Search results for: health and human rights

Authors: Ke Guek Nee, Wong Siew Fan, Nigel V. Marsh

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Excessive use of the Internet has become a cause for concern in many countries, including Malaysia. Such behaviour is reported to be more prevalent amongst young adults who are reported to be spending large amount of time on the Internet. The present study has three objectives. First one is designing a manual-based Cognitive Behavioural Therapy (CBT) programme to reduce problematic Internet use among young adults in Malaysia. Second one is examining the effectiveness of a manual-based CBT programme at the pilot study stage. Thirdly, the programme focuses on reducing the level of stress and anxiety in problematic Internet users. We adopted CBT with single subject experimental design method. A total of six participants completed the entire program. They were asked to report their daily Internet use and software was installed on their devices to record actual use. The data collection involved three time frame measurements: T1 (baseline), T2 (immediately during the last session of the intervention sessions), and T3 (follow-up). Three scales were used to measure the effectiveness of the program: Depression, Anxiety, Stress Scales (DASS), Social Interaction Anxiety Scale (SIAS), and Problematic Internet Use Questionnaire (PIUQ). The results revealed that the intervention programme has significantly improved two dimensions of problematic Internet use which were obsession and control disorder. The participants’ mental health also showed a deduction in means scores for depression, anxiety and stress with depression showing the greatest improvement after the intervention programme. The participants’ social anxiety showed a slight deduction in means scores. We concluded that the intervention programme designed was effective. However, its limitations need to be addressed in future research.

Keywords: excessive internet use, cognitive behavioral thearapy (CBT), psychological well-being, young adults

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Authors: Abeer A. Aljohani

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COVID-19 virus spread has been one of the extreme pandemics across the globe. It is also referred to as coronavirus, which is a contagious disease that continuously mutates into numerous variants. Currently, the B.1.1.529 variant labeled as omicron is detected in South Africa. The huge spread of COVID-19 disease has affected several lives and has surged exceptional pressure on the healthcare systems worldwide. Also, everyday life and the global economy have been at stake. This research aims to predict COVID-19 disease in its initial stage to reduce the death count. Machine learning (ML) is nowadays used in almost every area. Numerous COVID-19 cases have produced a huge burden on the hospitals as well as health workers. To reduce this burden, this paper predicts COVID-19 disease is based on the symptoms and medical history of the patient. This research presents a unique architecture for COVID-19 detection using ML techniques integrated with feature dimensionality reduction. This paper uses a standard UCI dataset for predicting COVID-19 disease. This dataset comprises symptoms of 5434 patients. This paper also compares several supervised ML techniques to the presented architecture. The architecture has also utilized 10-fold cross validation process for generalization and the principal component analysis (PCA) technique for feature reduction. Standard parameters are used to evaluate the proposed architecture including F1-Score, precision, accuracy, recall, receiver operating characteristic (ROC), and area under curve (AUC). The results depict that decision tree, random forest, and neural networks outperform all other state-of-the-art ML techniques. This achieved result can help effectively in identifying COVID-19 infection cases.

Keywords: supervised machine learning, COVID-19 prediction, healthcare analytics, random forest, neural network

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Authors: Ami Fadhillah Amir Abdul Nasir, Amanda C. Niehaus, Skye F. Cameron, Frank A. Von Hippel, John Postlethwait​, Robbie S. Wilson

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For suicidal breeders, the physiological stresses and energetic costs of breeding are fatal. Environmental stressors such as pollution should compound these costs, yet suicidal breeding is so rare among mammals that this is unknown. Here, we explored the consequences of metal contamination to the health, aging and performance of endangered, suicidally-breeding northern quolls (Dasyurus hallucatus) living near an active manganese mine on Groote Eylandt, Northern Territory, Australia. We found respirable manganese dust at levels exceeding international recommendations even 20km from mining sites and substantial accumulation of manganese within quolls’ hair, testes, and in two brain regions—the neocortex and cerebellum, responsible for sensory perception and motor function, respectively. Though quolls did not differ in sprint speeds, motor skill, or manoeuvrability, those with higher accumulation of manganese crashed at lower speeds during manoeuvrability tests, indicating a potential effect on sight or cognition. Immune function and telomere length declined over the breeding season, as expected with ageing, but manganese contamination exacerbated immune declines and suppressed cortisol. Unexpectedly, male quolls with higher levels of manganese had longer telomeres, supporting evidence of unusual telomere dynamics among Dasyurids—though whether this affects their lifespan is unknown. We posit that sublethal contamination via pollution, mining, or urbanisation imposes physiological costs on wildlife that may diminish reproductive success or survival.

Keywords: ecotoxicology, heavy metal, manganese, telomere length, cortisol, locomotor

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Authors: Chethika Gunasiri Wadumestrige Dona, Geetha Mohan, Kensuke Fukushi

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Solid waste in urban areas, especially from organic materials like garden waste, food, and degradable sources, can create health and environmental problems if not managed properly. Urban agriculture has emerged as a potential solution in developing countries to mitigate these issues. It offers the possibility of low-carbon economies and knowledge and innovation dissemination. Domestic composting is a significant aspect of urban agriculture, and its success relies on the attitudes of those who practice it. This study examines the perspectives of 402 urban farmers in the Colombo District, Sri Lanka, regarding domestic compost production. It aims to identify the factors that influence these perspectives. The research found that urban farmers are willing to participate in domestic composting because they believe that it facilitates effective recycling of organic waste within their households. The study used an ordinal regression model to determine the factors that shape farmers' perspectives. Age, family size, and crop preferences are significant determinants of the adoption of domestic composting practices among urban farmers in the Colombo District. These findings highlight the importance of understanding and addressing farmers' attitudes in designing effective waste management strategies. In addition, the study also emphasizes the need for tailored interventions that align with farmers' beliefs and preferences to enhance the adoption and implementation of domestic composting practices in urban areas. The insights gained from this study contribute to the academic discourse and offer practical guidance for policymakers and urban planners seeking to promote sustainable waste management practices and support the adoption of urban agriculture in the broader context of urban development.

Keywords: urban agriculture, domestic composting, farmers` perspectives, sustainable urban development

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Authors: Chueh Chi-An, Chan Hui-Ya

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Background and Aim: National Health Insurance (NHI) Administration released a new reimbursement policy for hospital patients who received a superior discharge plan on April 1, 2016. Each case could be claimed 1,500 points for fee-of service with related documents. The policy is considered a solution to help reducing the crowding in the emergency department, the length of stay of hospital, unplanned readmission rate and unplanned ER visit. This study aim is to explore the effect of the new reimbursement policy for discharge planning service in a medical center. Methods: The discharge team explained to general wards the new policy and encouraged early assessment, communication and connecting to community care for patients. They stated the benefit from the policy and asked documenting for reimbursement claiming from April to May 2016. The imbursement fee of NHI declaration from June 2015 to October 2017 was collected. The indicators included hospital occupancy rate, hospital bed turnover rate, long-term hospitalization rate, and patients’ satisfaction were analyzed after the policy implemented. Results: The results showed that the amount of service declaration was increasing from 2 cases in February 2016 to 110 cases in October 2017, the application rate was increasing from 0.029% to 1.576% of all inpatient cases, and the average payment from NHI was around 148,500 NT dollars per month in 2017. There are no significant differences in the indicators among hospital occupancy rate, hospital bed turnover rate, long-term hospitalization rate, and patients’ satisfaction. Conclusion: To provide a good discharge plan require a specialized case manager, the new reimbursement policy is too complicated and the total fee-of-service hospital could claim is too limited to hiring one. The results suggest more strategies combine with the new reimbursement policy will be needed.

