground cut in plots of land, sold then built independently without being finished, and support the relevance of the essential question of the improvement of the outside aspect bound to the appearance which can be revealed as a so important factor for a better use and a better acceptance of its housing environment, that the ratio of a number of houses on a plot of land or the number of square meters by house. To demonstrate the impact of the completion degree of the subdivision dwellings, roads system and urban public utilities on the density or the densification and therefore on the urban quality, we studied two residential subdivisions, the private subdivision Sellam and the subdivision El Imane with a common situation, and a different land surface, density and cutting, being occupied by various social classes, with different needs and different household average size. The approach of this work is based on the typo morphological analysis to reveal the differences in the degrees of completions of the subdivision’s built environment and on the investigation, by a household’s survey, to demonstrate importance of the degree of completion and to reveal the conditions of qualitative densification favourable and convenient to a better subdivision’s appropriation.Keywords: subdivision, degree of completion, densification, urban quality
Procedia PDF Downloads 366705 Patient Agitation and Violence in Medical-Surgical Settings at BronxCare Hospital, Before and During COVID-19 Pandemic; A Retrospective Chart Review
Authors: Soroush Pakniyat-Jahromi, Jessica Bucciarelli, Souparno Mitra, Neda Motamedi, Ralph Amazan, Samuel Rothman, Jose Tiburcio, Douglas Reich, Vicente Liz
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Violence is defined as an act of physical force that is intended to cause harm and may lead to physical and/or psychological damage. Violence toward healthcare workers (HCWs) is more common in psychiatric settings, emergency departments, and nursing homes; however, healthcare workers in medical setting are not spared from such events. Workplace violence has a huge burden in the healthcare industry and has a major impact on the physical and mental wellbeing of staff. The purpose of this study is to compare the prevalence of patient agitation and violence in medical-surgical settings in BronxCare Hospital (BCH) Bronx, New York, one year before and during the COVID-19 pandemic. Data collection occurred between June 2021 and August 2021, while the sampling time was from 2019 to 2021. The data were separated into two separate time categories: pre-COVID-19 (03/2019-03/2020) and COVID-19 (03/2020-03/2021). We created frequency tables for 19 variables. We used a chi-square test to determine a variable's statistical significance. We tested all variables against “restraint type”, determining if a patient was violent or became violent enough to restrain. The restraint types were “chemical”, “physical”, or both. This analysis was also used to determine if there was a statistical difference between the pre-COVID-19 and COVID-19 timeframes. Our data shows that there was an increase in incidents of violence in COVID-19 era (03/2020-03/2021), with total of 194 (62.8%) reported events, compared to pre COVID-19 era (03/2019-03/2020) with 115 (37.2%) events (p: 0.01). Our final analysis, completed using a chi-square test, determined the difference in violence in patients between pre-COVID-19 and COVID-19 era. We then tested the violence marker against restraint type. The result was statistically significant (p: 0.01). This is the first paper to systematically review the prevalence of violence in medical-surgical units in a hospital in New York, pre COVID-19 and during the COVID-19 era. Our data is in line with the global trend of increased prevalence of patient agitation and violence in medical settings during the COVID-19 pandemic. Violence and its management is a challenge in healthcare settings, and the COVID-19 pandemic has brought to bear a complexity of circumstances, which may have increased its incidence. It is important to identify and teach healthcare workers the best preventive approaches in dealing with patient agitation, to decrease the number of restraints in medical settings, and to create a less restrictive environment to deliver care.Keywords: COVID-19 pandemic, patient agitation, restraints, violence
Procedia PDF Downloads 138704 A pilot Study of Umbilical Cord Mini-Clamp
Authors: Seng Sing Tan
