Search results for: cost effective conservation

Authors: Mohammad Arabi

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Business Process Reengineering (BPR) is a systematic approach to fundamentally redesign organizational processes to achieve significant improvements in organizational performance. At Fars Regional Electric Company, implementing BPR is deemed essential to increase productivity, reduce costs, and improve service quality. This article examines how BPR can help enhance the performance of Fars Regional Electric Company. The objective of this research is to evaluate and analyze the advancements in process modeling and reengineering at Fars Regional Electric Company and to provide solutions for improving the productivity and efficiency of organizational processes. This study aims to demonstrate how BPR can be used to improve organizational processes and enhance the overall performance of the company. This research employs both qualitative and quantitative research methods and includes interviews with senior managers and experts at Fars Regional Electric Company. The analytical tools include process modeling software such as Bizagi and ARIS, and statistical analysis software such as SPSS and Minitab. Data analysis was conducted using advanced statistical methods. The results indicate that the use of BPR techniques can lead to a significant reduction in process execution time and overall improvement in quality. Implementing BPR at Fars Regional Electric Company has led to increased productivity, reduced costs, and improved overall performance of the company. This study shows that with proper implementation of BPR and the use of modeling tools, the company can achieve significant improvements in its processes. Recommendations: (1) Continuous Training for Staff: Invest in continuous training of staff to enhance their skills and knowledge in BPR. (2) Use of Advanced Technologies: Utilize modeling and analysis software to improve processes. (3) Implementation of Effective Management Systems: Employ knowledge and information management systems to enhance organizational performance. (4) Continuous Monitoring and Review of Processes: Regularly review and revise processes to ensure ongoing improvements. This article highlights the importance of improving organizational processes at Fars Regional Electric Company and recommends that managers and decision-makers at the company seriously consider reengineering processes and utilizing modeling technologies to achieve developmental goals and continuous improvement.

Keywords: business process reengineering, electric company, Fars province, process modeling advancements

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Authors: Abigail Ekeigwe, Bethany McGowan, Loran C. Parker, Stephen Byrn, Kari L. Clase

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There are growing calls in the literature to develop and implement competency-based regulatory sciences education (CBRSE) in sub-Saharan Africa to expand and create a pipeline of a competent workforce of regulatory scientists. A defined competence framework is an essential component in developing competency-based education. However, such a competence framework is not available for regulatory scientists in sub-Saharan Africa. The purpose of this research is to identify entry-level competencies for inclusion in a competency framework for regulatory scientists in sub-Saharan Africa as a first step in developing CBRSE. The team systematically reviewed the literature following the PRISMA guidelines for systematic reviews and based on a pre-registered protocol on Open Science Framework (OSF). The protocol has the search strategy and the inclusion and exclusion criteria for publications. All included publications were coded to identify entry-level competencies for regulatory scientists. The team deductively coded the publications included in the study using the 'framework synthesis' model for systematic literature review. The World Health Organization’s conceptualization of competence guided the review and thematic synthesis. Topic and thematic codings were done using NVivo 12™ software. Based on the search strategy in the protocol, 2345 publications were retrieved. Twenty-two (n=22) of the retrieved publications met all the inclusion criteria for the research. Topic and thematic coding of the publications yielded three main domains of competence: knowledge, skills, and enabling behaviors. The knowledge domain has three sub-domains: administrative, regulatory governance/framework, and scientific knowledge. The skills domain has two sub-domains: functional and technical skills. Identification of competencies is the primal step that serves as a bedrock for curriculum development and competency-based education. The competencies identified in this research will help policymakers, educators, institutions, and international development partners design and implement competence-based regulatory science education in sub-Saharan Africa, ultimately leading to access to safe, quality, and effective medical products.

Keywords: competence-based regulatory science education, competencies, systematic review, sub-Saharan Africa

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Authors: Anila Naz, Arusa Lakhani, Kiran Mubeen, Yasmeen Amarsi

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Pakistan's neonatal mortality rate has the highest proportion in the South Asian region and it is higher in the rural areas as compared to the urban areas. Poor resuscitation techniques and lack of basic newborn resuscitation skills in birth attendants, are contributing factors towards neonatal deaths. Based on the significant outcomes of the Helping Baby Breath (HBB) training, a similar training was implemented for Community Midwives (CMWs) in a low resource setting in Gujrat, Pakistan, to improve their knowledge and skills. The training evaluation was conducted and participant feedback was obtained through both qualitative and quantitative methods. The findings of the quantitative assessment of the training evaluation will be published elsewhere. This paper presents the qualitative evaluation of the training. Objective: The objective of the study was to determine the perceptions of HBB trained CMWs about the effectiveness of the HBB training, and the challenges faced in the implementation of HBB skills for newborn resuscitation, at their work settings. The qualitative descriptive design was used in this study. The purposive sampling technique was chosen to recruit midwives and key informants as participants of the training. Interviews were conducted by using a semi-structured interview guide. The study included a total of five interviews: two focus group interviews for CMWs (10 in each group), and three individual interviews of key informants. The content analysis of the qualitative data yielded three themes: the effectiveness of training, challenges, and suggestions. The findings revealed that the HBB training was effective for the CMWs in terms of its usability, regarding improvement in newborn resuscitation knowledge and skills. Moreover, it enhanced confidence and satisfaction in CMWs. However, less volume of patients was a challenge for a few CMWs with regards to practicing their skills. Due to the inadequate number of patients and less opportunities of practice for several CMWs, they required such trainings frequently, in order to maintain their competency. The CMWs also recommended that HBB training should be part of the Midwifery program curriculum. Moreover, similar trainings were also recommended for other healthcare providers working in low resource settings, including doctors and nurses.

Keywords: neonatal resuscitation technique, helping baby breathe, community midwives, training evaluation

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Authors: Marco Soto-Arriaza, Eduardo Cena-Ahumada, Jaime Melendez-Rojel

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Background: Liposomes have been widely used as a model of lipid bilayer to study the physicochemical properties of biological membrane, encapsulation, transport and release of different molecules. Furthermore, extensive research has focused on improving the efficiency in the transport of drugs, developing tools that improve the release of the encapsulated drug from liposomes. In this context, the enzymatic activity of PLA₂, despite having been shown to be an effective tool to promote the release of drugs from liposomes, is still an open field of research. Aim: The aim of the present study is to explore the effect of cholesterol (Cho) and amphipathic di- and tri-block copolymers, on calcein release mediated by enzymatic activity of PLA2 in Dipalmitoylphosphatidylcholine (DPPC) liposomes under physiological conditions. Methods: Different dispersions of DPPC, cholesterol, di-block POE₄₅-PCL₅₂ or tri-block PCL₁₂-POE₄₅-PCL₁₂ were prepared by the extrusion method after five freezing/thawing cycles; in Phosphate buffer 10mM pH 7.4 in presence of calcein. DPPC liposomes/Calcein were centrifuged at 15000rpm 10 min to separate free calcein. Enzymatic activity assays of PLA₂ were performed at 37°C using the TBS buffer pH 7.4. The size distribution, polydispersity, Z-potential and Calcein encapsulation of DPPC liposomes was monitored. Results: PLA₂ activity showed a slower kinetic of calcein release up to 20 mol% of cholesterol, evidencing a minimum at 10 mol% and then a maximum at 18 mol%. Regardless of the percentage of cholesterol, up to 18 mol% a one-hundred percentage release of calcein was observed. At higher cholesterol concentrations, PLA₂ showed to be inefficient or not to be involved in calcein release. In assays where copolymers were added in a concentration lower than their cmc, a similar behavior to those showed in the presence of Cho was observed, that is a slower kinetic in calcein release. In both experimental approaches, a one-hundred percentage of calcein release was observed. PLA₂ was shown to be sensitive to the 4-(4-Octadecylphenyl)-4-oxobutenoic acid inhibitor and calcium, reducing the release of calcein to 0%. Cell viability of HeLa cells decreased 7% in the presence of DPPC liposomes after 3 hours of incubation and 17% and 23% at 5 and 15 hours, respectively. Conclusion: Calcein release from DPPC liposomes, mediated by PLA₂ activity, depends on the percentage of cholesterol and the presence of copolymers. Both, cholesterol up to 20 mol% and copolymers below it cmc could be applied to the regulation of the kinetics of antitumoral drugs release without inducing cell toxicity per se.

Keywords: amphipathic copolymers, calcein release, cholesterol, DPPC liposome, phospholipase A₂

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Authors: Gurbanova J., Majidova N., Ali-Zade S., Hasanova A., Mikailzade P.

