Search results for: national higher education fund corporation
Commenced in January 2007
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Edition: International
Paper Count: 19946

Search results for: national higher education fund corporation

2336 Computation of Radiotherapy Treatment Plans Based on CT to ED Conversion Curves

Authors: B. Petrović, L. Rutonjski, M. Baucal, M. Teodorović, O. Čudić, B. Basarić

Abstract:

Radiotherapy treatment planning computers use CT data of the patient. For the computation of a treatment plan, treatment planning system must have an information on electron densities of tissues scanned by CT. This information is given by the conversion curve CT (CT number) to ED (electron density), or simply calibration curve. Every treatment planning system (TPS) has built in default CT to ED conversion curves, for the CTs of different manufacturers. However, it is always recommended to verify the CT to ED conversion curve before actual clinical use. Objective of this study was to check how the default curve already provided matches the curve actually measured on a specific CT, and how much it influences the calculation of a treatment planning computer. The examined CT scanners were from the same manufacturer, but four different scanners from three generations. The measurements of all calibration curves were done with the dedicated phantom CIRS 062M Electron Density Phantom. The phantom was scanned, and according to real HU values read at the CT console computer, CT to ED conversion curves were generated for different materials, for same tube voltage 140 kV. Another phantom, CIRS Thorax 002 LFC which represents an average human torso in proportion, density and two-dimensional structure, was used for verification. The treatment planning was done on CT slices of scanned CIRS LFC 002 phantom, for selected cases. Interest points were set in the lungs, and in the spinal cord, and doses recorded in TPS. The overall calculated treatment times for four scanners and default scanner did not differ more than 0.8%. Overall interest point dose in bone differed max 0.6% while for single fields was maximum 2.7% (lateral field). Overall interest point dose in lungs differed max 1.1% while for single fields was maximum 2.6% (lateral field). It is known that user should verify the CT to ED conversion curve, but often, developing countries are facing lack of QA equipment, and often use default data provided. We have concluded that the CT to ED curves obtained differ in certain points of a curve, generally in the region of higher densities. This influences the treatment planning result which is not significant, but definitely does make difference in the calculated dose.

Keywords: Computation of treatment plan, conversion curve, radiotherapy, electron density

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2335 Enhanced Methane Yield from Organic Fraction of Municipal Solid Waste with Coconut Biochar as Syntrophic Metabolism Biostimulant

Authors: Maria Altamirano, Alfonso Duran

Abstract:

Biostimulation has recently become important in order to improve the stability and performance of the anaerobic digestion (AD) process. This strategy involves the addition of nutrients or supplements to improve the rate of degradation of a native microbial consortium. With the aim of biostimulate sytrophism between secondary fermenting bacteria and methanogenic archaea, improving metabolite degradation and efficient conversion to methane, the addition of conductive materials, mainly carbon based have been studied. This research seeks to highlight the effect that coconut biochar (CBC) has on the metanogenic conversion of the organic fraction of municipal solid waste (OFMSW), analyzing the surface chemistry properties that give biochar its capacity to serve as a redox mediator in the anaerobic digestion process. The biochar characterization techniques were electrical conductivity (EC) scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS), Fourier Transform Infrared Transmission Spectroscopy (FTIR) and Cyclic Voltammetry (CV). Effect of coconut biochar addition was studied using Authomatic Methane Potential Test System (AMPTS II) applying a one-way variance analysis to determine the dose that leads to higher methane performance. The surface chemistry of the CBC could confer properties that enhance the AD process, such as the presence of alkaline and alkaline earth metals and their hydrophobicity that may be related to their buffering capacity and the adsorption of polar and non-polar compounds, such as NH4+ and CO2. It also has aromatic functional groups, just as quinones, whose potential as a redox mediator has been demonstrated and its morphology allows it to form an immobilizing matrix that favors a closer activity among the syntrophic microorganisms, which directly contributed in the oxidation of secondary metabolites and the final reduction to methane, whose yield is increased by 39% compared to controls, with a CBC dose of 1 g/L.

Keywords: anaerobic digestion, biochar, biostimulation, syntrophic metabolism

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2334 IT Investment Decision Making: Case Studies on the Implementation of Contactless Payments in Commercial Banks of Kazakhstan

Authors: Symbat Moldabekova

Abstract:

This research explores the practice of decision-making in commercial banks in Kazakhstan. It focuses on recent technologies, such as contactless payments and QR code, and uses interviews with bank executives and industry practitioners to gain an understanding of how decisions are made and the role of financial assessment methods. The aim of the research is (1) to study the importance of financial techniques to evaluate IT investments; (2) to understand the role of different expert groups; (3) to explore how market trends and industry features affect decisions on IT; (4) to build a model that defines the real practice of decision-making on IT in commercial banks in Kazakhstan. The theoretical framework suggests that decision-making on IT is a socially constructed process, where actor groups with different background interact and negotiate with each other to develop a shared understanding of IT and to make more effective decisions. Theory and observations suggest that the more parties involved in the process of decision-making, the higher the possibility of disagreements between them. As each actor group has their views on the rational decision on an IT project, it is worth exploring how the final decision is made in practice. Initial findings show that the financial assessment methods are used as a guideline and do not play a big role in the final decision. The commercial banks of Kazakhstan tend to study experience of neighboring countries before adopting innovation. Implementing contactless payments is widely regarded as pinnacle success factor due to increasing competition in the market. First-to-market innovations are considered as priorities therefore, such decisions can be made with exemption of some certain actor groups from the process. Customers play significant role and they participate in testing demo versions of the products before bringing innovation to the market. The study will identify the viewpoints of actors in the banking sector on a rational decision, and the ways decision-makers from a variety of disciplines interact with each other in order to make a decision on IT in retail banks.

Keywords: actor groups, decision making, technology investment, retail banks

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2333 Degradation of Commercial Polychlorinated Biphenyl Mixture by Naturally Occurring Facultative Microorganisms via Anaerobic Dechlorination and Aerobic Oxidation

Authors: P. M. G. Pathiraja, P. Egodawatta, A. Goonetilleke, V. S. J. Te'o

Abstract:

The production and use of Polychlorinated biphenyls (PCBs), a group of synthetic halogenated hydrocarbons have been restricted worldwide due to its toxicity and categorized as one of the twelve priority persistent organic pollutants (POP) by the Stockholm Convention. Low reactivity and high chemical stability of PCBs have made them highly persistent in the environment and bio-concentration and bio-magnification along the food chain contribute to multiple health impacts in humans and animals. Remediating environments contaminated with PCBs is a challenging task for decades. Use of microorganisms for remediation of PCB contaminated soils and sediments have been widely investigated due to the potential of breakdown these complex contaminants with minimum environmental impacts. To achieve an effective bioremediation of polychlorinated biphenyls (PCBs) contaminated environments, microbes were sourced from environmental samples and tested for their ability to hydrolyze PCBs under different conditions. Comparison of PCB degradation efficiencies of four naturally occurring facultative bacterial cultures isolated through selective enrichment under aerobic and anaerobic conditions were simultaneously investigated in minimal salt medium using 50 mg/L Aroclor 1260, a commonly used commercial PCB mixture as the sole source of carbon. The results of a six-week study demonstrated that all the tested facultative Achromobacter, Ochrobactrum, Lysinibacillus and Pseudomonas strains are capable of degrading PCBs under both anaerobic and aerobic conditions while assisting hydrophobic PCBs to make solubilize in the aqueous minimal medium. Overall, the results suggest that some facultative bacteria are capable of effective in degrading PCBs under anaerobic conditions through reductive dechlorination and under aerobic conditions through oxidation. Therefore, use of suitable facultative microorganisms under combined anaerobic-aerobic conditions and combination of such strains capable of solubilization and breakdown of PCBs has high potential in achieving higher PCB removal rates.

