Search results for: school food safety management
Commenced in January 2007
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Paper Count: 18070

Search results for: school food safety management

70 The Healthcare Costs of BMI-Defined Obesity among Adults Who Have Undergone a Medical Procedure in Alberta, Canada

Authors: Sonia Butalia, Huong Luu, Alexis Guigue, Karen J. B. Martins, Khanh Vu, Scott W. Klarenbach

Abstract:

Obesity is associated with significant personal impacts on health and has a substantial economic burden on payers due to increased healthcare use. A contemporary estimate of the healthcare costs associated with obesity at the population level are lacking. This evidence may provide further rationale for weight management strategies. Methods: Adults who underwent a medical procedure between 2012 and 2019 in Alberta, Canada were categorized into the investigational cohort (had body mass index [BMI]-defined class 2 or 3 obesity based on a procedure-associated code) and the control cohort (did not have the BMI procedure-associated code); those who had bariatric surgery were excluded. Characteristics were presented and healthcare costs ($CDN) determined over a 1-year observation period (2019/2020). Logistic regression and a generalized linear model with log link and gamma distribution were used to assess total healthcare costs (comprised of hospitalizations, emergency department visits, ambulatory care visits, physician visits, and outpatient prescription drugs); potential confounders included age, sex, region of residence, and whether the medical procedure was performed within 6-months before the observation period in the partial adjustment, and also the type of procedure performed, socioeconomic status, Charlson Comorbidity Index (CCI), and seven obesity-related health conditions in the full adjustment. Cost ratios and estimated cost differences with 95% confidence intervals (CI) were reported; incremental cost differences within the adjusted models represent referent cases. Results: The investigational cohort (n=220,190) was older (mean age: 53 standard deviation [SD]±17 vs 50 SD±17 years), had more females (71% vs 57%), lived in rural areas to a greater extent (20% vs 14%), experienced a higher overall burden of disease (CCI: 0.6 SD±1.3 vs 0.3 SD±0.9), and were less socioeconomically well-off (material/social deprivation was lower [14%/14%] in the most well-off quintile vs 20%/19%) compared with controls (n=1,955,548). Unadjusted total healthcare costs were estimated to be 1.77-times (95% CI: 1.76, 1.78) higher in the investigational versus control cohort; each healthcare resource contributed to the higher cost ratio. After adjusting for potential confounders, the total healthcare cost ratio decreased, but remained higher in the investigational versus control cohort (partial adjustment: 1.57 [95% CI: 1.57, 1.58]; full adjustment: 1.21 [95% CI: 1.20, 1.21]); each healthcare resource contributed to the higher cost ratio. Among urban-dwelling 50-year old females who previously had non-operative procedures, no procedures performed within 6-months before the observation period, a social deprivation index score of 3, a CCI score of 0.32, and no history of select obesity-related health conditions, the predicted cost difference between those living with and without obesity was $386 (95% CI: $376, $397). Conclusions: If these findings hold for the Canadian population, one would expect an estimated additional $3.0 billion per year in healthcare costs nationally related to BMI-defined obesity (based on an adult obesity rate of 26% and an estimated annual incremental cost of $386 [21%]); incremental costs are higher when obesity-related health conditions are not adjusted for. Results of this study provide additional rationale for investment in interventions that are effective in preventing and treating obesity and its complications.

Keywords: administrative data, body mass index-defined obesity, healthcare cost, real world evidence

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69 The Strategic Role of Accommodation Providers in Encouraging Travelers to Adopt Environmentally-Friendly Modes of Transportation: An Experiment from France

Authors: Luc Beal

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Introduction. Among the stakeholders involved in the tourist decision-making process, the accommodation provider has the potential to play a crucial role in raising awareness, disseminating information, and thus influencing the tourists’ choice of transportation. Since the early days of tourism, the accommodation provider has consistently served as the primary point of contact with the destination, and consequently, as the primary source of information for visitors. By offering accommodation and hospitality, the accommodation provider has evolved into a trusted third party, functioning as an 'ambassador' capable of recommending the finest attractions and activities available at the destination. In contemporary times, when tourists plan their trips, they make a series of consecutive decisions, with the most important decision being to lock-in the accommodation reservation for the earliest days, so as to secure a safe arrival. Consequently, tourists place their trust in the accommodation provider not only for lodging but also for recommendations regarding restaurants, activities, and more. Thus, the latter has the opportunity to inform and influence tourists well in advance of their arrival, particularly during the booking phase, namely when it comes to selecting their mode of transportation. The pressing need to reduce greenhouse gas emissions within the tourism sector presents an opportunity to underscore the influence that accommodation providers have historically exerted on tourist decision-making . Methodology A participatory research, currently ongoing in south-western France, in collaboration with a nationwide hotel group and several destination management organizations, aims at examining the factors that determine the ability of accommodation providers to influence tourist transportation choices. Additionally, the research seeks to identify the conditions that motivate accommodation providers to assume a proactive role, such as fostering customer loyalty, reduced distribution costs, and financial compensation mechanisms. A panel of hotels participated in a series of focus group sessions with tourists, with the objective of modeling the decision-making process of tourists regarding their choice of transportation mode and to identify and quantify the types and levels of incentives liable to encourage environmentally responsible choices. Individual interviews were also conducted with hotel staff, including receptionists and guest relations officers, to develop a framework for interactions with tourists during crucial decision-making moments related to transportation choices. The primary finding of this research indicates that financial incentives significantly outweigh symbolic incentives in motivating tourists to opt for eco-friendly modes of transportation. Another noteworthy result underscores the crucial impact of organizational conditions governing interactions with tourists both before and during their stay. These conditions greatly influence the ability to raise awareness at key decision-making moments and the possibility of gathering data about the chosen transportation mode during the stay. In conclusion, this research has led to the formulation of practical recommendations for accommodation providers and Destination Marketing Organizations (DMOs). These recommendations pertain to communication protocols with tourists, the collection of evidences confirming chosen transportation modes, and the implementation of necessary incentives. Through these measures, accommodation provider can assume a central role in guiding tourists towards making responsible choices in terms of transportation.

Keywords: accommodation provider, trusted third party, environmentally-friendly transportation, green house gas, tourist decision-making process

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68 Effects of Gym-Based and Audio-Visual Guided Home-Based Exercise Programmes on Some Anthropometric and Cardiovascular Parameters Among Overweight and Obese College Students

Authors: Abiodun Afolabi, Rufus Adesoji Adedoyin

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This study investigated and compared the effects of gym-based exercise programme (GEBP) and audio-visual guided home-based exercise programme (AVGHBEP) on selected Anthropometric variables (Weight (W), Body Mass Index (BMI), Waist Circumference (WC), Hip Circumference (HC), Thigh Circumference (TC), Waist-Hip-Ratio (WHR), Waist-Height-Ratio (WHtR), Waist-Thigh-Ratio (WTR), Biceps Skinfold Thickness (BSFT), Triceps Skinfold Thickness (TSFT), Suprailliac Skinfold Thickness (SISFT), Subscapular Skinfold Thickness (SSSFT) and Percent Body Fat (PBF)); and Cardiovasular variables (Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Heart Rate (HR)) of overweight and obese students of Federal College of Education (Special), Oyo, Oyo State, Nigeria, with a view to providing information and evidence for GBEP and AVGHBEP in reducing overweight and obesity for promoting cardiovascular fitness. Eighty overweight and obese students (BMI ≥ 25 Kg/m²) were involved in this pretest-posttest quasi experimental study. Participants were randomly assigned into GBEP (n = 40) and AVGBBEP (n = 40) groups. Anthropometric and cardiovascular variables were measured using a weighing scale, height meter, tape measure, skinfold caliper and electronic sphygmomanometer following standard protocols. GBEP and AVGHBEP were implemented following a circuit training (aerobic and resistance training) pattern with a duration of 40-60 minutes, thrice weekly for twelve weeks. GBEP consisted of gymnasium supervised exercise programme while AVGHBEP is a Visual Display guided exercise programme conducted at the home setting. Data were analyzed by Descriptive and Inferential Statistics. The mean ages of the participants were 22.55 ± 2.55 and 23.65 ± 2.89 years for the GBEP group and AVGHBEP group, respectively. Findings showed that in the GBEP group, there were significant reductions in anthropometric variables and adiposity measures of Weight, BMI, BSFT, TSFT, SISFT, SSSFT, WC, HC, TC, WHtR, and PBF at week 12 of the study. Similarly, in the AVGHBEP group, there were significant reductions in Weight, BMI, BSFT, TSFT, SISFT, SSSFT, WC, HC, TC, WHtR and PBF at the 12th week of intervention. Comparison of the effects of GEBP and AVGHBEP on anthropometric variables and measures of adiposity showed that there was no significant difference between the two groups in weight, BMI, BSFT, TSFT, SISFT, SSSFT, WC, HC, TC, WHR, WHtR, WTR and PBF between the two groups at week 12 of the study. Furthermore, findings on the effects of exercise on programmes on cardiovascular variables revealed that significant reductions occurred in SBP in GBEP group and AVGHBEP group respectively. Comparison of the effects of GBEP and AVGHBEP on cardiovascular variables showed that there was no significant difference in SBP, DBP and HR between the two groups at week 12 of the study. It was concluded that the Audio-Visual Guided Home-based Exercise Programme was as effective as the Gym-Based Exercise Programme in causing a significant reduction in anthropometric variables and body fat among college students who are overweight and obese over a period of twelve weeks. Both Gymnasium-Based Exercise Programme and Audio-Visual Guided Home-Based Exercise Programme led to significant reduction in Systolic Blood Pressure over a period of weeks. Audio-Visual Guided Home-Based Exercise Programme can, therefore, be used as an alternative therapy in the non-pharmacological management of people who are overweight and obese.

Keywords: gym-based exercises, audio-visual guided home-based exercises, anthropometric parameters, cardiovascular parameters, overweight students, obese students

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67 Comparative Assessment of the Thermal Tolerance of Spotted Stemborer, Chilo partellus Swinhoe (Lepidoptera: Crambidae) and Its Larval Parasitoid, Cotesia sesamiae Cameron (Hymenoptera: Braconidae)

Authors: Reyard Mutamiswa, Frank Chidawanyika, Casper Nyamukondiwa

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Under stressful thermal environments, insects adjust their behaviour and physiology to maintain key life-history activities and improve survival. For interacting species, mutual or antagonistic, thermal stress may affect the participants in differing ways, which may then affect the outcome of the ecological relationship. In agroecosystems, this may be the fate of relationships between insect pests and their antagonistic parasitoids under acute and chronic thermal variability. Against this background, we therefore investigated the thermal tolerance of different developmental stages of Chilo partellus Swinhoe (Lepidoptera: Crambidae) and its larval parasitoid Cotesia sesamiae Cameron (Hymenoptera: Braconidae) using both dynamic and static protocols. In laboratory experiments, we determined lethal temperature assays (upper and lower lethal temperatures) using direct plunge protocols in programmable water baths (Systronix, Scientific, South Africa), effects of ramping rate on critical thermal limits following standardized protocols using insulated double-jacketed chambers (‘organ pipes’) connected to a programmable water bath (Lauda Eco Gold, Lauda DR.R. Wobser GMBH and Co. KG, Germany), supercooling points (SCPs) following dynamic protocols using a Pico logger connected to a programmable water bath, heat knock-down time (HKDT) and chill-coma recovery (CCRT) time following static protocols in climate chambers (HPP 260, Memmert GmbH + Co.KG, Germany) connected to a camera (HD Covert Network Camera, DS-2CD6412FWD-20, Hikvision Digital Technology Co., Ltd, China). When exposed for two hours to a static temperature, lower lethal temperatures ranged -9 to 6; -14 to -2 and -1 to 4ºC while upper lethal temperatures ranged from 37 to 48; 41 to 49 and 36 to 39ºC for C. partellus eggs, larvae and C. sesamiae adults respectively. Faster heating rates improved critical thermal maxima (CTmax) in C. partellus larvae and adult C. partellus and C. sesamiae. Lower cooling rates improved critical thermal minima (CTmin) in C. partellus and C. sesamiae adults while compromising CTmin in C. partellus larvae. The mean SCPs for C. partellus larvae, pupae and adults were -11.82±1.78, -10.43±1.73 and -15.75±2.47 respectively with adults having the lowest SCPs. Heat knock-down time and chill-coma recovery time varied significantly between C. partellus larvae and adults. Larvae had higher HKDT than adults, while the later recovered significantly faster following chill-coma. Current results suggest developmental stage differences in C. partellus thermal tolerance (with respect to lethal temperatures and critical thermal limits) and a compromised temperature tolerance of parasitoid C. sesamiae relative to its host, suggesting potential asynchrony between host-parasitoid population phenology and consequently biocontrol efficacy under global change. These results have broad implications to biological pest management insect-natural enemy interactions under rapidly changing thermal environments.

