Search results for: oral delivery
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2930

Search results for: oral delivery

950 Transformational Entrepreneurship: Exploring Pedagogy in Tertiary Education

Authors: S. Karmokar

Abstract:

Over the last 20 years, there has been increasing interest in the topic of entrepreneurship education as it is seen in many countries as a way of enhancing the enterprise culture and promote capability building among community. There is also rapid growth of emerging technologies across the globe and forced entrepreneurs to searching for a new model of economic growth. There are two movements that are dominating and creating waves, Technology Entrepreneurship and Social Entrepreneurship. An increasing number of entrepreneurs are awakening to the possibility of combining the scalable tools and methodology of Technology Entrepreneurship with the value system of Social Entrepreneurship–‘Transformational Entrepreneurship’. To do this transitional educational institute’s need to figure out how to unite the scalable tools of Technology Entrepreneurship with the moral ethos of Social Entrepreneurship. The traditional entrepreneurship education model is wedded to top-down instructive approaches, that is widely used in management education have led to passive educational model. Despite the effort, disruptive’ pedagogies are rare in higher education; they remain underused and often marginalized. High impact and transformational entrepreneurship education and training require universities to adopt new practices and revise current, traditional ways of working. This is a conceptual research paper exploring the potential and growth of transformational entrepreneurship, investigating links between social entrepreneurship. Based on empirical studies and theoretical approaches, this paper outlines some educational approach for both academics and educational institutes to deliver emerging transformational entrepreneurship in tertiary education. The paper presents recommendations for tertiary educators to inform the designing of teaching practices, revise current delivery methods and encourage students to fulfill their potential as entrepreneurs.

Keywords: educational pedagogies, emerging technologies, social entrepreneurship, transformational entrepreneurship

Procedia PDF Downloads 176
949 Ethno-Botanical Research on Medicinal Plants Commonly Used for Children’s Health in South East Nigeria

Authors: Chioma J. Nwakamma, Blessing O. Oyedemi, Garuba Omosun

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This research surveys and documents information on medicinal plants and their botanical preparations used in the treatment of children’s ailments in South-Eastern Nigeria. Children under the age of 5 in developing countries suffer from diseases with high morbidity and mortality rate yearly due to inaccessible and unaffordable healthcare. Structured questionnaires were administered to herbal sellers, traditional medicine practitioners, nursing mothers, and adult dwellers to collect data on the names of plants used to treat the conditions, methods of preparation, duration of treatment, adverse effects, and the methods of administration of the plant materials. A total of 135 plants belonging to 55 families were identified for the management of children’s health in the area. Common pediatric ailments which were said to be treated with herbal remedies by the respondents included malaria, pneumonia, stomach ache, diarrhea, dysentery, measles, chickenpox/smallpox, convulsion, jaundice, pile, ringworm, scabies, eczema, stubborn cough, scurvy, catarrh, wounds, boils, insect bites, food poison, cholera, and umbilical cord complications. Percentages of respondents were; herbal sellers (48.2%), traditional medical practitioners (21.6%), nursing mothers (11.1%), and others (19.1%). The most occurring plant families were Euphorbiaceae, Fabaceae, and Apocynaceae, with 8 species of plants each followed by Annonaceae and Asteriaceae with 7 and 6 species, respectively. The recipes were made from the combination of different parts of two or more plant species, and others were made from single plant parts. Methods of extraction were mostly decoction and raw-squeezing out of the juice and infusion, while oral administration was the main route of administration.

Keywords: ethno-botanicals, children’s health, medicinal plants, South-Eastern Nigeria

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948 An Investigation into the Current Implementation of Design-Build Contracts in the Kingdom of Saudi Arabia

Authors: Ibrahim A. Alhammad, Suleiman A. Al-Otaibi, Khalid S. Al-Gahtani, Naïf Al-Otaibi, Abdulaziz A. Bubshait

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In the last decade, the use of project delivery system of design build engineering contracts is increasing in North America due to the reasons of reducing the project duration and minimizing costs. The shift from traditional approach of Design-Bid-Build to Design-Build contracts have been attributed to many factors such as evolution of the regulatory and legal frameworks governing the engineering contracts and improvement in integrating design and construction. The aforementioned practice of contracting is more appropriate in North America; yet, it may not be the case in Saudi Arabia where the traditional approach of construction contracting remains dominant. The authors believe there are number of factors related to the gaps in the level of sophistication of the engineering and management of the construction projects in both countries. A step towards improving the Saudi construction practice by adopting the new trend of construction contracting, this paper identifies the reasons why Design/Build form of contracting are not frequently utilized. A field survey, which includes the questionnaire addressing the research problem, is distributed to three main parties of the construction contracts: clients, consultants, and contractors. The analyzed collected data were statistically sufficient to finding the reasons of not adopting the new trend of good practice of deign build approach in Saudi Arabia. In addition, the reasons are: (1) lack of regulation and legal framework; (2) absence of clear criteria of the owner for the trade-off between competing contractors, (3) and lack of experience, knowledge and skill.