Keywords: bioremediation, combined anaerobic-aerobic degradation, facultative microorganisms, polychlorinated biphenyls

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2332 Enhancing Healthcare Delivery in Low-Income Markets: An Exploration of Wireless Sensor Network Applications

Authors: Innocent Uzougbo Onwuegbuzie

Abstract:

Healthcare delivery in low-income markets is fraught with numerous challenges, including limited access to essential medical resources, inadequate healthcare infrastructure, and a significant shortage of trained healthcare professionals. These constraints lead to suboptimal health outcomes and a higher incidence of preventable diseases. This paper explores the application of Wireless Sensor Networks (WSNs) as a transformative solution to enhance healthcare delivery in these underserved regions. WSNs, comprising spatially distributed sensor nodes that collect and transmit health-related data, present opportunities to address critical healthcare needs. Leveraging WSN technology facilitates real-time health monitoring and remote diagnostics, enabling continuous patient observation and early detection of medical issues, especially in areas with limited healthcare facilities and professionals. The implementation of WSNs can enhance the overall efficiency of healthcare systems by enabling timely interventions, reducing the strain on healthcare facilities, and optimizing resource allocation. This paper highlights the potential benefits of WSNs in low-income markets, such as cost-effectiveness, increased accessibility, and data-driven decision-making. However, deploying WSNs involves significant challenges, including technical barriers like limited internet connectivity and power supply, alongside concerns about data privacy and security. Moreover, robust infrastructure and adequate training for local healthcare providers are essential for successful implementation. It further examines future directions for WSNs, emphasizing innovation, scalable solutions, and public-private partnerships. By addressing these challenges and harnessing the potential of WSNs, it is possible to revolutionize healthcare delivery and improve health outcomes in low-income markets.

Keywords: wireless sensor networks (WSNs), healthcare delivery, low-Income markets, remote patient monitoring, health data security

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2331 Interfacial Adhesion and Properties Improvement of Polyethylene/Thermoplastic Starch Blend Compatibilized by Stearic Acid-Grafted-Starch

Authors: Nattaporn Khanoonkon, Rangrong Yoksan, Amod A. Ogale

Abstract:

Polyethylene (PE) is one of the most petroleum-based thermoplastic materials used in many applications including packaging due to its cheap, light-weight, chemically inert and capable to be converted into various shapes and sizes of products. Although PE is a commercially potential material, its non-biodegradability caused environmental problems. At present, bio-based polymers become more interesting owing to its bio-degradability, non-toxicity, and renewability as well as being eco-friendly. Thermoplastic starch (TPS) is a bio-based and biodegradable plastic produced from the plasticization of starch under applying heat and shear force. In many researches, TPS was blended with petroleum-based polymers including PE in order to reduce the cost and the use of those polymers. However, the phase separation between hydrophobic PE and hydrophilic TPS limited the amount of TPS incorporated. The immiscibility of two different polarity polymers can be diminished by adding compatibilizer. PE-based compatibilizers, e.g. polyethylene-grafted-maleic anhydride, polyethylene-co-vinyl alcohol, etc. have been applied for the PE/TPS blend system in order to improve their miscibility. Until now, there is no report about the utilization of starch-based compatibilizer for PE/TPS blend system. The aims of the present research were therefore to synthesize a new starch-based compatibilizer, i.e. stearic acid-grafted starch (SA-g-starch) and to study the effect of SA-g-starch on chemical interaction, morphological properties, tensile properties and water vapor as well as oxygen barrier properties of the PE/TPS blend films. PE/TPS blends without and with incorporating SA-g-starch with a content of 1, 3 and 5 part(s) per hundred parts of starch (phr) were prepared using a twin screw extruder and then blown into films using a film blowing machine. Incorporating 1 phr and 3 phr of SA-g-starch could improve miscibility of the two polymers as confirmed from the reduction of TPS phase size and the good dispersion of TPS phase in PE matrix. In addition, the blend containing SA-g-starch with contents of 1 phr and 3 phr exhibited higher tensile strength and extensibility, as well as lower water vapor and oxygen permeabilities than the naked blend. The above results suggested that SA-g-starch could be potentially applied as a compatibilizer for the PE/TPS blend system.

Keywords: blend, compatibilizer, polyethylene, thermoplastic starch

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2330 Reducing the Length of Stay and Mortality in COVID-19 Patients with Diabetes

Authors: Sara Alzahrani, Samia Bokari, Patan Khan, Muneera Alshareef, Rania Safwat, Mohammed Galal, Hamdi Alqadi, Ameerah Alzahrani, Rehab Alboraie

Abstract:

Introduction & Background: Diabetes in COVID-19 patients is individual risk factor and documented in worldwide studies to contribute to disease severity, increased length of stay and higher mortality. Aggressive management of blood sugars and acute diabetic complications reduce the length of stay and mortality. Methods: Randomly selected 200 patients admitted with diabetes and COVID-19 studied. The unified treatment protocol applied for all patients and blood sugars monitored closely and optimized .Data collected on bimonthly basis and analyzed. Patients’ characteristics taken from data extraction tool (Oasis) of hospital. Median values for length of stay and post discharge FBS and RBS were calculated via Microsoft Excel tool. Mortality rates were calculated by percentages. The results monitored in the post discharge clinic was 130 mg/dl and 170 mg/dl respectively. The results compared with the standard international studies. Discussion: Diabetes in COVID-19 patients posed great challenge as increased severity and mortalities reported compared to non-diabetic. Taking a pre-emptive strategy to combat this problem by aggressively manage diabetes help in reducing length of stay and morbidity. The length of stay in studded population was 3 days as compared to 13 days in a major international study. Financial saving come from rapid turnover of beds. The mortality was 2.5 % compared to reported 7.3% in a major study, reflecting the implications of aggressive management of diabetes. Regular follow-up and support by running post-discharge clinic definitely help reducing readmissions and acute complications of uncontrolled diabetes. Conclusion: Aggressive management of diabetes in COVID-19 patients by tailored treatment protocols and dedicated teams will help to decrease the morbidity and mortality.

Keywords: diabetes, covid-19, management, mortality

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2329 The Missing Link in Holistic Health Care: Value-Based Medicine in Entrustable Professional Activities for Doctor-Patient Relationship

Authors: Ling-Lang Huang

Abstract:

Background: The holistic health care should ideally cover physical, mental, spiritual, and social aspects of a patient. With very constrained time in current clinical practice system, medical decisions often tip the balance in favor of evidence-based medicine (EBM) in comparison to patient's personal values. Even in the era of competence-based medical education (CBME), when scrutinizing the items of entrustable professional activities (EPAs), we found that EPAs of establishing doctor-patient relationship remained incomplete or even missing. This phenomenon prompted us to raise this project aiming at advocating value-based medicine (VBM), which emphasizes the importance of patient’s values in medical decisions. A true and effective doctor-patient communication and relationship should be a well-balanced harmony of EBM and VBM. By constructing VBM into current EPAs, we can further promote genuine shared decision making (SDM) and fix the missing link in holistic health care. Methods: In this project, we are going to find out EPA elements crucial for establishing an ideal doctor-patient relationship through three distinct pairs of doctor-patient relationships: patients with pulmonary arterial hypertension (relatively young but with grave disease), patients undergoing surgery (facing critical medical decisions), and patients with terminal diseases (facing forthcoming death). We’ll search for important EPA elements through the following steps: 1. Narrative approach to delineate patients’ values among 2. distinct groups. 3.Hermeneutics-based interview: semi-structured interview will be conducted for both patients and physicians, followed by qualitative analysis of collected information by compiling, disassembling, reassembling, interpreting, and concluding. 4. Preliminarily construct those VBM elements into EPAs for doctor-patient relationships in 3 groups. Expected Outcomes: The results of this project are going to give us invaluable information regarding the impact of patients’ values, while facing different medical situations, on the final medical decision. The competence of well-blending and -balanced both values from patients and evidence from clinical sciences is the missing link in holistic health care and should be established in future EPAs to enhance an effective SDM.