Keywords: chill-coma recovery time, climate change, heat knock-down time, lethal temperatures, supercooling point

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66 Housing Recovery in Heavily Damaged Communities in New Jersey after Hurricane Sandy

Authors: Chenyi Ma

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Background: The second costliest hurricane in U.S. history, Sandy landed in southern New Jersey on October 29, 2012, and struck the entire state with high winds and torrential rains. The disaster killed more than 100 people, left more than 8.5 million households without power, and damaged or destroyed more than 200,000 homes across the state. Immediately after the disaster, public policy support was provided in nine coastal counties that constituted 98% of the major and severely damaged housing units in NJ overall. The programs include Individuals and Households Assistance Program, Small Business Loan Program, National Flood Insurance Program, and the Federal Emergency Management Administration (FEMA) Public Assistance Grant Program. In the most severely affected counties, additional funding was provided through Community Development Block Grant: Reconstruction, Rehabilitation, Elevation, and Mitigation Program, and Homeowner Resettlement Program. How these policies individually and as a whole impacted housing recovery across communities with different socioeconomic and demographic profiles has not yet been studied, particularly in relation to damage levels. The concept of community social vulnerability has been widely used to explain many aspects of natural disasters. Nevertheless, how communities are vulnerable has been less fully examined. Community resilience has been conceptualized as a protective factor against negative impacts from disasters, however, how community resilience buffers the effects of vulnerability is not yet known. Because housing recovery is a dynamic social and economic process that varies according to context, this study examined the path from community vulnerability and resilience to housing recovery looking at both community characteristics and policy interventions. Sample/Methods: This retrospective longitudinal case study compared a literature-identified set of pre-disaster community characteristics, the effects of multiple public policy programs, and a set of time-variant community resilience indicators to changes in housing stock (operationally defined by percent of building permits to total occupied housing units/households) between 2010 and 2014, two years before and after Hurricane Sandy. The sample consisted of 51 municipalities in the nine counties in which between 4% and 58% of housing units suffered either major or severe damage. Structural equation modeling (SEM) was used to determine the path from vulnerability to the housing recovery, via multiple public programs, separately and as a whole, and via the community resilience indicators. The spatial analytical tool ArcGIS 10.2 was used to show the spatial relations between housing recovery patterns and community vulnerability and resilience. Findings: Holding damage levels constant, communities with higher proportions of Hispanic households had significantly lower levels of housing recovery while communities with households with an adult >age 65 had significantly higher levels of the housing recovery. The contrast was partly due to the different levels of total public support the two types of the community received. Further, while the public policy programs individually mediated the negative associations between African American and female-headed households and housing recovery, communities with larger proportions of African American, female-headed and Hispanic households were “vulnerable” to lower levels of housing recovery because they lacked sufficient public program support. Even so, higher employment rates and incomes buffered vulnerability to lower housing recovery. Because housing is the "wobbly pillar" of the welfare state, the housing needs of these particular groups should be more fully addressed by disaster policy.

Keywords: community social vulnerability, community resilience, hurricane, public policy

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65 Impact of Increased Radiology Staffing on After-Hours Radiology Reporting Efficiency and Quality

Authors: Peregrine James Dalziel, Philip Vu Tran

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Objective / Introduction: Demand for radiology services from Emergency Departments (ED) continues to increase with greater demands placed on radiology staff providing reports for the management of complex cases. Queuing theory indicates that wide variability of process time with the random nature of request arrival increases the probability of significant queues. This can lead to delays in the time-to-availability of radiology reports (TTA-RR) and potentially impaired ED patient flow. In addition, greater “cognitive workload” of greater volume may lead to reduced productivity and increased errors. We sought to quantify the potential ED flow improvements obtainable from increased radiology providers serving 3 public hospitals in Melbourne Australia. We sought to assess the potential productivity gains, quality improvement and the cost-effectiveness of increased labor inputs. Methods & Materials: The Western Health Medical Imaging Department moved from single resident coverage on weekend days 8:30 am-10:30 pm to a limited period of 2 resident coverage 1 pm-6 pm on both weekend days. The TTA-RR for weekend CT scans was calculated from the PACs database for the 8 month period symmetrically around the date of staffing change. A multivariate linear regression model was developed to isolate the improvement in TTA-RR, between the two 4-months periods. Daily and hourly scan volume at the time of each CT scan was calculated to assess the impact of varying department workload. To assess any improvement in report quality/errors a random sample of 200 studies was assessed to compare the average number of clinically significant over-read addendums to reports between the 2 periods. Cost-effectiveness was assessed by comparing the marginal cost of additional staffing against a conservative estimate of the economic benefit of improved ED patient throughput using the Australian national insurance rebate for private ED attendance as a revenue proxy. Results: The primary resident on call and the type of scan accounted for most of the explained variability in time to report availability (R2=0.29). Increasing daily volume and hourly volume was associated with increased TTA-RR (1.5m (p<0.01) and 4.8m (p<0.01) respectively per additional scan ordered within each time frame. Reports were available 25.9 minutes sooner on average in the 4 months post-implementation of double coverage (p<0.01) with additional 23.6 minutes improvement when 2 residents were on-site concomitantly (p<0.01). The aggregate average improvement in TTA-RR was 24.8 hours per weekend day This represents the increased decision-making time available to ED physicians and potential improvement in ED bed utilisation. 5% of reports from the intervention period contained clinically significant addendums vs 7% in the single resident period but this was not statistically significant (p=0.7). The marginal cost was less than the anticipated economic benefit based assuming a 50% capture of improved TTA-RR inpatient disposition and using the lowest available national insurance rebate as a proxy for economic benefit. Conclusion: TTA-RR improved significantly during the period of increased staff availability, both during the specific period of increased staffing and throughout the day. Increased labor utilisation is cost-effective compared with the potential improved productivity for ED cases requiring CT imaging.

Keywords: workflow, quality, administration, CT, staffing

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64 Long-Term Tillage, Lime Matter and Cover Crop Effects under Heavy Soil Conditions in Northern Lithuania

Authors: Aleksandras Velykis, Antanas Satkus

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Clay loam and clay soils are typical for northern Lithuania. These soils are susceptible to physical degradation in the case of intensive use of heavy machinery for field operations. However, clayey soils having poor physical properties by origin require more intensive tillage to maintain proper physical condition for grown crops. Therefore not only choice of suitable tillage system is very important for these soils in the region, but also additional search of other measures is essential for good soil physical state maintenance. Research objective: To evaluate the long-term effects of different intensity tillage as well as its combinations with supplementary agronomic practices on improvement of soil physical conditions and environmental sustainability. The experiment examined the influence of deep and shallow ploughing, ploughless tillage, combinations of ploughless tillage with incorporation of lime sludge and cover crop for green manure and application of the same cover crop for mulch without autumn tillage under spring and winter crop growing conditions on clay loam (27% clay, 50% silt, 23% sand) Endocalcaric Endogleyic Cambisol. Methods: The indicators characterizing the impact of investigated measures were determined using the following methods and devices: Soil dry bulk density – by Eijkelkamp cylinder (100 cm3), soil water content – by weighing, soil structure – by Retsch sieve shaker, aggregate stability – by Eijkelkamp wet sieving apparatus, soil mineral nitrogen – in 1 N KCL extract using colorimetric method. Results: Clay loam soil physical state (dry bulk density, structure, aggregate stability, water content) depends on tillage system and its combination with additional practices used. Application of cover crop winter mulch without tillage in autumn, ploughless tillage and shallow ploughing causes the compaction of bottom (15-25 cm) topsoil layer. However, due to ploughless tillage the soil dry bulk density in subsoil (25-35 cm) layer is less compared to deep ploughing. Soil structure in the upper (0-15 cm) topsoil layer and in the seedbed (0-5 cm), prepared for spring crops is usually worse when applying the ploughless tillage or cover crop mulch without autumn tillage. Application of lime sludge under ploughless tillage conditions helped to avoid the compaction and structure worsening in upper topsoil layer, as well as increase aggregate stability. Application of reduced tillage increased soil water content at upper topsoil layer directly after spring crop sowing. However, due to reduced tillage the water content in all topsoil markedly decreased when droughty periods lasted for a long time. Combination of reduced tillage with cover crop for green manure and winter mulch is significant for preserving the environment. Such application of cover crops reduces the leaching of mineral nitrogen into the deeper soil layers and environmental pollution. This work was supported by the National Science Program ‘The effect of long-term, different-intensity management of resources on the soils of different genesis and on other components of the agro-ecosystems’ [grant number SIT-9/2015] funded by the Research Council of Lithuania.

