Search results for: emergency room
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2264

Search results for: emergency room

554 International E-Learning for Assuring Ergonomic Working Conditions of Orthopaedic Surgeons: First Research Outcomes from Train4OrthoMIS

Authors: J. Bartnicka, J. A. Piedrabuena, R. Portilla, L. Moyano - Cuevas, J. B. Pagador, P. Augat, J. Tokarczyk, F. M. Sánchez Margallo

Abstract:

Orthopaedic surgeries are characterized by a high degree of complexity. This is reflected by four main groups of resources: 1) surgical team which is consisted of people with different competencies, educational backgrounds and positions; 2) information and knowledge about medical and technical aspects of surgery; 3) medical equipment including surgical tools and materials; 4) space infrastructure which is important from an operating room layout point of view. These all components must be integrated and build a homogeneous organism for achieving an efficient and ergonomically correct surgical workflow. Taking this as a background, there was formulated a concept of international project, called “Online Vocational Training course on ergonomics for orthopaedic Minimally Invasive” (Train4OrthoMIS), which aim is to develop an e-learning tool available in 4 languages (English, Spanish, Polish and German). In the article, there is presented the first project research outcomes focused on three aspects: 1) ergonomic needs of surgeons who work in hospitals around different European countries, 2) the concept of structure of e-learning course, 3) the definition of tools and methods for knowledge assessment adjusted to users’ expectation. The methodology was based on the expert panels and two types of surveys: 1) on training needs, 2) on evaluation and self-assessment preferences. The major findings of the study allowed describing the subjects of four training modules and learning sessions. According to peoples’ opinion there were defined most expected test methods which are single choice test and right after quizzes: “True or False” and “Link elements”. The first project outcomes confirmed the necessity of creating a universal training tool for orthopaedic surgeons regardless of the country in which they work. Because of limited time that surgeons have, the e-learning course should be strictly adjusted to their expectation in order to be useful.

Keywords: international e-learning, ergonomics, orthopaedic surgery, Train4OrthoMIS

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553 Teachers’ Conception of and Perception towards the New Curriculum of Ethiopian Higher Education: A Case of Debre Birhan University

Authors: Kassahun Tilahun Dessie

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The purpose of this study was to explore the awareness of teachers and the attitude they have to the curriculum they implement as well as to assess the actual and desired magnitude of teachers' participation in curriculum development process. It also aimed at investigating the factors that affect teachers' level of conception and perception towards the new higher education curriculum. The study was carried out in Debre Birhan University. Teachers, course coordinators, team leaders and presidents were included in the study as research subjects. Teachers were proportionally selected from each department (of the six faculties) based on available sampling technique. Accordingly, a total of 103 teachers were chosen as a subject of the study. In order to collect first hand data from the teachers, a questionnaire with four parts was developed by the researcher. To this end, scales were designed for measuring the extent of teachers' awareness and attitude. Each of the scales encompasses 11 and 17 items respectively. An open ended questionnaire was also attached for the purpose of obtaining elaborated data on the issue. Information was also obtained from interviews with presidents, team leaders and course coordinators. The data obtained were analyzed qualitatively using descriptive statistical tools. The overall results of the analysis revealed that the awareness of teachers on the curriculum was low. The meager participation of teachers in the process of curriculum development and the deficiency of trainings on the concern were major factors. Teachers' perception towards the existence and implementation of the new curriculum was also inclined to the negative, though difficult to generalize. Lack of awareness, administrators poor approach and lack of facilitating appropriate incentives as well as absence of room for evaluating the curriculum etc plays big role in endangering teachers attitude while the up to datedness of the new curriculum, involvement of teachers in the curriculum development process, the wide ranging quality of the new curriculum etc laid a better ground to boost teachers attitude towards the curriculum. This may have implication to the university in that there is a need to facilitate workshops or awareness creation trainings, to have positive and cooperative administrators, and embracing committed teachers to implement the curriculum efficiently.

Keywords: conception, perception, curriculum, higher education, Ethiopia

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552 Solid Waste Management & Practise within the University Community: Case Study in Universiti Malaysia Terengganu, Terengganu

Authors: J. Izan, E.I. Tengku Azmina, F. Pey Thing

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Sustainability has been introduced globally since the emerging of the advancement of technology and product development in various aspects. This concept is regarded highly, listed among the seventeenth elements in Sustainable Development Goals (SDG), especially by developed countries in any of their development plans and being considered in the development of the developing countries. It is such as the concept of sustainability can undeniably provide a medium where the cost used by energy consumption and pollution problems can be greatly reduced. In Malaysia, many rules and policies had been advocated to achieve sustainability; however, the practice and implementation as well the enforcement to ensure its implementation are still not great. University, as an educational institution, shall practice and implement sustainability concepts in as much aspect as possible as a positive example for a wider community. University Malaysia Terengganu (UMT) has already published a blueprint guide in 2015, aims to introduce and implement sustainable practice in the university, and solid waste is one of the key elements highlighted. This study was conducted to determine the status of solid waste management practice among the university community associated with several factors that facilitate the room for sustainable management, as drawn in the established blueprint document. The quantitative analysis was carried out via survey conducted online, acquired the questions on green campus concept and implementation in general and solid waste in particular. The results showed that community UMT showed a high level of awareness and knowledge on sustainable solid waste; however, low percentage in managing solid waste in a sustainable manner. Respondents suggested that stringent guidelines and the establishment of policy greatly help in the realization and enforcement of sustainable solid waste handling and management. Facilities such as waste collection centre with separation and segregation containers will motivate the community to practice 3Rs on a daily basis. This will eventually reduce the generation of waste need to be sent to landfill hence reduce the disposal cost. Prolong, and continuous campaign on sustainable solid waste management need to be carried out more frequently.

Keywords: management, solid waste, sustainability, university

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551 Management of Severe Asthma with Omalizumab in United Arab Emirates

Authors: Shanza Akram, Samir Salah, Imran Saleem, Jassim Abdou, Ashraf Al Zaabi

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Estimated prevalence of asthma in UAE is around 10% (900,000 people). Patients with persistent symptoms despite using high dose ICS plus a second controller +/- Oral steroids are considered to have severe asthma. Omalizumab (Xolair) is an anti-IgE monoclonal antibody approved as add-on therapy for severe allergic asthma. The objective of our study was to obtain baseline characteristics of our local cohort, to determine the efficacy of omalizumab based on clinical outcomes pre and post 52 weeks of treatment and to assess safety and tolerability. Medical records of patients receiving omalizumab therapy for asthma at Zayed Military Hospital, Abu Dhabi were retrospectively reviewed. Patients fulfilling the criteria for severe allergic asthma as per GINA guidelines were included. Asthma control over 12 months pre and post omalizumab were analyzed by taking into account the number of exacerbations, hospitalizations, maintenance of medication dosages, the need for reliever therapy and PFT’s. 21 patients (5 females) with mean age 41 years were included. The mean duration of therapy was 22 months. 19 (91%) patients had Allergic Rhinitis/Sinusitis. Mean serum total IgE level was 648 IU/ml (65-1859). 11 (52%) patients were on oral maintenance steroids pre-treatment. 7 patients managed to stop steroids on treatment while 4 were able to decrease the dosage. Mean exacerbation rate decreased from 5 per year pre-treatment to 1.36 while on treatment. The number of hospitalizations decreased from a mean of 2 per year to 0.9 per year. Reliever inhaler usage decreased from mean of 40 to 15 puffs per week.2 patients discontinued therapy, 1 due to lack of benefit (2 doses) and 2nd due to severe persistent side effects. Patient compliance was poor in some cases. Treatment with omalizumab reduced the number of exacerbations, hospitalizations, maintenance and reliever medications, and is generally well tolerated. Our results show that there is room for improved documentation in terms of symptom recording and use of rescue medication at our institution. There is also need for better patient education and counseling in order to improve compliance.