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Currently, the problem of oncogynecological diseases is widespread and remains relevant in terms of quantitative growth. It is known that due to the increase in the number of benign diseases of the cervix, the development of precancerous conditions occurs. Benign diseases of the cervix represent the most common gynecological problem, which are often precursors of malignant neoplasms, especially cervical cancer. According to statistics, benign diseases of the cervix cover 25-45% of all gynecological diseases. Among women's oncogynecological diseases, cervical cancer ranks second in the world after breast cancer and ranks first in the mortality rate among oncological diseases in economically underdeveloped countries. We performed a comprehensive clinical and laboratory examination of 130 women aged 18 to 73 with benign cervical diseases. 59 (38.5%) women of reproductive age, as well as 39 (30%) premenopausal and 41 (31.5%) menopausal patients, participated in the study. Detailed anamnesis was collected from all patients, objective and gynecological examination was performed, laboratory and instrumental examinations (USM, IPV DNA, smear microscopy, and PCR bacteriological examination of sexually transmitted infections), simple and extended colposcopy, liquid-based РАР-smear smear and РАР-classic smear examinations were conducted. As a result of the research, the following nosological forms were found in women with benign diseases of the cervix: non-specific vaginitis in 10 (7.7%) cases; ectopia, endocervicitis - 60(46.2%); cervical ectropion - 7(5.4%); cervical polyp - 9(6.9%); cervical leukoplakia - 15(11.5%); atrophic vaginitis - 7(5.4%); condyloma - 12(9.2%); cervical stenosis - 2(1.5%); endometriosis of the cervix - was noted in 8 (6.2%) cases (p<0.001), respectively. Characteristics of the menstrual cycle among the examined women: normal cycle in 97 (74.6%) cases; oligomenorrhea – 23 (17.7%); polymenorrhea – 4(3.1%); algomenorrhea – noted in 6 (4.6%) cases (p<0.001). Cytological examination showed that: the specificity of liquid-based cytology was 76.2%, and the traditional PAP test was set at 70.6%. The overall diagnostic value was calculated to be 86% in liquid-based cytology and 78.5% in conventional PAP tests. Treatment of women with benign diseases of the cervix was carried out by diathermocoagulation method and "FOTEK EA 141M" device. It should be noted that 6 months after the treatment, after treatment with the "FOTEK EA 141M" device, there was no relapse in any patient. Recurrence was found in 23.7% of patients after diathermoelectrocoagulation. Thus, it is clear from the above that the study of cervical pathologies, the determination of optimal examinations, and effective treatment methods is one of the urgent problems facing obstetrics and gynecology.

Keywords: cervical cancer, cytological examination, PAP-smear, non-specific vaginitis

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Authors: Tan Xin Zhong Timothy, Chang Chen Jie Victor, Yew Kwan Tong, Lim Geok Peng Sandy

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Background: Leaders in crisis response teams such as Trauma Teams in hospitals are essential to the effective coordination and direction of the team. The response to emergency trauma situations must be accurate, rapid, and well executed. To this end, the team leader’s social, technical and leadership skills are essential factors that implicate the success of an emergency trauma intervention. While each emergency trauma case varies in severity and complexity, and the experience and expertise of team leaders may vary, it would be productive to identify certain coordinative and directive functions that improve the capacity for leading a team. Methods: This qualitative study of Trauma Team physicians in Singapore General Hospital (SGH) involved 50 in-depth interviews with doctors and nurses involved in Trauma Team activations, observations of Trauma Teams managing emergency patients, and reviews of audio/video recordings of 65 trauma activations. The interviews were conducted with doctors of various ranks across the relevant departments, 12 from the Emergency Department (ED), 11 from General Surgery (GS) and 8 from Orthopaedics, while the 6 nurses were from ED. In accordance with the grounded theory approach, the content of the interviews was coded and analysed in order to derive broad leadership themes that corresponded with certain behavioural traits exhibited by trauma team leaders, supplemented with the observational and audio/video data. Results: The leadership behaviours of the team leaders could be typified into three broad categories: team orientation, engagement and activeness. Team orientation corresponds with the source and form of cognitive responsibility, decision-making and informational contributions, divisible into individualistic and consultative sub-categories. Engagement refers to the type of activity that leaders prefer to engage in, and which implicates their attentional focus, divisible into participatory and supervisory sub-categories. Activeness is a function of the leader’s attitudes towards the behavioural regulation of the team, which manifests in inactivity or activity to augment or merely align with protocol. These factors are not exhaustive and are contextually sensitive, but collectively implicate a significant portion of the leadership activity observed in trauma teams.

Keywords: trauma team activations, critical event management, leadership, teamwork

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Authors: Y. Sakai, C. Wang

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The decrease in agricultural production due to soil deterioration has been an urgent task. Soil acidification is a potentially serious land degradation issue and it will have a major impact on agricultural productivity and sustainable farming systems. In China, acid soil is mainly distributed in the southern part, the decrease in agricultural production and heavy metal contamination are serious problems. In addition, not only environmental and health problems due to the exhaust gas such as mainly sulfur dioxide (SO₂) but also the generation of a huge amount of construction and demolition wastes with the accelerating urbanization has emerged as a social problem in China. Therefore, the need for the recycling and reuse of both desulfurization waste and waste concrete is very urgent and necessary. So we have investigated the effectiveness as acid soil amendments of both coal bio-briquette ash and waste concrete. In this paper, acid soil (AS1) in Nanjing (pH=6.0, EC=1.6dSm-1) and acid soil (AS2) in Guangzhou (pH=4.1, EC=0.2dSm-1) were investigated in soil amelioration test. Soil amendments were three coal bio-briquette ashes (BBA1, BBA2 and BBA3), the waste cement fine powders (CFP) ( < 200µm (particle diameter)), waste concrete particles (WCP) ( < 4.75mm ( < 0.6mm, 0.6-1.0mm, 1.0-2.0mm, 2.0-4.75mm)), and six mixtures with two coal bio-briquette ashes (BBA2 and BBA3), CFP, WCP( < 0.6mm) and WCP(2.0-4.75mm). In acid soil amelioration test, the three BBAs, CFP and various WCPs based on exchangeable calcium concentration were added to two acid soils. The application rates were from 0 wt% to 3.5 wt% in AS1 test and from 0 wt% to 6.0 wt% in AS2 test, respectively. Soil chemical properties (pH, EC, exchangeable and soluble ions (Na, Ca, Mg, K)) before and after mixing with soil amendments were measured. In addition, Al toxicity and the balance of salts (CaO, K₂O, MgO) in soil after amelioration was evaluated. The order of pH and exchangeable Ca concentration that is effective for acid soil amelioration was WCP(0.6mm) > CFP > WCP(2.0-4.25mm) > BB1 > BB2 > BB3. In all AS 1 and AS 2 amelioration tests using three BBAs, the pH and EC increased slightly with the increase of application rate and reached to the appropriate value range of both pH and EC in BBA1 only. Because BBA1 was higher value in pH and exchangeable Ca. After that, soil pH and EC with the increase in the application rate of BBA2, BBA3 and by using CFP, WC( < 0.6mm), WC(2.0-4.75mm) as soil amendment reached to each appropriate value range, respectively. In addition, the mixture amendments with BBA2, BBA3 CFP, WC( < 0.6mm), and WC(2.0-4.75mm) could ameliorate at a smaller amount of application rate in case of BBA only. And the exchangeable Al concentration decreased drastically with the increase in pH due to soil amelioration and was under the standard value. Lastly, the heavy metal (Cd, As, Se, Ni, Cr, Pb, Mo, B, Cu, Zn) contents in new soil amendments were under control standard values for agricultural use in China. Thus we could propose a new acid soil amelioration method using coal bio-briquette ash and waste concrete in China.

Keywords: acid soil, coal bio-briquette ash, soil amelioration, waste concrete

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Authors: Mohammed Elghazy, Ahmed El Refai, Usama Ebead, Antonio Nanni

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Rehabilitating corrosion-damaged reinforced concrete (RC) structures has been accomplished using various techniques such as steel plating, external post-tensioning, and external bonding of fiber reinforced polymer (FRP) composites. This paper reports on the use of an innovative technique to strengthen corrosion-damaged RC structures using fabric-reinforced cementitious matrix (FRCM) composites. FRCM consists of dry-fiber fabric embedded in cement-based matrix. Twelve large-scale RC beams were constructed and tested in flexural monotonic and fatigue loads. Prior to testing, ten specimens were subjected to accelerated corrosion process for 140 days leading to an average mass loss in the tensile steel bars of 18.8 %. Corrosion was restricted to the main reinforcement located in the middle third of the beam span. Eight corroded specimens were repaired and strengthened while two virgin and two corroded-unrepaired/unstrengthened beams were used as benchmarks for comparison purpose. The test parameters included the FRCM materials (Carbon-FRCM, PBO-FRCM), the number of FRCM plies, the strengthening scheme, and the type of loading (monotonic and fatigue). The effects of the pervious parameters on the flexural response, the mode of failure, and the fatigue life were reported. Test results showed that corrosion reduced the yield and ultimate strength of the beams. The corroded-unrepaired specimen failed to meet the provisions of the ACI-318 code for crack width criteria. The use of FRCM significantly increased the ultimate strength of the corroded specimen by 21% and 65% more than that of the corroded-unrepaired specimen. Corrosion significantly decreased the fatigue life of the corroded-unrepaired beam by 77% of that of the virgin beam. The fatigue life of the FRCM repaired-corroded beams increased to 1.5 to 3.8 times that of the corroded-unrepaired beam but was lower than that of the virgin specimen. The specimens repaired with U-wrapped PBO-FRCM strips showed higher fatigue life than those repaired with the end-anchored bottom strips having similar number of PBO-FRCM-layers. PBO-FRCM was more effective than Carbon-FRCM in restoring the fatigue life of the corroded specimens.