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Clamping of the umbilical cord after birth is widely practiced as a part of labor management. Further improvements were proposed to produce a smaller, lighter and more comfortable clamp while still maintaining current standards of clamping. A detachable holder was also developed to facilitate the clamping process. This pilot study on the efficacy of the mini-clamp was conducted to evaluate a tightness of the seal and a firm grip of the clamp on the umbilical cord. The study was carried out at National University Hospital, using 5 sets of placental cord. 18 samples of approximate 10 cm each were harvested. The test results showed that the mini-clamp was able to stop the flow through the cord after clamping without rupturing the cord. All slip tests passed with a load of 0.2 kg. In the pressure testing, 30kPa of saline was exerted into the umbilical veins. Although there was no physical sign of fluid leaking through the end secured by the mini-clamp, the results showed the pressure was not able to sustain the pressure set during the tests. 12 out of the 18 test samples have more than 7% of pressure drop in 30 seconds. During the pressure leak test, it was observed on several samples that when pressurized, small droplets of saline were growing on the outer surface of the cord lining membrane. It was thus hypothesized that the pressure drop was likely caused by the perfusion of the injected saline through the Wharton’s jelly and the cord lining membrane. The average pressure in the umbilical vein is roughly 2.67kPa (20 mmHg), less than 10% of 30kPa (~225mmHg), set for the pressure testing. As such, the pressure set could be over-specified, leading to undesirable outcomes. The development of the mini-clamp was an attempt to increase the comfort of newly born babies while maintaining the usability and efficacy of hospital grade umbilical cord clamp. The pressure leak in this study would be unfair to fully attribute it to the design and efficacy of the mini-clamp. Considering the unexpected leakage of saline through the umbilical membrane due to over-specified pressure exerted on the umbilical veins, improvements can definitely be made to the existing experimental setup to obtain a more accurate and conclusive outcome. If proven conclusive and effective, the mini-clamp with a detachable holder could be a smaller and potentially cheaper alternative to existing umbilical cord clamps. In addition, future clinical trials could be conducted to determine the user-friendliness of the mini-clamp and evaluate its practicality in the clinical setting by labor ward clinicians. A further potential improvement could be proposed on the sustainability factor of the mini-clamp. A biodegradable clamp would revolutionise the industry in this increasingly environmentally sustainability world.Keywords: leak test, mini-clamp, slip test, umbilical cord
Procedia PDF Downloads 126703 Investigating Student Behavior in Adopting Online Formative Assessment Feedback
Authors: Peter Clutterbuck, Terry Rowlands, Owen Seamons
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In this paper we describe one critical research program within a complex, ongoing multi-year project (2010 to 2014 inclusive) with the overall goal to improve the learning outcomes for first year undergraduate commerce/business students within an Information Systems (IS) subject with very large enrolment. The single research program described in this paper is the analysis of student attitudes and decision making in relation to the availability of formative assessment feedback via Web-based real time conferencing and document exchange software (Adobe Connect). The formative assessment feedback between teaching staff and students is in respect of an authentic problem-based, team-completed assignment. The analysis of student attitudes and decision making is investigated via both qualitative (firstly) and quantitative (secondly) application of the Theory of Planned Behavior (TPB) with a two statistically-significant and separate trial samples of the enrolled students. The initial qualitative TPB investigation revealed that perceived self-efficacy, improved time-management, and lecturer-student relationship building were the major factors in shaping an overall favorable student attitude to online feedback, whilst some students expressed valid concerns with perceived control limitations identified within the online feedback protocols. The subsequent quantitative TPB investigation then confirmed that attitude towards usage, subjective norms surrounding usage, and perceived behavioral control of usage were all significant in shaping student intention to use the online feedback protocol, with these three variables explaining 63 percent of the variance in the behavioral intention to use the online feedback protocol. The identification in this research of perceived behavioral control as a significant determinant in student usage of a specific technology component within a virtual learning environment (VLE) suggests that VLEs could now be viewed not as a single, atomic entity, but as a spectrum of technology offerings ranging from the mature and simple (e.g., email, Web downloads) to the cutting-edge and challenging (e.g., Web conferencing and real-time document exchange). That is, that all VLEs should not be considered the same. The results of this research suggest that tertiary students have the technological sophistication to assess a VLE in this more selective manner.Keywords: formative assessment feedback, virtual learning environment, theory of planned behavior, perceived behavioral control
Procedia PDF Downloads 389702 Surgical School Project: Implementation Educational Plan for Adolescents Awaiting Bariatric Surgery