Keywords: value-based medicine, shared decision making, entrustable professional activities, holistic health care

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2328 Development of Methotrexate Nanostructured Lipid Carriers for Topical Treatment of Psoriasis: Optimization, Evaluation, and in vitro Studies

Authors: Yogeeta O. Agrawal, Hitendra S. Mahajan, Sanjay J. Surana

Abstract:

Methotrexate is effective in controlling recalcitrant psoriasis when administered by the oral or parenteral route long-term. However, the systematic use of this drug may provoke any of a number of side effects, notably hepatotoxic effects. To reduce these effects, clinical studies have been done with topical MTx. It is useful in treating a number of cutaneous conditions, including psoriasis. A major problem in topical administration of MTx currently available in market is that the drug is hydrosoluble and is mostly in the dissociated form at physiological pH. Its capacity for passive diffusion is thus limited. Localization of MTx in effected layers of skin is likely to improve the role of topical dosage form of the drug as a supplementary to oral therapy for treatment of psoriasis. One of the possibilities for increasing the penetration of drugs through the skin is the use of Nanostructured lipid Carriers. The objective of the present study was to formulate and characterize Methotrexate loaded Nanostructured Lipid Carriers (MtxNLCs), to understand in vitro drug release and evaluate the role of the developed gel in the topical treatment of psoriasis. MtxNLCs were prepared by solvent diffusion technique using 3(2) full factorial design.The mean diameter and surface morphology of MtxNLC was evaluated. MtxNLCs were lyophilized and crystallinity of NLC was characterized by Differential Scanning Calorimtery (DSC) and powder X-Ray Diffraction (XRD). The NLCs were incorporated in 1% w/w Carbopol 934 P gel base and in vitro skin deposition studies in Human Cadaver Skin were conducted. The optimized MtxNLCs were spherical in shape, with average particle size of 253(±9.92)nm, zeta potential of -30.4 (±0.86) mV and EE of 53.12(±1.54)%. DSC and XRD data confirmed the formation of NLCs. Significantly higher deposition of Methotrexate was found in human cadaver skin from MtxNLC gel (71.52 ±1.23%) as compared to Mtx plain gel (54.28±1.02%). Findings of the studies suggest that there is significant improvement in therapeutic index in treatment of psoriasis by MTx-NLCs incorporated gel base developed in this investigation over plain drug gel currently available in the market.

Keywords: methotrexate, psoriasis, NLCs, hepatotoxic effects

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2327 Deconstruction of the Term 'Shaman' in the Metaphorical Pair 'Artist as a Shaman'

Authors: Ilona Ivova Anachkova

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The analogy between the artist and the shaman as both being practitioners that more easily recognize and explore spiritual matters, and thus contribute to the society in a unique way has been implied in both Modernity and Postmodernity. The Romantic conception of the shaman as a great artist who helps common men see and understand messages of a higher consciousness has been employed throughout Modernity and is active even now. This paper deconstructs the term ‘shaman’ in the metaphorical analogy ‘artist – shaman’ that was developed more fully in Modernity in different artistic and scientific discourses. The shaman is a figure that to a certain extent adequately reflects the late modern and postmodern holistic views on the world. Such views aim at distancing from traditional religious and overly rationalistic discourses. However, the term ‘shaman’ can be well substituted by other concepts such as the priest, for example. The concept ‘shaman’ is based on modern ethnographic and historical investigations. Its later philosophical, psychological and artistic appropriations designate the role of the artist as a spiritual and cultural leader. However, the artist and the shaman are not fully interchangeable terms. The figure of the shaman in ‘primitive’ societies has performed many social functions that are now delegated to different institutions and positions. The shaman incorporates the functions of a judge, a healer. He is a link to divine entities. He is the creative, aspiring human being that has heightened sensitivity to the world in both its spiritual and material aspects. Building the metaphorical analogy between the shaman and the artist comes in many ways. Both are seen as healers of the society, having propensity towards connection to spiritual entities, or being more inclined to creativity than others. The ‘shaman’ however is a fashionable word for a spiritual person used perhaps because of the anti-traditionalist religious modern and postmodern views. The figure of the priest is associated with a too rational, theoretical and detached attitude towards spiritual matters, while the practices of the shaman and the artist are considered engaged with spirituality on a deeper existential level. The term ‘shaman’ however does not have priority of other words/figures that can explore and deploy spiritual aspects of reality. Having substituted the term ‘shaman’ in the pair ‘artist as a shaman’ with ‘the priest’ or literally ‘anybody,' we witness destruction of spiritual hierarchies and come to the view that everybody is responsible for their own spiritual and creative evolution.

Keywords: artist as a shaman, creativity, extended theory of art, functions of art, priest as an artist

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2326 Spatio-temporal Distribution of Surface Water Quality in the Kebir Rhumel Basin, Algeria

Authors: Lazhar Belkhiri, Ammar Tiri, Lotfi Mouni, Fatma Elhadj Lakouas

Abstract:

This research aims to present a surface water quality assessment of hydrochemical parameters in the Kebir Rhumel Basin, Algeria. The water quality index (WQI), Mann–Kendall (MK) test, and hierarchical cluster analysis (HCA) were used in oder to understand the spatio-temporal distribution of the surface water quality in the study area. Eleven hydrochemical parameters were measured monthly at eight stations from January 2016 to December 2020. The dominant cation in the surface water was found to be calcium, followed by sodium, and the dominant anion was sulfate, followed by chloride. In terms of WQI, a significant percentage of surface water samples at stations Ain Smara (AS), Beni Haroune (BH), Grarem (GR), and Sidi Khlifa (SK) exhibited poor water quality, with approximately 89.5%, 90.6%, 78.2%, and 62.7%, respectively, falling into this category. Mann–Kendall trend analysis revealed a significantly increasing trend in WQI values at stations Oued Boumerzoug (ON) and SK, indicating that the temporal variation of WQI in these stations is significant. Hierarchical clustering analysis classified the data into three clusters. The first cluster contained approximately 22% of the total number of months, the second cluster included about 30%, and the third cluster had the highest representation, approximately 48% of the total number of months. Within these clusters, certain stations exhibited higher WQI values. In the first cluster, stations GR and ON had the highest WQI values. In the second cluster, stations Oued Boumerzoug (OB) and SK showed the highest WQI values, while in the last cluster, stations AS, BH, El Milia (EM), and Hammam Grouz (HG) had the highest mean WQI values. Also, approximately 38%, 41%, and 38% of the total water samples in the first, second, and third clusters, respectively, were classified as having poor water quality. The findings of this study can serve as a scientific basis for decision-makers to formulate strategies for surface water quality restoration and management in the region.

Keywords: surface water, water quality index (WQI), Mann Kendall (MK) test, hierarchical cluster analysis (HCA), spatial-temporal distribution, Kebir Rhumel Basin

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2325 Effects of Pterostilbene in Brown Adipose Tissue from Obese Rats

Authors: Leixuri Aguirre, Iñaki Milton-Laskibar, Elizabeth Hijona, Luis Bujanda, Agnes M. Rimando, Maria P. Portillo

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Introduction: In recent years great attention has been paid by scientific community to phenolic compounds as active biomolecules naturally present in foodstuffs due to their beneficial effects on health. Pterostilbene is a resveratrol dimethylether derivative which shows higher biodisponibility. Objective. To analyze the effects of two doses of pterostilbene on several markers of thermogenic capacity in a model of genetic obesity, which shows reduced thermogenesis. Methods: The experiment was conducted with thirty Zucker (fa/fa) rats that were distributed in 3 experimental groups, the control group and two groups orally administered with pterostilbene at 15 and 30 mg/kg body weight/day for 6 weeks. Gene expression of Ucp1, Pgc-1α, Cpt1b, Pparα, Nfr1, Tfam and Cox-2 were assessed by RT-PCR, protein expression of UCP1 and GLUT4 by western blot and enzyme activity of carnitine palmitoyl transferase 1b and citrate synthase by spectrophotometry in interscapular brown adipose tissue (iBAT). Statistical analysis was performed by using one way ANOVA and Newman-Keuls as post-hoc test. Results: Pterostilbene did not change gene expression of Pgc-1α. However, significant increases were found in the expression of Ucp1, Pparα, Nfr-1 and Cox-2. Protein expression of UCP1 and GLUT4 was increased in animals treated with pterostilbene, as well as the activities of CPT-1b and CS. These effects were observed with both doses of pterostilbene, without differences between them. Conclusions: These results show that pterostilbene increases thermogenic and oxidative capacity of brown adipose tissue in obese rats. Whether these effects effectively contribute to the anti-obesity properties of these compound needs further research. Acknowledgments: MINECO-FEDER (AGL2015-65719-R), Basque Government (IT-572-13), University of the Basque Country (ELDUNANOTEK UFI11/32), Institut of Health Carlos III (CIBERobn). Iñaki Milton is a fellowship from the Basque Government.

