Search results for: family planning methods
Commenced in January 2007
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Edition: International
Paper Count: 20382

Search results for: family planning methods

1362 Sequential and Combinatorial Pre-Treatment Strategy of Lignocellulose for the Enhanced Enzymatic Hydrolysis of Spent Coffee Waste

Authors: Rajeev Ravindran, Amit K. Jaiswal

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Waste from the food-processing industry is produced in large amount and contains high levels of lignocellulose. Due to continuous accumulation throughout the year in large quantities, it creates a major environmental problem worldwide. The chemical composition of these wastes (up to 75% of its composition is contributed by polysaccharide) makes it inexpensive raw material for the production of value-added products such as biofuel, bio-solvents, nanocrystalline cellulose and enzymes. In order to use lignocellulose as the raw material for the microbial fermentation, the substrate is subjected to enzymatic treatment, which leads to the release of reducing sugars such as glucose and xylose. However, the inherent properties of lignocellulose such as presence of lignin, pectin, acetyl groups and the presence of crystalline cellulose contribute to recalcitrance. This leads to poor sugar yields upon enzymatic hydrolysis of lignocellulose. A pre-treatment method is generally applied before enzymatic treatment of lignocellulose that essentially removes recalcitrant components in biomass through structural breakdown. Present study is carried out to find out the best pre-treatment method for the maximum liberation of reducing sugars from spent coffee waste (SPW). SPW was subjected to a range of physical, chemical and physico-chemical pre-treatment followed by a sequential, combinatorial pre-treatment strategy is also applied on to attain maximum sugar yield by combining two or more pre-treatments. All the pre-treated samples were analysed for total reducing sugar followed by identification and quantification of individual sugar by HPLC coupled with RI detector. Besides, generation of any inhibitory compounds such furfural, hydroxymethyl furfural (HMF) which can hinder microbial growth and enzyme activity is also monitored. Results showed that ultrasound treatment (31.06 mg/L) proved to be the best pre-treatment method based on total reducing content followed by dilute acid hydrolysis (10.03 mg/L) while galactose was found to be the major monosaccharide present in the pre-treated SPW. Finally, the results obtained from the study were used to design a sequential lignocellulose pre-treatment protocol to decrease the formation of enzyme inhibitors and increase sugar yield on enzymatic hydrolysis by employing cellulase-hemicellulase consortium. Sequential, combinatorial treatment was found better in terms of total reducing yield and low content of the inhibitory compounds formation, which could be due to the fact that this mode of pre-treatment combines several mild treatment methods rather than formulating a single one. It eliminates the need for a detoxification step and potential application in the valorisation of lignocellulosic food waste.

Keywords: lignocellulose, enzymatic hydrolysis, pre-treatment, ultrasound

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1361 Analysis of Distance Travelled by Plastic Consumables Used in the First 24 Hours of an Intensive Care Admission: Impacts and Methods of Mitigation

Authors: Aidan N. Smallwood, Celestine R. Weegenaar, Jack N. Evans

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The intensive care unit (ICU) is a particularly resource heavy environment, in terms of staff, drugs and equipment required. Whilst many areas of the hospital are attempting to cut down on plastic use and minimise their impact on the environment, this has proven challenging within the confines of intensive care. Concurrently, as globalization has progressed over recent decades, there has been a tendency towards centralised manufacturing with international distribution networks for products, often covering large distances. In this study, we have modelled the standard consumption of plastic single-use items over the course of the first 24-hours of an average individual patient’s stay in a 12 bed ICU in the United Kingdom (UK). We have identified the country of manufacture and calculated the minimum possible distance travelled by each item from factory to patient. We have assumed direct transport via the shortest possible straight line from country of origin to the UK and have not accounted for transport within either country. Assuming an intubated patient with invasive haemodynamic monitoring and central venous access, there are a total of 52 distincts, largely plastic, disposable products which would reasonably be required in the first 24-hours after admission. Each product type has only been counted once to account for multiple items being shipped as one package. Travel distances from origin were summed to give the total distance combined for all 52 products. The minimum possible total distance travelled from country of origin to the UK for all types of product was 273,353 km, equivalent to 6.82 circumnavigations of the globe, or 71% of the way to the moon. The mean distance travelled was 5,256 km, approximately the distance from London to Mecca. With individual packaging for each item, the total weight of consumed products was 4.121 kg. The CO2 produced shipping these items by air freight would equate to 30.1 kg, however doing the same by sea would produce 0.2 kg CO2. Extrapolating these results to the 211,932 UK annual ICU admissions (2018-2019), even with the underestimates of distance and weight of our assumptions, air freight would account for 6586 tons CO2 emitted annually, approximately 130 times that of sea freight. Given the drive towards cost saving within the UK health service, and the decline of the local manufacturing industry, buying from intercontinental manufacturers is inevitable However, transporting all consumables by sea where feasible would be environmentally beneficial, as well as being less costly than air freight. At present, the NHS supply chain purchases from medical device companies, and there is no freely available information as to the transport mode used to deliver the product to the UK. This must be made available to purchasers in order to give a fuller picture of life cycle impact and allow for informed decision making in this regard.

Keywords: CO2, intensive care, plastic, transport

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1360 Comfort Evaluation of Summer Knitted Clothes of Tencel and Cotton Fabrics

Authors: Mona Mohamed Shawkt Ragab, Heba Mohamed Darwish

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Context: Comfort properties of garments are crucial for the wearer, and with the increasing demand for cotton fabric, there is a need to explore alternative fabrics that can offer similar or superior comfort properties. This study focuses on comparing the comfort properties of tencel/cotton single jersey fabric and cotton single jersey fabric, with the aim of identifying fabrics that are more suitable for summer clothes. Research Aim: The aim of this study is to evaluate the comfort properties of tencel/cotton single jersey fabric and cotton single jersey fabric, with the goal of identifying fabrics that can serve as alternatives to cotton, considering their comfort properties for summer clothing. Methodology: An experimental, analytical approach was employed in this study. Two circular knitting machines were used to produce the fabrics, one with a 24 inches gauge and the other with a 28 inches gauge. Both fabrics were knitted with three different loop lengths (3.05 mm, 2.9 mm, and 2.6 mm) to obtain loose, medium, and tight fabrics for evaluation. Various comfort properties, including air permeability, water vapor permeability, wickability, and thermal resistance, were measured for both fabric types. Findings: The study found a significant difference in comfort properties between tencel/cotton single jersey fabric and cotton single jersey fabric. Tencel/cotton fabric exhibited higher air permeability, water vapor permeability, and wickability compared to cotton fabric. These findings suggest that tencel fabric is more suitable for summer clothes due to its superior ventilation and absorption properties. Theoretical Importance: This study contributes to the exploration of alternative fabrics to cotton by evaluating their comfort properties. By identifying fabrics that offer better comfort properties than cotton, particularly in terms of water usage, the study provides valuable insights into sustainable fabric choices for the fashion industry. Data Collection and Analysis Procedures: The comfort properties of the fabrics were measured using appropriate testing methods. Paired comparison t-tests were conducted to determine the significant differences between tencel/cotton fabric and cotton fabric in the measured properties. Correlation coefficients were also calculated to examine the relationships between the factors under study. Question Addressed: The study addresses the question of whether tencel/cotton single jersey fabric can serve as an alternative to cotton fabric for summer clothes, considering their comfort properties. Conclusion: The study concludes that tencel/cotton single jersey fabric offers superior comfort properties compared to cotton single jersey fabric, making it a suitable alternative for summer clothes. The findings also highlight the importance of considering fabric properties, such as air permeability, water vapor permeability, and wickability, when selecting materials for garments to enhance wearer comfort. This research contributes to the search for sustainable alternatives to cotton and provides valuable insights for the fashion industry in making informed fabric choices.