Authors: Brooke Sweeney, David White, Felix Amparano, Nick A. Clark, Amy R. Beck, Mathew Lindquist, Lora Edwards, Julie Vandal, Jennifer Lisondra, Katie Cox, Renee Arensberg, Allen Cummins, Jazmine Cedeno, Jason D. Fraser, Kelsey Dean, Helena H. Laroche, Cristina Fernandez
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Background: National organizations call for standardized pre-surgical requirements and education to optimize postoperative outcomes. Since 2017 our surgery program has used defined protocols and educational curricula pre- and post-surgery. In response to patient outcomes, our educational content was refined to include quizzes to assess patient knowledge and surgical preparedness. We aim to optimize adolescent pre-bariatric surgery preparedness by improving overall aggregate pre-surgical assessment performance from 68% to 80% within 12 months. Methods: A multidisciplinary improvement team was developed within the weight management clinic (WMC) of our tertiary care, free-standing children’s hospital. A manual has been utilized since 2017, with limitations in consistent delivery and patient uptake of information. The curriculum has been improved to include quizzes administered during WMC visits prior to bariatric surgery. The initial outcome measure is the pre-surgical quiz score of adolescents preparing for bariatric surgery. Process measure was the number of questions answered correctly to test the questions. Baseline performance was determined by a patient assessment survey of pre-surgical preparedness at patient visits. Plan-Do-Study-Act cycles (PDSA) included: 1) creation and implementation of a refined curriculum, 2) development of 5 new quizzes based upon learning objectives, and 3) improving provider-lead teaching and quiz administration within clinic workflow. Run charts assessed impact over time. Results: A total of 346 quiz questions were administered to 34 adolescents. The outcome measure improved from a baseline mean of 68% to 86% following PDSA 2 cycles, and it was sustained. Conclusion/Implication: Patient/family comprehension of surgical preparedness improved with standardized education via team member-led teaching and assessment using quizzes during pre-surgical clinic visits. The next steps include launching redesigned teaching materials with modules correlated to quizzes and assessment of comprehension and outcomes post-surgically.Keywords: bariatric surgery, adolescent, clinic, pre-bariatric training
Procedia PDF Downloads 55701 Cellular Technologies in Urology
Authors: R. Zhankina, U. Zhanbyrbekuly, A. Tamadon, M. Askarov, R. Sherkhanov, D. Akhmetov, D. Saipiyeva, N. Keulimzhaev
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Male infertility affects about 15% of couples of reproductive age. Approximately 10–15% have azoospermia who have previously been diagnosed with male infertility. Azoospermia is regarded as the absence of spermatozoa in the ejaculate and is found in 10-15% of infertile men. Non-obstructive azoospermia is considered a cause of male infertility that is not amenable to drug therapy. Patients with non-obstructive azoospermia are unable to have their "own" children and have only options for adoption or use of donor sperm. Advances in assisted reproductive technologies such as intracytoplasmic sperm injection in vitro fertilization have significantly changed the management of patients with non-obstructive azoospermia. Advances in biotechnology have increased the options for treating patients with non-obstructive azoospermia. Mesenchymal stem cell therapy has been recognized as a new option for infertility treatment. Material and methods of the study: After obtaining informed consent, 5 patients diagnosed with non-obstructive azoospermia were included in an open, non-randomized study. The age of the patients ranged from 24 to 35 years. The examination was carried out before the start of treatment, which included biochemical blood tests, hormonal profile levels (luteinizing hormone, follicle-stimulating hormone, testosterone, prolactin, inhibin B); tests for tumor markers; genetic research. All studies were carried out in compliance with the requirements of Protocol No. 8 dated 06/09/20, approved by the Local Ethical Commission of NJSC "Astana Medical University". The control examination of patients was carried out after 6 months, by re-taking the program and hormonal profile (testosterone, luteinizing hormone, follicle-stimulating hormone, prolactin, inhibin B). Before micro-TESE of the testis, all 5 patients underwent myeloexfusion in the operating room. During the micro-TESE, autotransplantation of mesenchymal stem cells into the testicular network, previously cultured in a cell technology laboratory for 2 weeks, was performed. Results of the study: in all patients, the levels of total testosterone increased, the level of follicle-stimulating hormone decreased, the levels of luteinizing hormone returned to normal, the level of inhibin B increased. IVF with a positive result; another patient (20%) had spermatogenesis cells. Non-obstructive azoospermia and mesenchymal stem cells Conclusions: The positive results of this work serve as the basis for the application of a new cellular therapeutic approach for the treatment of non-obstructive azoospermia using mesenchymal stem cells.Keywords: cell therapy, regenerative medicine, male infertility, mesenchymal stem cells