Keywords: clay loam, endocalcaric endogleyic cambisol, mineral nitrogen, physical state

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63 A Basic Concept for Installing Cooling and Heating System Using Seawater Thermal Energy from the West Coast of Korea

Authors: Jun Byung Joon, Seo Seok Hyun, Lee Seo Young

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As carbon dioxide emissions increase due to rapid industrialization and reckless development, abnormal climates such as floods and droughts are occurring. In order to respond to such climate change, the use of existing fossil fuels is reduced, and the proportion of eco-friendly renewable energy is gradually increasing. Korea is an energy resource-poor country that depends on imports for 93% of its total energy. As the global energy supply chain instability experienced due to the Russia-Ukraine crisis increases, countries around the world are resetting energy policies to minimize energy dependence and strengthen security. Seawater thermal energy is a renewable energy that replaces the existing air heat energy. It uses the characteristic of having a higher specific heat than air to cool and heat main spaces of buildings to increase heat transfer efficiency and minimize power consumption to generate electricity using fossil fuels, and Carbon dioxide emissions can be minimized. In addition, the effect on the marine environment is very small by using only the temperature characteristics of seawater in a limited way. K-water carried out a demonstration project of supplying cooling and heating energy to spaces such as the central control room and presentation room in the management building by acquiring the heat source of seawater circulated through the power plant's waterway by using the characteristics of the tidal power plant. Compared to the East Sea and the South Sea, the main system was designed in consideration of the large tidal difference, small temperature difference, and low-temperature characteristics, and its performance was verified through operation during the demonstration period. In addition, facility improvements were made for major deficiencies to strengthen monitoring functions, provide user convenience, and improve facility soundness. To spread these achievements, the basic concept was to expand the seawater heating and cooling system with a scale of 200 USRT at the Tidal Culture Center. With the operational experience of the demonstration system, it will be possible to establish an optimal seawater heat cooling and heating system suitable for the characteristics of the west coast ocean. Through this, it is possible to reduce operating costs by KRW 33,31 million per year compared to air heat, and through industry-university-research joint research, it is possible to localize major equipment and materials and develop key element technologies to revitalize the seawater heat business and to advance into overseas markets. The government's efforts are needed to expand the seawater heating and cooling system. Seawater thermal energy utilizes only the thermal energy of infinite seawater. Seawater thermal energy has less impact on the environment than river water thermal energy, except for environmental pollution factors such as bottom dredging, excavation, and sand or stone extraction. Therefore, it is necessary to increase the sense of speed in project promotion by innovatively simplifying unnecessary licensing/permission procedures. In addition, support should be provided to secure business feasibility by dramatically exempting the usage fee of public waters to actively encourage development in the private sector.

Keywords: seawater thermal energy, marine energy, tidal power plant, energy consumption

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62 Charcoal Traditional Production in Portugal: Contribution to the Quantification of Air Pollutant Emissions

Authors: Cátia Gonçalves, Teresa Nunes, Inês Pina, Ana Vicente, C. Alves, Felix Charvet, Daniel Neves, A. Matos

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The production of charcoal relies on rudimentary technologies using traditional brick kilns. Charcoal is produced under pyrolysis conditions: breaking down the chemical structure of biomass under high temperature in the absence of air. The amount of the pyrolysis products (charcoal, pyroligneous extract, and flue gas) depends on various parameters, including temperature, time, pressure, kiln design, and wood characteristics like the moisture content. This activity is recognized for its inefficiency and high pollution levels, but it is poorly characterized. This activity is widely distributed and is a vital economic activity in certain regions of Portugal, playing a relevant role in the management of woody residues. The location of the units establishes the biomass used for charcoal production. The Portalegre district, in the Alto Alentejo region (Portugal), is a good example, essentially with rural characteristics, with a predominant farming, agricultural, and forestry profile, and with a significant charcoal production activity. In this district, a recent inventory identifies almost 50 charcoal production units, equivalent to more than 450 kilns, of which 80% appear to be in operation. A field campaign was designed with the objective of determining the composition of the emissions released during a charcoal production cycle. A total of 30 samples of particulate matter and 20 gas samples in Tedlar bags were collected. Particulate and gas samplings were performed in parallel, 2 in the morning and 2 in the afternoon, alternating the inlet heads (PM₁₀ and PM₂.₅), in the particulate sampler. The gas and particulate samples were collected in the plume as close as the emission chimney point. The biomass (dry basis) used in the carbonization process was a mixture of cork oak (77 wt.%), holm oak (7 wt.%), stumps (11 wt.%), and charred wood (5 wt.%) from previous carbonization processes. A cylindrical batch kiln (80 m³) with 4.5 m diameter and 5 m of height was used in this study. The composition of the gases was determined by gas chromatography, while the particulate samples (PM₁₀, PM₂.₅) were subjected to different analytical techniques (thermo-optical transmission technique, ion chromatography, HPAE-PAD, and GC-MS after solvent extraction) after prior gravimetric determination, to study their organic and inorganic constituents. The charcoal production cycle presents widely varying operating conditions, which will be reflected in the composition of gases and particles produced and emitted throughout the process. The concentration of PM₁₀ and PM₂.₅ in the plume was calculated, ranging between 0.003 and 0.293 g m⁻³, and 0.004 and 0.292 g m⁻³, respectively. Total carbon, inorganic ions, and sugars account, in average, for PM10 and PM₂.₅, 65 % and 56 %, 2.8 % and 2.3 %, 1.27 %, and 1.21 %, respectively. The organic fraction studied until now includes more than 30 aliphatic compounds and 20 PAHs. The emission factors of particulate matter to produce charcoal in the traditional kiln were 33 g/kg (wooddb) and 27 g/kg (wooddb) for PM₁₀ and PM₂.₅, respectively. With the data obtained in this study, it is possible to fill the lack of information about the environmental impact of the traditional charcoal production in Portugal. Acknowledgment: Authors thanks to FCT – Portuguese Science Foundation, I.P. and to Ministry of Science, Technology and Higher Education of Portugal for financial support within the scope of the project CHARCLEAN (PCIF/GVB/0179/2017) and CESAM (UIDP/50017/2020 + UIDB/50017/2020).

Keywords: brick kilns, charcoal, emission factors, PAHs, total carbon

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61 Clinico-pathological Study of Xeroderma Pigmentosa: A Case Series of Eight Cases

Authors: Kakali Roy, Sahana P. Raju, Subhra Dhar, Sandipan Dhar

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Introduction: Xeroderma pigmentosa (XP) is a rare inherited (autosomal recessive) disease resulting from impairment in DNA repair that involves recognition and repair of ultraviolet radiation (UVR) induced DNA damage in the nucleotide excision repair pathway. Which results in increased photosensitivity, UVR induced damage to skin and eye, increased susceptibility of skin and ocular cancer, and progressive neurodegeneration in some patients. XP is present worldwide, with higher incidence in areas having frequent consanguinity. Being extremely rare, there is limited literature on XP and associated complications. Here, the clinico-pathological experience (spectrum of clinical presentation, histopathological findings of malignant skin lesions, and progression) of managing 8 cases of XP is presented. Methodology: A retrospective study was conducted in a pediatric tertiary care hospital in eastern India during a ten-year period from 2013 to 2022. A clinical diagnosis was made based on severe sun burn or premature photo-aging and/or onset of cutaneous malignancies at early age (1st decade) in background of consanguinity and autosomal recessive inheritance pattern in family. Results: The mean age of presentation was 1.2 years (range of 7month-3years), while three children presented during their infancy. Male to female ratio was 5:3, and all were born of consanguineous marriage. They presented with dermatological manifestations (100%) followed by ophthalmic (75%) and/or neurological symptoms (25%). Patients had normal skin at birth but soon developed extreme sensitivity to UVR in the form of exaggerated sun tanning, burning, and blistering on minimal sun exposure, followed by abnormal skin pigmentation like freckles and lentiginosis. Subsequently, over time there was progressive xerosis, atrophy, wrinkling, and poikiloderma. Six patients had varied degree of ocular involvement, while three of them had severe manifestation, including madarosis, tylosis, ectropion, Lagopthalmos, Pthysis bulbi, clouding and scarring of the cornea with complete or partial loss of vision, and ophthalmic malignancies. 50% (n=4) cases had skin and ocular pre-malignant (actinic keratosis) and malignant lesions, including melanoma and non melanoma skin cancer (NMSC) like squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) in their early childhood. One patient had simultaneous occurrence of multiple malignancies together (SCC, BCC, and melanoma). Subnormal intelligence was noticed as neurological feature, and none had sensory neural hearing loss, microcephaly, neuroregression, or neurdeficit. All the patients had been being managed by a multidisciplinary team of pediatricians, dermatologists, ophthalmologists, neurologists and psychiatrists. Conclusion: Although till date there is no complete cure for XP and the disease is ultimately fatal. But increased awareness, early diagnosis followed by persistent vigorous protection from UVR, and regular screening for early detection of malignancies along with psychological support can drastically improve patients’ quality of life and life expectancy. Further research is required on formulating optimal management of XP, specifically the role and possibilities of gene therapy in XP.

Keywords: childhood malignancies, dermato-pathological findings, eastern India, Xeroderma pigmentosa

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60 Thermally Conductive Polymer Nanocomposites Based on Graphene-Related Materials

Authors: Alberto Fina, Samuele Colonna, Maria del Mar Bernal, Orietta Monticelli, Mauro Tortello, Renato Gonnelli, Julio Gomez, Chiara Novara, Guido Saracco

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Thermally conductive polymer nanocomposites are of high interest for several applications including low-temperature heat recovery, heat exchangers in a corrosive environment and heat management in electronics and flexible electronics. In this paper, the preparation of thermally conductive nanocomposites exploiting graphene-related materials is addressed, along with their thermal characterization. In particular, correlations between 1- chemical and physical features of the nanoflakes and 2- processing conditions with the heat conduction properties of nanocomposites is studied. Polymers are heat insulators; therefore, the inclusion of conductive particles is the typical solution to obtain a sufficient thermal conductivity. In addition to traditional microparticles such as graphite and ceramics, several nanoparticles have been proposed, including carbon nanotubes and graphene, for the use in polymer nanocomposites. Indeed, thermal conductivities for both carbon nanotubes and graphenes were reported in the wide range of about 1500 to 6000 W/mK, despite such property may decrease dramatically as a function of the size, number of layers, the density of topological defects, re-hybridization defects as well as on the presence of impurities. Different synthetic techniques have been developed, including mechanical cleavage of graphite, epitaxial growth on SiC, chemical vapor deposition, and liquid phase exfoliation. However, the industrial scale-up of graphene, defined as an individual, single-atom-thick sheet of hexagonally arranged sp2-bonded carbons still remains very challenging. For large scale bulk applications in polymer nanocomposites, some graphene-related materials such as multilayer graphenes (MLG), reduced graphene oxide (rGO) or graphite nanoplatelets (GNP) are currently the most interesting graphene-based materials. In this paper, different types of graphene-related materials were characterized for their chemical/physical as well as for thermal properties of individual flakes. Two selected rGOs were annealed at 1700°C in vacuum for 1 h to reduce defectiveness of the carbon structure. Thermal conductivity increase of individual GNP with annealing was assessed via scanning thermal microscopy. Graphene nano papers were prepared from both conventional RGO and annealed RGO flakes. Characterization of the nanopapers evidenced a five-fold increase in the thermal diffusivity on the nano paper plane for annealed nanoflakes, compared to pristine ones, demonstrating the importance of structural defectiveness reduction to maximize the heat dissipation performance. Both pristine and annealed RGO were used to prepare polymer nanocomposites, by melt reactive extrusion. Thermal conductivity showed two- to three-fold increase in the thermal conductivity of the nanocomposite was observed for high temperature treated RGO compared to untreated RGO, evidencing the importance of using low defectivity nanoflakes. Furthermore, the study of different processing paremeters (time, temperature, shear rate) during the preparation of poly (butylene terephthalate) nanocomposites evidenced a clear correlation with the dispersion and fragmentation of the GNP nanoflakes; which in turn affected the thermal conductivity performance. Thermal conductivity of about 1.7 W/mK, i.e. one order of magnitude higher than for pristine polymer, was obtained with 10%wt of annealed GNPs, which is in line with state of the art nanocomposites prepared by more complex and less upscalable in situ polymerization processes.