Keywords: asthma, exacerbations, omalizumab, IgE

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550 Regeneration Nature of Rumex Species Root Fragment as Affected by Desiccation

Authors: Khalid Alshallash

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Small fragments of the roots of some Rumex species including R. obtusifolius and R. crispus have been found to regenerate readily, contributing to the severity of infestations by these very common, widespread and difficult to control perennial weeds of agricultural crops and grasslands. Their root fragments are usually created during routine agricultural practices. We found that fresh root fragments of both species containing 65-70 % of moisture, progressively lose their moisture content when desiccated under controlled growth room conditions matching summer weather of southeast England, with the greatest reduction occurring in the first 48 hours. Probability of shoot emergence and the time taken for emergence in glasshouse conditions were also reduced significantly by desiccation, with R. obtusifolius least affected up to 48-hour. However, the effects converged after 120 hours. In contrast, R. obtusifolius was significantly slower to emerge after up to 48 hours desiccation, again effects converging after longer periods, R. crispus entirely failed to emerge at 120 hours. The dry weight of emerged shoots was not significantly different between the species, until desiccated for 96 hours when R. obtusifolius was significantly reduced. At 120 hours, R. obtusifolius did not emerge. In outdoor trials, desiccation for 24 or 48 hours had less effect on emergence when planted at the soil surface or up to 10 cm of depth, compared to deeper plantings. In both species, emergence was significantly lower when desiccated fragments were planted at 15 or 20 cm. Time taken for emergence was not significantly different between the species until planted at 15 or 20 cm when R. obtusifolius was slower than R. crispus and reduced further by increasing desiccation. Similar variation in effects of increasing soil depth interacting with increasing desiccation was found in reductions in dry weight, the number of tillers and leaf area, with R obtusifolius generally but not exclusively better able to withstand more extreme trial conditions. Our findings suggest that infestations of these highly troublesome weeds may be partly controlled by appropriate agricultural practices, notably exposing cut fragments to drying environmental conditions followed by deep burial.

Keywords: regeneration, root fragment, rumex crispus, rumex obtusifolius

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549 Computational Assistance of the Research, Using Dynamic Vector Logistics of Processes for Critical Infrastructure Subjects Continuity

Authors: Urbánek Jiří J., Krahulec Josef, Urbánek Jiří F., Johanidesová Jitka

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These Computational assistance for the research and modelling of critical infrastructure subjects continuity deal with this paper. It enables us the using of prevailing operation system MS Office (SmartArt...) for mathematical models, using DYVELOP (Dynamic Vector Logistics of Processes) method. It serves for crisis situations investigation and modelling within the organizations of critical infrastructure. In the first part of the paper, it will be introduced entities, operators and actors of DYVELOP method. It uses just three operators of Boolean algebra and four types of the entities: the Environments, the Process Systems, the Cases and the Controlling. The Process Systems (PrS) have five “brothers”: Management PrS, Transformation PrS, Logistic PrS, Event PrS and Operation PrS. The Cases have three “sisters”: Process Cell Case, Use Case and Activity Case. They all need for the controlling of their functions special Ctrl actors, except ENV – it can do without Ctrl. Model´s maps are named the Blazons and they are able mathematically - graphically express the relationships among entities, actors and processes. In the second part of this paper, the rich blazons of DYVELOP method will be used for the discovering and modelling of the cycling cases and their phases. The blazons need live PowerPoint presentation for better comprehension of this paper mission. The crisis management of energetic crisis infrastructure organization is obliged to use the cycles for successful coping of crisis situations. Several times cycling of these cases is a necessary condition for the encompassment of the both the emergency event and the mitigation of organization´s damages. Uninterrupted and continuous cycling process bring for crisis management fruitfulness and it is a good indicator and controlling actor of organizational continuity and its sustainable development advanced possibilities. The research reliable rules are derived for the safety and reliable continuity of energetic critical infrastructure organization in the crisis situation.

Keywords: blazons, computational assistance, DYVELOP method, critical infrastructure

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548 Practical Skill Education for Doctors in Training: Economical and Efficient Methods for Students to Receive Hands-on Experience

Authors: Nathaniel Deboever, Malcolm Breeze, Adrian Sheen

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Basic surgical and suturing techniques are a fundamental requirement for all doctors. In order to gain confidence and competence, doctors in training need to obtain sufficient teaching and just as importantly: practice. Young doctors with an apt level of expertise on these simple surgical skills, which are often used in the Emergency Department, can help alleviate some pressure during a busy evening. Unfortunately, learning these skills can be quite difficult during medical school or even during junior doctor years. The aim of this project was to adequately train medical students attending University of Sydney’s Nepean Clinical School through a series of workshops highlighting practical skills, with hopes to further extend this program to junior doctors in the hospital. The sessions instructed basic skills via tutorials, demonstrations, and lastly, the sessions cemented these proficiencies with practical sessions. During such an endeavor, it is fundamental to employ models that appropriately resemble what students will encounter in the clinical setting. The sustainability of workshops is similarly important to the continuity of such a program. To address both these challenges, the authors have developed models including suturing platforms, knot tying, and vessel ligation stations, as well as a shave and punch biopsy models and ophthalmologic foreign body device. The unique aspect of this work is that we utilized hands-on teaching sessions, to address a gap in doctors-in-training and junior doctor curriculum. Presented to you through this poster are our approaches to creating models that do not employ animal products and therefore do not necessitate particular facilities or discarding requirements. Covering numerous skills that would be beneficial to all young doctors, these models are easily replicable and affordable. This exciting work allows for countless sessions at low cost, providing enough practice for students to perform these skills confidently as it has been shown through attendee questionnaires.

Keywords: medical education, surgical models, surgical simulation, surgical skills education

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547 Characterization of AlOOH Film Containing Mg-Al Layered Double Hydroxide Prepared on Al Alloy by Steam Coating

Authors: Ai Serizawa, Kotaro Mori, Takahiro Ishizaki

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Al alloys have been used as advanced structural materials in automobile and railway industries because of excellent physical and mechanical properties such as low density, good heat conductivity, and high specific strength. Their low corrosion resistance, however, limits their use in the corrosive environment. To improve the corrosion resistance of the Al alloys, the development of a novel coating technology has been highly desirable. Chemical conversion methods using layered double hydroxide (LDH) have attracted much attention because the LDH can suppress corrosion reaction due to their trapping ability of corrosive anions such as Cl- between layers. In this presentation, we report on a novel preparation method of AlOOH film containing Mg-Al layered double hydroxide (LDH) on Al alloy by steam coating. The corrosion resistance of the composite film including LDH was especially focused. Al-Mg-Si alloy was used as the substrate. The substrates were ultrasonically cleaned in ethanol for 10 min. The cleaned substrates were set in the autoclave with a 100 mL capacity. 20 ml of ultrapure water was located at the bottom of the autoclave to produce steam. The autoclave was heated up to a temperature of 100 to 200 °C, and then held at this temperature for up to 48 h, and was subsequently cooled naturally to room temperature, resulting in the formation of anticorrosive films on Al alloys. The resultant films were characterized by XRD, FT-IR, FE-SEM and electrochemical measurements. FE-SEM image of film surface treated at 180 °C for 48 h demonstrated that needle-like nanostructure was densely formed on the surface. XRD patterns revealed that the film formed on the Al alloys by steam coating was composed of crystal AlOOH and Mg-Al LDH. The corrosion resistance of the film was evaluated using electrochemical measurements. The potentiodynamic polarization curves of the film coated and uncoated substrates of Al-Mg-Si alloy after immersion in the 5 wt% NaCl aqueous solution for 30 min revealed that the corrosion current density, jcorr, of the film coated sample decreased by more than two orders of magnitude as compared to the uncoated sample, indicating that the corrosion resistance of the substrates of Al-Mg-Si alloy were improved by the formation of the anticorrosive film via steam coating.