Procedia PDF Downloads 109700 Support Services in Open and Distance Education: An Integrated Model of Open Universities
Authors: Evrim Genc Kumtepe, Elif Toprak, Aylin Ozturk, Gamze Tuna, Hakan Kilinc, Irem Aydin Menderis
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Support services are very significant elements for all educational institutions in general; however, for distance learners, these services are more essential than traditional (face-to-face) counterparts. One of the most important reasons for this is that learners and instructors do not share the same physical environment and that distance learning settings generally require intrapersonal interactions rather than interpersonal ones. Some learners in distance learning programs feel isolated. Furthermore, some fail to feel a sense of belonging to the institution because of lack of self-management skills, lack of motivation levels, and the need of being socialized, so that they are more likely to fail or drop out of an online class. In order to overcome all these problems, support services have emerged as a critical element for an effective and sustainable distance education system. Within the context of distance education support services, it is natural to include technology-based and web-based services and also the related materials. Moreover, institutions in education sector are expected to use information and communication technologies effectively in order to be successful in educational activities and programs. In terms of the sustainability of the system, an institution should provide distance education services through ICT enabled processes to support all stakeholders in the system, particularly distance learners. In this study, it is envisaged to develop a model based on the current support services literature in the field of open and distance learning and the applications of the distance higher education institutions. Specifically, content analysis technique is used to evaluate the existing literature in the distance education support services, the information published on websites, and applications of distance higher education institutions across the world. A total of 60 institutions met the inclusion criteria which are language option (English) and availability of materials in the websites. The six field experts contributed to brainstorming process to develop and extract codes for the coding scheme. During the coding process, these preset and emergent codes are used to conduct analyses. Two coders independently reviewed and coded each assigned website to ensure that all coders are interpreting the data the same way and to establish inter-coder reliability. Once each web page is included in descriptive and relational analysis, a model of support services is developed by examining the generated codes and themes. It is believed that such a model would serve as a quality guide for future institutions, as well as the current ones.Keywords: support services, open education, distance learning, support model
Procedia PDF Downloads 189699 Specification of Requirements to Ensure Proper Implementation of Security Policies in Cloud-Based Multi-Tenant Systems
Authors: Rebecca Zahra, Joseph G. Vella, Ernest Cachia
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The notion of cloud computing is rapidly gaining ground in the IT industry and is appealing mostly due to making computing more adaptable and expedient whilst diminishing the total cost of ownership. This paper focuses on the software as a service (SaaS) architecture of cloud computing which is used for the outsourcing of databases with their associated business processes. One approach for offering SaaS is basing the system’s architecture on multi-tenancy. Multi-tenancy allows multiple tenants (users) to make use of the same single application instance. Their requests and configurations might then differ according to specific requirements met through tenant customisation through the software. Despite the known advantages, companies still feel uneasy to opt for the multi-tenancy with data security being a principle concern. The fact that multiple tenants, possibly competitors, would have their data located on the same server process and share the same database tables heighten the fear of unauthorised access. Security is a vital aspect which needs to be considered by application developers, database administrators, data owners and end users. This is further complicated in cloud-based multi-tenant system where boundaries must be established between tenants and additional access control models must be in place to prevent unauthorised cross-tenant access to data. Moreover, when altering the database state, the transactions need to strictly adhere to the tenant’s known business processes. This paper focuses on the fact that security in cloud databases should not be considered as an isolated issue. Rather it should be included in the initial phases of the database design and monitored continuously throughout the whole development process. This paper aims to identify a number of the most common security risks and threats specifically in the area of multi-tenant cloud systems. Issues and bottlenecks relating to security risks in cloud databases are surveyed. Some techniques which might be utilised to overcome them are then listed and evaluated. After a description and evaluation of the main security threats, this paper produces a list of software requirements to ensure that proper security policies are implemented by a software development team when designing and implementing a multi-tenant based SaaS. This would then assist the cloud service providers to define, implement, and manage security policies as per tenant customisation requirements whilst assuring security for the customers’ data.Keywords: cloud computing, data management, multi-tenancy, requirements, security