Keywords: comfort properties, cotton fabric, tencel fabric, single jersey

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1359 Evolutionary Analysis of Influenza A (H1N1) Pdm 09 in Post Pandemic Period in Pakistan

Authors: Nazish Badar

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In early 2009, Pandemic type A (H1N1) Influenza virus emerged globally. Since then, it has continued circulation causing considerable morbidity and mortality. The purpose of this study was to evaluate the evolutionary changes in Influenza A (H1N1) pdm09 viruses from 2009-15 and their relevance with the current vaccine viruses. Methods: Respiratory specimens were collected with influenza-like illness and Severe Acute Respiratory Illness. Samples were processed according to CDC protocol. Sequencing and phylogenetic analysis of Haemagglutinin (HA) and neuraminidase (NA) genes was carried out comparing representative isolates from Pakistan viruses. Results: Between Jan2009 - Feb 2016, 1870 (13.2%) samples were positive for influenza A out of 14086. During the pandemic period (2009–10), Influenza A/ H1N1pdm 09 was the dominant strain with 366 (45%) of total influenza positives. In the post-pandemic period (2011–2016), a total of 1066 (59.6%) cases were positive Influenza A/ H1N1pdm 09 with co-circulation of different Influenza A subtypes. Overall, the Pakistan A(H1N1) pdm09 viruses grouped in two genetic clades. Influenza A(H1N1)pdm09 viruses only ascribed to Clade 7 during the pandemic period whereas viruses belong to clade 7 (2011) and clade 6B (2015) during the post-pandemic years. Amino acid analysis of the HA gene revealed mutations at positions S220T, I338V and P100S specially associated with outbreaks in all the analyzed strains. Sequence analyses of post-pandemic A(H1N1)pdm09 viruses showed additional substitutions at antigenic sites; S179N,K180Q (SA), D185N, D239G (CA), S202A (SB) and at receptor binding sites; A13T, S200P when compared with pandemic period. Substitution at Genetic markers; A273T (69%), S200P/T (15%) and D239G (7.6%) associated with severity and E391K (69%) associated with virulence was identified in viruses isolated during 2015. Analysis of NA gene revealed outbreak markers; V106I (23%) among pandemic and N248D (100%) during post-pandemic Pakistan viruses. Additional N-Glycosylation site; HA S179N (23%), NA I23T(7.6%) and N44S (77%) in place of N386K(77%) were only found in post-pandemic viruses. All isolates showed histidine (H) at position 275 in NA indicating sensitivity to neuraminidase inhibitors. Conclusion: This study shows that the Influenza A(H1N1)pdm09 viruses from Pakistan clustered into two genetic clades, with co-circulation of some variants. Certain key substitutions in the receptor binding site and few changes indicative of virulence were also detected in post-pandemic strains. Therefore, it is imperative to continue monitoring of the viruses for early identification of potential variants of high virulence or emergence of drug-resistant variants.

Keywords: Influenza A (H1N1) pdm09, evolutionary analysis, post pandemic period, Pakistan

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1358 Bivariate Analyses of Factors That May Influence HIV Testing among Women Living in the Democratic Republic of the Congo

Authors: Danielle A. Walker, Kyle L. Johnson, Patrick J. Fox, Jacen S. Moore

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The HIV Continuum of Care has become a universal model to provide context for the process of HIV testing, linkage to care, treatment, and viral suppression. HIV testing is the first step in moving toward community viral suppression. Countries with a lower socioeconomic status experience the lowest rates of testing and access to care. The Democratic Republic of the Congo is located in the heart of sub-Saharan Africa, where testing and access to care are low and women experience higher HIV prevalence compared to men. In the Democratic Republic of the Congo there is only a 21.6% HIV testing rate among women. Because a critical gap exists between a woman’s risk of contracting HIV and the decision to be tested, this study was conducted to obtain a better understanding of the relationship between factors that could influence HIV testing among women. The datasets analyzed were from the 2013-14 Democratic Republic of the Congo Demographic and Health Survey Program. The data was subset for women with an age range of 18-49 years. All missing cases were removed and one variable was recoded. The total sample size analyzed was 14,982 women. The results showed that there did not seem to be a difference in HIV testing by mean age. Out of 11 religious categories (Catholic, Protestant, Armee de salut, Kimbanguiste, Other Christians, Muslim, Bundu dia kongo, Vuvamu, Animist, no religion, and other), those who identified as Other Christians had the highest testing rate of 25.9% and those identified as Vuvamu had a 0% testing rate (p<0.001). There was a significant difference in testing by religion. Only 0.7% of women surveyed identified as having no religious affiliation. This suggests partnerships with key community and religious leaders could be a tool to increase testing. Over 60% of women who had never been tested for HIV did not know where to be tested. This highlights the need to educate communities on where testing facilities can be located. Almost 80% of women who believed HIV could be transmitted by supernatural means and/or witchcraft had never been tested before (p=0.08). Cultural beliefs could influence risk perception and testing decisions. Consequently, misconceptions need to be considered when implementing HIV testing and prevention programs. Location by province, years of education, and wealth index were also analyzed to control for socioeconomic status. Kinshasa had the highest testing rate of 54.2% of women living there, and both Equateur and Kasai-Occidental had less than a 10% testing rate (p<0.001). As the education level increased up to 12 years, testing increased (p<0.001). Women within the highest quintile of the wealth index had a 56.1% testing rate, and women within the lowest quintile had a 6.5% testing rate (p<0.001). This study concludes that further research is needed to identify culturally competent methods to increase HIV education programs, build partnerships with key community leaders, and improve knowledge on access to care.

Keywords: Democratic Republic of the Congo, cultural beliefs, education, HIV testing

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1357 Provisional Settlements and Urban Resilience: The Transformation of Refugee Camps into Cities

Authors: Hind Alshoubaki

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The world is now confronting a widespread urban phenomenon: refugee camps, which have mostly been established in ‘rushing mode,’ pointing toward affording temporary settlements for refugees that provide them with minimum levels of safety, security and protection from harsh weather conditions within a very short time period. In fact, those emergency settlements are transforming into permanent ones since time is a decisive factor in terms of construction and camps’ age. These play an essential role in transforming their temporary character into a permanent one that generates deep modifications to the city’s territorial structure, shaping a new identity and creating a contentious change in the city’s form and history. To achieve a better understanding for the transformation of refugee camps, this study is based on a mixed-methods approach: the qualitative approach explores different refugee camps and analyzes their transformation process in terms of population density and the changes to the city’s territorial structure and urban features. The quantitative approach employs a statistical regression analysis as a reliable prediction of refugees’ satisfaction within the Zaatari camp in order to predict its future transformation. Obviously, refugees’ perceptions of their current conditions will affect their satisfaction, which plays an essential role in transforming emergency settlements into permanent cities over time. The test basically discusses five main themes: the access and readiness of schools, the dispersion of clinics and shopping centers; the camp infrastructure, the construction materials, and the street networks. The statistical analysis showed that Syrian refugees were not satisfied with their current conditions inside the Zaatari refugee camp and that they had started implementing changes according to their needs, desires, and aspirations because they are conscious about the fact of their prolonged stay in this settlement. Also, the case study analyses showed that neglecting the fact that construction takes time leads settlements being created with below-minimum standards that are deteriorating and creating ‘slums,’ which lead to increased crime rates, suicide, drug use and diseases and deeply affect cities’ urban tissues. For this reason, recognizing the ‘temporary-eternal’ character of those settlements is the fundamental concept to consider refugee camps from the beginning as definite permanent cities. This is the key factor to minimize the trauma of displacement on both refugees and the hosting countries. Since providing emergency settlements within a short time period does not mean using temporary materials, having a provisional character or creating ‘makeshift cities.’

Keywords: refugee, refugee camp, temporary, Zaatari

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1356 Disaggregating Communities and the Making of Factional States: Evidence from Joint Forest Management in Sundarban, India

Authors: Amrita Sen

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In the face of a growing insurgent movement and the perceived failure of the state and the market towards sustainable resource management, a range of decentralized forest management policies was formulated in the last two decades, which recognized the need for community representations within the statutory methods of forest management. The recognition conceded on the virtues of ecological sustainability and traditional environmental knowledge, which were considered to be the principal repositories of the forest dependent communities. The present study, in the light of empirical insights, reflects on the contemporary disjunctions between the preconceived communitarian ethic in environmentalism and the lived reality of forest based life-worlds. Many of the popular as well as dominant ideologies, which have historically shaped the conceptual and theoretical understanding of sociology, needs further perusal in the context of the emerging contours of empirical knowledge, which lends opportunities for substantive reworking and analysis. The image of the community appears to be one of those concepts, an identity which has for long defined perspectives and processes associated with people living together harmoniously in small physical spaces. Through an ethnographic account of the implementation of Joint Forest Management (JFM) in a forest fringe village in Sundarban, the study explores the ways in which the idea of ‘community’ gets transformed through the process of state-making, rendering the necessity of its departure from the standard, conventional definition of homogeneity and internal equity. The study necessitates an attention towards the anthropology of micro-politics, disaggregating an essentially constructivist anthropology of ‘collective identities’, which can render the visibility of political mobilizations plausible within the seemingly culturalist production of communities. The two critical questions that the paper seeks to ask in this context are: how the ‘local’ is constituted within community based conservation practices? Within the efforts of collaborative forest management, how accurately does the depiction of ‘indigenous environmental knowledge’, subscribe to its role of sustainable conservation practices? Reflecting on the execution of JFM in Sundarban, the study critically explores the ways in which the state ceases to be ‘trans-national’ and interacts with the rural life-worlds through its local factions. Simultaneously, the study attempts to articulate the scope of constructing a competing representation of community, shaped by increasing political negotiations and bureaucratic alignments which strains against the usual preoccupations with tradition primordiality and non material culture as well as the amorous construction of indigeneity.

