Search results for: alcohol impaired driving

Authors: Adrienn Kiss, Karoly Zauer, Gyorgy Keglevich, Rita Molnarne Bernath

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Ginger (Zingiber officinale) is a perennial plant from Southeast Asia, widely used as a spice, herb, and medicine for many illnesses since its beneficial health effects were observed thousands of years ago. Among the compounds found in ginger, zingerone [4-hydroxy-3- methoxyphenyl-2-butanone] deserves special attention: it has an anti-inflammatory and antispasmodic effect, it can be used in case of diarrheal disease, helps to prevent the formation of blood clots, has antimicrobial properties, and can also play a role in preventing the Alzheimer's disease. Ferulic acid [(E)-3-(4-hydroxy-3-methoxyphenyl)-prop-2-enoic acid] is another cinnamic acid derivative in ginger, which has promising properties. Like many phenolic compounds, ferulic acid is also an antioxidant. Based on the results of animal experiments, it is assumed to have a direct antitumoral effect in lung and liver cancer. It also deactivates free radicals that can damage the cell membrane and the DNA and helps to protect the skin against UV radiation. The aim of this work was to synthesize these two compounds by new methods. A few of the reactions were based on the hydrogenation of dehydrozingerone [4-(4-Hydroxy-3-methoxyphenyl)-3-buten-2-one] to zingerone. Dehydrozingerone can be synthesized by a relatively simple method from acetone and vanillin with good yield (80%, melting point: 41 °C). Hydrogenation can be carried out chemically, for example by the reaction of zinc and acetic acid, or Grignard magnesium and ethyl alcohol. Another way to complete the reduction is the electrochemical pathway. The electrolysis of dehydrozingerone without diaphragm in aqueous media was attempted to produce ferulic acid in the presence of sodium carbonate and potassium iodide using platinum electrodes. The electrolysis of dehydrozingerone in the presence of potassium carbonate and acetic acid to prepare zingerone was carried out similarly. Ferulic acid was expected to be converted to dihydroferulic acid [3-(4-Hydroxy-3-methoxyphenyl)propanoic acid] in potassium hydroxide solution using iron electrodes, separating the anode and cathode space with a Soxhlet paper sheath impregnated with saturated magnesium chloride solution. For this reaction, ferulic acid was synthesized from vanillin and malonic acid in the presence of pyridine and piperidine (yield: 88.7%, melting point: 173°C). Unfortunately, in many cases, the expected transformations did not happen or took place in low conversions, although gas evolution occurred. Thus, a deeper understanding of these experiments and optimization are needed. Since both compounds are found in different plants, they can also be obtained by alkaline extraction or steam distillation from distinct plant parts (ferulic acid from ground bamboo shoots, zingerone from grated ginger root). The products of these reactions are rich in several other organic compounds as well; therefore, their separation must be solved to get the desired pure material. The products of the reactions described above were characterized by infrared spectral data and melting points. The use of these two simple methods may be informative for the formation of the products. In the future, we would like to study the ferulic acid and zingerone content of other plants and extract them efficiently. The optimization of electrochemical reactions and the use of other test methods are also among our plans.

Keywords: ferulic acid, ginger, synthesis, zingerone

Procedia PDF Downloads 175

Authors: Alisawi Alaa T., Collins P. E. F.

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The analysis and evaluation of slope stability and landslide hazards are landslide hazards are critically important in civil engineering projects and broader considerations of safety. The level of slope stability risk should be identified due to its significant and direct financial and safety effects. Slope stability hazard analysis is performed considering static and/or dynamic loading circumstances. To reduce and/or prevent the failure hazard caused by landslides, a sophisticated and practical hazard analysis method using advanced constitutive modeling should be developed and linked to an effective solution that corresponds to the specific type of slope stability and landslides failure risk. Previous studies on slope stability analysis methods identify the failure mechanism and its corresponding solution. The commonly used approaches include used approaches include limit equilibrium methods, empirical approaches for rock slopes (e.g., slope mass rating and Q-slope), finite element or finite difference methods, and district element codes. This study presents an overview and evaluation of these analysis techniques. Contemporary source materials are used to examine these various methods on the basis of hypotheses, the factor of safety estimation, soil types, load conditions, and analysis conditions and limitations. Limit equilibrium methods play a key role in assessing the level of slope stability hazard. The slope stability safety level can be defined by identifying the equilibrium of the shear stress and shear strength. The slope is considered stable when the movement resistance forces are greater than those that drive the movement with a factor of safety (ratio of the resistance of the resistance of the driving forces) that is greater than 1.00. However, popular and practical methods, including limit equilibrium approaches, are not effective when the slope experiences complex failure mechanisms, such as progressive failure, liquefaction, internal deformation, or creep. The present study represents the first episode of an ongoing project that involves the identification of the types of landslides hazards, assessment of the level of slope stability hazard, development of a sophisticated and practical hazard analysis method, linkage of the failure type of specific landslides conditions to the appropriate solution and application of an advanced computational method for mapping the slope stability properties in the United Kingdom, and elsewhere through geographical information system (GIS) and inverse distance weighted spatial interpolation(IDW) technique. This study investigates and assesses the different assesses the different analysis and solution techniques to enhance the knowledge on the mechanism of slope stability and landslides hazard analysis and determine the available solutions for each potential landslide failure risk.

Keywords: slope stability, finite element analysis, hazard analysis, landslides hazard

Procedia PDF Downloads 100

Authors: Nipa Debnath, Harinarayan Das, Takahiko Kawaguchi, Naonori Sakamoto, Kazuo Shinozaki, Hisao Suzuki, Naoki Wakiya

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Nowadays spinel ferrite magnetic thin films have drawn considerable attention due to their interesting magnetic and electrical properties with enhanced chemical and thermal stability. Spinel ferrite magnetic films can be implemented in magnetic data storage, sensors, and spin filters or microwave devices. It is well established that the structural, magnetic and transport properties of the magnetic thin films are dependent on microstructure. Spinodal decomposition (SD) is a phase separation process, whereby a material system is spontaneously separated into two phases with distinct compositions. The periodic microstructure is the characteristic feature of SD. Thus, SD can be exploited to control the microstructure at the nanoscale level. In bulk spinel ferrites having general formula, MₓFe₃₋ₓ O₄ (M= Co, Mn, Ni, Zn), phase separation via SD has been reported only for cobalt ferrite (CFO); however, long time post-annealing is required to occur the spinodal decomposition. We have found that SD occurs in CoF thin film without using any post-deposition annealing process if we apply magnetic field during thin film growth. Dynamic Aurora pulsed laser deposition (PLD) is a specially designed PLD system through which in-situ magnetic field (up to 2000 G) can be applied during thin film growth. The in-situ magnetic field suppresses the recombination of ions in the plume. In addition, the peak’s intensity of the ions in the spectra of the plume also increases when magnetic field is applied to the plume. As a result, ions with high kinetic energy strike into the substrate. Thus, ion-impingement occurred under magnetic field during thin film growth. The driving force of SD is the ion-impingement towards the substrates that is induced by in-situ magnetic field. In this study, we report about the occurrence of phase separation through SD and evolution of microstructure after phase separation in spinel ferrite thin films. The surface morphology of the phase separated films show checkerboard like domain structure. The cross-sectional microstructure of the phase separated films reveal columnar type phase separation. Herein, the decomposition wave propagates in lateral direction which has been confirmed from the lateral composition modulations in spinodally decomposed films. Large magnetic anisotropy has been found in spinodally decomposed nickel ferrite (NFO) thin films. This approach approves that magnetic field is also an important thermodynamic parameter to induce phase separation by the enhancement of up-hill diffusion in thin films. This thin film deposition technique could be a more efficient alternative for the fabrication of self-organized phase separated thin films and employed in controlling of the microstructure at nanoscale level.

Keywords: Dynamic Aurora PLD, magnetic anisotropy, spinodal decomposition, spinel ferrite thin film

Procedia PDF Downloads 366

Authors: B. Shahzamanian, S. Varga, D. C. Alarcón-Padilla

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Desalination is considered the primary alternative to increase water supply for domestic, agricultural and industrial use. Sustainable desalination is only possible in places where renewable energy resources are available. Solar energy is the most relevant type of renewable energy to driving desalination systems since most of the areas suffering from water scarcity are characterized by a high amount of available solar radiation during the year. Multi-Effect Desalination (MED) technology integrated with solar thermal concentrators is a suitable combination for heat-driven desalination. It can also be coupled with thermal vapour compressors or absorption heat pumps to boost overall system performance. The most interesting advantage of MED is the suitability to be used with a transient source of energy like solar. An experimental study was carried out to assess the performance of the most important life-size multi-effect desalination plant driven by solar energy located in the Plataforma Solar de Almería (PSA). The MED plant is used as a reference in many studies regarding multi-effect distillation. The system consists of a 14-effect MED plant coupled with a double-effect absorption heat pump. The required thermal energy to run the desalination system is supplied by means of hot water generated from 60 static flat-plate solar collectors with a total aperture area of 606 m2. In order to compensate for the solar energy variation, a thermal storage system with two interconnected tanks and an overall volume of 40 m3 is coupled to the MED unit. The multi-effect distillation unit is built in a forward feed configuration, and the last effect is connected to a double-effect LiBr-H2O absorption heat pump. The heat pump requires steam at 180 ºC (10 bar a) that is supplied by a small-aperture parabolic trough solar field with a total aperture area of 230 m2. When needed, a gas boiler is used as an auxiliary heat source for operating the heat pump and the MED plant when solar energy is not available. A set of experiments was carried out for evaluating the impact of the heating water temperature (Th), top brine temperature (TBT) and temperature difference between effects (ΔT) on the performance ratio of the MED plant. The considered range for variation of Th, TBT and ΔT was 60-70°C, 54-63°C and 1.1-1.6°C, respectively. The performance ratio (PR), defined as kg of distillate produced for every 2326 kJ of thermal energy supplied to the MED system, was almost independent of the applied variables with a variation of less than 5% for all the cases. The maximum recorded PR was 12.4. The results indicated that the system demonstrated robustness for the whole range of operating conditions considered. Author gratitude is expressed to the PSA for providing access to its installations, the support of its scientific and technical staff, and the financial support of the SFERA-III project (Grant Agreement No 823802). Special thanks to the access provider staff members who ensured the access support.