Keywords: discharge planning, reimbursement, unplanned ER visit, readmission rate

Procedia PDF Downloads 173

Authors: Chiara Di Tucci, Giulia Galati, Giulia Mattei, Valentina Bonanni, Oriana Capri, Renzo D'Amelio, Ludovico Muzii, Pierluigi Benedetti Panici

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Objective: Infertility is an increasingly frequent health condition, which may depend on female or male factors. Oxidative stress (OS), resulting from a disrupted balance between reactive oxygen species (ROS) and protective antioxidants, affects the reproductive lifespan of men and women. In this review, we examine if alpha lipoic acid (ALA), among the oral supplements currently in use, has an evidence-based beneficial role in the context of female and male infertility. Methods: We performed a search from English literature using the PubMed database with the following keywords: 'female infertility', 'male infertility', 'semen', 'sperm', 'sub-fertile man', 'alpha-lipoic acid', ' alpha lipoic acid', 'lipoid acid', 'endometriosis', 'chronic pelvic pain', 'follicular fluid' and 'oocytes'. We included clinical trials, multicentric studies, and reviews. The total number of references found after automatically and manually excluding duplicates was 180. After the primary and secondary screening, 28 articles were selected. Results: The available literature demonstrates the positive effects of ALA in multiple processes, from oocyte maturation (0.87 ± 0.9% of oocyte in MII vs 0.81 ± 3.9%; p < .05) to fertilization, embryo development (57.7% vs 75.7% grade 1 embryo; p < .05) and reproductive outcomes. Its regular administration both in sub-fertile women and men has been shown to reduce pelvic pain in endometriosis (p < .05), regularize menstrual flow and metabolic disorders (p < .01), and improve sperm quality (p < .001). Conclusions: ALA represents a promising new molecule in the field of couple infertility. More clinical studies are needed in order to enhance its use in clinical practice.

Keywords: alpha lipoic acid, endometriosis, infertility, male factor, polycystic ovary syndrome

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Authors: Andrea Vasquez, Pedro Maldonado-Alvarado

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In general, 'gluten-free' foods like breadmaking products provide functional or nutraceutical benefits for the consumer's health and increased their demand on the market. In Ecuador, there is an overproduction of superfoods, and the food by-products are undervalued. For the first time, to the author's best knowledge, gluten-free bread mixtures from quinoa and banana flour, cassava starch, lupine flour (LF), or whey protein (WP) with hydroxypropylmethylcellulose (HPMC) and transglutaminase (TG) were evaluated on their functional and sensory properties. Free amino groups and thiols, rheology, and electrophoresis SDS PAGE were performed to analyze the crosslinking of TG at different concentrations with HC or PL proteins. Dough characterization, pasting properties were evaluated, respectively, by a MIXOLAB and a rheometer with a pasting cell. The texture, porosity, and loaf volume were characterized using a texturometer, ImageJ software, and breadmaking ability, respectively. Finally, a breadmaking aptitude and sensorial bread acceptability were performed. A significant decrease in the content of free amino groups (0.16 to 0.11 and 0.46 to 0.36 mM/mg of protein) and free thiol groups (0.37 to 0.21 and 1.79 to 1.32 mM/mg protein) was observed when 1.0% and 0.5% TG were added to LF and WP, respectively. In apparent viscosity analysis, the action of TG on HC proteins changes their viscosity, while the viscosity of LF is not modified by TG. Results of electrophoresis in PL showed bands of higher molecular weight of different fragments of proteins with 1% TG. Formulation with 59.8, 39.9, 160.8, 6.0, 1.0, and 1.5% of, respectively, QF, BF, CS, LF or WP, TG, and HPMC had the best properties in dough parameters, pasting parameters (lower pasting temperature and higher peak viscosity), best crumb structure, lower crumb hardness and higher loaf volume (2.24 and 2.28 mL/g). All the loaves of bread were acceptable in baking aptitude and general acceptability.

Keywords: breadmaking, gluten-free, superfoods, by-products, Ecuador

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Authors: Vahab Behmanesh

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Metabolic syndrome is defined as having at least three of the five metabolic risk factors, including abdominal obesity, high blood pressure, high triglycerides, low HDL, and insulin resistance. Lifestyle changes towards reducing physical activity, unhealthy eating habits Especially the high-fat and high-carbohydrate diet is directly related to metabolic syndrome, and due to the epidemic of overweight and sedentary life, metabolic syndrome is a serious problem worldwide. On the other hand, vitamin D deficiency is considered as one of the most common problems in the world, which is related to the dysfunction of beta cells and insulin resistance, and therefore, vitamin D deficiency is considered as a factor in the occurrence of metabolic syndrome. 40 subjects (age: 16.12 ± 4.4 years and body mass index 25.61 ± 4.4 kg/m2) were randomly assigned to groups of aerobic exercise and placebo, aerobic exercise and vitamin D and placebo (no exercise) were divided. Vitamin D was taken at a dose of 50,000 units per week in a double-blind format for eight weeks, and the daily aerobic exercise program was performed for 50 to 60 minutes, three doses per week, with an intensity of 50-60% of the maximum heart rate. From one-way analysis of variance, Factorial variance analysis (2x2) repeated measurement and correlated t-test were used for data analysis. Aerobic exercise and vitamin D intake reduced all metabolic risk indicators and blood insulin (P < 0.05). However, the subjective feeling of hunger did not change significantly (P < 0.05). Regarding waist circumference and blood glucose, the effect of exercise combined with vitamin D consumption was greater than the corresponding effect in the vitamin D group (P < 0.05). Aerobic exercises and vitamin D intake are safe and effective for improving cardiometabolic health, Imam adds vitamin D to the exercise program has more benefits for weight and blood sugar control, which suggests prescribing it for patients with metabolic syndrome.