Keywords: community, environmentalism, JFM, state-making, identities, indigenous

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1355 Providing Health Promotion Information by Digital Animation to International Visitors in Japan: A Factorial Design View of Nurses

Authors: Mariko Nishikawa, Masaaki Yamanaka, Ayami Kondo

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Background: International visitors to Japan are at a risk of travel-related illnesses or injury that could result in hospitalization in a country where the language and customs are unique. Over twelve million international visitors came to Japan in 2015, and more are expected leading up to the Tokyo Olympics. One aspect of this is the potentially greater demand on healthcare services by foreign visitors. Nurses who take care of them have anxieties and concerns of their knowledge of the Japanese health system. Objectives: An effective distribution of travel-health information is vital for facilitating care for international visitors. Our research investigates whether a four-minute digital animation (Mari Info Japan), designed and developed by the authors and applied to a survey of 513 nurses who take care of foreigners daily, could clarify travel health procedures, reduce anxieties, while making it enjoyable to learn. Methodology: Respondents to a survey were divided into two groups. The intervention group watched Mari Info Japan. The control group read a standard guidebook. The participants were requested to fill a two-page questionnaire called Mari Meter-X, STAI-Y in English and mark a face scale, before and after the interventions. The questions dealt with knowledge of health promotion, the Japanese healthcare system, cultural concerns, anxieties, and attitudes in Japan. Data were collected from an intervention group (n=83) and control group (n=83) of nurses in a hospital, Japan for foreigners from February to March, 2016. We analyzed the data using Text Mining Studio for open-ended questions and JMP for statistical significance. Results: We found that the intervention group displayed more confidence and less anxiety to take care of foreign patients compared to the control group. The intervention group indicated a greater comfort after watching the animation. However, both groups were most likely to be concerned about language, the cost of medical expenses, informed consent, and choice of hospital. Conclusions: From the viewpoint of nurses, the provision of travel-health information by digital animation to international visitors to Japan was more effective than traditional methods as it helped them be better prepared to treat travel-related diseases and injury among international visitors. This study was registered number UMIN000020867. Funding: Grant–in-Aid for Challenging Exploratory Research 2010-2012 & 2014-16, Japanese Government.

Keywords: digital animation, health promotion, international visitor, Japan, nurse

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1354 Current Status and Influencing Factors of Transition Status of Newly Graduated Nurses in China: A Multi-center Cross-sectional Study

Authors: Jia Wang, Wanting Zhang, Yutong Xv, Zihan Guo, Weiguang Ma

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Background: Before becoming qualified nurses, newly graduated nurses(NGNs) must experience a painful transition period, even transition shocks. Transition shocks are public health issues. To address the transition issue of NGNs, many programs or interventions have been developed and implemented. However, there are no studies to understand and assess the transition state of newly graduated nurses from work to life, from external abilities to internal emotions. Aims: Assess the transition status of newly graduated nurses in China. Identify the factors influencing the transition status of newly graduated nurses. Methods: The multi-center cross-sectional study design was adopted. From May 2022 to June 2023, 1261 newly graduated nurse in hospitals were surveyed online with the the Demographic Questionnaire and Transition Status Scale for Newly Graduated Nurses. SPSS 26.0 were used for data input and statistical analysis. Statistic description were adopted to evaluate the demographic characteristics and transition status of NGNs. Independent-samples T-test, Analysis of Variance and Multiple regression analysis was used to explore the influencing factors of transition status. Results: The total average score of Transition Status Scale for Newly Graduated Nurses was 4.00(SD = 0.61). Among the various dimensions of Transition Status, the highest dimension was competence for nursing work, while the lowest dimension was balance between work and life. The results showed factors influencing the transition status of NGNs include taught by senior nurses, night shift status, internship department, attribute of working hospital, province of work and residence, educational background, reasons for choosing nursing, types of hospital, and monthly income. Conclusion: At present, the transition status score of new nurses in China is relatively high, and NGNs are more likely to agree with their own transition status, especially the dimension of competence for nursing work. However, they have a poor level of excess in terms of life-work balance. Nursing managers should reasonably arrange the working hours of NGNs, promote their work-life balance, increase the salary and reward mechanism of NGNs, arrange experienced nursing mentors to teach, optimize the level of hospitals, provide suitable positions for NGNs with different educational backgrounds, pay attention to the culture shock of NGNs from other provinces, etc. Optimize human resource management by intervening in these factors that affect the transition of new nurses and promote a better transition of new nurses.

Keywords: newly graduated nurse, transition, humanistic car, nursing management, nursing practice education

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1353 Uses of Fibrinogen Concentrate in the Management of Trauma-Induced Coagulopathy in the Prehospital Environment: A Scoping Review

Authors: Nura Khattab, Fayad Al-Haimus, Teruko Kishibe, Netanel Krugliak, Melissa McGowan, Brodie Nolan

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Trauma-induced coagulopathy remains a significant contributor to mortality in severely injured patients. Fibrinogen is essential for early hemostasis and is recognized as the first coagulation factor to fall below critical levels, compromising the coagulation cascade. Early administration of fibrinogen concentrate may be feasible and effective to prevent coagulopathy. We conducted this scoping review to characterize the existing quantity of literature, and to explore the usage of prehospital fibrinogen concentrate products in improving clinical outcomes in trauma patients. Methods: A search strategy was developed in consultation with an information specialist. We searched MEDLINE, Embase, Cochrane, and Scopus from inception to May 6th 2024. English studies evaluating prehospital/military usage of fibrinogen concentrate in trauma patients were included. Studies were assessed by three independent reviewers for meeting inclusion and exclusion criteria. Reference lists of included articles were reviewed to identify additional studies meeting inclusion criteria. Clinical endpoints regarding fibrinogen concentrate were extracted and synthesized. Results: The literature search returned 1301 articles with seven studies meeting the inclusion criteria. Five studies (71%) were conducted in civilian settings and two studies (29%) were conducted in military settings. Of the included studies, three (43%) utilized a randomized control trial. We identified seven outcomes that compared varying concentrations of fibrinogen or fibrinogen concentrate to a placebo group. The outcomes included overall mortality, death from hemorrhage, thromboembolic events, clotting time, maximum clot firmness, clot stability at ER admission, and fibrinogen concentration at ER admission. Apart from thromboembolic events, all other reported outcomes showed statistically significant differences in group comparisons, determined using p values. The four (57%) non-clinical studies underscored the robustness, practicality, and degree of fibrinogen concentrate utilization in military environments and retrieval services. Conclusion: Preliminary research suggests that prehospital fibrinogen concentrate administration in traumatic bleeding patients is both feasible and effective, improving mortality and clotting parameters. While implementing a time-saving and proactive approach with fibrinogen holds potential for enhancing trauma care, the current evidence is limited. Further studies in this novel field are warranted.

Keywords: fibrinogen concentrate, prehospital, military, trauma, trauma-induced coagulopathy

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1352 Structural Analysis of Archaeoseismic Records Linked to the 5 July 408 - 410 AD Utica Strong Earthquake (NE Tunisia)

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

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

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

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1351 Quantifying Multivariate Spatiotemporal Dynamics of Malaria Risk Using Graph-Based Optimization in Southern Ethiopia

Authors: Yonas Shuke Kitawa

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Background: Although malaria incidence has substantially fallen sharply over the past few years, the rate of decline varies by district, time, and malaria type. Despite this turn-down, malaria remains a major public health threat in various districts of Ethiopia. Consequently, the present study is aimed at developing a predictive model that helps to identify the spatio-temporal variation in malaria risk by multiple plasmodium species. Methods: We propose a multivariate spatio-temporal Bayesian model to obtain a more coherent picture of the temporally varying spatial variation in disease risk. The spatial autocorrelation in such a data set is typically modeled by a set of random effects that assign a conditional autoregressive prior distribution. However, the autocorrelation considered in such cases depends on a binary neighborhood matrix specified through the border-sharing rule. Over here, we propose a graph-based optimization algorithm for estimating the neighborhood matrix that merely represents the spatial correlation by exploring the areal units as the vertices of a graph and the neighbor relations as the series of edges. Furthermore, we used aggregated malaria count in southern Ethiopia from August 2013 to May 2019. Results: We recognized that precipitation, temperature, and humidity are positively associated with the malaria threat in the area. On the other hand, enhanced vegetation index, nighttime light (NTL), and distance from coastal areas are negatively associated. Moreover, nonlinear relationships were observed between malaria incidence and precipitation, temperature, and NTL. Additionally, lagged effects of temperature and humidity have a significant effect on malaria risk by either species. More elevated risk of P. falciparum was observed following the rainy season, and unstable transmission of P. vivax was observed in the area. Finally, P. vivax risks are less sensitive to environmental factors than those of P. falciparum. Conclusion: The improved inference was gained by employing the proposed approach in comparison to the commonly used border-sharing rule. Additionally, different covariates are identified, including delayed effects, and elevated risks of either of the cases were observed in districts found in the central and western regions. As malaria transmission operates in a spatially continuous manner, a spatially continuous model should be employed when it is computationally feasible.