Keywords: graphene, graphene-related materials, scanning thermal microscopy, thermally conductive polymer nanocomposites

Procedia PDF Downloads 268
59 Intrigues of Brand Activism versus Brand Antagonism in Rival Online Football Brand Communities: The Case of the Top Two Premier Football Clubs in Ghana

Authors: Joshua Doe, George Amoako

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Purpose: In an increasingly digital world, the realm of sports fandom has extended its borders, creating a vibrant ecosystem of online communities centered around football clubs. This study ventures into the intricate interplay of motivations that drive football fans to respond to brand activism and its profound implications for brand antagonism and engagement among two of Ghana's most revered premier football clubs. Methods: A sample of 459 fervent fans from these two rival clubs were engaged through self-administered questionnaires expertly distributed via social media and online platforms. Data was analysed, using PLS-SEM. Findings: The tapestry of motivations that weave through these online football communities is as diverse as the fans themselves. It becomes apparent that fans are propelled by a spectrum of incentives. They seek education, yearn for information, revel in entertainment, embrace socialization, and fortify their self-esteem through their interactions within these digital spaces. Yet, it is the nuanced distinction in these motivations that shapes the trajectory of brand antagonism and engagement. Surprisingly, the study reveals a remarkable pattern. Football fans, despite their fierce rivalries, do not engage in brand antagonism based on educational pursuits, information-seeking endeavors, or socialization. Instead, it is motivations rooted in entertainment and self-esteem that serve as the fertile grounds for brand antagonism. Paradoxically, it is these very motivations coupled with the desire for socialization that nurture brand engagement, manifesting as active support and advocacy for their chosen club brand. Originality: Our research charters new waters by extending the boundaries of existing theories in the field. The Technology Acceptance Uses and Gratifications Theory, and Social Identity Theory all find new dimensions within the context of online brand community engagement. This not only deepens our understanding of the multifaceted world of online football fandom but also invites us to explore the implications these insights carry within the digital realm. Contribution to Practice: For marketers, our findings offer a treasure trove of actionable insights. They beckon the development of targeted content strategies that resonate with fan motivations. The implementation of brand advocacy programs, fostering opportunities for socialization, and the effective management of brand antagonism emerge as pivotal strategies. Furthermore, the utilization of data-driven insights is poised to refine consumer engagement strategies and strengthen brand affinity. Future Studies: For future studies, we advocate for longitudinal, cross-cultural, and qualitative studies that could shed further light on this topic. Comparative analyses across different types of online brand communities, an exploration of the role of brand community leaders, and inquiries into the factors that contribute to brand community dissolution all beckon the research community. Furthermore, understanding motivation-specific antagonistic behaviors and the intricate relationship between information-seeking and engagement present exciting avenues for further exploration. This study unfurls a vibrant tapestry of fan motivations, brand activism, and rivalry within online football communities. It extends a hand to scholars and marketers alike, inviting them to embark on a journey through this captivating digital realm, where passion, rivalry, and engagement harmonize to shape the world of sports fandom as we know it.

Keywords: online brand engagement, football fans, brand antagonism, motivations

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58 Implementation of Autologous Adipose Graft from the Abdomen for Complete Fat Pad Loss of the Heel Following a Traumatic Open Fracture Secondary to a Motor Vehicle Accident: A Case Study

Authors: Ahmad Saad, Shuja Abbas, Breanna Marine

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Introduction: This study explores the potential applications of autologous pedal fat pad grafting as a minimally invasive therapeutic strategy for addressing pedal fat pad loss. Without adequate shock absorbing tissue, a patient can experience functional deficits, ulcerations, loss of quality of life, and significant limitations with ambulation. This study details a novel technique involving autologous adipose grafting from the abdomen to enhance plantar fat pad thickness in a patient involved in a severe motor vehicle accident which resulted in total fat pad loss of the heel. Autologous adipose grafting (AAG) was used following adipose allografting in an effort to recreate a normal shock absorbing surface to allow return to activities of daily living and painless ambulation. Methods: A 46-year-old male sustained multiple open pedal fractures and necrosis to the heel fat pad after a motorcycle accident, which resulted in complete loss of the calcaneal fat pad. The patient underwent serial debridement’s, utilization of wound vac therapy and split thickness skin grafting to accomplish complete closure, despite complete loss of adipose to area. Patient presented with complaints of pain on ambulation, inability to bear weight on the heel, recurrent ulcerations, admitted had not been ambulating for two years. Clinical exam demonstrated complete loss of the plantar fat pad with a thin layer of epithelial tissue overlying the calcaneal bone, allowing visibility of the osseous contour of the calcaneus. Scar tissue had formed in place of the fat pad, with thickened epithelial tissue extending from the midfoot to the calcaneus. After conservative measures were exhausted, the patient opted for initial management by adipose allograft matrix (AAM) injections. Post operative X-ray imaging revealed noticeable improvement in calcaneal fat pad thickness. At 1 year follow up, the patient was able to ambulate without assistive devices. The fat pad at this point was significantly thicker than it was pre-operatively, but the thickness did not restore to pre-accident thickness. In order to compare the take of allograft versus autografting of adipose tissue, the decision to use adipose autograft through abdominal liposuction harvesting was deemed suitable. A general surgeon completed harvesting of adipose cells from the patient’s abdomen via liposuction, and a podiatric surgeon performed the AAG injection into the heel. Total of 15 cc’s of autologous adipose tissue injected to the calcaneus. Results: There was a visual increase in the calcaneal fat pad thickness both clinically and radiographically. At the 6-week follow up, imaging revealed retention of the calcaneal fat pad thickness. Three months postop, patient returned to activities of daily living and increased quality of life due to their increased ability to ambulate. Discussion: AAG is a novel treatment for pedal fat pad loss. These treatments may be viable and reproducible therapeutic choices for patients suffering from fat pad atrophy, fat pad loss, and/or plantar ulcerations. Both treatments of AAM and AAG exhibited similar therapeutic results by providing pain relief for ambulation and allowing for patients to return to their quality of life.

Keywords: podiatry, wound, adipose, allograft, autograft, wound care, limb reconstruction, injection, limb salvage

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57 Well Inventory Data Entry: Utilization of Developed Technologies to Progress the Integrated Asset Plan

Authors: Danah Al-Selahi, Sulaiman Al-Ghunaim, Bashayer Sadiq, Fatma Al-Otaibi, Ali Ameen

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In light of recent changes affecting the Oil & Gas Industry, optimization measures have become imperative for all companies globally, including Kuwait Oil Company (KOC). To keep abreast of the dynamic market, a detailed Integrated Asset Plan (IAP) was developed to drive optimization across the organization, which was facilitated through the in-house developed software “Well Inventory Data Entry” (WIDE). This comprehensive and integrated approach enabled centralization of all planned asset components for better well planning, enhancement of performance, and to facilitate continuous improvement through performance tracking and midterm forecasting. Traditionally, this was hard to achieve as, in the past, various legacy methods were used. This paper briefly describes the methods successfully adopted to meet the company’s objective. IAPs were initially designed using computerized spreadsheets. However, as data captured became more complex and the number of stakeholders requiring and updating this information grew, the need to automate the conventional spreadsheets became apparent. WIDE, existing in other aspects of the company (namely, the Workover Optimization project), was utilized to meet the dynamic requirements of the IAP cycle. With the growth of extensive features to enhance the planning process, the tool evolved into a centralized data-hub for all asset-groups and technical support functions to analyze and infer from, leading WIDE to become the reference two-year operational plan for the entire company. To achieve WIDE’s goal of operational efficiency, asset-groups continuously add their parameters in a series of predefined workflows that enable the creation of a structured process which allows risk factors to be flagged and helps mitigation of the same. This tool dictates assigned responsibilities for all stakeholders in a method that enables continuous updates for daily performance measures and operational use. The reliable availability of WIDE, combined with its user-friendliness and easy accessibility, created a platform of cross-functionality amongst all asset-groups and technical support groups to update contents of their respective planning parameters. The home-grown entity was implemented across the entire company and tailored to feed in internal processes of several stakeholders across the company. Furthermore, the implementation of change management and root cause analysis techniques captured the dysfunctionality of previous plans, which in turn resulted in the improvement of already existing mechanisms of planning within the IAP. The detailed elucidation of the 2 year plan flagged any upcoming risks and shortfalls foreseen in the plan. All results were translated into a series of developments that propelled the tool’s capabilities beyond planning and into operations (such as Asset Production Forecasts, setting KPIs, and estimating operational needs). This process exemplifies the ability and reach of applying advanced development techniques to seamlessly integrated the planning parameters of various assets and technical support groups. These techniques enables the enhancement of integrating planning data workflows that ultimately lay the founding plans towards an epoch of accuracy and reliability. As such, benchmarks of establishing a set of standard goals are created to ensure the constant improvement of the efficiency of the entire planning and operational structure.

Keywords: automation, integration, value, communication

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56 Preliminary Results on a Study of Antimicrobial Susceptibility Testing of Bacillus anthracis Strains Isolated during Anthrax Outbreaks in Italy from 2001 to 2017

Authors: Viviana Manzulli, Luigina Serrecchia, Adelia Donatiello, Valeria Rondinone, Sabine Zange, Alina Tscherne, Antonio Parisi, Antonio Fasanella

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Anthrax is a zoonotic disease that affects a wide range of animal species (primarily ruminant herbivores), and can be transmitted to humans through consumption or handling of contaminated animal products. The etiological agent B.anthracis is able to survive in unfavorable environmental conditions by forming endospore which remain viable in the soil for many decades. Furthermore, B.anthracis is considered as one of the most feared agents to be potentially misused as a biological weapon and the importance of the disease and its treatment in humans has been underscored before the bioterrorism events in the United States in 2001. Due to the often fatal outcome of human cases, antimicrobial susceptibility testing plays especially in the management of anthrax infections an important role. In Italy, animal anthrax is endemic (predominantly found in the southern regions and on islands) and is characterized by sporadic outbreaks occurring mainly during summer. Between 2012 and 2017 single human cases of cutaneous anthrax occurred. In this study, 90 diverse strains of B.anthracis, isolated in Italy from 2001 to 2017, were screened to their susceptibility to sixteen clinically relevant antimicrobial agents by using the broth microdilution method. B.anthracis strains selected for this study belong to the strain collection stored at the Anthrax Reference Institute of Italy located inside the Istituto Zooprofilattico Sperimentale of Puglia and Basilicata. The strains were isolated at different time points and places from various matrices (human, animal and environmental). All strains are a representative of over fifty distinct MLVA 31 genotypes. The following antibiotics were used for testing: gentamicin, ceftriaxone, streptomycin, penicillin G, clindamycin, chloramphenicol, vancomycin, linezolid, cefotaxime, tetracycline, erythromycin, rifampin, amoxicillin, ciprofloxacin, doxycycline and trimethoprim. A standard concentration of each antibiotic was prepared in a specific diluent, which were then twofold serial diluted. Therefore, each wells contained: bacterial suspension of 1–5x104 CFU/mL in Mueller-Hinton Broth (MHB), the antibiotic to be tested at known concentration and resazurin, an indicator of cell growth. After incubation overnight at 37°C, the wells were screened for color changes caused by the resazurin: a change from purple to pink/colorless indicated cell growth. The lowest concentration of antibiotic that prevented growth represented the minimal inhibitory concentration (MIC). This study suggests that B.anthracis remains susceptible in vitro to many antibiotics, in addition to doxycycline (MICs ≤ 0,03 µg/ml), ciprofloxacin (MICs ≤ 0,03 µg/ml) and penicillin G (MICs ≤ 0,06 µg/ml), recommend by CDC for the treatment of human cases and for prophylactic use after exposure to the spores. In fact, the good activity of gentamicin (MICs ≤ 0,25 µg/ml), streptomycin (MICs ≤ 1 µg/ml), clindamycin (MICs ≤ 0,125 µg/ml), chloramphenicol(MICs ≤ 4 µg/ml), vancomycin (MICs ≤ 2 µg/ml), linezolid (MICs ≤ 2 µg/ml), tetracycline (MICs ≤ 0,125 µg/ml), erythromycin (MICs ≤ 0,25 µg/ml), rifampin (MICs ≤ 0,25 µg/ml), amoxicillin (MICs ≤ 0,06 µg/ml), towards all tested B.anthracis strains demonstrates an appropriate alternative choice for prophylaxis and/or treatment. All tested B.anthracis strains showed intermediate susceptibility to the cephalosporins (MICs ≥ 16 µg/ml) and resistance to trimethoprim (MICs ≥ 128 µg/ml).