Keywords: brown adipose tissue, pterostilbene, thermogenesis, uncoupling protein 1

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2324 Approach for Evaluating Wastewater Reuse Options in Agriculture

Authors: Manal Elgallal, Louise Fletcher, Barbara Evans

Abstract:

Water scarcity is a growing concern in many arid and semi-arid countries. The increase of water scarcity threatens economic development and sustainability of human livelihoods as well as environment especially in developing countries. Globally, agriculture is the largest water consumption sector, accounting for approximately 70% of all freshwater extraction. Growing competition between the agricultural and higher economic value in urban and industrial uses of high-quality freshwater supplies, especially in regions where water scarcity major problems, will increase the pressure on this precious resource. In this circumstance, wastewater may provide reliable source of water for agriculture and enable freshwater to be exchanged for more economically valuable purposes. Concern regarding the risks from microbial and toxic components to human health and environment quality is a serious obstacle for wastewater reuse particularly in agriculture. Although powerful approaches and tools for microbial risk assessment and management for safe use of wastewater are now available, few studies have attempted to provide any mechanism to quantitatively assess and manage the environmental risks resulting from reusing wastewater. In seeking pragmatic solutions to sustainable wastewater reuse, there remains a lack of research incorporating both health and environmental risk assessment and management with economic analysis in order to quantitatively combine cost, benefits and risks to rank alternative reuse options. This study seeks to enhance effective reuse of wastewater for irrigation in arid and semi-arid areas, the outcome of the study is an evaluation approach that can be used to assess different reuse strategies and to determine the suitable scale at which treatment alternatives and interventions are possible, feasible and cost effective in order to optimise the trade-offs between risks to protect public health and the environment and preserving the substantial benefits.

Keywords: environmental risks, management, life cycle costs, waste water irrigation

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2323 Seismic Retrofit of Reinforced Concrete Structures by Highly Dissipative Technologies

Authors: Stefano Sorace, Gloria Terenzi, Giulia Mazzieri, Iacopo Costoli

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The prolonged earthquake sequence that struck several urban agglomerations and villages in Central Italy, starting from 24 August 2016 through January 2017, highlighted once again the seismic vulnerability of pre-normative reinforced concrete (R/C) structures. At the same time, considerable damages were surveyed in recently retrofitted R/C buildings too, one of which also by means of a dissipative bracing system. The solution adopted for the latter did not expressly take into account the performance of non-structural elements, and namely of infills and partitions, confirming the importance of their dynamic interaction with the structural skeleton. Based on this consideration, an alternative supplemental damping-based retrofit solution for this representative building, i.e., a school with an R/C structure situated in the municipality of Norcia, is examined in this paper. It consists of the incorporation of dissipative braces equipped with pressurized silicone fluid viscous (FV) dampers, instead of the BRAD system installed in the building, the delayed activation of which -caused by the high stiffness of the constituting metallic dampers- determined the observed non-structural damages. Indeed, the alternative solution proposed herein, characterized by dissipaters with mainly damping mechanical properties, guarantees an earlier activation of the protective system. A careful assessment analysis, preliminarily carried out to simulate and check the case study building performance in originally BRAD-retrofitted conditions, confirms that the interstorey drift demand related to the Norcia earthquake's mainshock and aftershocks is beyond the response capacity of infills. The verification analyses developed on the R/C structure, including the FV-damped braces, highlight their higher performance, giving rise to a completely undamaged response both of structural and non-structural elements up to the basic design earthquake normative level of seismic action.

Keywords: dissipative technologies, performance assessment analysis, concrete structures, seismic retrofit

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2322 Relationship between Left Ventricle Position and Hemodynamic Parameters during Cardiopulmonary Resuscitation in a Pig Model

Authors: Hyun Chang Kim, Yong Hun Jung, Kyung Woon Jeung

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Background: From the viewpoint of cardiac pump theory, the area of the left ventricle (LV) subjected to compression increases as the LV lies closer to the sternum, possibly resulting in higher blood flow in patients with LV closer to the sternum. However, no study has evaluated LV position during cardiac arrest or its relationship with hemodynamic parameters during cardiopulmonary resuscitation (CPR). The objectives of this study were to determine whether the position of the LV relative to the anterior-posterior axis representing the direction of chest compression shifts during cardiac arrest and to examine the relationship between LV position and hemodynamic parameters during CPR. Methods: Subcostal view echocardiograms were obtained from 15 pigs with the transducer parallel to the long axis of the sternum before inducing ventricular fibrillation (VF) and during cardiac arrest. Computed tomography was performed in three pigs to objectively observe LV position during cardiac arrest. LV position parameters including the shortest distance between the anterior-posterior axis and the mid-point of the LV chamber (DAP-MidLV), the shortest distance between the anterior-posterior axis and the LV apex (DAP-Apex), and the area fraction of the LV located on the right side of the anterior-posterior axis (LVARight/LVATotal) were measured. Results: DAP-MidLV, DAP-Apex, and LVARight/LVATotal decreased progressively during untreated VF and basic life support (BLS), and then increased during advanced cardiovascular life support (ACLS). A repeated measures analysis of variance revealed significant time effects for these parameters. During BLS, the end-tidal carbon dioxide and systolic right atrial pressure were significantly correlated with the LV position parameters. During ACLS, systolic arterial pressure and systolic right atrial pressure were significantly correlated with DAP-MidLV and DAP-Apex. Conclusions: LV position changed significantly during cardiac arrest compared to the pre-arrest baseline. LV position during CPR had significant correlations with hemodynamic parameters.

Keywords: heart arrest, cardiopulmonary resuscitation, heart ventricle, hemodynamics

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2321 Evaluation of the Effect of Milk Recording Intervals on the Accuracy of an Empirical Model Fitted to Dairy Sheep Lactations

Authors: L. Guevara, Glória L. S., Corea E. E, A. Ramírez-Zamora M., Salinas-Martinez J. A., Angeles-Hernandez J. C.

Abstract:

Mathematical models are useful for identifying the characteristics of sheep lactation curves to develop and implement improved strategies. However, the accuracy of these models is influenced by factors such as the recording regime, mainly the intervals between test day records (TDR). The current study aimed to evaluate the effect of different TDR intervals on the goodness of fit of the Wood model (WM) applied to dairy sheep lactations. A total of 4,494 weekly TDRs from 156 lactations of dairy crossbred sheep were analyzed. Three new databases were generated from the original weekly TDR data (7D), comprising intervals of 14(14D), 21(21D), and 28(28D) days. The parameters of WM were estimated using the “minpack.lm” package in the R software. The shape of the lactation curve (typical and atypical) was defined based on the WM parameters. The goodness of fit was evaluated using the mean square of prediction error (MSPE), Root of MSPE (RMSPE), Akaike´s Information Criterion (AIC), Bayesian´s Information Criterion (BIC), and the coefficient of correlation (r) between the actual and estimated total milk yield (TMY). WM showed an adequate estimate of TMY regardless of the TDR interval (P=0.21) and shape of the lactation curve (P=0.42). However, we found higher values of r for typical curves compared to atypical curves (0.9vs.0.74), with the highest values for the 28D interval (r=0.95). In the same way, we observed an overestimated peak yield (0.92vs.6.6 l) and underestimated time of peak yield (21.5vs.1.46) in atypical curves. The best values of RMSPE were observed for the 28D interval in both lactation curve shapes. The significant lowest values of AIC (P=0.001) and BIC (P=0.001) were shown by the 7D interval for typical and atypical curves. These results represent the first approach to define the adequate interval to record the regime of dairy sheep in Latin America and showed a better fitting for the Wood model using a 7D interval. However, it is possible to obtain good estimates of TMY using a 28D interval, which reduces the sampling frequency and would save additional costs to dairy sheep producers.