Keywords: disease mapping, MSTCAR, graph-based optimization algorithm, P. falciparum, P. vivax, waiting matrix

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1350 The Development of Explicit Pragmatic Knowledge: An Exploratory Study

Authors: Aisha Siddiqa

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The knowledge of pragmatic practices in a particular language is considered key to effective communication. Unlike one’s native language where this knowledge is acquired spontaneously, more conscious attention is required to learn second language pragmatics. Traditional foreign language (FL) classrooms generally focus on the acquisition of vocabulary and lexico-grammatical structures, neglecting pragmatic functions that are essential for effective communication in the multilingual networks of the modern world. In terms of effective communication, of particular importance is knowledge of what is perceived as polite or impolite in a certain language, an aspect of pragmatics which is not perceived as obligatory but is nonetheless indispensable for successful intercultural communication and integration. While learning a second language, the acquisition of politeness assumes more prominence as the politeness norms and practices vary according to language and culture. Therefore, along with focusing on the ‘use’ of politeness strategies, it is crucial to examine the ‘acquisition’ and the ‘acquisitional development’ of politeness strategies by second language learners, particularly, by lower proficiency leaners as the norms of politeness are usually focused in lower levels. Hence, there is an obvious need for a study that not only investigates the acquisition of pragmatics by young FL learners using innovative multiple methods; but also identifies the potential causes of the gaps in their development. The present research employs a cross sectional design to explore the acquisition of politeness by young English as a foreign language learners (EFL) in France; at three levels of secondary school learning. The methodology involves two phases. In the first phase a cartoon oral production task (COPT) is used to elicit samples of requests from young EFL learners in French schools. These data are then supplemented by a) role plays, b) an analysis of textbooks, and c) video recordings of classroom activities. This mixed method approach allows us to explore the repertoire of politeness strategies the learners possess and delve deeper into the opportunities available to learners in classrooms to learn politeness strategies in requests. The paper will provide the results of the analysis of COPT data for 250 learners at three different stages of English as foreign language development. Data analysis is based on categorization of requests developed in CCSARP project. The preliminary analysis of the COPT data shows that there is substantial evidence of pragmalinguistic development across all levels but the developmental process seems to gain momentum in the second half of the secondary school period as compared to the early period at school. However, there is very little evidence of sociopragmatic development. The study aims to document the current classroom practices in France by looking at the development of young EFL learner’s politeness strategies across three levels of secondary schools.

Keywords: acquisition, English, France, interlanguage pragmatics, politeness

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1349 The Correspondence between Self-regulated Learning, Learning Efficiency and Frequency of ICT Use

Authors: Maria David, Tunde A. Tasko, Katalin Hejja-Nagy, Laszlo Dorner

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The authors have been concerned with research on learning since 1998. Recently, the focus of our interest is how prevalent use of information and communication technology (ICT) influences students' learning abilities, skills of self-regulated learning and learning efficiency. Nowadays, there are three dominant theories about the psychic effects of ICT use: According to social optimists, modern ICT devices have a positive effect on thinking. As to social pessimists, this effect is rather negative. And, regarding the views of biological optimists, the change is obvious, but these changes can fit into the mankind's evolved neurological system as did writing long ago. Mentality of 'digital natives' differ from that of elder people. They process information coming from the outside world in an other way, and different experiences result in different cerebral conformation. In this regard, researchers report about both positive and negative effects of ICT use. According to several studies, it has a positive effect on cognitive skills, intelligence, school efficiency, development of self-regulated learning, and self-esteem regarding learning. It is also proven, that computers improve skills of visual intelligence such as spacial orientation, iconic skills and visual attention. Among negative effects of frequent ICT use, researchers mention the decrease of critical thinking, as permanent flow of information does not give scope for deeper cognitive processing. Aims of our present study were to uncover developmental characteristics of self-regulated learning in different age groups and to study correlations of learning efficiency, the level of self-regulated learning and frequency of use of computers. Our subjects (N=1600) were primary and secondary school students and university students. We studied four age groups (age 10, 14, 18, 22), 400 subjects of each. We used the following methods: the research team developed a questionnaire for measuring level of self-regulated learning and a questionnaire for measuring ICT use, and we used documentary analysis to gain information about grade point average (GPA) and results of competence-measures. Finally, we used computer tasks to measure cognitive abilities. Data is currently under analysis, but as to our preliminary results, frequent use of computers results in shorter response time regarding every age groups. Our results show that an ordinary extent of ICT use tend to increase reading competence, and had a positive effect on students' abilities, though it didn't show relationship with school marks (GPA). As time passes, GPA gets worse along with the learning material getting more and more difficult. This phenomenon draws attention to the fact that students are unable to switch from guided to independent learning, so it is important to consciously develop skills of self-regulated learning.

Keywords: digital natives, ICT, learning efficiency, reading competence, self-regulated learning

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1348 A Study to Explore the Effectiveness of an Educational Program on Awareness of Cancer Signs, Symptoms, and Risk Factors Among School Students in Oman

Authors: Khadija Al-Hosni, Moon Fai Chan, Mohammed Al-Azri

Abstract:

Background: Several studies suggest that most school-age adolescents are poorly informed on cancer warning signs and risk factors. Providing adolescents with sufficient knowledge would increase their awareness in adulthood and improve seeking behaviors later. Significant: The results will provide a clear vision in assisting key decision-makers in formulating policies on the students' awareness programs towards cancer. So, the likelihood of avoiding cancer in the future will be increased or even promote early diagnosis. Objectives: to evaluate the effectiveness of an education program designed to increase awareness of cancer signs and symptoms risk factors, improve the behavior of seeking help among school students in Oman, and address the barriers to obtaining medical help. Methods: A randomized controlled trial with two groups was conducted in Oman. A total of 1716 students (n=886/control, n= 830/education), aged 15-17 years, at 10th and 11th grade from 12 governmental schools 3 in governorates from 20-February-2022 to 12-May-2022. Basic demographic data were collected, and the Cancer Awareness Measure (CAM) was used as the primary outcome. Data were collected at baseline (T0) and 4 weeks after (T1). The intervention group received an education program about cancer's cause and its signs and symptoms. In contrast, the control group did not receive any education related to this issue during the study period. Non-parametric tests were used to compare the outcomes between groups. Results: At T0, the lamp was the most recognized cancer warning sign in the control (55.0%) and intervention (55.2%) groups. However, there were no significant changes at T1 for all signs in the control group. In contrast, all sign outcomes were improved significantly (p<0.001) in the intervention group, and the highest response was unexplained pain (93.3%). Smoking was the most recognized risk factor in both groups: (82.8% for control; 84.1% for intervention) at T0. However, there was no significant change in T1 for the control group, but there was for the intervention group (p<0.001), the highest identification was smoking cigarettes (96.5%). Too scared was the largest barrier to seeking medical help by students in the control group at T0 (63.0%) and T1 (62.8%). However, there were no significant changes in all barriers in this group. Otherwise, being too embarrassed (60.2%) was the largest barrier to seeking medical help for students in the intervention group at T0 and too scared (58.6%) at T1. Although there were reductions in all barriers, significant differences were found in six of ten only (p<0.001). Conclusion: The intervention was effective in improving students' awareness of cancer symptoms, warning signs (p<0.001), and risk factors (p<0.001 reduced the most addressed barriers to seeking medical help (p<0.001) in comparison to the control group. The Ministry of Education in Oman could integrate awareness of cancer within the curriculum, and more interventions are needed on the sociological part to overcome the barriers that interfere with seeking medical help.

Keywords: adolescents, awareness, cancer, education, intervention, student

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1347 Reaching the Goals of Routine HIV Screening Programs: Quantifying and Implementing an Effective HIV Screening System in Northern Nigeria Facilities Based on Optimal Volume Analysis

Authors: Folajinmi Oluwasina, Towolawi Adetayo, Kate Ssamula, Penninah Iutung, Daniel Reijer

Abstract:

Objective: Routine HIV screening has been promoted as an essential component of efforts to reduce incidence, morbidity, and mortality. The objectives of this study were to identify the optimal annual volume needed to realize the public health goals of HIV screening in the AIDS Healthcare Foundation supported hospitals and establish an implementation process to realize that optimal annual volume. Methods: Starting in 2011 a program was established to routinize HIV screening within communities and government hospitals. In 2016 Five-years of HIV screening data were reviewed to identify the optimal annual proportions of age-eligible patients screened to realize the public health goals of reducing new diagnoses and ending late-stage diagnosis (tracked as concurrent HIV/AIDS diagnosis). Analysis demonstrated that rates of new diagnoses level off when 42% of age-eligible patients were screened, providing a baseline for routine screening efforts; and concurrent HIV/AIDS diagnoses reached statistical zero at screening rates of 70%. Annual facility based targets were re-structured to meet these new target volumes. Restructuring efforts focused on right-sizing HIV screening programs to align and transition programs to integrated HIV screening within standard medical care and treatment. Results: Over one million patients were screened for HIV during the five years; 16, 033 new HIV diagnoses and access to care and treatment made successfully for 82 % (13,206), and concurrent diagnosis rates went from 32.26% to 25.27%. While screening rates increased by 104.7% over the 5-years, volume analysis demonstrated that rates need to further increase by 62.52% to reach desired 20% baseline and more than double to reach optimal annual screening volume. In 2011 facility targets for HIV screening were increased to reflect volume analysis, and in that third year, 12 of the 19 facilities reached or exceeded new baseline targets. Conclusions and Recommendation: Quantifying targets against routine HIV screening goals identified optimal annual screening volume and allowed facilities to scale their program size and allocate resources accordingly. The program transitioned from utilizing non-evidence based annual volume increases to establishing annual targets based on optimal volume analysis. This has allowed efforts to be evaluated on the ability to realize quantified goals related to the public health value of HIV screening. Optimal volume analysis helps to determine the size of an HIV screening program. It is a public health tool, not a tool to determine if an individual patient should receive screening.

