Search results for: water quality standards

Authors: Ibrahim Burki

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Unfortunately, all organizations (Industrial and Humanitarian/ Non-governmental organizations) are prone to fraud and corruption in their supply chain management routines. The reputational and financial fallout can be disastrous. With the growing number of companies using suppliers based in the local market has certainly increased the threat of fraud as well as corruption. There are various potential threats like, poor or non-existent record keeping, purchasing of lower quality goods at higher price, excessive entertainment of staff by suppliers, deviations in communications between procurement staff and suppliers, such as calls or text messaging to mobile phones, staff demanding extended periods of notice before they allow an audit to take place, inexperienced buyers and more. But despite all the above-mentioned threats, this research paper emphasize upon the effectiveness of well-maintained vendor/s records and sorting/filtration of vendor/s to cut down the possible threats of corruption and fraud. This exercise is applied in a humanitarian organization of Pakistan but it is applicable to whole South Asia region due to the similarity of culture and contexts. In that firm, there were more than 550 (five hundred and fifty) registered vendors. As during the disasters or emergency phases requirements are met on urgent basis thus, providing golden opportunities for the fake companies or for the brother/sister companies of the already registered companies to be involved in the tendering process without declaration or even under some different (new) company’s name. Therefore, a list of required documents (along with checklist) was developed and sent to all of the vendor(s) in the current database and based upon the receipt of the requested documents vendors were sorted out. Furthermore, these vendors were divided into active (meeting the entire set criterion) and non-active groups. This initial filtration stage allowed the firm to continue its work without a complete shutdown that is only vendors falling in the active group shall be allowed to participate in the tenders by the time whole process is completed. Likewise only those companies or firms meeting the set criterion (active category) shall be allowed to get registered in the future along with a dedicated filing system (soft and hard shall be maintained), and all of the companies/firms in the active group shall be physically verified (visited) by the Committee comprising of senior members of at least Finance department, Supply Chain (other than procurement) and Security department.

Keywords: corruption reduction, fraud prevention, supplier management, industrial/humanitarian organizations

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Authors: Mehmood Ali, Attaullah Khan, Md. Abul Kalam

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Petroleum crude oil reserves are going to deplete in future due to the consumption of fossil fuels in transportation and energy generating sector. Thus, increasing the fossil fuel prices and also causing environmental degradation issues such as climate change and global warming due to air pollution. Therefore, to tackle these issues the environmentally friendly fuels are the potential substitute with lower emissions of toxic gases. A non-edible vegetable oilseed crop, Jatropha curcas, from different origins such as Malaysia, Thailand and India were cultivated in Pakistan. The harvested seeds physical, chemical and mechanical properties were measured, having an influence on the post-harvesting machines design parameters for dehulling, storing bins, drying, oil extraction from seeds with a screw expeller and in-situ transesterification reaction to produce biodiesel fuel. The seed variety from Thailand was found better in comparison of its properties with other varieties from Malaysia and India. The seed yield from these three varieties i.e. Malaysia, Thailand and India were 829, 943 and 735 kg/ acre/ year respectively. While the oil extraction yield from Thailand variety seed was found higher (i.e. 32.61 % by wt.) as compared to other two varieties from Malaysia and India were 27.96 and 24.96 % by wt respectively. The physical properties investigated showed the geometric mean diameter of seeds from three varieties Malaysia, Thailand and India were 11.350, 10.505 and 11.324 mm, while the sphericity of seeds were found 0.656, 0.664 and 0.655. The bulk densities of the powdered seeds from three varieties Malaysia, Thailand and India, were found as 0.9697, 0.9932 and 0.9601 g/cm³ and % passing was obtained with sieve test were 78.7, 87.1 and 79.3 respectively. The densities of the extracted oil from three varieties Malaysia, Thailand and India were found 0.902, 0.898 and 0.902 g/ mL with corresponding kinematic viscosities 54.50, 49.18 and 48.16 mm2/sec respectively. The higher heating values (HHV) of extracted oil from Malaysia, Thailand and India seed varieties were measured as 40.29, 36.41 and 34.27 MJ/ kg, while the HHV of de-oiled cake from these varieties were 21.23, 20.78 and 17.31 MJ/kg respectively. The de-oiled cake can be used as compost with nutrients and carbon content to enhance soil fertility to grow future Jatropha curcas oil seed crops and also can be used as a fuel for heating and cooking purpose. Moreover, the mechanical parameter micro Vickers hardness of Malaysia seed was found lowest 16.30 HV measured with seed in a horizontal position to the loading in comparison to other two varieties as 25.2 and 18.7 HV from Thailand and India respectively. The fatty acid composition of three varieties of seed oil showed the presence of C8-C22, required to produce good quality biodiesel fuel. In terms of physicochemical properties of seeds and its extracted oil, the variety from Thailand was found better as compared to the other two varieties.

Keywords: biodiesel, Jatropha curcas, mechanical property, physico-chemical properties

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Authors: Clare Flood, Shareen Forbes

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Background: Type 1 diabetes mellitus (T1DM) is an autoimmune disorder affecting >400,000 people in the UK alone, with the global prevalence expected to double in the next decade. Islet transplant offers a minimally-invasive procedure with very low morbidity and almost no mortality, and is now as effective as whole pancreas transplant. The procedure was introduced to the UK in 2011 for patients with the most severe type 1 diabetes mellitus (T1DM) – those with unstable blood glucose, frequently occurring episodes of severe hypoglycemia and impaired awareness of hypoglycemia (IAH). Objectives: To evaluate the effectiveness of islet transplantation in improving glycemic control, reducing the burden of hypoglycemia and improving awareness of hypoglycemia through a single-centre cohort study at the Royal Infirmary of Edinburgh. Glycemic control and degree of hypoglycemic awareness will be determined and monitored pre- and post-transplantation to determine effectiveness of the procedure. Methods: A retrospective analysis of data collected over three years from the 16 patients who have undergone islet transplantation in Scotland. Glycated haemoglobin (HbA1c) was measured and continuous glucose monitoring systems (CGMS) were utilised to assess glycemic control, while Gold and Clarke score questionnaires tested IAH. Results: All patients had improved glycemic control following transplant, with optimal control seen visually at 3 months post-transplant. Glycemic control significantly improved, as illustrated by percentage time in hypoglycemia in the months following transplant (p=0.0211) and HbA1c (p=0.0426). Improved Clarke (p=0.0034) and Gold (p=0.0001) scores indicate improved glycemic awareness following transplant. Conclusion: While the small sample of islet transplant recipients at the Royal Infirmary of Edinburgh prevents definitive conclusions being drawn, it is indicated that through our retrospective, single-centre cohort study of 16 patients, islet transplant is capable of improving glycemic control, reducing the burden of hypoglycemia and IAH post-transplant. Data can be combined with similar trials at other centres to increase statistical power but from research in Edinburgh, it can be suggested that the minimally invasive procedure of islet transplantation offers selected patients with extremely unstable T1DM the incredible opportunity to regain control of their condition and improve their quality of life.

Keywords: diabetes, islet, transplant, CGMS

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Authors: Warsi A. Ibrahim, Qureshi A. Ambrina, Younus M. Anjum

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Introduction: Oral lesions related to commercially available Smokeless Tobacco (ST), such as, Pan, Gutka, Mahwa, Naswar is considered a serious challenge for dental health care providers in Pakistan. Majority of labored Pakistani population consume ST, where public transporters and drivers are no exception. It was necessary to identify individuals of this particular population group and screen their oral health and early signs of pre-cancerous lesions so that appropriate preventive measures could be taken to reduce the burden on health providers. Aim of Study: To estimate Prevalence of ST consumption and perception of use, and to evaluate Oral Health status among public drivers of Karachi. Material & methods: A cross-sectional study survey was conducted over duration of 2 months, through convenient sampling. Sample size (n=615) of public drivers (age > 18 years) all over Karachi was gathered. A structured proforma was used to record socio-demographics, addiction profile, perception of use and oral health status (oral lesions, oral sub-mucosal fibrosis and dental caries) of study participants. Data was entered and analyzed using SPSS version 16.0 using descriptive statistics only. Results: Prevalence of ST consumption among the study participants was figured to 92.5%. Out of these almost 70% suffered from one or the other form of oral lesion(s). Four major types of ST consumption were observed out of which 60 % of oral lesion were related to Gutka chewers showing early signs of oral cancer. In addition, occurrence of Oral sub-mucosal fibrosis (OSF) was found to be significantly high around 54.8%. Overall dental caries status was also high, showing on an average 5 teeth of an individual were decayed, missing or filled deviating from WHO normal criteria (mean < 3). It was thus proven from the study that public drivers relied on oral tobacco consumption because it helps them ‘Improve consciousness’ (p-value: < 0.01; using chi-square test). Multivariate analysis showed that there were higher prevalence of smokeless tobacco among highway drivers versus local drivers (A.O.R: 2.82 [0.83-9.61], p-value: < 0.01) Conclusion: Smokeless tobacco (ST) consumption has a direct effect on oral health. However, the type of ST, the duration of consumption are factors which are directly related to the severity. Moreover, Gutka may be considered as having most lethal effects on oral health which may lead to oral cancer and affect individual’s quality of life. Specific preventive programs must be undertaken to reduce the consumption of Gutka among public transporters and drivers.