Keywords: aluminum alloy, boehmite, corrosion resistance, steam process

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546 Using a Train-the-Trainer Model to Deliver Post-Partum Haemorrhage Simulation in Rural Uganda

Authors: Michael Campbell, Malaz Elsaddig, Kevin Jones

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Background: Despite encouraging progress, global maternal mortality has remained stubbornly high since the declaration of the Millennium development goals. Sub-Saharan Africa accounts for well over half of maternal deaths with Post-Partum Haemorrhage (PPH) being the lead cause. ‘In house’ simulation training delivered by local doctors may be a sustainable approach for improving emergency obstetric care. The aim of this study was to evaluate the use of a Train-the-Trainer (TtT) model in a rural Ugandan hospital to ascertain whether it can feasibly improve practitioners’ management of PPH. Methods: Three Ugandan doctors underwent a training course to enable them to design and deliver simulation training. These doctors used MamaNatalie® models to simulate PPH scenarios for midwives, nurses and medical students. The main outcome was improvement in participants’ knowledge and confidence, assessed using self-reported scores on a 10-point scale. Results: The TtT model produced significant improvements in the confidence and knowledge scores of the ten participants. The mean confidence score rose significantly (p=0.0005) from 6.4 to 8.6 following the simulation training. There was also a significant increase in the mean knowledge score from 7.2 to 9.0 (p=0.04). Medical students demonstrated the greatest overall increase in confidence scores whilst increases in knowledge scores were largest amongst nurses. Conclusions: This study demonstrates that a TtT model can be used in a low resource setting to improve healthcare professionals’ confidence and knowledge in managing obstetric emergencies. This Train-the-Trainer model represents a sustainable approach to addressing skill deficits in low resource settings. We believe that its expansion across healthcare institutions in Sub-Saharan Africa will help to reduce the region’s high maternal mortality rate and step closer to achieving the ambitions of the Millennium development goals.

Keywords: low resource setting, post-partum haemorrhage, simulation training, train the trainer

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545 Methylation Profiling and Validation of Candidate Tissue-Specific Differentially Methylated Regions for Identification of Human Blood, Saliva, Semen and Vaginal Fluid and Its Application in Forensics

Authors: Meenu Joshi, Natalie Naidoo, Farzeen Kader

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Identification of body fluids is an essential step in forensic investigation to aid in crime reconstruction. Tissue-specific differentially methylated regions (tDMRs) of the human genome can be targeted to be used as biomarkers to differentiate between body fluids. The present study was undertaken to establish the methylation status of potential tDMRs in blood, semen, saliva, and vaginal fluid by using methylation-specific PCR (MSP) and bisulfite sequencing (BS). The methylation statuses of 3 potential tDMRS in genes ZNF282, PTPRS, and HPCAL1 were analysed in 10 samples of each body fluid. With MSP analysis, the ZNF282, and PTPRS1 tDMR displayed semen-specific hypomethylation while HPCAL1 tDMR showed saliva-specific hypomethylation. With quantitative analysis by BS, the ZNF282 tDMR showed statistically significant difference in overall methylation between semen and all other body fluids as well as at individual CpG sites (p < 0.05). To evaluate the effect of environmental conditions on the stability of methylation profiles of the ZNF282 tDMR, five samples of each body fluid were subjected to five different forensic simulated conditions (dry at room temperature, wet in an exsiccator, outside on the ground, sprayed with alcohol, and sprayed with bleach) for 50 days. Vaginal fluid showed highest DNA recovery under all conditions while semen had least DNA quantity. Under outside on the ground condition, all body fluids except semen showed a decrease in methylation level; however, a significant decrease in methylation level was observed for saliva. A statistical significant difference was observed for saliva and semen (p < 0.05) for outside on the ground condition. No differences in methylation level were observed for the ZNF282 tDMR under all conditions for vaginal fluid samples. Thus, in the present study ZNF282 tDMR has been identified as a novel and stable semen-specific hypomethylation marker.

Keywords: body fluids, bisulphite sequencing, forensics, tDMRs, MSP

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544 Preliminary Study of the Cost-Effectiveness of Green Walls: Analyzing Cases from the Perspective of Life Cycle

Authors: Jyun-Huei Huang, Ting-I Lee

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Urban heat island effect is derived from the reduction of vegetative cover by urban development. Because plants can improve air quality and microclimate, green walls have been applied as a sustainable design approach to cool building temperature. By using plants to green vertical surfaces, they decrease room temperature and, as a result, decrease the energy use for air conditioning. Based on their structures, green walls can be divided into two categories, green façades and living walls. A green façade uses the climbing ability of a plant itself, while a living wall assembles planter modules. The latter one is widely adopted in public space, as it is time-effective and less limited. Although a living wall saves energy spent on cooling, it is not necessarily cost-effective from the perspective of a lifecycle analysis. The Italian study shows that the overall benefit of a living wall is only greater than its costs after 47 years of its establishment. In Taiwan, urban greening policies encourage establishment of green walls by referring to their benefits of energy saving while neglecting their low performance on cost-effectiveness. Thus, this research aims at understanding the perception of appliers and consumers on the cost-effectiveness of their living wall products from the lifecycle viewpoint. It adopts semi-structured interviews and field observations on the maintenance of the products. By comparing the two results, it generates insights for sustainable urban greening policies. The preliminary finding shows that stakeholders do not have a holistic sense of lifecycle or cost-effectiveness. Most importantly, a living wall well maintained is often with high input due to the availability of its maintenance budget, and thus less sustainable. In conclusion, without a comprehensive sense of cost-effectiveness throughout a product’s lifecycle, it is very difficult for suppliers and consumers to maintain a living wall system while achieve sustainability.

Keywords: case study, maintenance, post-occupancy evaluation, vertical greening

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543 Exploring the Perspective of Service Quality in mHealth Services during the COVID-19 Pandemic

Authors: Wan-I Lee, Nelio Mendoza Figueredo

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The impact of COVID-19 has a significant effect on all sectors of society globally. Health information technology (HIT) has become an effective health strategy in this age of distancing. In this regard, Mobile Health (mHealth) plays a critical role in managing patient and provider workflows during the COVID-19 pandemic. Therefore, the users' perception of service quality about mHealth services plays a significant role in shaping confidence and subsequent behaviors regarding the mHealth users' intention of use. This study's objective was to explore levels of user attributes analyzed by a qualitative method of how health practitioners and patients are satisfied or dissatisfied with using mHealth services; and analyzed the users' intention in the context of Taiwan during the COVID-19 pandemic. This research explores the experienced usability of a mHealth services during the Covid-19 pandemic. This study uses qualitative methods that include in-depth and semi-structured interviews that investigate participants' perceptions and experiences and the meanings they attribute to them. The five cases consisted of health practitioners, clinic staff, and patients' experiences using mHealth services. This study encourages participants to discuss issues related to the research question by asking open-ended questions, usually in one-to-one interviews. The findings show the positive and negative attributes of mHealth service quality. Hence, the significant importance of patients' and health practitioners' issues on several dimensions of perceived service quality is system quality, information quality, and interaction quality. A concept map for perceptions regards to emergency uses' intention of mHealth services process is depicted. The findings revealed that users pay more attention to "Medical care", "ease of use" and "utilitarian benefits" and have less importance for "Admissions and Convenience" and "Social influence". To improve mHealth services, the mHealth providers and health practitioners should better manage users' experiences to enhance mHealth services. This research contributes to the understanding of service quality issues in mHealth services during the COVID-19 pandemic.

