Search results for: difficult airway
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2715

Search results for: difficult airway

765 Study on Accurate Calculation Method of Model Attidude on Wind Tunnel Test

Authors: Jinjun Jiang, Lianzhong Chen, Rui Xu

Abstract:

The accurate of model attitude angel plays an important role on the aerodynamic test results in the wind tunnel test. The original method applies the spherical coordinate system transformation to obtain attitude angel calculation.The model attitude angel is obtained by coordinate transformation and spherical surface mapping applying the nominal attitude angel (the balance attitude angel in the wind tunnel coordinate system) indicated by the mechanism. First, the coordinate transformation of this method is not only complex but also difficult to establish the transformed relationship between the space coordinate systems especially after many steps of coordinate transformation, moreover it cannot realize the iterative calculation of the interference relationship between attitude angels; Second, during the calculate process to solve the problem the arc is approximately used to replace the straight line, the angel for the tangent value, and the inverse trigonometric function is applied. Therefore, in the calculation of attitude angel, the process is complex and inaccurate, which can be solved approximately when calculating small attack angel. However, with the advancing development of modern aerodynamic unsteady research, the aircraft tends to develop high or super large attack angel and unsteadyresearch field.According to engineering practice and vector theory, the concept of vector angel coordinate systemis proposed for the first time, and the vector angel coordinate system of attitude angel is established.With the iterative correction calculation and avoiding the problem of approximate and inverse trigonometric function solution, the model attitude calculation process is carried out in detail, which validates that the calculation accuracy and accuracy of model attitude angels are improved.Based on engineering and theoretical methods, a vector angel coordinate systemis established for the first time, which gives the transformation and angel definition relations between different flight attitude coordinate systems, that can accurately calculate the attitude angel of the corresponding coordinate systemand determine its direction, especially in the channel coupling calculation, the calculation of the attitude angel between the coordinate systems is only related to the angel, and has nothing to do with the change order s of the coordinate system, whichsimplifies the calculation process.

Keywords: attitude angel, angel vector coordinate system, iterative calculation, spherical coordinate system, wind tunnel test

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764 Research on the Effectiveness of Online Guided Case Teaching in Problem-Based Learning: A Preschool Special Education Course

Authors: Chen-Ya Juan

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Problem-Based Learning uses vague questions to guide student thinking and enhance their self-learning and collaboration. Most teachers implement PBL in a physical classroom, where teachers can monitor and evaluate students’ learning progress and guide them to search resources for answers. However, the prevalence of the Covid-19 in the world had changed from physical teaching to distance teaching. This instruction used many cases and applied Problem-Based Learning combined on the distance teaching via the internet for college students. This study involved an experimental group with PBL and a control group without PBL. The teacher divided all students in PBL class into eight groups, and 7~8 students in each group. The teacher assigned different cases for each group of the PBL class. Three stages of instruction were developed, including background knowledge of Learning, case analysis, and solving problems for each case. This study used a quantitative research method, a two-sample t-test, to find a significant difference in groups with PBL and without PBL. Findings indicated that PBL incased the average score of special education knowledge. The average score was improved by 20.46% in the PBL group and 15.4% without PBL. Results didn’t show significant differences (0.589>0.05) in special education professional knowledge. However, the feedback of the PBL students implied learning more about the application, problem-solving skills, and critical thinking. PBL students were more likely to apply professional knowledge on the actual case, find questions, resources, and answers. Most of them understood the importance of collaboration, working as a team, and communicating with other team members. The suggestions of this study included that (a) different web-based teaching instruments influenced student’s Learning; (b) it is difficult to monitor online PBL progress; (c) online PBL should be implemented flexible and multi-oriented; (d) although PBL did not show a significant difference on the group with PBL and without PBL, it did increase student’s problem-solving skills and critical thinking.

Keywords: problem-based learning, college students, distance learning, case analysis, problem-solving

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763 Clinicians’ Perspectives on Child Language Brokering

Authors: Carmen Pena-Díaz

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Linguistic and cultural difficulties regarding the access and use of public services, as well as facilitating communication at all levels, are problems which have not yet been tackled by authorities in Spain. In fact, linguistic and cultural issues are often not recognised as an integral part of migratory movements or social integration. While professionals of interlinguistic and intercultural communication (translators, interpreters, mediators) know that language and culture are key components to achieve immigrant integration and consolidate a truly multilingual society, policymakers at local, national, or supranational levels do not always seem aware of the risks and costs of not providing interpreting and translation services, particularly those affecting the health of users. Regarding the services currently used to cover the communication-related needs between the non-Spanish speaking population and healthcare professionals, evidence proves that there are no effective provisions for communication problems at present in Spanish hospitals. An example that suggests the poor management of the situation in relation to the migrants’ access to public healthcare is the fact that relying on a family member (often a minor) in medical consultations is one of the main practices that affects communication. At present, most medical professionals will explain that in their consultations with migrants who do not speak Spanish, they ask them to bring along a family member or friend who speaks Spanish. In fact, an abundant body of literature describes situations in which family members, children, friends, or anyone who speaks or understands a language helps to break language barriers in hospitals, not only in Spain. It is not difficult to see the problems this may cause, from ethical issues to comprehension problems and misunderstandings. This paper will present the results of Narrative Inquiry from a sample of eight clinicians about their perceptions and experiences using child language brokers in their appointments with non-Spanish speaking families. The main aim is to collect information about child language brokering as recalled and perceived by clinicians who present CLB as a routine practice and express their concerns and worries about using children to convey negative news to their parents or family members.

Keywords: child language brokering, community interpreting, healthcare, PSIT

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762 A Study of the Frequency of Individual Support for the Pupils With Developmental Disabilities or Suspected Developmental Disabilities in Regular Japanese School Classes - From a Questionnaire Survey of Teachers

Authors: Maho Komura

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The purpose of this study was to determine from a questionnaire survey of teachers the status of implementation of individualized support for the pupils with suspected developmental disabilities in regular elementary school classes in Japan. In inclusive education, the goal is for all pupils to learn in the same place as much as possible by receiving the individualized support they need. However, in the Japanese school culture, strong "homogeneity" sometimes surfaces, and it is pointed out that it is difficult to provide individualized support from the viewpoint of formal equality. Therefore, we decided to conduct this study in order to examine whether there is a difference in the frequency of implementation depending on the content of individualized support and to consider the direction of future individualized support. The subjects of the survey were 196 public elementary school teachers who had been in charge of regular classes within the past five years. In the survey, individualized support was defined as individualized consideration including rational consideration, and did not include support for the entire class or all pupils enrolled in the class (e.g., reducing the amount of homework for pupils who have trouble learning, changing classroom rules, etc.). (e.g., reducing the amount of homework for pupils with learning difficulties, allowing pupils with behavioral concerns to use the library or infirmary when they are unstable). The respondents were asked to choose one answer from four options, ranging from "very much" to "not at all," regarding the degree to which they implemented the nine individual support items that were set up with reference to previous studies. As a result, it became clear that the majority of teachers had pupils with developmental disabilities or pupils who require consideration in terms of learning and behavior, and that the majority of teachers had experience in providing individualized support to these pupils. Investigating the content of the individualized support that had been implemented, it became clear that the frequency with which it was implemented varied depending on the individualized support. Individualized support that allowed pupils to perform the same learning tasks was implemented more frequently, but individualized support that allowed different learning tasks or use of places other than the classroom was implemented less frequently. It was suggested that flexible support methods tailored to each pupil may not have been considered.