Keywords: Bacillus anthracis, antibiotic susceptibility, treatment, minimum inhibitory concentration

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55 Gender Mainstreaming at the Institute of Technology Tribhuvan University Nepal: A Collaborative Approach to Architecture and Design Education

Authors: Martina Maria Keitsch, Sangeeta Singh

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There has been a growing recognition that sustainable development needs to consider economic, social and environmental aspects including gender. In Nepal, the majority of the population lives in rural areas, and many households do not have access to electricity. In rural areas, the difficulty of accessing energy is becoming one of the greatest constraints for improving living conditions. This is particularly true for women and children, who spent much time for collecting firewood and cooking and thus are often deprived of time for education, political- and business activities. The poster introduces an education and research project financed by the Norwegian Government. The project runs from 2015-2020 and is a collaboration between the Norwegian University of Science (NTNU) and Technology Institute of Engineering (IOE), Tribhuvan University. It has the title Master program and Research in Energy for Sustainable Social Development Energy for Sustainable Social Development (MSESSD). The project addresses engineering and architecture students and comprises several integral activities towards gender mainstreaming. The following activities are conducted; 1. Creating academic opportunities, 2. Updating administrative personnel on strategies to effectively include gender issues, 3. Integrating female and male stakeholders in the design process, 4. Sensitizing female and male students for gender issues in energy systems. The project aims to enable students to design end-user-friendly solutions which can, for example, save time that can be used to generate and enhance income. Relating to gender mainstreaming, design concepts focus on smaller-scale technologies, which female stakeholders can take control of and manage themselves. Creating academic opportunities, we have a 30% female students’ rate in each master student batch in the program with the goal to educate qualified female personnel for academia and policy-making/government. This is a very ambitious target in a Nepalese context. The rate of female students, who completed the MSc program at IOE between 1998 and January 2015 is 10% out of 180 students in total. For recruiting, female students were contacted personally and encouraged to apply for the program. Further, we have established a Master course in gender mainstreaming and energy. On an administrative level, NTNU has hosted a training program for IOE on gender-mainstreaming information and -strategies for academic education. Integrating female and male stakeholders, local women groups such as, e.g., mothers group are actively included in research and education for example in planning, decision-making, and management to establish clean energy solutions. The project meets women’s needs not just practically by providing better technology, but also strategically by providing solutions that enhance their social and economic decision-making authority. Sensitizing the students for gender issues in energy systems, the project makes it mandatory to discuss gender mainstreaming based on the case studies in the Master thesis. All activities will be discussed in detail comprising an overview of MSESSD, the gender mainstreaming master course contents’, and case studies where energy solutions were co-designed with men and women as lead-users and/or entrepreneurs. The goal is to motivate educators to develop similar forms of transnational gender collaboration.

Keywords: knowledge generation on gender mainstreaming, sensitizing students, stakeholder inclusion, education strategies for design and architecture in gender mainstreaming, facilitation for cooperation

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54 Pulmonary Disease Identification Using Machine Learning and Deep Learning Techniques

Authors: Chandu Rathnayake, Isuri Anuradha

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Early detection and accurate diagnosis of lung diseases play a crucial role in improving patient prognosis. However, conventional diagnostic methods heavily rely on subjective symptom assessments and medical imaging, often causing delays in diagnosis and treatment. To overcome this challenge, we propose a novel lung disease prediction system that integrates patient symptoms and X-ray images to provide a comprehensive and reliable diagnosis.In this project, develop a mobile application specifically designed for detecting lung diseases. Our application leverages both patient symptoms and X-ray images to facilitate diagnosis. By combining these two sources of information, our application delivers a more accurate and comprehensive assessment of the patient's condition, minimizing the risk of misdiagnosis. Our primary aim is to create a user-friendly and accessible tool, particularly important given the current circumstances where many patients face limitations in visiting healthcare facilities. To achieve this, we employ several state-of-the-art algorithms. Firstly, the Decision Tree algorithm is utilized for efficient symptom-based classification. It analyzes patient symptoms and creates a tree-like model to predict the presence of specific lung diseases. Secondly, we employ the Random Forest algorithm, which enhances predictive power by aggregating multiple decision trees. This ensemble technique improves the accuracy and robustness of the diagnosis. Furthermore, we incorporate a deep learning model using Convolutional Neural Network (CNN) with the RestNet50 pre-trained model. CNNs are well-suited for image analysis and feature extraction. By training CNN on a large dataset of X-ray images, it learns to identify patterns and features indicative of lung diseases. The RestNet50 architecture, known for its excellent performance in image recognition tasks, enhances the efficiency and accuracy of our deep learning model. By combining the outputs of the decision tree-based algorithms and the deep learning model, our mobile application generates a comprehensive lung disease prediction. The application provides users with an intuitive interface to input their symptoms and upload X-ray images for analysis. The prediction generated by the system offers valuable insights into the likelihood of various lung diseases, enabling individuals to take appropriate actions and seek timely medical attention. Our proposed mobile application has significant potential to address the rising prevalence of lung diseases, particularly among young individuals with smoking addictions. By providing a quick and user-friendly approach to assessing lung health, our application empowers individuals to monitor their well-being conveniently. This solution also offers immense value in the context of limited access to healthcare facilities, enabling timely detection and intervention. In conclusion, our research presents a comprehensive lung disease prediction system that combines patient symptoms and X-ray images using advanced algorithms. By developing a mobile application, we provide an accessible tool for individuals to assess their lung health conveniently. This solution has the potential to make a significant impact on the early detection and management of lung diseases, benefiting both patients and healthcare providers.

Keywords: CNN, random forest, decision tree, machine learning, deep learning

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53 Unknown Groundwater Pollution Source Characterization in Contaminated Mine Sites Using Optimal Monitoring Network Design

Authors: H. K. Esfahani, B. Datta

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Groundwater is one of the most important natural resources in many parts of the world; however it is widely polluted due to human activities. Currently, effective and reliable groundwater management and remediation strategies are obtained using characterization of groundwater pollution sources, where the measured data in monitoring locations are utilized to estimate the unknown pollutant source location and magnitude. However, accurately identifying characteristics of contaminant sources is a challenging task due to uncertainties in terms of predicting source flux injection, hydro-geological and geo-chemical parameters, and the concentration field measurement. Reactive transport of chemical species in contaminated groundwater systems, especially with multiple species, is a complex and highly non-linear geochemical process. Although sufficient concentration measurement data is essential to accurately identify sources characteristics, available data are often sparse and limited in quantity. Therefore, this inverse problem-solving method for characterizing unknown groundwater pollution sources is often considered ill-posed, complex and non- unique. Different methods have been utilized to identify pollution sources; however, the linked simulation-optimization approach is one effective method to obtain acceptable results under uncertainties in complex real life scenarios. With this approach, the numerical flow and contaminant transport simulation models are externally linked to an optimization algorithm, with the objective of minimizing the difference between measured concentration and estimated pollutant concentration at observation locations. Concentration measurement data are very important to accurately estimate pollution source properties; therefore, optimal design of the monitoring network is essential to gather adequate measured data at desired times and locations. Due to budget and physical restrictions, an efficient and effective approach for groundwater pollutant source characterization is to design an optimal monitoring network, especially when only inadequate and arbitrary concentration measurement data are initially available. In this approach, preliminary concentration observation data are utilized for preliminary source location, magnitude and duration of source activity identification, and these results are utilized for monitoring network design. Further, feedback information from the monitoring network is used as inputs for sequential monitoring network design, to improve the identification of unknown source characteristics. To design an effective monitoring network of observation wells, optimization and interpolation techniques are used. A simulation model should be utilized to accurately describe the aquifer properties in terms of hydro-geochemical parameters and boundary conditions. However, the simulation of the transport processes becomes complex when the pollutants are chemically reactive. Three dimensional transient flow and reactive contaminant transport process is considered. The proposed methodology uses HYDROGEOCHEM 5.0 (HGCH) as the simulation model for flow and transport processes with chemically multiple reactive species. Adaptive Simulated Annealing (ASA) is used as optimization algorithm in linked simulation-optimization methodology to identify the unknown source characteristics. Therefore, the aim of the present study is to develop a methodology to optimally design an effective monitoring network for pollution source characterization with reactive species in polluted aquifers. The performance of the developed methodology will be evaluated for an illustrative polluted aquifer sites, for example an abandoned mine site in Queensland, Australia.

Keywords: monitoring network design, source characterization, chemical reactive transport process, contaminated mine site

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52 Familiarity with Intercultural Conflicts and Global Work Performance: Testing a Theory of Recognition Primed Decision-Making

Authors: Thomas Rockstuhl, Kok Yee Ng, Guido Gianasso, Soon Ang

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Two meta-analyses show that intercultural experience is not related to intercultural adaptation or performance in international assignments. These findings have prompted calls for a deeper grounding of research on international experience in the phenomenon of global work. Two issues, in particular, may limit current understanding of the relationship between international experience and global work performance. First, intercultural experience is too broad a construct that may not sufficiently capture the essence of global work, which to a large part involves sensemaking and managing intercultural conflicts. Second, the psychological mechanisms through which intercultural experience affects performance remains under-explored, resulting in a poor understanding of how experience is translated into learning and performance outcomes. Drawing on recognition primed decision-making (RPD) research, the current study advances a cognitive processing model to highlight the importance of intercultural conflict familiarity. Compared to intercultural experience, intercultural conflict familiarity is a more targeted construct that captures individuals’ previous exposure to dealing with intercultural conflicts. Drawing on RPD theory, we argue that individuals’ intercultural conflict familiarity enhances their ability to make accurate judgments and generate effective responses when intercultural conflicts arise. In turn, the ability to make accurate situation judgements and effective situation responses is an important predictor of global work performance. A relocation program within a multinational enterprise provided the context to test these hypotheses using a time-lagged, multi-source field study. Participants were 165 employees (46% female; with an average of 5 years of global work experience) from 42 countries who relocated from country to regional offices as part a global restructuring program. Within the first two weeks of transfer to the regional office, employees completed measures of their familiarity with intercultural conflicts, cultural intelligence, cognitive ability, and demographic information. They also completed an intercultural situational judgment test (iSJT) to assess their situation judgment and situation response. The iSJT comprised four validated multimedia vignettes of challenging intercultural work conflicts and prompted employees to provide protocols of their situation judgment and situation response. Two research assistants, trained in intercultural management but blind to the study hypotheses, coded the quality of employee’s situation judgment and situation response. Three months later, supervisors rated employees’ global work performance. Results using multilevel modeling (vignettes nested within employees) support the hypotheses that greater familiarity with intercultural conflicts is positively associated with better situation judgment, and that situation judgment mediates the effect of intercultural familiarity on situation response quality. Also, aggregated situation judgment and situation response quality both predicted supervisor-rated global work performance. Theoretically, our findings highlight the important but under-explored role of familiarity with intercultural conflicts; a shift in attention from the general nature of international experience assessed in terms of number and length of overseas assignments. Also, our cognitive approach premised on RPD theory offers a new theoretical lens to understand the psychological mechanisms through which intercultural conflict familiarity affects global work performance. Third, and importantly, our study contributes to the global talent identification literature by demonstrating that the cognitive processes engaged in resolving intercultural conflicts predict actual performance in the global workplace.