Procedia PDF Downloads 147698 Serum Sickness-Like Reaction to D-Mannose Supplement
Authors: Emma Plante, Charles Ekwunwa, Diego Illanes
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Introduction: Serum Sickness-Like Reaction (SSLR) is an inflammatory immune response characterized by a rash, polyarthralgias, and fever. SSLR usually occurs in response to a new medication (most commonly antibiotics, anticonvulsants, or antiinflammatory agents) and is believed to involve the formation of drug-specific immune complexes. Here we present a case of a 16-year-old female patient who developed an SSLR in response to the D-mannose-containing over-the-counter supplement, Uqora, used to promote bladder health. Methodology: The methodology for this study included a thorough literature search for other cases of SSLR associated with D-Mannose containing products. Data collection was performed through a review of the patient’s medical record, including history, physical examination, relevant laboratory results, and treatment plan. Findings: A 16-year-old female with a history of overactive bladder and anemia presented with a diffuse urticarial rash, headaches, joint pain, and swelling for three days. Her medications included oral contraceptive pills, iron, mirabegron, UQora, and a probiotic. Physical examination revealed a diffuse urticarial rash, and her musculoskeletal exam revealed swelling and tenderness in her wrists. Her CBC, basic metabolic panel, liver function panel, lyme titers, and urinalysis were all within normal limits. The patient was referred to an allergist, who diagnosed her with SSLR. All medications were discontinued, and she was treated with a 7-day course of prednisone and cetirizine. Her symptoms resolved, and her medications were slowly resumed sequentially over several months. However, UQora triggered a recurrence of her symptoms, and it was identified as the culprit medication. Consequently, UQora was permanently discontinued, and the patient has remained symptom-free. Conclusion: This case report describes the first documented case of SSLR caused by UQora (active ingredient D-mannose). D-Mannose is a monosaccharide found in many plants and fruits, and it is commonly used to prevent urinary tract infections. While the clinical features and timeline, in this case, were typical of SSLR, UQora as the trigger was highly unusual. Clinicians should be aware of the diverse triggers of SSLR and the importance of prompt identification and management to enhance patient safety. It is possible D-mannose was not the trigger, and further research is necessary to better understand the potential therapeutic applications of D-mannose, as well as the potential risks and interactions.Keywords: serum sickness-like reaction, d-mannose, hypersensitivity reaction, urticaria
Procedia PDF Downloads 84697 Congenital Diaphragmatic Hernia Outcomes in a Low-Volume Center
Authors: Michael Vieth, Aric Schadler, Hubert Ballard, J. A. Bauer, Pratibha Thakkar
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Introduction: Congenital diaphragmatic hernia (CDH) is a condition characterized by the herniation of abdominal contents into the thoracic cavity requiring postnatal surgical repair. Previous literature suggests improved CDH outcomes at high-volume regional referral centers compared to low-volume centers. The purpose of this study was to examine CDH outcomes at Kentucky Children’s Hospital (KCH), a low-volume center, compared to the Congenital Diaphragmatic Hernia Study Group (CDHSG). Methods: A retrospective chart review was performed at KCH from 2007-2019 for neonates with CDH, and then subdivided into two cohorts: those requiring ECMO therapy and those not requiring ECMO therapy. Basic demographic data and measures of mortality and morbidity including ventilator days and length of stay were compared to the CDHSG. Measures of morbidity for the ECMO cohort including duration of ECMO, clinical bleeding, intracranial hemorrhage, sepsis, need for continuous renal replacement therapy (CRRT), need for sildenafil at discharge, timing of surgical repair, and total ventilator days were collected. Statistical analysis was performed using IBM SPSS Statistics version 28. One-sample t-tests and one-sample Wilcoxon Signed Rank test were utilized as appropriate.Results: There were a total of 27 neonatal patients with CDH at KCH from 2007-2019; 9 of the 27 required ECMO therapy. The birth weight and