Keywords: gamma incomplete, ewes, shape curves, modeling

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2320 Perception of Predictive Confounders for the Prevalence of Hypertension among Iraqi Population: A Pilot Study

Authors: Zahraa Albasry, Hadeel D. Najim, Anmar Al-Taie

Abstract:

Background: Hypertension is considered as one of the most important causes of cardiovascular complications and one of the leading causes of worldwide mortality. Identifying the potential risk factors associated with this medical health problem plays an important role in minimizing its incidence and related complications. The objective of this study is to explore the prevalence of receptor sensitivity regarding assess and understand the perception of specific predictive confounding factors on the prevalence of hypertension (HT) among a sample of Iraqi population in Baghdad, Iraq. Materials and Methods: A randomized cross sectional study was carried out on 100 adult subjects during their visit to the outpatient clinic at a certain sector of Baghdad Province, Iraq. Demographic, clinical and health records alongside specific screening and laboratory tests of the participants were collected and analyzed to detect the potential of confounding factors on the prevalence of HT. Results: 63% of the study participants suffered from HT, most of them were female patients (P < 0.005). Patients aged between 41-50 years old significantly suffered from HT than other age groups (63.5%, P < 0.001). 88.9% of the participants were obese (P < 0.001) and 47.6% had diabetes with HT. Positive family history and sedentary lifestyle were significantly higher among all hypertensive groups (P < 0.05). High salt and fatty food intake was significantly found among patients suffered from isolated systolic hypertension (ISHT) (P < 0.05). A significant positive correlation between packed cell volume (PCV) and systolic blood pressure (SBP) (r = 0.353, P = 0.048) found among normotensive participants. Among hypertensive patients, a positive significant correlation found between triglycerides (TG) and both SBP (r = 0.484, P = 0.031) and diastolic blood pressure (DBP) (r = 0.463, P = 0.040), while low density lipoprotein-cholesterol (LDL-c) showed a positive significant correlation with DBP (r = 0.443, P = 0.021). Conclusion: The prevalence of HT among Iraqi populations is of major concern. Further consideration is required to detect the impact of potential risk factors and to minimize blood pressure (BP) elevation and reduce the risk of other cardiovascular complications later in life.

Keywords: Correlation, Hypertension, Iraq, Risk factors

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2319 The Role of Situational Factors in User Experience during Human-Robot Interaction

Authors: Da Tao, Tieyan Wang, Mingfu Qin

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While social robots have been increasingly developed and rapidly applied in our daily life, how robots should interact with humans is still an urgent problem to be explored. Appropriate use of interactive behavior is likely to create a good user experience in human-robot interaction situations, which in turn can improve people’s acceptance of robots. This paper aimed to systematically and quantitatively examine the effects of several important situational factors (i.e., interaction distance, interaction posture, and feedback style) on user experience during human-robot interaction. A three-factor mixed designed experiment was adopted in this study, where subjects were asked to interact with a social robot in different interaction situations by combinations of varied interaction distance, interaction posture, and feedback style. A set of data on users’ behavioral performance, subjective perceptions, and eye movement measures were tracked and collected, and analyzed by repeated measures analysis of variance. The results showed that the three situational factors showed no effects on behavioral performance in tasks during human-robot interaction. Interaction distance and feedback style yielded significant main effects and interaction effects on the proportion of fixation times. The proportion of fixation times on the robot is higher for negative feedback compared with positive feedback style. While the proportion of fixation times on the robot generally decreased with the increase of the interaction distance, it decreased more under the positive feedback style than under the negative feedback style. In addition, there were significant interaction effects on pupil diameter between interaction distance and posture. As interaction distance increased, mean pupil diameter became smaller in side interaction, while it became larger in frontal interaction. Moreover, the three situation factors had significant interaction effects on user acceptance of the interaction mode. The findings are helpful in the underlying mechanism of user experience in human-robot interaction situations and provide important implications for the design of robot behavioral expression and for optimal strategies to improve user experience during human-robot interaction.

Keywords: social robots, human-robot interaction, interaction posture, interaction distance, feedback style, user experience

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2318 Exploration Of The Nonlinear Viscoelastic Behavior Of Yogurt Using Lissajous Curves

Authors: Hugo Espinosa-Andrews

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Introduction: Yogurt is widely accepted worldwide due to its high nutritional value, consistency, and texture. Their rheological properties play a significant role in consumer acceptance and are related to the manufacturing process and formulation. Typically, the viscoelastic characteristics of yogurts are studied using the small amplitude oscillatory shear test; however, the initial stages of flow and oral processing are described in the nonlinear zone, in which a large amplitude oscillatory stress test is applied. The objective of this work was to analyze the nonlinear viscoelastic behavior of commercial yogurts using Lissajous curves. Methods: Two commercial yogurts were purchased in a local store in Guadalajara Jalisco Mexico: a natural Greek-style yogurt and a low-fat traditional yogurt. Viscoelastic properties were evaluated using a large amplitude oscillatory stress procedure (LAOS). A crosshatch geometry of 40 mm and a truncation of 1000 µm were used. Stress sweeps were performed at 6.28 rad/s from 1 to 250 Pa at 5°C. The nonlinear viscoelastic properties were analyzed using the Lissajous curves. Results: The yogurts showed strain-viscoelastic behavior related to deformation-dependent materials. In the low-strain region, the elastic modulus predominated over the viscous modulus, showing gel-elastic properties. The sol-gel transitions were observed at approximately 66.5 Pa for the Greek yogurt, double that detected for traditional yogurt. The viscoelastic behavior of the yogurts was characteristic of weak excess deformation: behavior indicating a stable molecular structure at rest, and moderate structure at medium shear-forces. The normalized Lissajous curves characterized viscoelastic transitions of the yogurt as the stress increased. Greater viscoelasticity deformation was observed in Greek yogurt than in traditional yogurt, which is related to the presence of a protein network with a greater degree of crosslinking. Conclusions: The yogurt composition influences the viscoelastic properties of the material. Yogurt with the higher percentage of protein has greater viscoelastic and viscous properties, which describe a product of greater consistency and creaminess.

Keywords: yogurt, viscoelastic properties, LAOS, elastic modulus

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2317 Integrating Evidence Into Health Policy: Navigating Cross-Sector and Interdisciplinary Collaboration

Authors: Tessa Heeren

Abstract:

The following proposal pertains to the complex process of successfully implementing health policies that are based on public health research. A systematic review was conducted by myself and faculty at the Cluj School of Public Health in Romania. The reviewed articles covered a wide range of topics, such as barriers and facilitators to multi-sector collaboration, differences in professional cultures, and systemic obstacles. The reviewed literature identified communication, collaboration, user-friendly dissemination, and documentation of processes in the execution of applied research as important themes for the promotion of evidence in the public health decision-making process. This proposal fits into the Academy Health National Health Policy conference because it identifies and examines differences between the worlds of research and politics. Implications and new insights for federal and/or state health policy: Recommendations made based on the findings of this research include using politically relevant levers to promote research (e.g. campaign donors, lobbies, established parties, etc.), modernizing dissemination practices, and reforms in which the involvement of external stakeholders is facilitated without relying on invitations from individual policy makers. Description of how evidence and/or data was or could be used: The reviewed articles illustrated shortcomings and areas for improvement in policy research processes and collaborative development. In general, the evidence base in the field of integrating research into policy lacks critical details of the actual process of developing evidence based policy. This shortcoming in logistical details creates a barrier for potential replication of collaborative efforts described in studies. Potential impact of the presentation for health policy: The reviewed articles focused on identifying barriers and facilitators that arise in cross sector collaboration, rather than the process and impact of integrating evidence into policy. In addition, the type of evidence used in policy was rarely specified, and widely varying interpretations of the definition of evidence complicated overall conclusions. Background: Using evidence to inform public health decision making processes has been proven effective; however, it is not clear how research is applied in practice. Aims: The objectives of the current study were to assess the extent to which evidence is used in public health decision-making process. Methods: To identify eligible studies, seven bibliographic databases, specifically, PubMed, Scopus, Cochrane Library, Science Direct, Web of Science, ClinicalKey, Health and Safety Science Abstract were screened (search dates: 1990 – September 2015); a general internet search was also conducted. Primary research and systematic reviews about the use of evidence in public health policy in Europe were included. The studies considered for inclusion were assessed by two reviewers, along with extracted data on objective, methods, population, and results. Data were synthetized as a narrative review. Results: Of 2564 articles initially identified, 2525 titles and abstracts were screened. Ultimately, 30 articles fit the research criteria by describing how or why evidence is used/not used in public health policy. The majority of included studies involved interviews and surveys (N=17). Study participants were policy makers, health care professionals, researchers, community members, service users, experts in public health.