Keywords: smokeless tobacco, oral lesions, drivers, public transporters

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Authors: Sylvain Perrin, Thomas Saillour

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The Grande-Motte port and seafront development project on the French Mediterranean coastline entailed evaluating wave impact loads (pressures and forces) on the new beach seawall and comparing the resulting scour potential at the base of the existing and new seawall. A physical model was built at ARTELIA’s hydraulics laboratory in Grenoble (France) to provide insight into the evolution of scouring overtime at the front of the wall, quasi-static and impulsive wave force intensity and distribution on the wall, and water and sand overtopping discharges over the wall. The beach was constituted of fine sand and approximately 50 m wide above mean sea level (MSL). Seabed slopes were in the range of 0.5% offshore to 1.5% closer to the beach. A smooth concrete structure will replace the existing concrete seawall with an elevated curved crown wall. Prior the start of breaking (at -7 m MSL contour), storm-driven maximum spectral significant wave heights of 2.8 m and 3.2 m were estimated for the benchmark historical storm event dated of 1997 and the 50-year return period storms respectively, resulting in 1 m high waves at the beach. For the wave load assessment, a tensor scale measured wave forces and moments and five piezo / piezo-resistive pressure sensors were placed on the wall. Light-weight sediment physical model and pressure and force measurements were performed with scale 1:18. The polyvinyl chloride light-weight particles used to model the prototype silty sand had a density of approximately 1 400 kg/m3 and a median diameter (d50) of 0.3 mm. Quantitative assessments of the seabed evolution were made using a measuring rod and also a laser scan survey. Testing demonstrated the occurrence of numerous impulsive wave impacts on the reflector (22%), induced not by direct wave breaking but mostly by wave run-up slamming on the top curved part of the wall. Wave forces of up to 264 kilonewtons and impulsive pressure spikes of up to 127 kilonewtons were measured. Maximum scour of -0.9 m was measured for the new seawall versus -0.6 m for the existing seawall, which is imputable to increased wave reflection (coefficient was 25.7 - 30.4% vs 23.4 - 28.6%). This paper presents a methodology for the setup and operation of a physical model in order to assess the hydrodynamic and morphodynamic processes at a beach seawall during storms events. It discusses the pros and cons of such methodology versus others, notably regarding structures peculiarities and model effects.

Keywords: beach, impacts, scour, seawall, waves

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Authors: Ying-Chang Yu, Yuan-Lung Lo

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Building envelope design is one of the most popular design fields of architectural profession in nowadays. The main design trend of such system is to highlight the designer's aesthetic intention from the outlook of building project. Due to the trend of current façade design, the building envelope contains more and more layers of components, such as double skin façade, photovoltaic panels, solar control system, or even ornamental components. These exterior components are designed for various functional purposes. Most researchers focus on how these exterior elements should be structurally sound secured. However, not many researchers consider these elements would help to improve the performance of façade system. When the exterior elements are deployed in large scale, it creates an additional layer outside of original façade system and acts like a porous interface which would interfere with the aerodynamic of façade surface in micro-scale. A standard façade performance consists with 'water penetration, air infiltration rate, operation force, and component deflection ratio', and these key performances are majorly driven by the 'Design Wind Load' coded in local regulation. A design wind load is usually determined by the maximum wind pressure which occurs on the surface due to the geometry or location of building in extreme conditions. This research was designed to identify the air damping phenomenon of micro turbulence caused by porous exterior layer leading to surface wind load reduction for improvement of façade system performance. A series of wind tunnel test on dynamic pressure sensor array covered by various scale of porous exterior skin was conducted to verify the effect of wind pressure reduction. The testing specimens were designed to simulate the typical building with two-meter extension offsetting from building surface. Multiple porous exterior skins were prepared to replicate various opening ratio of surface which may cause different level of damping effect. This research adopted 'Pitot static tube', 'Thermal anemometers', and 'Hot film probe' to collect the data of surface dynamic pressure behind porous skin. Turbulence and distributed resistance are the two main factors of aerodynamic which would reduce the actual wind pressure. From initiative observation, the reading of surface wind pressure was effectively reduced behind porous media. In such case, an actual building envelope system may be benefited by porous skin from the reduction of surface wind pressure, which may improve the performance of envelope system consequently.

Keywords: multi-layer facade, porous media, facade performance, turbulence and distributed resistance, wind tunnel test

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Authors: Anne C. Richer-De-Forges, Dominique Arrouays, Songchao Chen, Mercedes Roman Dobarco

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Most of the digital soil mapping (DSM) products rely on machine learning (ML) prediction models and/or the use or pedotransfer functions (PTF) in which calibration data come from soil analyses performed in labs. However, many other observations (often qualitative, nominal, or ordinal) could be used as proxies of lab measurements or as input data for ML of PTF predictions. DSM and ML are briefly described with some examples taken from the literature. Then, we explore the potential of an ordinal qualitative variable, i.e., the hand-feel soil texture (HFST) estimating the mineral particle distribution (PSD): % of clay (0-2µm), silt (2-50µm) and sand (50-2000µm) in 15 classes. The PSD can also be measured by lab measurements (LAST) to determine the exact proportion of these particle-sizes. However, due to cost constraints, HFST are much more numerous and spatially dense than LAST. Soil texture (ST) is a very important soil parameter to map as it is controlling many of the soil properties and functions. Therefore, comes an essential question: is it possible to use HFST as a proxy of LAST for calibration and/or validation of DSM predictions of ST? To answer this question, the first step is to compare HFST with LAST on a representative set where both information are available. This comparison was made on ca 17,400 samples representative of a French region (34,000 km2). The accuracy of HFST was assessed, and each HFST class was characterized by a probability distribution function (PDF) of its LAST values. This enables to randomly replace HFST observations by LAST values while respecting the PDF previously calculated and results in a very large increase of observations available for the calibration or validation of PTF and ML predictions. Some preliminary results are shown. First, the comparison between HFST classes and LAST analyses showed that accuracies could be considered very good when compared to other studies. The causes of some inconsistencies were explored and most of them were well explained by other soil characteristics. Then we show some examples applying these relationships and the increase of data to several issues related to DSM. The first issue is: do the PDF functions that were established enable to use HSFT class observations to improve the LAST soil texture prediction? For this objective, we replaced all HFST for topsoil by values from the PDF 100 time replicates). Results were promising for the PTF we tested (a PTF predicting soil water holding capacity). For the question related to the ML prediction of LAST soil texture on the region, we did the same kind of replacement, but we implemented a 10-fold cross-validation using points where we had LAST values. We obtained only preliminary results but they were rather promising. Then we show another example illustrating the potential of using HFST as validation data. As in numerous countries, the HFST observations are very numerous; these promising results pave the way to an important improvement of DSM products in all the countries of the world.

Keywords: digital soil mapping, improvement of digital soil mapping predictions, potential of using hand-feel soil texture, soil texture prediction

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Authors: Gulden Aykinbaeva, Assem Umirzakova, Assel Makhadiyeva

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The problem of studying of young married couples in connection with a change of social institute of a family and marriage is represented very actual for family consultation, considering a family role in the development of modern society. Results of numerous researchs say that one of difficult in formation and stabilization of a matrimony is the period of a young family. This period is characterized by various processes of integration, adaptation and emotional compatibility of spouses. The young family in it the period endures the first standard crisis which postpones a print for the further development of the family scenario. Emergence new, earlier not existing, systems of values render a huge value on the process of formation of a young family and each of spouses separately. Possibly to solve the set family tasks at the development of the uniform system of the family relations in which socially mature persons capable to consider a family as the creativity of each other act as subjects. Due to the research objective in work the following techniques were used: a questionnaire of satisfaction with V. V. Stolin's marriage and A. N. Volkova's technique directed on detection of coherence of family values and role installations in a married couple, and also content – the analysis. Development of an internal basis of a family on mutual clearing of values is important during the work with married couples. 'The mature view' of the partner in the marriage union provides coherence between the expected and real behavior of the partner that is important for the realization of the purposes of adaptation in a family. For research of communication of the data obtained by means of A. N. Volkova's techniques, V. V. Stolina and content – the analysis, the correlation analysis, with the application of the criterion of Spirmen was used. The analysis of results of the conducted research allowed us to determine the number of consistent patterns: 1. Nature of change of satisfaction with marriage at spouses testifies that the matrimonial relations undergo high-quality changes at different stages of formation of a young family. 2. The matrimonial relations in the course of their development, formation and functioning in young marriage undergo considerable changes on psychological, social and psychological and insignificant — at the psychophysiological and sociocultural levels. The material received by us allows to plan ways of further detailed researches of the development of the matrimonial relations not only in the young marriage but also at further stages of development of a matrimony. We believe that the results received in this research can be almost applied at creation of algorithms of selection of marriage partners, at diagnostics of character and the maintenance of matrimonial disharmonies, at the forecast of stability of marriage and a family.