Keywords: COVID-19, mobile health, service quality, use intention

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542 Translanguaging as a Decolonial Move in South African Bilingual Classrooms

Authors: Malephole Philomena Sefotho

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Nowadays, it is a fact that the majority of people, worldwide, are bilingual rather than monolingual due to the surge of globalisation and mobility. Consequently, bilingual education is a topical issue of discussion among researchers. Several studies that have focussed on it have highlighted the importance and need for incorporating learners’ linguistic repertoires in multilingual classrooms and move away from the colonial approach which is a monolingual bias – one language at a time. Researchers pointed out that a systematic approach that involves the concurrent use of languages and not a separation of languages must be implemented in bilingual classroom settings. Translanguaging emerged as a systematic approach that assists learners to make meaning of their world and it involves allowing learners to utilize all their linguistic resources in their classrooms. The South African language policy also room for diverse languages use in bi/multilingual classrooms. This study, therefore, sought to explore how teachers apply translanguaging in bilingual classrooms in incorporating learners’ linguistic repertoires. It further establishes teachers’ perspectives in the use of more than one language in teaching and learning. The participants for this study were language teachers who teach at bilingual primary schools in Johannesburg in South Africa. Semi-structured interviews were conducted to establish their perceptions on the concurrent use of languages. Qualitative research design was followed in analysing data. The findings showed that teachers were reluctant to allow translanguaging to take place in their classrooms even though they realise the importance thereof. Not allowing bilingual learners to use their linguistic repertoires has resulted in learners’ negative attitude towards their languages and contributed in learners’ loss of their identity. This article, thus recommends a drastic change to decolonised approaches in teaching and learning in multilingual settings and translanguaging as a decolonial move where learners are allowed to translanguage freely in their classroom settings for better comprehension and making meaning of concepts and/or related ideas. It further proposes continuous conversations be encouraged to bring eminent cultural and linguistic genocide to a halt.

Keywords: bilingualism, decolonisation, linguistic repertoires, translanguaging

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541 Oro-Facial Manifestations of Acute Myeloid Leukaemia -A Case Report

Authors: Aamna Tufail, Kajal Kotecha, Iordanis Toursounidis, Ravinder Pabla

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Introduction/Aims: Acute Myeloid Leukaemia (AML) is a part of leukaemic group of hematopoietic disorders with a varying range of presentations, including oro-facial manifestations. Early recognition and management are essential for favourable outcomes. Materials and Methods: We present our experience, clinical presentation, and clinical photographs of a patient with previously undiagnosed AML who presented with oral symptoms to the emergency department of our hospital. An analysis of clinical characteristics, diagnostic investigations, and management modalities was performed. Results/Statistics: A 58-year-old man presented to A&E reporting an 11-day history of right sided facial swelling, acute TMJ symptoms, and oral discomfort. A dentist ruled out acute dental causes one day post onset of symptoms. Initial assessment was anatomically inconsistent and did not reveal a routine oral or maxillofacial etiology. Detailed clinical examination demonstrated fever, generalised pallor, swelling and erythema of right nasolabial region, bilateral masseteric tenderness, intraoral palatal ecchymosis, palatal ulceration, buccal and labial petechiae, cervical lymphadenopathy, and haematoma on dorsum of right hand overlying right 2nd metacarpal joint. Suspecting a systemic medical cause, we requested haematological investigations, which revealed neutropenia, thrombocytopenia, and anaemia. Flow cytometry confirmed CD34 + AML. Oral discomfort was managed symptomatically. The patient was referred to a tertiary care centre for acute haematologic care, where he was treated with IV antibiotics and continuing cycles of chemotherapy. Conclusions/Clinical Relevance: Oro-facial manifestations may be the first clinical sign of AML. Awareness of its features is vital in early diagnosis. In this context, dentists and oral medicine specialists can play an important role in detecting clinical signs of haematological disorders such as AML.

Keywords: acute myeloid leukaemia, oral symptoms, ulceration, diagnosis, management

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540 A Case Study on Theme-Based Approach in Health Technology Engineering Education: Customer Oriented Software Applications

Authors: Mikael Soini, Kari Björn

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Metropolia University of Applied Sciences (MUAS) Information and Communication Technology (ICT) Degree Programme provides full-time Bachelor-level undergraduate studies. ICT Degree Programme has seven different major options; this paper focuses on Health Technology. In Health Technology, a significant curriculum change in 2014 enabled transition from fragmented curriculum including dozens of courses to a new integrated curriculum built around three 30 ECTS themes. This paper focuses especially on the second theme called Customer Oriented Software Applications. From students’ point of view, the goal of this theme is to get familiar with existing health related ICT solutions and systems, understand business around health technology, recognize social and healthcare operating principles and services, and identify customers and users and their special needs and perspectives. This also acts as a background for health related web application development. Built web application is tested, developed and evaluated with real users utilizing versatile user centred development methods. This paper presents experiences obtained from the first implementation of Customer Oriented Software Applications theme. Student feedback was gathered with two questionnaires, one in the middle of the theme and other at the end of the theme. Questionnaires had qualitative and quantitative parts. Similar questionnaire was implemented in the first theme; this paper evaluates how the theme-based integrated curriculum has progressed in Health Technology major by comparing results between theme 1 and 2. In general, students were satisfied for the implementation, timing and synchronization of the courses, and the amount of work. However there is still room for development. Student feedback and teachers’ observations have been and will be used to develop the content and operating principles of the themes and whole curriculum.

Keywords: engineering education, integrated curriculum, learning and teaching methods, learning experience

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539 Metal Extraction into Ionic Liquids and Hydrophobic Deep Eutectic Mixtures

Authors: E. E. Tereshatov, M. Yu. Boltoeva, V. Mazan, M. F. Volia, C. M. Folden III

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Room temperature ionic liquids (RTILs) are a class of liquid organic salts with melting points below 20 °C that are considered to be environmentally friendly ‘designers’ solvents. Pure hydrophobic ILs are known to extract metallic species from aqueous solutions. The closest analogues of ionic liquids are deep eutectic solvents (DESs), which are a eutectic mixture of at least two compounds with a melting point lower than that of each individual component. DESs are acknowledged to be attractive for organic synthesis and metal processing. Thus, these non-volatile and less toxic compounds are of interest for critical metal extraction. The US Department of Energy and the European Commission consider indium as a key metal. Its chemical homologue, thallium, is also an important material for some applications and environmental safety. The aim of this work is to systematically investigate In and Tl extraction from aqueous solutions into pure fluorinated ILs and hydrophobic DESs. The dependence of the Tl extraction efficiency on the structure and composition of the ionic liquid ions, metal oxidation state, and initial metal and aqueous acid concentrations have been studied. The extraction efficiency of the TlXz3–z anionic species (where X = Cl– and/or Br–) is greater for ionic liquids with more hydrophobic cations. Unexpectedly high distribution ratios (> 103) of Tl(III) were determined even by applying a pure ionic liquid as receiving phase. An improved mathematical model based on ion exchange and ion pair formation mechanisms has been developed to describe the co-extraction of two different anionic species, and the relative contributions of each mechanism have been determined. The first evidence of indium extraction into new quaternary ammonium- and menthol-based hydrophobic DESs from hydrochloric and oxalic acid solutions with distribution ratios up to 103 will be provided. Data obtained allow us to interpret the mechanism of thallium and indium extraction into ILs and DESs media. The understanding of Tl and In chemical behavior in these new media is imperative for the further improvement of separation and purification of these elements.