Keywords: intercultural conflict familiarity, job performance, judgment and decision making, situational judgment test

Procedia PDF Downloads 179
51 Tailoring Workspaces for Generation Z: Harmonizing Teamwork, Privacy, and Connectivity

Authors: Maayan Nakash

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The modern workplace is undergoing a revolution, with Generation Z (Gen-Z) at the forefront of this transformative shift. However, empirical investigations specifically targeting the workplace preferences of this generation remain limited. Through direct examination of their tendencies via a survey approach, this study offers vital insights for aligning organizational policies and practices. The results presented in this paper are part of a comprehensive study that explored Gen Z's viewpoints on various employment market aspects, likely to decisively influence the design of future work environments. Data were collected via an online survey distributed among a cohort of 461 individuals from Gen-Z, born between the mid-1990s and 2010, consisting of 241 males (52.28%) and 220 females (47.72%). Responses were gauged using Likert scale statements that probed preferences for teamwork versus individual work, virtual versus personal interactions, and open versus private workspaces. Descriptive statistics and analytical analyses were conducted to pinpoint key patterns. We discovered that a high proportion of respondents (81.99%, n=378) exhibited a preference for teamwork over individual work. Correspondingly, the data indicate strong support for the recognition of team-based tasks as a tool contributing to personal and professional development. In terms of communication, the majority of respondents (61.38%) either disagreed (n=154) or slightly agreed (n=129) with the exclusive reliance on virtual interactions with their organizational peers. This finding underscores that despite technological progress, digital natives place significant value on physical interaction and non-mediated communication. Moreover, we understand that they also value a quiet and private work environment, clearly preferring it over open and shared workspaces. Considering that Gen-Z does not necessarily experience high levels of stress within social frameworks in the workplace, this can be attributed to a desire for a space that allows for focused engagement with work tasks. A One-Sample Chi-Square Test was performed on the observed distribution of respondents' reactions to each examined statement. The results showed statistically significant deviations from a uniform distribution (p<.001), indicating that the response patterns did not occur by chance and that there were meaningful tendencies in the participants' responses. The findings expand the theoretical knowledge base on human resources in the dynamics of a multi-generational workforce, illuminating the values, approaches, and expectations of Gen-Z. Practically, the results may lead organizations to equip themselves with tools to create policies tailored to Gen-Z in the context of workspaces and social needs, which could potentially foster a fertile environment and aid in attracting and retaining young talent. Future studies might include investigating potential mitigating factors, such as cultural influences or individual personality traits, which could further clarify the nuances in Gen-Z's work style preferences. Longitudinal studies tracking changes in these preferences as the generation matures may also yield valuable insights. Ultimately, as the landscape of the workforce continues to evolve, ongoing investigations into the unique characteristics and aspirations of emerging generations remain essential for nurturing harmonious, productive, and future-ready organizational environments.

Keywords: workplace, future of work, generation Z, digital natives, human resources management

Procedia PDF Downloads 53
50 Phytochemicals and Photosynthesis of Grape Berry Exocarp and Seed (Vitis vinifera, cv. Alvarinho): Effects of Foliar Kaolin and Irrigation

Authors: Andreia Garrido, Artur Conde, Ana Cunha, Ric De Vos

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Climate changes predictions point to increases in abiotic stress for crop plants in Portugal, like pronounced temperature variation and decreased precipitation, which will have negative impact on grapevine physiology and consequently, on grape berry and wine quality. Short-term mitigation strategies have, therefore, been implemented to alleviate the impacts caused by adverse climatic periods. These strategies include foliar application of kaolin, an inert mineral, which has radiation reflection proprieties that decreases stress from excessive heat/radiation absorbed by its leaves, as well as smart irrigation strategies to avoid water stress. However, little is known about the influence of these mitigation measures on grape berries, neither on the photosynthetic activity nor on the photosynthesis-related metabolic profiles of its various tissues. Moreover, the role of fruit photosynthesis on berry quality is poorly understood. The main objective of our work was to assess the effects of kaolin and irrigation treatments on the photosynthetic activity of grape berry tissues (exocarp and seeds) and on their global metabolic profile, also investigating their possible relationship. We therefore collected berries of field-grown plants of the white grape variety Alvarinho from two distinct microclimates, i.e. from clusters exposed to high light (HL, 150 µmol photons m⁻² s⁻¹) and low light (LL, 50 µmol photons m⁻² s⁻¹), from both kaolin and non-kaolin (control) treated plants at three fruit developmental stages (green, véraison and mature). Plant irrigation was applied after harvesting the green berries, which also enabled comparison of véraison and mature berries from irrigated and non-irrigated growth conditions. Photosynthesis was assessed by pulse amplitude modulated chlorophyll fluorescence imaging analysis, and the metabolite profile of both tissues was assessed by complementary metabolomics approaches. Foliar kaolin application resulted in, for instance, an increased photosynthetic activity of the exocarp of LL-grown berries at green developmental stage, as compared to the control non-kaolin treatment, with a concomitant increase in the levels of several lipid-soluble isoprenoids (chlorophylls, carotenoids, and tocopherols). The exocarp of mature berries grown at HL microclimate on kaolin-sprayed non-irrigated plants had higher total sugar levels content than all other treatments, suggesting that foliar application of this mineral results in an increased accumulation of photoassimilates in mature berries. Unbiased liquid chromatography-mass spectrometry-based profiling of semi-polar compounds followed by ASCA (ANOVA simultaneous component analysis) and ANOVA statistical analysis indicated that kaolin had no or inconsistent effect on the flavonoid and phenylpropanoid composition in both seed and exocarp at any developmental stage; in contrast, both microclimate and irrigation influenced the level of several of these compounds depending on berry ripening stage. Overall, our study provides more insight into the effects of mitigation strategies on berry tissue photosynthesis and phytochemistry, under contrasting conditions of cluster light microclimate. We hope that this may contribute to develop sustainable management in vineyards and to maintain grape berries and wines with high quality even at increasing abiotic stress challenges.

Keywords: climate change, grape berry tissues, metabolomics, mitigation strategies

Procedia PDF Downloads 124
49 The Plight of the Rohingyas: Design Guidelines to Accommodate Displaced People in Bangladesh

Authors: Nazia Roushan, Maria Kipti

Abstract:

The sensitive issue of a large-scale entry of Rohingya refugees to Bangladesh has arisen again since August of 2017. Incited by ethnic and religious conflict, the Rohingyas—an ethnic group concentrated in the north-west state of Rakhine in Myanmar—have been fleeing to what is now Bangladesh from as early as the late 1700s in four main exoduses. This long-standing persecution has recently escalated, and accommodating the recent wave of exodus has been especially challenging due to the sheer volume of a million refugees concentrated in refugee camps in two small administrative units (upazilas) in the south-east of the country: the host area. This drastic change in the host area’s social fabric is putting a lot of strain on the country’s economic, demographic and environmental stability, and security. Although Bangladesh’s long-term experience with disaster management has enabled it to respond rapidly to the crisis, the government is failing to cope with this enormous problem and has taken insufficient steps towards improving the living conditions to inhibit the inflow of more refugees. On top of that, the absence of a comprehensive national refugee policy, and the density of the structures of the camps are constricting the upgrading of the shelters to international standards. As of December 2016, the combined number of internally displaced persons (IDPs) due to conflict and violence (stock), and new displacements due to disasters (flow) in Bangladesh had exceeded 1 million. These numbers have increased dramatically in the last few months. Moreover, by 2050, Bangladesh will have as much as 25 million climate refugees just from its coastal districts. To enhance the resilience of the vulnerable, it is crucial to methodically factorize further interventions between Disaster Risk Reduction for Resilience (DRR) and the concept of Building Back Better (BBB) in the rehabilitation-reconstruction period. Considering these points, this paper provides a palette of options for design guidelines related to the living spaces and infrastructures for refugees. This will encourage the development of national standards for refugee camps, and the national and local level rehabilitation-reconstruction practices. Unhygienic living conditions, vulnerability, and the general lack of control over life are pervasive throughout the camps. This paper, therefore, proposes site-specific strategic and physical planning and design for shelters for refugees in Bangladesh that will lead to sustainable living environments through the following: a) site survey of existing two registered and one makeshift unregistered refugee camps to document and study their physical conditions, b) questionnaires and semi-structured focus group discussions carried out among the refugees and stakeholders to understand what the lived experiences and needs are; and c) combining the findings with international minimum standards for shelter and settlement from International Federation of Red Cross and Red Crescent (IFRC), Médecins Sans Frontières (MSF), United Nations High Commissioner for Refugees (UNHCR). These proposals include temporary shelter solutions that balance between lived spaces and regimented, repetitive plans using readily available and cheap materials, erosion control and slope stabilization strategies, and most importantly, coping mechanisms for the refugees to be self-reliant and resilient.

Keywords: architecture, Bangladesh, refugee camp, resilience, Rohingya

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48 Reverse Logistics Network Optimization for E-Commerce

Authors: Albert W. K. Tan

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This research consolidates a comprehensive array of publications from peer-reviewed journals, case studies, and seminar reports focused on reverse logistics and network design. By synthesizing this secondary knowledge, our objective is to identify and articulate key decision factors crucial to reverse logistics network design for e-commerce. Through this exploration, we aim to present a refined mathematical model that offers valuable insights for companies seeking to optimize their reverse logistics operations. The primary goal of this research endeavor is to develop a comprehensive framework tailored to advising organizations and companies on crafting effective networks for their reverse logistics operations, thereby facilitating the achievement of their organizational goals. This involves a thorough examination of various network configurations, weighing their advantages and disadvantages to ensure alignment with specific business objectives. The key objectives of this research include: (i) Identifying pivotal factors pertinent to network design decisions within the realm of reverse logistics across diverse supply chains. (ii) Formulating a structured framework designed to offer informed recommendations for sound network design decisions applicable to relevant industries and scenarios. (iii) Propose a mathematical model to optimize its reverse logistics network. A conceptual framework for designing a reverse logistics network has been developed through a combination of insights from the literature review and information gathered from company websites. This framework encompasses four key stages in the selection of reverse logistics operations modes: (1) Collection, (2) Sorting and testing, (3) Processing, and (4) Storage. Key factors to consider in reverse logistics network design: I) Centralized vs. decentralized processing: Centralized processing, a long-standing practice in reverse logistics, has recently gained greater attention from manufacturing companies. In this system, all products within the reverse logistics pipeline are brought to a central facility for sorting, processing, and subsequent shipment to their next destinations. Centralization offers the advantage of efficiently managing the reverse logistics flow, potentially leading to increased revenues from returned items. Moreover, it aids in determining the most appropriate reverse channel for handling returns. On the contrary, a decentralized system is more suitable when products are returned directly from consumers to retailers. In this scenario, individual sales outlets serve as gatekeepers for processing returns. Considerations encompass the product lifecycle, product value and cost, return volume, and the geographic distribution of returns. II) In-house vs. third-party logistics providers: The decision between insourcing and outsourcing in reverse logistics network design is pivotal. In insourcing, a company handles the entire reverse logistics process, including material reuse. In contrast, outsourcing involves third-party providers taking on various aspects of reverse logistics. Companies may choose outsourcing due to resource constraints or lack of expertise, with the extent of outsourcing varying based on factors such as personnel skills and cost considerations. Based on the conceptual framework, the authors have constructed a mathematical model that optimizes reverse logistics network design decisions. The model will consider key factors identified in the framework, such as transportation costs, facility capacities, and lead times. The authors have employed mixed LP to find the optimal solutions that minimize costs while meeting organizational objectives.