Keywords: married couples, formation of the young family, psychological consultation, matrimony

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Authors: Anderson Braga Mendes

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Itaipu Hydroelectric Power Plant is settled on the Paraná River, which is a natural boundary between Brazil and Paraguay; thus, the facility is shared by both countries. Itaipu Power Plant is the biggest hydroelectric generator in the world, and provides clean and renewable electrical energy supply for 17% and 76% of Brazil and Paraguay, respectively. The plant started its generation in 1984. It counts on 20 Francis turbines and has installed capacity of 14,000 MWh. Its historic generation record occurred in 2016 (103,098,366 MWh), and since the beginning of its operation until the last day of 2016 the plant has achieved the sum of 2,415,789,823 MWh. The distinct sedimentologic aspects of the drainage area of Itaipu Power Plant, from its stretch upstream (Porto Primavera and Rosana dams) to downstream (Itaipu dam itself), were taken into account in order to best estimate the increase/decrease in the sediment yield by using data from 2001 to 2016. Such data are collected through a network of 14 automatic sedimentometric stations managed by the company itself and operating in an hourly basis, covering an area of around 136,000 km² (92% of the incremental drainage area of the undertaking). Since 1972, a series of lifespan studies for the Itaipu Power Plant have been made, being first assessed by Sir Hans Albert Einstein, at the time of the feasibility studies for the enterprise. From that date onwards, eight further studies were made through the last 44 years aiming to confer more precision upon the estimates based on more updated data sets. From the analysis of each monitoring station, it was clearly noticed strong increase tendencies in the sediment yield through the last 14 years, mainly in the Iguatemi, Ivaí, São Francisco Falso and Carapá Rivers, the latter situated in Paraguay, whereas the others are utterly in Brazilian territory. Five lifespan scenarios considering different sediment yield tendencies were simulated with the aid of the softwares SEDIMENT and DPOSIT, both developed by the author of the present work. Such softwares thoroughly follow the Borland & Miller methodology (empirical method of area-reduction). The soundest scenario out of the five ones under analysis indicated a lifespan foresight of 168 years, being the reservoir only 1.8% silted by the end of 2016, after 32 years of operation. Besides, the mass balance in the reservoir (water inflows minus outflows) between 1986 and 2016 shows that 2% of the whole Itaipu lake is silted nowadays. Owing to the convergence of both results, which were acquired by using different methodologies and independent input data, it is worth concluding that the mathematical modeling is satisfactory and calibrated, thus assigning credibility to this most recent lifespan estimate.

Keywords: Borland and Miller method, hydroelectricity, Itaipu Power Plant, lifespan, mass balance

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Authors: Tanima Chatterjee, Maitree Bhattacharyya

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The global challenge of type 2 diabetes mellitus is a major health concern in this millennium, and researchers are continuously exploring new targets to develop a novel therapeutic strategy. Type 2 diabetes mellitus (T2DM) is often coupled with dyslipidemia increasing the risks for cardiovascular (CVD) complications. Enhanced oxidative and nitrosative stresses appear to be the major risk factors underlying insulin resistance, dyslipidemia, β-cell dysfunction, and T2DM pathogenesis. Autophagy emerges to be a promising defense mechanism against stress-mediated cell damage regulating tissue homeostasis, cellular quality control, and energy production, promoting cell survival. In this study, we have attempted to explore the pivotal role of autophagy in T2DM subjects with or without dyslipidemia in peripheral blood mononuclear cells and insulin-resistant HepG2 cells utilizing flow cytometric platform, confocal microscopy, and molecular biology techniques like western blotting, immunofluorescence, and real-time polymerase chain reaction. In the case of T2DM with dyslipidemia higher population of autophagy, positive cells were detected compared to patients with the only T2DM, which might have resulted due to higher stress. Autophagy was observed to be triggered both by oxidative and nitrosative stress revealing a novel finding of our research. LC3 puncta was observed in peripheral blood mononuclear cells and periphery of HepG2 cells in the case of the diabetic and diabetic-dyslipidemic conditions. Increased expression of ATG5, LC3B, and Beclin supports the autophagic pathway in both PBMC and insulin-resistant Hep G2 cells. Upon blocking autophagy by 3-methyl adenine (3MA), the apoptotic cell population increased significantly, as observed by caspase‐3 cleavage and reduced expression of Bcl2. Autophagy has also been evidenced to control oxidative stress-mediated up-regulation of inflammatory markers like IL-6 and TNF-α. To conclude, this study elucidates autophagy to play a protective role in the case of diabetes mellitus with dyslipidemia. In the present scenario, this study demands to have a significant impact on developing a new therapeutic strategy for diabetic dyslipidemic subjects by enhancing autophagic activity.

Keywords: autophagy, apoptosis, dyslipidemia, reactive oxygen species, reactive nitrogen species, Type 2 diabetes

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Authors: Matthew Sedgwick

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Introduction: Social media continues to grow in popularity and Instagram is one of the largest platforms available. It provides an invaluable method of communication between health care professionals and patients. Both patients and dentists can benefit from seeing clinical cases posted by other members of the profession. It can prompt discussion about how the outcome was achieved and showcases what is possible with the right techniques and planning. This study aimed to identify what people were posting about the topic ‘veneers’ and inform health care professionals as to what content had the most engagement and make recommendations as to how to improve the quality of social media posts. Design: 150 consecutive posts for the search term ‘veneers’ were analyzed retrospectively between 21st October 2021 to 31st October 2021. Non-English language posts duplicated posts, and posts not about dental veneers were excluded. After exclusions were applied, 80 posts were included in the study for analysis. The content of the posts was analyzed and coded and the main themes were identified. The number of comments, likes and views were also recorded for each post. Results: The themes were: before and after treatment, cost, dental training courses, treatment process and trial smiles. Dentists were the most common posters of content (82.5%) and it was interesting to note that there were no patients who posted about treatment in this sample. The main type of media was photographs (93.75%) compared to video (6.25%). Videos had an average of 45,541 views and more comments and likes than the average for photographs. The average number of comments and likes per post were 20.88 and 761.58, respectively. Conclusion: Before and after photographs were the most common finding as this is how dentists showcase their work. The study showed that videos showing the treatment process had more engagement than photographs. Dentists should consider making video posts showing the patient journey, including before and after veneer treatment, as this can result in more potential patients and colleagues viewing the content. Video content could help dentists distinguish their posts from others as it can also be used across other platforms such as TikTok or Facebook reaching a wider audience. More informative posts about how the result has shown are achieved required, including potential costs. This will help increase transparency regarding this treatment method, including the financial and potential biological cost to teeth. As a result, this will improve patient understanding and become an invaluable adjunct in informed consent.