Keywords: inclusive education, ndividualized support, regular class, elementary school

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761 Embedding Employability in the Curriculum: Experiences from New Zealand

Authors: Narissa Lewis, Susan Geertshuis

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The global and national employability agenda is changing the higher education landscape as academic staff are faced with the responsibility of developing employability capabilities and attributes in addition to delivering discipline specific content and skills. They realise that the shift towards teaching sustainable capabilities means a shift in the way they teach. But what that shift should be or how they should bring it about is unclear. As part of a national funded project, representatives from several New Zealand (NZ) higher education institutions and the NZ Association of Graduate Employers partnered to discover, trial and disseminate means of embedding employability in the curriculum. Findings from four focus groups (n=~75) and individual interviews (n=20) with staff from several NZ higher education institutions identified factors that enable or hinder embedded employability development within their respective institutions. Participants believed that higher education institutions have a key role in developing graduates for successful lives and careers however this requires a significant shift in culture within their respective institutions. Participants cited three main barriers: lack of strategic direction, support and guidance; lack of understanding and awareness of employability; and lack of resourcing and staff capability. Without adequate understanding and awareness of employability, participants believed it is difficult to understand what employability is let alone how it can be embedded in the curriculum. This presentation will describe some of the impacts that the employability agenda has on staff as they try to move from traditional to contemporary forms of teaching to develop employability attributes of students. Changes at the institutional level are required to support contemporary forms of teaching, however this is often beyond the sphere of influence at the teaching staff level. The study identified that small changes to teaching practices were necessary and a simple model to facilitate change from traditional to contemporary forms of teaching was developed. The model provides a framework to identify small but impactful teaching practices and exemplar teaching practices were identified. These practices were evaluated for transferability into other contexts to encourage small but impactful changes to embed employability in the curriculum.

Keywords: curriculum design, change management, employability, teaching exemplars

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760 A Study on Conventional and Improved Tillage Practices for Sowing Paddy in Wheat Harvested Field

Authors: R. N. Pateriya, T. K. Bhattacharya

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In India, rice-wheat cropping system occupies the major area and contributes about 40% of the country’s total food grain production. It is necessary that production of rice and wheat must keep pace with growing population. However, various factors such as degradation in natural resources, shift in cropping pattern, energy constraints etc. are causing reduction in the productivity of these crops. Seedbed for rice after wheat is difficult to prepare due to presence of straw and stubbles, and require excessive tillage operations to bring optimum tilth. In addition, delayed sowing and transplanting of rice is mainly due to poor crop residue management, multiplicity of tillage operations and non-availability of the power source. With increasing concern for fuel conservation and energy management, farmers might wish to estimate the best cultivation system for more productivity. The widest spread method of tilling land is ploughing with mould board plough. However, with the mould board plough upper layer of soil is neither always loosened at the desired extent nor proper mixing of different layers are achieved. Therefore, additional operations carried out to improve tilth. The farmers are becoming increasingly aware of the need for minimum tillage by minimizing the use of machines. Soil management can be achieved by using the combined active-passive tillage machines. A study was therefore, undertaken in wheat-harvested field to study the impact of conventional and modified tillage practices on paddy crop cultivation. Tillage treatments with tractor as a power source were selected during the experiment. The selected level of tillage treatments of tractor machinery management were (T1:- Direct Sowing of Rice), (T2:- 2 to 3 harrowing and no Puddling with manual transplanting), (T3:- 2 to 3 harrowing and Puddling with paddy harrow with manual transplanting), (T4:- 2 to 3 harrowing and Puddling with Rotavator with manual transplanting). The maximum output was obtained with treatment T1 (7.85 t/ha)) followed by T4 (6.4 t/ha), T3 (6.25 t/ha) and T2 (6.0 t/ha)) respectively.

Keywords: crop residues, cropping system, minimum tillage, yield

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759 Combining Multiscale Patterns of Weather and Sea States into a Machine Learning Classifier for Mid-Term Prediction of Extreme Rainfall in North-Western Mediterranean Sea

Authors: Pinel Sebastien, Bourrin François, De Madron Du Rieu Xavier, Ludwig Wolfgang, Arnau Pedro

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Heavy precipitation constitutes a major meteorological threat in the western Mediterranean. Research has investigated the relationship between the states of the Mediterranean Sea and the atmosphere with the precipitation for short temporal windows. However, at a larger temporal scale, the precursor signals of heavy rainfall in the sea and atmosphere have drawn little attention. Moreover, despite ongoing improvements in numerical weather prediction, the medium-term forecasting of rainfall events remains a difficult task. Here, we aim to investigate the influence of early-spring environmental parameters on the following autumnal heavy precipitations. Hence, we develop a machine learning model to predict extreme autumnal rainfall with a 6-month lead time over the Spanish Catalan coastal area, based on i) the sea pattern (main current-LPC and Sea Surface Temperature-SST) at the mesoscale scale, ii) 4 European weather teleconnection patterns (NAO, WeMo, SCAND, MO) at synoptic scale, and iii) the hydrological regime of the main local river (Rhône River). The accuracy of the developed model classifier is evaluated via statistical analysis based on classification accuracy, logarithmic and confusion matrix by comparing with rainfall estimates from rain gauges and satellite observations (CHIRPS-2.0). Sensitivity tests are carried out by changing the model configuration, such as sea SST, sea LPC, river regime, and synoptic atmosphere configuration. The sensitivity analysis suggests a negligible influence from the hydrological regime, unlike SST, LPC, and specific teleconnection weather patterns. At last, this study illustrates how public datasets can be integrated into a machine learning model for heavy rainfall prediction and can interest local policies for management purposes.

Keywords: extreme hazards, sensitivity analysis, heavy rainfall, machine learning, sea-atmosphere modeling, precipitation forecasting

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758 Formulating a Definition of Hate Speech: From Divergence to Convergence

Authors: Avitus A. Agbor

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Numerous incidents, ranging from trivial to catastrophic, do come to mind when one reflects on hate. The victims of these belong to specific identifiable groups within communities. These experiences evoke discussions on Islamophobia, xenophobia, homophobia, anti-Semitism, racism, ethnic hatred, atheism, and other brutal forms of bigotry. Common to all these is an invisible but portent force that drives all of them: hatred. Such hatred is usually fueled by a profound degree of intolerance (to diversity) and the zeal to impose on others their beliefs and practices which they consider to be the conventional norm. More importantly, the perpetuation of these hateful acts is the unfortunate outcome of an overplay of invectives and hate speech which, to a greater extent, cannot be divorced from hate. From a legal perspective, acknowledging the existence of an undeniable link between hate speech and hate is quite easy. However, both within and without legal scholarship, the notion of “hate speech” remains a conundrum: a phrase that is quite easily explained through experiences than propounding a watertight definition that captures the entire essence and nature of what it is. The problem is further compounded by a few factors: first, within the international human rights framework, the notion of hate speech is not used. In limiting the right to freedom of expression, the ICCPR simply excludes specific kinds of speeches (but does not refer to them as hate speech). Regional human rights instruments are not so different, except for the subsequent developments that took place in the European Union in which the notion has been carefully delineated, and now a much clearer picture of what constitutes hate speech is provided. The legal architecture in domestic legal systems clearly shows differences in approaches and regulation: making it more difficult. In short, what may be hate speech in one legal system may very well be acceptable legal speech in another legal system. Lastly, the cornucopia of academic voices on the issue of hate speech exude the divergence thereon. Yet, in the absence of a well-formulated and universally acceptable definition, it is important to consider how hate speech can be defined. Taking an evidence-based approach, this research looks into the issue of defining hate speech in legal scholarship and how and why such a formulation is of critical importance in the prohibition and prosecution of hate speech.