Keywords: corrosion, concrete, fabric-reinforced cementitious matrix (FRCM), fatigue, flexure, repair

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Authors: Mayoorika Shukla, Pramila Jakhar, Tejendra Dixit, I. A. Palani, Vipul Singh

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Biosensors are analytical devices with wide range of applications in biological, chemical, environmental and clinical analysis. It comprises of bio-recognition layer which has biomolecules (enzymes, antibodies, DNA, etc.) immobilized over it for detection of analyte and transducer which converts the biological signal into the electrical signal. The performance of biosensor primarily the depends on the bio-recognition layer and therefore it has to be chosen wisely. In this regard, nanostructures of metal oxides such as ZnO, SnO2, V2O5, and TiO2, etc. have been explored extensively as bio-recognition layer. Recently, ZnO has the attracted attention of researchers due to its unique properties like high iso-electric point, biocompatibility, stability, high electron mobility and high electron binding energy, etc. Although there have been many reports on usage of ZnO as bio-recognition layer but to the authors’ knowledge, none has ever observed correlation between optical properties like defect suppression and biosensing capability of the sensor. Here, ZnO nanorods (ZNR) have been synthesized by a low cost, simple and low-temperature hydrothermal growth process, over Platinum (Pt) coated glass substrate. The ZNR have been synthesized in two steps viz. initially a seed layer was coated over substrate (Pt coated glass) followed by immersion of it into nutrient solution of Zinc nitrate and Hexamethylenetetramine (HMTA) with in situ addition of KMnO4. The addition of KMnO4 was observed to have a profound effect over the growth rate anisotropy of ZnO nanostructures. Clustered and powdery growth of ZnO was observed without addition of KMnO4, although by addition of it during the growth, uniform and crystalline ZNR were found to be grown over the substrate. Moreover, the same has resulted in suppression of defects as observed by Normalized Photoluminescence (PL) spectra since KMnO4 is a strong oxidizing agent which provides an oxygen rich growth environment. Further, to explore the correlation between defect suppression and biosensing capability of the ZNR Glucose oxidase (Gox) was immobilized over it, using physical adsorption technique followed by drop casting of nafion. Here the main objective of the work was to analyze effect of defect suppression over biosensing capability, and therefore Gox has been chosen as model enzyme, and electrochemical amperometric glucose detection was performed. The incorporation of KMnO4 during growth has resulted in variation of optical and charge transfer properties of ZNR which in turn were observed to have deep impact on biosensor figure of merits. The sensitivity of biosensor was found to increase by 12-18 times, due to variations introduced by addition of KMnO4 during growth. The amperometric detection of glucose in continuously stirred buffer solution was performed. Interestingly, defect suppression has been observed to contribute towards the improvement of biosensor performance. The detailed mechanism of growth of ZNR along with the overall influence of defect suppression on the sensing capabilities of the resulting enzymatic electrochemical biosensor and different figure of merits of the biosensor (Glass/Pt/ZNR/Gox/Nafion) will be discussed during the conference.

Keywords: biosensors, defects, KMnO4, ZnO nanorods

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Authors: Sandra Rigot, Samira Demaria, Frederic Lemaire

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The starting point of this research is the contemporary capitalist paradox: there is a real scarcity of long term investment despite the boom of potential long term investors. This gap represents a major challenge: there are important needs for long term financing in developed and emerging countries in strategic sectors such as energy, transport infrastructure, information and communication networks. Moreover, the recent financial and sovereign debt crises, which have respectively reduced the ability of financial banking intermediaries and governments to provide long term financing, questions the identity of the actors able to provide long term financing, their methods of financing and the most appropriate forms of intermediation. The issue of long term financing is deemed to be very important by the EU Commission, as it issued a 2013 Green Paper (GP) on long-term financing of the EU economy. Among other topics, the paper discusses the impact of the recent regulatory reforms on long-term investment, both in terms of accounting (in particular fair value) and prudential standards for banks. For banks, prudential and accounting standards are also crucial. Fair value is indeed well adapted to the trading book in a short term view, but this method hardly suits for a medium and long term portfolio. Banks’ ability to finance the economy and long term projects depends on their ability to distribute credit and the way credit is valued (fair value or amortised cost) leads to different banking strategies. Furthermore, in the banking industry, accounting standards are directly connected to the prudential standards, as the regulatory requirements of Basel III use accounting figures with prudential filter to define the needs for capital and to compute regulatory ratios. The objective of these regulatory requirements is to prevent insolvency and financial instability. In the same time, they can represent regulatory constraints to long term investing. The balance between financial stability and the need to stimulate long term financing is a key question raised by the EU GP. Does fair value accounting contributes to short-termism in the investment behaviour? Should prudential rules be “appropriately calibrated” and “progressively implemented” not to prevent banks from providing long-term financing? These issues raised by the EU GP lead us to question to what extent the main regulatory requirements incite or constrain banks to finance long term projects. To that purpose, we study the 292 responses received by the EU Commission during the public consultation. We analyze these contributions focusing on particular questions related to fair value accounting and prudential norms. We conduct a two stage content analysis of the responses. First, we proceed to a qualitative coding to identify arguments of respondents and subsequently we run a quantitative coding in order to conduct statistical analyses. This paper provides a better understanding of the position that a large panel of European stakeholders have on these issues. Moreover, it adds to the debate on fair value accounting and its effects on prudential requirements for banks. This analysis allows us to identify some short term bias in banking regulation.

Keywords: basel 3, fair value, securitization, long term investment, banks, insurers

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Authors: Fionnuala Tynan, Margaret Nohilly

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Wellbeing in not only a national priority in Ireland but in the international context. A review of the literature highlights the consistent efforts of researchers to define the concept of wellbeing. This study sought to explore the understating of Wellbeing in Irish primary schools. National Wellbeing Guidelines in the Irish context frame the concept of wellbeing through a mental health paradigm, which is but one aspect of wellbeing. This exploratory research sought the views of Irish primary-school teachers on their understanding of the concept of wellbeing and the practical application of strategies to promote wellbeing both in the classroom and across the school. Teacher participants from four counties in the West of Ireland were invited to participate in focus group discussion and workshops through the Education Centre Network. The purpose of this process was twofold; firstly to explore teachers’ understanding of wellbeing in the primary school context and, secondly, for teachers to be co-creators in the development of practical strategies for classroom and whole school implementation. The voice of the teacher participants was central to the research design. The findings of this study indicate that the definition of wellbeing in the Irish context is too abstract a definition for teachers and the focus on mental health dominates the discourse in relation to wellbeing. Few teachers felt that they were addressing wellbeing adequately in their classrooms and across the school. The findings from the focus groups highlighted that while teachers are incorporating a range of wellbeing strategies including mindfulness and positive psychology, there is a clear disconnect between the national definition and the implementation of national curricula which causes them concern. The teacher participants requested further practical strategies to promote wellbeing at whole school and classroom level within the framework of the Irish Primary School Curriculum and enable them to become professionally confident in developing a culture of wellbeing. In conclusion, considering wellbeing is a national priority in Ireland, this research promoted the timely discussion the wellbeing guidelines and the development of a conceptual framework to define wellbeing in concrete terms for practitioners. The centrality of teacher voices ensured the strategies proposed by this research is both practical and effective. The findings of this research have prompted the development of a national resource which will support the implementation of wellbeing in the primary school at both national and international level.

Keywords: primary education, shared understanding, teacher voice, wellbeing

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Authors: Zdzisław Kobos, Robert Jędrys, Zbigniew Wochyński

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Motor activity and good health are sine qua non determinants of a proper practice of the profession, especially aviation. Therefore, candidates to the aviation are selected according their psychomotor ability by both specialist medical commissions. Moreover, they must past an examination of the physical fitness. During the studies in the air force academy, eye-hand coordination is formed in two stages. The future aircraft pilots besides all-purpose physical education must practice specialist training on SAGI. Training includes: looping, aerowheel, and gyroscope. Aim of the training on the above listed apparatuses is to form eye-hand coordination during the tasks in the air. Such coordination is necessary to perform various figures in the real flight. Therefore, during the education of the future pilots, determinants of the effective ways of this important parameter of the human body functioning are sought for. Several studies of the sport psychology indicate an important role of the temperament as a factor determining human behavior during the task performance and acquiring operating skills> Polish psychologist Jan Strelau refers to the basic, relatively constant personality features which manifest themselves in the formal characteristics of the human behavior. Temperament, being initially determined by the inborn physiological mechanisms, changes in the course of maturation and some environmental factors and concentrates on the energetic level and reaction characteristics in time. Objectives. This study aimed at seeking a relationship between temperamental features and eye-hand coordination formation during training on SAGI. Material and Methods: Group of 30 students of pilotage was examined in two situations. The first assessment of the eye-hand coordination level was carried out before the beginning of a 30-hour training on SAGI. The second assessment was carried out after training completion. Training lasted for 2 hours once a week. Temperament was evaluated with The Formal Characteristics of Behavior − Temperament Inventory (FCB-TI) developed by Bogdan Zawadzki and Jan Strelau. Eye-hand coordination was assessed with a computer version of the Warsaw System of Psychological Tests. Results: It was found that the training on SAGI increased the level of eye-hand coordination in the examined students. Conclusions: Higher level of the eye-hand coordination was obtained after completion of the training. Moreover, a relationship between eye-hand coordination level and selected temperamental features was statistically significant.