Keywords: HIV screening, optimal volume, HIV diagnosis, routine

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1346 Empirical Testing of Hofstede’s Measures of National Culture: A Study in Four Countries

Authors: Nebojša Janićijević

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At the end of 1970s, Dutch researcher Geert Hofstede, had conducted an enormous empirical research on the differences between national cultures. In his huge research, he had identified four dimensions of national culture according to which national cultures differ and determined the index for every dimension of national culture for each country that took part in his research. The index showed a country’s position on the continuum between the two extreme poles of the cultural dimensions. Since more than 40 years have passed since Hofstede's research, there is a doubt that, due to the changes in national cultures during that period, they are no longer a good basis for research. The aim of this research is to check the validity of Hofstee's indices of national culture The empirical study conducted in the branches of a multinational company in Serbia, France, the Netherlands and Denmark aimed to determine whether Hofstede’s measures of national culture dimensions are still valid. The sample consisted of 155 employees of one multinational company, where 40 employees came from three countries and 35 employees were from Serbia. The questionnaire that analyzed the positions of national cultures according to the Hofstede’s four dimensions was formulated on the basis of the initial Hofstede’s questionnaire, but it was much shorter and significantly simplified comparing to the original questionnaire. Such instrument had already been used in earlier researches. A statistical analysis of the obtained questionnaire results was done by a simple calculation of the frequency of the provided answers. Due to the limitations in methodology, sample size, instrument, and applied statistical methods, the aim of the study was not to explicitly test the accuracy Hofstede’s indexes but to enlighten the general position of the four observed countries in national culture dimensions and their mutual relations. The study results have indicated that the position of the four observed national cultures (Serbia, France, the Netherlands and Denmark) is precisely the same in three out of four dimensions as Hofstede had described in his research. Furthermore, the differences between national cultures and the relative relations between their positions in three dimensions of national culture correspond to Hofstede’s results. The only deviation from Hofstede’s results is concentrated around the masculinity–femininity dimension. In addition, the study revealed that the degree of power distance is a determinant when choosing leadership style. It has been found that national cultures with high power distance, like Serbia and France, favor one of the two authoritative leadership styles. On the other hand, countries with low power distance, such as the Netherlands and Denmark, prefer one of the forms of democratic leadership styles. This confirms Hofstede’s premises about the impact of power distance on leadership style. The key contribution of the study is that Hofstede’s national culture indexes are still a reliable tool for measuring the positions of countries in national culture dimensions, and they can be applied in the cross-cultural research in management. That was at least the case with four observed countries: Serbia, France, the Netherlands, and Denmark.

Keywords: national culture, leadership styles, power distance, collectivism, masculinity, uncertainty avoidance

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1345 Risk Based Inspection and Proactive Maintenance for Civil and Structural Assets in Oil and Gas Plants

Authors: Mohammad Nazri Mustafa, Sh Norliza Sy Salim, Pedram Hatami Abdullah

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Civil and structural assets normally have an average of more than 30 years of design life. Adding to this advantage, the assets are normally subjected to slow degradation process. Due to the fact that repair and strengthening work for these assets are normally not dependent on plant shut down, the maintenance and integrity restoration of these assets are mostly done based on “as required” and “run to failure” basis. However unlike other industries, the exposure in oil and gas environment is harsher as the result of corrosive soil and groundwater, chemical spill, frequent wetting and drying, icing and de-icing, steam and heat, etc. Due to this type of exposure and the increasing level of structural defects and rectification in line with the increasing age of plants, assets integrity assessment requires a more defined scope and procedures that needs to be based on risk and assets criticality. This leads to the establishment of risk based inspection and proactive maintenance procedure for civil and structural assets. To date there is hardly any procedure and guideline as far as integrity assessment and systematic inspection and maintenance of civil and structural assets (onshore) are concerned. Group Technical Solutions has developed a procedure and guideline that takes into consideration credible failure scenario, assets risk and criticality from process safety and structural engineering perspective, structural importance, modeling and analysis among others. Detailed inspection that includes destructive and non-destructive tests (DT & NDT) and structural monitoring is also being performed to quantify defects, assess severity and impact on integrity as well as identify the timeline for integrity restoration. Each defect and its credible failure scenario is assessed against the risk on people, environment, reputation and production loss. This technical paper is intended to share on the established procedure and guideline and their execution in oil & gas plants. In line with the overall roadmap, the procedure and guideline will form part of specialized solutions to increase production and to meet the “Operational Excellence” target while extending service life of civil and structural assets. As the result of implementation, the management of civil and structural assets is now more systematically done and the “fire-fighting” mode of maintenance is being gradually phased out and replaced by a proactive and preventive approach. This technical paper will also set the criteria and pose the challenge to the industry for innovative repair and strengthening methods for civil & structural assets in oil & gas environment, in line with safety, constructability and continuous modification and revamp of plant facilities to meet production demand.

Keywords: assets criticality, credible failure scenario, proactive and preventive maintenance, risk based inspection

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1344 Mental Balance, Emotional Balance, and Stress Management: The Role of Ancient Vedic Philosophy from India

Authors: Emily Schulz

Abstract:

The ancient Vedic culture from India had traditions that supported all aspects of health, including psychological health, and are relevant in the current era. These traditions have been compiled by Professor Dr. Purna, a rare Himalayan Master, into the Purna Health Management System (PHMS). The PHMS is a unique, holistic, and integrated approach to health management. It is comprised of four key factors: Health, Fitness, and Nutrition (HF&N), Life Balance (Stress Management) (LB-SM), Spiritual Growth and Development (SG&D); and Living in Harmony with the Natural Environment (LHWNE). The purpose of the PHMS is to give people the tools to take responsibility for managing their own holistic health and wellbeing. A study using a cross-sectional mixed-methods anonymous online survey was conducted during 2017-2018. Adult students of Professor Dr. Purna were invited to participate through announcements made at various events He held throughout the globe. Follow-up emails were sent with consenting language for interested parties and provided them with a link to the survey. Participation in the study was completely voluntary and no incentives were given to respond to the survey. The overall aim of the study was to investigate the effectiveness of implementation of the PHMS on practitioners' emotional balance. However, given the holistic nature of the PHMS, survey questions also inquired about participants’ physical health, stress level, ability to manage stress, and wellbeing using Likert scales. The survey also included some open-ended questions to gain an understanding of the participants’ experiences with the PHMS relative to their emotional balance. In total, 52 people out of 253 potential respondents participated in the study. Data were analyzed using nonparametric Spearman’s Rho correlation coefficient (rs) since the data were not on a normal distribution. Statistical significance was set at p < .05. Results of the study suggested that there are moderate to strong statistically significant relationships (p < .001) between participants' frequent implementation of each of the four key factors of the PHMS and self-reported mental/emotional health (HF&N rs = 0.42; LB-SM rs = 0.54; SG&D rs = 0.49; LHWNE rs = 0.45) Results also demonstrated statistically significant relationships (p < .001) between participants' frequent implementation of each of the four key factors of the PHMS and their self-reported ability to manage stress (HF&N rs = 0.44; LB-SM rs = 0.55; SG&D rs = 0.39; LHWNE rs = 0.55). Additionally, those who reported experiencing better physical health also reported better mental/emotional health (rs = 0.49, p < .001) and better ability to manage stress (rs = 0.46, p < .001). The findings of this study suggest that wisdom from the ancient Vedic culture may be useful for those working in the field of psychology and related fields who would like to assist clients in calming their mind and emotions and managing their stress levels.