Keywords: hate speech, international human rights law, international criminal law, freedom of expression

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757 Evaluation of a Piecewise Linear Mixed-Effects Model in the Analysis of Randomized Cross-over Trial

Authors: Moses Mwangi, Geert Verbeke, Geert Molenberghs

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Cross-over designs are commonly used in randomized clinical trials to estimate efficacy of a new treatment with respect to a reference treatment (placebo or standard). The main advantage of using cross-over design over conventional parallel design is its flexibility, where every subject become its own control, thereby reducing confounding effect. Jones & Kenward, discuss in detail more recent developments in the analysis of cross-over trials. We revisit the simple piecewise linear mixed-effects model, proposed by Mwangi et. al, (in press) for its first application in the analysis of cross-over trials. We compared performance of the proposed piecewise linear mixed-effects model with two commonly cited statistical models namely, (1) Grizzle model; and (2) Jones & Kenward model, used in estimation of the treatment effect, in the analysis of randomized cross-over trial. We estimate two performance measurements (mean square error (MSE) and coverage probability) for the three methods, using data simulated from the proposed piecewise linear mixed-effects model. Piecewise linear mixed-effects model yielded lowest MSE estimates compared to Grizzle and Jones & Kenward models for both small (Nobs=20) and large (Nobs=600) sample sizes. It’s coverage probability were highest compared to Grizzle and Jones & Kenward models for both small and large sample sizes. A piecewise linear mixed-effects model is a better estimator of treatment effect than its two competing estimators (Grizzle and Jones & Kenward models) in the analysis of cross-over trials. The data generating mechanism used in this paper captures two time periods for a simple 2-Treatments x 2-Periods cross-over design. Its application is extendible to more complex cross-over designs with multiple treatments and periods. In addition, it is important to note that, even for single response models, adding more random effects increases the complexity of the model and thus may be difficult or impossible to fit in some cases.

Keywords: Evaluation, Grizzle model, Jones & Kenward model, Performance measures, Simulation

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756 An Investigation on Interactions between Social Security with Police Operation and Economics in the Field of Tourism

Authors: Mohammad Mahdi Namdari, Hosein Torki

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Security as an abstract concept, has involved human being from the beginning of creation to the present, and certainly to the future. Accordingly, battles, conflicts, challenges, legal proceedings, crimes and all issues related to human kind are associated with this concept. Today by interviewing people about their life, the security of societies and Social crimes are interviewed too. Along with the security as an infrastructure and vital concept, the economy and related issues e.g. welfare, per capita income, total government revenue, export, import and etc. is considered another infrastructure and vital concept. These two vital concepts (Security and Economic) have linked together complexly and significantly. The present study employs analytical-descriptive research method using documents and Statistics of official sources. Discovery and explanation of this mutual connection are comprising a profound and extensive research; so management, development and reform in system and relationships of the scope of this two concepts are complex and difficult. Tourism and its position in today's economy is one of the main pillars of the economy of the 21st century that maybe associate with the security and social crimes more than other pillars. Like all human activities, economy of societies and partially tourism dependent on security especially in the public and social security. On the other hand, the true economic development (generally) and the growth of the tourism industry (dedicated) are a security generating and supporting for it, because a dynamic economic infrastructure prevents the formation of centers of crime and illegal activities by providing a context for socio-economic development for all segments of society in a fair and humane. This relationship is a formula of the complexity between the two concept of economy and security. Police as a revealed or people-oriented organization in the field of security directly has linked with the economy of a community and is very effective In the face of the tourism industry. The relationship between security and national crime index, and economic indicators especially ones related to tourism is confirming above discussion that is notable. According to understanding processes about security and economic as two key and vital concepts are necessary and significant for sovereignty of governments.

Keywords: economic, police, tourism, social security

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755 The Experiences and Needs of Fathers’ of Children With Cancer in Coping With the Child's Illness

Authors: Karina Lõbus, Silver Muld, Kadri Kööp, Mare Tupits

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Aim: The aim of the research is to describe the experiences and needs of fathers’ of children with cancer in coping with the child's disease. Background: Today, about 80% of children diagnosed with malignancy in developed countries survive. Despite the positive statistics, recovery is not always certain, treatment is often very intensive and long-term. Cancer is affecting an increasing number of the population, which is increasing the demand for quality care, but the nature of expected care is currently unclear. This topic is important for the development of professional practice, as nurses complain that their knowledge to deal with the relatives of a patient with a difficult diagnosis is limited and would therefore like additional information to deal with the situation. Design: Qualitative, empirical, descriptive research. Method: The data were collected through semi-structured interviews and analysed by inductive content analysis method. Interviews were conducted during Autumn 2020. 4 subjects participated in the research. Results and Conclusions: The thesis revealed that fathers had different experiences and needs in dealing with the child's illness. Fathers' experiences of coping with child's diseases encompassed experiences with information, social relationships, healthcare, changes in personal health and experiences regarding the child. Regarding information, the respondents pointed out bad experiences with the availability of information and the ability to convey the necessary information. Experiences regarding social relationships included experiences with relatives and strangers. Regarding healthcare, fathers mentioned experiences related to the child's health and healthcare professionals. In regards to personal health, fathers pointed out negative changes in their mental and physical health. In relation to the child, the subjects revealed experiences regarding changed values, way of life and raising the child. According to the research, fathers’ needs in relation to dealing with child's cancer included material, social, and spiritual needs. In regard to material needs, fathers pointed out the need for state assistance and the needs related to the surrounding environment. The needs concerning social belonging involved needs for a driving force and involvement in the treatment process. Regarding spiritual needs, fathers expressed mixed feelings towards the need for outside and professional help.

Keywords: father, coping, cancer, child, experience, need

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754 The Role of Criminal Law in Combating Transnational Organized Crime

Authors: Rizoyeva Marjona Rustam Qizi

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Transnational organized crime (TOC) represents one of the most significant threats to global security and social stability in the 21st century. Criminal networks operating across borders engage in activities such as drug trafficking, human trafficking, arms smuggling, and cybercrime, exploiting legal loopholes and jurisdictional challenges. In response, criminal law has evolved to address the complexities of TOC through enhanced international cooperation, harmonization of legal standards, and stronger enforcement mechanisms. This abstract explores the role of criminal law in combating TOC, focusing on three key areas: legislative frameworks, international collaboration, and enforcement practices. First, the development of international legal instruments such as the United Nations Convention against Transnational Organized Crime (UNTOC) has facilitated the standardization of legal definitions and procedures. Countries have adopted these frameworks to ensure a coordinated response to TOC, closing jurisdictional gaps and simplifying extradition processes. Second, international collaboration among law enforcement agencies, facilitated by organizations like INTERPOL and Europol, has enhanced information sharing and joint operations, making it more difficult for criminal organizations to evade detection. Finally, advancements in technology have improved investigative techniques, enabling law enforcement to track and dismantle criminal networks more effectively. However, despite these achievements, challenges remain. Issues such as corruption, insufficient resources, and differing legal systems continue to hinder the global fight against TOC. In conclusion, criminal law plays a pivotal role in the global effort to combat transnational organized crime by providing a legal framework for prosecution and fostering international cooperation. Ongoing reforms and technological innovations are essential for overcoming existing challenges and ensuring a more secure future. This abstract highlights the need for continuous adaptation of criminal law to address the evolving nature of TOC and underscores the importance of a unified international approach in achieving long-term success.