Keywords: reverse logistics, supply chain management, optimization, e-commerce

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47 Chronic Progressive External Ophthalmoplegia (CPEO)

Authors: Gagandeep Singh Digra, Pawan Kumar, Mandeep Kaur Sidhu

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INTRODUCTION: Chronic Progressive External Ophthalmoplegia (CPEO), also known as Progressive External Ophthalmoplegia (PEO), is a type of eye disorder characterized by a loss of the muscle functions involved in eye and eyelid movement. CPEO can be caused by mutations in mitochondrial DNA. It typically manifests in young adults with bilateral and progressive ptosis as the most common presentation but can also present with difficulty swallowing (dysphagia) and general weakness of the skeletal muscles (myopathy), particularly in the neck, arms, or legs. CASE PRESENTATION: This is a case discussion of 3 cousins who presented to our clinic. A 23-year-old male with past surgical history (PSH) of ptosis repair 2 years ago presented with a chief complaint of nasal intonation for 1.5 years associated with difficulty swallowing. The patient also complained of nasal regurgitation of liquids. He denied any headaches, fever, seizures, weakness of arms or legs, urinary complaints or changes in bowel habits. Physical Examination was positive for facial muscle weakness, including an inability to lift eyebrows (Frontalis), inability to close eyes tightly (Orbicularis Oculi), corneal reflex absent bilaterally, difficulty clenching jaw (Masseter muscle), difficulty smiling (Zygomaticus major), inability to elevate upper lip (Zygomaticus minor). Another cousin of the first patient, a 25-year-old male with no past medical history, presented with complaints of nasal intonation for 2 years associated with difficulty swallowing. He denied a history of nasal regurgitation, headaches, fever, seizures, weakness, urinary complaints or changes in bowel habits. Physical Examination showed facial muscle weakness of the Frontalis muscle, Orbicularis Oculi muscle, Masseter Muscle, Zygomaticus Major, Zygomaticus Minor and absent corneal reflexes. A 28-year-old male, a cousin of the first two patients, presented with chief complaints of ptosis and nasal intonation for the last 8 years. He also complained of difficulty swallowing and nasal regurgitation of liquids. His physical examination showed facial muscle weakness, including frontalis muscle (inability to lift eyebrows), Orbicularis Oculi (inability to close eyes tightly), absent corneal reflexes bilaterally, Zygomaticus Major (difficulty smiling), and Zygomaticus Minor (inability to elevate upper lip). MRI brain and visual field of all the patients were normal. Differential diagnoses, including Grave’s disease, Myasthenia Gravis and Glioma, were ruled out. Due to financial reasons, muscle biopsy could not be pursued. Pedigree analysis revealed only males were affected, likely due to maternal inheritance, so the clinical diagnosis of CPEO was made. The patients underwent symptomatic management, including ptosis surgical correction for the third patient. CONCLUSION: Chronic Progressive External Ophthalmoplegia (CPEO), a rare case entity, occurs in young adults as a manifestation of mitochondrial myopathy. There are three modes of transmission- maternal transmission associated with mitochondrial point mutations, autosomal recessive, and autosomal dominant. CPEO can sometimes be difficult to diagnose, especially in asymmetric presentation. Therefore, it is crucial to keep it in differential diagnosis to avoid delay in diagnosis.

Keywords: neurology, chronic, progressive, ophthalmoplegia

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46 Renewable Energy Micro-Grid Control Using Microcontroller in LabVIEW

Authors: Meena Agrawal, Chaitanya P. Agrawal

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The power systems are transforming and becoming smarter with innovations in technologies to enable embark simultaneously upon the sustainable energy needs, rising environmental concerns, economic benefits and quality requirements. The advantages provided by inter-connection of renewable energy resources are becoming more viable and dependable with the smart controlling technologies. The limitation of most renewable resources have their diversity and intermittency causing problems in power quality, grid stability, reliability, security etc. is being cured by these efforts. A necessitate of optimal energy management by intelligent Micro-Grids at the distribution end of the power system has been accredited to accommodate sustainable renewable Distributed Energy Resources on large scale across the power grid. All over the world Smart Grids are emerging now as foremost concern infrastructure upgrade programs. The hardware setup includes NI cRIO 9022, Compact Reconfigurable Input Output microcontroller board connected to the PC on a LAN router with three hardware modules. The Real-Time Embedded Controller is reconfigurable controller device consisting of an embedded real-time processor controller for communication and processing, a reconfigurable chassis housing the user-programmable FPGA, Eight hot-swappable I/O modules, and graphical LabVIEW system design software. It has been employed for signal analysis, controls and acquisition and logging of the renewable sources with the LabVIEW Real-Time applications. The employed cRIO chassis controls the timing for the module and handles communication with the PC over the USB, Ethernet, or 802.11 Wi-Fi buses. It combines modular I/O, real-time processing, and NI LabVIEW programmable. In the presented setup, the Analog Input Module NI 9205 five channels have been used for input analog voltage signals from renewable energy sources and NI 9227 four channels have been used for input analog current signals of the renewable sources. For switching actions based on the programming logic developed in software, a module having Electromechanical Relays (single-pole single throw) with 4-Channels, electrically isolated and LED indicating the state of that channel have been used for isolating the renewable Sources on fault occurrence, which is decided by the logic in the program. The module for Ethernet based Data Acquisition Interface ENET 9163 Ethernet Carrier, which is connected on the LAN Router for data acquisition from a remote source over Ethernet also has the module NI 9229 installed. The LabVIEW platform has been employed for efficient data acquisition, monitoring and control. Control logic utilized in program for operation of the hardware switching Related to Fault Relays has been portrayed as a flowchart. A communication system has been successfully developed amongst the sources and loads connected on different computers using Hypertext transfer protocol, HTTP or Ethernet Local Stacked area Network TCP/IP protocol. There are two main I/O interfacing clients controlling the operation of the switching control of the renewable energy sources over internet or intranet. The paper presents experimental results of the briefed setup for intelligent control of the micro-grid for renewable energy sources, besides the control of Micro-Grid with data acquisition and control hardware based on a microcontroller with visual program developed in LabVIEW.

Keywords: data acquisition and control, LabVIEW, microcontroller cRIO, Smart Micro-Grid

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45 Comparing Implications of Manual and ROSA-assisted Total Knee Replacements on Patients and Physicians: A Scoping Review

Authors: Bassem M. Darwish, Robert H. Ablove

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Introduction: Total knee arthroscopy (TKA) is a commonly performed procedure in patients with end-stage osteoarthritis and inaccuracy of component alignment in TKA has been shown to have many adverse post-operative outcomes such as accelerated implant wear, reduced functional outcomes, and shorter overall implant survival. Robotic surgical systems have been introduced to try and improve joint alignment and functional outcomes in knee arthroscopy, one recent iteration is the ROSA knee system, released to the market in 2019. The objective of this scoping review is to map the available evidence, identify the current types of evidence, and identify knowledge gaps to guide future studies on patient outcomes following ROSA-assisted total knee arthroplasties. Methods: An electronic search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews. Search terms included ROSA, knee arthroscopy, osteoarthritis, robotic, and malalignment. Types of study participants included patients with osteoarthritis, ages 18 and older, male or female, who received manual TKA (mTKA) or ROSA-assisted TKA (rTKA), and human patients or cadavers. Published, peer-reviewed controlled trials, observational studies, and case series were included. Case reports were not included in article review. Resulting articles were first screened based on title and abstract. Articles meeting inclusion criteria based on title and abstract review then underwent full-text review by the same reviewer. Results: This scoping review identified 11 total studies, 3 prospective observational studies, and 8 retrospective observational studies - a total of 970 rTKA patients and 1745 mTKA patients. There were no case series or randomized controlled trials comparing rTKA and mTKA. Patient-centered outcomes showed promise for rTKA, where it frequently showed significantly favorable functional outcomes, measured via KOOS-JR, VAS, KSS, OKS, FJS, and PROMIS scores, at various times postoperatively. However, there was much discrepancy about which score yielded significance at which postoperative follow-up. Complication rates, reoperation rates, and LOS were very similar between mTKA and rTKA groups. Studies also showed rTKA had more accurate joint alignment within the 0 ± 3o corridor and had significantly higher rates of achieving postoperative joint angles similar to the preoperative plan. Finally, there was major agreement that rTKA cases take significantly longer time at the start, however, there is a rapid learning curve. Once past the learning curve, rTKA cases are performed in a similar time to mTKA and reduced physician stress and strain. Conclusion: The ROSA knee system represents a promising option for the management of osteoarthritis via total knee arthroscopy. The studies reviewed in this paper favor the patient-centered function outcomes, joint alignments, and physician health implications of the ROSA knee system to conventional total knee arthroscopy. Further study is warranted, however, to better understand recovery periods, longer-term functional outcomes, operative fatigue, and reduction in radiation exposure.