Keywords: deep eutectic solvents, indium, ionic liquids, thallium

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538 A Case Series on Isolated Lead aVR ST-Segment Elevation Clinical Significance and Outcome

Authors: Fae Princess Bermudez

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Background: One of the least significant leads on a 12-lead electrocardiogram is the augmented right lead (aVR), as it is not as specific compared to the other leads. In this case series, the value of lead aVR, which is more often than not ignored, is highlighted. Three cases of aVR ST segment elevation on 12-lead electrocardiogram are described, with the end outcome of demise of all three patients. The importance of immediate revascularization is described to improve prognosis in this group of patients. Objectives: This case series aims to primarily present under-reported cases of isolated aVR ST-segrment elevation myocardial infarction (STEMI), their course and outcome. More specific aims are to identify the criteria in determination of isolated aVR STEMI, know its clinical significance, and determine appropriate management for patients with this ECG finding. Method: A short review of previous studies, case reports, articles and guidelines from 2011-2016 was done. The author reviewed available literature, sorted out those that proved to be significant for the presented cases, and described them in conjunction with the aforementioned cases. Findings: Based on the limited information on these rare or under-reported cases, it was found that isolated aVR STEMI had a poorer prognosis that led to significant mortality and morbidity of patients. The significance of aVR ST-elevation was that of an occlusion of the left coronary artery or a severe three-vessel disease in the presence of an Acute Coronary Syndrome. Guidelines from American Heart Association/American College of Cardiology Foundation in 2013 already recognized ST-elevation of lead aVR in isolation as a STEMI; hence, recommended that patients with this particular ECG finding should undergo reperfusion strategies to improve prognosis. Conclusion: The indispensability of isolated aVR ST-segment elevation on ECG should alert physicians, especially Emergency physicians, to the high probability of Acute Coronary Syndrome with a very poor prognosis. If this group of patients is not promptly managed, demise may ensue, with cardiogenic shock as the most probable cause. With this electrocardiogram finding, physicians must be quick to make clinical decisions to increase chances of survival of this group of patients.

Keywords: AVR ST-elevation, diffuse ST-segment depression, left coronary artery infarction, myocardial infarction

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537 Preparation of Tempeh Spores Powder

Authors: Jaruwan Chutrtong, Tanakwan Bussabun

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Study production of tempeh inoculums powder by freeze-drying comparison with dry at 50°C and the sun bask for developing efficient tempeh inoculums for tempeh producing. Rhizopus oligosporus in PDA slant cultures was incubated at 30°C for 3-5 days until spores and mycelium. Preparation spores suspension with sterilized water and then count the number of started spores. Fill spores suspension in Rice flour and soy flour, mixed with water (in the ratio 10: 7), which is steamed and sterilized at 121°C 15min. Incubated at room temperature for 4 days, count number of spores. Then take the progressive infection and full spore dough to dry at 50°C, sun bask, and lyophilize. Grind to powder. Then pack in plastic bags, stored at 5°C. To investigate quality of inoculums which use different methods, tempeh was fermented every 4 weeks for 24 weeks of the experiment. The result found that rice flour is not suitable to use as raw material in the production of powdered spores. Fungi can growth rarely. Less number of spores and requires more time than soy flour. For drying method, lyophilization is the least possible time. Samples from this method are very hard and very dark and harder to grind than other methods. Drying at 50°C takes longer time than lyophilization but can also set time use for drying. Character of the dry samples is hard solid and brown color, but can be grinded easier. The sun drying takes the longest time, can’t determine the exact time. When the spore powder was used to fermented tempeh immediately, product has similar characters as which use spores that was fresh prepared. The tempeh has normal quality. When spore powder stored at low temperature, tempeh from storage spore in weeks 4, 8 and 12 is still normal. Time spending in production was close to the production of fresh spores. After storage spores for 16 and 20 weeks, tempeh is still normal but growth and sporulation were take longer time than usual (about 6 hours). At 24 week storage, fungal growth is not good, made tempeh looks inferior to normal color, also smell and texture.

Keywords: freez drying, preparation, spores powder, tempeh

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536 Therapeutic Nihilism: Challenging Aging Diseases in Cameroon

Authors: Chick Loveline Ayoh Epse Ndi

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Our cultural stance has deep implications for the psychological and physical well-being of the old. Cameroon is still rooted on the traditional belief that stipulates that; the aged are best catered for in the family setting where the children and grandchildren are supposed to give in return for services invested on them by the former. This is why up till date, there are no “Rest Homes” or “Convalescent hospitals” despite the rising challenges faced by the aged in this context. Beside the special measure set aside to cater for the aged, such as “Rest Homes” for the healthy, “Convalescent hospitals” are created set to cater for the health of the aged in the Western context with other facilities such as geriatric units. The health care practitioners are aware of aging diseases and have trained human resources like Gerontologists to cater for the aged and aging diseases. Meanwhile, in Africa and Cameroon in particular, such infrastructural and human resources are still to be considered in the health care system. It can be assumed that the aged and aging diseases are still to be considered in the health care system in this context. This is why we talk of therapeutic nihilism, where the aged are mixed up with other categories of patients with no special attention given to them. This qualitative study carried out in the Yaounde, the capital city of Cameroon, with their best referent hospitals, reveal that; the aged and aging diseases are still a myth in this context. Data collected in both private and public health institutions show that there is only one public institution in Cameroon that has a geriatric unit with no specialists. Patients who aretreated in this unit are considered as aged with terminal diseases that need palliative care and not intensive care. Cameroon is still lacking in terms of health care to the aged and ageing diseases. Like other patients, the aged are treated with a lot of laxity and no value. There is an emergency to create special health care units for geriatrics and and train gerontologist. Mentally or physically ill aged faced medical rational with psychodynamic treatment considered as waste of time. The aged are less likely to be regarded salvageable when they enter a hospital in serious conditions due to the lack of specialists and geriatric units for them. The implication of this study is to sensitization the stake holders for an urgent need to extend special care units for the aged and aging diseases in this context.