Keywords: multi-effect distillation, performance ratio, robustness, solar energy

Procedia PDF Downloads 189

Authors: Dina Farran, Mark Ashworth, Fiona Gaughran

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Atrial fibrillation (AF), the most prevalent cardiac arrhythmia, is associated with an increased risk of stroke, contributing to heart failure and death. In this project, we aim to improve patient safety by screening for stroke risk among people with AF and co-morbid mental illness. To do so, we started by conducting a systematic review and meta-analysis on prevalence, management, and outcomes of AF in people with Serious Mental Illness (SMI) versus the general population. We then evaluated oral anticoagulation (OAC) prescription trends in people with AF and co-morbid SMI in King’s College Hospital. We also evaluated the association between mental illness severity and OAC prescription in eligible patients in South London and Maudsley (SLaM) NHS Foundation Trust. Next, we implemented an electronic clinical decision support system (eCDSS) consisting of a visual prompt on patient electronic Personal Health Records to screen for AF-related stroke risk in three Mental Health of Older Adults wards at SLaM. Finally, we assessed the feasibility and acceptability of the eCDSS by qualitatively investigating clinicians’ perspectives of the potential usefulness of the eCDSS (pre-intervention) and their experiences and their views regarding its impact on clinicians and patients (post-intervention). The systematic review showed that people with SMI had low reported rates of AF. AF patients with SMI were less likely to receive OAC than the general population. When receiving warfarin, people with SMI, particularly bipolar disorder, experienced poor anticoagulation control compared to the general population. Meta-analysis showed that SMI was not significantly associated with an increased risk of stroke or major bleeding when adjusting for underlying risk factors. The main findings of the first observational study were that among AF patients having a high stroke risk, those with co-morbid SMI were less likely than non-SMI to be prescribed any OAC, particularly warfarin. After 2019, there was no significant difference between the two groups. In the second observational study, patients with AF and co-morbid SMI were less likely to be prescribed any OAC compared to those with dementia, substance use disorders, or common mental disorders, adjusting for age, sex, stroke, and bleeding risk scores. Among AF patients with co-morbid SMI, warfarin was less likely to be prescribed to those having alcohol or substance dependency, serious self-injury, hallucinations or delusions, and activities of daily living impairment. In the intervention, clinicians were asked to confirm the presence of AF, clinically assess stroke and bleeding risks, record risk scores in clinical notes, and refer patients at high risk of stroke to OAC clinics. Clinicians reported many potential benefits for the eCDSS, including improving clinical effectiveness, better identification of patients at risk, safer and more comprehensive care, consistency in decision making and saving time. Identified potential risks included rigidity in decision-making, overreliance, reduced critical thinking, false positive recommendations, annoyance, and increased workload. This study presents a unique opportunity to quantify AF patients with mental illness who are at high risk of severe outcomes using electronic health records. This has the potential to improve health outcomes and, therefore patients' quality of life.

Keywords: atrial fibrillation, stroke, mental health conditions, electronic clinical decision support systems

Procedia PDF Downloads 49

Authors: B. Casper

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The energy transition towards renewable energies and drastically reduced carbon dioxide emissions in Germany drives multiple sectors into a transformation process. Photovoltaic and on-shore wind power are predominantly feeding in the low and medium-voltage grids. The electricity grid is not laid out to allow an increasing feed-in of power in low and medium voltage grids. Electric mobility is currently in the run-up phase in Germany and still lacks a significant amount of charging stations. The additional power demand by e-mobility cannot be supplied by the existing electric grids in most cases. The future demands in heating and cooling of commercial and residential buildings are increasingly generated by heat-pumps. Yet the most important part in the energy transition is the storage of surplus energy generated by photovoltaic and wind power sources. Water electrolysis is one way to store surplus energy known as power-to-gas. With the vehicle-to-grid technology, the upcoming fleet of electric cars could be used as energy storage to stabilize the grid. All these processes use direct current (DC). The demand of bi-directional flow and higher efficiency in the future grids can be met by using DC. The Flexible Electrical Networks (FEN) research campus at RWTH Aachen investigates interdisciplinary about the advantages, opportunities, and limitations of DC grids. This paper investigates the impact of DC grids as a technological innovation on the urban form and urban life. Applying explorative scenario development, analyzation of mapped open data sources on grid networks and research-by-design as a conceptual design method, possible starting points for a transformation to DC medium voltage grids could be found. Several fields of action have emerged in which DC technology could become a catalyst for future urban development: energy transition in urban areas, e-mobility, and transformation of the network infrastructure. The investigation shows a significant potential to increase renewable energy production within cities with DC grids. The charging infrastructure for electric vehicles will predominantly be using DC in the future because fast and ultra fast charging can only be achieved with DC. Our research shows that e-mobility, combined with autonomous driving has the potential to change the urban space and urban logistics fundamentally. Furthermore, there are possible win-win-win solutions for the municipality, the grid operator and the inhabitants: replacing overhead transmission lines by underground DC cables to open up spaces in contested urban areas can lead to a positive example of how the energy transition can contribute to a more sustainable urban structure. The outlook makes clear that target grid planning and urban planning will increasingly need to be synchronized.

Keywords: direct current, e-mobility, energy transition, grid planning, renewable energy, urban planning

Procedia PDF Downloads 128

Authors: Sergio A. Bernal-Chavez, Sergio Alcalá-Alcalá, Doris A. Cerecedo-Mercado, Adriana Ganem-Rondero

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The prevalence of people with chronic wounds has increased dramatically by many factors including smoking, obesity and chronic diseases, such as diabetes, that can slow the healing process and increase the risk of becoming chronic. Because of this situation, the improvement of chronic wound treatments is a necessity, which has led to the scientific community to focus on improving the effectiveness of current therapies and the development of new treatments. The wound formation is a physiological complex process, which is characterized by an inflammatory stage with the presence of proinflammatory cells that create a proteolytic microenvironment during the healing process, which includes the degradation of important growth factors and cytokines. This decrease of growth factors and cytokines provides an interesting strategy for wound healing if they are administered externally. The use of nanometric drug delivery systems, such as polymer nanoparticles (NP), also offers an interesting alternative around dermal systems. An interesting strategy would be to propose a formulation based on a thermosensitive hydrogel loaded with polymeric nanoparticles that allows the inclusion and application of a platelet lysate (PL) on damaged skin, with the aim of promoting wound healing. In this work, NP were prepared by a double emulsion-solvent evaporation technique, using polylactic-co-glycolic acid (PLGA) as biodegradable polymer. Firstly, an aqueous solution of PL was emulsified into a PLGA organic solution, previously prepared in dichloromethane (DCM). Then, this disperse system (W/O) was poured into a polyvinyl alcohol (PVA) solution to get the double emulsion (W/O/W), finally the DCM was evaporated by magnetic stirring resulting in the NP formation containing PL. Once the NP were obtained, these systems were characterized by morphology, particle size, Z-potential, encapsulation efficiency (%EE), physical stability, infrared spectrum, calorimetric studies (DSC) and in vitro release profile. The optimized nanoparticles were included in a thermosensitive gel formulation of Pluronic® F-127. The gel was prepared by the cold method at 4 °C and 20% of polymer concentration. Viscosity, sol-gel phase transition, time of no flow solid-gel at wound temperature, changes in particle size by temperature-effect using dynamic light scattering (DLS), occlusive effect, gel degradation, infrared spectrum and micellar point by DSC were evaluated in all gel formulations. PLGA NP of 267 ± 10.5 nm and Z-potential of -29.1 ± 1 mV were obtained. TEM micrographs verified the size of NP and evidenced their spherical shape. The %EE for the system was around 99%. Thermograms and in infrared spectra mark the presence of PL in NP. The systems did not show significant changes in the parameters mentioned above, during the stability studies. Regarding the gel formulation, the transition sol-gel occurred at 28 °C with a time of no flow solid-gel of 7 min at 33°C (common wound temperature). Calorimetric, DLS and infrared studies corroborated the physical properties of a thermosensitive gel, such as the micellar point. In conclusion, the thermosensitive gel described in this work, contains therapeutic amounts of PL and fulfills the technological properties to be used in damaged skin, with potential application in wound healing and tissue regeneration.