Keywords: vitamin D, aerobic exercise, metabolic control, adolescents

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Authors: Monika Dmitrzak-Weglarz, Aleksandra Rajewska-Rager, Maria Skibinska, Natalia Lepczynska, Piotr Sibilski, Joanna Pawlak, Pawel Kapelski, Joanna Hauser

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Epidermal growth factor (EGF) is a well-known neurotrophic factor that involves in neuronal growth and synaptic plasticity. The proteomic research provided in order to identify novel candidate biological markers for mood disorders focused on elevated EGF serum level in patients during depression episode. However, the EGF association with mood disorder spectrum among adolescents and young adults has not been studied extensively. In this study, we aim to investigate the serum levels of EGF in adolescents and young adults during hypo/manic, depressive episodes and in remission compared to healthy control group. In our study, we involved 80 patients aged 12-24 years in 2-year follow-up study with a primary diagnosis of mood disorder spectrum, and 35 healthy volunteers matched by age and gender. Diagnoses were established according to DSM-IV-TR criteria using structured clinical interviews: K-SADS for child and adolescents, and SCID for young adults. Clinical and biological evaluations were made at baseline and euthymic mood (at 3th or 6th month of treatment and after 1 and 2 years). The Young Mania Rating Scale and Hamilton Rating Scale for Depression were used for assessment. The study protocols were approved by the relevant ethics committee. Serum protein concentration was determined by Enzyme-Linked Immunosorbent Assays (ELISA) method. Human EGF (cat. no DY 236) DuoSet ELISA kit was used (R&D Systems). Serum EGF levels were analysed with following variables: age, age under 18 and above 18 years old, sex, family history of affective disorders, drug-free vs. medicated. Shapiro-Wilk test was used to test the normality of the data. The homogeneity of variance was calculated with Levene’s test. EGF levels showed non-normal distribution and the homogeneity of variance was violated. Non-parametric tests: Mann-Whitney U test, Kruskall-Wallis ANOVA, Friedman’s ANOVA, Wilcoxon signed rank test, Spearman correlation coefficient was applied in the analyses The statistical significance level was set at p<0.05. Elevated EGF level at baseline (p=0.001) and at month 24 (p=0.02) was detected in study subjects compared with controls. Increased EGF level in women at month 12 (p=0.02) compared to men in study group have been observed. Using Wilcoxon signed rank test differences in EGF levels were detected: decrease from baseline to month 3 (p=0.014) and increase comparing: month 3 vs. 24 (p=0.013); month 6 vs. 12 (p=0.021) and vs. 24 (p=0.008). EGF level at baseline was negatively correlated with depression and mania occurrence at 24 months. EGF level at 24 months was positively correlated with depression and mania occurrence at 12 months. No other correlations of EGF levels with clinical and demographical variables have been detected. The findings of the present study indicate that EGF serum level is significantly elevated in the study group of patients compared to the controls. We also observed fluctuations in EGF levels during two years of disease observation. EGF seems to be useful as an early marker for prediction of diagnosis, course of illness and treatment response in young patients during first episode od mood disorders, which requires further investigation. Grant was founded by National Science Center in Poland no 2011/03/D/NZ5/06146.

Keywords: biological marker, epidermal growth factor, mood disorders, prediction

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Authors: Bangun F., Crevits B., Bellet T., Banet A., Boy G. A., Katili I.

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This paper seeks the incoherencies in cognitive process during an accident of Powered Two Wheelers (PTW) by understanding the factual sequences of events and causal relations for each case of accident. The principle of this approach is undertaking in-depth investigations on case per case of PTW accidents based on elaborate data acquisitions on accident sites that officially stamped in Police Crash Report (PCRs) 2012 of Medan with criteria, involved at least one PTW and resulted in serious injury and fatalities. The analysis takes into account four modules: accident chronologies, perpetrator, and victims, injury surveillance, vehicles and road infrastructures, comprising of traffic facilities, road geometry, road alignments and weather. The proposal for improvement could have provided a favorable influence on the chain of functional processes and events leading to collision. Decision Aiding Processes (DAP) assists in structuring different entities at different decisional levels, as each of these entities has its own objectives and constraints. The entities (A) are classified into 6 groups of accidents: solo PTW accidents; PTW vs. PTW; PTW vs. pedestrian; PTW vs. motor-trishaw; and PTW vs. other vehicles and consecutive crashes. The entities are also distinguished into 4 decisional levels: level of road users and street systems; operational level (crash-attended police officers or CAPO and road engineers), tactical level (Regional Traffic Police, Department of Transportation, and Department of Public Work), and strategic level (Traffic Police Headquarters (TCPHI)), parliament, Ministry of Transportation and Ministry of Public Work). These classifications will lead to conceptualization of Problem Situations (P) and Problem Formulations (I) in DAP context. The DAP concerns the sequences process of the incidents until the time the accident occurs, which can be modelled in terms of five activities of procedural rationality: identification on initial human features (IHF), investigation on proponents attributes (PrAT), on Injury Surveillance (IS), on the interaction between IHF and PrAt and IS (intercorrelation), then unravel the sequences of incidents; filtering and disclosure, which include: what needs to activate, modify or change or remove, what is new and what is priority. These can relate to the activation or modification or new establishment of law. The PrAt encompasses the problems of environmental, road infrastructure, road and traffic facilities, and road geometry. The evaluation model (MP) is generated to bridge P and I since MP is produced by the intercorrelations among IHF, PrAT and IS extracted from the PCRs 2012 of Medan. There are 7 findings of incoherences: lack of knowledge and awareness on the traffic regulations and the risks of accidents, especially when riding between 0 < x < 10 km from house, riding between 22 p.m.–05.30 a.m.; lack of engagements on procurement of IHF Data by CAPO; lack of competency of CAPO on data procurement in accident-sites; no intercorrelation among IHF and PrAt and IS in the database systems of PCRs; lack of maintenance and supervision on the availabilities and the capacities of traffic facilities and road infrastructure; instrumental bias with wash-back impacts towards the TCPHI; technical robustness with wash-back impacts towards the CAPO and TCPHI.

Keywords: decision aiding processes, evaluation model, PTW accidents, police crash reports

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Authors: Cornelius Arome Omatola, Ropo Ebenezer Ogunsakin, Anyebe Bernard Onoja, Martin-Luther Oseni Okolo, Joseph Abraham-Oyiguh, Kehinde Charles Mofolorunso, Phoebe Queen Akoh, Omebije Patience Adejo, Joshua Idakwo, Therisa Ojomideju Okeme, Danjuma Muhammed, David Moses Adaji, Sunday Ocholi Samson, Ruth Aminu, Monday Eneojo Akor