Keywords: content analysis, dental veneers, Instagram, social media

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Authors: N. E. Gallagher, C. E. Neville, N. Lyner, J. Yarnell, C. C. Patterson, J. E. Gallacher, Y. Ben-Shlomo, A. Fehily, J. V. Woodside

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Hearing loss is highly prevalent in older people and can reduce quality of life substantially. Emerging research suggests that potentially modifiable risk factors, including risk factors previously related to cardiovascular disease risk, may be associated with a decreased or increased incidence of hearing loss. This has prompted investigation into the possibility that certain nutrients, foods or dietary patterns may also be associated with incidence of hearing loss. The aim of this study was to determine any associations between dietary patterns and hearing loss in men enrolled in the Caerphilly study. The Caerphilly prospective cohort study began in 1979-1983 with recruitment of 2512 men aged 45-59 years. Dietary data was collected using a self-administered, semi-quantitative, 56-item food frequency questionnaire (FFQ) at baseline (1979-1983), and 7-day weighed food intake (WI) in a 30% sub-sample, while pure-tone unaided audiometric threshold was assessed at 0.5, 1, 2 and 4 kHz, between 1984 and 1988. Principal components analysis (PCA) was carried out to determine a posteriori dietary patterns and multivariate linear and logistic regression models were used to examine associations with hearing level (pure tone average (PTA) of frequencies 0.5, 1, 2 and 4 kHz in decibels (dB)) for linear regression and with hearing loss (PTA>25dB) for logistic regression. Three dietary patterns were determined using PCA on the FFQ data- Traditional, Healthy, High sugar/Alcohol avoider. After adjustment for potential confounding factors, both linear and logistic regression analyses showed a significant and inverse association between the Healthy pattern and hearing loss (P<0.001) and linear regression analysis showed a significant association between the High sugar/Alcohol avoider pattern and hearing loss (P=0.04). Three similar dietary patterns were determined using PCA on the WI data- Traditional, Healthy, High sugar/Alcohol avoider. After adjustment for potential confounding factors, logistic regression analyses showed a significant and inverse association between the Healthy pattern and hearing loss (P=0.02) and a significant association between the Traditional pattern and hearing loss (P=0.04). A Healthy dietary pattern was found to be significantly inversely associated with hearing loss in middle-aged men in the Caerphilly study. Furthermore, a High sugar/Alcohol avoider pattern (FFQ) and a Traditional pattern (WI) were associated with poorer hearing levels. Consequently, the role of dietary factors in hearing loss remains to be fully established and warrants further investigation.

Keywords: ageing, diet, dietary patterns, hearing loss

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Authors: Akulov M. A., Orlova O. R., Zaharov V. O., Tomskij A. A.

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Introduction: One of the common postoperative complications of posterior cranial fossa (PCF) and cerebello-pontine angle tumor treatment is a facial nerve palsy, which leads to multiple and resistant to treatment impairments of mimic muscles structure and functions. After 4-6 months after facial nerve palsy with insufficient therapeutic intervention patients develop a postparalythic syndrome, which includes such symptoms as mimic muscle insufficiency, mimic muscle contractures, synkinesis and spontaneous muscular twitching. A novel method of treatment is the use of a recent local neuromuscular blocking agent– botulinum toxin A (BTA). Experience of BTA treatment enables an assumption that it can be successfully used in late facial nerve palsy complications to significantly increase quality of life of patients. Study aim. To evaluate the efficacy of botulinum toxin A (BTA) (Xeomin) treatment in patients with late facial nerve palsy complications. Patients and Methods: 31 patients aged 27-59 years 6 months after facial nerve palsy development were evaluated. All patients received conventional treatment, including massage, movement therapy etc. Facial nerve palsy developed after acoustic nerve tumor resection in 23 (74,2%) patients, petroclival meningioma resection – in 8 (25,8%) patients. The first group included 17 (54,8%) patients, receiving BT-therapy; the second group – 14 (45,2%) patients continuing conventional treatment. BT-injections were performed in synkinesis or contracture points 1-2 U on injured site and 2-4 U on healthy side (for symmetry). Facial nerve function was evaluated on 2 and 4 months of therapy according to House-Brackman scale. Pain syndrome alleviation was assessed on VAS. Results: At baseline all patients in the first and second groups demonstrated аpostparalytic syndrome. We observed a significant improvement in patients receiving BTA after only one month of treatment. Mean VAS score at baseline was 80,4±18,7 and 77,9±18,2 in the first and second group, respectively. In the first group after one month of treatment we observed a significant decrease of pain syndrome – mean VAS score was 44,7±10,2 (р<0,01), whereas in the second group VAS score was as high as 61,8±9,4 points (p>0,05). By the 3d month of treatment pain syndrome intensity continued to decrease in both groups, but, the first group demonstrated significantly better results; mean score was 8,2±3,1 and 31,8±4,6 in the first and second group, respectively (р<0,01). Total House-Brackman score at baseline was 3,67±0,16 in the first group and 3,74±0,19 in the second group. Treatment resulted in a significant symptom improvement in the first group, with no improvement in the second group. After 4 months of treatment House-Brockman score in the first group was 3,1-fold lower, than in the second group (р<0,05). Conclusion: Botulinum toxin injections decrease postparalytic syndrome symptoms in patients with facial nerve palsy.

Keywords: botulinum toxin, facial nerve palsy, postparalytic syndrome, synkinesis

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Authors: Stefanie Santorsola, Natasha Frank

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Improving healthcare safety necessitates examining current trends and beliefs about safety and devising strategies to improve. Errors in healthcare continue to increase and be experienced by patients, which is preventable and directly correlated to a breakdown in healthcare communication. TeamSTEPPS is an evidence-based process designed to improve the quality and safety of healthcare by improving communication and team processes. Communication is at the core of effective team collaboration and is vital for patient safety. TeamSTEPPS offers insights and strategies for improving communication and teamwork and reducing preventable errors to create a safer healthcare environment for patients. The academic, clinical, and educational environment for nursing students is vital in preparing them for professional practice by providing them with foundational knowledge and abilities. This environment provides them with a prime opportunity to learn about errors and the importance of effective communication to enhance patient safety, as nursing students are often unprepared to deal with errors. Proactively introducing and discussing errors through a supportive culture during the nursing student’s academic beginnings has the potential to carry key concepts into practice to improve and enhance patient safety. TeamSTEPPS has been used globally and has collectively positively impacted improvements in patient safety and teamwork. A workshop study was introduced in winter 2023 of registered practical nurses (RPN) students bridging to the baccalaureate nursing program; the majority of the RPNs in the bridging program were actively employed in a variety of healthcare facilities during the semester. The workshop study did receive academic institution ethics board approval, and participants signed a consent form prior to participating in the study. The premise of the workshop was to introduce TeamSTEPPS and a variety of strategies to these students and have students keep a reflective journal to incorporate the presented communication strategies in their practicum setting and keep a reflective journal on the effect and outcomes of the strategies in the healthcare setting. Findings from the workshop study supported the objective of the project, resulting in students verbalizing notable improvements in team functioning in the healthcare environment resulting from the incorporation of enhanced communication strategies from TeamSTEPPS that they were introduced to in the workshop study. Implication for educational institutions is the potential of further advancing the safety literacy and abilities of nursing students in preparing them for entering the workforce and improving safety for patients.

Keywords: teamstepps, education, patient safety, communication

Procedia PDF Downloads 40

Authors: Toslim Uddin Khan, Jesmin Akter, Mohiuddin Ahmed

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Menstrual hygiene management (MHM) and personal health-care practice is a critical issue to prevent morbidity and other reproductive health complications among adolescent girls in Bangladesh. Inadequate access to water, sanitation and hygiene (WASH) facilities lead to unhealthy MHM practices that resulted in poor reproductive health outcomes. It is evident from different studies that superstitions and misconception are more common in rural communities that limit young girls’ access to and understanding of the menstrual hygiene and self care practices. The state-of-the-art approach of Social Marketing Company (SMC) is proved to be instrumental in delivering reinforcing health messages, making public health and hygiene products available at the door steps of the community through community mobilization programs in rural Bangladesh. School health program is one of the flagship interventions of SMC to equip adolescent girls and boys with correct knowledge of health and hygiene practices among themselves, their families and peers. In Bangladeshi culture, adolescent girls often feel shy to ask fathers or male family members about buying sanitary napkin from local pharmacy and they seem to be reluctant to seek help regarding their menstrual problems. A recent study reveals that 48% adolescent girls are using sanitary napkins while majority of them are unaware of menstrual hygiene practices in Bangladesh. Under school adolescent program, SMC organizes health education sessions for adolescent girls from grade seven to ten using enter-educate approach with special focus on sexual and reproductive health and menstrual hygiene issues including delaying marriage and first pregnancy. In addition, 2500 rural women entrepreneurs branded as community sales agents are also involved in disseminating health messages and selling priority health products including sanitary napkin at the household level. These women entrepreneurs are serving as a source of sustainable supply of the sanitary napkins for the rural adolescent girls and thereby they are earning profit margins on the sales they make. A recent study on the impact of adolescent program activities reveals that majority (71%) of the school adolescent girls are currently using sanitary napkins. Health education equips and empowers adolescent girls with accurate knowledge about menstrual hygiene practices and self-care as well. Therefore, engagement of female entrepreneurs in school adolescent health program at the community level is one of the promising ways to improve menstrual hygiene practices leading to increased use of sanitary napkin in rural and semi-rural communities in Bangladesh.