Keywords: challeng, therapy, agtng, diseases cameroon

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535 Development of Vapor Absorption Refrigeration System for Mini-Bus Car’s Air Conditioning: A Two-Fluid Model

Authors: Yoftahe Nigussie

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This research explores the implementation of a vapor absorption refrigeration system (VARS) in mini-bus cars to enhance air conditioning efficiency. The conventional vapor compression refrigeration system (VCRS) in vehicles relies on mechanical work from the engine, leading to increased fuel consumption. The proposed VARS aims to utilize waste heat and exhaust gas from the internal combustion engine to cool the mini-bus cabin, thereby reducing fuel consumption and atmospheric pollution. The project involves two models: Model 1, a two-fluid vapor absorption system (VAS), and Model 2, a three-fluid VAS. Model 1 uses ammonia (NH₃) and water (H₂O) as refrigerants, where water absorbs ammonia rapidly, producing a cooling effect. The absorption cycle operates on the principle that absorbing ammonia in water decreases vapor pressure. The ammonia-water solution undergoes cycles of desorption, condensation, expansion, and absorption, facilitated by a generator, condenser, expansion valve, and absorber. The objectives of this research include reducing atmospheric pollution, minimizing air conditioning maintenance costs, lowering capital costs, enhancing fuel economy, and eliminating the need for a compressor. The comparison between vapor absorption and compression systems reveals advantages such as smoother operation, fewer moving parts, and the ability to work at lower evaporator pressures without affecting the Coefficient of Performance (COP). The proposed VARS demonstrates potential benefits for mini-bus air conditioning systems, providing a sustainable and energy-efficient alternative. By utilizing waste heat and exhaust gas, this system contributes to environmental preservation while addressing economic considerations for vehicle owners. Further research and development in this area could lead to the widespread adoption of vapor absorption technology in automotive air conditioning systems.

Keywords: room, zone, space, thermal resistance

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534 Morphology Analysis of Apple-Carrot Juice Treated by Manothermosonication (MTS) and High Temperature Short Time (HTST) Processes

Authors: Ozan Kahraman, Hao Feng

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Manothermosonication (MTS), which consists of the simultaneous application of heat and ultrasound under moderate pressure (100-700 kPa), is one of the technologies which destroy microorganisms and inactivates enzymes. Transmission electron microscopy (TEM) is a microscopy technique in which a beam of electrons is transmitted through an ultra-thin specimen, interacting with the specimen as it passes through it. The environmental scanning electron microscope or ESEM is a scanning electron microscope (SEM) that allows for the option of collecting electron micrographs of specimens that are "wet," uncoated. These microscopy techniques allow us to observe the processing effects on the samples. This study was conducted to investigate the effects of MTS and HTST treatments on the morphology of apple-carrot juices by using TEM and ESEM microscopy. Apple-carrot juices treated with HTST (72 0C, 15 s), MTS 50 °C (60 s, 200 kPa), and MTS 60 °C (30 s, 200 kPa) were observed in both ESEM and TEM microscopy. For TEM analysis, a drop of the solution dispersed in fixative solution was put onto a Parafilm ® sheet. The copper coated side of the TEM sample holder grid was gently laid on top of the droplet and incubated for 15 min. A drop of a 7% uranyl acetate solution was added and held for 2 min. The grid was then removed from the droplet and allowed to dry at room temperature and presented into the TEM. For ESEM analysis, a critical point drying of the filters was performed using a critical point dryer (CPD) (Samdri PVT- 3D, Tousimis Research Corp., Rockville, MD, USA). After the CPD, each filter was mounted onto a stub and coated with gold/palladium with a sputter coater (Desk II TSC Denton Vacuum, Moorestown, NJ, USA). E.Coli O157:H7 cells on the filters were observed with an ESEM (Philips XL30 ESEM-FEG, FEI Co., Eindhoven, The Netherland). ESEM (Environmental Scanning Electron Microscopy) and TEM (Transmission Electron Microscopy) images showed extensive damage for the samples treated with MTS at 50 and 60 °C such as ruptured cells and breakage on cell membranes. The damage was increasing with increasing exposure time.

Keywords: MTS, HTST, ESEM, TEM, E.COLI O157:H7

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533 Characterization of the Ignitability and Flame Regression Behaviour of Flame Retarded Natural Fibre Composite Panel

Authors: Timine Suoware, Sylvester Edelugo, Charles Amgbari

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Natural fibre composites (NFC) are becoming very attractive especially for automotive interior and non-structural building applications because they are biodegradable, low cost, lightweight and environmentally friendly. NFC are known to release high combustible products during exposure to heat atmosphere and this behaviour has raised concerns to end users. To improve on their fire response, flame retardants (FR) such as aluminium tri-hydroxide (ATH) and ammonium polyphosphate (APP) are incorporated during processing to delay the start and spread of fire. In this paper, APP was modified with Gum Arabic powder (GAP) and synergized with carbon black (CB) to form new FR species. Four FR species at 0, 12, 15 and 18% loading ratio were added to oil palm fibre polyester composite (OPFC) panels as follows; OPFC12%APP-GAP, OPFC15%APP-GAP/CB, OPFC18%ATH/APP-GAP and OPFC18%ATH/APPGAP/CB. The panels were produced using hand lay-up compression moulding and cured at room temperature. Specimens were cut from the panels and these were tested for ignition time (Tig), peak heat released rate (HRRp), average heat release rate (HRRavg), peak mass loss rate (MLRp), residual mass (Rm) and average smoke production rate (SPRavg) using cone calorimeter apparatus as well as the available flame energy (ɸ) in driving the flame using radiant panel flame spread apparatus. From the ignitability data obtained at 50 kW/m2 heat flux (HF), it shows that the hybrid FR modified with APP that is OPFC18%ATH/APP-GAP exhibited superior flame retardancy and the improvement was based on comparison with those without FR which stood at Tig = 20 s, HRRp = 86.6 kW/m2, HRRavg = 55.8 kW/m2, MLRp =0.131 g/s, Rm = 54.6% and SPRavg = 0.05 m2/s representing respectively 17.6%, 67.4%, 62.8%, 50.9%, 565% and 62.5% improvements less than those without FR (OPFC0%). In terms of flame spread, the least flame energy (ɸ) of 0.49 kW2/s3 for OPFC18%ATH/APP-GAP caused early flame regression. This was less than 39.6 kW2/s3 compared to those without FR (OPFC0%). It can be concluded that hybrid FR modified with APP could be useful in the automotive and building industries to delay the start and spread of fire.

Keywords: flame retardant, flame regression, oil palm fibre, composite panel

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532 The Legal Implications of Gender Quota for Public Companies

Authors: Murat Can Pehlivanoglu

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Historically, gender equality has been mainly defended in the legal arenas of constitutional law and employment law. However, social and economic progress has required corporate law to provide gender equality on corporate boards. Recently, following the trend in Europe, the State of California (United States) enacted a law requiring that every publicly traded corporation based in California should have women on its board of directors. Still, the legal, social and economic implications of this law are yet to be discovered. The contractarian view of corporate law is predominant in the U.S. jurisprudence. However, gender quota law may not be justified through contractarian theory grounds. Therefore, the conformity of gender quota law with the general principles of U.S. corporate law remains questionable, and the immunity of close corporations from the scope of gender quota legislation provides support for the discrepancy. The methodology employed in this paper in the discussion of the rule’s conformity with corporate law is doctrinal, and American case law and legal scholarship are the basis for this discussion. This paper uses the aforementioned California law as sample legislation to evaluate the gender quota laws’ conformity with the contractarian theory of corporate law. It chooses California law as the sample due to its newness and the presence of pending shareholder lawsuits against it. Also, since California is home to global companies, the effect of such law is expected to be wider. As alternative theories laid down by corporate law may already be activated to provide gender equality on boards of publicly traded corporations, enacting a specific gender quota law would not be justified by an allegedly present statutory deficiency based on contractarian theory. However, this theoretical reality would not enable shareholders to succeed in their lawsuits against such law on corporate law grounds, and investors will have limited options against its results. This will eventually harm the integrity of the marketplace. Through the analysis of the contractarian theory of corporate law and California gender quota law, the major finding of this paper is that the contractarian theory of corporate law does not permit mandating board room equality through corporate law. In conclusion, it expresses that the issue should be dealt with through separate legislation with a different remedial structure, to preserve the traditional rationale of corporate law in U.S. law.