Keywords: transnational organized crime, criminal law, international cooperation, legal frameworks

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753 Migrantional Entrepreneurship: Ethnography of a Journey That Changes Lives and the Territory

Authors: Francesca Alemanno

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As a complex socio-spatial phenomenon, migration is a practice that also contains a strong imaginative component with respect to the place that, through displacement, one person wants to reach. Every migrant has undertaken his journey having in his mind an image of the displacement he was about to make, of its implications and finally, of the place or city in which he was or would have liked to land. Often, however, the imaginary that has come to build before departure does not fully correspond to the reality of landing; this discrepancy, which can be more or less wide, plays an important role in the relationship that is established with the territory and in the evolution, therefore, of the city itself. In this sense, therefore, the clash that occurs between the imagined and the real is one of the factors that can contribute to making the entry of a migrant into new territory as critical as it can be. Starting from this perspective, the experiences of people who derive from a migratory context and who, over time, manage to create a bond with the land of reception, are taken into account as stories of resistance as they are necessarily charged with a force that is capable of driving difficult and articulated processes of change. The phenomenon of migrant entrepreneurship that is taken into consideration by this abstract plays a very important role because it highlights the story of many people who have managed to build such a close bond with the new territory of arrival that they can imagine and then realize the construction of their own personal business. The margin of contrast between the imagined city and the one that will be inhabited will be observed through the narratives of those who, through the realization of his business project has acted directly on the reality in which he landed. The margin of contrast that exists between the imagined city and the one actually inhabited, together with the implications that this may have on real life, has been observed and analyzed through a period of fieldwork, practicing ethnography, through the narratives of people who find themselves living in a new city as a result of a migration path, and has been contextualized with the support of semi-structured interviews and field notes. At the theoretical level, the research is inserted into a constructionist framework, particularly suited to detect and analyze processes of change, construction of the imaginary and its own modification, being able to capture the consequent repercussions of this process on the conceptual, emotional and practical level.

Keywords: entrepreneurship, imagination, migration, resistance

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752 An Online Questionnaire Investigating UK Mothers' Experiences of Bottle Refusal by Their Breastfed Baby

Authors: Clare Maxwell, Lorna Porcellato, Valerie Fleming, Kate Fleming

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A review of global online forums and social media reveals large numbers of mothers experiencing bottle refusal by their breastfed baby. It is difficult to determine precise numbers due to a lack of data, however, established virtual communities illustrate thousands of posts in relation to the issue. Mothers report various negative consequences of bottle refusal including delaying their return to work, time and financial outlay spent on methods to overcome it and experiencing stress, anxiety, and resentment of breastfeeding. A search of the literature revealed no studies being identified, and due to a lack of epidemiological data, a study investigating mother’s experiences of bottle refusal by their breastfed baby was undertaken. The aim of the study was to investigate UK mothers’ experiences of bottle refusal by their breastfed baby. Data were collected using an online questionnaire collecting quantitative and qualitative data. 841 UK mothers who had experienced or were experiencing bottle refusal by their breastfed baby completed the questionnaire. Data were analyzed using descriptive statistics and non-parametric testing. The results showed 61% (516/840) of mothers reported their breastfed baby was still refusing/had never accepted a bottle, with 39% (324/840) reporting their baby had eventually accepted. The most frequently reported reason to introduce a bottle was so partner/family could feed the baby 59% (499/839). 75% (634/841) of mothers intended their baby to feed on a bottle ‘occasionally’. Babies who accepted a bottle were more likely to be older at 1st attempt to introduce one than those babies who refused (Mdn = 12 weeks v 8 weeks, n = 286) (p = <0.001). Length of time taken to acceptance was 9 weeks (Mdn = 9, IQR = 18, R = 103.9, n = 306) with the older the baby was at 1st attempt to introduce a bottle being associated with a shorter length of time to acceptance (p = < 0.002). 60% (500/841) of mothers stated that none of the methods they used had worked. 26% (222/841) of mothers reported bottle refusal had had a negative impact upon their overall breastfeeding experience. 47% (303/604) reported they would have tried to introduce a bottle earlier to prevent refusal. This study provides a unique insight into the scenario of bottle refusal by breastfed babies. It highlights that bottle refusal by breastfed babies is a significant issue, which requires recognition from those communicating breastfeeding information to mothers.

Keywords: bottle feeding, bottle refusal, breastfeeding, infant feeding

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751 The Effect of Expanding the Early Pregnancy Assessment Clinic and COVID-19 on Emergency Department and Urgent Care Visits for Early Pregnancy Bleeding

Authors: Harley Bray, Helen Pymar, Michelle Liu, Chau Pham, Tomislav Jelic, Fran Mulhall

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Background: Our study assesses the impact of the COVID-19 pandemic on early pregnancy assessment clinic (EPAC) referrals and the use of virtual consultation in Winnipeg, Manitoba. Our clinic expanded to accept referrals from all Winnipeg Emergency Department (ED)/Urgent Care (UC) sites beginning November 2019 to April 2020. By May 2020, the COVID-19 pandemic reached Manitoba and EPAC virtual care was expanded by performing hCG remotely and reviewing blood and ED/UC ultrasound results by phone. Methods: Emergency Department Information Systems (EDIS) and EPAC data reviewed ED/UC visits for pregnancy <20 weeks and vaginal bleeding 1-year pre-COVID (March 12, 2019, to March 11, 2020) and during COVID (March 12, 2020 (first case in Manitoba) to March 11, 2021). Results: There were fewer patient visits for vaginal bleeding or pregnancy of <20 weeks (4264 vs. 5180), diagnoses of threatened abortion (1895 vs. 2283), and ectopic pregnancy (78 vs. 97) during COVID compared with pre-COVID, respectively. ICD 10 codes were missing in 849 (20%) and 1183 (23%) of patients during COVID and pre-COVID, respectively. Wait times for all patient visits improved during COVID-19 compared to pre-COVID (5.1 ± 4.4 hours vs. 5.5 ± 3.8 hours), more patients received obstetrical ultrasounds, 761 (18%) vs. 787 (15%), and fewer patients returned within 30 days (1360 (32%) vs. 1848 (36%); p<0.01). EPAC saw 708 patients (218; 31% new ED/UC) during COVID-19 compared to 552 (37; 7% new ED/UC) pre-COVID. Fewer operative interventions for pregnancy loss (346 vs. 456) and retained products (236 vs. 272) were noted. Surgeries to treat ectopic pregnancy (106 vs 113) remained stable during the study time interval. Conclusion: Accurate identification of pregnancy complications was difficult, with over 20% missing ICD-10 diagnostic codes. There were fewer ED/UC visits and surgical management for threatened abortion during COVID-19, but ectopic pregnancy operative management remained unchanged.