Keywords: growth factors, polymeric nanoparticles, thermosensitive hydrogels, tissue regeneration

Procedia PDF Downloads 172

Authors: Adam Majczak, Michał Bialy, Zbigniew Czyż, Zdzislaw Kaminski

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Increasingly stringent emission standards for passenger cars require us to find alternative drives. The share of electric vehicles in the sale of new cars increases every year. However, their performance and, above all, range cannot be today successfully compared to those of cars with a traditional internal combustion engine. Battery recharging lasts hours, which can be hardly accepted due to the time needed to refill a fuel tank. Therefore, the ways to reduce the adverse features of cars equipped with electric motors only are searched for. One of the methods is a combination of an electric engine as a main source of power and a small internal combustion engine as an electricity generator. This type of drive enables an electric vehicle to achieve a radically increased range and low emissions of toxic substances. For several years, the leading automotive manufacturers like the Mazda and the Audi together with the best companies in the automotive industry, e.g., AVL have developed some electric drive systems capable of recharging themselves while driving, known as a range extender. An electricity generator is powered by a Wankel engine that has seemed to pass into history. This low weight and small engine with a rotating piston and a very low vibration level turned out to be an excellent source in such applications. Its operation as an energy source for a generator almost entirely eliminates its disadvantages like high fuel consumption, high emission of toxic substances, or short lifetime typical of its traditional application. The operation of the engine at a constant rotational speed enables a significant increase in its lifetime, and its small external dimensions enable us to make compact modules to drive even small urban cars like the Audi A1 or the Mazda 2. The algorithm to maintain a constant speed was investigated on the engine dynamometer with an eddy current brake and the necessary measuring apparatus. The research object was the Aixro XR50 rotary engine with the electronic power supply developed at the Lublin University of Technology. The load torque of the engine was altered during the research by means of the eddy current brake capable of giving any number of load cycles. The parameters recorded included speed and torque as well as a position of a throttle in an inlet system. Increasing and decreasing load did not significantly change engine speed, which means that control algorithm parameters are correctly selected. This work has been financed by the Polish Ministry of Science and Higher Education.

Keywords: electric vehicle, power generator, range extender, Wankel engine

Procedia PDF Downloads 157

Authors: Tatiana Butkova, Nikolai Kibrik, Kristina Malsagova, Alexander Izotov, Alexander Stepanov, Anna Kaysheva

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Relevance. The genetic risk of developing schizophrenia is determined by two factors: single nucleotide polymorphisms and gene copy number variations. The search for serological markers for early diagnosis of schizophrenia is driven by the fact that the first five years of the disease are accompanied by significant biological, psychological, and social changes. It is during this period that pathological processes are most amenable to correction. The aim of this study was to analyze single nucleotide polymorphisms (SNPs) that are hypothesized to potentially influence the onset and development of the endogenous process. Materials and Methods It was analyzed 73 single nucleotide polymorphism variants. The study included 48 patients undergoing inpatient treatment at "Psychiatric Clinical Hospital No. 1" in Moscow, comprising 23 females and 25 males. Inclusion criteria: - Patients aged 18 and above. - Diagnosis according to ICD-10: F20.0, F20.2, F20.8, F21.8, F25.1, F25.2. - Voluntary informed consent from patients. Exclusion criteria included: - The presence of concurrent somatic or neurological pathology, neuroinfections, epilepsy, organic central nervous system damage of any etiology, and regular use of medication. - Substance abuse and alcohol dependence. - Women who were pregnant or breastfeeding. Clinical and psychopathological assessment was complemented by psychometric evaluation using the PANSS scale at the beginning and end of treatment. The duration of observation during therapy was 4-6 weeks. Total DNA extraction was performed using QIAamp DNA. Blood samples were processed on Illumina HiScan and genotyped for 652,297 markers on the Infinium Global Chips Screening Array-24v2.0 using the IMPUTE2 program with parameters Ne=20,000 and k=90. Additional filtration was performed based on INFO>0.5 and genotype probability>0.5. Quality control of the obtained DNA was conducted using agarose gel electrophoresis, with each tested sample having a volume of 100 µL. Results. It was observed that several SNPs exhibited gender dependence. We identified groups of single nucleotide polymorphisms with a membership of 80% or more in either the female or male gender. These SNPs included rs2661319, rs2842030, rs4606, rs11868035, rs518147, rs5993883, and rs6269.Another noteworthy finding was the limited combination of SNPs sufficient to manifest clinical symptoms leading to hospitalization. Among all 48 patients, each of whom was analyzed for deviations in 73 SNPs, it was discovered that the combination of involved SNPs in the manifestation of pronounced clinical symptoms of schizophrenia was 19±3 out of 73 possible. In study, the frequency of occurrence of single nucleotide polymorphisms also varied. The most frequently observed SNPs were rs4849127 (in 90% of cases), rs1150226 (86%), rs1414334 (75%), rs10170310 (73%), rs2857657, and rs4436578 (71%). Conclusion. Thus, the results of this study provide additional evidence that these genes may be associated with the development of schizophrenia spectrum disorders. However, it's impossible cannot rule out the hypothesis that these polymorphisms may be in linkage disequilibrium with other functionally significant polymorphisms that may actually be involved in schizophrenia spectrum disorders. It has been shown that missense SNPs by themselves are likely not causative of the disease but are in strong linkage disequilibrium with non-functional SNPs that may indeed contribute to disease predisposition.

Keywords: gene polymorphisms, genotyping, single nucleotide polymorphisms, schizophrenia.

Procedia PDF Downloads 80

Authors: Oluwafunmibi Omotayo Fasanya, Augustine Kena Adjei

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Controlling blood pressure is critical to reducing the risk of cardiovascular disease. However, BP control rates (systolic BP < 140 mm Hg and diastolic BP < 90 mm Hg) have declined since 2013, warranting further analysis to identify contributing factors and potential interventions. This study investigates the factors associated with the decline in blood pressure (BP) control among U.S. adults with hypertension over the past decade. Data from the U.S. National Health and Nutrition Examination Survey (NHANES) were used to assess BP control trends between 2013 and 2020. The analysis included 18,927 U.S. adults with hypertension aged 18 years and older who completed study interviews and examinations. The dataset, obtained from the cardioStatsUSA and RNHANES R packages, was merged based on survey IDs. Key variables analyzed included demographic factors, lifestyle behaviors, hypertension status, BMI, comorbidities, antihypertensive medication use, and cardiovascular disease history. The prevalence of BP control declined from 78.0% in 2013-2014 to 71.6% in 2017-2020. Non-Hispanic Whites had the highest BP control prevalence (33.6% in 2013-2014), but this declined to 26.5% by 2017-2020. In contrast, BP control among Non-Hispanic Blacks increased slightly. Younger adults (aged 18-44) exhibited better BP control, but control rates declined over time. Obesity prevalence increased, contributing to poorer BP control. Antihypertensive medication use rose from 26.1% to 29.2% across the study period. Lifestyle behaviors, such as smoking and diet, also affected BP control, with nonsmokers and those with better diets showing higher control rates. Key findings indicate significant disparities in blood pressure control across racial/ethnic groups. Non-Hispanic Black participants had consistently higher odds (OR ranging from 1.84 to 2.33) of poor blood pressure control compared to Non-Hispanic Whites, while odds among Non-Hispanic Asians varied by cycle. Younger age groups (18-44 and 45-64) showed significantly lower odds of poor blood pressure control compared to those aged 75+, highlighting better control in younger populations. Men had consistently higher odds of poor control compared to women, though this disparity slightly decreased in 2017-2020. Medical comorbidities such as diabetes and chronic kidney disease were associated with significantly higher odds of poor blood pressure control across all cycles. Participants with chronic kidney disease had particularly elevated odds (OR=5.54 in 2015-2016), underscoring the challenge of managing hypertension in these populations. Antihypertensive medication use was also linked with higher odds of poor control, suggesting potential difficulties in achieving target blood pressure despite treatment. Lifestyle factors such as alcohol consumption and physical activity showed no consistent association with blood pressure control. However, dietary quality appeared protective, with those reporting an excellent diet showing lower odds (OR=0.64) of poor control in the overall sample. Increased BMI was associated with higher odds of poor blood pressure control, particularly in the 30-35 and 35+ BMI categories during 2015-2016. The study highlights a significant decline in BP control among U.S. adults with hypertension, particularly among certain demographic groups and those with increasing obesity rates. Lifestyle behaviors, antihypertensive medication use, and socioeconomic factors all played a role in these trends.

Keywords: diabetes, blood pressure, obesity, logistic regression, odd ratio

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Authors: Michael Josef Schwerer

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Background: The identification of unknown victims from mass disasters, violent crimes, or terrorist attacks is frequently facilitated through information from missing persons lists, portrait photos, old or recent pictures showing unique characteristics of a person such as scars or tattoos, or simply reference samples from blood relatives for DNA analysis. In contrast, the identification or at least the characterization of an unknown perpetrator from criminal or terrorist actions remains challenging, particularly in the absence of material or data for comparison, such as fingerprints, which had been previously stored in criminal records. In scenarios that result in high levels of destruction of the perpetrator’s corpse, for instance, blast or fire events, the chance for a positive identification using standard techniques is further impaired. Objectives: This study shows the forensic genetic procedures in the Legal Medicine Service of the German Air Force for the identification of unknown individuals, including such cases in which reference samples are not available. Scenarios requiring such efforts predominantly involve aircraft crash investigations, which are routinely carried out by the German Air Force Centre of Aerospace Medicine as one of the Institution’s essential missions. Further, casework by military police or military intelligence is supported based on administrative cooperation. In the talk, data from study projects, as well as examples from real casework, will be demonstrated and discussed with the audience. Methods: Forensic genetic identification in our laboratories involves the analysis of Short Tandem Repeats and Single Nucleotide Polymorphisms in nuclear DNA along with mitochondrial DNA haplotyping. Extended DNA analysis involves phenotypic markers for skin, hair, and eye color together with the investigation of a person’s biogeographic ancestry. Assessment of the biological age of an individual employs CpG-island methylation analysis using bisulfite-converted DNA. Forensic Investigative Genealogy assessment allows the detection of an unknown person’s blood relatives in reference databases. Technically, end-point-PCR, real-time PCR, capillary electrophoresis, pyrosequencing as well as next generation sequencing using flow-cell-based and chip-based systems are used. Results and Discussion: Optimization of DNA extraction from various sources, including difficult matrixes like formalin-fixed, paraffin-embedded tissues, degraded specimens from decomposed bodies or from decedents exposed to blast or fire events, provides soil for successful PCR amplification and subsequent genetic profiling. For cases with extremely low yields of extracted DNA, whole genome preamplification protocols are successfully used, particularly regarding genetic phenotyping. Improved primer design for CpG-methylation analysis, together with validated sampling strategies for the analyzed substrates from, e.g., lymphocyte-rich organs, allows successful biological age estimation even in bodies with highly degraded tissue material. Conclusions: Successful identification of unknown individuals or at least their phenotypic characterization using pigmentation markers together with age-informative methylation profiles, possibly supplemented by family tree search employing Forensic Investigative Genealogy, can be provided in specialized laboratories. However, standard laboratory procedures must be adapted to work with difficult and highly degraded sample materials.