Keywords: school adolescent program, social marketing, women entrepreneurs, menstrual hygiene management

Procedia PDF Downloads 173

Authors: Anuruddha Jayasuriya, Thanakorn Pheeraphan

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In this paper, a review of different mathematical models which can be used as prediction tools to assess the time to crack reinforced concrete (RC) due to corrosion is investigated. This investigation leads to an experimental study to validate a selected prediction model. Most of these mathematical models depend upon the mechanical behaviors, chemical behaviors, electrochemical behaviors or geometric aspects of the RC members during a corrosion process. The experimental program is designed to verify the accuracy of a well-selected mathematical model from a rigorous literature study. Fundamentally, the experimental program exemplifies both one-dimensional chloride diffusion using RC squared slab elements of 500 mm by 500 mm and two-dimensional chloride diffusion using RC squared column elements of 225 mm by 225 mm by 500 mm. Each set consists of three water-to-cement ratios (w/c); 0.4, 0.5, 0.6 and two cover depths; 25 mm and 50 mm. 12 mm bars are used for column elements and 16 mm bars are used for slab elements. All the samples are subjected to accelerated chloride corrosion in a chloride bath of 5% (w/w) sodium chloride (NaCl) solution. Based on a pre-screening of different models, it is clear that the well-selected mathematical model had included mechanical properties, chemical and electrochemical properties, nature of corrosion whether it is accelerated or natural, and the amount of porous area that rust products can accommodate before exerting expansive pressure on the surrounding concrete. The experimental results have shown that the selected model for both one-dimensional and two-dimensional chloride diffusion had ±20% and ±10% respective accuracies compared to the experimental output. The half-cell potential readings are also used to see the corrosion probability, and experimental results have shown that the mass loss is proportional to the negative half-cell potential readings that are obtained. Additionally, a statistical analysis is carried out in order to determine the most influential factor that affects the time to corrode the reinforcement in the concrete due to chloride diffusion. The factors considered for this analysis are w/c, bar diameter, and cover depth. The analysis is accomplished by using Minitab statistical software, and it showed that cover depth is the significant effect on the time to crack the concrete from chloride induced corrosion than other factors considered. Thus, the time predictions can be illustrated through the selected mathematical model as it covers a wide range of factors affecting the corrosion process, and it can be used to predetermine the durability concern of RC structures that are vulnerable to chloride exposure. And eventually, it is further concluded that cover thickness plays a vital role in durability in terms of chloride diffusion.

Keywords: accelerated corrosion, chloride diffusion, corrosion cracks, passivation layer, reinforcement corrosion

Procedia PDF Downloads 199

Authors: Tahamina Begum, Wan Nor Azlen Wan Mohamad, Faruque Reza, Wan Rosilawati Wan Rosli

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To assess auditory perception and cognitive function during pregnancy is necessary as the pregnant women need extra effort for attention mainly for their executive function to maintain their quality of life. This study aimed to investigate neural correlates of cognitive and behavioral processing during mid trimester pregnancy. Event-Related Potentials (ERPs) were studied by using 128-sensor net and PAS or COWA (controlled Oral Word Association), WCST (Wisconsin Card Sorting Test), RAVLTIM (Rey Auditory Verbal and Learning Test: immediate or interference recall, delayed recall (RAVLT DR) and total score (RAVLT TS) were tested for neuropsychology assessment. In total 18 subjects were recruited (n= 9 in each group; control and pregnant group). All participants of the pregnant group were within 16-27 (mid trimester) weeks gestation. Age and education matched control healthy subjects were recruited in the control group. Participants were given a standardized test of auditory cognitive function as auditory oddball paradigm during ERP study. In this paradigm, two different auditory stimuli (standard and target stimuli) were used where subjects counted silently only target stimuli with giving attention by ignoring standard stimuli. Mean differences between target and standard stimuli were compared across groups. N100 (auditory sensory ERP component) and P300 (auditory cognitive ERP component) were recorded at T3, T4, T5, T6, Cz and Pz electrode sites. An equal number of electrodes showed non-significantly shorter amplitude of N100 component (except significantly shorter at T3, P= 0.05) and non-significant longer latencies (except significantly longer latency at T5, P= 0.008) of N100 component in pregnant group comparing control. In case of P300 component, maximum electrode sites showed non-significantly higher amplitudes and equal number of sites showed non-significant shorter latencies in pregnant group comparing control. Neuropsychology results revealed the non-significant higher score of PAS, lower score of WCST, lower score of RAVLTIM and RAVLTDR in pregnant group comparing control. The results of N100 component and RAVLT scores concluded that auditory perception is mildly impaired and P300 component proved very mild cognitive dysfunction with good executive functions in second trimester of pregnancy.

Keywords: auditory perception, pregnancy, stimuli, trimester

Procedia PDF Downloads 358

Authors: Lisa Robins, Jill Newby, Kay Wilhelm, Therese Fletcher, Jessica Smith, Trevor Ma, Adam Finch, Lesley Campbell, Jerry Greenfield, Gavin Andrews

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Background:Depression treatment for people living with depression comorbid with diabetes is of critical importance for improving quality of life and diabetes self-management, however depression remains under-recognised and under-treated in this population. Cost—effective and accessible forms of depression treatment that can enhance the delivery of mental health services in routine diabetes care are needed. Provision of internet-delivered Cognitive Behaviour Therapy (iCBT) provides a promising way to deliver effective depression treatment to people with diabetes. Aims:To explore the outcomes of the clinician assisted iCBT program for people with comorbid Major Depressive Disorder (MDD) and diabetes compared to those who remain under usual care. The main hypotheses are that: (1) Participants in the treatment group would show a significant improvement on disorder specific measures (Patient Health Questionnaire; PHQ-9) relative to those in the control group; (2) Participants in the treatment group will show a decrease in diabetes-related distress relative to those in the control group. This study will also examine: (1) the effect of iCBT for MDD on disability (as measured by the SF-12 and SDS), general distress (as measured by the K10), (2) the feasibility of these treatments in terms of acceptability to diabetes patients and practicality for clinicians (as measured by the Credibility/Expectancy Questionnaire; CEQ). We hypothesise that associated disability, and general distress will reduce, and that patients with comorbid MDD and diabetes will rate the program as acceptable. Method:Recruit 100 people with MDD comorbid with diabetes (either Type 1 or Type 2), and randomly allocate to: iCBT (over 10 weeks) or treatment as usual (TAU) for 10 weeks, then iCBT. Measure pre- and post-intervention MDD severity, anxiety, diabetes-related distress, distress, disability, HbA1c, lifestyle, adherence, satisfaction with clinicians input and the treatment. Results:Preliminary results comparing MDD symptom levels, anxiety, diabetes-specific distress, distress, disability, HbA1c levels, and lifestyle factors from baseline to conclusion of treatment will be presented, as well as data on adherence to the lessons, homework downloads, satisfaction with the clinician's input and satisfaction with the mode of treatment generally.

Keywords: cognitive behaviour therapy, depression, diabetes, internet

Procedia PDF Downloads 478

Authors: Aisha Giwa, Mohammed-Faosy Adeniran, Olufunke Femi-Ojo

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Four decades ago, the World Health Organization (WHO) launched the Expanded Programme on Immunization (EPI). The EPI blueprint laid out the technical and managerial functions necessary to routinely vaccinate children with a limited number of vaccines, providing protection against diphtheria, tetanus, whooping cough, measles, polio, and tuberculosis, and to prevent maternal and neonatal tetanus by vaccinating women of childbearing age with tetanus toxoid. Despite global efforts, the Routine Immunization (RI) coverage in two of the World Health Organization (WHO) regions; the African Region and the South-East Asia Region, still remains short of its targets. As a result, the WHO Regional Director for Africa declared 2012 as the year for intensifying RI in these regions and this also coincided with the declaration of polio as a programmatic emergency by the WHO Executive Board. In order to intensify routine immunization, the National Routine Immunization Strategic Plan (2013-2015) stated that its core priority is to ensure 100% adequacy and availability of vaccines for safe immunization. To achieve 100% availability, the “PUSH System” and then “Push-Plus” were adopted for vaccine distribution, which replaced the inefficient “PULL” method. The NPHCDA plays the key role in coordinating activities in area advocacy, capacity building, engagement of 3PL for the state as well as monitoring and evaluation of the vaccine delivery process. eHealth Africa (eHA) is a player as a 3PL service provider engaged by State Primary Health Care Boards (SPHCDB) to ensure vaccine availability through Vaccine Direct Delivery (VDD) project which is essential to successful routine immunization services. The VDD project ensures the availability and adequate supply of high-quality vaccines and immunization-related materials to last-mile facilities. eHA’s commitment to the VDD project saw the need for an assessment of the project vis-a-vis the overall project performance, evaluation of a process for necessary improvement suggestions as well as general impact across Kano State (Where eHA had transitioned to the state), Bauchi State (currently manage delivery to all LGAs except 3 LGAs currently being managed by the state), Sokoto State (eHA currently covers all LGAs) and Zamfara State (Currently, in-sourced and managed solely by the state).