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Gastroenteritis viruses are the leading etiologic agents of diarrhea in children worldwide. We present data from thirty-three (33) eligible studies published between 2003 and 2023 from African countries bearing the brunt of the virus-associated diarrheal mortality. Random effects meta-analysis with proportion, subgroups, and meta-regression analyses were employed. Overall, rotavirus with estimated pooled prevalence of 31.0% (95% CI 24.0–39.0) predominated in all primary care visits and hospitalizations, followed by norovirus, adenovirus, sapovirus, astrovirus, and aichivirus with pooled prevalence estimated at 15.0% (95% CI 12.0–20.0), 10% (95% CI 6-15), 4.0% (95% CI 2.0–6.0), 4% (95% CI 3-6), and 2.3% (95% CI 1-3), respectively. Predominant rotavirus genotype was G1P[8] (38%), followed by G3P[8] (11.7%), G9P[8] (8.7%), and G2P[4] (7.1%); although, unusual genotypes were also observed, including G3P[6] (2.7%), G8P[6] (1.7%), G1P[6] (1.5%), G10P[8] (0.9%), G8P[4] (0.5%), and G4P[8] (0.4%). The genogroup II norovirus predominated over the genogroup I-associated infections (84.6%, 613/725 vs 14.9%, 108/725), with the GII.4 (79.3%) being the most prevalent circulating genotype. In conclusion, this review showed that rotavirus remains the leading driver of viral diarrhea requiring health care visits and hospitalization among under-five years children in Africa. Thus, improved rotavirus vaccination in the region and surveillance to determine the residual burden of rotavirus and the evolving trend of other enteric viruses are needed for effective control and management of cases.

Keywords: enteric viruses, rotavirus, norovirus, adenovirus, astrovirus, gastroenteritis

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Authors: Neel Ahuja

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Per- and polyfluoroalkyl substances (PFAS), known as ”forever chemicals”, are one of the most common and dangerous water pollutants, having carcinogenic effects and causing 382,000 global deaths annually. Current methods to purify PFAS-contaminated water can cost millions of dollars and require existing infrastructure, making them difficult to implement in low-income and rural areas without industrial treatment plants. Hydroponics plants colonized by beneficial mycorrhizal fungi present an affordable and sustainable solution to purifying PFAS-contaminated water. In this study, mycorrhizal-inoculated basil and lettuce plants were cultivated in hydroponics systems under controlled conditions. Root samples were stained and analyzed under a light microscope to confirm mycorrhizal presence. PFAS was added to the systems and an LC/QQQ-MS instrument was used to measure the reduction in PFAS concentrations over 72 hours. Results showed that mycorrhizal plants removed 71.1% of PFAS in a water system compared to 59.9% by non-mycorrhizal plants, and a t-test (p-value=0.00367) was used to prove statistical significance. Relative health of plants was measured through root length, with results revealing that mycorrhizal plant roots were 2.8 inches longer on average than non-mycorrhizal roots. Further analysis revealed a direct relationship between plant root length and PFAS purification, indicating the suitability of species with naturally longer roots for real-world phytoremediation applications, such as at stormwater detention ponds. This study provided a proof-of-concept of the effectiveness of mycorrhizal hydroponics plants in reducing PFAS contamination in water systems, presenting applications as an inexpensive and large-scale purification system.

Keywords: Perfluoroalkyl and polyfluoroalkyl substances, hydroponics, mycorrhizal fungi, water contamination, stormwater detention ponds

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Authors: Włodzimierz Przewodowski, Agnieszka Przewodowska

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Colloidal metal nanoparticles have drawn increasing attention in the field of phytopathology because of their unique properties and possibilities of applications. Their antibacterial activity, no induction of the development of pathogen resistance and the ability to penetrate most of biological barriers make them potentially useful in the fighting against dangerous pathogens. These properties are very important in the case of protection of strategic crops in the world, like potato - fourth crop in the world - which is host to numerous pathogenic microorganisms causing serious diseases, significantly affecting yield and causing the economic losses. One of the most important and difficult to reduce pathogen of potato plant is quarantine bacterium Clavibacter michiganensis ssp. sepedonicus (Cms) responsible for ring rot disease. Control and detection of these pathogens is very complicated. Application of healthy, certified seed material as well as hygiene in potato production and storage are the most efficient ways of preventing of ring rot disease. Currently used disinfectants and pesticides, have many disadvantages, such as toxicity, low efficiency, selectivity, corrosiveness, and the inability to eliminate the pathogens in potato tissue. In this situation, it becomes important to search for new formulations based on components harmful to health, yet efficient, stable during prolonged period of time and a with wide range of biocide activity. Such capabilities are offered by the latest generation of biocidal nanoparticles such as colloidal metals. Therefore the aim of the presented research was to develop newly antibacterial preparation based on colloidal metal nanoparticles and checking their influence on the Cms bacteria. Our preliminary results confirmed high efficacy of the nano-colloids in controlling the this selected pathogen.

Keywords: clavibacter michiganensis ssp. sepedonicus, colloidal metal nanoparticles, phytopathology, bacteria

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Authors: Thea Freese

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Environmental legislation to protect North and Baltic Sea areas from harmful vessel-source emissions has received increased political attention in recent years. Legislative measures are expected to show positive effects on the health of the marine environment and society. At the same time, compliance might increase the costs to industry and have effects on freight rates and volumes shipped with potential negative repercussions on the environment. Building on an exploratory sequential mixed methods approach, this research project will study the economic effects of maritime environmental legislation in two phases. In Phase I, exploratory in-depth interviews were conducted with 12 experts from various stakeholder groups aiming at identifying variables influencing the relationship between environmental legislation, freight rates and volumes shipped. Influencing factors like compliance, enforcement and modal shift were identified and studied. Phase II will comprise of a quantitative study conducted with the aim of verifying the theory build in Phase I and quantifying economic effects of rules on shipping pollution. Research in this field might inform policy-makers about determinants of behaviour of ship operators in the face of the law and might further the development of a comprehensive legal system for marine environmental protection. At the present stage of research, first tentative results from the qualitative phase may be examined and open research questions to be addressed in the quantitative phase as well as possible research designs for phase II may be discussed. Input from other researchers will be highly valuable at this point.

Keywords: clean shipping operations, compliance, maritime environmental legislation, maritime law and economics, mixed methods research, North and Baltic Sea area