Keywords: identification, forensic genetics, phenotypic markers, CPG methylation, biological age estimation, forensic investigative genealogy

Procedia PDF Downloads 51

Authors: M. Zielinski, M. Debowski, P. Rusanowska, A. Glowacka-Gil, M. Zielinska, A. Cydzik-Kwiatkowska, J. Kazimierowicz

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Technologies for the micro-biogas plant with heating and mixing systems are presented as a part of the Research Coordination for a Low-Cost Biomethane Production at Small and Medium Scale Applications (Record Biomap). The main objective of the Record Biomap project is to build a network of operators and scientific institutions interested in cooperation and the development of promising technologies in the sector of small and medium-sized biogas plants. The activities carried out in the project will bridge the gap between research and market and reduce the time of implementation of new, efficient technological and technical solutions. Reactor with simultaneously mixing and heating system is a concrete tank with a rectangular cross-section. In the reactor, heating is integrated with the mixing of substrate and anaerobic sludge. This reactor is solution dedicated for substrates with high solids content, which cannot be introduced to the reactor with pumps, even with positive displacement pumps. Substrates are poured to the reactor and then with a screw pump, they are mixed with anaerobic sludge. The pumped sludge, flowing through the screw pump, is simultaneously heated by a heat exchanger. The level of the fermentation sludge inside the reactor chamber is above the bottom edge of the cover. Cover of the reactor is equipped with the screw pump driver. Inside the reactor, an electric motor is installed that is driving a screw pump. The heated sludge circulates in the digester. The post-fermented sludge is collected using a drain well. The inlet to the drain well is below the level of the sludge in the digester. The biogas is discharged from the reactor by the biogas intake valve located on the cover. The technology is very useful for fermentation of lignocellulosic biomass and substrates with high content of dry mass (organic wastes). The other technology is a reactor for micro-biogas plant with a pressure mixing system. The reactor has a form of plastic or concrete tank with a circular cross-section. The effective mixing of sludge is ensured by profiled at 90° bottom of the tank. Substrates for fermentation are supplied by an inlet well. The inlet well is equipped with a cover that eliminates odour release. The introduction of a new portion of substrates is preceded by pumping of digestate to the disposal well. Optionally, digestate can gravitationally flow to digestate storage tank. The obtained biogas is discharged into the separator. The valve supplies biogas to the blower. The blower presses the biogas from the fermentation chamber in such a way as to facilitate the introduction of a new portion of substrates. Biogas is discharged from the reactor by valve that enables biogas removal but prevents suction from outside the reactor.

Keywords: biogas, digestion, heating system, mixing system

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Authors: Nur Fareza Mustapha

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Solutions to policy problems need to be curated to the local context, taking into account the trajectory of the local development path to ensure its efficacy. For Kuala Lumpur, rapid urbanization and migration into the city for the past few decades have increased the demand for housing to accommodate a growing urban population. As a critical factor affecting housing affordability, land supply constraints have been attributed to intensifying market pressures, which grew in tandem with the demands of urban development, along with existing institutional constraints in the governance of land. While demand-side pressures are inevitable given the fixed supply of land, supply-side constraints in regulations distort markets and if addressed inappropriately, may lead to mistargeted policy interventions. Given Malaysia’s historical development, regulatory barriers for land may originate from the British colonial period, when many aspects of the current laws governing tenure were introduced and formalized, and henceforth, became engrained in the system. This research undertakes a postcolonial institutional analysis approach to uncover the causal mechanism driving the evolution of land tenure systems in post-colonial Kuala Lumpur. It seeks to determine the sources of these shifts, focusing on the incentives and bargaining positions of actors during periods of institutional flux/change. It aims to construct a conceptual framework to further this understanding and to elucidate how this historical trajectory affects current access to urban land markets for housing. Archival analysis is used to outline and analyse the evolution of land tenure systems in Kuala Lumpur while stakeholder interviews are used to analyse its impact on the current urban land market, with a particular focus on the provision of and access to affordable housing in the city. Preliminary findings indicate that many aspects of the laws governing tenure that were introduced and formalized during the British colonial period have endured until the present day. Customary rules of tenure were displaced by rules following a European tradition, which found legitimacy through a misguided interpretation of local laws regarding the ownership of land. Colonial notions of race and its binary view of native vs. non-natives have also persisted in the construction and implementation of current legislation regarding land tenure. More concrete findings from this study will generate a more nuanced understanding of the regulatory land supply constraints in Kuala Lumpur, taking into account both the long and short term spatial and temporal processes that affect how these rules are created, implemented and enforced.

Keywords: colonial discourse, historical institutionalism, housing, land policy, post-colonial city

Procedia PDF Downloads 128

Authors: A. Bhatt, C. Bassi, H. Farragher, J. Musk

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Background: All medicines placed on the EU market are legally required to be accompanied by labeling and package leaflet, which provide comprehensive information, enabling its safe and appropriate use. Mock-ups with results of assessments using a target patient group must be submitted for a marketing authorisation application. Consumers need confidence in non-prescription, OTC medicines in order to manage their minor ailments and umbrella brands assist purchasing decisions by assisting easy identification within a particular therapeutic area. A number of regulatory agencies have risk management tools and guidelines to assist in developing umbrella brands for OTC medicines, however assessment and decision making is subjective and inconsistent. This study presents an evaluation in the UK following the US FDA warning concerning methaemoglobinaemia following 21 reported cases (11 children under 2 years) caused by OTC oral analgesics containing benzocaine. METHODS: A standard face to face, 25 structured task based user interview testing methodology using a standard questionnaire and rating scale in consumers aged 15-91 years, was conducted independently between June and October 2015 in their homes. Whether individuals could discriminate between the labelling, safety information and warnings on cartons and PILs between 3 different OTC medicines packs with the same umbrella name was evaluated. Each pack was presented with differing information hierarchy using, different coloured cartons, containing the 3 different active ingredients, benzocaine (oromucosal spray) and two lozenges containing 2, 4, dichlorobenzyl alcohol, amylmetacresol and hexylresorcinol respectively (for the symptomatic relief of sore throat pain). The test was designed to determine whether warnings on the carton and leaflet were prominent, accessible to alert users that one product contained benzocaine, risk of methaemoglobinaemia, and refer to the leaflet for the signs of the condition and what to do should this occur. Results: Two consumers did not locate the warnings on the side of the pack, eventually found them on the back and two suggestions to further improve accessibility of the methaemoglobinaemia warning. Using a gold pack design for the oromucosal spray, all consumers could differentiate between the 3 drugs, minimum age particulars, pharmaceutical form and the risk factor methaemoglobinaemia. The warnings for benzocaine were deemed to be clear or very clear; appearance of the 3 packs were either very well differentiated or quite well differentiated. The PIL test passed on all criteria. All consumers could use the product correctly, identify risk factors ensuring the critical information necessary for the safe use was legible and easily accessible so that confusion and errors were minimised. Conclusion: Patients with known methaemoglobinaemia are likely to be vigilant in checking for benzocaine containing products, despite similar umbrella brand names across a range of active ingredients. Despite these findings, the package design and spray format were not deemed to be sufficient to mitigate potential safety risks associated with differences in target populations and contraindications when submitted to the Regulatory Agency. Although risk management tools are increasingly being used by agencies to assist in providing objective assurance of package safety, further transparency, reduction in subjectivity and proportionate risk should be demonstrated.

Keywords: labelling, OTC, risk, user testing

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Authors: S. Grinnell

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A PhD Research Project exploring the Social Health and Well-Being Impacts associated with Hydraulic Fracturing, with an aim to produce a Best Practice Support Guidance for those anticipating dealing with planning applications or submitting Environmental Impact Assessments (EIAs). Amid a possible global energy crisis, founded upon a number of factors, including unstable political situations, increasing world population growth, people living longer, it is perhaps inevitable that Hydraulic Fracturing (commonly referred to as ‘fracking’) will become a major player within the global long-term energy and sustainability agenda. As there is currently no best practice guidance for governing bodies the Best Practice Support Document will be targeted at a number of audiences including, consultants undertaking EIAs, Planning Officers, those commissioning EIAs Industry and interested public stakeholders. It will offer a robust, evidence-based criteria and recommendations which provide a clear narrative and consistent and shared approach to the language used along with containing an understanding of the issues identified. It is proposed that the Best Practice Support Document will also support the mitigation of health impacts identified. The Best Practice Support Document will support the newly amended Environmental Impact Assessment Directive (2011/92/EU), to be transposed into UK law by 2017. A significant amendment introduced focuses on, ‘higher level of protection to the environment and health.’ Methodology: A qualitative research methods approach is being taken with this research. It will have a number of key stages. A literature review has been undertaken and been critically reviewed and analysed. This was followed by a descriptive content analysis of a selection of international and national policies, programmes and strategies along with published Environmental Impact Assessments and associated planning guidance. In terms of data collection, a number of stakeholders were interviewed as well as a number of focus groups of local community groups potentially affected by fracking. These were determined from across the UK. A theme analysis of all the data collected and the literature review will be undertaken, using NVivo. Best Practice Supporting Document will be developed based on the outcomes of the analysis and be tested and piloted in the professional fields, before a live launch. Concluding statement: Whilst fracking is not a new concept, the technology is now driving a new force behind the use of this engineering to supply fuels. A number of countries have pledged moratoria on fracking until further investigation from the impacts on health have been explored, whilst other countries including Poland and the UK are pushing to support the use of fracking. If this should be the case, it will be important that the public’s concerns, perceptions, fears and objections regarding the wider social health and well-being impacts are considered along with the more traditional biomedical health impacts.