Keywords: cold chain logistics, health supply chain system strengthening, logistics management information system, vaccine delivery traceability and accountability

Procedia PDF Downloads 269

Authors: D. Falliano, G. Ricciardi, E. Gugliandolo

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Foamed concrete belongs to the category of lightweight concrete. It is characterized by a density which is generally ranging from 200 to 2000 kg/m³ and typically comprises cement, water, preformed foam, fine sand and eventually fine particles such as fly ash or silica fume. The foam component mixed with the cement paste give rise to the development of a system of air-voids in the cementitious matrix. The peculiar characteristics of foamed concrete elements are summarized in the following aspects: 1) lightness which allows reducing the dimensions of the resisting frame structure and is advantageous in the scope of refurbishment or seismic retrofitting in seismically vulnerable areas; 2) thermal insulating properties, especially in the case of low densities; 3) the good resistance against fire as compared to ordinary concrete; 4) the improved workability; 5) cost-effectiveness due to the usage of rather simple constituting elements that are easily available locally. Classic foamed concrete cannot be extruded, as the dimensional stability is not permitted in the green state and this severely limits the possibility of industrializing them through a simple and cost-effective process, characterized by flexibility and high production capacity. In fact, viscosity enhancing agents (VEA) used to extrude traditional concrete, in the case of foamed concrete cause the collapsing of air bubbles, so that it is impossible to extrude a lightweight product. These requirements have suggested the study of a particular additive that modifies the rheology of foamed concrete fresh paste by increasing cohesion and viscosity and, at the same time, stabilizes the bubbles into the cementitious matrix, in order to allow the dimensional stability in the green state and, consequently, the extrusion of a lightweight product. There are plans to submit the additive’s formulation to patent. In addition to the general benefits of using the extrusion process, extrudable foamed concrete allow other limits to be exceeded: elimination of formworks, expanded application spectrum, due to the possibility of extrusion in a range varying between 200 and 2000 kg/m³, which allows the prefabrication of both structural and non-structural constructive elements. Besides, this contribution aims to present the significant differences regarding extrudable and classic foamed concrete fresh properties in terms of slump. Plastic air content, plastic density, hardened density and compressive strength have been also evaluated. The outcomes show that there are no substantial differences between extrudable and classic foamed concrete compression resistances.

Keywords: compressive strength, extrusion, foamed concrete, fresh properties, plastic air content, slump.

Procedia PDF Downloads 162

Authors: Cecilia Moreira, Rita Paiva, Daniela Macedo, Leonor Ribeiro, Isabel Fernandes, Luis Costa

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Background: Head and neck paragangliomas are a rare group of tumors with a large spectrum of clinical manifestations. The approach to evaluate and treat these lesions has evolved over the last years. Surgery was the standard for the approach of these patients, but nowadays new techniques of imaging and radiation therapy changed that paradigm. Despite advances in treating, the growth potential and clinical outcome of individual cases remain largely unpredictable. Objectives: Characterization of our institutional experience with clinical management of these tumors. Methods: This was a cross-sectional study of patients followed in our institution between 01 January and 31 December 2017 with paragangliomas of the head and neck and cranial base. Data on tumor location, catecholamine levels, and specific imaging modalities employed in diagnostic workup, treatment modality, tumor control and recurrence, complications of treatment and hereditary status were collected and summarized. Results: A total of four female patients were followed between 01 January and 31 December 2017 in our institution. The mean age of our cohort was 53 (± 16.1) years. The primary locations were at the level of the tympanic jug (n=2, 50%) and carotid body (n=2, 50%), and only one of the tumors of the carotid body presented pulmonary metastasis at the time of diagnosis. None of the lesions were catecholamine-secreting. Two patients underwent genetic testing, with no mutations identified. The initial clinical presentation was variable highlighting the decrease of visual acuity and headache as symptoms present in all patients. In one of the cases, loss of all teeth of the lower jaw was the presenting symptomatology. Observation with serial imaging, surgical extirpation, radiation, and stereotactic radiosurgery were employed as treatment approaches according to anatomical location and resectability of lesions. As post-therapeutic sequels the persistence of tinnitus and disabling pain stands out, presenting one of the patients neuralgia of the glossopharyngeal. Currently, all patients are under regular surveillance with a median follow up of 10 months. Conclusion: Ultimately, clinical management of these tumors remains challenging owing to heterogeneity in clinical presentation, the existence of multiple treatment alternatives, and potential to cause serious detriment to critical functions and consequently interference with the quality of life of the patients.

Keywords: clinical outcomes, head and neck, management, paragangliomas

Procedia PDF Downloads 127

Authors: Orsolya Horvath, Laszlo Deres, Krisztian Eros, Katalin Ordog, Tamas Habon, Balazs Sumegi, Kalman Toth, Robert Halmosi

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Introduction: Oxidative stress induces an imbalance in mitochondrial fusion and fission processes, finally leading to cell death. The two antioxidant molecules, BGP-15 and L2286 have beneficial effects on mitochondrial functions and on cellular oxidative stress response. In this work, we studied the effects of these compounds on the processes of mitochondrial quality control. Methods: We used H9c2 cardiomyoblast and isolated neonatal rat cardiomyocytes (NRCM) for the experiments. The concentration of stressors and antioxidants was beforehand determined with MTT test. We applied 1-Methyl-3-nitro-1-nitrosoguanidine (MNNG) in 125 µM, 400 µM and 800 µM concentrations for 4 and 8 hours on H9c2 cells. H₂O₂ was applied in 150 µM and 300 µM concentration for 0.5 and 4 hours on both models. L2286 was administered in 10 µM, while BGP-15 in 50 µM doses. Cellular levels of the key proteins playing role in mitochondrial dynamics were measured in Western blot samples. For the analysis of mitochondrial network dynamics, we applied electron microscopy and immunocytochemistry. Results: Due to MNNG treatment the level of fusion proteins (OPA1, MFN2) decreased, while the level of fission protein DRP1 elevated markedly. The levels of fusion proteins OPA1 and MNF2 increased in the L2286 and BGP-15 treated groups. During the 8 hour treatment period, the level of DRP1 also increased in the treated cells (p < 0.05). In the H₂O₂ stressed cells, administration of L2286 increased the level of OPA1 in both H9c2 and NRCM models. MFN2 levels in isolated neonatal rat cardiomyocytes raised considerably due to BGP-15 treatment (p < 0.05). L2286 administration decreased the DRP1 level in H9c2 cells (p < 0.05). We observed that the H₂O₂-induced mitochondrial fragmentation could be decreased by L2286 treatment. Conclusion: Our results indicated that the PARP-inhibitor L2286 has beneficial effect on mitochondrial dynamics during oxidative stress scenario, and also in the case of directly induced DNA damage. We could make the similar conclusions in case of BGP-15 administration, which, via reducing ROS accumulation, propagates fusion processes, this way aids preserving cellular viability. Funding: GINOP-2.3.2-15-2016-00049; GINOP-2.3.2-15-2016-00048; GINOP-2.3.3-15-2016-00025; EFOP-3.6.1-16-2016-00004; ÚNKP-17-4-I-PTE-209

Keywords: H9c2, mitochondrial dynamics, neonatal rat cardiomyocytes, oxidative stress

Procedia PDF Downloads 134

Authors: Ana Carolina Kogawa, Selma Gutierrez Antonio, Hérida Regina Nunes Salgado