gestational age were similar between KCH and the CDHSG (2.99 kg vs 2.92 kg, p =0.655; 37.0 weeks vs 37.4 weeks, p =0.51). About half of the patients were inborn in both cohorts (52% vs 56%, p =0.676). KCH cohort had significantly more Caucasian patients (96% vs 55%, p=<0.001). Unadjusted mortality was similar in both groups (KCH 70% vs CDHSG 72%, p =0.857). Using ECMO utilization (KCH 78% vs CDHSG 52%, p =0.118) and need for surgical repair (KCH 95% vs CDHSG 85%, p =0.060) as proxy for severity, both groups’ mortality were comparable. No significant difference was noted for pulmonary outcomes such as average ventilator days (KCH 43.2 vs. CDHSG 17.3, p =0.078) and home oxygen dependency (KCH 44% vs. CDHSG 24%, p =0.108). Average length of hospital stay for patients treated at KCH was similar to CDHSG (64.4 vs 49.2, p=1.000). Conclusion: Our study demonstrates that outcome in CDH patients is independent of center’s case volume status. Management of CDH with a standardized approach in a low-volume center can yield similar outcomes. This data supports the treatment of patients with CDH at low-volume centers as opposed to transferring to higher-volume centers.Keywords: ECMO, case volume, congenital diaphragmatic hernia, congenital diaphragmatic hernia study group, neonate
Procedia PDF Downloads 83696 An Informative Marketing Platform: Methodology and Architecture
Authors: Martina Marinelli, Samanta Vellante, Francesco Pilotti, Daniele Di Valerio, Gaetanino Paolone
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Any development in web marketing technology requires changes in information engineering to identify instruments and techniques suitable for the production of software applications for informative marketing. Moreover, for large web solutions, designing an interface that enables human interactions is a complex process that must bridge between informative marketing requirements and the developed solution. A user-friendly interface in web marketing applications is crucial for a successful business. The paper introduces mkInfo - a software platform that implements informative marketing. Informative marketing is a new interpretation of marketing which places the information at the center of every marketing action. The creative team includes software engineering researchers who have recently authored an article on automatic code generation. The authors have created the mkInfo software platform to generate informative marketing web applications. For each web application, it is possible to automatically implement an opt in page, a landing page, a sales page, and a thank you page: one only needs to insert the content. mkInfo implements an autoresponder to send mail according to a predetermined schedule. The mkInfo platform also includes e-commerce for a product or service. The stakeholder can access any opt-in page and get basic information about a product or service. If he wants to know more, he will need to provide an e-mail address to access a landing page that will generate an e-mail sequence. It will provide him with complete information about the product or the service. From this point on, the stakeholder becomes a user and is now able to purchase the product or related services through the mkInfo platform. This paper suggests a possible definition for Informative Marketing, illustrates its basic principles, and finally details the mkInfo platform that implements it. This paper also offers some Informative Marketing models, which are implemented in the mkInfo platform. Informative marketing can be applied to products or services. It is necessary to realize a web application for each product or service. The mkInfo platform enables the product or the service producer to send information concerning a specific product or service to all stakeholders. In conclusion, the technical contributions of this paper are: a different interpretation of marketing based on information; a modular architecture for web applications, particularly for one with standard features such as information storage, exchange, and delivery; multiple models to implement informative marketing; a software platform enabling the implementation of such models in a web application. Future research aims to enable stakeholders to provide information about a product or a service so that the information gathered about a product or a service includes both the producer’s and the stakeholders' point of view. The purpose is to create an all-inclusive management system of the knowledge regarding a specific product or service: a system that includes everything about the product or service and is able to address even unexpected questions.Keywords: informative marketing, opt in page, software platform, web application
Procedia PDF Downloads 122695 Baseline Study of Water Quality in Indonesia Using Dynamic Methods and Technologies
Authors: R. L. P. de Lima, F. C. B. Boogaard, D. Setyo Rini, P. Arisandi, R. E. de Graaf-Van Dinther