Keywords: arthroplasty, knee, robotics, malalignment

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44 Phytochemical Investigation, Leaf Structure and Antimicrobial Screening of Pistacia lentiscus against Multi-Drug Resistant Bacteria

Authors: S. Mamoucha, N.Tsafantakis, T. Ioannidis, S. Chatzipanagiotou, C. Nikolaou, L. Skaltsounis, N. Fokialakis, N. Christodoulakis

Abstract:

Introduction: Pistacia lentiscus L. (well known as Mastic tree) is an evergreen sclerophyllous shrub that extensively thrives in the eastern Mediterranean area yet only the trees cultivated in the southern region of the Greek island Chios produces mastic resin. Different parts of P. lentiscus L. var. chia have been used in folk medicine for various purposes, such as tonic, aphrodisiac, antiseptic, antihypertensive and management of dental, gastrointestinal, liver, urinary, and respiratory tract disorders. Several studies have focused on the antibacterial activity of its resin (gum) and its essential oil. However, there is no study combining anatomy of the plant organs, phytochemical profile, and antibacterial screening of the plant. In our attempt to discover novel bioactive metabolites from the mastic tree, we screened its antibacterial activity not only against ATCC strains but also against clinical, resistant strains. Materials-methods: Leaves were investigated using Transmission (ΤΕΜ) and Scanning Εlectron Microscopy (SEM). Histochemical tests were performed on fresh and fixed tissue. Extracts prepared from dried, powdered leaves using 3 different solvents (DCM, MeOH and H2O) the waste water obtained after a hydrodistillation process for essential oil production were screened for their phytochemical content and antibacterial activity. Μetabolite profiling of polar and non-polar extracts was recorded by GC-MS and LC-HRMS techniques and analyzed using in-house and commercial libraries. The antibacterial screening was performed against Staphylococcus aureus ATCC25923, Escherichia coli ATCC25922, Pseudomonas aeruginosa ATCC27853 and against clinical, resistant strains Methicillin-resistant S. aureus (MRSA), Carbapenem-Resistant Metallo-β-Lactamase (carbapenemase) P. aeruginosa (VIM), Klebsiella pneumoniae carbapenemases (KPCs) and Acinetobacter baumanii resistant strains. The antibacterial activity was tested by the Kirby Bauer and the Agar Well Diffusion method. The zone of inhibition (ZI) of each extract was measured and compared with those of common antibiotics. Results: Leaf is compact with inosclereids and numerous idioblasts containing a globular, spiny crystal. The major nerves of the leaf contain a resin duct. Mesophyll cells showed accumulation of osmiophillic metabolites. Histochemical treatments defined secondary metabolites in subcellular localization. The phytochemical investigation revealed the presence of a large number of secondary metabolites, belonging to different chemical groups, such as terpenoids, phenolic compounds (mainly myricetin, kaempferol and quercetin glycosides), phenolic, and fatty acids. Among the extracts, the hydrostillation wastewater achieved the best results against most of the bacteria tested. MRSA, VIM and A. baumanii were inhibited. Conclusion: Extracts from plants have recently been of great interest with respect to their antimicrobial activity. Their use emerged from a growing tendency to replace synthetic antimicrobial agents with natural ones. Leaves of P. lentiscus L. var. chia showed a high antimicrobial activity even against drug - resistant bacteria. Future prospects concern the better understanding of mode of action of the antibacterial activity, the isolation of the most bioactive constituents and the clarification if the activity is related to a single compound or to the synergistic effect of several ones.

Keywords: antibacterial screening, leaf anatomy, phytochemical profile, Pistacia lentiscus var. chia

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43 Exploring Problem-Based Learning and University-Industry Collaborations for Fostering Students’ Entrepreneurial Skills: A Qualitative Study in a German Urban Setting

Authors: Eylem Tas

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This empirical study aims to explore the development of students' entrepreneurial skills through problem-based learning within the context of university-industry collaborations (UICs) in curriculum co-design and co-delivery (CDD). The research question guiding this study is: "How do problem-based learning and university-industry collaborations influence the development of students' entrepreneurial skills in the context of curriculum co-design and co-delivery?” To address this question, the study was conducted in a big city in Germany and involved interviews with stakeholders from various industries, including the private sector, government agencies (govt), and non-governmental organizations (NGOs). These stakeholders had established collaborative partnerships with the targeted university for projects encompassing entrepreneurial development aspects in CDD. The study sought to gain insights into the intricacies and subtleties of UIC dynamics and their impact on fostering entrepreneurial skills. Qualitative content analysis, based on Mayring's guidelines, was employed to analyze the interview transcriptions. Through an iterative process of manual coding, 442 codes were generated, resulting in two main sections: "the role of problem-based learning and UIC in fostering entrepreneurship" and "challenges and requirements of problem-based learning within UIC for systematical entrepreneurship development.” The chosen experimental approach of semi-structured interviews was justified by its capacity to provide in-depth perspectives and rich data from stakeholders with firsthand experience in UICs in CDD. By enlisting participants with diverse backgrounds, industries, and company sizes, the study ensured a comprehensive and heterogeneous sample, enhancing the credibility of the findings. The first section of the analysis delved into problem-based learning and entrepreneurial self-confidence to gain a deeper understanding of UIC dynamics from an industry standpoint. It explored factors influencing problem-based learning, alignment of students' learning styles and preferences with the experiential learning approach, specific activities and strategies, and the role of mentorship from industry professionals in fostering entrepreneurial self-confidence. The second section focused on various interactions within UICs, including communication, knowledge exchange, and collaboration. It identified key elements, patterns, and dynamics of interaction, highlighting challenges and limitations. Additionally, the section emphasized success stories and notable outcomes related to UICs' positive impact on students' entrepreneurial journeys. Overall, this research contributes valuable insights into the dynamics of UICs and their role in fostering students' entrepreneurial skills. UICs face challenges in communication and establishing a common language. Transparency, adaptability, and regular communication are vital for successful collaboration. Realistic expectation management and clearly defined frameworks are crucial. Responsible data handling requires data assurance and confidentiality agreements, emphasizing the importance of trust-based relationships when dealing with data sharing and handling issues. The identified key factors and challenges provide a foundation for universities and industrial partners to develop more effective UIC strategies for enhancing students' entrepreneurial capabilities and preparing them for success in today's digital age labor market. The study underscores the significance of collaborative learning and transparent communication in UICs for entrepreneurial development in CDD.

Keywords: collaborative learning, curriculum co-design and co-delivery, entrepreneurial skills, problem-based learning, university-industry collaborations

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42 Lab-on-Chip Multiplexed qPCR Analysis Utilizing Melting Curve Analysis Detects Up to 144 Alleles with Sub-hour Turn-around Time

Authors: Jeremy Woods, Fanqing Chen

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Rapid genome testing can provide results in at best hours to days, though there are certain clinical decisions that could be guided by genetic test results that need results in hours to minutes. As such, methods of genetic Point of Care Testing (POCT) are required if genetic data is to guide management in illnesses in a wide variety of critical and emergent medical situations such as neonatal sepsis, chemotherapy administration in endometrial cancer, and glucose-6-phosphate dehydrogenase deficiency (G6PD)-associated neonatal hyperbilirubinemia. As such, we developed a POCT “lab-on-chip” technology capable of identifying up to 144 alleles in under an hour. This test required no specialized training to utilize and is suitable to deployment in clinics and hospitals for use by non-laboratory personnel such as nurses. We developed a multiplexed qPCR-based sample-to-answer system with melting curve analysis capable of detecting up to 144 alleles utilizing the Kelliop RapidSeq126 PCR platform combined with a single-use microfluidic cartridge. The RapidSeq126 is the size of a standard desktop printer and the microfluidic cartridges are smaller than a deck of playing cards. Thus the system was deployable in the outpatient setting for clinical trials of MT-RNR1 genotyping. The sample (buccal swab from volunteers or plasmids in media) used for DNA extraction was placed in the cartridge sample inlet prior to inserting the cartridge into the RapidSeq126. The microfluidic cartridge was composed of heat resistant polymer with a sample inlet, 100um conduits, liquid and solid reagents, valves, extraction chamber, lyophilization chamber, 12 PCR reaction chambers, and a waste chamber. No human effort was required for processing the sample and performing the assay other than placing the sample in the cartridge and placing the cartridge in the RapidSeq126. The RapidSeq126 has demonstrated ex vivo detection in plasmids and in vivo detection from human volunteer samples of up to 144 alleles per microfluidic cartridge used and did not require specialized laboratory training to operate. Efficacy was proven for several applications, such as multiple microsatellite instability (MSI) sites (SULF/RYR3/MRE11/ACVR2A/DIDO1/SEC31A/BTBD7), endometrial cancer POLE exonuclease domain (EMD) mutation status, and G6PD variants such as those commonly associated with hemolysis (c.202G>A, c.376A>G, c.680G>A>T, c.968T>C, 404A>C, c.871G>A). The RapidSeq126 system was also able to identify the three MT-RNR1 variants associated with aminoglycoside-induced sensorineural hearing loss (m.1555A>G, m.1095T>C, m.1494C>T). Results were provided in under an hour in a sample-to-answer fashion requiring no processing other than inserting the cartridge with the sample into the RapidSeq126. Results were provided in a digital, HL7-compliant format suitable for interfacing with Electronic Healthcare Record (EHR). The RapidSeq126 system provides a solution for emergency and critical medical situations requiring results in a matter of minutes to hours. The HL7-compliant data format of results enables the RapidSeq126 to interface directly with EHRs to generate best practice advisories and further reduce errors and time to diagnosis by providing digital results.

Keywords: genetic testing, pharmacogenomics, point of care testing, rapid genetic testing

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41 Continuity Through Best Practice. A Case Series of Complex Wounds Manage by Dedicated Orthopedic Nursing Team

Authors: Siti Rahayu, Khairulniza Mohd Puat, Kesavan R., Mohammad Harris A., Jalila, Kunalan G., Fazir Mohamad

Abstract:

The greatest challenge has been in establishing and maintaining the dedicated nursing team. Continuity is served when nurses are assigned exclusively for managing wound, where they can continue to build expertise and skills. In addition, there is a growing incidence of chronic wounds and recognition of the complexity involved in caring for these patients. We would like to share 4 cases with different techniques of wound management. 1st case, 39 years old gentleman with underlying rheumatoid arthritis with chronic periprosthetic joint infection of right total knee replacement presented with persistent drainage over right knee. Patient was consulted for two stage revision total knee replacement. However, patient only agreed for debridement and retention of implant. After debridement, large medial and lateral wound was treated with Instillation Negative Pressure Wound Therapy Dressings. After several cycle, the wound size reduced, and conventional dressing was applied. 2nd case, 58 years old gentleman with underlying diabetes presented with right foot necrotizing fasciitis with gangrene of 5th toe. He underwent extensive debridement of foot with rays’ amputation of 5th toe. Post debridement patient was started on Instillation Negative Pressure Wound Therapy Dressings. After several cycle of VAC, the wound bed was prepared, and he underwent split skin graft over right foot. 3 rd case, 60 years old gentleman with underlying diabetes mellitus presented with right foot necrotizing soft tissue infection. He underwent rays’ amputation and extensive wound debridement. Upon stabilization of general condition, patient was discharge with regular wound dressing by same nurse and doctor during each visit to clinic follow up. After 6 months of follow up, the wound healed well. 4th case, 38-year-old gentleman had alleged motor vehicle accident and sustained closed fracture right tibial plateau. Open reduction and proximal tibial locking plate were done. At 2 weeks post-surgery, the patient presented with warm, erythematous leg and pus discharge from the surgical site. Empirical antibiotic was started, and wound debridement was done. Intraoperatively, 50cc pus was evacuated, unhealthy muscle and tissue debrided. No loosening of the implant. Patient underwent multiple wound debridement. At 2 weeks post debridement wound healed well, but the proximal aspect was unable to close immediately. This left the proximal part of the implant to be exposed. Patient was then put on VAC dressing for 3 weeks until healthy granulation tissue closes the implant. Meanwhile, antibiotic was change according to culture and sensitivity. At 6 weeks post the first debridement, the wound was completely close, and patient was discharge home well. At 3 months post operatively, patient wound and fracture healed uneventfully and able to ambulate independently. Complex wounds are too serious to be dealt with. Team managing complex wound need continuous support through the provision of educational tools to support their professional development, engagement with local and international expert, as well as highquality products that increase efficiencies in services

Keywords: VAC (Vacuum Assisted Closure), empirical- initial antibiotics, NPWT- negative pressure wound therapy, NF- necrotizing fasciitis, gangrene- blackish discoloration due to poor blood supply

Procedia PDF Downloads 105