Keywords: fracking, hydraulic fracturing, socio-economic health, well-being

Procedia PDF Downloads 243

Authors: Simon Grossemy, Peggy P. Y. Chan, Pauline M. Doran

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Nerve tissue engineering is the main field of research aimed at finding an alternative to autografts as a treatment for nerve injuries. Scaffolds are used as a support to enhance nerve regeneration. In order to successfully design novel scaffolds and in vitro cell culture systems, a deep understanding of the factors affecting nerve regeneration processes is needed. Physical and biological parameters associated with the culture environment have been identified as potentially influential in nerve cell differentiation, including electrical stimulation, exposure to extracellular-matrix (ECM) proteins, dynamic medium conditions and co-culture with glial cells. The mechanisms involved in driving the cell to differentiation in the presence of these factors are poorly understood; the complexity of each of them raises the possibility that they may strongly influence each other. Some questions that arise in investigating nerve regeneration include: What are the best protein coatings to promote neural cell attachment? Is the scaffold design suitable for providing all the required factors combined? What is the influence of dynamic stimulation on cell viability and differentiation? In order to study these effects, scaffolds adaptable to bioreactor culture conditions were designed to allow electrical stimulation of cells exposed to ECM proteins, all within a dynamic medium environment. Gold coatings were used to make the surface of viscose rayon microfiber scaffolds (VRMS) conductive, and poly-L-lysine (PLL) and laminin (LN) surface coatings were used to mimic the ECM environment and allow the attachment of rat PC12 neural cells. The robustness of the coatings was analyzed by surface resistivity measurements, scanning electron microscope (SEM) observation and immunocytochemistry. Cell attachment to protein coatings of PLL, LN and PLL+LN was studied using DNA quantification with Hoechst. The double coating of PLL+LN was selected based on high levels of PC12 cell attachment and the reported advantages of laminin for neural differentiation. The underlying gold coatings were shown to be biocompatible using cell proliferation and live/dead staining assays. Coatings exhibiting stable properties over time under dynamic fluid conditions were developed; indeed, cell attachment and the conductive power of the scaffolds were maintained over 2 weeks of bioreactor operation. These scaffolds are promising research tools for understanding complex neural cell behavior. They have been used to investigate major factors in the physical culture environment that affect nerve cell viability and differentiation, including electrical stimulation, bioreactor hydrodynamic conditions, and combinations of these parameters. The cell and tissue differentiation response was evaluated using DNA quantification, immunocytochemistry, RT-qPCR and functional analyses.

Keywords: bioreactor, electrical stimulation, nerve differentiation, PC12 cells, scaffold

Procedia PDF Downloads 243

Authors: Samuel N. Forjuoh, Marcia G. Ory, Jaewoong Won, Samuel D. Towne, Suojin Wang, Chanam Lee

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The public health burden of obesity is well established as is the influence of physical activity (PA) on the health and wellness of individuals who are obese. This study examined the influence of selected demographic, health, and socioenvironmental factors on the walking behaviors of middle-aged and older overweight and obese adults. Online and paper surveys were administered to community-dwelling overweight and obese adults aged ≥ 50 years residing in four cities in central Texas and seen by a family physician in the primary care clinic from October 2013 to June 2014. Descriptive statistics were used to characterize participants’ anthropometric and demographic data as well as their health conditions and walking, socioenvironmental, and more broadly defined PA behaviors. Then Pearson chi-square tests were used to assess differences between participants who reported walking the recommended ≥ 150 minutes for any purpose in a typical week as a proxy to meeting the U.S. Centers for Disease Control and Prevention’s PA guidelines and those who did not. Finally, logistic regression was used to predict walking the recommended ≥ 150 minutes for any purpose, controlling for covariates. The analysis was conducted in 2016. Of the total sample (n=253, survey response rate of 6.8%), the majority were non-Hispanic white (81.7%), married (74.5%), male (53.5%), and reported an annual household income of ≥ $50,000 (65.7%). Approximately, half were employed (49.6%), or had at least a college degree (51.8%). Slightly more than 1 in 5 (n=57, 22.5%) reported walking the recommended ≥150 minutes for any purpose in a typical week. The strongest predictors of walking the recommended ≥ 150 minutes for any purpose in a typical week in adjusted analysis were related to education and a high favorable perception of the neighborhood environment. Compared to those with a high school diploma or some college, participants with at least a college degree were five times as likely to walk the recommended ≥ 150 minutes for any purpose (OR=5.55, 95% CI=1.79-17.25). Walking the recommended ≥ 150 minutes for any purpose was significantly associated with participants who disagreed that there were many distracted drivers (e.g., on the cell phone while driving) in their neighborhood (OR=4.08, 95% CI=1.47-11.36) and those who agreed that there are sidewalks or protected walkways (e.g., walking trails) in their neighborhood (OR=3.55, 95% CI=1.10-11.49). Those employed were less likely to walk the recommended ≥ 150 minutes for any purpose compared to those unemployed (OR=0.31, 95% CI=0.11-0.85) as were those who reported some difficulty walking for a quarter of a mile (OR=0.19, 95% CI=0.05-0.77). Other socio-environmental factors such as having care-giver responsibilities for elders, someone to walk with, or a dog in the household as well as Walk Score™ were not significantly associated with walking the recommended ≥ 150 minutes for any purpose in a typical week. Neighborhood perception appears to be an important factor associated with the walking behaviors of middle-aged and older overweight and obese individuals. Enhancing the neighborhood environment (e.g., providing walking trails) may promote walking among these individuals.

Keywords: determinants of walking, obesity, older adults, physical activity

Procedia PDF Downloads 259

Authors: Richa Jaiswal, Vidisha Sharma, Amulya Rattan, Sushma Sagar, Subodh Kumar, Amit Gupta, Biplab Mishra, Maneesh Singhal

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Background: Adequate nutritional support and daily patient monitoring have an independent therapeutic role in the successful management of high output fistulae and early recovery after abdominal trauma. Case presentation: An 18-year-old girl was brought to AIIMS emergency with alleged history of fall of a heavy weight (electric motor) over abdomen. She was evaluated as per Advanced Trauma Life Support(ATLS) protocols and diagnosed to have significant abdominal trauma. After stabilization, she was referred to Trauma center. Abdomen was guarded and focused assessment with sonography for trauma(FAST) was found positive. Complete duodenojejunal(DJ) junction transection was found at laparotomy, and end-to-end repair was done. However, patient was re-explored in view of biliary peritonitis on post-operative day3, and anastomotic leak was found with sloughing of duodenal end. Resection of non-viable segments was done followed by side-to-side anastomosis. Unfortunately, the anastomosis leaked again, this time due to a post-anastomotic kink, diagnosed on dye study. Due to hostile abdomen, the patient was planned for supportive care, with plan of build-up and delayed definitive surgery. Percutaneous transheptic biliary drainage (PTBD) and STSG were required in the course as well. Nutrition: In intensive care unit (ICU), major goals of nutritional therapy were to improve wound healing, optimize nutrition, minimize enteral feed associated complications, reduce biliary fistula output, and prepare the patient for definitive surgeries. Feeding jejunostomy (FJ) was started from day 4 at the rate of 30ml/h along with total parenteral nutrition (TPN) and intra-venous (IV) micronutrients support. Due to high bile output, bile refeed started from day 13.After 23 days of ICU stay, patient was transferred to general ward with body mass index (BMI)<11kg/m2 and serum albumin –1.5gm%. Patient was received in the ward in catabolic phase with high risk of refeeding syndrome. Patient was kept on FJ bolus feed at the rate of 30–50 ml/h. After 3–4 days, while maintaining patient diet book log it was observed that patient use to refuse feed at night and started becoming less responsive with every passing day. After few minutes of conversation with the patient for a couple of days, she complained about enteral feed discharge in urine, mild pain and sign of dumping syndrome. Dye study was done, which ruled out any enterovesical fistula and conservative management were planned. At this time, decision was taken for continuous slow rate feeding through commercial feeding pump at the rate of 2–3ml/min. Drastic improvement was observed from the second day in gastro-intestinal symptoms and general condition of the patient. Nutritional composition of feed, TPN and diet ranged between 800 and 2100 kcal and 50–95 g protein. After STSG, TPN was stopped. Periodic diet counselling was given to improve oral intake. At the time of discharge, serum albumin level was 2.1g%, weight – 38.6, BMI – 15.19 kg/m2. Patient got discharge on an oral diet. Conclusion: Successful management of post-traumatic proximal high output fistulae is a challenging task, due to impaired nutrient absorption and enteral feed associated complications. Strategic- and goal-based nutrition support can salvage such critically ill patients, as demonstrated in the present case.