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Authors: Amna Tariq Shah

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Amid the pandemic, the contemporary landscape has experienced accelerated growth in small business activities and an expanding digital marketplace, further exacerbating the issue of non-compliance among self-employed individuals through aggressive tax planning and evasion. This research seeks to address these challenges by developing strategic tax policies that promote voluntary compliance and improve taxpayer facilitation. The study employs the innovative MINDSPACE framework to examine three psychosocial factors—tax communication, tax literacy, and shaming—to optimize policy responses, address administrative shortcomings, and ensure adequate revenue collection for public goods and services. Preliminary findings suggest that incomprehensible communication from tax authorities drives individuals to seek alternative, potentially biased sources of tax information, thereby exacerbating non-compliance. Furthermore, the study reveals low tax literacy among Australian and Pakistani respondents, with many struggling to navigate complex tax processes and comprehend tax laws. Consequently, policy recommendations include simplifying tax return filing and enhancing pre-populated tax returns. In terms of shaming, the research indicates that Australians, being an individualistic society, may not respond well to shaming techniques due to privacy concerns. In contrast, Pakistanis, as a collectivistic society, may be more receptive to naming and shaming approaches. The study employs a mixed-method approach, utilizing interviews and surveys to analyze the issue in both jurisdictions. The use of mixed methods allows for a more comprehensive understanding of tax compliance behavior, combining the depth of qualitative insights with the generalizability of quantitative data, ultimately leading to more robust and well-informed policy recommendations. By examining evidence from opposite jurisdictions, namely a developed country (Australia) and a developing country (Pakistan), the study's applicability is enhanced, providing perspectives from two disparate contexts that offer insights from opposite ends of the economic, cultural, and social spectra. The non-comparative case study methodology offers valuable insights into human behavior, which can be applied to other jurisdictions as well. The application of the MINDSPACE framework in this research is particularly significant, as it introduces a novel approach to tax compliance behavior analysis. By integrating insights from behavioral economics, the framework enables a comprehensive understanding of the psychological and social factors influencing taxpayer decision-making, facilitating the development of targeted and effective policy interventions. This research carries substantial importance as it addresses critical challenges in tax compliance and administration, with far-reaching implications for revenue collection and the provision of public goods and services. By investigating the psychosocial factors that influence taxpayer behavior and utilizing the MINDSPACE framework, the study contributes invaluable insights to the field of tax policy. These insights can inform policymakers and tax administrators in developing more effective tax policies that enhance taxpayer facilitation, address administrative obstacles, promote a more equitable and efficient tax system, and foster voluntary compliance, ultimately strengthening the financial foundation of governments and communities.

Keywords: individual tax compliance behavior, psychosocial factors, tax non-compliance, tax policy

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Authors: Ejazulhaq Rahimi

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The development of techniques evaluating deterioration on concrete structures is vital for structural health monitoring (SHM). One of the main reasons for reinforced concrete structure's deterioration is the corroding of embedded rebars. It is a natural process that begins when the rebar starts to rust. It occurs when the protective layer on the rebar is destroyed. The rebar in concrete is usually protected against corrosion by the high pH of the surrounding cement paste. However, there are chemicals that can destroy the protective layer, making it susceptible to corrosion. It is very destructive for the lifespan and durability of the concrete structure. Corrosion products which are 3 to 6 times voluminous than the rebar stress its surrounding concrete and lead to fracture as cracks even peeling off the cover concrete over the rebar. As is clear that concrete shows limit elastic behavior in its stress strain property, so corrosion product stresses can be detected as strains from the concrete surface. It means that surface strains have a relation with the situation and amount of corrosion products and related concrete fractures inside reinforced concrete. In this paper, a comparative study of surface strains due to corrosion products detected by strain gauges and acoustic emission (AE) testing under periodic accelerated corrosion in the salty environment with 3% NaCl is reported. From the results, three different stages of strains were clearly observed based on the type and rate of strains in each corrosion situation and related fracture types. AE parameters which mostly are related to fracture and their shapes, describe the same phases. It is confirmed that there is a great agreement to the result of each other and describes three phases as generation and expansion of corrosion products and initiation and propagation of corrosion-induced cracks, and surface cracks. In addition, the strain on the concrete surface was rapidly increased before the cracks arrived at the surface of the concrete.

Keywords: acoustic emission, monitoring, rebar corrosion, reinforced concrete, strain

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Authors: G. K. Sruthi, Sila Bhattacharya

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Sorghum is an important food crop in the dry tropical areas of the world, and possesses significant levels of phytochemicals and dietary fiber to offer health benefits. However, the absence of gluten is a limitation for converting the sorghum dough into sheeted/flattened/rolled products. Chapathi/roti (flat unleavened bread prepared conventionally from whole wheat flour dough) was attempted from sorghum as wheat gluten causes allergic reactions leading to celiac disease. Dynamic oscillatory rheology of sorghum flour dough (control sample) and enzyme treated sorghum doughs were studied and linked to the attributes of the finished ready-to-eat product. Enzymes like amylase, xylanase, and a mix of amylase and xylanase treated dough affected drastically the rheological behaviour causing a lowering of dough consistency. In the case of amylase treated dough, marked decrease of the storage modulus (G') values from 85513 Pa to 23041 Pa and loss modulus (G") values from 8304 Pa to 7370 Pa was noticed while the phase angle (δ) increased from 5.6 to 10.1o for treated doughs. There was a 2 and 3 fold increase in the total sugar content after α-amylase and xylanase treatment, respectively, with simultaneous changes in the structure of the dough and finished product. Scanning electron microscopy exhibited enhanced extent of changes in starch granules. Amylase and mixed enzyme treatment produced a sticky dough which was difficult to roll/flatten. The dough handling properties were improved by the use of xylanase and quality attributes of the chapath/roti. It is concluded that enzyme treatment can offer improved rheological status of gluten free doughs and products.

Keywords: sorghum dough, amylase, xylanase, dynamic oscillatory rheology, sensory assessment

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Authors: A. Hayrapetyan, A. Simon, P. Marques, G. Renart

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Business survival is a question of greatest interest for any economy. Firm characteristics that can explain or predict performance and, ultimately, business survival become of the greatest significance, as the sustainable longevity of any business can mean health for the future of the country. Family Firms (FFs) are one of the most ubiquitous forms of business worldwide, as more than half of European firms (60%) are considered as family firms. Therefore, the inherent characteristics of FFs are one of the possible explanatory variables for firm survival because FFs have strategic goals that differentiate them from other types of businesses. Although there is literature on the performance of FFs across generations, there are fewer studies on the factors that impact the survival of family and non-family FFs, as there is a lack of data on failed firms. To address this gap, this paper explores the differential survival of family firms versus non-family firms with a representative sample of companies of the region of Catalonia (Northeast of Spain) that were adhoc classified as family or nonfamily firms, as well as classified as failed or surviving, since no census data for family firms or for failed firms is available in Spain. By using the COX regression model on a representative sample of 629 family and non-family firms, this study investigates to what extent financial ratios, such as Liquidity, Solvency Rate can impact business survival, taking into consideration the socioemotional side of family firms, as well as revealing the differences between family and non-family firms. The findings show that the liquidity rate is significant for non-family firm survival, whereas not for family firms. On the other hand, FFs can benefit while having a higher solvency rate. Ultimately, this paper discovers that FFs increase their chances of survival when they are small, as the growth in size starts negatively impacting the socioemotional objectives of the firm. This study proves the existence of significant differences between family and non-family firms’ survival during economic crises, suggesting that the prioritization of emotional wealth creates distinct conditions for both types of firms.