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Rifaximin is an oral antimicrobial, gut - selective and not systemic with adverse effects compared to placebo. It is used for the treatment of hepatic encephalopathy, travelers diarrhea, irritable bowel syndrome, Clostridium difficile, ulcerative colitis and acute diarrhea. The crystalline form present in the rifaximin with minimal systemic absorption is α, being the amorphous form significantly different. Regulators are increasingly attention to polymorphisms. Polymorphs can change the form by altering the drug characteristics compromising the effectiveness and safety of the finished product. International Conference on Harmonization issued the ICH Guidance Q6A, which aim to improve the control of polymorphism in new and existing pharmaceuticals. The objective of this study was to obtain polymorphic forms of rifaximin employing recrystallization processes and characterize them by thermal analysis (thermogravimetry - TG and differential scanning calorimetry - DSC), X-ray diffraction, scanning electron microscopy and solubility test. Six polymorphic forms of rifaximin, designated I to VI were obtained by the crystallization process by evaporation of the solvent. The profiles of the TG curves obtained from polymorphic forms of rifaximin are similar to rifaximin and each other, however, the DTG are different, indicating different thermal behaviors. Melting temperature values of all the polymorphic forms were greater to that shown by the rifaximin, indicating the higher thermal stability of the obtained forms. The comparison of the diffractograms of the polymorphic forms of rifaximin with rifaximin α, β and γ constant in patent indicate that forms III, V and VI are formed by mixing polymorph β and α and form III is formed by polymorph β. The polymorphic form I is formed by polymorph β, but with a significant amount of amorphous material. Already, the polymorphic form II consists of polymorph γ, amorphous. In scanning electron microscope is possible to observe the heterogeneity of morphological characteristics of crystals of polymorphic forms among themselves and with rifaximin. The solubility of forms I and II was greater than the solubility of rifaximin, already, forms III, IV and V presented lower solubility than of rifaximin. Similarly, the bioavailability of the amorphous form of rifaximin is considered significantly higher than the form α, the polymorphic forms obtained in this work can not guarantee the excellent tolerability of the reference medicine. Therefore, studies like these are extremely important and they point to the need for greater requirements by the regulatory agencies competent about polymorphs analysis of the raw materials used in the manufacture of medicines marketed globally. These analyzes are not required in the majority of official compendia. Partnerships between industries, research centers and universities would be a viable way to consolidate researches in this area and contribute to improving the quality of solid drugs.

Keywords: electronic microscopy, polymorphism, rifaximin, solubility, X-ray diffraction

Procedia PDF Downloads 640

Authors: Heather Fulford, Melanie Liddell

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The recruitment and retention of high quality employees can prove to be challenging for social enterprises, particularly in some of the core business support functions such as marketing, communications, IT and finance. This holds true for social enterprises in urban contexts, where roles with more attractive remuneration in these business functions can often be found quite readily in the private sector. For social enterprises situated in rural locations, the challenges of staff recruitment and retention are even more acute. Such challenges can lead to a skills deficit in rural social enterprises, which can, at best, hinder their growth potential, and worse, jeopardise their chances of survival. This in turn, can have a negative impact on the sustainability and resilience of the surrounding rural community in which the social enterprise is located. The purpose of this paper is to report on aspects of a collaborative initiative established to stimulate innovation and business growth in remote rural businesses in Scotland. Launched in 2010, this initiative was designed to attract young students and graduates from the region to stay in the region upon completion of their studies, and to attract others from outside the region to re-locate there post-university. To facilitate this, SMEs in the region were offered wage subsidies to encourage them to recruit a student or graduate on a work placement for up to one year to participate in an innovation or business growth-oriented project. A number of the employers offering work placements were social enterprises. Through analysis of the placement project and role specifications devised by the participating social enterprises, an overview is provided of their business development needs and the skills they require to stimulate innovation and growth. Scrutiny of the reflective accounts compiled by the students and graduates at the close of their work placements highlights the benefits they derived from being able to put their academic knowledge and skills into action within a social enterprise. Examination of interviews conducted with a sample of placement employers reveals the contribution the students and graduates made during the business development projects with the social enterprises. The challenges of hosting such placements are also discussed. The paper concludes with indications of the lessons learned and an outline of the wider implications for other remote rural locations in which social enterprises play an important role in the local economy and life of the community.

Keywords: resilience, rural development, regeneration, regional development, recruitment, resource management, retention, remuneration

Procedia PDF Downloads 301

Authors: Noureddine Ben Ayed, Abdelkader Soumaya, Saïd Maouche, Ali Kadri, Mongi Gueddiche, Hayet Khayati-Ammar, Ahmed Braham

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The archaeological monument of Utica, located in north-eastern Tunisia, was founded (8th century BC) By the Phoenicians as a port installed on the trade route connecting Phoenicia and the Straits of Gibraltar in the Mediterranean Sea. The flourishment of this city as an important settlement during the Roman period was followed by a sudden abandonment, disuse and progressive oblivion in the first half of the fifth century AD. This decadence can be attributed to the destructive earthquake of 5 July 408 - 410 AD, affecting this historic city as documented in 1906 by the seismologist Fernand De Montessus De Ballore. The magnitude of the Utica earthquake was estimated at 6.8 by the Tunisian National Institute of Meteorology (INM). In order to highlight the damage caused by this earthquake, a field survey was carried out at the Utica ruins to detect and analyse the earthquake archaeological effects (EAEs) using structural geology methods. This approach allowed us to highlight several structural damages, including: (1) folded mortar pavements, (2) cracks affecting the mosaic and walls of a water basin in the "House of the Grand Oecus", (3) displaced columns, (4) block extrusion in masonry walls, (5) undulations in mosaic pavements, (6) tilted walls. The structural analysis of these EAEs and data measurements reveal a seismic cause for all evidence of deformation in the Utica monument. The maximum horizontal strain of the ground (e.g. SHmax) inferred from the building oriented damage in Utica shows a NNW-SSE direction under a compressive tectonic regime. For the seismogenic source of this earthquake, we propose the active E-W to NE-SW trending Utique - Ghar El Melh reverse fault, passing through the Utica Monument and extending towards the Ghar El Melh Lake, as the causative tectonic structure. The active fault trace is well supported by instrumental seismicity, geophysical data (e.g., gravity, seismic profiles) and geomorphological analyses. In summary, we find that the archaeoseismic records detected at Utica are similar to those observed at many other archaeological sites affected by destructive ancient earthquakes around the world. Furthermore, the calculated orientation of the average maximum horizontal stress (SHmax) closely match the state of the actual stress field, as highlighted by some earthquake focal mechanisms in this region.

Keywords: Tunisia, utica, seimogenic fault, archaeological earthquake effects

Procedia PDF Downloads 24

Authors: Jacolien Barnard, Corlia Van Heerden

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Effective and accessible consensual dispute resolution and in particular alternative dispute resolution, are central to consumer protection legislation. In this regard, the Consumer Protection Act 68 of 2008 (CPA) of South Africa is no exception. Due to the nature of consumer disputes, alternative dispute resolution (in theory) is an effective vehicle for the adjudication of disputes in a timely manner avoiding overburdening of the courts. The CPA sets down as one of its core purposes the provision of ‘an accessible, consistent, harmonized, effective and efficient system of redress for consumers’ (section 3(1)(h) of the CPA). Section 69 of the Act provides for the enforcement of consumer rights and provides for the National Consumer Commission to be the Central Authority which streamlines, adjudicates and channels disputes to the appropriate forums which include Alternative Dispute Resolution Agents (ADR-agents). The purpose of this paper is to analyze the regulation of these enforcement and redress mechanisms with particular focus on the Central Authority as well as the ADR-agents and their crucial role in successful and efficient adjudication of disputes in South Africa. The South African position will be discussed comparatively with the European Union (EU) position. In this regard, the European Union (EU) Directive on Alternative Dispute Resolution for Consumer Disputes (2013/11/EU) will be discussed (The ADR Directive). The aim of the ADR Directive is to solve contractual disputes between consumers and traders (suppliers or businesses) regardless of whether the agreement was concluded offline or online or whether or not the trader is situated in another member state (Recitals 4-6). The ADR Directive provides for a set of quality requirements that an ADR body or entity tasked with resolving consumer disputes should adhere to in member states which include regulatory mechanisms for control. Transparency, effectiveness, fairness, liberty and legality are all requirements for a successful ADR body and discussed within this chapter III of the Directive. Chapters III and IV govern the importance of information and co-operation. This includes information between ADR bodies and the European Commission (EC) but also between ADR bodies or entities and national authorities enforcing legal acts on consumer protection and traders. (In South Africa the National Consumer Tribunal, Provincial Consumer Protectors and Industry ombuds come to mind). All of which have a responsibility to keep consumers informed. Ultimately the papers aims to provide recommendations as to the successfulness of the current South African position in light of the comparative position in Europe and the highlight the importance of proper regulation of these redress and enforcement institutions.

