Search results for: mode II critical stress intensity factor
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 16561

Search results for: mode II critical stress intensity factor

571 Religious Discourses and Their Impact on Regional and Global Geopolitics: A Study of Deobandi in India, Pakistan and Afghanistan

Authors: Soumya Awasthi

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The spread of radical ideology is possible not merely through public meetings, protests, and mosques but even in schools, seminaries, and madrasas. The rhetoric created around the relationship between religion and conflict has been the primary factor for instigating global conflicts – when religion is used to achieve broader objectives. There have been numerous cases of religion-driven conflict around the world be it the Jewish revolt between 66 AD and 628 AD or the 1119 AD the Crusades revolt or during the Cold War period or the rise of right-wing politics in India. Some of the major developments which reiterate the significance of religion in the contemporary times include: (1) The emergence of theocracy in Iran in 1979 (2) Resurgence of world-wide religious beliefs in post-Soviet space. (3) Emergence of transnational terrorism shaped by twisted depiction of Islam by the self proclaimed protectors of the religion. Therefore this paper is premised in the argument that religion has always found itself on the periphery of the discipline of International Relations (IR), and has received less attention than it deserves. The focus of the topic is on the discourses of ‘Deobandi’ and its impact both on the geopolitics of the region- particularly in India, Pakistan, and Afghanistan- and also at the global level. Discourse is a mechanism in use since time immemorial and has been a key tool to mobilise masses against the ruling authority. With the help of field surveys, qualitative and analytical method of research in religion and international relations, it has been found that they are numerous madrassas that are running illegally and are unregistered. These seminaries are operating in the Khyber-Pakhtunkhwa and Federally Administered Tribal Area (FATA). During the Soviet invasion of Afghanistan in 1979, relation between religion and geopolitics was highlighted when there was a sudden spread of radical ideas, finding support from countries like Saudi Arabia (who funded the campaign) and Pakistan (which organised the Saudi funds and set up training camps, both educational and military). During this period there was a huge influence of Wahabi theology on the madrasas which started with Deoband philosophy and later became a mix of Wahabi (influenced by Ahmad Ibn Hannabal and Ibn Taimmiya) and Deobandi philosophy, tending towards fundamentalism. Later the impact of regional geopolitics had influence on the global geopolitics when the incidents like attack on the US in 2001, bomb blasts in U.K, Indonesia, Turkey, and Israel in 2000s. In the midst of all this, there were several scholars who pointed towards Deobandi Philosophy as one of the drivers in the creation of armed Islamic groups in Pakistan, Afghanistan. Hence this paper will make an attempt to understand the trend as to how Deobandi religious discourses originating from India have changed over the decades, and who the agents of such changes are. It will throw light on Deoband from pre-independence till date to create a narrative around the religious discourses and Deobandi philosophy and its spill over impact on the map of global and regional security.

Keywords: Deobandi School of Thought, radicalization, regional and global geopolitics, religious discourses, Whabi movement

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570 The Transformation of Hot Spring Destinations in Taiwan in a Post-pandemic Future: Exploring the COVID-19 Impacts on Hot Spring Experiences and Resilience of Local Residents from a Posttraumatic Growth Perspective

Authors: Hsin-Hung Lin, Janet Chang, Te-Yi Chang, You-Sheng Huang

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The natural and men-made disasters have become huge challenges for tourism destinations as well as emphasizing the fragility of the industry. Hot springs, among all destinations, are prone to disasters due to their dependence on natural resources and locations. After the COVID-19 outbreak, hot spring destinations have experienced not only the loss of businesses but also the psychological trauma. However, evidence has also shown that the impacts may not necessarily reduce the resilience for people but may be converted into posttraumatic growth. In Taiwan, a large proportion of hot springs are located in rural or indigenous areas. As a result, hot spring resources are associated with community cohesion for local residents. Yet prior research on hot spring destinations has mainly focused on visitors, whereas residents have been overlooked. More specifically, the relationship between hot springs resources and resident resilience in the face of the COVID-19 impacts remains unclear. To fulfill this knowledge gap, this paper aims to explore the COVID-19 impacts on residents’ hot spring experiences as well as individual and community resilience from the perspective of posttraumatic growth. A total of 315 residents of 13 hot spring destinations that are most popular in Taiwan were recruited. Online questionnaires were distributed over travel forums and social networks after the COVID-19. This paper subsequently used Partial Least Squares Structural Equation Modeling for data analysis as the technique offers significant advantages in addressing nonnormal data and small sample sizes. A preliminary test was conducted, and the results showed acceptable internal consistency and no serious common method variance. The path analysis demonstrated that the COVID-19 impacts strengthened residents’ perceptions of hot spring resources and experiences, implying that the pandemic had propelled the residents to visit hot springs for the healing benefits. In addition, the COVID-19 impacts significantly enhanced residents’ individual and community resilience, which indicates that the residents at hot springs are more resilient thanks to their awareness of external risks. Thirdly, residents’ individual resilience was positively associated with hot spring experiences, while community resilience was not affected by hot spring experiences. Such findings may suggest that hot spring experiences are more related to individual-level experiences and, consequently, have insignificant influence on community resilience. Finally, individual resilience was proved to be the most relevant factor that help foster community resilience. To conclude, the authorities may consider exploiting the hot spring resources so as to increase individual resilience for local residents. Such implications can be used as a reference for other post-disaster tourist destinations as well.As for future research, longitudinal studies with qualitative methods are suggested to better understand how the hot spring experiences have changed individuals and communities over the long term. It should be noted that the main subjects of this paper were focused on the hot spring communities in Taiwan. Therefore, the results cannot be generalized for all types of tourism destinations. That is, more diverse tourism destinations may be investigated to provide a broader perspective of post-disaster recovery.

Keywords: community resilience, hot spring destinations, individual resilience, posttraumatic growth (PTG)

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569 Greener Minds: Understanding Students' Perceptions of Environmental Sustainability in Higher Education, Sultan Qaboos University

Authors: Aisha Alshdefat, Lina Shakman

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Objective: With environmental sustainability (ES) emerging as a critical concern due to its global impact, higher education institutions play a vital role in promoting ES through curricula and campus operations. This study examines the perceptions, attitudes, and behaviors related to ES among students at Sultan Qaboos University, aiming to identify areas for improved integration of sustainability practices in higher education. Design: A descriptive cross-sectional study, conducted via an online questionnaire, examines perceptions and attitudes toward environmental sustainability among students at Sultan Qaboos University, Muscat, Oman. The survey instrument employs a 5-point Likert scale to assess six key areas: awareness, concern, attitude, willingness to participate, current behaviors, and recommendations for enhancing campus sustainability initiatives. A convenience sample of 200 students was initially targeted, with 157 students ultimately responding between September and November 2024. Eligible participants included Undergraduate and graduate students who consented after being fully informed of the study objectives and design were included, while those who withdrew or refused participation were excluded. Following ethical approval, data collection was carried out through Google Forms. SPSS Version 23 was used for descriptive and inferential analyses, including Pearson’s correlation, chi-square, and Fisher's exact test, to explore associations among key variables. Findings: Preliminary analysis indicates that 68% of participants are familiar with core environmental sustainability (ES) concepts, including the Sustainable Development Goals (SDGs), and express high concern regarding environmental issues. However, only 47% report active involvement in campus-led ES initiatives, underscoring an engagement gap. Over 70% of respondents believe that sustainability should be prioritized as a university policy, and 62% expressed willingness to participate in additional ES-related programs. Despite this interest, 58% advocated for more sustainability-focused courses in their curriculum, suggesting current offerings are insufficient. Statistical analysis revealed a significant positive correlation between ES awareness and willingness to engage in sustainable practices (p < 0.05). These findings highlight the need for expanded institutional efforts, including targeted programs and curriculum integration, to cultivate a more sustainability-centered culture among students. Conclusion: The results emphasize that while students demonstrate a strong foundational awareness of ES, greater institutional support is essential to transform this awareness into active engagement. More comprehensive integration of sustainability within academic programs and campus life could substantially enhance students’ involvement and commitment to environmental stewardship.

Keywords: environmental sustainability, higher education, students, perceptions, Sultan Qaboos University.

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568 Automatic Identification and Classification of Contaminated Biodegradable Plastics using Machine Learning Algorithms and Hyperspectral Imaging Technology

Authors: Nutcha Taneepanichskul, Helen C. Hailes, Mark Miodownik

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Plastic waste has emerged as a critical global environmental challenge, primarily driven by the prevalent use of conventional plastics derived from petrochemical refining and manufacturing processes in modern packaging. While these plastics serve vital functions, their persistence in the environment post-disposal poses significant threats to ecosystems. Addressing this issue necessitates approaches, one of which involves the development of biodegradable plastics designed to degrade under controlled conditions, such as industrial composting facilities. It is imperative to note that compostable plastics are engineered for degradation within specific environments and are not suited for uncontrolled settings, including natural landscapes and aquatic ecosystems. The full benefits of compostable packaging are realized when subjected to industrial composting, preventing environmental contamination and waste stream pollution. Therefore, effective sorting technologies are essential to enhance composting rates for these materials and diminish the risk of contaminating recycling streams. In this study, it leverage hyperspectral imaging technology (HSI) coupled with advanced machine learning algorithms to accurately identify various types of plastics, encompassing conventional variants like Polyethylene terephthalate (PET), Polypropylene (PP), Low density polyethylene (LDPE), High density polyethylene (HDPE) and biodegradable alternatives such as Polybutylene adipate terephthalate (PBAT), Polylactic acid (PLA), and Polyhydroxyalkanoates (PHA). The dataset is partitioned into three subsets: a training dataset comprising uncontaminated conventional and biodegradable plastics, a validation dataset encompassing contaminated plastics of both types, and a testing dataset featuring real-world packaging items in both pristine and contaminated states. Five distinct machine learning algorithms, namely Partial Least Squares Discriminant Analysis (PLS-DA), Support Vector Machine (SVM), Convolutional Neural Network (CNN), Logistic Regression, and Decision Tree Algorithm, were developed and evaluated for their classification performance. Remarkably, the Logistic Regression and CNN model exhibited the most promising outcomes, achieving a perfect accuracy rate of 100% for the training and validation datasets. Notably, the testing dataset yielded an accuracy exceeding 80%. The successful implementation of this sorting technology within recycling and composting facilities holds the potential to significantly elevate recycling and composting rates. As a result, the envisioned circular economy for plastics can be established, thereby offering a viable solution to mitigate plastic pollution.