Keywords: early pregnancy, ultrasound, COVID-19, obstetrics

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750 In Vivo Investigation of microRNA Expression and Function at the Mammalian Synapse by AGO-APP

Authors: Surbhi Surbhi, Andrea Erni, Gunter Meister, Harold Cremer, Christophe Beclin

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MicroRNAs (miRNAs) are short 20-23 nucleotide long non-coding RNAs; there are 2605 miRNA in humans and 1936 miRNA in mouse in total (miRBase). The nervous system expresses the most abundant miRNA and most diverse. MiRNAs play a role in many steps during neurogenesis, like cell proliferation, differentiation, neural patterning, axon pathfinding, etc. Moreover, in vitro studies suggested a role in the regulation of local translation at the synapse, thus controlling neuronal plasticity. However, due to the specific structure of miRNA molecules, an in-vivo confirmation of the general role of miRNAs in the control of neuronal plasticity is still pending. For example, their small size and their high level of sequence homology make difficult the analysis of their cellular and sub-cellular localization in-vivo by in-situ hybridization. Moreover, it was found that only 40% of the expressed miRNA molecules in a cell are included in RNA-Induced Silencing Complexes (RISC) and, therefore, involved in inhibitory interactions while the rest is silent. Definitively, the development of new tools is needed to have a better understanding of the cellular function of miRNAs, in particular their role in neuronal plasticity. Here we describe a new technique called in-vivo AGO-APP designed to investigate miRNA expression and function in-vivo. This technique is based on the expression of a small peptide derived from the human RISC-complex protein TNRC6B, called T6B, which binds all known Argonaute (Ago) proteins with high affinity allowing the efficient immunoprecipitation of AGO-bound miRNAs. We have generated two transgenic mouse lines conditionally expressing T6B either ubiquitously in the cell or targeted at the synapse. A comparison of the repertoire of miRNAs immuno-precipitated from mature neurons of both mouse lines will provide us with a list of miRNAs showing a specific activity at the synapse. The physiological role of these miRNAs will be subsequently addressed through gain and loss of function experiments.

Keywords: RNA-induced silencing complexes, TNRC6B, miRNA, argonaute, synapse, neuronal plasticity, neurogenesis

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749 Integration of Design Management in the Product Development Process in SME's

Authors: Vitor Carneiro, Augusto Barata Da Rocha, Barbara Rangel, Jorge Lino Alves

Abstract:

In the European Union countries, Small and Medium-Sized Enterprises (SME’s) have an important contribution to economic activity and to the Gross Domestic Product (GDP). The implementation of design practices in SME’s is often a difficult task due to resources limitations. Unlike large companies, their product development and innovation processes frequentlylack adequate planning and systematic procedures. Design management interest has grown exponentially in recent years, but as it is a recent topic there is an absence of systematic methodologies to implement design management in SME’s with little or no design experience. This work presents a contribution to improve and optimize the process of design integration and management in SME’s. A review analysis is presented to select relevant articles on the subject, review and classify the main published contributions. Based on the selected articles content it was possible to identify five main themes related to the subject under analysis: Design Function Organization, Design Management Integration, Design Management Capabilities, Managing Design Projects, and Tools and Methods. Design management is discussed from different perspectives depending on the focus on which it is placed, whether in a design or management perspective, leading to different visions and definitions: from a more upstream strand at the intersection of design and the organization's strategic management (strategic design management) to a more downstream strand related to project management and design process (design management operational). The review analysis of the selected articles allowed the identification of a high level of complexity of connections and parameters in the design management during the product development process in the context of SME’s. Within each group of the five main themes, several sub-themes, directly or indirectly related, should be considered.Sub-connections also occur between sub-themes of different themes creating a complex and intricate web of connections. This complexity of connections is often the main obstacle to conduct design management and product development efficiently. This work proposes a formulation of a systematic methodological approach to optimize the integrated project and the management and control of the product development process among SME's. The implementation of this formulation will improve the integration of design management in the product development and innovation process in SME’s.

Keywords: design management, product development, product innovation, SME’s.

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748 The Spatial Pattern of Economic Rents of an Airport Development Area: Lessons Learned from the Suvarnabhumi International Airport, Thailand

Authors: C. Bejrananda, Y. Lee, T. Khamkaew

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With the rise of the importance of air transportation in the 21st century, the role of economics in airport planning and decision-making has become more important to the urban structure and land value around it. Therefore, this research aims to examine the relationship between an airport and its impacts on the distribution of urban land uses and land values by applying the Alonso’s bid rent model. The New Bangkok International Airport (Suvarnabhumi International Airport) was taken as a case study. The analysis was made over three different time periods of airport development (after the airport site was proposed, during airport construction, and after the opening of the airport). The statistical results confirm that Alonso’s model can be used to explain the impacts of the new airport only for the northeast quadrant of the airport, while proximity to the airport showed the inverse relationship with the land value of all six types of land use activities through three periods of time. It indicates that the land value for commercial land use is the most sensitive to the location of the airport or has the strongest requirement for accessibility to the airport compared to the residential and manufacturing land use. Also, the bid-rent gradients of the six types of land use activities have declined dramatically through the three time periods because of the Asian Financial Crisis in 1997. Therefore, the lesson learned from this research concerns about the reliability of the data used. The major concern involves the use of different areal units for assessing land value for different time periods between zone block (1995) and grid block (2002, 2009). As a result, this affect the investigation of the overall trends of land value assessment, which are not readily apparent. In addition, the next concern is the availability of the historical data. With the lack of collecting historical data for land value assessment by the government, some of data of land values and aerial photos are not available to cover the entire study area. Finally, the different formats of using aerial photos between hard-copy (1995) and digital photo (2002, 2009) made difficult for measuring distances. Therefore, these problems also affect the accuracy of the results of the statistical analyses.

Keywords: airport development area, economic rents, spatial pattern, suvarnabhumi international airport

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747 Demystifying Board Games for Teachers

Authors: Shilpa Sharma, Lakshmi Ganesh, Mantra Gurumurthy, Shweta Sharma

Abstract:

Board games provide affordances of 21st-century skills like collaboration, critical thinking, and strategy. Board games such as chess, Catan, Battleship, Scrabble, and Taboo can enhance learning in these areas. While board games are popular in informal child settings, their use in formal K-12 education is limited. To encourage teachers to incorporate board games, it's essential to grasp their perceptions and tailor professional development programs accordingly. This paper aims to explore teacher attitudes toward board games and propose interventions to motivate teachers to integrate and create board games in the classroom. A user study was conceived, designed, and administered with teachers (n=38) to understand their experience in playing board games and using board games in the classroom. Purposive sampling was employed as the questionnaire was floated to teacher groups that the authors were aware of. The teachers taught in K-12 affordable private schools. The majority of them had experience ranging from 2-5 years. The questionnaire consisted of questions on teacher perceptions and beliefs of board game usage in the classroom. From the responses, it was observed that ~90% of teachers, though they had experience of playing board games, rarely did it translate to using board games in the classroom. Additionally, it was observed that translating learning objectives to board game objectives is the key factor that teachers consider while using board games in the classroom. Based on the results from the questionnaire, a professional development workshop was co-designed with the objective of motivating teachers to design, create and use board games in the classroom. The workshop is based on the principles of gamification. This is to ensure that the teachers experience a board game in a learning context. Additionally, the workshop is based on the principles of andragogy, such as agency, pertinence, and relevance. The workshop will begin by modifying and reusing known board games in the learning context so that the teachers do not find it difficult and daunting. The intention is to verify the face validity and content validity of the workshop design, orchestration and content with experienced teacher development professionals and education researchers. The results from this study will be published in the full paper.