Keywords: cross-sector, dissemination, health policy, policy implementation

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2316 Improving Creative Problem Solving for Teams through a Web-Based Peer Review System

Authors: JungYeon Park, Jooyong Park

Abstract:

Brainstorming and discussion are widely used around the world as formal techniques of collaborative creative problem solving. This study investigated whether a web-based peer review system would improve collaborative creative problem solving. In order to assess the efficiency of using web-based peer review system before brainstorming and discussion, we conducted a between-group design study for two conditions (a web-based peer review system vs. face-to-face brainstorming only) using two different scenarios. One hundred and twenty participants were divided into teams of four and randomly assigned to one of the four conditions. The participants were given problems for them to solve. The participants in the experimental group first generated ideas independently for 20 minutes and wrote down their ideas. Afterwards, they reviewed the list of ideas of their peers and gave and received feedback for 10 minutes. These activities were performed on-line. The last activity was face-to-face brain-storming and discussion for 30 minutes. In contrast, the control group participated in brainstorming and discussion for 60 minutes. The quantity and the quality of ideas were measured as dependent variables of creative problem solving. Two evaluators rated the quantity and quality of the proposed ideas. Inter-rater agreement rate was good or strong. The results showed that both the average number of unique ideas and the average quality of ideas generated for the experimental condition were significantly higher than those for the control condition in both scenarios. The results of this study support the hypothesis that collaborative creative problem solving is enhanced when individuals write their thoughts individually and review ideas written by peers before face-to-face brainstorming and discussion. The present study provides preliminary evidence that a web-based peer review system can be instrumental in improving creative problem solving for teams. This system also offers an effective means to quantify the contribution of each member in collaborative team activity. We are planning to replicate these results in real-life situations.

Keywords: brainstorming, creative problem solving, peer-review, team efficiency

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2315 Investigative Study of Consumer Perceptions to the Quality and Safety Attributes of 'Fresh' versus 'Frozen' Cassava (Manihot esculenta Crantz): A Case for Agro-Processing in Trinidad and Tobago, West Indies

Authors: Nadia Miranda Lorick, Neela Badrie, Marsha Singh

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Cassava (Manihot esculenta, Crantz) which is also known as ‘yucca’ or ‘manioc’ has been acknowledged as a millennium crop which has been utilized for food security purposes. The crop provides considerable amount of energy. The aim of the study was to assess consumer groups of both ‘fresh’ and ‘frozen’ in terms of their perceptions toward the quality and safety attributes of frozen cassava. The questionnaire included four sections: consumer demographics, consumer perceptions on quality attributes of ‘frozen’ cassava, consumer knowledge, awareness and attitudes toward food safety of ‘frozen’ cassava and consumer suggestions toward the improvement of frozen cassava. A face-to-face questionnaire was administered to 200 consumers of cassava between April and May 2016. The criteria for inclusion in the survey were that they must be 15 years and over and consumer of cassava. The sections of the questionnaire included demographics of respondents, consumer perception on quality and safety attributes of cassava and suggestions for the improvement of the value-added product. The data was analysed by descriptive and chi-square using SPSS as well as qualitative information was captured. Only 17% of respondents purchased frozen cassava and this was significantly (P<0.05) associated to income. Some (15%) of fresh cassava purchasers had never heard of frozen cassava products and 7.5% o perceived that these products were unhealthy for consumption. More than half (51.3%) of the consumers (all from the ‘fresh’ cassava group) believed that there were ‘no toxins’ within cassava. The ‘frozen’ cassava products were valued for convenience but purchasers were least satisfied with ‘value for money’ (50%), ‘product safety’ (50%) and ‘colour’ (52.9%). Cassava purchasers demonstrated highest dissatisfaction levels with the quality attribute: value for money (6.6%, 11.8%) respectively. The most predominant area outlined by respondents for frozen cassava improvement was promotion /advertising/education (23%). The ‘frozen’ cassava purchasers were ‘least satisfied’ thus most concern that clean knives and clean surface would not be used agro- processing. Fresh cassava purchasers were comparatively more knowledgeable on the potential existence of naturally occurring toxins in cassava, however with 1% respondents being able to specifically identify the toxin as ‘cyanide’. Dangerous preservatives (31%), poor hygiene (30%) and chemicals from the packaging (11%) were identified as some sources of contamination of ‘frozen’ cassava. Purchasers of frozen cassava indicated that the information on packaging label was unclear (P<0.01) when compared to ‘fresh’ cassava consumers.

Keywords: consumer satisfaction, convenience, cyanide toxin, product safety, price, label

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2314 Divergent Weathering on Two Sides of Plastic Fragments from Coastal Environments Around the Globe

Authors: Bo Hu, Mui-Choo Jong, João Frias, Irina Chubarenko, Gabriel Enrique De-la-Torre, Prabhu Kolandhasamy, Md. Jaker Hossain, Elena Esiukova, Lei Su, Hua Deng, Huahong Shi

Abstract:

Plastic debris in coastal environments undergoes a series of aging processes due to the diverse environmental conditions they are exposed to. Existing research to date lacks a thorough understanding of how these processes affect exposed and non-exposed sides of plastic fragments, leading to potentially biased conclusions on how degradation occurs. This study addresses this knowledge gap by examining surface aging characteristics on both sides (e.g., cracks, delaminations, pits, wrinkles and color residues) of 1573 plastic fragments collected from 15 coastal sites worldwide and conducting outdoor aging simulations. A clear contrast was observed between the two sides of the plastic fragments, where one of the sides often displayed more pronounced aging features. Three key indicators were introduced to quantify the aging characteristics of plastic fragments, with values ranging from 0.00 to 58.00 mm/mm2 (line density), 0.00 to 92.12% (surface loss) and 0.00 to 1.51 (texture index), respectively. Outdoor simulations revealed that sun-exposed sides of plastic sheets developed more cracks, pores, and bubbles, while the shaded sides remained smoother. The annual average solar radiation intensity of 4.47 kWh in the experimental area exacerbated the degradation of the sun-exposed side, as confirmed by a significant increase in carbonyl index, with PE rising from 0.50 to 1.70, PP from 0.18 to 1.10, and PVC from 0.45 to 1.57, indicating photoaging. These results highlight the uneven weathering patterns of plastic fragments on shorelines due to varying environmental stresses. In particular, the side facing the sun exhibited more pronounced signs of aging. Outdoor experiments confirmed that the fragments’ sun-exposed sides experienced significantly higher degrees of weathering compared to the shaded sides. This study demonstrated that the divergent weathering patterns on the two sides of beach plastic fragments were primarily driven by differences in light exposure, duration, and mechanical stress.

Keywords: plastic fragments, coastal environment, surface aging features, two-sided differences

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2313 Exploring Social and Economic Barriers in Adoption and Expansion of Agricultural Technologies in Woliatta Zone, Southern Ethiopia

Authors: Akalework Mengesha

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The adoption of improved agricultural technologies has been connected with higher earnings and lower poverty, enhanced nutritional status, lower staple food prices, and increased employment opportunities for landless laborers. The adoption and extension of the technologies are vastly crucial in that it enables the countries to achieve the millennium development goals (MDG) of reducing extreme poverty and hunger. There are efforts which directed to the enlargement and provision of modern crop varieties in sub-Saharan Africa in the past 30 years. Nevertheless, by and large, the adoption and expansion of rates for improved technologies have insulated behind other regions. This research aims to assess social and economic barriers in the adoption and expansion of agricultural technologies by local communities living around a private agricultural farm in Woliatta Zone, Southern Ethiopia. The study has been carried out among rural households which are located in the three localities selected for the study in the Woliatta zone. Across sectional mixed method, the design was used to address the study objective. The qualitative method was employed (in-depth interview, key informant, and focus group discussion) involving a total of 42 in-depth informants, 17 key-informant interviews, 2 focus group discussions comprising of 10 individuals in each group through purposive sampling techniques. The survey method was mainly used in the study to examine the impact of attitudinal, demographic, and socioeconomic variables on farmers’ adoption of agricultural technologies for quantitative data. The finding of the study revealed that Amibara commercial farm has not made a resolute and well-organized effort to extend agricultural technology to the surrounding local community. A comprehensive agricultural technology transfer scheme hasn’t been put in place by the commercial farm ever since it commenced operating in the study area. Besides, there is an ongoing conflict of interest between the farm and the community, which has kept on widening through time, bounds to be irreversible.