Keywords: biodegradable plastics, sorting technology, hyperspectral imaging technology, machine learning algorithms

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567 Exploring Drivers and Barriers to Environmental Supply Chain Management in the Pharmaceutical Industry of Ghana

Authors: Gifty Kumadey, Albert Tchey Agbenyegah

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(i) Overview and research goal(s): This study aims to address research gaps in the Ghanaian pharmaceutical industry by examining the impact of environmental supply chain management (ESCM) practices on environmental and operational performance. Previous studies have provided inconclusive evidence on the relationship between ESCM practices and environmental and operational performance. The research aims to provide a clearer understanding of the impact of ESCM practices on environmental and operational performance in the context of the Ghanaian pharmaceutical industry. Limited research has been conducted on ESCM practices in developing countries, particularly in Africa. The study aims to bridge this gap by examining the drivers and barriers specific to the pharmaceutical industry in Ghana. The research aims to analyze the impact of ESCM practices on the achievement of Sustainable Development Goals (SDGs) in the Ghanaian pharmaceutical industry, focusing on SDGs 3, 12, 13, and 17. It also explores the potential for partnerships and collaborations to advance ESCM practices in the pharmaceutical industry. The research hypotheses suggest that pressure from stakeholder positively influences the adoption of ESCM practices in the Ghanaian pharmaceutical industry. By addressing these goals, the study aims to contribute to sustainable development initiatives and offer practical recommendations to enhance ESCM A practices in the industry. (ii) Research methods and data: This study uses a quantitative research design to examine the drivers and barriers to environmental supply chain management in the pharmaceutical industry in Accra.The sample size is approximately 150 employees, with senior and middle-level managers from pharmaceutical industry of Ghana. A purposive sampling technique is used to select participants with relevant knowledge and experience in environmental supply chain management. Data will be collected using a structured questionnaire using Likert scale responses. Descriptive statistics will be used to analyze the data and provide insights into current practices and their impact on environmental and operational performance. (iii) Preliminary results and conclusions: Main contributions: Identifying drivers/barriers to ESCM in Ghana's pharmaceutical industry, evaluating current ESCM practices, examining impact on performance, providing practical insights, contributing to knowledge on ESCM in Ghanaian context. The research contributes to SDGs 3, 9, and 12 by promoting sustainable practices and responsible consumption in the industry. The study found that government rules and regulations are the most critical drivers for ESCM adoption, with senior managers playing a significant role. However, employee and competitor pressures have a lesser impact. The industry has made progress in implementing certain ESCM practices, but there is room for improvement in areas like green distribution and reverse logistics. The study emphasizes the importance of government support, management engagement, and comprehensive implementation of ESCM practices in the industry. Future research should focus on overcoming barriers and challenges to effective ESCM implementation.

Keywords: environmental supply chain, sustainable development goal, ghana pharmaceutical industry, government regulations

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566 Barriers to Social Entrepreneurship by Refugees: An Explorative Study How Prior Experience Influences Social Orientation

Authors: D. M. Koers, A. J. Groen, P. D. Englis, R. Harms

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We are witnessing the largest level of displacement of people since World War II. Refugees want to become independent as quickly as possible and build a new, safe future; however, access to the labor market is difficult and they face many problems that are not easily solved. This makes self-employment including social entrepreneurship a valuable alternative. Our research studied refugee-based entrepreneurship and examined whether prior knowledge, unmet personal needs and contextual factors influence how refugees recognize opportunities and if this influences their social orientation. In addition, we examine the barriers refugees face when starting up a company in the Netherlands. We use a case study design with a mixed-method approach, combining in-depth interviews and survey data. Data was collected from two Dutch entrepreneurial training programs in the Netherlands. We have a sample size of 27 latent refugee entrepreneurs. Our results show that refugees score high on the social entrepreneurial measures. They perceive themselves as having a strong social vision and are determined to defend a social need. They also score high on sustainability and state that their business ideas improve the quality of life on the long run. Based on these findings, we did not expect that only 5 participants had business ideas with a social orientation. In this group, 37,5% started a company before and 77.8% used their personal experience to come up with this business idea. Another 70,3% had the higher professional education or academic education. In the interviews, we found that they often copy and paste their gained experience from a previous profession on their new context and expect that it would work well. The social aspect lies in their cultural values and personal beliefs but is not reflected in their business models. One of the reasons could be that the context in which the refugee operates as a moderator suppressing the social mission and social value creation opportunities. Refugees are first and foremost focused on their survival. They do not want to be on social welfare and feel a strong need to be independent. Since they cannot access the labor market easily and face labor market discrimination they want to start a company. Another factor that explains lack of the social orientation in their business ideas is that social entrepreneurship is not a known concept in their home countries. Their idea of entrepreneurship differs substantially. We found that a huge barrier for refugees is their expectations about setting up a business, which are often not realistic because they have little knowledge about the system, institutions and corresponding red tape. In those instances, can the institutional configuration of a country, cultural differences, and perspective on entrepreneurship hinders social entrepreneurship. In conclusion, there might be latent potential for social entrepreneurship in refugees but there are many barriers to overcome. Overcoming these barriers can enhance local communities and enhance integration. In addition it has a positive financial impact on the host country because it reduces the pressure on the social system and stimulate the economy.

Keywords: immigrant entrepreneurship, refugee entrepreneurship, social entrepreneurship, prior experience, opportunity recognition

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565 Brand Building in Higher Education: A Grounded Theory Investigation of the Impact of the ‘Positive-Visualization-Course in Brand Identity’ upon Freshmen Student's Perception

Authors: Maria Kountouridou, Dino Domic

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Within an increasingly competitive and dynamic environment, the higher education sector is becoming more commodified, with the concept of branding to become exceedingly imperative and an inextricable ingredient for the university’s success. Branding in higher education has proven to be an effective strategy that managed to receive considerable attention in the recent few years, and a growing number of articles have begun to appear in the literature. However, a clear void in the literature confirms that the concept of students’ perceptions towards the university’s brand image has not been researched extensively. An investigation on this central concept is of paramount importance since it will facilitate the development of an inductively generated theoretical model concerning branding in higher education. This research focuses on examining the impact of the ‘positive-visualization-course in brand identity’ upon the perception of freshmen students towards a university’s brand image. A grounded theory methodology has been selected, consisting of semi-structured interviews. Forty-two students have participated in the research, among which twenty-five women and seventeen men. The identification of the sample emerged through the use of the snowball sampling technique. The participants were divided into two groups (experimental and control group) after the researcher had taken into consideration the factor ‘program of study’, to eliminate any possible interaction between the participants of each group. An experiment was carried out where a ‘positive-visualization-course in brand identity’ was conducted among the participants of the experimental group, while the participants of the control group have not been exposed to the course. For the purpose of this research, the term ‘positive-visualization-course in brand identity’ refers to a course where brand history, past achievements/recognitions/awards, its values, and its mission are presented. Prior to the course implementation, face-to-face semi-structured interviews were carried out among the participants of both groups, with the aim of examining the freshmen students’ perceptions towards the university’s brand image. One week after the course implementation, the researcher carried out semi-structured interviews with the participants of the experimental group only in order to identify whether students’ perceptions had been affected after the course completion. Four months after the course completion, semi-structured interviews were carried out among the participants of both groups. Eight months after the course completion, semi-structured interviews were conducted with the aim of identifying the freshmen students’ updated perceptions. Data has been analyzed using substantive coding (open and selective coding), theoretical coding, field memos, and constant comparative analysis. The findings strongly suggest that the ‘positive-visualization-course in brand identity’ can positively affect freshmen students’ perceptions towards a university’s brand image. Additionally, other factors conduce to the formation of perception throughout the months. This study contributes and expands upon the existing literature by presenting an inductively generated theoretical model to guide future research in the links between ‘positive-visualization-course in brand identity’ and the perception of freshmen students towards a university’s brand image.

Keywords: brand image, brand name, branding, higher education marketing, perception

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564 Privacy Paradox and the Internet of Medical Things

Authors: Isabell Koinig, Sandra Diehl

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In recent years, the health-care context has not been left unaffected by technological developments. In recent years, the Internet of Medical Things (IoMT)has not only led to a collaboration between disease management and advanced care coordination but also to more personalized health care and patient empowerment. With more than 40 % of all health technology being IoMT-related by 2020, questions regarding privacy become more prevalent, even more so during COVID-19when apps allowing for an intensive tracking of people’s whereabouts and their personal contacts cause privacy advocates to protest and revolt. There is a widespread tendency that even though users may express concerns and fears about their privacy, they behave in a manner that appears to contradict their statements by disclosing personal data. In literature, this phenomenon is discussed as a privacy paradox. While there are some studies investigating the privacy paradox in general, there is only scarce research related to the privacy paradox in the health sector and, to the authors’ knowledge, no empirical study investigating young people’s attitudes toward data security when using wearables and health apps. The empirical study presented in this paper tries to reduce this research gap by focusing on the area of digital and mobile health. It sets out to investigate the degree of importance individuals attribute to protecting their privacy and individual privacy protection strategies. Moreover, the question to which degree individuals between the ages of 20 and 30 years are willing to grant commercial parties access to their private data to use digital health services and apps are put to the test. To answer this research question, results from 6 focus groups with 40 participants will be presented. The focus was put on this age segment that has grown up in a digitally immersed environment. Moreover, it is particularly the young generation who is not only interested in health and fitness but also already uses health-supporting apps or gadgets. Approximately one-third of the study participants were students. Subjects were recruited in August and September 2019 by two trained researchers via email and were offered an incentive for their participation. Overall, results indicate that the young generation is well informed about the growing data collection and is quite critical of it; moreover, they possess knowledge of the potential side effects associated with this data collection. Most respondents indicated to cautiously handle their data and consider privacy as highly relevant, utilizing a number of protective strategies to ensure the confidentiality of their information. Their willingness to share information in exchange for services was only moderately pronounced, particularly in the health context, since health data was seen as valuable and sensitive. The majority of respondents indicated to rather miss out on using digital and mobile health offerings in order to maintain their privacy. While this behavior might be an unintended consequence, it is an important piece of information for app developers and medical providers, who have to find a way to find a user base for their products against the background of rising user privacy concerns.