Keywords: temperament, eye-hand coordination, pilot, SAGI

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Authors: Kanchan Mondal, Adam Sims, Madhav Soti, Jitendra Gautam, David Carron

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Fischer-Tropsch (FT) synthesis is a complex series of heterogeneous reactions between CO and H2 molecules (present in the syngas) on the surface of an active catalyst (Co, Fe, Ru, Ni, etc.) to produce gaseous, liquid, and waxy hydrocarbons. This product is composed of paraffins, olefins, and oxygenated compounds. The key challenge in applying the Fischer-Tropsch process to produce transportation fuels is to make the capital and production costs economically feasible relative to the comparative cost of existing petroleum resources. To meet this challenge, it is imperative to enhance the CO conversion while maximizing carbon selectivity towards the desired liquid hydrocarbon ranges (i.e. reduction in CH4 and CO2 selectivities) at high throughputs. At the same time, it is equally essential to increase the catalyst robustness and longevity without sacrificing catalyst activity. This paper focuses on process development to achieve the above. The paper describes the influence of operating parameters on Fischer Tropsch synthesis (FTS) from coal derived syngas in supercritical carbon dioxide (ScCO2). In addition, the unreacted gas and solvent recycle was incorporated and the effect of unreacted feed recycle was evaluated. It was expected that with the recycle, the feed rate can be increased. The increase in conversion and liquid selectivity accompanied by the production of narrower carbon number distribution in the product suggest that higher flow rates can and should be used when incorporating exit gas recycle. It was observed that this process was capable of enhancing the hydrocarbon selectivity (nearly 98 % CO conversion), reducing improving the carbon efficiency from 17 % to 51 % in a once through process and further converting 16 % CO2 to liquid with integrated recycle of the product gas stream and increasing the life of the catalyst. Catalyst robustness enhancement has been attributed to the absorption of heat of reaction by the compressed CO2 which reduced the formation of hotspots and the dissolution of waxes by the CO2 solvent which reduced the blinding of active sites. In addition, the recycling the product gas stream reduced the reactor footprint to one-fourth of the once through size and product fractionation utilizing the solvent effects of supercritical CO2 were realized. In addition to the negative CO2 selectivities, methane production was also inhibited and was limited to less than 1.5%. The effect of the process conditions on the life of the catalysts will also be presented. Fe based catalysts are known to have a high proclivity for producing CO2 during FTS. The data of the product spectrum and selectivity on Co and Fe-Co based catalysts as well as those obtained from commercial sources will also be presented. The measurable decision criteria were the increase in CO conversion at H2:CO ratio of 1:1 (as commonly found in coal gasification product stream) in supercritical phase as compared to gas phase reaction, decrease in CO2 and CH4 selectivity, overall liquid product distribution, and finally an increase in the life of the catalysts.

Keywords: carbon efficiency, Fischer Tropsch synthesis, low GHG, pressure tunable fractionation

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Authors: Ghada El-Husseiny, Dina Yousri, Christian Richter

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Social services are often characterized by market failures, which justifies government intervention in the provision of these services. It is widely acknowledged that government intervention breeds corruption since resources are being transferred from one party to another. However, what is still being extensively studied is the magnitude of the negative impact of corruption on publicly provided services and development outcomes. Corruption has the power to hinder development and cripple our march towards the Sustainable Development Goals. Corruption diminishes the efficiency and effectiveness of public health and education spending and directly impacts the outcomes of these sectors. This paper empirically examines the impact of Institutional Failure on public sector services provision, with the sole purpose of studying the impact of corruption on SDG3 and 4; Good health and wellbeing and Quality education, respectively. The paper explores the effect of corruption on these goals from various perspectives and extends the analysis by examining if the impact of corruption on these goals differed when it accounted for the current corruption state. Using Pooled OLS(Ordinary Least Square) and Fixed effects panel estimation on 22 corrupt and 22 clean countries between 2000 and 2017. Results show that corruption in both corrupt and clean countries has a more severe impact on Health than the Education sector. In almost all specifications, corruption has an insignificant effect on School Enrollment rates but a significant effect on Infant Mortality rates. Results further indicate that, on average, a 1 point increase in the CPI(Consumer Price Index) can increase health expenditures by 0.116% in corrupt and clean countries. However, the fixed effects model indicates that the way Health and Education expenditures are determined in clean and corrupt countries are completely country-specific, in which corruption plays a minimal role. Moreover, the findings show that School Enrollment rates and Infant Mortality rates depend, to a large extent, on public spending. The most astounding results-driven is that corrupt countries, on average, have more effective and efficient healthcare expenditures. While some insights are provided as to why these results prevail, they should be further researched. All in all, corruption impedes development outcomes, and any Anti-corrupt policies taken will bring forth immense improvements and speed up the march towards sustainability.

Keywords: corruption, education, health, public spending, sustainable development

Procedia PDF Downloads 164

Authors: Allyson Augusta Shrikhande, Alexa Rains, Tayyaba Ahmed, Marjorie Mamsaang, Rakhi Vyas, Janaki Natarajan, Erika Moody, Christian Reutter, Kimberlee Leishear, Yogita Tailor, Sandra Sandhu-Restaino, Lora Liu, Neha James, Rosemarie Filart

Abstract:

Characterized by consistent difficulty getting and keeping an erection firm enough for intercourse, Erectile Dysfunction may affect up to 15% of adult men. Although awareness and access to treatment have improved in recent years, many patients do not actively seek diagnosis or treatment due to the stigma surrounding this condition. Patients who do seek treatment are often dissatisfied by the efficacy of the medication. The condition inhibits patients’ quality of life by worsening mental health and relationships. The purpose of this study was to test the effectiveness of an outpatient neuromuscular treatment protocol in treating the symptoms of Chronic Pelvic Pain and Erectile Dysfunction, improving pain and function. 56 patients ages 20-79 presented to an outpatient clinic for treatment of pelvic pain and Erectile Dysfunction symptoms. These symptoms had persisted for an average of 4 years. All patients underwent external ultrasound-guided hydro-dissection technique targeted at pelvic peripheral nerves in combination with pelvic floor musculature trigger-point injections. To measure the effects of this treatment, a five question Erectile Dysfunction questionnaire was completed by each patient at their first visit to a clinic and three months after treatment began. Answers were summed for a total score of 5-25, with a higher score indicating optimal function. The average score before treatment was 14.125 (SD 5.411) (a=0.05; CI 12.708-15.542), which increased by 18% to an average of 16.625 (SD 6.423) (a=0.05; CI 14.943-18.307) after treatment (P=0.0004). Secondary outcome variables included a Visual Analogue Scale (VAS) to measure pelvic pain intensity and the Functional Pelvic Pain Scale (FPPS) to measure function across multiple areas. VAS scores reduced by 51% after three months. Before treatment, the mean VAS score was 5.87, and the posttreatment mean VAS score was 2.89. Pelvic pain functionality improved by 34% after three months. Pretreatment FPPS scores averaged at 7.48, decreasing to 4.91 after treatment. These results indicate that this unique treatment was very effective at relieving pain and increasing function for patients with Erectile Dysfunction.