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Water quality in many Asian countries is very poor due to inefficient solid waste management, high population growth and the lack of sewage and purification systems for households and industry. A consortium of Indonesian and Dutch organizations has begun a large-scale international research project to evaluate and propose solutions to face the surface water pollution challenges in Brantas Basin, Indonesia (East Java: Malang / Surabaya). The first phase of the project consisted in a baseline study to assess the current status of surface water bodies and to determine the ambitions and strategies among local stakeholders. This study was conducted with high participatory / collaborative and knowledge sharing objectives. Several methods such as using mobile sensors (attached to boats or underwater drones), test strips and mobile apps, bio-monitoring (sediments), ecology scans using underwater cameras, or continuous / static measurements, were applied in different locations in the regions of the basin, at multiple locations within the water systems (e.g. spring, upstream / downstream of industry and urban areas, mouth of the Surabaya River, groundwater). Results gave an indication of (reference) values of basic water quality parameters such as turbidity, electrical conductivity, dissolved oxygen or nutrients (ammonium / nitrate). An important outcome was that collecting random samples may not be representative of a body of water, given that water quality parameters can vary widely in space (x, y, and depth) and time (day / night and seasonal). Innovative / dynamic monitoring methods (e.g. underwater drones, sensors on boats) can contribute to better understand the quality of the living environment (water, ecology, sediment) and factors that affect it. The field work activities, in particular, underwater drones, revealed potential as awareness actions as they attracted interest from locals and local press. This baseline study involved the cooperation with local managing organizations with Dutch partners, and their willingness to work together is important to ensure participatory actions and social awareness regarding the process of adaptation and strengthening of regulations, or for the construction of facilities such as sewage.Keywords: water quality monitoring, pollution, underwater drones, social awareness
Procedia PDF Downloads 183694 Development of an Ecological Binder by Geopolymerization of Untreated Dredged Sediments
Authors: Lisa Monteiro, Jacqueline Saliba, Nadia Saiyouri, Humberto Y. Godoy
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Theevolution of the global environmental context incites companies to reduce their impact by reusing local materials and promoting circular economy. Dredged sediments represent a potential source of materials due to their large volume. Indeed, the dredging operations carried out in Gironde alone generated an annual volume of sediment of approximately 9 million m³. Moreover, on the eve of the evolution of laws concerning dredging practices, the recovery of sediments is necessary to create a viable economy for their management. This thesis work is oriented towards the development of an ecological binder from the fine fraction of untreated dredged sediments. In fact, their physico-chemical properties make them favorable for the synthesis of geopolymer, current competitor of cement, thanks to its lower carbon footprint and environmental impact. However, several obstacles must be overcome before implementing this new family of materials: the use of sediments without thermal or chemical treatment, the absence of a formulation approach, ignorance of the reactions produced, etc. During the first year of the thesis, a physico-chemical characterization of the sediments made it possible to validate their use as precursors forgeopolymerization according to three criteria: their fineness, their mineralogical composition, and the percentage of amorphous phase. Following these results, several formulations have been defined, taking into account the environmental impact. The sediments were activated with an alkaline solution of sodium hydroxide and sodium silicate. Two other formulations with cement and blast furnace slag have been defined for comparison. The results highlighted the possibility of forming geopolymers from untreated and still wet dredged sediments. The development of structural bonds through the formation of hydrated sodium aluminosilicate thus leads to higher strengths at 90 days (4.78 MPa) than a mixture with cement (0.75 MPa). A 30% gain in CO₂ emissions has also been obtained compared to cement. In order to reduce the uncertainties linked to the absence of a formulation approach, to optimize the number of experiments to be carried out in the laboratory, and to obtain an optimal formulation, an analysis by mixing plan was conducted in order to frame the responses according to the proportions of the constituents. Following the obtaining of an optimal binder, the work will focus on the study of the durability and the interspecific variability of the sediments on the mechanical properties by testing the binder developed with different sediments dredged from the Bordeaux estuary. , the Grand Port Maritime of Bayonne, La Rochelle, and the Bassinsd'Arcachon.Keywords: compressive strength, dredged sediments, ecological binder, geopolymers
Procedia PDF Downloads 93