Keywords: COX regression, economy crises, family firm, non-family firm, survival

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Authors: S. Bellagamba, S. Malinconico, P. De Simone, F. Paglietti

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Until the 1990s, Italy was among the world’s leading producers of raw asbestos fibres and Asbestos Containing Materials (ACM) and one of the most contaminated Countries in Europe. To reduce asbestos-related health effects, Italy has adopted many laws and regulations regarding exposure thresholds, limits, and remediation tools. The Italian Environmental Ministry (MASE) has identified 42 Italian Superfund sites, 11 of which are mainly contaminated by Asbestos. The highest levels of exposure occur during remediation activities in the 42 superfund-sites and during the management of asbestos containing waste in landfills, which requires specific procedures. INAIL-DIT play a role as MASE scientific consultant on issues concerning pollution, remediation, and Asbestos Containing Waste (ACW) management. The aim is to identify the best Emergency Safety Measures, to suggest specific best pratics for remediation through occupational on site monitorings and laboratory analysis. Moreover, the aim of INAIL research is testing the available technologies for working activities and analytical methodologies. This paper describes the remediation of Bagnoli industrial facility (Naples), an Eternit factory which produced asbestos cement products. The remediation has been analyzed, considering a first phase focused on the demolition of structures and plants and a second phase regarding the characterization, screening, removal, and disposal of polluted soils. The project planned the complete removal of all the asbestos dispersed in the soil and subsoil and the recovery of the clean fraction. This work highlights the remediation techniques used and the prevention measures provide for workers and daily life areas protection. This study, considering the high number of asbestos cement factories in the world, can to serve as an important reference for similar situation at European or international scale.

Keywords: safety, asbestos, workers, contaminated sites, hazardous waste

Procedia PDF Downloads 86

Authors: Kuni Vergauwen, Ivan P. J. Huijnen, Astrid Depuydt, Jasmine Van Regenmortel, Mira Meeus

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A lower activity level and imbalanced activity pattern are frequently observed in persons with chronic fatigue syndrome (CFS) / myalgic encephalomyelitis (ME) due to debilitating fatigue and post-exertional malaise (PEM). Identification of measurement instruments to evaluate the activity level and pattern is therefore important. The objective is to identify measurement instruments suited to evaluate the activity level and/or pattern in patients with CFS/ME and review their psychometric properties. A systematic literature search was performed in the electronic databases PubMed and Web of Science until 12 October 2016. Articles including relevant measurement instruments were identified and included for further analysis. The psychometric properties of relevant measurement instruments were extracted from the included articles and rated based on the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. The review was performed and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A total of 49 articles and 15 unique measurement instruments were found, but only three instruments were evaluated in patients with CFS/ME: the Chronic Fatigue Syndrome-Activity Questionnaire (CFS-AQ), Activity Pattern Interview (API) and International Physical Activity Questionnaire-Short Form (IPAQ-SF), three self-report instruments measuring the physical activity level. The IPAQ-SF, CFS-AQ and API are all equally capable of evaluating the physical activity level, but none of the three measurement instruments are optimal to use. No studies about the psychometric properties of activity monitors in patients with CFS/ME were found, although they are often used as the gold standard to measure the physical activity pattern. More research is needed to evaluate the psychometric properties of existing instruments, including the use of activity monitors.

Keywords: chronic fatigue syndrome, data collection, physical activity, psychometrics

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Authors: Elham Sharif, Nasser Rizk, Sirin Abu Aqel, Ofelia Masoud

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Background: Previous studies have investigated the association of rs1544410, rs7975232 and rs731236 polymorphisms in vitamin D receptor gene and its impact on diseases such as cancer, diabetes and hypertension in different ethnic backgrounds. Aim: The aim of this study is to investigate the association between VDR polymorphisms using three SNP’s (rs1544410, rs7975232 and rs731236) and the severity of the significant lesion in coronary arteries among angiographically diagnosed CAD. Methods: A prospective-retrospective study was conducted on 192 CAD patients enrolled from the cardiology department-Heart Hospital HMC, grouped in 96 subjects with significant stenosis and 96 with non-significant stenosis with a mean age between 30 and 75 years old. Genotyping was performed for the following SNPs rs1544410, rs7975232 and rs731236 using TaqMan assay by the Real Time PCR, ABI 7500 in Health Sciences Labs at Qatar University Biomedical Research Center. Results: The results showed that both groups have matched age and gender distribution but patients with the significant stenosis have significantly higher; BMI (p=0.047); smoking status (p=0.039); FBS (p= 0.031); CK-MB (p=0.025) and Troponin (p=0.002) than the patients with non–significant lesion. Among the traditional risk factors, smoking increases the odds of the severe stenotic lesion in CAD patients by 1.984, with 95% CI between 1.024 – 7.063, with p= 0.042.HWE showed deviations of the rs1544410 and rs731236 among the study subjects. The most frequent genotype in distribution of rs7975232 is the AA among the significant stenosis patients, while the heterozygous AC was the frequent genotype in distribution among the non-significant stenosis group. The carriers of CC genotype in rs7975232 increased the risk of having significant coronary arteries stenotic lesion by 1.83 with 95% CI (1.020 – 3.280), p=0.043. No association was found between the rs7975232 with vitamin D and VDBP. Conclusion: There is a significant association between rs7975232 and the severity of CAD lesion. The carrier of CC genotype in rs7975232 increased the risk of having significant coronary arteries atherosclerotic lesion especially in patients with smoking history independent of vitamin D.

Keywords: vitamin D, vitamin D receptor, polymorphism, coronary harat disease

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Authors: Stephanie Nihan, Jayson M. Fadrigalan, Pyay P. San, Steven M. Santos, Weihui Li

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People of all ages who use wheelchairs are left with the inconvenience of not having an easy way to take their vital signs. Typically, patients are required to visit the hospital in order to take the vital signs. VitalGO is a wheel chair system that equipped with medical devices to take vital signs and then transmit data to a mobile application for convenient, long term health monitoring. The vital signs include oxygen saturation, heart rate, and blood pressure, breathing rate and body temperature. Oxygen saturation and heart rate are monitored through pulse oximeter. Blood pressure is taken through a radar sensor. Breathing rate is derived through thoracic impedance while body temperature is measured through an infrared thermometer. The application receives data through bluetooth and stores in a database for review in a simple graphical interface. The application will have the ability to display this data over various time intervals such as a day, week, month, 3 months, 6 months and a year. The final system for the mobile app can also provide an interface for both the user and their physician(s) to record notes or keep record of daily symptoms that a patient might be having. The user’s doctor will be granted access by the user to view the patient information for assistance with a more accurate diagnosis. Also, this wheelchair accessory conveniently includes a foldable table/desk as somewhere to place an electronic device that may be used to access the app. The foldable table will overall contribute to the wheelchair user’s increased comfort and will give them somewhere to place food, a book, or any other form of entertainment that would normally be hard to juggle on their lap.