Keywords: chronic pelvic pain, erectile dysfunction, nonsurgical, outpatient, trigger point injections

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Authors: Samuele Abagnato, Lucia Rigamonti

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Life-Cycle-Assessment (LCA) is an effective tool to quantify the environmental impacts of reuse models and recycling technologies for textiles. In this work, publications in the last ten years about LCA on textile waste are classified according to location, goal and scope, functional unit, waste composition, impact assessment method, impact categories, and sensitivity analysis. Twenty papers have been selected: 50% are focused only on recycling, 30% only on reuse, the 15% on both, while only one paper considers only the final disposal of the waste. It is found that reuse is generally the best way to decrease the environmental impacts of textiles waste management because of the avoided impacts of manufacturing a new item. In the comparison between a product made with recycled yarns and a product from virgin materials, in general, the first option is less impact, especially for the categories of climate change, water depletion, and land occupation, while for other categories, such as eutrophication or ecotoxicity, under certain conditions the impacts of the recycled fibres can be higher. Cultivation seems to have quite high impacts when natural fibres are involved, especially in the land use and water depletion categories, while manufacturing requires a remarkable amount of electricity, with its associated impact on climate change. In the analysis of the reuse processes, relevant importance is covered by the laundry phase, with water consumption and impacts related to the use of detergents. About the sensitivity analysis, it can be stated that one of the main variables that influence the LCA results and that needs to be further investigated in the modeling of the LCA system about this topic is the substitution rate between recycled and virgin fibres, that is the amount of recycled material that can be used in place of virgin one. Related to this, also the yield of the recycling processes has a strong influence on the results of the impact. The substitution rate is also important in the modeling of the reuse processes because it represents the number of avoided new items bought in place of the reused ones. Another aspect that appears to have a large influence on the impacts is consumer behaviour during the use phase (for example, the number of uses between two laundry cycles). In conclusion, to have a deeper knowledge of the impacts of a life-cycle approach of textile waste, further data and research are needed in the modeling of the substitution rate and of the use phase habits of the consumers.

Keywords: environmental impacts, life-cycle-assessment, textiles recycling, textiles reuse, textiles waste management

Procedia PDF Downloads 82

Authors: Sadia Munir, Diana White, Aya Albahri, Pratiwi Hastania, Eltahir Mohamed, Mahmood Khan, Fathima Mohamed, Ayat Kadhi, Haila Saleem

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Preeclampsia is a major complication of pregnancy. Prediction and management of preeclampsia is a challenge for obstetricians. To our knowledge, no major progress has been achieved in the prevention and early detection of preeclampsia. There is very little known about the clear treatment path of this disorder. Preeclampsia puts both mother and baby at risk of several short term- and long term-health problems later in life. There is huge health service cost burden in the health care system associated with preeclampsia and its complications. Preeclampsia is divided into two different types. Early onset preeclampsia develops before 34 weeks of gestation, and late onset develops at or after 34 weeks of gestation. Different genetic and environmental factors, prognosis, heritability, biochemical and clinical features are associated with early and late onset preeclampsia. Prevalence of preeclampsia greatly varies all over the world and is dependent on ethnicity of the population and geographic region. To authors best knowledge, no published data on preeclampsia exist in Qatar. In this study, we are reporting the incidence of preeclampsia in Qatar. The purpose of this study is to compare the incidence and risk factors of both early onset and late onset preeclampsia in Qatar. This retrospective longitudinal cohort study was conducted using data from the hospital record of Women’s Hospital, Hamad Medical Corporation (HMC), from May 2014-May 2016. Data collection tool, which was approved by HMC, was a researcher made extraction sheet that included information such as blood pressure during admission, socio demographic characteristics, delivery mode, and new born details. A total of 1929 patients’ files were identified by the hospital information management when they apply codes of preeclampsia. Out of 1929 files, 878 had significant gestational hypertension without proteinuria, 365 had preeclampsia, 364 had severe preeclampsia, and 188 had preexisting hypertension with superimposed proteinuria. In this study, 78% of the data was obtained by hospital electronic system (Cerner) and the remaining 22% was from patient’s paper records. We have gone through detail data extraction from 560 files. Initial data analysis has revealed that 15.02% of pregnancies were complicated with preeclampsia from May 2014-May 2016. We have analyzed difference in the two different disease entities in the ethnicity, maternal age, severity of hypertension, mode of delivery and infant birth weight. We have identified promising differences in the risk factors of early onset and late onset preeclampsia. The data from clinical findings of preeclampsia will contribute to increased knowledge about two different disease entities, their etiology, and similarities/differences. The findings of this study can also be used in predicting health challenges, improving health care system, setting up guidelines, and providing the best care for women suffering from preeclampsia.

Keywords: preeclampsia, incidence, risk factors, maternal

Procedia PDF Downloads 133

Authors: Kalep Filli, Sophia Wassén, Annika Krona, Mats Stading

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Food security challenge and the growing population in Sub-Saharan Africa centers on its agricultural transformation, where about 70% of its population is directly involved in farming. Research input can create economic opportunities, reduce malnutrition and poverty, and generate faster, fairer growth. Africa is discarding $4 billion worth of grain annually due to pre and post-harvest losses. Grains and tubers play a central role in food supply in the region but their production has generally lagged behind because no robust scientific input to meet up with the challenge. The African grains are still chronically underutilized to the detriment of the well-being of the people of Africa and elsewhere. The major reason for their underutilization is because they are under-researched. Any commitment by scientific community to intervene needs creative solutions focused on innovative approaches that will meet the economic growth. In order to mitigate this hurdle, co-creation activities and initiatives are necessary.An example of such initiatives has been initiated through Modibbo Adama University of Technology Yola, Nigeria and RISE (The Research Institutes of Sweden) Gothenburg, Sweden. Exchange of expertise in research activities as a possibility to create channel for value addition to agricultural commodities in the region under the ´Traditional Grain Network programme´ is in place. Process technologies, such as extrusion offers the possibility of creating products in the food and feed sectors, with better storage stability, added value, lower transportation cost and new markets. The Swedish–Nigerian initiative has focused on the development of high protein pasta. Dry microscopy of pasta sample result shows a continuous structural framework of proteins and starch matrix. The water absorption index (WAI) results showed that water was absorbed steadily and followed the master curve pattern. The WAI values ranged between 250 – 300%. In all aspect, the water absorption history was within a narrow range for all the eight samples. The total cooking time for all the eight samples in our study ranged between 5 – 6 minutes with their respective dry sample diameter ranging between 1.26 – 1.35 mm. The percentage water solubility index (WSI) ranged from 6.03 – 6.50% which was within a narrow range and the cooking loss which is a measure of WSI is considered as one of the main parameters taken into consideration during the assessment of pasta quality. The protein contents of the samples ranged between 17.33 – 18.60 %. The value of the cooked pasta firmness ranged from 0.28 - 0.86 N. The result shows that increase in ratio of cowpea flour and level of pregelatinized cowpea tends to increase the firmness of the pasta. The breaking strength represent index of toughness of the dry pasta ranged and it ranged from 12.9 - 16.5 MPa.

Keywords: cowpea, extrusion, gluten free, high protein, pasta, sorghum

Procedia PDF Downloads 185

Authors: Anita Bajpai, Sarah Duan, Ashlee Erskine, Shehzein Khan, Raymond Kramer

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Introduction: This research focuses on exploring the beneficial effects if any, of Vitamin-D in reducing the need for supplemental oxygen among hospitalized COVID-19 patients. Two questions are investigated – Q1)Doeshaving a healthy level of baselineVitamin-D 25-OH (≥ 30ng/ml) help,andQ2) does administering Vitamin-D therapy after-the-factduring inpatient hospitalization help? Methods/Study Design: This is a comprehensive, retrospective, observational study of all inpatients at RUHS from March through December 2020 who tested positive for COVID-19 based on real-time reverse transcriptase–polymerase chain reaction assay of nasal and pharyngeal swabs and rapid assay antigen test. To address Q1, we looked atall N1=182 patients whose baseline plasma Vitamin-D 25-OH was known and who needed supplemental oxygen. Of this, a total of 121 patients had a healthy Vitamin-D level of ≥30 ng/mlwhile the remaining 61 patients had low or borderline (≤ 29.9ng/ml)level. Similarly, for Q2, we looked at a total of N2=893 patients who were given supplemental oxygen, of which713 were not given Vitamin-D and 180 were given Vitamin-D therapy. The numerical value of the maximum amount of oxygen flow rate(dependent variable) administered was recorded for each patient. The mean values and associated standard deviations for each group were calculated. Thesetwo sets of independent data served as the basis for independent, two-sample t-Test statistical analysis. To be accommodative of any reasonable benefitof Vitamin-D, ap-value of 0.10(α< 10%) was set as the cutoff point for statistical significance. Results: Given the large sample sizes, the calculated statistical power for both our studies exceeded the customary norm of 80% or better (β< 0.2). For Q1, the mean value for maximumoxygen flow rate for the group with healthybaseline level of Vitamin-D was 8.6 L/min vs.12.6L/min for those with low or borderline levels, yielding a p-value of 0.07 (p < 0.10) with the conclusion that those with a healthy level of baseline Vitamin-D needed statistically significant lower levels of supplemental oxygen. ForQ2, the mean value for a maximum oxygen flow rate for those not administered Vitamin-Dwas 12.5 L/min vs.12.8L/min for those given Vitamin-D, yielding a p-valueof 0.87 (p > 0.10). We thereforeconcludedthat there was no statistically significant difference in the use of oxygen therapy between those who were or were not administered Vitamin-D after-the-fact in the hospital. Discussion/Conclusion: We found that patients who had healthy levels of Vitamin-D at baseline needed statistically significant lower levels of supplemental oxygen. Vitamin-D is well documented, including in a recent article in the Lancet, for its anti-inflammatory role as an adjuvant in the regulation of cytokines and immune cells. Interestingly, we found no statistically significant advantage for giving Vitamin-D to hospitalized patients. It may be a case of “too little too late”. A randomized clinical trial reported in JAMA also did not find any reduction in hospital stay of patients given Vitamin-D. Such conclusions come with a caveat that any delayed marginal benefits may not have materialized promptly in the presence of a significant inflammatory condition. Since Vitamin-D is a low-cost, low-risk option, it may still be useful on an inpatient basis until more definitive findings are established.