Keywords: board games, professional development, teacher motivation, teacher perception

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746 Uranoplasty Using Tongue Flap for Bilateral Clefts

Authors: Saidasanov Saidazal Shokhmurodovich, Topolnickiy Orest Zinovyevich, Afaunova Olga Arturovna

Abstract:

Relevance: Bilateral congenital cleft is one of the most complex forms of all clefts, which makes it difficult to choose a surgical method of treatment. During primary operations to close the hard and soft palate, there is a shortage of soft tissues and their lack during standard uranoplasty, and these factors aggravate the period of rehabilitation of patients. Materials and methods: The results of surgical treatment of children with bilateral cleft, who underwent uranoplasty using a flap from the tongue, were analyzed. The study used methods: clinical and statistical, which allowed us to solve the tasks, based on the principles of evidence-based medicine. Results and discussion: in our study, 15 patients were studied, who underwent surgical treatment in the following volume: uranoplasty using a flap from the tongue in two stages. Of these, 9 boys and 6 girls aged 2.5 to 6 years. The first stage was surgical treatment in the volume: veloplasty. The second stage was a surgical intervention in volume: uranoplasty using a flap from the tongue. In all patients, the width of the cleft ranged from 1.6-2.8 cm. All patients in this group were orthodontically prepared. Using this method, the surgeon can achieve the following results: maximum narrowing of the palatopharyngeal ring, long soft palate, complete closure of the hard palate, alveolar process, and the mucous membrane of the nasal cavity is also sutured, which creates good conditions for the next stage of osteoplastic surgery. Based on the result obtained, patients have positive results of working with a speech therapist. In all patients, the dynamics were positive without complications. Conclusions: Based on our observation, tongue flap uranoplasty is one of the effective techniques for patients with wide clefts of the hard and soft palate. The use of a flap from the tongue makes it possible to reduce the number of repeated reoperations and improve the quality of social adaptation of this group of patients, which is one of the important stages of rehabilitation. Upon completion of the stages of rehabilitation, all patients had the maximum improvement in functional, anatomical and social indicators.

Keywords: congenital cleft lips and palate, bilateral cleft, child surgery, maxillofacial surgery

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745 Experimental Studies on the Effect of Premixing Methods in Anaerobic Digestor with Corn Stover

Authors: M. Sagarika, M. Chandra Sekhar

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Agricultural residues are producing in large quantities in India and account for abundant but underutilized source of renewable biomass in agriculture. In India, the amount of crop residues available is estimated to be approximately 686 million tons. Anaerobic digestion is a promising option to utilize the surplus agricultural residues and can produce biogas and digestate. Biogas is mainly methane (CH4), which can be utilized as an energy source in replacement for fossil fuels such as natural gas, oil, in other hand, digestate contains high amounts of nutrients, can be employed as fertilizer. Solid state anaerobic digestion (total solids ≥ 15%) is suitable for agricultural residues, as it reduces the problems like stratification and floating issues that occur in liquid anaerobic digestion (total solids < 15%). The major concern in solid-state anaerobic digestion is the low mass transfer of feedstock and inoculum that resulting in low performance. To resolve this low mass transfer issue, effective mixing of feedstock and inoculum is required. Mechanical mixing using stirrer at the time of digestion process can be done, but it is difficult to operate the stirring of feedstock with high solids percentage and high viscosity. Complete premixing of feedstock and inoculum is an alternative method, which is usual in lab scale studies but may not be affordable due to high energy demand in large-scale digesters. Developing partial premixing methods may reduce this problem. Current study is to improve the performance of solid-state anaerobic digestion of corn stover at feedstock to inoculum ratios 3 and 5, by applying partial premixing methods and to compare the complete premixing method with two partial premixing methods which are two alternative layers of feedstock and inoculum and three alternative layers of feedstock and inoculum where higher inoculum ratios in the top layers. From experimental studies it is observed that, partial premixing method with three alternative layers of feedstock and inoculum yielded good methane.

Keywords: anaerobic digestion, premixing methods, methane yield, corn stover, volatile solids

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744 Enzymatic Degradation of Poly (Butylene Adipate Terephthalate) Copolymer Using Lipase B From Candida Antarctica and Effect of Poly (Butylene Adipate Terephthalate) on Plant Growth

Authors: Aqsa Kanwal, Min Zhang, Faisal Sharaf, Li Chengtao

Abstract:

The globe is facing increasing challenges of plastic pollution due to single-use of plastic-based packaging material. The plastic material is continuously being dumped into the natural environment, which causes serious harm to the entire ecosystem. Polymer degradation in nature is very difficult, so the use of biodegradable polymers instead of conventional polymers can mitigate this issue. Due to the good mechanical properties and biodegradability, aliphatic-aromatic polymers are being widely commercialized. Due to the advancement in molecular biology, many studies have reported specific microbes that can effectively degrade PBAT. Aliphatic polyesters undergo hydrolytic cleavage of ester groups, so they can be easily degraded by microorganisms. In this study, we investigated the enzymatic degradation of poly (butylene adipate terephthalate) (PBAT) copolymer using lipase B from Candida Antarctica (CALB). Results of the study displayed approximately 5.16 % loss in PBAT mass after 2 days which significantly increased to approximately 15.7 % at the end of the experiment (12 days) as compared to blank. The pH of the degradation solution also displayed significant reduction and reached the minimum value of 6.85 at the end of the experiment. The structure and morphology of PBAT after degradation were characterized by FTIR, XRD, SEM, and TGA. FTIR analysis showed that after degradation many peaks become weaker and the peak at 2950 cm-1 almost disappeared after 12 days. The XRD results indicated that as the degradation time increases the intensity of diffraction peaks slightly increases as compared to the blank PBAT. TGA analysis also confirmed the successful degradation of PBAT with time. SEM micrographs further confirmed that degradation has occurred. Hence, biodegradable polymers can widely be used. The effect of PBAT biodegradation on plant growth was also studied and it was found that PBAT has no toxic effect on the growth of plants. Hence PBAT can be employed in a wide range of applications.

Keywords: aliphatic-aromatic co-polyesters, polybutylene adipate terephthalate, lipase (CALB), biodegradation, plant growth

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743 Presenting of 'Local Wishes Map' as a Tool for Promoting Dialogue and Developing Healthy Cities

Authors: Ana Maria G. Sperandio, Murilo U. Malek-Zadeh, João Luiz de S. Areas, Jussara C. Guarnieri

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Intersectoral governance is a requirement for developing healthy cities. However, this achievement is difficult to be succeeded, especially in regions at low resources condition. Therefore, it was developed a cheap investigative procedure to diagnose sectoral wishes related to urban planning and health promotion. This procedure is composed of two phases, which can be applied to different groups in order to compare the results. The first phase is a conversation guided by a list of questions. Some of those questions aim to gather information about how individuals understand concepts such as healthy city or a health promotion and what they believe that constitutes the relation between urban planning and urban health. Other questions investigate local issues, and how citizens would like to promote dialogue between sectors. At second phase individuals stand around the investigated city (or city region) map and are asked to represent their wishes on it. They can represent it by writing text notations or inserting icons on it, with the latter representing a city element, for example, some trees, a square, a playground, a hospital, a cycle track. After groups had represented their wishes, the map can be photographed, and then the results from distinct groups can be compared. This procedure was conducted at a small city in Brazil (Holambra), in 2017 which is the first out of four years of the mayor’s term. The prefecture asked for this tool in order to make Holambra become a city of Potential Healthy Municipalities Network in Brazil. Two sectors were investigated: the government and the urban population. By the end of our investigation, the intersection from the group (i.e., population and government) maps was accounted for creating a map of common wishes. Therefore, the material produced can be used as a guide for promoting dialogue between sectors and as a tool of monitoring politics progress. The report of this procedure was directed to public managers, so they could see the common wishes between themselves and local populations, and use this tool as a guide for creating urban politics which intends to enhance health promotion and to develop a healthy city, even at low resources condition.