Keywords: wheel chair, vital sign, mobile application, telemedicine

Procedia PDF Downloads 330

Authors: Asnate Kirse, Daina Karklina, Sandra Muizniece-Brasava, Ruta Galoburda

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Pulses are high in plant protein and dietary fiber, and contain slowly digestible starches. Innovative products from pulses could increase their consumption and benefit consumer health. This study was conducted to evaluate physicochemical stability of processed cowpea (Vigna unguiculata (L.) Walp. cv. Fradel) and maple pea (Pisum sativum var. arvense L. cv. Bruno) spreads at 5 °C temperature during 62-day storage. Physicochemical stability of pulse spreads was compared after sous vide treatment (80 °C/15 min) and high pressure processing (700 MPa/10 min/20 °C). Pulse spreads were made by homogenizing cooked pulses in a food processor together with salt, citric acid, oil, and bruschetta seasoning. A total of four different pulse spreads were studied: Cowpea spread without and with seasoning, maple pea spread without and with seasoning. Transparent PA/PE and light proof PET/ALU/PA/PP film pouches were used for packaging of pulse spreads under vacuum. The parameters investigated were pH, water activity and mass losses. Pulse spreads were tested on days 0, 15, 29, 42, 50, 57 and 62. The results showed that sous-vide treatment and high pressure processing had an insignificant influence on pH, water activity and mass losses after processing, irrespective of packaging material did not change (p>0.1). pH and water activity of sous-vide treated and high pressure processed pulse spreads in different packaging materials proved to be stable throughout the storage. Mass losses during storage accounted to 0.1% losses. Chosen sous-vide treatment and high pressure processing regimes and packaging materials are suitable to maintain consistent physicochemical quality of the new products during 62-day storage.

Keywords: cowpea, flexible packaging, maple pea, water activity

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Authors: Xiao-Yin Liu, Liang-Xue Zhou

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Traumatic brain injury (TBI), as a kind of nerve trauma caused by an external force, affects people all over the world and is a global public health problem. Although there are various clinical treatments for brain injury, including surgery, drug therapy, and rehabilitation therapy, the therapeutic effect is very limited. To improve the therapeutic effect of TBI, scaffolds combined with exosomes are a promising but challenging method for TBI repair. In this study, we examined whether a novel 3D-printed collagen/chitosan scaffold/exosomes derived from neural stem cells (NSCs) pretreated with insulin growth factor-1 (IGF-I) scaffolds (3D-CC-INExos) could be used to improve TBI repair and functional recovery after TBI. Our results showed that composite scaffolds of collagen-, chitosan- and exosomes derived from NSCs pretreated with IGF-I (INExos) could continuously release the exosomes for two weeks. In the rat TBI model, 3D-CC-INExos scaffold transplantation significantly improved motor and cognitive function after TBI, as assessed by the Morris water maze test and modified neurological severity scores. In addition, immunofluorescence staining and transmission electron microscopy showed that the recovery of damaged nerve tissue in the injured area was significantly improved by 3D-CC-INExos implantation. In conclusion, our data suggest that 3D-CC-INExos might provide a potential strategy for the treatment of TBI and lay a solid foundation for clinical translation.

Keywords: traumatic brain injury, exosomes, insulin growth factor-1, neural stem cells, collagen, chitosan, 3D printing, neural regeneration, angiogenesis, functional recovery

Procedia PDF Downloads 80

Authors: Olajumoke Temilola Fatimat, Fasasi Fausat Kikelomo, Ishola Ganiyat Folasayo, Omayeka Mary

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Psychoactive substances are chemical substances that affect the normal functioning of the brain and cause changes in behavior, mood, and consciousness. Psychoactive substance abuse constitutes one of the most important risk–taking behavior among adolescents and young adults in secondary schools. The study, therefore, assessed the factors influencing the use of psychoactive substances among senior secondary students in Ibadan South–West Local Government Area, Oyo State. A descriptive non-experimental design was adopted; purposive and simple random sampling techniques were used to select 330 respondents, while questionnaires were used for data collection. The descriptive statistics of frequency count, percentages, inferential statistics of chi-square, and analysis of variance were used for the analysis. The results revealed that the majority of the respondents had heard of the term substance abuse before 226 (75.3%); it was also revealed that the majority of the respondents had good knowledge of psychoactive substances, 67.8%. There was no significant relationship between age and knowledge of psychoactive substances among senior secondary students, with a p-value of 0.199. The outcome of this study indicates that drug abuse is increasing day by day among secondary school students and may have greatly contributed to poor performance in examinations as well as undermining academic ability and performance among students. It was recommended that efforts should be made by the school authorities of the secondary schools in Ibadan South–West Local Government Area, Oyo State, and in Oyo State generally in collaboration with health personnel to educate adolescents on psychoactive substance abuse. This is to ensure that adolescents are adequately educated and updated on knowledge of psychoactive substance abuse.

Keywords: factors, influence, psychoactive substance, secondary school

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Authors: Farah Fazlinda Binti Mohamad, Ahmad Saifizul Abdullah, Mohamed Rehan Karim , Jamilah Mohamad, Siti Hikmah Musthar

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Road safety is an important issue in Malaysia. It become important as it is discussed widely throughout printed and electronic media. Most of the news portrays on road accident and fatalities have increased the concern of everyone. This issue affects everyone's life as everyone shares the roads. The most vulnerable victims are the road user who uses the roads every day. It is appalling when World Health Organization (WHO) reported that in every 100,000 of population in Malaysia, 23 fatalities recorded due to road accident alone. This figure is quite alarming and requires serious attention. Furthermore, research by Malaysian Institute of Road Safety Research concluded that that speeding has contributed to 60% of all road accident in the country. Therefore, this study aims to elucidate the factors that influence road users’ speeding behaviour on selected roads in Peninsular Malaysia. To achieve this, set of questionnaires has distributed to 500 respondents on selected roads in Peninsular Malaysia. The respondents came from various demographic backgrounds in order to have a fair opinion on the issue. Using descriptive analysis, the results have indicated that psychological factors such as emotion and attitude of road user are the prominent factors that influence the road user’s speeding behaviour. Furthermore, the results have shown that male road users were dominant in speeding compared to female, which led to increased vulnerability to road injuries and fatalities. These findings are very useful in order for us to understand road users’ driving behaviour. Relevant authorities should also revise the existing countermeasures and find ways to reduce road accident. Engineers and road experts could cooperate in designing new road specifications for the road user. Nevertheless, it is important to comprehend this speeding issue and factors associated with it. Each road user should take this matter seriously and responsibly as road safety is a responsibility of all.