Keywords: COVID-19, vitamin-D, supplemental oxygen, vitamin-D in primary care

Procedia PDF Downloads 146

Authors: Antonis Skouloudis, Georgios Deligiannakis, Panagiotis Vouros, Konstantinos Evangelinos, Loannis Nikolaou

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On November 15th, 2017, a catastrophic flash flood devastated the city of Mandra in Central Greece, resulting in 24 fatalities and extensive damages to the built environment and infrastructure. It was Greece's deadliest and most destructive flood event for the past 40 years. In this paper, we examine the consequences of this event too small and medium-sized enterprises (SMEs) operating in Mandra during the flood event, which were affected by the floodwaters to varying extents. In this context, we conducted semi-structured interviews with business owners-managers of 45 SMEs located in flood inundated areas and are still active nowadays, based on an interview guide that spanned 27 topics. The topics pertained to the disaster experience of the business and business owners-managers, knowledge and attitudes towards climate change and extreme weather, aspects of disaster preparedness and related assistance needs. Our findings reveal that the vast majority of the affected businesses experienced heavy damages in equipment and infrastructure or total destruction, which resulted in business interruption from several weeks up to several months. Assistance from relatives or friends helped for the damage repairs and business recovery, while state compensations were deemed insufficient compared to the extent of the damages. Most interviewees pinpoint flooding as one of the most critical risks, and many connect it with the climate crisis. However, they are either not willing or unable to apply property-level prevention measures in their businesses due to cost considerations or complex and cumbersome bureaucratic processes. In all cases, the business owners are fully aware of the flood hazard implications, and since the recovery from the event, they have engaged in basic mitigation measures and contingency plans in case of future flood events. Such plans include insurance contracts whenever possible (as the vast majority of the affected SMEs were uninsured at the time of the 2017 event) as well as simple relocations of critical equipment within their property. The study offers fruitful insights on latent drivers and barriers of SMEs' resilience capacity to flash flooding. In this respect, findings such as ours, highlighting tensions that underpin behavioral responses and experiences, can feed into a) bottom-up approaches for devising actionable and practical guidelines, manuals and/or standards on business preparedness to flooding, and, ultimately, b) policy-making for an enabling environment towards a flood-resilient SME sector.

Keywords: flash flood, small and medium-sized enterprises, organizational resilience capacity, disaster preparedness, qualitative study

Procedia PDF Downloads 128

Authors: Cláudia Patrocínio, Beatriz Fernandes, Ana Filipa Pires

Abstract:

Background: Mirror therapy (MT) is used to improve motor function after stroke. During MT, a mirror is placed between the two upper limbs (UL), thus reflecting movements of the non- affected side as if it were the affected side. Objectives: The aim of this review is to analyze the evidence on the effec.tiveness of MT in the recovery of UL function in population with post chronic stroke. Methods: The literature search was carried out in PubMed, ISI Web of Science, and PEDro database. Inclusion criteria: a) studies that include individuals diagnosed with stroke for at least 6 months; b) intervention with MT in UL or comparing it with other interventions; c) articles published until 2023; d) articles published in English or Portuguese; e) randomized controlled studies. Exclusion criteria: a) animal studies; b) studies that do not provide a detailed description of the intervention; c) Studies using central electrical stimulation. The methodological quality of the included studies was assessed using the Physiotherapy Evidence Database (PEDro) scale. Studies with < 4 on PEDro scale were excluded. Eighteen studies met all the inclusion criteria. Main results and conclusions: The quality of the studies varies between 5 and 8. One article compared muscular strength training (MST) with MT vs without MT and four articles compared the use of MT vs conventional therapy (CT), one study compared extracorporeal shock therapy (EST) with and without MT and another study compared functional electrical stimulation (FES), MT and biofeedback, three studies compared MT with Mesh Glove (MG) or Sham Therapy, five articles compared performing bimanual exercises with and without MT and three studies compared MT with virtual reality (VR) or robot training (RT). The assessment of changes in function and structure (International Classification of Functioning, Disability and Health parameter) was carried out, in each article, mainly using the Fugl Meyer Assessment-Upper Limb scale, activity and participation (International Classification of Functioning, Disability and Health parameter) were evaluated using different scales, in each study. The positive results were seen in these parameters, globally. Results suggest that MT is more effective than other therapies in motor recovery and function of the affected UL, than these techniques alone, although the results have been modest in most of the included studies. There is also a more significant improvement in the distal movements of the affected hand than in the rest of the UL.

Keywords: physical therapy, mirror therapy, chronic stroke, upper limb, hemiplegia

Procedia PDF Downloads 45

Authors: Mohamed Aljarallah, Mohamed Nurullah, George Saridakis

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This paper aims and objectives are to investigate how the structural change of the financial regulatory bodies affect the financial supervision and how the regulators can design such a structure with taking into account; the Central Bank, the conduct of business and the prudential regulators, it will also consider looking at the structure of the international regulatory bodies and what barriers are found. There will be five questions to be answered; should conduct of business and prudential regulation be separated? Should the financial supervision and financial stability be separated? Should the financial supervision be under the Central Bank? To what extent the politician should intervene in changing the regulatory and supervisory structure? What should be the regulatory and supervisory structure when there is financial conglomerate? Semi structure interview design will be applied. This research sample selection contains a collective of financial regulators and supervisors from the emerged and emerging countries. Moreover, financial regulators and supervisors must be at a senior level at their organisations. Additionally, senior financial regulators and supervisors would come from different authorities and from around the world. For instance, one of the participants comes from the International Bank Settlements, others come from European Central Bank, and an additional one will come from Hong Kong Monetary Authority and others. Such a variety aims to fulfil the aims and objectives of the research and cover the research questions. The analysis process starts with transcription of the interview, using Nvivo software for coding, applying thematic interview to generate the main themes. The major findings of the study are as follow. First, organisational structure changes quite frequently if the mandates are not clear. Second, measuring structural change is difficult, which makes the whole process unclear. Third, effective coordination and communication are what regulators looking for when they change the structure and that requires; openness, trust, and incentive. In addition to that, issues appear during the event of crisis tend to be the reason why the structure change. Also, the development of the market sometime causes a change in the regulatory structure. And, some structural change occurs simply because of the international trend, fashion, or other countries' experiences. Furthermore, when the top management change the structure tends to change. Moreover, the structure change due to the political change, or politicians try to show they are doing something. Finally, fear of being blamed can be a driver of structural change. In conclusion, this research aims to provide an insight from the senior regulators and supervisors from fifty different countries to have a clear understanding of why the regulatory structure keeps changing from time to time through a qualitative approach, namely, semi-structure interview.

Keywords: financial regulation bodies, financial regulatory structure, global financial regulation, financial crisis

Procedia PDF Downloads 137

Authors: Shivani Thakur, Jasmin Dominguez Cervantes, Ahmed Zabiba, Fatima Zabiba, Sandhini Agarwal, Kamalpreet Kaur, Hussein Maatouk, Shae Chand, Omar Madriz, Tiffany Huang, Saloni Bansal

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The prevalence of lymphedema in women in rural communities highlights the importance of developing effective treatment and prevention methods. Subjects with secondary lymphedema in California’s Central Valley were surveyed at 6 surgical clinics to assess demographics and symptoms of lymphedema. Additionally, subjects on semaglutide treatment for obesity and/or T2DM were monitored for their diabetes management, weight loss progress, and lymphedema symptoms compared to subjects who were not treated with semaglutide. The subjects were followed for 12 months. Subjects who were treated with semaglutide completed pre-treatment questionnaires and follow-up post-treatment questionnaires at 3, 6, 9, 12 months, along with medical assessment. The untreated subjects completed similar questionnaires. The questionnaires investigated subjective feelings regarding lymphedema symptoms and management using a Likert-scale; quantitative leg measurements were collected, and blood work reviewed at these appointments. Paired difference t-tests, chi-squared tests, and independent sample t-tests were performed. 50 subjects, aged 18-75 years, completed the surveys evaluating secondary lymphedema: 90% female, 69% Hispanic, 45% Spanish speaking, 42% disabled, 57 % employed, 54% income range below 30 thousand dollars, and average BMI of 40. Both treatment and non-treatment groups noted the most common symptoms were leg swelling (x̄=3.2, ▁d= 1.3), leg pain (x̄=3.2, ▁d=1.6 ), loss of daily function (x̄=3, ▁d=1.4 ), and negative body image (x̄=4.4, ▁d=0.54). Subjects in the semaglutide treatment group >3 months of treatment compared to the untreated group demonstrated: 55% subject in the treated group had a 10% weight loss vs 3% in the untreated group (average BMI reduction by 11% vs untreated by 2.5%, p<0.05) and improved subjective feelings about their lymphedema symptoms: leg swelling (x̄=2.4, ▁d=0.45 vs x̄=3.2, ▁d=1.3, p<0.05), leg pain (x̄=2.2, ▁d=0.45 vs x̄= 3.2, ▁d= 1.6, p<0.05), and heaviness (x̄=2.2, ▁d=0.45 vs x̄=3, ▁d=1.56, p<0.05). Improvement in diabetes management was demonstrated by an average of 0.9 % decrease in A1C values compared to untreated 0.1 %, p<0.05. In comparison to untreated subjects, treatment subjects on semaglutide noted 6 cm decrease in the circumference of the leg, knee, calf, and ankle compared to 2 cm in untreated subjects, p<0.05. Semaglutide was shown to significantly improve weight loss, T2DM management, leg circumference, and secondary lymphedema functional, physical and psychosocial symptoms.