Keywords: balanced emotions, balanced mind, stress management, Vedic philosophy

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1343 Dimensionality Reduction in Modal Analysis for Structural Health Monitoring

Authors: Elia Favarelli, Enrico Testi, Andrea Giorgetti

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Autonomous structural health monitoring (SHM) of many structures and bridges became a topic of paramount importance for maintenance purposes and safety reasons. This paper proposes a set of machine learning (ML) tools to perform automatic feature selection and detection of anomalies in a bridge from vibrational data and compare different feature extraction schemes to increase the accuracy and reduce the amount of data collected. As a case study, the Z-24 bridge is considered because of the extensive database of accelerometric data in both standard and damaged conditions. The proposed framework starts from the first four fundamental frequencies extracted through operational modal analysis (OMA) and clustering, followed by density-based time-domain filtering (tracking). The fundamental frequencies extracted are then fed to a dimensionality reduction block implemented through two different approaches: feature selection (intelligent multiplexer) that tries to estimate the most reliable frequencies based on the evaluation of some statistical features (i.e., mean value, variance, kurtosis), and feature extraction (auto-associative neural network (ANN)) that combine the fundamental frequencies to extract new damage sensitive features in a low dimensional feature space. Finally, one class classifier (OCC) algorithms perform anomaly detection, trained with standard condition points, and tested with normal and anomaly ones. In particular, a new anomaly detector strategy is proposed, namely one class classifier neural network two (OCCNN2), which exploit the classification capability of standard classifiers in an anomaly detection problem, finding the standard class (the boundary of the features space in normal operating conditions) through a two-step approach: coarse and fine boundary estimation. The coarse estimation uses classics OCC techniques, while the fine estimation is performed through a feedforward neural network (NN) trained that exploits the boundaries estimated in the coarse step. The detection algorithms vare then compared with known methods based on principal component analysis (PCA), kernel principal component analysis (KPCA), and auto-associative neural network (ANN). In many cases, the proposed solution increases the performance with respect to the standard OCC algorithms in terms of F1 score and accuracy. In particular, by evaluating the correct features, the anomaly can be detected with accuracy and an F1 score greater than 96% with the proposed method.

Keywords: anomaly detection, frequencies selection, modal analysis, neural network, sensor network, structural health monitoring, vibration measurement

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1342 Staphylococcus Aureus Septic Arthritis and Necrotizing Fasciitis in a Patient With Undiagnosed Diabetes Mellitus.

Authors: Pedro Batista, André Vinha, Filipe Castelo, Bárbara Costa, Ricardo Sousa, Raquel Ricardo, André Pinto

Abstract:

Background: Septic arthritis is a diagnosis that must be considered in any patient presenting with acute joint swelling and fever. Among the several risk factors for septic arthritis, such as age, rheumatoid arthritis, recent surgery, or skin infection, diabetes mellitus can sometimes be the main risk factor. Staphylococcus aureus is the most common pathogen isolated in septic arthritis; however, it is uncommon in monomicrobial necrotizing fasciitis. Objectives: A case report of concomitant septic arthritis and necrotizing fasciitis in a patient with undiagnosed diabetes based on clinical history. Study Design & Methods: We report a case of a 58-year-old Portuguese previously healthy man who presented to the emergency department with fever and left knee swelling and pain for two days. The blood work revealed ketonemia of 6.7 mmol/L and glycemia of 496 mg/dL. The vital signs were significant for a temperature of 38.5 ºC and 123 bpm of heart rate. The left knee had edema and inflammatory signs. Computed tomography of the left knee showed diffuse edema of the subcutaneous cellular tissue and soft tissue air bubbles. A diagnosis of septic arthritis and necrotising fasciitis was made. He was taken to the operating room for surgical debridement. The samples collected intraoperatively were sent for microbiological analysis, revealing infection by multi-sensitive Staphylococcus aureus. Given this result, the empiric flucloxacillin (500 mg IV) and clindamycin (1000 mg IV) were maintained for 3 weeks. On the seventh day of hospitalization, there was a significant improvement in subcutaneous and musculoskeletal tissues. After two weeks of hospitalization, there was no purulent content and partial closure of the wounds was possible. After 3 weeks, he was switched to oral antibiotics (flucloxacillin 500 mg). A week later, a urinary infection by Pseudomonas aeruginosa was diagnosed and ciprofloxacin 500 mg was administered for 7 days without complications. After 30 days of hospital admission, the patient was discharged home and recovered. Results: The final diagnosis of concomitant septic arthritis and necrotizing fasciitis was made based on the imaging findings, surgical exploration and microbiological tests results. Conclusions: Early antibiotic administration and surgical debridement are key in the management of septic arthritis and necrotizing fasciitis. Furthermore, risk factors control (euglycemic blood glucose levels) must always be taken into account given the crucial role in the patient's recovery.

Keywords: septic arthritis, Necrotizing fasciitis, diabetes, Staphylococcus Aureus

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1341 Effect of Progressive Muscle Relaxation on the Postpartum Depression and General Comfort Levels

Authors: İlknur Gökşin, Sultan Ayaz Alkaya

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Objective: Progressive muscle relaxation (PMR) include the deliberate stretching and relaxation of the major muscle groups of the human body. This study was conducted to evaluate the effect of PMR applied in women on the postpartum depression and general comfort level. Methods: The study population of this quasi-experimental study with pre-test, post-test and control group consisted of primipara women who had vaginal delivery in the obstetric service of a university hospital. The experimental and control groups consisted of 35 women each. The data were collected by questionnaire, the Edinburgh Postnatal Depression Scale (EPDS) and the General Comfort Questionnaire (GCQ). The women were matched according to their age and education level and divided into the experimental and control groups by simple random selection. Postpartum depression risk and general comfort was evaluated at the 2nd and 5th days, 10th and 15th days, fourth week and eighth week after birth. The experimental group was visited at home and PMR was applied. After the first visit, women were asked to apply PMR regularly three times a week for eight weeks. During the application, the researcher called the participants twice a week to follow up the continuity of the application. No intervention was performed in the control group. For data analysis, descriptive statistics such as number, percentage, mean, standard deviation, significance test of difference between two means and ANOVA were used. Approval of the ethics committee and permission of the institution were obtained for the study. Results: There were no significant differences between the women in the experimental and control groups in terms of age, education status and employment status (p>0.05). There was no statistically significant difference between the experimental and control groups in terms of EPDS pre-test, 1st, 2nd and 3rd follow-up mean scores (p>0.05). There was a statistically significant difference between EPDS pre-test and 3rd follow-up scores of the experimental group (p<0.05), whereas there was no such difference in the control group (p>0.05). There was no statistically significant difference between the experimental and control groups in terms of mean GCQ pre-test scores (p>0.05), whereas in the 1st, 2nd and 3rd follow-ups there was a statistically significant difference between the mean GCQ scores (p<0.05). It was found that there was a significant increase in the GCQ physical, psychospiritual and sociocultural comfort sub-scales, relief and relaxation levels of the experimental group between the pre-test and 3rd follow-ups scores (p<0.05). And, a significant decrease was found between pre-test and 3rd follow-up GCQ psychospiritual, environmental and sociocultural comfort sub-scale, relief, relaxation and superiority levels (p<0.05). Conclusion: Progressive muscle relaxation was effective on reducing the postpartum depression risk and increasing general comfort. It is recommended to provide progressive muscle relaxation training to women in the postpartum period as well as ensuring the continuity of this practice.

Keywords: general comfort, postpartum depression, postpartum period, progressive muscle relaxation

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1340 Facial Recognition of University Entrance Exam Candidates using FaceMatch Software in Iran

Authors: Mahshid Arabi

Abstract:

In recent years, remarkable advancements in the fields of artificial intelligence and machine learning have led to the development of facial recognition technologies. These technologies are now employed in a wide range of applications, including security, surveillance, healthcare, and education. In the field of education, the identification of university entrance exam candidates has been one of the fundamental challenges. Traditional methods such as using ID cards and handwritten signatures are not only inefficient and prone to fraud but also susceptible to errors. In this context, utilizing advanced technologies like facial recognition can be an effective and efficient solution to increase the accuracy and reliability of identity verification in entrance exams. This article examines the use of FaceMatch software for recognizing the faces of university entrance exam candidates in Iran. The main objective of this research is to evaluate the efficiency and accuracy of FaceMatch software in identifying university entrance exam candidates to prevent fraud and ensure the authenticity of individuals' identities. Additionally, this research investigates the advantages and challenges of using this technology in Iran's educational systems. This research was conducted using an experimental method and random sampling. In this study, 1000 university entrance exam candidates in Iran were selected as samples. The facial images of these candidates were processed and analyzed using FaceMatch software. The software's accuracy and efficiency were evaluated using various metrics, including accuracy rate, error rate, and processing time. The research results indicated that FaceMatch software could accurately identify candidates with a precision of 98.5%. The software's error rate was less than 1.5%, demonstrating its high efficiency in facial recognition. Additionally, the average processing time for each candidate's image was less than 2 seconds, indicating the software's high efficiency. Statistical evaluation of the results using precise statistical tests, including analysis of variance (ANOVA) and t-test, showed that the observed differences were significant, and the software's accuracy in identity verification is high. The findings of this research suggest that FaceMatch software can be effectively used as a tool for identifying university entrance exam candidates in Iran. This technology not only enhances security and prevents fraud but also simplifies and streamlines the exam administration process. However, challenges such as preserving candidates' privacy and the costs of implementation must also be considered. The use of facial recognition technology with FaceMatch software in Iran's educational systems can be an effective solution for preventing fraud and ensuring the authenticity of university entrance exam candidates' identities. Given the promising results of this research, it is recommended that this technology be more widely implemented and utilized in the country's educational systems.