Keywords: digital health, privacy, privacy paradox, IoMT

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563 Influence of Interpersonal Communication on Family Planning Practices among Rural Women in South East Nigeria

Authors: Chinwe Okpoko, Vivian Atasie

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One of the leading causes of death amongst women of child-bearing age in southeast Nigeria is pregnancy. Women in the reproductive age group die at a higher rate than men of the same age bracket. Furthermore, most maternal deaths occur among poor women who live in rural communities, and who generally fall within the low socio-economic group in society. Failure of policy makers and the media to create the strategic awareness and communication that conform with the sensibilities of this group account, in part, for the persistence of this malaise. Family planning (FP) is an essential component of safe motherhood, which is designed to ensure that women receive high-quality care to achieve an optimum level of health of mother and infant. The aim is to control the number of children a woman can give birth to and prevent maternal and child mortality and morbidity. This is what sustainable development goal (SDG) health target of World Health Organization (WHO) also strives to achieve. FP programmes reduce exposure to the risks of child-bearing. Indeed, most maternal deaths in the developing world can be prevented by fully investing simultaneously in FP and maternal and new-born care. Given the intrinsic value of communication in health care delivery, it is vital to adopt the most efficacious means of awareness creation and communication amongst rural women in FP. In a country where over 50% of her population resides in rural areas with attendant low-level profile standard of living, the need to communicate health information like FP through indigenous channels becomes pertinent. Interpersonal communication amongst family, friends, religious groups and other associations, is an efficacious means of communicating social issues in rural Africa. Communication in informal settings identifies with the values and social context of the recipients. This study therefore sought to determine the place of interpersonal communication on the knowledge of rural women on FP and how it influences uptake of FP. Descriptive survey design was used in the study, with interviewer administered questionnaire constituting the instrument for data collection. The questionnaire was administered on 385 women from rural communities in southeast Nigeria. The results show that majority (58.5%) of the respondents agreed that interpersonal communication helps women understand how to plan their family size. Many rural women (82%) prefer the short term natural method to the more effective modern contraceptive methods (38.1%). Husbands’ approval of FP, as indicated in the Mean response of 2.56, is a major factor that accounts for the adoption of FP messages among rural women. Socio-demographic data also reveal that educational attainment and/or exposure influenced women’s acceptance or otherwise of FP messages. The study, therefore, recommends amongst others, the targeting of husbands in subsequent FP communication interventions, since they play major role on contraceptive usage.

Keywords: family planning, interpersonal communication, interpersonal interaction, traditional communication

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562 An Evidence-Based Laboratory Medicine (EBLM) Test to Help Doctors in the Assessment of the Pancreatic Endocrine Function

Authors: Sergio J. Calleja, Adria Roca, José D. Santotoribio

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Pancreatic endocrine diseases include pathologies like insulin resistance (IR), prediabetes, and type 2 diabetes mellitus (DM2). Some of them are highly prevalent in the U.S.—40% of U.S. adults have IR, 38% of U.S. adults have prediabetes, and 12% of U.S. adults have DM2—, as reported by the National Center for Biotechnology Information (NCBI). Building upon this imperative, the objective of the present study was to develop a non-invasive test for the assessment of the patient’s pancreatic endocrine function and to evaluate its accuracy in detecting various pancreatic endocrine diseases, such as IR, prediabetes, and DM2. This approach to a routine blood and urine test is based around serum and urine biomarkers. It is made by the combination of several independent public algorithms, such as the Adult Treatment Panel III (ATP-III), triglycerides and glucose (TyG) index, homeostasis model assessment-insulin resistance (HOMA-IR), HOMA-2, and the quantitative insulin-sensitivity check index (QUICKI). Additionally, it incorporates essential measurements such as the creatinine clearance, estimated glomerular filtration rate (eGFR), urine albumin-to-creatinine ratio (ACR), and urinalysis, which are helpful to achieve a full image of the patient’s pancreatic endocrine disease. To evaluate the estimated accuracy of this test, an iterative process was performed by a machine learning (ML) algorithm, with a training set of 9,391 patients. The sensitivity achieved was 97.98% and the specificity was 99.13%. Consequently, the area under the receiver operating characteristic (AUROC) curve, the positive predictive value (PPV), and the negative predictive value (NPV) were 92.48%, 99.12%, and 98.00%, respectively. The algorithm was validated with a randomized controlled trial (RCT) with a target sample size (n) of 314 patients. However, 50 patients were initially excluded from the study, because they had ongoing clinically diagnosed pathologies, symptoms or signs, so the n dropped to 264 patients. Then, 110 patients were excluded because they didn’t show up at the clinical facility for any of the follow-up visits—this is a critical point to improve for the upcoming RCT, since the cost of each patient is very high and for this RCT almost a third of the patients already tested were lost—, so the new n consisted of 154 patients. After that, 2 patients were excluded, because some of their laboratory parameters and/or clinical information were wrong or incorrect. Thus, a final n of 152 patients was achieved. In this validation set, the results obtained were: 100.00% sensitivity, 100.00% specificity, 100.00% AUROC, 100.00% PPV, and 100.00% NPV. These results suggest that this approach to a routine blood and urine test holds promise in providing timely and accurate diagnoses of pancreatic endocrine diseases, particularly among individuals aged 40 and above. Given the current epidemiological state of these type of diseases, these findings underscore the significance of early detection. Furthermore, they advocate for further exploration, prompting the intention to conduct a clinical trial involving 26,000 participants (from March 2025 to December 2026).

Keywords: algorithm, diabetes, laboratory medicine, non-invasive

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561 WASH Governance Opportunity for Inspiring Innovation and a Circular Economy in Karnali Province of Nepal

Authors: Nirajan Shrestha

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Karnali is one of the most vulnerable provinces in Nepal, facing challenges from climate change, poverty, and natural calamities across different regions. In recent years, the province has been severely impacted by climate change stress such as temperature rises in glacier lake of mountainous region and spring source water shortages, particularly in hilly areas where settlements are located, and water sources have depleted from their original ground levels. As a result, Karnali could face a future without enough water for all. Deep causes of sustainable safe water supply have always been neglected in rural areas of Nepal, and communities are unfairly burdened with a challenge of keeping water facilities functioning in areas affected by frequent natural disasters where there is a substantial, well-documented funding gap between the revenues from user payments and the full cost of sustained services. The key importance of a permanent system to support communities in service delivery has been always underrated so far. The complexity of water service sustainability as a topic should be simplified to one clear indicator: the functionality rate, which can be expressed as uptime or the percentage of time that the service is delivered over the total time. For example, a functionality rate of 80% means that the water service is operational 80% of the time, while 20% of the time the system is not functioning. This represents 0.2 multiplied by 365, which equals 73 days every year, or roughly two and a half months without water. This percentage should be widely understood and used in Karnali. All local governments should report their targets and performance in improving it, and there should be a broader discussion about what target is acceptable and what can be realistically achieved. In response to these challenges, the Sustainable WASH for All (SUSWA) project has introduced innovative models and policy formulation strategies in various working local government. SUSWA’s approach, which delegates rural water supply and sanitation responsibilities to local governments, has been instrumental in addressing these issues. To keep pace with the growing demand, the province has adopted a service support center model, linking local governments with federal authorities to ensure effective service delivery to the communities By enhancing WASH governance through local governments engagement, capacity building and inclusive WASH policy frameworks, there is potential to address WASH gaps while fostering a circular economy. This strategy emphasizes resource recovery, waste minimization and the creation of local employment generation opportunities. The research highlights key governance mechanisms, innovative practices and policy interventions that can be scaled up across other regions. It also provides recommendations on how to leverage Karnali’s unique socio-economic and environmental context nature-based solutions to inspire innovation and drive sustainable WASH solutions. Key findings suggest that with strong ownership and leadership of local governments, community engagement and appropriate technology, Karnali Province can become a model for integrating WASH governance with circular economy concept, providing broader lessons for other regions in Nepal.

Keywords: vulnerable provinces, natural calamities, climate change stres, spring source depletion, resources recovery, governance mechanisms, appropriate technology, community engagement, innovation

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560 Development of a Human Skin Explant Model for Drug Metabolism and Toxicity Studies

Authors: K. K. Balavenkatraman, B. Bertschi, K. Bigot, A. Grevot, A. Doelemeyer, S. D. Chibout, A. Wolf, F. Pognan, N. Manevski, O. Kretz, P. Swart, K. Litherland, J. Ashton-Chess, B. Ling, R. Wettstein, D. J. Schaefer

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Skin toxicity is poorly detected during preclinical studies, and drug-induced side effects in humans such as rashes, hyperplasia or more serious events like bullous pemphigus or toxic epidermal necrolysis represent an important hurdle for clinical development. In vitro keratinocyte-based epidermal skin models are suitable for the detection of chemical-induced irritancy, but do not recapitulate the biological complexity of full skin and fail to detect potential serious side-effects. Normal healthy skin explants may represent a valuable complementary tool, having the advantage of retaining the full skin architecture and the resident immune cell diversity. This study investigated several conditions for the maintenance of good morphological structure after several days of culture and the retention of phase II metabolism for 24 hours in skin explants in vitro. Human skin samples were collected with informed consent from patients undergoing plastic surgery and immediately transferred and processed in our laboratory by removing the underlying dermal fat. Punch biopsies of 4 mm diameter were cultured in an air-liquid interface using transwell filters. Different cultural conditions such as the effect of calcium, temperature and cultivation media were tested for a period of 14 days and explants were histologically examined after Hematoxylin and Eosin staining. Our results demonstrated that the use of Williams E Medium at 32°C maintained the physiological integrity of the skin for approximately one week. Upon prolonged incubation, the upper layers of the epidermis become thickened and some dead cells are present. Interestingly, these effects were prevented by addition of EGFR inhibitors such as Afatinib or Erlotinib. Phase II metabolism of the skin such as glucuronidation (4-methyl umbeliferone), sulfation (minoxidil), N-acetyltransferase (p-toluidene), catechol methylation (2,3-dehydroxy naphthalene), and glutathione conjugation (chlorodinitro benzene) were analyzed by using LCMS. Our results demonstrated that the human skin explants possess metabolic activity for a period of at least 24 hours for all the substrates tested. A time course for glucuronidation with 4-methyl umbeliferone was performed and a linear correlation was obtained over a period of 24 hours. Longer-term culture studies will indicate the possible evolution of such metabolic activities. In summary, these results demonstrate that human skin explants maintain a normal structure for several days in vitro and are metabolically active for at least the first 24 hours. Hence, with further characterisation, this model may be suitable for the study of drug-induced toxicity.