Keywords: diabetes, secondary lymphedema, semaglutide, obesity

Procedia PDF Downloads 56

Authors: Suehyun Cho, Darrell Harrington, Florent Cros, Olin Palmer, John Caputo, Michael Kardosh, Eran Oren, William Loudon, Alex Kiselyov, Michael Shpigelmacher

Abstract:

The Dandy-Walker malformation (DWM) represents a clinical syndrome manifesting as a combination of posterior fossa cyst, hypoplasia of the cerebellar vermis, and obstructive hydrocephalus. Anatomic hallmarks include hypoplasia of the cerebellar vermis, enlargement of the posterior fossa, and cystic dilatation of the fourth ventricle. Current treatments of DWM, including shunting of the cerebral spinal fluid ventricular system and endoscopic third ventriculostomy (ETV), are frequently clinically insufficient, require additional surgical interventions, and carry risks of infections and neurological deficits. Bionaut Labs develops an alternative way to treat Dandy-Walker Malformation (DWM) associated with non-communicating hydrocephalus. We utilize our discreet microsurgical Bionaut™ particles that are controlled externally and remotely to perform safe, accurate, effective fenestration of the Dandy-Walker cyst, specifically in the posterior fossa of the brain, to directly normalize intracranial pressure. Bionaut™ allows for complex non-linear trajectories not feasible by any conventional surgical techniques. The microsurgical particle safely reaches targets in the lower occipital section of the brain. Bionaut™ offers a minimally invasive surgical alternative to highly involved posterior craniotomy or shunts via direct fenestration of the fourth ventricular cyst at the locus defined by the individual anatomy. Our approach offers significant advantages over the current standards of care in patients exhibiting anatomical challenge(s) as a manifestation of DWM, and therefore, is intended to replace conventional therapeutic strategies. Current progress, including platform optimization, Bionaut™ control, and real-time imaging and in vivo safety studies of the Bionauts™ in large animals, specifically the spine and the brain of ovine models, will be discussed.

Keywords: Bionaut™, cerebral spinal fluid, CSF, cyst, Dandy-Walker, fenestration, hydrocephalus, micro-robot

Procedia PDF Downloads 213

Authors: Mohammad R. Jafari, Francois G. Bernardeau

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With its arid climate, Qatar experiences low annual rainfall, intense storms, and high evaporation rates. However, the fast-paced rate of infrastructure development in the capital city of Doha has led to recurring instances of surface water flooding as well as rising groundwater levels. Public Work Authority (PWA/ASHGHAL) has implemented an approach to collect and discharge the flood water into a) positive gravity systems; b) Emergency Flooding Area (EFA) – Evaporation, Infiltration or Storage off-site using tankers; and c) Discharge to deep injection wells. As part of the flood prevention scheme, 21 deep injection wells have been constructed to discharge the collected surface and groundwater table in Doha city. These injection wells function as an alternative in localities that do not possess either positive gravity systems or downstream networks that can accommodate additional loads. These injection wells are 400-m deep and are constructed in a complex karstic subsurface condition with large cavities. The injection well system will discharge collected groundwater and storm surface runoff into the permeable Umm Er Radhuma Formation, which is an aquifer present throughout the Persian Gulf Region. The Umm Er Radhuma formation contains saline water that is not being used for water supply. The injection zone is separated by an impervious gypsum formation which acts as a barrier between upper and lower aquifer. State of the art drilling, grouting, and geophysical techniques have been implemented in construction of the wells to assure that the shallow aquifer would not be contaminated and impacted by injected water. Injection and pumping tests were performed to evaluate injection well functionality (injectability). The results of these tests indicated that majority of the wells can accept injection rate of 200 to 300 m³ /h (56 to 83 l/s) under gravity with average value of 250 m³ /h (70 l/s) compared to design value of 50 l/s. This paper presents design and construction process and issues associated with these injection wells, performing injection/pumping tests to determine capacity and effectiveness of the injection wells, the detailed design of collection system and conveying system into the injection wells, and the operation and maintenance process. This system is completed now and is under operation, and therefore, construction of injection wells is an effective option for flood control.

Keywords: deep injection well, flood prevention scheme, geophysical tests, pumping and injection tests, wellhead assembly

Procedia PDF Downloads 114

Authors: Alexander Harrison Greer, Edward King, Elijah Lee, Safa Obuz, Ruhao Sun, Aditya Sardesai, Toby Ma, Daniel Chow, Bryce Broadus, Calvin Costner, Troy Barnes, Biagio DeSimone, Yeshwin Sankuratri, Yiheng Chen, Holly Golecki

Abstract:

Although a relatively new field, soft robotics is experiencing a rise in applicability in the secondary school setting through The Soft Robotics Toolkit, shared fabrication resources and a design competition. Exposing students outside of university research groups to this rapidly growing field allows for development of the soft robotics industry in new and imaginative ways. Soft robotic actuators have remained difficult to implement in classrooms because of their relative cost or difficulty of fabrication. Traditionally, a two-part molding system is used; however, this configuration often results in delamination. In an effort to make soft robotics more accessible to young students, we aim to develop a simple, single-mold method of fabricating soft robotic actuators from common household materials. These actuators are made by embedding a soluble polymer insert into silicone. These inserts can be made from hand-cut polystyrene, 3D-printed polyvinyl alcohol (PVA) or acrylonitrile butadiene styrene (ABS), or molded sugar. The insert is then dissolved using an appropriate solvent such as water or acetone, leaving behind a negative form which can be pneumatically actuated. The resulting actuators are seamless, eliminating the instability of adhering multiple layers together. The benefit of this approach is twofold: it simplifies the process of creating a soft robotic actuator, and in turn, increases its effectiveness and durability. To quantify the increased durability of the single-mold actuator, it was tested against the traditional two-part mold. The single-mold actuator could withstand actuation at 20psi for 20 times the duration when compared to the traditional method. The ease of fabrication of these actuators makes them more accessible to hobbyists and students in classrooms. After developing these actuators, they were applied, in collaboration with a ceramics teacher at our school, to a glove used to transfer nuanced hand motions used to throw pottery from an expert artist to a novice. We quantified the improvement in the users’ pottery-making skill when wearing the glove using image analysis software. The seamless actuators proved to be robust in this dynamic environment. Seamless soft robotic actuators created by high school students show the applicability of the Soft Robotics Toolkit for secondary STEM education and outreach. Making students aware of what is possible through projects like this will inspire the next generation of innovators in materials science and robotics.

Keywords: pneumatic actuator fabrication, soft robotic glove, soluble polymers, STEM outreach

Procedia PDF Downloads 127

Authors: Toshiki Ito, Takahiro Yamane, Yuki Adachi, Yoshiko Kato, Eiji Tsuda, Kousaku Nagasaka, Keigo Yoshida, Yoshiko Kawasaki, Naoki Aizawa, Kyouhei Nishi, Tetsuko Kato

Abstract:

The epidemic of the coronavirus (COVID-19), first reported in Wuhan at the end of 2019, has drastically changed our daily lives. Under these circumstances, counseling, which provides psychological support to people, was also greatly affected. The structure of counseling, which had generally been implicitly common practice to be conducted in person, was greatly shaken. The author wondered how counseling can be conducted in situations where it is impossible to meet face-to-face. This is where telepsychological support (online counseling) came into use. The authors found that there were the following problems in telepsychological support: (1) anxiety about whether the communication is appropriate, (2) difficulty in understanding the client's situation and condition, (3) inability to perceive what was normally perceived in person, (4) difficulty in adjusting to severely ill clients, (5) difficulty in dealing with emergency situations, etc. In this study, we interviewed psychologists who had been accustomed to telepsychological support for more than two years after the Corona disaster began to clarify how they had or had not overcome the problems of telepsychological support identified in the above studies. We also aim to consider the unique possibilities of how telepsychological support, a new technique of psychological support, can be implemented to provide more effective and meaningful support in society after the end of the Corona disaster (post-Corona society). Thirteen psychologists who are currently providing telepsychological support in the Corona Disaster will be interviewed, and semi-structured interviews will be conducted for one hour per person. In order to empirically examine how the problems in telepsychological support had been overcome or not through the interview survey, the authors asked (1) how they overcame their anxiety about whether they were able to communicate appropriately, (2) how they devised ways to overcome it, (3) how they overcame the difficulty in adapting to heavy clients in terms of the level of the disease, (4) how they overcame the difficulty in dealing with emergency situations. The interviews were analyzed using Thematic Analysis, a qualitative analysis method commonly used in qualitative research overseas. The authors found that some devices and perspectives were newly discovered as a result of two years of practice of telepsychological support and that psychologists in this study considered face-to-face interviews and telepsychological support to be separate and were flexible enough to use them when available and to move to face-to-face interviews when not appropriate.