Keywords: board of directors, gender equality, gender quota, publicly traded corporations

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531 Diagnosis of Choledocholithiasis with Endosonography

Authors: A. Kachmazova, A. Shadiev, Y. Teterin, P. Yartcev

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Introduction: Biliary calculi disease (LCS) still occupies the leading position among urgent diseases of the abdominal cavity, manifesting itself from asymptomatic course to life-threatening states. Nowadays arsenal of diagnostic methods for choledocholithiasis is quite wide: ultrasound, hepatobiliscintigraphy (HBSG), magnetic resonance imaging (MRI), endoscopic retrograde cholangiography (ERCP). Among them, transabdominal ultrasound (TA ultrasound) is the most accessible and routine diagnostic method. Nowadays ERCG is the "gold" standard in diagnosis and one-stage treatment of biliary tract obstruction. However, transpapillary techniques are accompanied by serious postoperative complications (postmanipulative pancreatitis (3-5%), endoscopic papillosphincterotomy bleeding (2%), cholangitis (1%)), the lethality being 0.4%. GBSG and MRI are also quite informative methods in the diagnosis of choledocholithiasis. Small size of concrements, their localization in intrapancreatic and retroduodenal part of common bile duct significantly reduces informativity of all diagnostic methods described above, that demands additional studying of this problem. Materials and Methods: 890 patients with the diagnosis of cholelithiasis (calculous cholecystitis) were admitted to the Sklifosovsky Scientific Research Institute of Hospital Medicine in the period from August, 2020 to June, 2021. Of them 115 people with mechanical jaundice caused by concrements in bile ducts. Results: Final EUS diagnosis was made in all patients (100,0%). In all patients in whom choledocholithiasis diagnosis was revealed or confirmed after EUS, ERCP was performed urgently (within two days from the moment of its detection) as the X-ray operation room was provided; it confirmed the presence of concrements. All stones were removed by lithoextraction using Dormia basket. The postoperative period in these patients had no complications. Conclusions: EUS is the most informative and safe diagnostic method, which allows to detect choledocholithiasis in patients with discrepancies between clinical-laboratory and instrumental methods of diagnosis in shortest time, that in its turn will help to decide promptly on the further tactics of patient treatment. We consider it reasonable to include EUS in the diagnostic algorithm for choledocholithiasis. Disclosure: Nothing to disclose.

Keywords: endoscopic ultrasonography, choledocholithiasis, common bile duct, concrement, ERCP

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530 Formulation and Evaluation of Antioxidant Cream Containing Nepalese Medicinal Plants

Authors: Ajaya Acharya, Prem Narayan Paudel, Rajendra Gyawali

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Due to strong tyrosinase inhibition and antioxidant effects, green tea and Licorice are valuable in cosmetics for the skin. However, data on the addition of essential oils to green tea and Licorice in cream formulation to examine antioxidant activities are limited. The purpose of this study was to develop and assess a phytocosmetic cream’s antioxidant and tyrosinase inhibitory characteristics using crude aqueous extracts of green tea, Licorice, and loaded with essential oils. To load the best concentration on cream formulations, plant aqueous extracts were designed, evaluated, and correlated in terms of total phenolic content (TPC), total flavonoids content (TFC), and 2, 2-diphenyl-1-picrylhydrazyl (DPPH) scavenging activity. Moreover, o. tenuiflorum and o. basilicum essential oils were extracted and added to a cream formulation. The spreadability profile, water washability, centrifugation test, and organoleptic characteristics of formulated oil in water cream were all satisfactory. The cream exhibited a non-Newtonian rheological profile and pH range of 6.353 ± 0.065 to 6.467±0.050 over successive 0, 1, 2, and 3 months at normal room temperature. The 50% inhibition concentrations shown by herbal cream were 13.764 ± 0.153 µg/ml, 301.445 ± 1.709 µg/ml and 8.082 ± 0.055 respectively for 2, 2-diphenyl-1-picrylhydrazyl (DPPH) scavenging activity, ferric (Fe³⁺) reducing antioxidant power (FRAP) and 2, 2’-azinobis-3-ethylbenzothiazoline-6-sulfonic acid (ABTS) radical scavenging activity, and that of standard ascorbic acid were 6.716 ± 0.077 µg/ml, 171.604 ± 1.551µg/ml and 5.645±0.034µg/ml which showed formulated cream had strong antioxidant characteristics. The formulated herbal cream with a 50% tyrosinase inhibition concentration of 22.254 ± 0.369µg/ml compared to standard Kojic acid 12.535 ± 0.098µg/ml demonstrated a satisfactory tyrosinase inhibition profile for skin whitening property. Herbal cream was reportedly stable in physical and chemical parameters for successive 0, 1, 2, and 3 months at both real and accelerated time study zones, according to obtained stability study results.

Keywords: crude extracts, antioxidant, tyrosinase inhibition, green tea polyphenols

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529 Eco-Efficient Cementitious Materials for Construction Applications in Ireland

Authors: Eva Ujaczki, Rama Krishna Chinnam, Ronan Courtney, Syed A. M. Tofail, Lisa O'Donoghue

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Concrete is the second most widely used material in the world and is made of cement, sand, and aggregates. Cement is a hydraulic binder which reacts with water to form a solid material. In the cement manufacturing process, the right mix of minerals from mined natural rocks, e.g., limestone is melted in a kiln at 1450 °C to form a new compound, clinker. In the final stage, the clinker is milled into a fine cement powder. The principal cement types manufactured in Ireland are: 1) CEM I – Portland cement; 2) CEM II/A – Portland-fly ash cement; 3) CEM II/A – Portland-limestone cement and 4) CEM III/A – Portland-round granulated blast furnace slag (GGBS). The production of eco-efficient, blended cement (CEM II, CEM III) reduces CO₂ emission and improves energy efficiency compared to traditional cements. Blended cements are produced locally in Ireland and more than 80% of produced cement is blended. These eco-efficient, blended cements are a relatively new class of construction materials and a kind of geopolymer binders. From a terminological point of view, geopolymer cement is a binding system that is able to harden at room temperature. Geopolymers do not require calcium-silicate-hydrate gel but utilize the polycondensation of SiO₂ and Al₂O₃ precursors to achieve a superior strength level. Geopolymer materials are usually synthesized using an aluminosilicate raw material and an activating solution which is mainly composed of NaOH or KOH and Na₂SiO₃. Cement is the essential ingredient in concrete which is vital for economic growth of countries. The challenge for the global cement industry is to reach to increasing demand at the same time recognize the need for sustainable usage of resources. Therefore, in this research, we investigated the potential for Irish wastes to be used in geopolymer cement type applications through a national stakeholder workshop with the Irish construction sector and relevant stakeholders. This paper aims at summarizing Irish stakeholder’s perspective for introducing new secondary raw materials, e.g., bauxite residue or increasing the fly ash addition into cement for eco-efficient cement production.