Keywords: human skin explant, phase II metabolism, epidermal growth factor receptor, toxicity

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559 The Power-Knowledge Relationship in the Italian Education System between the 19th and 20th Century

Authors: G. Iacoviello, A. Lazzini

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This paper focuses on the development of the study of accounting in the Italian education system between the 19th and 20th centuries. It also focuses on the subsequent formation of a scientific and experimental forma mentis that would prepare students for administrative and managerial activities in industry, commerce and public administration. From a political perspective, the period was characterized by two dominant movements - liberalism (1861-1922) and fascism (1922-1945) - that deeply influenced accounting practices and the entire Italian education system. The materials used in the study include both primary and secondary sources. The primary sources used to inform this study are numerous original documents issued from 1890-1935 by the government and maintained in the Historical Archive of the State in Rome. The secondary sources have supported both the development of the theoretical framework and the definition of the historical context. This paper assigns to the educational system the role of cultural producer. Foucauldian analysis identifies the problem confronted by the critical intellectual in finding a way to deploy knowledge through a 'patient labour of investigation' that highlights the contingency and fragility of the circumstances that have shaped current practices and theories. Education can be considered a powerful and political process providing students with values, ideas, and models that they will subsequently use to discipline themselves, remaining as close to them as possible. It is impossible for power to be exercised without knowledge, just as it is impossible for knowledge not to engender power. The power-knowledge relationship can be usefully employed for explaining how power operates within society, how mechanisms of power affect everyday lives. Power is employed at all levels and through many dimensions including government. Schools exercise ‘epistemological power’ – a power to extract a knowledge of individuals from individuals. Because knowledge is a key element in the operation of power, the procedures applied to the formation and accumulation of knowledge cannot be considered neutral instruments for the presentation of the real. Consequently, the same institutions that produce and spread knowledge can be considered part of the ‘power-knowledge’ interrelation. Individuals have become both objects and subject in the development of knowledge. If education plays a fundamental role in shaping all aspects of communities in the same way, the structural changes resulting from economic, social and cultural development affect the educational systems. Analogously, the important changes related to social and economic development required legislative intervention to regulate the functioning of different areas in society. Knowledge can become a means of social control used by the government to manage populations. It can be argued that the evolution of Italy’s education systems is coherent with the idea that power and knowledge do not exist independently but instead are coterminous. This research aims to reduce such a gap by analysing the role of the state in the development of accounting education in Italy.

Keywords: education system, government, knowledge, power

Procedia PDF Downloads 139
558 Neutrophil-to-Lymphocyte Ratio: A Predictor of Cardiometabolic Complications in Morbid Obese Girls

Authors: Mustafa M. Donma, Orkide Donma

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Obesity is a low-grade inflammatory state. Childhood obesity is a multisystem disease, which is associated with a number of complications as well as potentially negative consequences. Gender is an important universal risk factor for many diseases. Hematological indices differ significantly by gender. This should be considered during the evaluation of obese children. The aim of this study is to detect hematologic indices that differ by gender in morbid obese (MO) children. A total of 134 MO children took part in this study. The parents filled an informed consent form and the approval from the Ethics Committee of Namik Kemal University was obtained. Subjects were divided into two groups based on their genders (64 females aged 10.2±3.1 years and 70 males aged 9.8±2.2 years; p ≥ 0.05). Waist-to-hip as well as head-to-neck ratios and body mass index (BMI) values were calculated. The children, whose WHO BMI-for age and sex percentile values were > 99 percentile, were defined as MO. Hematological parameters [haemoglobin, hematocrit, erythrocyte count, mean corpuscular volume, mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration, red blood cell distribution width, leukocyte count, neutrophil %, lymphocyte %, monocyte %, eosinophil %, basophil %, platelet count, platelet distribution width, mean platelet volume] were determined by the automatic hematology analyzer. SPSS was used for statistical analyses. P ≤ 0.05 was the degree for statistical significance. The groups included children having mean±SD value of BMI as 26.9±3.4 kg/m2 for males and 27.7±4.4 kg/m2 for females (p ≥ 0.05). There was no significant difference between ages of females and males (p ≥ 0.05). Males had significantly increased waist-to-hip ratios (0.95±0.08 vs 0.91±0.08; p=0.005) and mean corpuscular hemoglobin concentration values (33.6±0.92 vs 33.1±0.83; p=0.001) compared to those of females. Significantly elevated neutrophil (4.69±1.59 vs 4.02±1.42; p=0.011) and neutrophil-to-lymphocyte ratios (1.70±0.71 vs 1.39±0.48; p=0.004) were detected in females. There was no statistically significant difference between groups in terms of C-reactive protein values (p ≥ 0.05). Adipose tissue plays important roles during the development of obesity and associated diseases such as metabolic syndrom and cardiovascular diseases (CVDs). These diseases may cause changes in complete blood cell count parameters. These alterations are even more important during childhood. Significant gender effects on the changes of neutrophils, one of the white blood cell subsets, were observed. The findings of the study demonstrate the importance of considering gender in clinical studies. The males and females may have distinct leukocyte-trafficking profiles in inflammation. Female children had more circulating neutrophils, which may be the indicator of an increased risk of CVDs, than male children within this age range during the late stage of obesity. In recent years, females represent about half of deaths from CVDs; therefore, our findings may be the indicator of the increasing tendency of this risk in females starting from childhood.

Keywords: children, gender, morbid obesity, neutrophil-to-lymphocyte ratio

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557 Structural Behavior of Subsoil Depending on Constitutive Model in Calculation Model of Pavement Structure-Subsoil System

Authors: M. Kadela

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The load caused by the traffic movement should be transferred in the road constructions in a harmless way to the pavement as follows: − on the stiff upper layers of the structure (e.g. layers of asphalt: abrading and binding), and − through the layers of principal and secondary substructure, − on the subsoil, directly or through an improved subsoil layer. Reliable description of the interaction proceeding in a system “road construction – subsoil” should be in such case one of the basic requirements of the assessment of the size of internal forces of structure and its durability. Analyses of road constructions are based on: − elements of mechanics, which allows to create computational models, and − results of the experiments included in the criteria of fatigue life analyses. Above approach is a fundamental feature of commonly used mechanistic methods. They allow to use in the conducted evaluations of the fatigue life of structures arbitrarily complex numerical computational models. Considering the work of the system “road construction – subsoil”, it is commonly accepted that, as a result of repetitive loads on the subsoil under pavement, the growth of relatively small deformation in the initial phase is recognized, then this increase disappears, and the deformation takes the character completely reversible. The reliability of calculation model is combined with appropriate use (for a given type of analysis) of constitutive relationships. Phenomena occurring in the initial stage of the system “road construction – subsoil” is unfortunately difficult to interpret in the modeling process. The classic interpretation of the behavior of the material in the elastic-plastic model (e-p) is that elastic phase of the work (e) is undergoing to phase (e-p) by increasing the load (or growth of deformation in the damaging structure). The paper presents the essence of the calibration process of cooperating subsystem in the calculation model of the system “road construction – subsoil”, created for the mechanistic analysis. Calibration process was directed to show the impact of applied constitutive models on its deformation and stress response. The proper comparative base for assessing the reliability of created. This work was supported by the on-going research project “Stabilization of weak soil by application of layer of foamed concrete used in contact with subsoil” (LIDER/022/537/L-4/NCBR/2013) financed by The National Centre for Research and Development within the LIDER Programme. M. Kadela is with the Department of Building Construction Elements and Building Structures on Mining Areas, Building Research Institute, Silesian Branch, Katowice, Poland (phone: +48 32 730 29 47; fax: +48 32 730 25 22; e-mail: m.kadela@ itb.pl). models should be, however, the actual, monitored system “road construction – subsoil”. The paper presents too behavior of subsoil under cyclic load transmitted by pavement layers. The response of subsoil to cyclic load is recorded in situ by the observation system (sensors) installed on the testing ground prepared for this purpose, being a part of the test road near Katowice, in Poland. A different behavior of the homogeneous subsoil under pavement is observed for different seasons of the year, when pavement construction works as a flexible structure in summer, and as a rigid plate in winter. Albeit the observed character of subsoil response is the same regardless of the applied load and area values, this response can be divided into: - zone of indirect action of the applied load; this zone extends to the depth of 1,0 m under the pavement, - zone of a small strain, extending to about 2,0 m.