Keywords: nutritional monitoring, nutritional support, duodenal fistula, abdominal trauma

Procedia PDF Downloads 261

Authors: Davide Cocchi, Andrea Zucchelli, Luca Raimondi, Maria Brugo Tommaso

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The increasing attention is given to the issues of environmental pollution and climate change is exponentially stimulating the development of electrically propelled vehicles powered by renewable energy, in particular, the solar one. Given the small amount of solar energy that can be stored and subsequently transformed into propulsive energy, it is necessary to develop vehicles with high mechanical, electrical and aerodynamic efficiencies along with reduced masses. The reduction of the masses is of fundamental relevance especially for the unsprung masses, that is the assembly of those elements that do not undergo a variation of their distance from the ground (wheel, suspension system, hub, upright, braking system). Therefore, the reduction of unsprung masses is fundamental in decreasing the rolling inertia and improving the drivability, comfort, and performance of the vehicle. This principle applies even more in solar propelled vehicles, equipped with an electric motor that is connected directly to the wheel hub. In this solution, the electric motor is integrated inside the wheel. Since the electric motor is part of the unsprung masses, the development of compact and lightweight solutions is of fundamental importance. The purpose of this research is the design development and optimization of a CFRP 16 wheel hub motor for solar propulsion vehicles that can carry up to four people. In addition to trying to maximize aspects of primary importance such as mass, strength, and stiffness, other innovative constructive aspects were explored. One of the main objectives has been to achieve a high geometric packing in order to ensure a reduced lateral dimension, without reducing the power exerted by the electric motor. In the final solution, it was possible to realize a wheel hub motor assembly completely comprised inside the rim width, for a total lateral overall dimension of less than 100 mm. This result was achieved by developing an innovative connection system between the wheel and the rotor with a double purpose: centering and transmission of the driving torque. This solution with appropriate interlocking noses allows the transfer of high torques and at the same time guarantees both the centering and the necessary stiffness of the transmission system. Moreover, to avoid delamination in critical areas, evaluated by means of FEM analysis using 3D Hashin damage criteria, electrospun nanofibrous mats have been interleaved between CFRP critical layers. In order to reduce rolling resistance, the rim has been designed to withstand high inflation pressure. Laboratory tests have been performed on the rim using the Digital Image Correlation technique (DIC). The wheel has been tested for fatigue bending according to E/ECE/324 R124e.

Keywords: composite laminate, delamination, DIC, lightweight vehicle, motor hub wheel, nanofiber

Procedia PDF Downloads 214

Authors: Lamia Bouzgarrou, Amira Omrane, Naima Bouatay, Chaima Harrathi, Samia Machroughl, Ahmed Mhalla

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Background and Aims: Professionals of health care sector are exposed to psychosocial constraints like stress, harassment, violence, which can lead to many mental health problems such as, depression, addictive behavior, and burn-out. Moreover, it’s well established that caregivers affected to intensive care units are more likely to experience such constraints and mental health problems. For these caregivers, the mental health state may affect care quality and patient’s safety. This study aims either to identify occupational psychosocial constraints and their mental health consequences among paramedical and medical caregivers affected to intensive units in Tunisian public hospital. Methods: An exhaustive three months cross-sectional study conducted among medical and paramedical staffs of intensive care units in three Tunisian university hospitals. After informed consent collection, we evaluated work-related stress, workplace harassment, depression, anxious troubles, addictive behavior, and self-esteems through an anonymous self-completed inquiry form. Five validated questionnaires and scales were included in this form: Karasek's Job Content Questionnaire, Negative Acts Questionnaire, Rosenberg, Beck depression inventory and Hamilton Anxiety scale. Results: We included 129 intensive unit caregivers; with a mean age of 36.1 ± 1.1 years and a sex ratio of 0.58. Among these caregivers, 30% were specialist or under-specialization doctors. The average seniority in the intensive care was 6.1 ± 1.2 (extremes=1 to 40 years). Atypical working schedules were noted among 36.7% of the subjects with an imposed choice in 52.4% of cases. During the last 12 months preceding the survey, 51.7% of care workers were absent from work because of a health problem with stops exceeding 15 days in 11.7%. Job strain was objective among 15% of caregivers and 38.33% of them were victims of moral harassment. A low or very low self-esteem was noted among 40% of respondents. Moreover, active smoking was reported by 20% subjects, alcohol consumption by 13.3% and psychotropic substance use by 1.7% of them. According to Beck inventory and Hamilton Anxiety scale, we concluded that 61.7% of intensive care providers were depressed, with 'severe' depression in 13.3% of cases and 49.9% of them present anxious disorders. Multivariate analysis objective that, job strain was correlated with young age (p=0.005) and shorter work seniority (p=0.001). Workplace and moral harassment was more prevalent among females (p=0.009), under-specialization doctor (p=0.021), those affected to atypical schedules (p=0.008). Concerning depression, it was more prevalent among staff in job strain situation (p = 0.004), among smokers caregivers (p = 0.048), and those with no leisure activity (p < 0.001). Anxious disorders were positively correlated to chronic diseases history (p = 0.001) and work-bullying exposure (p = 0.004). Conclusions: Our findings reflected a high frequency of caregivers who are under stress at work and those who are victims of moral harassment. These health professionals were at increased risk for developing psychiatric illness such depressive and anxious disorders and addictive behavior. Our results suggest the necessity of preventive strategies of occupational psychosocial constraints in order to preserve professional’s mental health and maximize patient safety and quality of care.

Keywords: health care sector, intensive care units, mental health, psychosocial constraints

Procedia PDF Downloads 155

Authors: Chun-Liang Wu, Kai-Ping Shaw, Cheng-Ping Yu, Wu-Chien Chien, Hsiao-Ting Chen, Shao-Huang Wu

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Objective: This study analyzed three criminal judicial cases. We applied the patterned injuries of the rider to demonstrate the facts of each accident, reconstruct the scenes, and pursue the truth. Methods: Case analysis, a method that collects evidence and reasons the results in judicial procedures, then the importance of the pattern of injury as evidence will be compared and evaluated. The patterned injuries analysis method is to compare the collision situation between an object and human body injuries to determine whether the characteristics can reproduce the unique pattern of injury. Result: Case 1: Two motorcycles, A and B, head-on collided; rider A dead, and rider B was accused. During the prosecutor’s investigation, the defendant learned that rider A had an 80 mm open wound on his neck. During the court trial, the defendant requested copies of the case file and found out that rider A had a large contusion on his chest wall, and the cause of death was traumatic hemothorax and abdominal wall contusion. The defendant compared all the evidence at the scene and determined that the injury was obviously not caused by the collision of the body or the motorcycle of rider B but that rider was out of control and injured himself when he crossed the double yellow line. In this case, the defendant was innocent in the High Court judgment in April 2022. Case 2: Motorcycles C and D head-on crashed, and rider C died of massive abdominal bleeding. The prosecutor decided that rider C was driving under the influence (DUI), but rider D was negligent and sued rider D. The defendant requested the copies’ file and found the special phenomenon that the front wheel of motorcycle C was turned left. The defendant’s injuries were a left facial bone fracture, a left femur fracture, and other injuries on the left side. The injuries were of human-vehicle separation and human-vehicle collision, which proved that rider C suddenly turned left when the two motorcycles approached, knocked down motorcycle D, and the defendant flew forward. Case 3: Motorcycle E and F’s rear end collided, the front rider E was sentenced to 3 months, and the rear rider F sued rider E for more than 7 million N.T. The defendant found in the copies’ file that the injury of rider F was the left tibial platform fracture, etc., and then proved that rider F made the collision with his left knee, causing motorcycle E to fall out of control. This evidence was accepted by the court and is still on trial. Conclusion: The application of patterned injuries in the reconstruction of a motorcycle accident could discover the truth and provide the basis for judicial justice. The cases and methods could be the reference for the policy of preventing traffic accident casualties.

Keywords: judicial evidence, patterned injuries analysis, accident reconstruction, fatal motorcycle injuries

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Authors: Mairaj Salim, Asma Zaheer

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Oman has accomplished as much or more than its fellow Gulf monarchies, despite starting from scratch considerably later, having less oil income to utilize, dealing with a larger and more rugged geography, and resolving a bitter civil war along the way. Of course, Oman's progress in the past 30-plus years has not been without problems and missteps, but the balance is squarely on the positive side of the ledger. Oil has been the driving force of the Omani economy since Oman began commercial production in 1967. The oil industry supports the country’s high standard of living and is primarily responsible for its modern and expansive infrastructure, including electrical utilities, telephone services, roads, public education and medical services. In addition to extensive oil reserves, Oman also has substantial natural gas reserves, which are expected to play a leading role in the Omani economy in the Twenty-first Century. To reduce the country’s dependence on oil revenues, the government is restructuring the economy by directing investment to non-oil activities. Since the 21st century IT has changed the performing tasks. To manage the affairs for the benefits of organizations and economy, the Omani government has adopted E-Business technologies for the development. E-Business is important because it allows • Transformation of old economy relationships (vertical/linear relationships) to new economy relationships characterized by end-to-end relationship management solutions (integrated or extended relationships) • Facilitation and organization of networks, small firms depend on ‘partner’ firms for supplies and product distribution to meet customer demands • SMEs to outsource back-end process or cost centers enabling the SME to focus on their core competence • ICT to connect, manage and integrate processes internally and externally • SMEs to join networks and enter new markets, through shortened supply chains to increase market share, customers and suppliers • SMEs to take up the benefits of e-business to reduce costs, increase customer satisfaction, improve client referral and attract quality partners • New business models of collaboration for SMEs to increase their skill base • SMEs to enter virtual trading arena and increase their market reach A national strategy for the advancement of information and communication technology (ICT) has been worked out, mainly to introduce e-government, e-commerce, and a digital society. An information technology complex KOM (Knowledge Oasis Muscat) had been established, consisting of section for information technology, incubator services, a shopping center of technology software and hardware, ICT colleges, E-Government services and other relevant services. So, all these efforts play a vital role in the development of Oman economy.