Keywords: countermeasures, psychological, road safety, speeding

Procedia PDF Downloads 525

Authors: Samuel Kwaku Essien, Catherine Trask, Niels Koehncke, Brenna Bath

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Background: Low back disorder (LBD) is the most common musculoskeletal problem among farmers, with higher prevalence than other occupations. Operators of tractors and other farm machinery such as combines or all-terrain vehicles (ATV) can have considerable cumulative exposure to whole body vibration (WBV). Although there appears to be an association between LBD and WBV, lack of prospective studies makes the relationship between LBD and WBV unclear. Purpose: This study investigates the association between WBV and LBD among Saskatchewan farmers using a prospective cohort study Methods: The Saskatchewan Farm Injury Cohort Study Phase I (2007) and II (2013) data were used. Baseline data were collected via postal questionnaire on accumulated yearly tractor, combine, and ATV use as well as several covariates to support a biopsychosocial model of LBD. Follow-up data on musculoskeletal symptoms were collected for the 6-year with sample size of 1149. Questions on ‘low back trouble’ (ache, pain, discomfort) experienced in the last 12 months answered by farmer participants as ‘yes’ or ‘no’. A GEE-modified Poisson approach was performed using SPSS 22 and SAS 9.4. Results: Twelve-month Prevalence of LBD was 59.8%. In multivariate analysis of the 6-year follow-up, LBD was associated with ATV operation and tractor operation, with a dose-response relationship for annual accumulated tractor operation. Although combine operation ≥ 61 hrs/year was related to LBD in bivariate analysis, this difference did not persist after adjustment for confounder. Age was found to be a confounder in relationship between WBV and LBD and no interactions were found. Conclusion: Longer annual tractor operation and older age are important predictors of LBD symptoms in farmers. Future research involving direct measurement can help identify appropriate prevention strategies.

Keywords: agriculture, low back disorder, low back pain, occupational health

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Authors: Bulcha Belay Etana, Benny Malengier, Janarthanan Krishnamoorthy, Timothy Kwa, Lieva VanLangenhove

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Electromyography measures the electrical activity of muscles using surface electrodes or needle electrodes to monitor various disease conditions. Recent developments in the signal acquisition of electromyograms using textile electrodes facilitate wearable devices, enabling patients to monitor and control their health status outside of healthcare facilities. Here, we have developed and tested wearable textile electrodes to acquire electromyography signals from patients suffering from Parkinson’s disease and incorporated a feedback-control system to relieve muscle cramping through thermal stimulus. In brief, the textile electrodes made of stainless steel was knitted into a textile fabric as a sleeve, and their electrical characteristic, such as signal-to-noise ratio, was compared with traditional electrodes. To relieve muscle cramping, a heating element made of stainless-steel conductive yarn sewn onto cotton fabric, coupled with a vibration system, was developed. The system integrated a microcontroller and a Myoware muscle sensor to activate the heating element as well as the vibration motor when cramping occurs, and at the same time, the element gets deactivated when the muscle cramping subsides. An optimum therapeutic temperature of 35.5 °C is regulated by continuous temperature monitoring to deactivate the heating system when this threshold value is reached. The textile electrode exhibited a signal-to-noise ratio of 6.38dB, comparable to that of the traditional electrode’s value of 7.05 dB. For a given 9 V power supply, the rise time was about 6 minutes for the developed heating element to reach an optimum temperature.

Keywords: smart textile system, wearable electronic textile, electromyography, heating textile, vibration therapy, Parkinson’s disease

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Authors: Dharshika Rajalingam, Jeffery W. Peng

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Acinetobacter baumannii is a challenging threat to global health, recognized as a multidrug-resistant pathogen. -lactamase is one of the principal resistant mechanisms developed by A. baumannii to survive against -lactam antibiotics. OXA24/40 is one of the types of -lactamases, a well-documented carbapenem hydrolyzing class D -lactamases (CHDL). It was revealed that OXA24/40 showed resistivity against doripenem, one of the carbapenems, by two different mechanisms as hydrolysis and -lactonization. Furthermore, it undergoes genetic mutations to broaden the -lactamase activity to survive against antibiotic environments. One of the crucial characterizations of prokaryotes to develop adaptation is post-translational modification (PTM), mainly phosphorylation. However, the PTM of OXA24/40 is an unknown feature, and the impact of PTM on antibiotic resistivity is yet to be explored. We approached these hypotheses using NMR and MS techniques and found that the OXA24/40 could be phosphorylated in vitro. The Ser81 at the active STFK motif of OXA24/40 of catalytic pocket was identified as the site of phosphorylation using 1D 31P NMR experiment, whereas S81 is required to form an acyl-enzyme complex between enzyme and -lactam antibiotics. The activity of completely phosphorylated OXA24/40 wild type against doripenem revealed that the phosphorylation of active Ser inactivates the -lactamases activity of OXA24/40. The 1D 1H CPMG NMR-based activity assay of phosphorylated OXA24/40 against doripenem confirmed that both deactivating mechanisms are inhibited by phosphorylation. Carbamylated Lysine at the active STFK motif is one of the critical features of CHDL required for the acylation and deacylation reactions of the enzyme. The 1D 13C NMR experiment confirmed that the K84 of phosphorylated OXA24/40 is de-carbamylated. Phosphorylation of OXA24/40 affects both active S81 and carbamylated K84 of OXA24 that are required for the resistivity of -lactamase. So, phosphorylation could be one of the reasons for the genetic mutation of OXA24/40 for the development of antibiotic resistivity. Further research can lead to an understanding of the effect of phosphorylation on the clinical mutants of the OXA24-like -lactamase family on the broadening of -lactamase activity.

Keywords: OXA24/40, phosphorylation, clinical mutants, resistivity

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Authors: Fuad Alzahrani, Yiannis Kyratsis

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Although emergency nurses, being the frontline workers in mass-gatherings, are essential for providing an effective public health response, little is known about the skills that emergency nurses have, or require, in order to respond effectively to a disaster event. This paper is designed to address this gap in the literature by conducting an empirical study on emergency nurses’ preparedness at the mass-gathering event of Hajj in Mecca city. To achieve this aim, this study conducted a cross-sectional survey among 106 emergency department nurses in all the public hospitals in Mecca in 2014. The results revealed that although emergency nurses’ role understanding is high; they have limited knowledge and awareness of how to respond appropriately to mass-gathering disaster events. To address this knowledge gap, the top three most beneficial types of education and training courses suggested are: hospital education sessions, the Emergency Management Saudi Course and workshop; and short courses in disaster management. Finally, recommendations and constructive strategies are developed to provide the best practice in enhancing disaster preparedness. This paper adds to the body of knowledge regarding emergency nurses and mass gathering disasters. This paper measures the level of disaster knowledge, previous disaster response experience and disaster education and training amongst emergency nurses in Mecca, Saudi Arabia. It is anticipated that this study will provide a foundation for future studies aimed at better preparing emergency nurses for disaster response. This paper employs new strategies to improve the emergency nurses’ response during mass gatherings for the Hajj. Increasing the emergency nurses’ knowledge will develop their effective responses in mass-gathering disasters.

Keywords: emergency nurses, mass-gatherings, hajj, disaster preparedness, disaster knowledge, perceived role, disaster training, previous disaster response experience

Procedia PDF Downloads 428