Keywords: road structure, constitutive model, calculation model, pavement, soil, FEA, response of soil, monitored system

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556 Inputs and Outputs of Innovation Processes in the Colombian Services Sector

Authors: Álvaro Turriago-Hoyos

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Most research tends to see innovation as an explanatory factor in achieving high levels of competitiveness and productivity. More recent studies have begun to analyze the determinants of innovation in the services sector as opposed to the much-discussed industrial sector of a country’s economy. This research paper focuses on the services sector in Colombia, one of Latin America’s fastest growing and biggest economies. Over the past decade, much of Colombia’s economic expansion has relied on commodity exports (mainly oil and coffee) whilst the industrial sector has performed relatively poorly. Such developments highlight the potential of the innovative role played by the services sector of the Colombian economy and its future growth prospects. This research paper analyzes the relationship between inputs, which at the same time are internal sources of innovation (such as R&D activities), and external sources that are improved by technology acquisition. The outputs are basically the four kinds of innovation that the OECD Oslo Manual recognizes: product, process, marketing and organizational innovations. The instrument used to measure this input-output relationship is based on Knowledge Production Function approaches. We run Probit models in order to identify the existing relationships between the above inputs and outputs, but also to identify spill-overs derived from interactions of the components of the value chain of the services firms analyzed: customers, suppliers, competitors, and complementary firms. Data are obtained from the Colombian National Administrative Department of Statistics for the period 2008 to 2013 published in the II and III Colombian National Innovation Survey. A short summary of the results obtained lead to conclude that firm size and a firm’s level of technological development turn out to be important discriminating factors for the description of the innovative process at the firm level. The model’s outcomes show a positive impact on the probability of introducing any kind of innovation both on R&D and Technology Acquisition investment. Also, cooperation agreements with customers, research institutes, competitors, and the suppliers are significant. Belonging to a particular industrial group is an important determinant but only to product and organizational innovation. It is possible to establish that Health Services, Education, Computer, Wholesale trade, and Financial Intermediation are the ISIC sectors, which report the highest number of frequencies of the considered set of firms. Those five sectors of the sixteen considered, in all cases, explained more than half of the total of all kinds of innovations. Product Innovation, which is followed by Marketing Innovation, gets the highest results. Displaying the same set of firms distinguishing by size, and belonging to high and low tech services sector shows that the larger the firms the larger a number of innovations, but also that always high-tech firms show a better innovation performance.

Keywords: Colombia, determinants of innovation, innovation, services sector

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555 Ground Motion Modeling Using the Least Absolute Shrinkage and Selection Operator

Authors: Yildiz Stella Dak, Jale Tezcan

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Ground motion models that relate a strong motion parameter of interest to a set of predictive seismological variables describing the earthquake source, the propagation path of the seismic wave, and the local site conditions constitute a critical component of seismic hazard analyses. When a sufficient number of strong motion records are available, ground motion relations are developed using statistical analysis of the recorded ground motion data. In regions lacking a sufficient number of recordings, a synthetic database is developed using stochastic, theoretical or hybrid approaches. Regardless of the manner the database was developed, ground motion relations are developed using regression analysis. Development of a ground motion relation is a challenging process which inevitably requires the modeler to make subjective decisions regarding the inclusion criteria of the recordings, the functional form of the model and the set of seismological variables to be included in the model. Because these decisions are critically important to the validity and the applicability of the model, there is a continuous interest on procedures that will facilitate the development of ground motion models. This paper proposes the use of the Least Absolute Shrinkage and Selection Operator (LASSO) in selecting the set predictive seismological variables to be used in developing a ground motion relation. The LASSO can be described as a penalized regression technique with a built-in capability of variable selection. Similar to the ridge regression, the LASSO is based on the idea of shrinking the regression coefficients to reduce the variance of the model. Unlike ridge regression, where the coefficients are shrunk but never set equal to zero, the LASSO sets some of the coefficients exactly to zero, effectively performing variable selection. Given a set of candidate input variables and the output variable of interest, LASSO allows ranking the input variables in terms of their relative importance, thereby facilitating the selection of the set of variables to be included in the model. Because the risk of overfitting increases as the ratio of the number of predictors to the number of recordings increases, selection of a compact set of variables is important in cases where a small number of recordings are available. In addition, identification of a small set of variables can improve the interpretability of the resulting model, especially when there is a large number of candidate predictors. A practical application of the proposed approach is presented, using more than 600 recordings from the National Geospatial-Intelligence Agency (NGA) database, where the effect of a set of seismological predictors on the 5% damped maximum direction spectral acceleration is investigated. The set of candidate predictors considered are Magnitude, Rrup, Vs30. Using LASSO, the relative importance of the candidate predictors has been ranked. Regression models with increasing levels of complexity were constructed using one, two, three, and four best predictors, and the models’ ability to explain the observed variance in the target variable have been compared. The bias-variance trade-off in the context of model selection is discussed.

Keywords: ground motion modeling, least absolute shrinkage and selection operator, penalized regression, variable selection

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554 Indigenous Firms Out-leverage other New Zealand firms through Cultural Practices: A Mixed Methods Study

Authors: Jarrod Haar, David Brougham, Azka Ghafoor

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Māori are the indigenous people of Aotearoa (New Zealand) and have a unique perspective called Te Ao Māori (the Māori worldview) and important cultural values around utu (reciprocation), collectivism, long-term orientation, and whanaungatanga (networking, relationships). The present research conducts two studies to better understand how Māori businesses might have similarities and differences to New Zealand businesses. In study 1, we conducted 50 interviews with 25 Māori business owners and 25 New Zealand (non-Māori) owners. For the indigenous population, we used a kaupapa Māori research approach using Māori protocols. This ensured the research is culturally safe. Interviews were conducted around semi-structured questions tapping into the existing business challenges, the role of innovation, and business values and approaches. Transcripts were analyzed using interpretative phenomenological analytic techniques. We identified several themes shared across all business owners: (1) the critical challenge around staff attraction and retention; (2) cost pressures including inflation; (3) and a focus on human resource (HR) practices to address issues including retention. Amongst the Māori businesses, the analysis also identified (4) a unique cultural approach to business relationships. Specifically, amongst the indigenous businesses we find a strong Te Ao Māori perspective amongst Māori business towards innovation. Analysis within this group only identified, within the following sub-themes: (a) whanaungatanga, around the development of strong relationships as a way to aid recruitment and retention, and business fluctuations; (b) mātauranga (knowledge) whereby Māori businesses seek to access advanced knowledge via universities; (c) taking a long-term orientation to business relationships – including with universities. The findings suggest people practices might be a way that firms address workforce retention issues, and we also acknowledge that Māori businesses might also leverage cultural practices to achieve better gains. Thus, in study 2, we survey 606 New Zealand private sector firms including 85 who self-identify as Māori Firms. We test the benefits of high-performance work-systems (HPWS), which represent bundle of human-resource practices designed to bolster workforce productivity through enhancing knowledge, skills, abilities, and commitment of the workforce. We test these on workforce retention and include Māori firm status and cultural capital (reflecting workforce knowledge around Māori cultural values) as moderators. Overall, we find all firms achieve superior workforce retention when they have high levels of HPWS, but Māori firms with high cultural capital are better able to leverage these HR practices to achieve superior workforce retention. In summary, the present study highlights how indigenous businesses in New Zealand might achieve superior performance by leveraging their unique cultural values. The study provides unique insights into established literatures around retention and HR practices and highlights the lessons around indigenous cultural values that appear to aid businesses.

Keywords: Māori business, cultural values, employee retention, human resource practices

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553 An Approach to Addressing Homelessness in Hong Kong: Life Story Approach

Authors: Tak Mau Simon Chan, Ying Chuen Lance Chan

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Homelessness has been a popular and controversial debate in Hong Kong, a city which is densely populated and well-known for very expensive housing. The constitution of the homeless as threats to the community and environmental hygiene is ambiguous and debatable in the Hong Kong context. The lack of an intervention model is the critical research gap thus far, aside from the tangible services delivered. The life story approach (LSA), with its unique humanistic orientation, has been well applied in recent decades to depict the needs of various target groups, but not the homeless. It is argued that the life story approach (LSA), which has been employed by health professionals in the landscape of dementia, and health and social care settings, can be used as a reference in the local Chinese context through indigenization. This study, therefore, captures the viewpoints of service providers and users by constructing an indigenous intervention model that refers to the LSA in serving the chronically homeless. By informing 13 social workers and 27 homeless individuals in 8 focus groups whilst 12 homeless individuals have participated in individual in-depth interviews, a framework of LSA in homeless people is proposed. Through thematic analysis, three main themes of their life stories was generated, namely, the family, negative experiences and identity transformation. The three domains solidified framework that not only can be applied to the homeless, but also other disadvantaged groups in the Chinese context. Based on the three domains of family, negative experiences and identity transformation, the model is applied in the daily practices of social workers who help the homeless. The domain of family encompasses familial relationships from the past to the present to the speculated future with ten sub-themes. The domain of negative experiences includes seven sub-themes, with reference to the deviant behavior committed. The last domain, identity transformation, incorporates the awareness and redefining of one’s identity and there are a total of seven sub-themes. The first two domains are important components of personal histories while the third is more of an unknown, exploratory and yet to-be-redefined territory which has a more positive and constructive orientation towards developing one’s identity and life meaning. The longitudinal temporal dimension of moving from the past – present - future enriches the meaning making process, facilitates the integration of life experiences and maintains a more hopeful dialogue. The model is tested and its effectiveness is measured by using qualitative and quantitative methods to affirm the extent that it is relevant to the local context. First, it contributes to providing a clear guideline for social workers who can use the approach as a reference source. Secondly, the framework acts as a new intervention means to address problem saturated stories and the intangible needs of the homeless. Thirdly, the model extends the application to beyond health related issues. Last but not least, the model is highly relevant to the local indigenous context.