Keywords: ICT, ITA, CRM, SCM, ERP, KOM, SMEs, e-commerce and e-business

Procedia PDF Downloads 251

Authors: Tariq Ahamad, Mohammed S. Al-Kahtani, Taisir Eldos

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Optical communications technology has made enormous and steady progress for several decades, providing the key resource in our increasingly information-driven society and economy. Much of this progress has been in finding innovative ways to increase the data carrying capacity of a single optical fiber. In this research article we have explored basic issues in terms of security and reliability for secure and reliable information transfer through the fiber infrastructure. Conspicuously, one potentially enormous source of improvement has however been left untapped in these systems: fibers can easily support hundreds of spatial modes, but today’s commercial systems (single-mode or multi-mode) make no attempt to use these as parallel channels for independent signals. Bandwidth, performance, reliability, cost efficiency, resiliency, redundancy, and security are some of the demands placed on telecommunications today. Since its initial development, fiber optic systems have had the advantage of most of these requirements over copper-based and wireless telecommunications solutions. The largest obstacle preventing most businesses from implementing fiber optic systems was cost. With the recent advancements in fiber optic technology and the ever-growing demand for more bandwidth, the cost of installing and maintaining fiber optic systems has been reduced dramatically. With so many advantages, including cost efficiency, there will continue to be an increase of fiber optic systems replacing copper-based communications. This will also lead to an increase in the expertise and the technology needed to tap into fiber optic networks by intruders. As ever before, all technologies have been subject to hacking and criminal manipulation, fiber optics is no exception. Researching fiber optic security vulnerabilities suggests that not everyone who is responsible for their networks security is aware of the different methods that intruders use to hack virtually undetected into fiber optic cables. With millions of miles of fiber optic cables stretching across the globe and carrying information including but certainly not limited to government, military, and personal information, such as, medical records, banking information, driving records, and credit card information; being aware of fiber optic security vulnerabilities is essential and critical. Many articles and research still suggest that fiber optics is expensive, impractical and hard to tap. Others argue that it is not only easily done, but also inexpensive. This paper will briefly discuss the history of fiber optics, explain the basics of fiber optic technologies and then discuss the vulnerabilities in fiber optic systems and how they can be better protected. Knowing the security risks and knowing the options available may save a company a lot embarrassment, time, and most importantly money.

Keywords: in-house networks, fiber optics, security risk, money

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Authors: Zheng Lulin, Xiong Guoping

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In recent years, agriculture, rural development, and peasants are among the top concerns and priorities of the Chinese Government. Several related issues have been paid many attentions by academic communities, including the impacts of corresponding policies on the rural villages, the mechanisms of these impacts, and the future development of rural society. However, most of the researchers focus on single rural policy instead of integral rural policy system. Hence, this dissertation focused on the mechanisms of policies’ influence on rural changes through a case study from Changfu Village in central Guangxi Province, China, to propose the optimized suggestions for rural development. Forty-three relevant pivotal policies of significant influence on rural development are summarized from literature and documents, covering five aspects of agricultural production, rural living security, open rural markets, rural household registration systems, and farmland transferring. Besides, having been live in this area for more than 20 years, researchers obtain the basic information about changing the social connection between citizens and villagers, the habitat of villagers by years of informal interviews. Furthermore, more than 200 questionnaires are given to villagers to analyze the changing of their personal and family information. The summary of rural policies revealed that the development trend of public rural policies followed the U-shape curve and these policies are characterized by economic intentions and operative economy. Report of questionnaires and interviews show that the development of rural economy was promoted greatly by public policies. Firstly, Social communication and rural culture were affected to a certain extent. Secondly, the educational level of rural individuals was significantly enhanced, whereas the quality of population had limited progress. Finally, the freedom of occupational choice for rural individuals into cities was greater than before, but still restricted by the class solidification of social background, resulting in more obstacles for rural individuals to settle down in cities. From what we discuss about, we may reach the conclusion on several perspectives: Firstly, the impact of the rural policies has a significant role in promoting the economy development of the rural area. However, separations between rural and urban area are still a major problem since rural policy contributed little to improve the rural population quality. Therefore, in the future, providing high quality educational facilities including teachers, libraries, and opportunities of broadening their knowledge base are key issues of future rural policy. Secondly, the development of rural economy would be a lack of driving force for further improvement owning to the fact that working hard couldn’t get more improvement. In the future, public policies should support the rural development of culture, technology, and personal qualities to create favorable social environment for the free increase of rural population.

Keywords: changing of rural area, rural development of China, rural policy, social environment

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Authors: Andi Setiawan, Annisa Ulfah Pristya

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Indonesian rubber plant area reached 2.9 million hectares with productivity reached 1.38 million. High rubber productivity is directly proportional to the amount of waste produced rubber processing industry. Rubber industry would produce a negative impact on the rubber industry in the form of environmental pollution caused by waste that has not been treated optimally. Rubber industrial wastewater containing high-nitrogen compounds (nitrate and ammonia) and phosphate compounds which cause water pollution and odor problems due to the high ammonia content. On the other hand, demand for NPK fertilizers in Indonesia continues to increase from year to year and in need of ammonia and phosphate as raw material. Based on domestic demand, it takes a year to 400,000 tons of ammonia and Indonesia imports 200,000 tons of ammonia per year valued at IDR 4.2 trillion. As well, the lack of phosphoric acid to be imported from Jordan, Morocco, South Africa, the Philippines, and India as many as 225 thousand tons per year. During this time, the process of wastewater treatment is generally done with a rubber on the tank to contain the waste and then precipitated, filtered and the rest released into the environment. However, this method is inefficient and thus require high energy costs because through many stages before producing clean water that can be discharged into the river. On the other hand, Indonesia has the potential of pineapple fruit can be harvested throughout the year in all of Indonesia. In 2010, production reached 1,406,445 tons of pineapple in Indonesia or about 9.36 percent of the total fruit production in Indonesia. Increased productivity is directly proportional to the amount of pineapple waste pineapple leaves are kept continuous and usually just dumped in the ground or disposed of with other waste at the final disposal. Through Eco-Nanofiltration Membrane-Based Fiber Pineapple leaves Waste so that environmental problems can be solved efficiently. Nanofiltration is a process that uses pressure as a driving force that can be either convection or diffusion of each molecule. Nanofiltration membranes that can split water to nano size so as to separate the waste processed residual economic value that N and P were higher as a raw material for the manufacture of NPK fertilizer to overcome the crisis in Indonesia. The raw materials were used to manufacture Eco-Nanofiltration Membrane is cellulose from pineapple fiber which processed into cellulose acetate which is biodegradable and only requires a change of the membrane every 6 months. Expected output target is Green eco-technology so with nanofiltration membranes not only treat waste rubber industry in an effective, efficient and environmentally friendly but also lowers the cost of waste treatment compared to conventional methods.

Keywords: biodegradable, cellulose diacetate, fertilizers, pineapple, rubber

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Authors: Susie Pryor, Palak Sadhwani

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The purpose of this research is to provide the foundations for a broad research agenda examining the role loneliness plays in entrepreneurship. While qualitative research in entrepreneurship incidentally captures the existence of loneliness as a part of the lived reality of entrepreneurs, to the authors’ knowledge, no academic work has to date explored this construct in this context. Moreover, many individuals reporting high levels of loneliness (women, ethnic minorities, immigrants, low income, low education) reflect those who are currently driving small business growth in the United States. Loneliness is a persistent state of emotional distress which results from feelings of estrangement and rejection or develops in the absence of social relationships and interactions. Empirical work finds links between loneliness and depression, suicide and suicide ideation, anxiety, hostility and passiveness, lack of communication and adaptability, shyness, poor social skills and unrealistic social perceptions, self-doubts, fear of rejection, and negative self-evaluation. Lonely individuals have been found to exhibit lower levels of self-esteem, higher levels of introversion, lower affiliative tendencies, less assertiveness, higher sensitivity to rejection, a heightened external locus of control, intensified feelings of regret and guilt over past events and rigid and overly idealistic goals concerning the future. These characteristics are likely to impact entrepreneurs and their work. Research identifies some key dangers of loneliness. Loneliness damages human love and intimacy, can disturb and distract individuals from channeling creative and effective energies in a meaningful way, may result in the formation of premature, poorly thought out and at times even irresponsible decisions, and produce hard and desensitized individuals, with compromised health and quality of life concerns. The current study utilizes meta-analysis and text analytics to distinguish loneliness from other related constructs (e.g., social isolation) and categorize antecedents and effects of loneliness across subpopulations. This work has the potential to materially contribute to the field of entrepreneurship by cleanly defining constructs and providing foundational background for future research. It offers a richer understanding of the evolution of loneliness and related constructs over the life cycle of entrepreneurial start-up and development. Further, it suggests preliminary avenues for exploration and methods of discovery that will result in knowledge useful to the field of entrepreneurship. It is useful to both entrepreneurs and those work with them as well as academics interested in the topics of loneliness and entrepreneurship. It adopts a grounded theory approach.