Keywords: adoption, technology transfer, agriculture, barriers

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2312 Comparing Trastuzumab-Related Cardiotoxicity between Elderly and Younger Patients with Breast Cancer: A Prospective Cohort Study

Authors: Afrah Aladwani, Alexander Mullen, Mohammad AlRashidi, Omamah Alfarisi, Faisal Alterkit, Abdulwahab Aladwani, Asit Kumar, Emad Eldosouky

Abstract:

Introduction: Trastuzumab is a HER-2 targeted humanized monoclonal antibody that significantly improves the therapeutic outcomes of metastatic and non-metastatic breast cancer. However, it is associated with increased risk of cardiotoxicity that ranges from mild decline in the cardiac ejection fraction to permanent cardiomyopathy. Concerns have been raised in treating eligible older patients. This study compares trastuzumab outcomes between two age cohorts in the Kuwait Cancer Control Centre (KCCC). Methods: In a prospective comparative observational study, 93 HER-2 positive breast cancer patients undergoing different chemotherapy protocols + trastuzumab were included and divided into two cohorts based on their age (˂60 and ≥60 years old). The baseline left ventricular ejection fraction (LVEF) was assessed and monitored every three months during trastuzumab treatment. Event of cardiotoxicity was defined as ≥10% decline in the LVEF from the baseline. The lower accepted normal limit of the LVEF was 50%. Results: The median baseline LVEF was 65% in both age cohorts (IQR 8% and 9% for older and younger patients respectively). Whereas, the median LVEF post-trastuzumab treatment was 51% and 55% in older and younger patients respectively (IQR 8%; p-value = 0.22), despite the fact that older patients had significantly lower exposure to anthracyclines compared to younger patients (60% and 84.1% respectively; p-value ˂0.001). 86.7% and 55.6% of older and younger patients, respectively, developed ≥10% decline in their LVEF from the baseline. Among those, only 29% of older and 27% of younger patients reached a LVEF value below 50% (p-value = 0.88). Statistically, age was the only factor that significantly correlated with trastuzumab induced cardiotoxicity (OR 4; p-value ˂0.012), but it did not increase the requirement for permanent discontinuation of treatment. A baseline LVEF value below 60% contributed to developing a post-treatment value below normal ranges (50%). Conclusion: Breast cancer patients aged 60 years and above in Kuwait were at 4-fold higher risk of developing ≥10% decline in their LVEF from the baseline than younger patients during trastuzumab treatment. Surprisingly, previous exposure to anthracyclines and multiple comorbidities were not associated with significant increased risk of cardiotoxicity.

Keywords: breast cancer, elderly, Trastuzumab, cardiotoxicity

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2311 Antioxidant Efficacy of Lovi (Flacourtia inermis) Peel Extract in Edible Oils during Storage

Authors: Sasini U. G. Nanayakkara, Nishala E. Wedamulla, W. A. J. P. Wijesinghe

Abstract:

Lovi (Flacourtia inermis) is an underutilized fruit crop grown in Sri Lanka with promising antioxidant properties; thus, exhibits the great potential to use as a natural antioxidant. With the concern of synthetic antioxidants, there is a growing trend towards the addition of a natural antioxidant to retard the rancidity of edible oils. Hence, in this backdrop, extract obtained from the peel of F. inermis fruit was used to retard the rancidity of selected edible oils. Free fatty acid (FFA) content and peroxide value (PV) of sunflower oil (SO) and virgin coconut oil (VCO) were measured at 3-day intervals for 21 days at 65 ± 5°C after addition of extract at 500, 1000, 2000 ppm levels and α-tocopherol at 500 ppm level was used as positive control. SO and VCO without added extract was used as the control. The extract was prepared with 70% ethanol using ultrasound-assisted extraction, and antioxidant efficacy and total phenolic content (TPC) of the extract were measured using 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging capacity and Folin-Ciocalteu method respectively. Antioxidant activity (IC50) and TPC of the extract were 227.14 ± 4.12 µgmL⁻¹ and 4.87 ± 0.01 mg GAE per gram, respectively. During the storage period, FFA content and PV of both oils were increased with time. However, SO showed comparatively high PV than that of VCO and thereby indicate the progression of lipid oxidation as PV is a good indicator of the extent of primary oxidative products formed in oils. The most effective extract concentration was 2000 ppm. After 21 days of storage, VCO (control) sample exhibited significantly (p < 0.05) high FFA (0.36%) and PV (1.93 meq kg⁻¹) than that of VCO with 1000 ppm (FFA: 0.35%; PV: 1.72 meq kg⁻¹) and 2000 ppm (FFA: 0.28%; PV: 1.19 meq kg-1) levels of extract. Thus, demonstrates the efficacy of lovi peel extract in retardation of lipid oxidation of edible oils during storage at higher concentrations of the extract addition. Moreover, FFA and PV of SO (FFA: 0.10%; PV: 12.38 meq kg⁻¹) and VCO (FFA: 0.28%; PV: 1.19 meq kg⁻¹) at 2000 ppm level of extract were significantly (p < 0.05) lower than that of positive control: SO with α-tocopherol (FFA: 0.22%, PV: 17.94 meq kg⁻¹) and VCO with α-tocopherol (FFA: 0.29%, PV: 1.39 meq kg⁻¹) after 21 days. Accordingly, lovi peel extract at 2000 ppm level was more effective than α-tocopherol in retardation of lipid oxidation of edible oils. In conclusion, lovi peel extract has strong antioxidant properties and can be used as a natural antioxidant to inhibit deteriorative oxidation of edible oils.

Keywords: antioxidant, Flacourtia inermis, peroxide value, virgin coconut oil

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2310 An Empirical Study of Shariah Legitimacy of Islamic Banking Operations in Pakistan

Authors: Muhammad Khaleequzzaman, Muhammad Mansoori, Abdul Rashid

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The legitimacy of Islamic banking refers to the compliance with the precepts of Shariah (Islamic law) of the pronouncements and their implementation, requisites of various contracts, as well as, observance of the welfare objectives. Therefore, the Islamic banks are supposed to follow the Islamic values focused to bring benefit to the society alongside the commercial motive. These distinguishing features establish identity of the Islamic banks separate from their conventional counterparts and require pursuing normative values of Islamic injunctions instead of profit maximization merely through commercial motive. Given this, the efficiency of the Islamic banks should be evaluated against the value judgements prescribed by the Islamic economic philosophy and their role in establishing the just economy. Nevertheless, the empirical evidence on such value-oriented role of Islamic banking is limited that is filled by this research. The primary focus of the research is two folds; developing a theoretical framework that affords a holistic approach of Shariah legitimacy of Islamic banking practices, including welfare pursuits in addition to the usual compliance mechanism, to help evaluating legitimacy of Islamic banking practices in Pakistan. Therefore, the research has been commissioned by developing the constructs of Shariah legitimacy through extensive review of the relevant literature. At the same time, the empirical analysis based on the opinion of 836 customers of Islamic and conventional banks in all the four provinces and the capital city of Pakistan has produced important conclusions regarding their perception about legitimacy of the Islamic banking practices. The results have helped to know as to how the legitimacy through Shariah perspective is viewed by them. The data analysis using various statistical techniques has yielded results consistent with the objectives of the study. The key findings of the theoretical framework conclude that the value judgements have been grossly ignored by the Islamic banks. The empirical research achieves that about half of the customers perceived Islamic banking as Shariah legitimate. On overall basis, the other half viewed contrary to this or preferred to remain indifferent. There is a need that Islamic banks should look into the desired goals of Shariah legitimacy in both contexts; the value judgement and the perception of the customers.