Keywords: homeless, indigenous intervention, life story approach, social work practice

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552 Case Report: A Rare Presentation of Fowler's Syndrome in Pregnancy with Mitrofanoff Procedure

Authors: Humaira Saeed Malik, Salma Saad

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Introduction: Fowler's syndrome, first described by Clare Fowler in 1985, is a rare urological condition characterized by difficulty in urination due to the abnormal function of the urethral sphincter. It predominantly affects young women and leads to chronic urinary retention. The main concern in managing this condition is ensuring regular bladder emptying. Clam cystoplasty is a bladder augmentation surgery in which the bladder is clam-shelled open, and a segment of the intestine is used to increase the bladder's capacity and reduce bladder pressure. The Mitrofanoff procedure, a surgical creation of a continent urinary diversion, is often performed in patients with Fowler's syndrome who require long-term catheterization. This procedure involves creating a conduit (from the appendix or a segment of the small intestine) between the bladder and the skin, allowing for intermittent self-catheterization to manage urinary retention. Study: This case study examines a 39-year-old gravida 3, para 0+2 woman with a BMI of 40, Fowler's syndrome, type I diabetes, and post-traumatic stress disorder (PTSD), presenting at Dumfries and Galloway Royal Infirmary at 8 weeks of gestation. Diagnosed with Fowler's syndrome at 23, . A sacral nerve stimulator (SNS) device was initially placed but was subsequently removed after one year due to malfunction caused by trauma, subsequently she had undergone clam cystoplasty and the Mitrofanoff procedure for bladder management. Her pregnancy was complicated by vaginal bleeding at 10 weeks, treated with progesterone pessaries, and a urinary tract infection at 14 weeks, managed with antibiotics. Despite these challenges, she continued self-catheterization through the Mitrofanoff stoma and was placed on prophylactic antibiotics. Her diabetes was well-controlled on insulin, and a 20-week fetal anomaly scan was normal. The multidisciplinary team, including an obstetrician and a urologist, planned for serial growth scans and the initiation of low molecular weight heparin (LMWH) from 28 weeks due to the intermediate risk of venous thromboembolism (VTE) and to continue six weeks after delivery. A planned cesarean delivery at 37 weeks was arranged, with an MRI scan scheduled later in the pregnancy to assist in surgical planning, ensuring the preservation of the Mitrofanoff stoma's function. The surgery will occur in an elective setting and include a consultant urologist. Conclusion: Pregnancy in women with Fowler's syndrome who have undergone Clam cystoplasty and the Mitrofanoff procedure is rare, and management requires careful planning and a multidisciplinary approach. This case highlights the importance of individualized care plans and close monitoring of both mother and fetus. The patient's risk of recurrent UTIs, coupled with her diabetes and high BMI, necessitated coordinated care across specialties to ensure the best possible outcomes. The Mitrofanoff procedure proved effective in managing her urinary retention, allowing her to maintain self-catheterization during pregnancy. The multidisciplinary team approach was crucial in addressing her complex medical needs, involving obstetrics, urology, and endocrinology. This case adds valuable information to the limited literature on pregnancy management in patients with Fowler's syndrome who have undergone the Mitrofanoff procedure, highlighting the need for comprehensive, individualized care and the involvement of a multidisciplinary team to achieve the best results.

Keywords: fowler's syndrome, clam cystoplasty, mitrofanoff procedure, pregnancy

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551 Decarbonising Urban Building Heating: A Case Study on the Benefits and Challenges of Fifth-Generation District Heating Networks

Authors: Mazarine Roquet, Pierre Dewallef

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The building sector, both residential and tertiary, accounts for a significant share of greenhouse gas emissions. In Belgium, partly due to poor insulation of the building stock, but certainly because of the massive use of fossil fuels for heating buildings, this share reaches almost 30%. To reduce carbon emissions from urban building heating, district heating networks emerge as a promising solution as they offer various assets such as improving the load factor, integrating combined heat and power systems, and enabling energy source diversification, including renewable sources and waste heat recovery. However, mainly for sake of simple operation, most existing district heating networks still operate at high or medium temperatures ranging between 120°C and 60°C (the socalled second and third-generations district heating networks). Although these district heating networks offer energy savings in comparison with individual boilers, such temperature levels generally require the use of fossil fuels (mainly natural gas) with combined heat and power. The fourth-generation district heating networks improve the transport and energy conversion efficiency by decreasing the operating temperature between 50°C and 30°C. Yet, to decarbonise the building heating one must increase the waste heat recovery and use mainly wind, solar or geothermal sources for the remaining heat supply. Fifth-generation networks operating between 35°C and 15°C offer the possibility to decrease even more the transport losses, to increase the share of waste heat recovery and to use electricity from renewable resources through the use of heat pumps to generate low temperature heat. The main objective of this contribution is to exhibit on a real-life test case the benefits of replacing an existing third-generation network by a fifth-generation one and to decarbonise the heat supply of the building stock. The second objective of the study is to highlight the difficulties resulting from the use of a fifth-generation, low-temperature, district heating network. To do so, a simulation model of the district heating network including its regulation is implemented in the modelling language Modelica. This model is applied to the test case of the heating network on the University of Liège's Sart Tilman campus, consisting of around sixty buildings. This model is validated with monitoring data and then adapted for low-temperature networks. A comparison of primary energy consumptions as well as CO2 emissions is done between the two cases to underline the benefits in term of energy independency and GHG emissions. To highlight the complexity of operating a lowtemperature network, the difficulty of adapting the mass flow rate to the heat demand is considered. This shows the difficult balance between the thermal comfort and the electrical consumption of the circulation pumps. Several control strategies are considered and compared to the global energy savings. The developed model can be used to assess the potential for energy and CO2 emissions savings retrofitting an existing network or when designing a new one.

Keywords: building simulation, fifth-generation district heating network, low-temperature district heating network, urban building heating

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550 The Influence of the State on the Internal Governance of Universities: A Comparative Study of Quebec (Canada) and Western Systems

Authors: Alexandre Beaupré-Lavallée, Pier-André Bouchard St-Amant, Nathalie Beaulac

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The question of internal governance of universities is a political and scientific debate in the province of Quebec (Canada). Governments have called or set up inquiries on the subject on three separate occasions since the complete overhaul of the educational system in the 1960s: the Parent Commission (1967), the Angers Commission (1979) and the Summit on Higher Education (2013). All three produced reports that highlight the constant tug-of-war for authority and legitimacy within universities. Past and current research that cover Quebec universities have studied several aspects regarding internal governance: the structure as a whole or only some parts of it, the importance of certain key aspects such as collegiality or strategic planning, or of stakeholders, such as students or administrators. External governance has also been studied, though, as with internal governance, research so far as only covered well delineated topics like financing policies or overall impacts from wider societal changes such as New Public Management. The latter, NPM, is often brought up as a factor that influenced overall State policies like “steering-at-a-distance” or internal shifts towards “managerialism”. Yet, to the authors’ knowledge, there is not study that specifically maps how the Quebec State formally influences internal governance. In addition, most studies about the Quebec university system are not comparative in nature. This paper presents a portion of the results produced by a 2022- 2023 study that aims at filling these last two gaps in knowledge. Building on existing governmental, institutional, and scientific papers, we documented the legal and regulatory framework of the Quebec university system and of twenty-one other university systems in North America and Europe (2 in Canada, 2 in the USA, 16 in Europe, with the addition of the European Union as a distinct case). This allowed us to map the presence (or absence) of mandatory structures of governance enforced by States, as well as their composition. Then, using Clark’s “triangle of coordination”, we analyzed each system to assess the relative influences of the market, the State and the collegium upon the governance model put in place. Finally, we compared all 21 non-Quebec systems to characterize the province’s policies in an internal perspective. Preliminary findings are twofold. First, when all systems are placed on a continuum ranging from “no State interference in internal governance” to “State-run universities”, Quebec comes in the middle of the pack, albeit with a slight lean towards institutional freedom. When it comes to overall governance (like Boards and Senates), the dual nature of the Quebec system, with its public university and its coopted yet historically private (or ecclesiastic) institutions, in fact mimics the duality of all university systems. Second, however, is the sheer abundance of legal and regulatory mandates from the State that, while not expressly addressing internal governance, seems to require de facto modification of internal governance structure and dynamics to ensure institutional conformity with said mandates. This study is only a fraction of the research that is needed to better understand State-universities interactions regarding governance. We hope it will set the stage for future studies.

Keywords: internal governance, legislation, Quebec, universities

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549 Inflation and Deflation of Aircraft's Tire with Intelligent Tire Pressure Regulation System

Authors: Masoud Mirzaee, Ghobad Behzadi Pour

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An aircraft tire is designed to tolerate extremely heavy loads for a short duration. The number of tires increases with the weight of the aircraft, as it is needed to be distributed more evenly. Generally, aircraft tires work at high pressure, up to 200 psi (14 bar; 1,400 kPa) for airliners and higher for business jets. Tire assemblies for most aircraft categories provide a recommendation of compressed nitrogen that supports the aircraft’s weight on the ground, including a mechanism for controlling the aircraft during taxi, takeoff; landing; and traction for braking. Accurate tire pressure is a key factor that enables tire assemblies to perform reliably under high static and dynamic loads. Concerning ambient temperature change, considering the condition in which the temperature between the origin and destination airport was different, tire pressure should be adjusted and inflated to the specified operating pressure at the colder airport. This adjustment superseding the normal tire over an inflation limit of 5 percent at constant ambient temperature is required because the inflation pressure remains constant to support the load of a specified aircraft configuration. On the other hand, without this adjustment, a tire assembly would be significantly under/over-inflated at the destination. Due to an increase of human errors in the aviation industry, exorbitant costs are imposed on the airlines for providing consumable parts such as aircraft tires. The existence of an intelligent system to adjust the aircraft tire pressure based on weight, load, temperature, and weather conditions of origin and destination airports, could have a significant effect on reducing the aircraft maintenance costs, aircraft fuel and further improving the environmental issues related to the air pollution. An intelligent tire pressure regulation system (ITPRS) contains a processing computer, a nitrogen bottle with 1800 psi, and distribution lines. Nitrogen bottle’s inlet and outlet valves are installed in the main wheel landing gear’s area and are connected through nitrogen lines to main wheels and nose wheels assy. Controlling and monitoring of nitrogen will be performed by a computer, which is adjusted according to the calculations of received parameters, including the temperature of origin and destination airport, the weight of cargo loads and passengers, fuel quantity, and wind direction. Correct tire inflation and deflation are essential in assuring that tires can withstand the centrifugal forces and heat of normal operations, with an adequate margin of safety for unusual operating conditions such as rejected takeoff and hard landings. ITPRS will increase the performance of the aircraft in all phases of takeoff, landing, and taxi. Moreover, this system will reduce human errors, consumption materials, and stresses imposed on the aircraft body.