Keywords: alternative dispute resolution, consumer protection law, enforcement, redress

Procedia PDF Downloads 205

Authors: Meiying Liao, Poya Huang

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The aesthetic domain is one of the six major domains in the Taiwanese preschool curriculum, encompassing visual arts, music, and dramatic play. Its primary objective is to cultivate children’s abilities in exploration and awareness, expression and creation, and response and appreciation. The purpose of this study was to explore the effects of hosting a vocal music concert on aesthetic inspiration and learning among preschoolers in a preschool setting. The primary research method employed was a case study focusing on a private preschool in Northern Taiwan that organized a school-wide event featuring two vocalists. The concert repertoires included children’s songs, folk songs, and arias performed in Mandarin, Hakka, English, German, and Italian. In addition to professional performances, preschool teachers actively participated by presenting a children’s song. A total of 5 classes, comprising approximately 150 preschoolers, along with 16 teachers and staff, participated in the event. Data collection methods included observation, interviews, and documents. Results indicated that both teachers and children thoroughly enjoyed the concert, with high levels of acceptance when the program was appropriately designed and hosted. Teachers reported that post-concert discussions with children revealed the latter’s ability to recall people, events, and elements observed during the performance, expressing their impressions of the most memorable segments. The concert effectively achieved the goals of the aesthetic domain, particularly in fostering response and appreciation. It also inspired preschoolers’ interest in music. Many teachers noted an increased desire for performance among preschoolers after exposure to the concert, with children imitating the performers and their expressions. Remarkably, one class extended this experience by incorporating it into the curriculum, autonomously organizing a high-quality concert in the music learning center. Parents also reported that preschoolers enthusiastically shared their concert experiences at home. In conclusion, despite being a single event, the positive responses from preschoolers towards the music performance suggest a meaningful impact. These experiences extended into the curriculum, as firsthand exposure to performances allowed teachers to deepen related topics, fostering a habit of autonomous learning in the designated learning centers.

Keywords: concert, early childhood music education, aesthetic education, music develpment

Procedia PDF Downloads 35

Authors: Jerzy Bański

Abstract:

Central and Eastern European agriculture is characterized by large spatial variations in the structure of agricultural land and the structure of crops on arable land. In general, field crops predominate among the land used for agriculture. In the southern part of the study area, permanent crops have a relatively large share, which is due to favorable climatic conditions. Clear differences between the north and south of the region concern the structure of crop cultivation. In the north, the cultivation of cereals, mainly wheat, definitely prevails. In the south of the region, on the other hand, the structure of crops is more diverse, as more industrial crops are grown in addition to cereals. The primary cognitive objective of the study is to diagnose and identify the directions of changes in the structure of agricultural land use in the CEE region. Particular attention was paid to the spatial differentiation of this structure and its importance in its formation of various conditions. The analysis included the basic elements of the structure of agricultural land use and the structure of crops on arable land. The decrease in the area of arable land is characteristic of the entire region and is the result of the territorial growth of cities, the development of communications infrastructure (rail and road), and the increase in the rationality of crop production involving, among other things, the exclusion from the cultivation of land with the lowest agro-ecological values and their afforestation. It can be summarized that the directions of changes in the basic categories of agricultural land are related to agro-ecological conditions, which indicates an increase in the rationality of crop production. In countries with lower-quality of agricultural production space, the share of grassland generally increased, while in countries with favorable conditions -mainly soil- the share of arable land increased. As for the structure of field crops, the direction of its changes seems to be mainly due to economic and social reasons. Ownership changes shaping an unfavorable agrarian structure (fragmentation and fragmentation of arable fields) and the process of aging of the rural population resulted in the abandonment of resource- and labor-intensive crops. As a result, the importance of growing fruits and vegetables, and potatoes has declined. The structure of vegetable crops has been greatly influenced by the accession of Central and Eastern European countries to the European Union. This is primarily the increase in the importance of oil crops (rapeseed and sunflower) related to biofuel production. In the case of cereal crops, the main direction of change was the increase in the share of wheat at the expense of other cereal species.

Keywords: agriculture, land use, Central and Eastern Europe, crops, arable land

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Authors: Isidro Perez, Maryam Nazari

Abstract:

Numerous earthquakes, which have taken place across the world, led to catastrophic damage and collapse of structures (e.g., 1971 San Fernando; 1995 Kobe-Japan; and 2010 Chile earthquakes). Engineers are constantly studying methods to moderate the effect this phenomenon has on structures to further reduce damage, costs, and ultimately to provide life safety to occupants. However, there are regions where structures, cities, or water reservoirs are built near fault lines. When an earthquake occurs near the fault lines, they can be categorized as near-field earthquakes. In contrary, a far-field earthquake occurs when the region is further away from the seismic source. A near-field earthquake generally has a higher initial peak resulting in a larger seismic response, when compared to a far-field earthquake ground motion. These larger responses may result in serious consequences in terms of structural damage which can result in a high risk for the public’s safety. Unfortunately, the response of structures subjected to near-field records are not properly reflected in the current building design specifications. For example, in ASCE 7-10, the design response spectrum is mostly based on the far-field design-level earthquakes. This may result in the catastrophic damage of structures that are not properly designed for near-field earthquakes. This research investigates the knowledge that the effect of near-field earthquakes has on the response of structures. To fully examine this topic, a structure was designed following the current seismic building design specifications, e.g. ASCE 7-10 and ACI 318-14, being analytically modeled, utilizing the SAP2000 software. Next, utilizing the FEMA P695 report, several near-field and far-field earthquakes were selected, and the near-field earthquake records were scaled to represent the design-level ground motions. Upon doing this, the prototype structural model, created using SAP2000, was subjected to the scaled ground motions. A Linear Time History Analysis and Pushover analysis were conducted on SAP2000 for evaluation of the structural seismic responses. On average, the structure experienced an 8% and 1% increase in story drift and absolute acceleration, respectively, when subjected to the near-field earthquake ground motions. The pushover analysis was ran to find and aid in properly defining the hinge formation in the structure when conducting the nonlinear time history analysis. A near-field ground motion is characterized by a high-energy pulse, making it unique to other earthquake ground motions. Therefore, pulse extraction methods were used in this research to estimate the maximum response of structures subjected to near-field motions. The results will be utilized in the generation of a design spectrum for the estimation of design forces for buildings subjected to NF ground motions.

Keywords: near-field, pulse, pushover, time-history

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Authors: Sidra Suleman, Maliha Suleman, Stephen Brindley

Abstract:

Oral rehabilitation of head and neck cancer patients plays a crucial role in the quality of life for such individuals post-treatment. Placement of dental implants or implant-retained prostheses can help restore oral function and aesthetics, which is often compromised following surgery. Conventional prosthodontic techniques can be insufficient in rehabilitating such patients due to their altered anatomy and reduced oral competence. Hence, there is a strong clinical need for the placement of dental implants. With an increasing incidence of head and neck cancer patients, the demand for such treatment is rising. Aim: The aim of the study was to determine the survival rate of dental implants in head and neck cancer patients placed at the Restorative and Maxillofacial Department, Royal Stoke University Hospital (RSUH), United Kingdom. Methodology: All patients who received dental implants between January 1, 2013 to December 31, 2020 were identified. Patients were excluded based on three criteria: 1) non-head and neck cancer patients, 2) no outpatient follow-up post-implant placement 3) provision of non-dental implants. Scanned paper notes and electronic records were extracted and analyzed. Implant survival was defined as fixtures that had remained in-situ / not required removal. Sample: Overall, 61 individuals were recruited from the 143 patients identified. The mean age was 64.9 years, with a range of 35 – 89 years. The sample included 37 (60.7%) males and 24 (39.3%) females. In total, 211 implants were placed, of which 40 (19.0%) were in the maxilla, 152 (72.0%) in the mandible and 19 (9.0%) in autogenous bone graft sites. Histologically 57 (93.4%) patients had squamous cell carcinoma, with 43 (70.5%) patients having either stage IVA or IVB disease. As part of treatment, 42 (68.9%) patients received radiotherapy, which was carried out post-operatively for 29 (69.0%) cases. Whereas 21 (34.4%) patients underwent chemotherapy, 13 (61.9%) of which were post-operative. The Median follow-up period was 21.9 months with a range from 0.9 – 91.4 months. During the study, 23 (37.7%) patients died and their data was censored beyond the date of death. Results: In total, four patients who had received radiotherapy had one implant failure each. Two mandibular implants failed secondary to osteoradionecrosis, and two maxillary implants did not survive as a result of failure to osseointegrate. The overall implant survival rates were 99.1% at three years and 98.1% at both 5 and 7 years. Conclusions: Although this data shows that implant failure rates are low, it highlights the difficulty in predicting which patients will be affected. Future studies involving larger cohorts are warranted to further analyze factors affecting outcomes.

Keywords: oncology, dental implants, survival, restorative

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