Keywords: Islamic banking, Shariah legitimacy, Maqasid al Shariah (higher purposes of the lawgiver), value judgment, distributive justice

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2309 Systems Strengthening for Sustainable Family Planning Service Provision in Uganda

Authors: D. Muyama, M. Luyiga, P. Buyungo, D. Chemonges, M. Namukwaya, L. Ssekabembe, B. Lukwago, D. Kyamagwa

Abstract:

Context: The study focuses on the sustainability of health interventions in Uganda, particularly in the private sector, beyond donor-funded project periods. The Population Services International (PSI) implemented the Women Health Project (WHP) to ensure continued access to quality family planning, cervical cancer screening, and post-abortion care services through private clinics. Research Aim: The aim of the study is to assess the continued access to quality family planning, cervical cancer screening, and post-abortion care services through the private sector after the closure or reduction in funding of the WHP. Methodology: PSI trained and mentored 83 clinics to establish functional systems in self-regulatory quality improvement, supply chain, referral, and demand creation. The clinics were also connected to the national reporting system and utilized Ministry of Health reporting tools. An assessment tool with six criteria was designed and used to evaluate the progress of the clinics. Clinics scoring 75% and above were considered independent and graduated from the program. Findings: Out of the 83 private clinics, 56 successfully met the graduation criteria and graduated from the program, while 25 lost interest and were gradually dropped. Two clinics failed to achieve the criteria due to leadership challenges. The 59 graduating clinics continued to provide high-quality family planning services, including IUD, implant, Depo-Provera, oral contraceptives, and post-abortion care. All graduating clinics were reassessed and found to still be capable of offering services, attributing their success to government stock availability and acquired skills through mentorships. The clinics expressed appreciation to PSI for the sustainable plan that allowed them to operate beyond the project period. Theoretical Importance: This study contributes to the understanding of sustainability planning and the importance of clinic owners' attitudes and buy-in for continued service provision. It emphasizes the implementation of sustainability plans through existing structures to leverage available resources and ensure continuity of care. Data Collection and Analysis Procedures: The study collected data through the assessment tool that evaluated the progress of clinics based on the established criteria. The tool was scored out of 100%, and clinics scoring above 75% were deemed independent. The findings were analyzed quantitatively to determine the success rate of clinics in meeting the graduation criteria. Questions Addressed: The study addresses the question of whether private clinics in Uganda can sustain the provision of family planning, cervical cancer screening, and post-abortion care services after the closure or reduction in funding of the WHP. Conclusion: The study concludes that the attitude and buy-in of clinic owners are essential for sustainability planning. Implementing sustainability plans through existing structures and leveraging available resources are crucial for the continuity of care after the end of a project or reduced funding. The findings highlight the importance of establishing sustainable plans to ensure continued access to essential health services beyond the project period. Contributions: This study contributes to the existing knowledge for programmers implementing or intending to implement donor-funded projects. It provides insights into designing sustainable plans that enable the independent operation of clinics even after the end of a project.

Keywords: graduation, family planning, systems strengthening, sustainability

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2308 Effect of Tai-Chi and Cyclic Meditation on Hemodynamic Responses of the Prefrontal Cortex: A Functional near Infrared Spectroscopy

Authors: Singh Deepeshwar, N. K. Manjunath, M. Avinash

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Meditation is a self-regulated conscious process associated with improved awareness, perception, attention and overall performance. Different traditional origin of meditation technique may have different effects on autonomic activity and brain functions. Based on this quest, the present study evaluated the effect of Tai-Chi Chuan (TCC, a Chines movement based meditation technique) and Cyclic Meditation (CM, an Indian traditional based stimulation and relaxation meditation technique) on the hemodynamic responses of the prefrontal cortex (PFC) and autonomic functions (such as R-R interval of heart rate variability and respiration). These two meditation practices were compared with simple walking. Employing 64 channel near infrared spectroscopy (NIRS), we measured hemoglobin concentration change (i.e., Oxyhemoglobin [ΔHbO], Deoxyhemoglobin [ΔHbR] and Total hemoglobin change [ΔTHC]) in the bilateral PFC before and after TCC, CM and Walking in young college students (n=25; average mean age ± SD; 23.4 ± 3.1 years). We observed the left PFC activity predominantly modulates sympathetic activity effects during the Tai-Chi whereas CM showed changes on right PFC with vagal dominance. However, the changes in oxyhemoglobin and total blood volume change after Tai-Chi was significant higher (p < 0.05, spam t-maps) on the left hemisphere, whereas after CM, there was a significant increase in oxyhemoglobin (p < 0.01) with a decrease in deoxyhemoglobin (p < 0.05) on right PFC. The normal walking showed decrease in Oxyhemoglobin with an increase in deoxyhemoglobin on left PFC. The autonomic functions result showed a significant increase in RR- interval (p < 0.05) along with significant reductions in HR (p < 0.05) in CM, whereas Tai-chi session showed significant increase in HR (p < 0.05) when compared to walking session. Within a group analysis showed a significant reduction in RR-I and significant increase in HR both in Tai-chi and walking sessions. The CM showed there were a significant improvement in the RR - interval of HRV (p < 0.01) with the reduction of heart rate and breath rate (p < 0.05). The result suggested that Tai-Chi and CM both have a positive effect on left and right prefrontal cortex and increase sympathovagal balance (alertful rest) in autonomic nervous system activity.

Keywords: brain, hemodynamic responses, yoga, meditation, Tai-Chi Chuan (TCC), walking, heart rate variability (HRV)

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2307 To Be a Nurse in Turkey: A Comparison Based on International Labour Organization's Nursing Personnel Recommendation

Authors: Arzu K. Harmanci Seren, Feride Eskin Bacaksiz

Abstract:

The shortage of nursing personnel is considered one of the most important labour force issues in health sector of developed countries since early 1970s. International Labour Organization developed standards for working conditions of nurses in collaboration with World Health Organization with the aim of helping to solve nursing shortage problem all over the world. As a result of this collaboration, ILO Nursing Personnel Convention (C. 149), and the accompanying Recommendation (R. 157) were adopted in 1977. Turkey as a country that has a serious nurse shortage problem, has been a member of ILO since 1932, and has not signed this convention yet. This study was planned to compare some of the working standards in Convention with the present working conditions of nurses in Turkey. The data were collected by an on line survey between 19 January-16 February 2015 for this cross-sectional study. Participants were reached through social network accounts in collaboration with nursing associations. Totally 828 nurses from the 57 provinces of Turkey participated in the study. Survey was consisted of 14 open ended questions related to working conditions of nurses and 34 Likert statements related to nursing policies of the facilities they are working in. The data were analysed using the IBM SPSS 21.0 (licensed to Istanbul University) software. Descriptive and comparative statistics were performed. Most of the participants (81.5%) were staff and 18.5% of them were manager nurses. Most of them had baccalaureate (57.9%) or master (27.4%) degree in nursing. 18.5% of the participants were working in private hospitals, 34.9% of them in university hospitals and 46.6% of them were in Ministry of Health Hospitals. It was found that monthly working schedules were announced mostly 7 days ago (18%), working time of nurses was at least 8 hours (41.5%) and at most 24 hours (22.8%) in a day and had time for lunch or dinner 25.18 (SD=16.66), for resting 21.02 (SD=29.25) minutes. On the other hand, it was determined that 316 (43.2%) nurses did not have time for lunch and 61 (7.9%) of them could not find time for eating anything. It was also explored they were working 15-96 hours in a week (mean=48.28, SD=8.89 hours), 4-29 days in a month (mean=19.29, SD=5.03 days) and 597 (72%) nurses overworked changing form 1 hour to 150 hours (32.80, SD=23.42 hours) before the month in which surveys were filled. Most of the participants did not leave the job due to the sickness (47.5%) even if they felt sick. Also most of them did not leave the job due to any excuse (67.2%) or education (57.3%). This study has significance because of nurses from different provinces participated in and it provides brief information about the working conditions of nurses nationwide. It was explored that nurses in Turkey were working at worse conditions according the International Labour Organization’s recommendations.

Keywords: nurse, international labour organization, recommendations for nurses, working conditions

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