Keywords: avionic system, improve efficiency, ITPRS, human error, reduced cost, tire pressure

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548 Smart Laboratory for Clean Rivers in India - An Indo-Danish Collaboration

Authors: Nikhilesh Singh, Shishir Gaur, Anitha K. Sharma

Abstract:

Climate change and anthropogenic stress have severely affected ecosystems all over the globe. Indian rivers are under immense pressure, facing challenges like pollution, encroachment, extreme fluctuation in the flow regime, local ignorance and lack of coordination between stakeholders. To counter all these issues a holistic river rejuvenation plan is needed that tests, innovates and implements sustainable solutions in the river space for sustainable river management. Smart Laboratory for Clean Rivers (SLCR) an Indo-Danish collaboration project, provides a living lab setup that brings all the stakeholders (government agencies, academic and industrial partners and locals) together to engage, learn, co-creating and experiment for a clean and sustainable river that last for ages. Just like every mega project requires piloting, SLCR has opted for a small catchment of the Varuna River, located in the Middle Ganga Basin in India. Considering the integrated approach of river rejuvenation, SLCR embraces various techniques and upgrades for rejuvenation. Likely, maintaining flow in the channel in the lean period, Managed Aquifer Recharge (MAR) is a proven technology. In SLCR, Floa-TEM high-resolution lithological data is used in MAR models to have better decision-making for MAR structures nearby of the river to enhance the river aquifer exchanges. Furthermore, the concerns of quality in the river are a big issue. A city like Varanasi which is located in the last stretch of the river, generates almost 260 MLD of domestic waste in the catchment. The existing STP system is working at full efficiency. Instead of installing a new STP for the future, SLCR is upgrading those STPs with an IoT-based system that optimizes according to the nutrient load and energy consumption. SLCR also advocate nature-based solutions like a reed bed for the drains having less flow. In search of micropollutants, SLCR uses fingerprint analysis involves employing advanced techniques like chromatography and mass spectrometry to create unique chemical profiles. However, rejuvenation attempts cannot be possible without involving the entire catchment. A holistic water management plan that includes storm management, water harvesting structure to efficiently manage the flow of water in the catchment and installation of several buffer zones to restrict pollutants entering into the river. Similarly, carbon (emission and sequestration) is also an important parameter for the catchment. By adopting eco-friendly practices, a ripple effect positively influences the catchment's water dynamics and aids in the revival of river systems. SLCR has adopted 4 villages to make them carbon-neutral and water-positive. Moreover, for the 24×7 monitoring of the river and the catchment, robust IoT devices are going to be installed to observe, river and groundwater quality, groundwater level, river discharge and carbon emission in the catchment and ultimately provide fuel for the data analytics. In its completion, SLCR will provide a river restoration manual, which will strategise the detailed plan and way of implementation for stakeholders. Lastly, the entire process is planned in such a way that will be managed by local administrations and stakeholders equipped with capacity-building activity. This holistic approach makes SLCR unique in the field of river rejuvenation.

Keywords: sustainable management, holistic approach, living lab, integrated river management

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547 Seismic Assessment of Flat Slab and Conventional Slab System for Irregular Building Equipped with Shear Wall

Authors: Muhammad Aji Fajari, Ririt Aprilin Sumarsono

Abstract:

Particular instability of structural building under lateral load (e.g earthquake) will rise due to irregularity in vertical and horizontal direction as stated in SNI 03-1762-2012. The conventional slab has been considered for its less contribution in increasing the stability of the structure, except special slab system such as flat slab turned into account. In this paper, the analysis of flat slab system at Sequis Tower located in South Jakarta will be assessed its performance under earthquake. It consists of 6 floors of the basement where the flat slab system is applied. The flat slab system will be the main focus in this paper to be compared for its performance with conventional slab system under earthquake. Regarding the floor plan of Sequis Tower basement, re-entrant corner signed for this building is 43.21% which exceeded the allowable re-entrant corner is 15% as stated in ASCE 7-05 Based on that, the horizontal irregularity will be another concern for analysis, otherwise vertical irregularity does not exist for this building. Flat slab system is a system where the slabs use drop panel with shear head as their support instead of using beams. Major advantages of flat slab application are decreasing dead load of structure, removing beams so that the clear height can be maximized, and providing lateral resistance due to lateral load. Whilst, deflection at middle strip and punching shear are problems to be detail considered. Torsion usually appears when the structural member under flexure such as beam or column dimension is improper in ratio. Considering flat slab as alternative slab system will keep the collapse due to torsion down. Common seismic load resisting system applied in the building is a shear wall. Installation of shear wall will keep the structural system stronger and stiffer affecting in reduced displacement under earthquake. Eccentricity of shear wall location of this building resolved the instability due to horizontal irregularity so that the earthquake load can be absorbed. Performing linear dynamic analysis such as response spectrum and time history analysis due to earthquake load is suitable as the irregularity arise so that the performance of structure can be significantly observed. Utilization of response spectrum data for South Jakarta which PGA 0.389g is basic for the earthquake load idealization to be involved in several load combinations stated on SNI 03-1726-2012. The analysis will result in some basic seismic parameters such as period, displacement, and base shear of the system; besides the internal forces of the critical member will be presented. Predicted period of a structure under earthquake load is 0.45 second, but as different slab system applied in the analysis then the period will show a different value. Flat slab system will probably result in better performance for the displacement parameter compare to conventional slab system due to higher contribution of stiffness to the whole system of the building. In line with displacement, the deflection of the slab will result smaller for flat slab than a conventional slab. Henceforth, shear wall will be effective to strengthen the conventional slab system than flat slab system.

Keywords: conventional slab, flat slab, horizontal irregularity, response spectrum, shear wall

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546 Literacy Practices in Immigrant Detention Centers: A Conceptual Exploration of Access, Resistance, and Connection

Authors: Mikel W. Cole, Stephanie M. Madison, Adam Henze

Abstract:

Since 2004, the U.S. immigrant detention system has imprisoned more than five million people. President John F. Kennedy famously dubbed this country a “Nation of Immigrants.” Like many of the nation’s imagined ideals, the historical record finds its practices have never lived up to the tenets championed as defining qualities.The United Nations High Commission on Refugees argues the educational needs of people in carceral spaces, especially those in immigrant detention centers, are urgent and supported by human rights guarantees. However, there is a genuine dearth of literacy research in immigrant detention centers, compounded by a general lack of access to these spaces. Denying access to literacy education in detention centers is one way the history of xenophobic immigration policy persists. In this conceptual exploration, first-hand accounts from detained individuals, their families, and the organizations that work with them have been shared with the authors. In this paper, the authors draw on experiences, reflections, and observations from serving as volunteers to develop a conceptual framework for the ways in which literacy practices are enacted in detention centers. Literacy is an essential tool for accessing those detained in immigrant detention centers and a critical tool for those being detained to access legal and other services. One of the most striking things about the detention center is how to behave; gaining access for a visit is neither intuitive nor straightforward. The men experiencing detention are also at a disadvantage. The lack of access to their own documents is a profound barrier to men navigating the complex immigration process. Literacy is much more than a skill for gathering knowledge or accessing carceral spaces; literacy is fundamentally a source of personal empowerment. Frequently men find a way to reclaim their sense of dignity through work on their own terms by exchanging their literacy services for products or credits at the commissary. They write cards and letters for fellow detainees, read mail, and manage the exchange of information between the men and their families. In return, the men who have jobs trade items from the commissary or transfer money to the accounts of the men doing the reading, writing, and drawing. Literacy serves as a form of resistance by providing an outlet for productive work. At its core, literacy is the exchange of ideas between an author and a reader and is a primary source of human connection for individuals in carceral spaces. Father’s Day and Christmas are particularly difficult at detention centers. Men weep when speaking about their children and the overwhelming hopelessness they feel by being separated from them. Yet card-writing campaigns have provided these men with words of encouragement as thousands of hand-written cards make their way to the detention center. There are undoubtedly more literacies being practiced in the immigrant detention center where we work and at other detention centers across the country, and these categories are early conceptions with which we are still wrestling.

Keywords: detention centers, education, immigration, literacy

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545 Use of Analytic Hierarchy Process for Plant Site Selection

Authors: Muzaffar Shaikh, Shoaib Shaikh, Mark Moyou, Gaby Hawat

Abstract:

This paper presents the use of Analytic Hierarchy Process (AHP) in evaluating the site selection of a new plant by a corporation. Due to intense competition at a global level, multinational corporations are continuously striving to minimize production and shipping costs of their products. One key factor that plays significant role in cost minimization is where the production plant is located. In the U.S. for example, labor and land costs continue to be very high while they are much cheaper in countries such as India, China, Indonesia, etc. This is why many multinational U.S. corporations (e.g. General Electric, Caterpillar Inc., Ford, General Motors, etc.), have shifted their manufacturing plants outside. The continued expansion of the Internet and its availability along with technological advances in computer hardware and software all around the globe have facilitated U.S. corporations to expand abroad as they seek to reduce production cost. In particular, management of multinational corporations is constantly engaged in concentrating on countries at a broad level, or cities within specific countries where certain or all parts of their end products or the end products themselves can be manufactured cheaper than in the U.S. AHP is based on preference ratings of a specific decision maker who can be the Chief Operating Officer of a company or his/her designated data analytics engineer. It serves as a tool to first evaluate the plant site selection criteria and second, alternate plant sites themselves against these criteria in a systematic manner. Examples of site selection criteria are: Transportation Modes, Taxes, Energy Modes, Labor Force Availability, Labor Rates, Raw Material Availability, Political Stability, Land Costs, etc. As a necessary first step under AHP, evaluation criteria and alternate plant site countries are identified. Depending upon the fidelity of analysis, specific cities within a country can also be chosen as alternative facility locations. AHP experience in this type of analysis indicates that the initial analysis can be performed at the Country-level. Once a specific country is chosen via AHP, secondary analyses can be performed by selecting specific cities or counties within a country. AHP analysis is usually based on preferred ratings of a decision-maker (e.g., 1 to 5, 1 to 7, or 1 to 9, etc., where 1 means least preferred and a 5 means most preferred). The decision-maker assigns preferred ratings first, criterion vs. criterion and creates a Criteria Matrix. Next, he/she assigns preference ratings by alternative vs. alternative against each criterion. Once this data is collected, AHP is applied to first get the rank-ordering of criteria. Next, rank-ordering of alternatives is done against each criterion resulting in an Alternative Matrix. Finally, overall rank ordering of alternative facility locations is obtained by matrix multiplication of Alternative Matrix and Criteria Matrix. The most practical aspect of AHP is the ‘what if’ analysis that the decision-maker can conduct after the initial results to provide valuable sensitivity information of specific criteria to other criteria and alternatives.