Keywords: facial recognition, FaceMatch software, Iran, university entrance exam

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1339 First-Trimester Screening of Preeclampsia in a Routine Care

Authors: Tamar Grdzelishvili, Zaza Sinauridze

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Introduction: Preeclampsia is a complication of the second trimester of pregnancy, which is characterized by high morbidity and multiorgan damage. Many complex pathogenic mechanisms are now implicated to be responsible for this disease (1). Preeclampsia is one of the leading causes of maternal mortality worldwide. Statistics are enough to convince you of the seriousness of this pathology: about 100,000 women die of preeclampsia every year. It occurs in 3-14% (varies significantly depending on racial origin or ethnicity and geographical region) of pregnant women, in 75% of cases - in a mild form, and in 25% - in a severe form. During severe pre-eclampsia-eclampsia, perinatal mortality increases by 5 times and stillbirth by 9.6 times. Considering that the only way to treat the disease is to end the pregnancy, the main thing is timely diagnosis and prevention of the disease. Identification of high-risk pregnant women for PE and giving prophylaxis would reduce the incidence of preterm PE. First-trimester screening model developed by the Fetal Medicine Foundation (FMF), which uses the Bayes-theorem to combine maternal characteristics and medical history together with measurements of mean arterial pressure, uterine artery pulsatility index, and serum placental growth factor, has been proven to be effective and have superior screening performance to that of traditional risk factor-based approach for the prediction of PE (2) Methods: Retrospective single center screening study. The study population consisted of women from the Tbilisi maternity hospital “Pineo medical ecosystem” who met the following criteria: they spoke Georgian, English, or Russian and agreed to participate in the study after discussing informed consent and answering questions. Prior to the study, the informed consent forms approved by the Institutional Review Board were obtained from the study subjects. Early assessment of preeclampsia was performed between 11-13 weeks of pregnancy. The following were evaluated: anamnesis, dopplerography of the uterine artery, mean arterial blood pressure, and biochemical parameter: Pregnancy-associated plasma protein A (PAPP-A). Individual risk assessment was performed with performed by Fast Screen 3.0 software ThermoFisher scientific. Results: A total of 513 women were recruited and through the study, 51 women were diagnosed with preeclampsia (34.5% in the pregnant women with high risk, 6.5% in the pregnant women with low risk; P<0.000 1). Conclusions: First-trimester screening combining maternal factors with uterine artery Doppler, blood pressure, and pregnancy-associated plasma protein-A is useful to predict PE in a routine care setting. More patient studies are needed for final conclusions. The research is still ongoing.

Keywords: first-trimester, preeclampsia, screening, pregnancy-associated plasma protein

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1338 Comparative Histological, Immunohistochemical and Biochemical Study on the Effect of Vit. C, Vit. E, Gallic Acid and Silymarin on Carbon Tetrachloride Model of Liver Fibrosis in Rats

Authors: Safaa S. Hassan, Mohammed H. Elbakry, Safwat A. Mangoura, Zainab M. Omar

Abstract:

Background: Liver fibrosis is the main reason for increased mortality in chronic liver disease. It has no standard treatment. Antioxidants from a variety of sources are capable of slowing or preventing oxidation of other molecules. Aim: to evaluate the hepatoprotective effect of vit. C, vit. E and gallic acid in comparison to silymarin in the rat model of carbon tetrachloride induced liver fibrosis and their possible mechanisms of action. Material& Methods: A total number of 60 adult male albino rats 160-200gm were divided into six equal groups; received subcutaneous (s.c) injection for 8 weeks. Group I: as control. Group II: received 1.5 mL/kg of CCL4 .Group III: CCL4 and co- treatment with silymarin 100mg/kg p.o. daily. Group IV: CCL4 and co-treatment with vit. C 50mg/kg p.o. daily. Group V: CCL4 and co-treatment with vit. E 200mg/kg. p.o. Group VI: CCL4 and co-treatment with Gallic acid 100mg/kg. p.o. daily. Liver was processed for histological and immunohistochemical examination. Levels of AST, ALT, ALP, reduced GSH, MDA, SOD and hydroxyproline concentration were measured and evaluated statistically. Results: Light and electron microscopic examination of liver of group II exhibited foci of altered cells with dense nuclei and vacuolated, granular cytoplasm, mononuclear cell infiltration in portal areas, profuse collagen fiber deposits were found around portal tract, more intense staining α-SMA-positive cells occupied most of the liver fibrosis tissue, electron lucent areas in the cytoplasm of the hepatocytes, margination of nuclear chromatin. Treatment by any of the antioxidants variably reduced the hepatic structural changes induced by CCL4. Biochemical analysis showed that carbon tetrachloride significantly increased the levels of serum AST, ALT, ALP, hepatic malondialdehyde and hydroxyproline content. Moreover, it decreased the activities of superoxide dismutase and glutathione. Treatment with silymarin, gallic acid, vit. C and vit. E decreased significantly the AST, ALT, and ALP levels in plasma, MDA and hydroxyproline and increased the activities of SOD and glutathione in liver tissue. The effect of administration of CCl4 was improved with the used antioxidants in variable degrees. The most efficient antioxidant was silymarin followed by gallic acid and vit. C then vit. E. It is possibly due to their antioxidant effect, free radical scavenging properties and the reduction of oxidant dependent activation and proliferation of HSCs. Conclusion: So these antioxidants can be a promising drugs candidate for ameliorating liver fibrosis better than the use of the drugs and their side effects.

Keywords: antioxidant, ccl4, gallic acid, liver fibrosis

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1337 Spare Part Carbon Footprint Reduction with Reman Applications

Authors: Enes Huylu, Sude Erkin, Nur A. Özdemir, Hatice K. Güney, Cemre S. Atılgan, Hüseyin Y. Altıntaş, Aysemin Top, Muammer Yılman, Özak Durmuş

Abstract:

Remanufacturing (reman) applications allow manufacturers to contribute to the circular economy and help to introduce products with almost the same quality, environment-friendly, and lower cost. The objective of this study is to present that the carbon footprint of automotive spare parts used in vehicles could be reduced by reman applications based on Life Cycle Analysis which was framed with ISO 14040 principles. In that case, it was aimed to investigate reman applications for 21 parts in total. So far, research and calculations have been completed for the alternator, turbocharger, starter motor, compressor, manual transmission, auto transmission, and DPF (diesel particulate filter) parts, respectively. Since the aim of Ford Motor Company and Ford OTOSAN is to achieve net zero based on Science-Based Targets (SBT) and the Green Deal that the European Union sets out to make it climate neutral by 2050, the effects of reman applications are researched. In this case, firstly, remanufacturing articles available in the literature were searched based on the yearly high volume of spare parts sold. Paper review results related to their material composition and emissions released during incoming production and remanufacturing phases, the base part has been selected to take it as a reference. Then, the data of the selected base part from the research are used to make an approximate estimation of the carbon footprint reduction of the relevant part used in Ford OTOSAN. The estimation model is based on the weight, and material composition of the referenced paper reman activity. As a result of this study, it was seen that remanufacturing applications are feasible to apply technically and environmentally since it has significant effects on reducing the emissions released during the production phase of the vehicle components. For this reason, the research and calculations of the total number of targeted products in yearly volume have been completed to a large extent. Thus, based on the targeted parts whose research has been completed, in line with the net zero targets of Ford Motor Company and Ford OTOSAN by 2050, if remanufacturing applications are preferred instead of recent production methods, it is possible to reduce a significant amount of the associated greenhouse gas (GHG) emissions of spare parts used in vehicles. Besides, it is observed that remanufacturing helps to reduce the waste stream and causes less pollution than making products from raw materials by reusing the automotive components.

Keywords: greenhouse gas emissions, net zero targets, remanufacturing, spare parts, sustainability

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1336 Reconstruction of Alveolar Bone Defects Using Bone Morphogenetic Protein 2 Mediated Rabbit Dental Pulp Stem Cells Seeded on Nano-Hydroxyapatite/Collagen/Poly(L-Lactide)

Authors: Ling-Ling E., Hong-Chen Liu, Dong-Sheng Wang, Fang Su, Xia Wu, Zhan-Ping Shi, Yan Lv, Jia-Zhu Wang

Abstract:

Objective: The objective of the present study is to evaluate the capacity of a tissue-engineered bone complex of recombinant human bone morphogenetic protein 2 (rhBMP-2) mediated dental pulp stem cells (DPSCs) and nano-hydroxyapatite/collagen/poly(L-lactide)(nHAC/PLA) to reconstruct critical-size alveolar bone defects in New Zealand rabbit. Methods: Autologous DPSCs were isolated from rabbit dental pulp tissue and expanded ex vivo to enrich DPSCs numbers, and then their attachment and differentiation capability were evaluated when cultured on the culture plate or nHAC/PLA. The alveolar bone defects were treated with nHAC/PLA, nHAC/PLA+rhBMP-2, nHAC/PLA+DPSCs, nHAC/PLA+DPSCs+rhBMP-2, and autogenous bone (AB) obtained from iliac bone or were left untreated as a control. X-ray and a polychrome sequential fluorescent labeling were performed post-operatively and the animals were sacrificed 12 weeks after operation for histological observation and histomorphometric analysis. Results: Our results showed that DPSCs expressed STRO-1 and vementin, and favoured osteogenesis and adipogenesis in conditioned media. DPSCs attached and spread well, and retained their osteogenic phenotypes on nHAC/PLA. The rhBMP-2 could significantly increase protein content, alkaline phosphatase (ALP) activity/protein, osteocalcin (OCN) content, and mineral formation of DPSCs cultured on nHAC/PLA. The X-ray graph, the fluorescent, histological observation and histomorphometric analysis showed that the nHAC/PLA+DPSCs+rhBMP-2 tissue-engineered bone complex had an earlier mineralization and more bone formation inside the scaffold than nHAC/PLA, nHAC/PLA+rhBMP-2 and nHAC/PLA+DPSCs, or even autologous bone. Implanted DPSCs contribution to new bone were detected through transfected eGFP genes. Conclutions: Our findings indicated that stem cells existed in adult rabbit dental pulp tissue. The rhBMP-2 promoted osteogenic capability of DPSCs as a potential cell source for periodontal bone regeneration. The nHAC/PLA could serve as a good scaffold for autologous DPSCs seeding, proliferation and differentiation. The tissue-engineered bone complex with nHAC/PLA, rhBMP-2, and autologous DPSCs might be a better alternative to autologous bone for the clinical reconstruction of periodontal bone defects.

Keywords: nano-hydroxyapatite/collagen/poly (L-lactide), dental pulp stem cell, recombinant human bone morphogenetic protein, bone tissue engineering, alveolar bone

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1335 Movie and Theater Marketing Using the Potentials of Social Networks

Authors: Seyed Reza Naghibulsadat

Abstract:

The nature of communication includes various forms of media productions, which include film and theater. In the current situation, since social networks have emerged, they have brought their own communication capabilities and have features that show speed, public access, lack of media organization and the production of extensive content, and the development of critical thinking; Also, they contain capabilities to develop access to all kinds of media productions, including movies and theater shows; Of course, this works differently in different conditions and communities. In terms of the scale of exploitation, the film has a more general audience, and the theater has a special audience. The film industry is more developed based on more modern technologies, but the theater, based on the older ways of communication, contains more intimate and emotional aspects. ; But in general, the main focus is the development of access to movies and theater shows, which is emphasized by those involved in this field due to the capabilities of social networks. In this research, we will look at these 2 areas and the relevant components for both areas through social networks and also the common points of both types of media production. The main goal of this research is to know the strengths and weaknesses of using social networks for the marketing of movies and theater shows and, at the same time are, also considered the opportunities and threats of this field. The attractions of these two types of media production, with the emergence of social networks, and the ability to change positions, can provide the opportunity to become a media with greater exploitation and higher profitability; But the main consideration is the opinions about these capabilities and the ability to use them for film and theater marketing. The main question of the research is, what are the marketing components for movies and theaters using social media capabilities? What are its strengths and weaknesses? And what opportunities and threats are facing this market? This research has been done with two methods SWOT and meta-analysis. Non-probability sampling has been used with purposeful technique. The results show that a recent approach is an approach based on eliminating threats and weaknesses and emphasizing strengths, and exploiting opportunities in the direction of developing film and theater marketing based on the capabilities of social networks within the framework of local cultural values and presenting achievements on an international scale or It is universal. This introduction leads to the introduction of authentic Iranian culture and foreign enthusiasts in the framework of movies and theater art. Therefore, for this issue, the model for using the capabilities of social networks for movie or theater marketing, according to the results obtained from Respondents, is a model based on SO strategies and, in other words, offensive strategies so that it can take advantage of the internal strengths and made maximum use of foreign situations and opportunities to develop the use of movies and theater performances.

Keywords: marketing, movies, theatrical show, social network potentials

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1334 Predictors for Success in Methadone Maintenance Treatment Clinic: 24 Years of Experience

Authors: Einat E. Peles, Shaul Schreiber, Miriam Adelson

Abstract:

Background: Since established more than 50 years ago, methadone maintenance treatment (MMT) is the most effective treatment for opioid addiction, a chronic relapsing brain disorder that became an epidemic in western societies. Treatment includes daily individual optimal medication methadone dose (a long acting mu opioid receptor full agonist), accompanied with psychosocial therapy. It is well established that the longer retention in treatment the better outcome and survival occur. It reduces the likelihood to infectious diseases and overdose death that associated with drug injecting, enhanced social rehabilitation and eliminate criminal activity, and lead to healthy productive life. Aim: To evaluate predictors for long term retention in treatment we analyzed our prospective follow up of a major MMT clinic affiliated to a big tertiary medical center. Population Methods: Between June 25, 1993, and June 24, 2016, all 889 patients ( ≥ 18y) who ever admitted to the clinic were prospectively followed-up until May 2017. Duration in treatment from the first admission until the patient quit treatment or until the end of follow-up (24 years) was taken for calculating cumulative retention in treatment using survival analyses (Kaplan Meier) with log-rank and Cox regression for multivariate analyses. Results: Of the 889 patients, 25.2% were females who admitted to treatment at younger age (35.0 ± 7.9 vs. 40.6 ± 9.8, p < .0005), but started opioid usage at same age (22.3 ± 6.9). In addition to opioid use, on admission to MMT 58.5% had positive urine for benzodiazepines, 25% to cocaine, 12.4% to cannabis and 6.9% to amphetamines. Hepatitis C antibody tested positive in 55%, and HIV in 7.8% of the patients and 40%. Of all patients, 75.7% stayed at least one year in treatment, and of them, 67.7% stopped opioid usage (based on urine tests), and a net reduction observed in all other substance abuse (proportion of those who stopped minus proportion of those who have started). Long term retention up to 24 years was 8.0 years (95% Confidence Interval (CI) 7.4-8.6). Predictors for longer retention in treatment (Cox regression) were being older on admission ( ≥ 30y) Odds Ratio (OR) =1.4 (CI 1.1-1.8), not abusing opioids after one year OR=1.8 (CI 1.5-2.1), not abusing benzodiazepine after one year OR=1.7 (CI 1.4-2.1) and treating with methadone dose ≥ 100mg/day OR =1.8 (CI 1.5-2.3). Conclusions: Treating and following patients over 24 years indicate success of two main outcomes, high rate of retention after one year (75.7%) and high proportion of opiate abuse cessation (67.7%). As expected, longer cumulative retention was associated with patients treated with high adequate methadone dose that successfully result in opioid cessation. Based on these findings, in order to reduce morbidity and mortality, we find the establishment of more MMT clinics within a general hospital, a most urgent necessity.

Keywords: methadone maintenance treatment, epidemic, opioids, retention

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1333 Estimation of Soil Nutrient Content Using Google Earth and Pleiades Satellite Imagery for Small Farms

Authors: Lucas Barbosa Da Silva, Jun Okamoto Jr.

Abstract:

Precision Agriculture has long being benefited from crop fields’ aerial imagery. This important tool has allowed identifying patterns in crop fields, generating useful information to the production management. Reflectance intensity data in different ranges from the electromagnetic spectrum may indicate presence or absence of nutrients in the soil of an area. Different relations between the different light bands may generate even more detailed information. The knowledge of the nutrients content in the soil or in the crop during its growth is a valuable asset to the farmer that seeks to optimize its yield. However, small farmers in Brazil often lack the resources to access this kind information, and, even when they do, it is not presented in a comprehensive and/or objective way. So, the challenges of implementing this technology ranges from the sampling of the imagery, using aerial platforms, building of a mosaic with the images to cover the entire crop field, extracting the reflectance information from it and analyzing its relationship with the parameters of interest, to the display of the results in a manner that the farmer may take the necessary decisions more objectively. In this work, it’s proposed an analysis of soil nutrient contents based on image processing of satellite imagery and comparing its outtakes with commercial laboratory’s chemical analysis. Also, sources of satellite imagery are compared, to assess the feasibility of using Google Earth data in this application, and the impacts of doing so, versus the application of imagery from satellites like Landsat-8 and Pleiades. Furthermore, an algorithm for building mosaics is implemented using Google Earth imagery and finally, the possibility of using unmanned aerial vehicles is analyzed. From the data obtained, some soil parameters are estimated, namely, the content of Potassium, Phosphorus, Boron, Manganese, among others. The suitability of Google Earth Imagery for this application is verified within a reasonable margin, when compared to Pleiades Satellite imagery and to the current commercial model. It is also verified that the mosaic construction method has little or no influence on the estimation results. Variability maps are created over the covered area and the impacts of the image resolution and sample time frame are discussed, allowing easy assessments of the results. The final results show that easy and cheaper remote sensing and analysis methods are possible and feasible alternatives for the small farmer, with little access to technological and/or financial resources, to make more accurate decisions about soil nutrient management.

Keywords: remote sensing, precision agriculture, mosaic, soil, nutrient content, satellite imagery, aerial imagery

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