Keywords: governance, health promotion, intersectorality, urban planning

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742 Literature Review of Rare Synchronous Tumours

Authors: Diwei Lin, Amanda Tan, Rajinder Singh-Rai

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We present the first reported case of a concomitant Leydig cell tumor (LCT) and paratesticular leiomyoma in an adult male with a known history of bilateral cryptorchidism. An 80-year-old male presented with a 2-month history of a left testicular lump associated with mild discomfort and a gradual increase in size on a background of bilateral cryptorchidism requiring multiple orchidopexy procedures as a child. Ultrasound confirmed a lesion suspicious for malignancy and he proceeded to a left radical orchidectomy. Histopathological assessment of the left testis revealed a concomitant testicular LCT with malignant features and paratesticular leiomyoma. Leydig cell tumors (LCTs) are the most common pure testicular sex cord-stromal tumors, accounting for up to 3% of all testicular tumors. They can occur at almost any age, but are noted to have a bi-modal distribution, with a peak incidence at 6 to 10 and at 20 to 50 years of age. LCT’s are often hormonally active and can lead to feminizing or virilizing syndromes. LCT’s are usually regarded as benign but can rarely exhibit malignant traits. Paratesticular tumours are uncommon and their reported prevalence varies between 3% and 16%. They occur in a complex anatomical area which includes the contents of the spermatic cord, testicular tunics, epididymis and vestigial remnants. Up to 90% of paratesticular tumours are believed to originate from the spermatic cord, though it is often difficult to definitively ascertain the exact site of origin. Although any type of soft-tissue neoplasm can be found in the paratesticular region, the most common benign tumors reported are lipomas of the spermatic cord, adenomatoid tumours of the epididymis and leiomyomas of the testis. Genetic studies have identified potential mutations that could potentially cause LCTs, but there are no known associations between concomitant LCTs and paratesticular tumors. The presence of cryptorchidism in adults with both LCTs and paratesticular neoplasms individually has been previously reported and it appears intuitive that cryptorchidism is likely to be associated with the concomitant presentation in this case report. This report represents the first documented case in the literature of a unilateral concomitant LCT and paratesticular leiomyoma on a background of bilateral cryptorchidism.

Keywords: testicular cancer, leydig cell tumour, leiomyoma, paratesticular neoplasms

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741 A Machine Learning Model for Dynamic Prediction of Chronic Kidney Disease Risk Using Laboratory Data, Non-Laboratory Data, and Metabolic Indices

Authors: Amadou Wurry Jallow, Adama N. S. Bah, Karamo Bah, Shih-Ye Wang, Kuo-Chung Chu, Chien-Yeh Hsu

Abstract:

Chronic kidney disease (CKD) is a major public health challenge with high prevalence, rising incidence, and serious adverse consequences. Developing effective risk prediction models is a cost-effective approach to predicting and preventing complications of chronic kidney disease (CKD). This study aimed to develop an accurate machine learning model that can dynamically identify individuals at risk of CKD using various kinds of diagnostic data, with or without laboratory data, at different follow-up points. Creatinine is a key component used to predict CKD. These models will enable affordable and effective screening for CKD even with incomplete patient data, such as the absence of creatinine testing. This retrospective cohort study included data on 19,429 adults provided by a private research institute and screening laboratory in Taiwan, gathered between 2001 and 2015. Univariate Cox proportional hazard regression analyses were performed to determine the variables with high prognostic values for predicting CKD. We then identified interacting variables and grouped them according to diagnostic data categories. Our models used three types of data gathered at three points in time: non-laboratory, laboratory, and metabolic indices data. Next, we used subgroups of variables within each category to train two machine learning models (Random Forest and XGBoost). Our machine learning models can dynamically discriminate individuals at risk for developing CKD. All the models performed well using all three kinds of data, with or without laboratory data. Using only non-laboratory-based data (such as age, sex, body mass index (BMI), and waist circumference), both models predict chronic kidney disease as accurately as models using laboratory and metabolic indices data. Our machine learning models have demonstrated the use of different categories of diagnostic data for CKD prediction, with or without laboratory data. The machine learning models are simple to use and flexible because they work even with incomplete data and can be applied in any clinical setting, including settings where laboratory data is difficult to obtain.

Keywords: chronic kidney disease, glomerular filtration rate, creatinine, novel metabolic indices, machine learning, risk prediction

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740 Zinc Oxide Nanoparticle-Doped Poly (8-Anilino-1-Napthalene Sulphonic Acid/Nat Nanobiosensors for TB Drugs

Authors: Rachel Fanelwa Ajayi, Anovuyo Jonnas, Emmanuel I. Iwuoha

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Tuberculosis (TB) is an infectious disease caused by the bacterium (Mycobacterium tuberculosis) which has a predilection for lung tissue due to its rich oxygen supply. The mycobacterial cell has a unique innate characteristic which allows it to resist human immune systems and drug treatments; hence, it is one of the most difficult of all bacterial infections to treat, let alone to cure. At the same time, multi-drug resistance TB (MDR-TB) caused by poorly managed TB treatment, is a growing problem and requires the administration of expensive and less effective second line drugs which take much longer treatment duration than fist line drugs. Therefore, to acknowledge the issues of patients falling ill as a result of inappropriate dosing of treatment and inadequate treatment administration, a device with a fast response time coupled with enhanced performance and increased sensitivity is essential. This study involved the synthesis of electroactive platforms for application in the development of nano-biosensors suitable for the appropriate dosing of clinically diagnosed patients by promptly quantifying the levels of the TB drug; Isonaizid. These nano-biosensors systems were developed on gold surfaces using the enzyme N-acetyletransferase 2 coupled to the cysteamine modified poly(8-anilino-1-napthalene sulphonic acid)/zinc oxide nanocomposites. The morphology of ZnO nanoparticles, PANSA/ZnO nano-composite and nano-biosensors platforms were characterized using High-Resolution Transmission Electron Microscopy (HRTEM) and High-Resolution Scanning Electron Microscopy (HRSEM). On the other hand, the elemental composition of the developed nanocomposites and nano-biosensors were studied using Fourier Transform Infra-Red Spectroscopy (FTIR) and Energy Dispersive X-Ray (EDX). The electrochemical studies showed an increase in electron conductivity for the PANSA/ZnO nanocomposite which was an indication that it was suitable as a platform towards biosensor development.