Keywords: entrepreneurship, grounded theory, loneliness, meta-analysis

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Authors: Antonio Martín-Pardo

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With regard to the context in which this paper is inserted, it is noteworthy that the current criminal policy model in which we find immersed, denominated by some doctrine sector as the citizen security model, is characterized by a marked tendency towards the discredit of expert knowledge. This type of technic knowledge has been displaced by the common sense and by the daily experience of the people at the time of legislative drafting, as well as by excessive attention to the short-term political effects of the law. Despite this criminal-political adverse scene, we still find valuable efforts in the side of experts to bring some rationality to the legislative development. This is the case of the proposal for a new cannabis regulation model in Spain carried out by the Cannabis Policy Studies Group (hereinafter referred as ‘GEPCA’). The GEPCA is a multidisciplinary group composed by authors with multiple/different orientations, trajectories and interests, but with a common minimum objective: the conviction that the current situation regarding cannabis is unsustainable and, that a rational legislative solution must be given to the growing social pressure for the regulation of their consumption and production. This paper details the main lines through which this technical proposal is developed with the purpose of its dissemination and discussion in the Congress. The basic methodology of the proposal is inductive-expository. In that way, firstly, we will offer a brief, but solid contextualization of the situation of cannabis in Spain. This contextualization will touch on issues such as the national regulatory situation and its relationship with the international context; the criminal, judicial and penitentiary impact of the offer and consumption of cannabis, or the therapeutic use of the substance, among others. In second place, we will get down to the business properly by detailing the minutia of the three main cannabis access channels that are proposed. Namely: the regulated market, the associations of cannabis users and personal self-cultivation. In each of these options, especially in the first two, special attention will be paid to both, the production and processing of the substance and the necessary administrative control of the activity. Finally, in a third block, some notes will be given on a series of subjects that surround the different access options just mentioned above and that give fullness and coherence to the proposal outlined. Among those related issues we find some such as consumption and tenure of the substance; the issue of advertising and promotion of cannabis; consumption in areas of special risk (work or driving v. g.); the tax regime; the need to articulate evaluation instruments for the entire process; etc. The main conclusion drawn from the analysis of the proposal is the unsustainability of the current repressive system, clearly unsuccessful, and the need to develop new access routes to cannabis that guarantee both public health and the rights of people who have freely chosen to consume it.

Keywords: cannabis regulation proposal, cannabis policies studies group, criminal policy, expertise participation

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Authors: R. Tariq, R. Lee

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Background: Heywood, Middleton & Rochdale Urgent Community Care Team (UCCT)1 is a great example of using a multidisciplinary team to cope with demand. The service reduces unnecessary admissions to hospitals and ensures that patients can leave the hospital quicker by making care more readily available within the community and patient’s homes. The team comprises nurses, community practitioners, and allied health professions, including physiotherapy, occupational therapy, pharmacy, and GPs. The main challenge for a team with a range of experiences and skill sets is to maintain consistency of care, which technology can help address. Allied healthcare professionals (HCPs) are often used in expanded roles with duties mainly involving patient consultations and decision making to ease pressure on doctors. The Clinical Reasoning Platform (CRP) Dem Dx is used to support new as well as experienced professionals in the decision making process. By guiding HCPs through diagnosing patients from an expansive directory of differential diagnoses, patients can receive quality care in the community. Actions on the platform are determined using NICE guidelines along with local guidance influencing the assessment and management of a patient. Objective: To compare the clinical assessment, decisions, and actions taken by the UCCT multidisciplinary team in the community and Dem Dx, using retrospective clinical cases. Methodology: Dem Dx was used to analyse 192 anonymised cases provided by the HMR UCCT. The team’s performance was compared with Dem Dx regarding the quality of the documentation of the clinical assessment and the next steps on the patient’s journey, including the initial management, actions, and any onward referrals made. The cases were audited by two medical doctors. Results: The study found that the actions outlined by the Dem Dx platform were appropriate in almost 87% of cases. When in a direct comparison between DemDX and the actions taken by the clinical team, it was found that the platform was suitable 83% (p<0.001) of the time and could lead to a potential improvement of 66% in the assessment and management of cases. Dem Dx also served to highlight the importance of comprehensive and high quality clinical documentation. The quality of documentation of cases by UCCT can be improved to provide a detailed account of the assessment and management process. By providing step-by-step guidance and documentation at every stage, Dem Dx may ensure that legal accountability has been fulfilled. Conclusion: With the ever expanding workforce in the NHS, technology has become a key component in driving healthcare outcomes. To improve healthcare provision and clinical reasoning, a decision support platform can be integrated into HCPs’ clinical practice. Potential assistance with clinical assessments, the most appropriate next step and actions in a patient’s care, and improvements in the documentation was highlighted by this retrospective study. A further study has been planned to ascertain the effectiveness of improving outcomes using the clinical reasoning platform within the clinical setting by clinicians.

Keywords: allied health professional, assessment, clinical reasoning, clinical records, clinical decision-making, ocumentation

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Authors: Chuanxiang Cheng, Tiantian Min, Jin Yue

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Antimicrobial active packaging enables extensive biological effects to improve food safety. However, the efficacy of antimicrobial packaging hinges on factors including the diffusion rate of the active agent toward the food surface, the initial content in the antimicrobial agent, and the targeted food shelf life. Among the possibilities of antimicrobial packaging design, an interesting approach involves the incorporation of volatile antimicrobial agents into the packaging material. In this case, the necessity for direct contact between the active packaging material and the food surface is mitigated, as the antimicrobial agent exerts its action through the packaging headspace atmosphere towards the food surface. However, it still remains difficult to achieve controlled and precise release of bioactive compounds to the specific target location with required quantity in food packaging applications. Remarkably, the development of stimuli-responsive materials for electrospinning has introduced the possibility of achieving controlled release of active agents under specific conditions, thereby yielding enduring biological effects. Relative humidity (RH) for the storage of food categories such as meat and aquatic products typically exceeds 90%. Consequently, high RH can be used as an abiotic trigger for the release of active agents to prevent microbial growth. Hence, a novel RH - responsive polyvinyl alcohol/chitosan (PVA/CS) composite nanofibrous film incorporated with 4-terpineol/β-cyclodextrin inclusion complexes (4-TA@β-CD ICs) was engineered by electrospinning that can be deposited as a functional packaging materials. The characterization results showed the thermal stability of the films was enhanced after the incorporation due to the hydrogen bonds between ICs and polymers. Remarkably, the 4 wt% 4-TA@β-CD ICs/PVA/CS film exhibited enhanced crystallinity, moderate hydrophilic (Water contact angle of 81.53°), light barrier property (Transparency of 1.96%) and water resistance (Water vapor permeability of 3.17 g mm/m2 h kPa). Moreover, this film also showed optimized mechanical performance with a Young’s modulus of 11.33 MPa, a tensile strength of 19.99 MPa and an elongation at break of 4.44 %. Notably, the antioxidant and antibacterial properties of this packaging material were significantly improved. The film demonstrated the half-inhibitory concentrations (IC50) values of 87.74% and 85.11% for scavenging 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2, 2′-azinobis (3-ethylbenzothiazoline-6-sulfonic) (ABTS) free radicals, respectively, in addition to an inhibition efficiency of 65% against Shewanella putrefaciens, the characteristic bacteria in aquatic products. Most importantly, the film achieved controlled release of 4-TA under high 98% RH by inducing the plasticization of polymers caused by water molecules, swelling of polymer chains, and destruction of hydrogen bonds within the cyclodextrin inclusion complex. Consequently, low relative humidity is suitable for the preservation of nanofibrous film, while high humidity conditions typical in fresh food packaging environments effectively stimulated the release of active compounds in the film. This film with a long-term antimicrobial effect successfully extended the shelf life of Litopenaeus vannamei shrimp to 7 days at 4 °C. This attractive design could pave the way for the development of new food packaging materials.

Keywords: controlled release, electrospinning, nanofibrous film, relative humidity–responsive, shrimp preservation

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Authors: Ahlem Dhahri, Audrey Becuwe

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This study examines the adoption of sustainable purchasing practices among Tunisian SMEs, with a focus on assessing how environmental and social sustainability maturity affects the implementation of sustainable supplier selection (SSS) criteria. Using institutional theory to classify coercive, normative, and mimetic pressures, as well as emerging drivers and barriers, this study explores the institutional factors influencing sustainable purchasing practices and the specific barriers faced by Tunisian SMEs in this area. An exploratory, abductive qualitative research design was adopted for this multiple case study, which involved 19 semi-structured interviews with owners and managers of 17 Tunisian manufacturing SMEs. The Gioia method was used to analyze the data, thus enabling the identification of key themes and relationships directly from the raw data. This approach facilitated a structured interpretation of the institutional factors influencing sustainable purchasing practices, with insights drawn from the participants' perspectives. The study reveals that Tunisian SMEs are at different levels of sustainability maturity, with a significant impact on their procurement practices. SMEs with advanced sustainability maturity integrate both environmental and social criteria into their supplier selection processes, while those with lower maturity levels rely on mostly traditional criteria such as cost, quality, and delivery. Key institutional drivers identified include regulatory pressure, market expectations, and stakeholder influence. Additional emerging drivers—such as certifications and standards, economic incentives, environmental commitment as a core value, and group-wide strategic alignment—also play a critical role in driving sustainable procurement. Conversely, the study reveals significant barriers, including economic constraints, limited awareness, and resource limitations. It also identifies three main categories of emerging barriers: (1) logistical and supply chain constraints, including retailer/intermediary dependency, tariff regulations, and a perceived lack of direct responsibility in B2B supply chains; (2) economic and financial constraints; and (3) operational barriers, such as unilateral environmental responsibility, a product-centric focus and the influence of personal relationships. Providing valuable insights into the role of sustainability maturity in supplier selection, this study is the first to explore sustainable procurement practices in the Tunisian SME context. Integrating an analysis of institutional drivers, including emerging incentives and barriers, provides practical implications for SMEs seeking to improve sustainability in procurement. The results highlight the need for stronger regulatory frameworks and support mechanisms to facilitate the adoption of sustainable practices among SMEs in Tunisia.

Keywords: Tunisian SME, sustainable supplier selection, institutional theory, determinant, qualitative study

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