Keywords: analytic hierarchy process, multinational corporations, plant site selection, preference ratings

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544 Networked Media, Citizen Journalism and Political Participation in Post-Revolutionary Tunisia: Insight from a European Research Project

Authors: Andrea Miconi

Abstract:

The research will focus on the results of the Tempus European Project eMEDia dedicated to Cross-Media Journalism. The project is founded by the European Commission as it involves four European partners - IULM University, Tampere University, University of Barcelona, and the Mediterranean network Unimed - and three Tunisian Universities – IPSI La Manouba, Sfax and Sousse – along with the Tunisian Ministry for Higher Education and the National Syndicate of Journalists. The focus on Tunisian condition is basically due to the role played by digital activists in its recent history. The research is dedicated to the relationship between political participation, news-making practices and the spread of social media, as it is affecting Tunisian society. As we know, Tunisia during the Arab Spring had been widely considered as a laboratory for the analysis the use of new technologies for political participation. Nonetheless, the literature about the Arab Spring actually fell short in explaining the genesis of the phenomenon, on the one hand by isolating technologies as a casual factor in the spread of demonstrations, and on the other by analyzing North-African condition through a biased perspective. Nowadays, it is interesting to focus on the consolidation of the information environment three years after the uprisings. And what is relevant, only a close, in-depth analysis of Tunisian society is able to provide an explanation of its history, and namely of the part of digital media in the overall evolution of political system. That is why the research is based on different methodologies: desk stage, interviews, and in-depth analysis of communication practices. Networked journalism is the condition determined by the technological innovation on news-making activities: a condition upon which professional journalist can no longer be considered the only player in the information arena, and a new skill must be developed. Along with democratization, nonetheless, the so-called citizen journalism is also likely to produce some ambiguous effects, such as the lack of professional standards and the spread of information cascades, which may prove to be particularly dangerous in an evolving media market as the Tunisian one. This is why, according to the project, a new profile must be defined, which is able to manage this new condition, and which can be hardly reduced to the parameters of traditional journalistic work. Rather than simply using new devices for news visualization, communication professionals must also be able to dialogue with all new players and to accept the decentralized nature of digital environments. This networked nature of news-making seemed to emerge during the Tunisian revolution, when bloggers, journalists, and activists used to retweet each other. Nonetheless, this intensification of communication exchange was inspired by the political climax of the uprising, while all media, by definition, are also supposed to bring some effects on people’s state of mind, culture and daily life routines. That is why it is worth analyzing the consolidation of these practices in a normal, post-revolutionary situation.

Keywords: cross-media, education, Mediterranean, networked journalism, social media, Tunisia

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543 Development of Three-Dimensional Bio-Reactor Using Magnetic Field Stimulation to Enhance PC12 Cell Axonal Extension

Authors: Eiji Nakamachi, Ryota Sakiyama, Koji Yamamoto, Yusuke Morita, Hidetoshi Sakamoto

Abstract:

The regeneration of injured central nerve network caused by the cerebrovascular accidents is difficult, because of poor regeneration capability of central nerve system composed of the brain and the spinal cord. Recently, new regeneration methods such as transplant of nerve cells and supply of nerve nutritional factor were proposed and examined. However, there still remain many problems with the canceration of engrafted cells and so on and it is strongly required to establish an efficacious treating method of a central nerve system. Blackman proposed the electromagnetic stimulation method to enhance the axonal nerve extension. In this study, we try to design and fabricate a new three-dimensional (3D) bio-reactor, which can load a uniform AC magnetic field stimulation on PC12 cells in the extracellular environment for enhancement of an axonal nerve extension and 3D nerve network generation. Simultaneously, we measure the morphology of PC12 cell bodies, axons, and dendrites by the multiphoton excitation fluorescence microscope (MPM) and evaluate the effectiveness of the uniform AC magnetic stimulation to enhance the axonal nerve extension. Firstly, we designed and fabricated the uniform AC magnetic field stimulation bio-reactor. For the AC magnetic stimulation system, we used the laminated silicon steel sheets for a yoke structure of 3D chamber, which had a high magnetic permeability. Next, we adopted the pole piece structure and installed similar specification coils on both sides of the yoke. We searched an optimum pole piece structure using the magnetic field finite element (FE) analyses and the response surface methodology. We confirmed that the optimum 3D chamber structure showed a uniform magnetic flux density in the PC12 cell culture area by using FE analysis. Then, we fabricated the uniform AC magnetic field stimulation bio-reactor by adopting analytically determined specifications, such as the size of chamber and electromagnetic conditions. We confirmed that measurement results of magnetic field in the chamber showed a good agreement with FE results. Secondly, we fabricated a dish, which set inside the uniform AC magnetic field stimulation of bio-reactor. PC12 cells were disseminated with collagen gel and could be 3D cultured in the dish. The collagen gel were poured in the dish. The collagen gel, which had a disk shape of 6 mm diameter and 3mm height, was set on the membrane filter, which was located at 4 mm height from the bottom of dish. The disk was full filled with the culture medium inside the dish. Finally, we evaluated the effectiveness of the uniform AC magnetic field stimulation to enhance the nurve axonal extension. We confirmed that a 6.8 increase in the average axonal extension length of PC12 under the uniform AC magnetic field stimulation at 7 days culture in our bio-reactor, and a 24.7 increase in the maximum axonal extension length. Further, we confirmed that a 60 increase in the number of dendrites of PC12 under the uniform AC magnetic field stimulation. Finally, we confirm the availability of our uniform AC magnetic stimulation bio-reactor for the nerve axonal extension and the nerve network generation.

Keywords: nerve regeneration, axonal extension , PC12 cell, magnetic field, three-dimensional bio-reactor

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542 Prevalence and Associated Risk Factors of Age-Related Macular Degeneration in the Retina Clinic at a Tertiary Center in Makkah Province, Saudi Arabia: A Retrospective Record Review

Authors: Rahaf Mandura, Fatmah Abusharkh, Layan Kurdi, Rahaf Shigdar, Khadijah Alattas

Abstract:

Introduction: Age-related macular degeneration (AMD) in older individuals are serious health issues that severely impact the quality of life of millions globally. In 2020, the fourth leading cause of blindness worldwide was AMD. The global prevalence of AMD is estimated to be around 8.7%. AMD is a progressive disease involving the macular region of the retina, and it has a complex pathophysiology. RPE cell dysfunction plays a crucial step in the pathway leading to irreversible degeneration of photoreceptors with yellowish lipid-rich, protein-containing drusen deposits accumulating between Bruch's membrane and the RPE. Furthermore, lipofuscinogenesis, drusogenesis, inflammation, and neovascularization are four main processes responsible for the formation of the two types of AMD: the wet (exudative, neovascular) and dry (non-exudative, geographic atrophy) types. We retrospectively evaluated the prevalence of AMD among patients visiting the retina clinic at King Abdulaziz University Hospital (Jeddah, Makkah Province, Saudi Arabia) to identify the commonly associated risk factors of AMD. Methods: The records of 3,067 individuals from 2017 to 2021 were reviewed. Of these, 1,935 satisfied the inclusion criteria and were included in this study. We excluded all patient below 18 years, and those who did not undergo fundus imaging or attend their booked appointments, follow-ups, treatments, and referrals were excluded. Results: The prevalence of AMD among the patients was 4%. The age of patients with AMD was significantly greater than those without AMD (72.4 ± 9.8 years vs. 57.2 ± 15.5 years; p < 0.001). Participants with a family history of AMD tended to have the disease more than those without such a history (85.7% vs. 45%; p = 0.043). Ex- and current smokers were more likely to have AMD than non-smokers (34% and 18.6% vs. 7.2%; p < 0.001). Patients with hypertension and those without type 1 diabetes were at a higher risk of developing AMD than those without hypertension (5.5% vs. 2.8%; p = 0.002) and those with type 1 diabetes (4.2% vs. 0.8%; p = 0.040). In contrast, sex, nationality, type 2 diabetes, and abnormal lipid profile were not significantly associated with AMD. Regarding the clinical characteristics of AMD cases, most cases (70.4%) were of the dry type and affected both eyes (77.2%). The disease duration was ≥5 years in 43.1% of the patients. The most frequent chronic diseases associated with AMD were type 2 diabetes (69.1%), hypertension (61.7%), and dyslipidemia (18.5%). Conclusion: In summary, our single tertiary center study showed that AMD is widely prevalent in Jeddah, Saudi Arabia (4%) and linked to a wide range of risk factors. Some of these are modifiable risk factors that can be adjusted to help reduce AMD occurrence. Furthermore, this study has shown the importance of screening and follow-up of family members of patients with AMD to promote early detection and intervention of AMD. We recommend conducting further research on AMD in Saudi Arabia. Concerning the study design, a community-based cross-sectional study would be more helpful for assessing the disease's prevalence. Finally, recruiting a larger sample size is required for more accurate estimation.

Keywords: age related macular degeneration, prevelence, risk factor, dry AMD

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