Keywords: N-acetyletransferase 2, isonaizid, tuberculosis, zinc oxide

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739 Malpractice, Even in Conditions of Compliance With the Rules of Dental Ethics

Authors: Saimir Heta, Kers Kapaj, Rialda Xhizdari, Ilma Robo

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Despite the existence of different dental specialties, the dentist-patient relationship is unique, in the very fact that the treatment is performed by one doctor and the patient identifies the malpractice presented as part of that doctor's practice; this is in complete contrast to cases of medical treatments where the patient can be presented to a team of doctors, to treat a specific pathology. The rules of dental ethics are almost the same as the rules of medical ethics. The appearance of dental malpractice affects exactly this two-party relationship, created on the basis of professionalism, without deviations in this direction, between the dentist and the patient, but with very narrow individual boundaries, compared to cases of medical malpractice. Main text: Malpractice can have different reasons for its appearance, starting from professional negligence, but also from the lack of professional knowledge of the dentist who undertakes the dental treatment. It should always be seen in perspective that we are not talking about the individual - the dentist who goes to work with the intention of harming their patients. Malpractice can also be a consequence of the impossibility, for anatomical or physiological reasons of the tooth under dental treatment, to realize the predetermined dental treatment plan. On the other hand, the dentist himself is an individual who can be affected by health conditions, or have vices that affect the systemic health of the dentist as an individual, which in these conditions can cause malpractice. So, depending on the reason that led to the appearance of malpractice, the method of treatment from a legal point of view also varies, for the dentist who committed the malpractice, evaluating the latter if the malpractice came under the conditions of applying the rules of dental ethics. Conclusions: The deviation from the predetermined dental plan is the minimum sign of malpractice and the latter should not be definitively related only to cases of difficult dental treatments. The identification of the reason for the appearance of malpractice is the initial element, which makes the difference in the way of its treatment, from a legal point of view, and the involvement of the dentist in the assessment of the malpractice committed, must be based on the legislation in force, which must be said to have their specific changes in different states. Malpractice should be referred to, or included in the lectures or in the continuing education of professionals, because it serves as a method of obtaining professional experience in order not to repeat the same thing several times, by different professionals.

Keywords: dental ethics, malpractice, negligence, legal basis, continuing education, dental treatments

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738 Regional Flood Frequency Analysis in Narmada Basin: A Case Study

Authors: Ankit Shah, R. K. Shrivastava

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Flood and drought are two main features of hydrology which affect the human life. Floods are natural disasters which cause millions of rupees’ worth of damage each year in India and the whole world. Flood causes destruction in form of life and property. An accurate estimate of the flood damage potential is a key element to an effective, nationwide flood damage abatement program. Also, the increase in demand of water due to increase in population, industrial and agricultural growth, has let us know that though being a renewable resource it cannot be taken for granted. We have to optimize the use of water according to circumstances and conditions and need to harness it which can be done by construction of hydraulic structures. For their safe and proper functioning of hydraulic structures, we need to predict the flood magnitude and its impact. Hydraulic structures play a key role in harnessing and optimization of flood water which in turn results in safe and maximum use of water available. Mainly hydraulic structures are constructed on ungauged sites. There are two methods by which we can estimate flood viz. generation of Unit Hydrographs and Flood Frequency Analysis. In this study, Regional Flood Frequency Analysis has been employed. There are many methods for estimating the ‘Regional Flood Frequency Analysis’ viz. Index Flood Method. National Environmental and Research Council (NERC Methods), Multiple Regression Method, etc. However, none of the methods can be considered universal for every situation and location. The Narmada basin is located in Central India. It is drained by most of the tributaries, most of which are ungauged. Therefore it is very difficult to estimate flood on these tributaries and in the main river. As mentioned above Artificial Neural Network (ANN)s and Multiple Regression Method is used for determination of Regional flood Frequency. The annual peak flood data of 20 sites gauging sites of Narmada Basin is used in the present study to determine the Regional Flood relationships. Homogeneity of the considered sites is determined by using the Index Flood Method. Flood relationships obtained by both the methods are compared with each other, and it is found that ANN is more reliable than Multiple Regression Method for the present study area.

Keywords: artificial neural network, index flood method, multi layer perceptrons, multiple regression, Narmada basin, regional flood frequency

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737 The Basin Management Methodology for Integrated Water Resources Management and Development

Authors: Julio Jesus Salazar, Max Jesus De Lama

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The challenges of water management are aggravated by global change, which implies high complexity and associated uncertainty; water management is difficult because water networks cross domains (natural, societal, and political), scales (space, time, jurisdictional, institutional, knowledge, etc.) and levels (area: patches to global; knowledge: a specific case to generalized principles). In this context, we need to apply natural and non-natural measures to manage water and soil. The Basin Management Methodology considers multifunctional measures of natural water retention and erosion control and soil formation to protect water resources and address the challenges related to the recovery or conservation of the ecosystem, as well as natural characteristics of water bodies, to improve the quantitative status of water bodies and reduce vulnerability to floods and droughts. This method of water management focuses on the positive impacts of the chemical and ecological status of water bodies, restoration of the functioning of the ecosystem and its natural services; thus, contributing to both adaptation and mitigation of climate change. This methodology was applied in 7 interventions in the sub-basin of the Shullcas River in Huancayo-Junín-Peru, obtaining great benefits in the framework of the participation of alliances of actors and integrated planning scenarios. To implement the methodology in the sub-basin of the Shullcas River, a process called Climate Smart Territories (CST) was used; with which the variables were characterized in a highly complex space. The diagnosis was then worked using risk management and adaptation to climate change. Finally, it was concluded with the selection of alternatives and projects of this type. Therefore, the CST approach and process face the challenges of climate change through integrated, systematic, interdisciplinary and collective responses at different scales that fit the needs of ecosystems and their services that are vital to human well-being. This methodology is now replicated at the level of the Mantaro river basin, improving with other initiatives that lead to the model of a resilient basin.

Keywords: climate-smart territories, climate change, ecosystem services, natural measures, Climate Smart Territories (CST) approach

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736 Multiscale Process Modeling of Ceramic Matrix Composites

Authors: Marianna Maiaru, Gregory M. Odegard, Josh Kemppainen, Ivan Gallegos, Michael Olaya

Abstract:

Ceramic matrix composites (CMCs) are typically used in applications that require long-term mechanical integrity at elevated temperatures. CMCs are usually fabricated using a polymer precursor that is initially polymerized in situ with fiber reinforcement, followed by a series of cycles of pyrolysis to transform the polymer matrix into a rigid glass or ceramic. The pyrolysis step typically generates volatile gasses, which creates porosity within the polymer matrix phase of the composite. Subsequent cycles of monomer infusion, polymerization, and pyrolysis are often used to reduce the porosity and thus increase the durability of the composite. Because of the significant expense of such iterative processing cycles, new generations of CMCs with improved durability and manufacturability are difficult and expensive to develop using standard Edisonian approaches. The goal of this research is to develop a computational process-modeling-based approach that can be used to design the next generation of CMC materials with optimized material and processing parameters for maximum strength and efficient manufacturing. The process modeling incorporates computational modeling tools, including molecular dynamics (MD), to simulate the material at multiple length scales. Results from MD simulation are used to inform the continuum-level models to link molecular-level characteristics (material structure, temperature) to bulk-level performance (strength, residual stresses). Processing parameters are optimized such that process-induced residual stresses are minimized and laminate strength is maximized. The multiscale process modeling method developed with this research can play a key role in the development of future CMCs for high-temperature and high-strength applications. By combining multiscale computational tools and process modeling, new manufacturing parameters can be established for optimal fabrication and performance of CMCs for a wide range of applications.

Keywords: digital engineering, finite elements, manufacturing, molecular dynamics

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