Keywords: eco-efficient, cement, geopolymer, blending

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528 Embodied Spirituality in Gestalt Therapy

Authors: Silvia Alaimo

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This lecture brings to our attention the theme of spirituality within Gestalt therapy’s theoretical and clinical perspectives and which is closely connected to the fertile emptiness and creative indifference’ experiences. First of all, the premise that must be done is the overcoming traditional western culture’s philosophical and religious misunderstandings, such as the dicotomy between spirituality and pratical/material daily life, as well as the widespread secular perspective of classic psychology. Even fullness and emptiness have traditionally been associated with the concepts of being and not being. "There is only one way through which we can contact the deepest layers of our existence, rejuvenate our thinking and reach intuition (the harmony of thought and being): inner silence" (Perls) *. Therefore, "fertile void" doesn't mean empty in itself, but rather an useful condition of every creative and responsible act, making room for a deeper dimension close to spirituality. Spirituality concerns questions about the meaning of existence, which lays beyond the concrete and literal dimension, looking for the essence of things, and looking at the value of personal experience. Looking at fundamentals of Gestalt epistemology, phenomenology, aesthetics, and the relationship, we can reach the heart of a therapeutic work that takes spiritual contours and which are based on an embodied (incarnate size), through the relational aesthetic knowledge (Spagnuolo Lobb ), the deep contact with each other, the role of compassion and responsibility, as the patient's recognition criteria (Orange, 2013) rooted in the body. The aesthetic dimension, like the spiritual dimension to which it is often associated, is a subtle dimension: it is the dimension of the essence of things, of their "soul." In clinical practice, it implies that the relationship between therapist and patient is "in the absence of judgment," also called "zero point of creative indifference," expressed by ‘therapeutic mentality’. It consists in following with interest and authentic curiosity where the patient wants to go and support him in his intentionality of contact. It’s a condition of pure and simple awareness, of the full acceptance of "what is," a moment of detachment from one's own life in which one does not take oneself too seriously, a starting point for finding a center of balance and integration that brings to the creative act, to growth, and, as Perls would say, to the excitement and adventure of living.

Keywords: spirituality, bodily, embodied aesthetics, phenomenology, relationship

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527 Functional Characterization of Rv1019, a Putative TetR Family Transcriptional Regulator of Mycobacterium Tuberculosis H37Rv

Authors: Akhil Raj Pushparajan, Ranjit Ramachandran, Jijimole Gopi Reji, Ajay Kumar Ramakrishnan

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Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb), is one of the leading causes of death by an infectious disease. In spite of the availability of effective drugs and a vaccine, TB is a major health concern and was declared a global emergency by the World Health Organization (WHO). The success of intracellular pathogens like Mtb depends on its ability to overcome the challenging environment in the host. Gene regulation controlled by transcriptional regulators (TRs) plays a crucial role for the bacteria to adapt to the host environment. In vitro studies on gene regulatory mechanisms during dormancy and reactivation have provided insights into the adaptations employed by Mtb to survive in the host. Here we present our efforts to functionally characterize Rv1019, a putative TR of Mtb H37Rv which was found to be present at significantly varying levels during dormancy and reactivation in vitro. The expression of this protein in the dormancy-reactivation model was validated by qRT-PCR and western blot. By DNA- protein interaction studies and reporter assays we found that under normal laboratory conditions of growth this protein behaves as an auto-repressor and tetracycline was found to abrogate this repression by interfering with its ability to bind DNA. Further, by cDNA analysis, we found that this TR is co-transcribed with its downstream genes Rv1020 (mfd) and Rv1021 (mazG) which are involved in DNA damage response in Mtb. Constitutive expression of this regulator in the surrogate host M. smegmatis showed downregulation of the orthologues of downstream genes suggested that Rv1019 could negatively regulate these genes. Our finds also show that M. smegmatis expressing Rv1019 is sensitive to DNA damage suggests the role of this protein in regulating DNA damage response induced by oxidative stress. Because of its role in regulating DNA damage response which may help in the persistence of Mtb, Rv1019 could be used as a prospective target for therapeutic intervention to fight TB.

Keywords: auto-repressor, DNA repair, mycobacterium smegmatis, mycobacterium tuberculosis, tuberculosis

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526 Robustness of the Deep Chroma Extractor and Locally-Normalized Quarter Tone Filters in Automatic Chord Estimation under Reverberant Conditions

Authors: Luis Alvarado, Victor Poblete, Isaac Gonzalez, Yetzabeth Gonzalez

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In MIREX 2016 (http://www.music-ir.org/mirex), the deep neural network (DNN)-Deep Chroma Extractor, proposed by Korzeniowski and Wiedmer, reached the highest score in an audio chord recognition task. In the present paper, this tool is assessed under acoustic reverberant environments and distinct source-microphone distances. The evaluation dataset comprises The Beatles and Queen datasets. These datasets are sequentially re-recorded with a single microphone in a real reverberant chamber at four reverberation times (0 -anechoic-, 1, 2, and 3 s, approximately), as well as four source-microphone distances (32, 64, 128, and 256 cm). It is expected that the performance of the trained DNN will dramatically decrease under these acoustic conditions with signals degraded by room reverberation and distance to the source. Recently, the effect of the bio-inspired Locally-Normalized Cepstral Coefficients (LNCC), has been assessed in a text independent speaker verification task using speech signals degraded by additive noise at different signal-to-noise ratios with variations of recording distance, and it has also been assessed under reverberant conditions with variations of recording distance. LNCC showed a performance so high as the state-of-the-art Mel Frequency Cepstral Coefficient filters. Based on these results, this paper proposes a variation of locally-normalized triangular filters called Locally-Normalized Quarter Tone (LNQT) filters. By using the LNQT spectrogram, robustness improvements of the trained Deep Chroma Extractor are expected, compared with classical triangular filters, and thus compensating the music signal degradation improving the accuracy of the chord recognition system.

Keywords: chord recognition, deep neural networks, feature extraction, music information retrieval

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525 A New Co(II) Metal Complex Template with 4-dimethylaminopyridine Organic Cation: Structural, Hirshfeld Surface, Phase Transition, Electrical Study and Dielectric Behavior

Authors: Mohamed dammak

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Great attention has been paid to the design and synthesis of novel organic-inorganic compounds in recent decades because of their structural variety and the large diversity of atomic arrangements. In this work, the structure for the novel dimethyl aminopyridine tetrachlorocobaltate (C₇H₁₁N₂)₂CoCl₄ prepared by the slow evaporation method at room temperature has been successfully discussed. The X-ray diffraction results indicate that the hybrid material has a triclinic structure with a P space group and features a 0D structure containing isolated distorted [CoCl₄]2- tetrahedra interposed between [C7H11N²⁻]+ cations forming planes perpendicular to the c axis at z = 0 and z = ½. The effect of the synthesis conditions and the reactants used, the interactions between the cationic planes, and the isolated [CoCl4]2- tetrahedra are employing N-H...Cl and C-H…Cl hydrogen bonding contacts. The inspection of the Hirshfeld surface analysis helps to discuss the strength of hydrogen bonds and to quantify the inter-contacts. A phase transition was discovered by thermal analysis at 390 K, and comprehensive dielectric research was reported, showing a good agreement with thermal data. Impedance spectroscopy measurements were used to study the electrical and dielectric characteristics over a wide range of frequencies and temperatures, 40 Hz–10 MHz and 313–483 K, respectively. The Nyquist plot (Z" versus Z') from the complex impedance spectrum revealed semicircular arcs described by a Cole-Cole model. An electrical circuit consisting of a link of grain and grain boundary elements is employed. The real and imaginary parts of dielectric permittivity, as well as tg(δ) of (C₇H₁₁N₂)₂CoCl₄ at different frequencies, reveal a distribution of relaxation times. The presence of grain and grain boundaries is confirmed by the modulus investigations. Electric and dielectric analyses highlight the good protonic conduction of this material.

Keywords: organic-inorganic, phase transitions, complex impedance, protonic conduction, dielectric analysis

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