Keywords: telepsychology, COVID-19, Corona, psychologist

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Authors: Klazina T. Havinga, Hilde R. H. de Geus

Abstract:

Introduction: Pre-operative coagulation management of Apixaban prescribed patients, a new oral anticoagulant (a factor Xa inhibitor), is difficult, especially when chronic kidney disease (CKD) causes drug overdose. Apixaban is not dialyzable due to its high level of protein binding. An antidote, Andexanet α, is available but expensive and has an unfavorable short half-life. We report the successful extracorporeal removal of Apixaban prior to emergency surgery with the CytoSorb® Hemoadsorption device. Methods: A 89-year-old woman with CKD, with an Apixaban prescription for atrial fibrillation, was presented at the ER with traumatic rib fractures, a flail chest, and an unstable spinal fracture (T12) for which emergency surgery was indicated. However, due to very high Apixaban levels, this surgery had to be postponed. Based on the Apixaban-specific anti-factor Xa activity (AFXaA) measurements at admission and 10 hours later, complete clearance was expected after 48 hours. In order to enhance the Apixaban removal and reduce the time to operation, and therefore reduce pulmonary complications, CRRT with CytoSorb® cartridge was initiated. Apixaban-specific anti-factor Xa activity (AFXaA) was measured frequently as a substitute for Apixaban drug concentrations, pre- and post adsorber, in order to calculate the adsorber-related clearance. Results: The admission AFXaA concentration, as a substitute for Apixaban drug levels, was 218 ng/ml, which decreased to 157 ng/ml after ten hours. Due to sustained anticoagulation effects, surgery was again postponed. However, the AFXaA levels decreased quickly to sub-therapeutic levels after CRRT (Multifiltrate Pro, Fresenius Medical Care, Blood flow 200 ml/min, Dialysate Flow 4000 ml/h, Prescribed renal dose 51 ml-kg-h) with Cytosorb® connected in series into the circuit was initiated (within 5 hours). The adsorber-related (indirect) Apixaban clearance was calculated every half hour (Cl=Qe * (AFXaA pre- AFXaA post/ AFXaA pre) with Qe=plasma flow rate calculated with Ht=0.38 and system blood flow rate 200 ml-min): 100 ml/min, 72 ml/min and 57 ml/min. Although, as expected, the adsorber-related clearance decreased quickly due to saturation of the beads, still the reduction rate achieved resulted in a very rapid decrease in AFXaA levels. Surgery was ordered and possible within 5 hours after Cytosorb initiation. Conclusion: The CytoSorb® Hemoadsorption device enabled rapid correction of Apixaban associated anticoagulation.

Keywords: Apixaban, CytoSorb, emergency surgery, Hemoadsorption

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Authors: Fuad Hamsyah

Abstract:

Since last two decades, major disasters have happened in the Philippines and Indonesia as two countries that are located in the pacific ring of fire territory. While in Southeast Asian countries, the process of psychosocial support provision is facing various constraints such as limited number of mental health professionals and the limited knowledge about the provision of psychosocial support for disaster survivors. Yet after the tsunami disaster in 2004, many Asian countries begin to develop policies about the provision of psychosocial interventions as an effort for future disasters preparedness. In addition, mental health professionals have to consider the local cultural values and beliefs in order to provide people with effective psychosocial support since cultural values and beliefs play a significant role in the diversity of psychological distress that forms symptoms formation, and people’s way to seek for psychological assistance. This study is a critical literature review on 130 relevant selected documents and literatures. IASC MHPSS guideline is used as the research framework in doing critical analysis. The purpose of this study is to conduct a critical analysis on the mental health and psychosocial support provision in the Philippines and Indonesia with three main objectives: 1) To describe strengths, weaknesses, and challenges in the process of psychosocial supports given by public and private organizations in emergency settings of disaster in the Philippines and Indonesia, 2) To compare psychosocial support practices between the Philippines and Indonesia, and to identify the good practices among these countries, 3) To learn how cultural values influence the implementation of psychosocial supports in emergency settings of disaster. This research indicated that almost every function from IASC MHPSS guidelines has been implemented effectively in the Philippines and Indonesia, yet not in every detail of IASC MHPSS guidelines. Several similarities and differences are indicated in this study also based on the IASC MHPSS guidelines as the analysis framework. Further, both countries have some good practices that can be useful as an example of a comprehensive psychosocial support implementation. Apart from the IASC MHPSS guideline, cultural values and beliefs in the Philippines such as kanya-kanya syndrome, pakikipakapwa, utang na loob, bahala na, pagkaya are indicated as several cultural values that have strong influences towards people’s attitude and behavior in disaster situations. While in Indonesia, several cultural values such as sabar and nrimo become two important attitudes to cope disaster situations.

Keywords: disaster, Indonesia, psychosocial support, Philippines

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Authors: Linghua Kong, Xinxia Chen, Mika Gissler, Catharina Lavebratt

Abstract:

Background: Prenatal exposure to preeclampsia has been associated with an increased risk of offspring attention-deficit/hyperactivity disorders (ADHD), autism spectrum disorder (ASD), and intellectual disability. However, little is known about the association between prenatal exposure to severe preeclampsia and neurodevelopmental and psychiatric disorders in offspring. Objective: This study aimed to assess the risk of maternal preeclampsia combined with perinatal problems, specifically low birth weight and prematurity, on offspring neuropsychiatric disorders. Methods: All singleton live births in Finland between 1996 and 2014 (n=1 012 723) were followed up in nation-wide registries until 2018. Main exposures included pre-eclampsia, small for gestational age, and delivery before 34 gestational weeks. Offspring neurodevelopmental and psychiatric disorders (ICD-10 codes) were examined as outcomes variables. Offspring birth year, sex, maternal age at delivery, parity, marital status at birth, mother's country of birth, maternal smoking, maternal gestational diabetes, maternal use of psychotropic medication during pregnancy, and maternal systemic inflammatory diseases were used as covariates. Risks for neurodevelopmental and psychiatric disorders were estimated using Cox proportional hazards modeling. Results: Of the 1 012 723 offspring, 25 901 (2.6%) were exposed to preeclampsia, and 93 281 (9.2%) were diagnosed with a neuropsychiatric disorder. Compared to births unexposed to preeclampsia, small for gestational age or delivery before 34 gestational weeks, those exposed to preeclampsia only had a 21% increase in the likelihood of any neuropsychiatric disorders after adjusting for potential confounding (adjusted HR=1.21, 95% CI: 1.15-1.26), while exposure to preeclampsia combined with small for gestational age or delivery before 34 gestational weeks had a more than twofold increased risk of having a child with neuropsychiatric disorders (adjusted HR=2.16, 95% CI: 2.02-2.32). The adjusted HR for neuropsychiatric disorders in offspring with small for gestational age or delivery before 34 gestational weeks only was 1.79 (95% CI: 1.73-1.83). In addition, the risk estimate in offspring exposed to both preeclampsia and perinatal problems was greater than those only exposed to preeclampsia for having personality disorders (adjusted HR=1.66; 95% CI: 1.07-2.57), intellectual disabilities (adjusted HR=3.47; 95% CI: 2.86-4.22), specific developmental disorders (adjusted HR=2.91; 95% CI: 2.69-3.15), ASD (adjusted HR=1.75; 95% CI: 1.42-2.17), ADHD and conduct disorders (adjusted HR=2.00; 95%CI: 1.76-2.27), and other behavioral and emotional disorders (adjusted HR=2.09; 95% CI: 1.84-2.37). Conclusion: In utero exposure to severe preeclampsia increased the risk of several neurodevelopmental and psychiatric disorders in offspring. Our findings are relevant to women with hypertensive disorders with regard to pregnancy consultation and management and may yield effective clues for the prevention of neurodevelopmental and psychiatric disorders in childhood.

Keywords: low birth weight, neurodevelopmental disorders, preeclampsia, prematurity, psychiatric disorders

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