Keywords: design built projects, Saudi Arabia, GCC, mega projects

Procedia PDF Downloads 212
947 Improving the Safety Performance of Workers by Assessing the Impact of Safety Culture on Workers’ Safety Behaviour in Nigeria Oil and Gas Industry: A Pilot Study in the Niger Delta Region

Authors: Efua Ehiaguina, Haruna Moda

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Interest in the development of appropriate safety culture in the oil and gas industry has taken centre stage among stakeholders in the industry. Human behaviour has been identified as a major contributor to occupational accidents, where abnormal activities associated with safety management are taken as normal behaviour. Poor safety culture is one of the major factors that influence employee’s safety behaviour at work, which may consequently result in injuries and accidents and strengthening such a culture can improve workers safety performance. Nigeria oil and gas industry has contributed to the growth and development of the country in diverse ways. However, in terms of safety and health of workers, this industry is a dangerous place to work as workers are often exposed to occupational safety and health hazard. To ascertain the impact of employees’ safety and how it impacts health and safety compliance within the local industry, online safety culture survey targeting frontline workers within the industry was administered covering major subjects that include; perception of management commitment and style of leadership; safety communication method and its resultant impact on employees’ behaviour; employee safety commitment and training needs. The preliminary result revealed that 54% of the participants feel that there is a lack of motivation from the management to work safely. In addition, 55% of participants revealed that employers place more emphasis on work delivery over employee’s safety on the installation. It is expected that the study outcome will provide measures aimed at strengthening and sustaining safety culture in the Nigerian oil and gas industry.

Keywords: oil and gas safety, safety behaviour, safety culture, safety compliance

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946 Formulation and Evaluation of TDDS for Sustained Release Ondansetron HCL Patches

Authors: Baljinder Singh, Navneet Sharma

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The skin can be used as the site for drug administration for continuous transdermal drug infusion into the systemic circulation. For the continuous diffusion/penetration of the drugs through the intact skin surface membrane-moderated systems, matrix dispersion type systems, adhesive diffusion controlled systems and micro reservoir systems have been developed. Various penetration enhancers are used for the drug diffusion through skin. In matrix dispersion type systems, the drug is dispersed in the solvent along with the polymers and solvent allowed to evaporate forming a homogeneous drug-polymer matrix. Matrix type systems were developed in the present study. In the present work, an attempt has been made to develop a matrix-type transdermal therapeutic system comprising of ondansetron-HCl with different ratios of hydrophilic and hydrophobic polymeric combinations using solvent evaporation technique. The physicochemical compatibility of the drug and the polymers was studied by infrared spectroscopy. The results obtained showed no physical-chemical incompatibility between the drug and the polymers. The patches were further subjected to various physical evaluations along with the in-vitro permeation studies using rat skin. On the basis of results obtained form the in vitro study and physical evaluation, the patches containing hydrophilic polymers i.e. polyvinyl alcohol and poly vinyl pyrrolidone with oleic acid as the penetration enhancer(5%) were considered as suitable for large scale manufacturing with a backing layer and a suitable adhesive membrane.

Keywords: transdermal drug delivery, penetration enhancers, hydrophilic and hydrophobic polymers, ondansetron HCl

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945 Tocotrienol Rich Fraction in Nicotine-Induced Embryos: Cytoskeletal Changes of Actin and Tubulin

Authors: Nurul Hamirah Kamsani, Mohd Hamim Rajikin, Nor Ashikin Mohamed Noor Khan, Sharaniza Abdul Rahim

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Cytoskeletal structures, in particular actin and tubulin, provide a fundamental framework in all cells, including embryos. Under influence of nicotine, the cytoskeletal organization may be subjected to oxidative stress (OS) insult and cause alteration. Tocotrienol-rich fraction (TRF) is proven to enhance fertility better than the other sub-group of Vitamin E, tocopherols (TCPs). The objective of this study was to evaluate the effects of TRF on 1) actin and tubulin of 2- and 8-cell murine embryos and 2) the regulation of reactive oxygen species (ROS)-scavenging enzymes; induced by nicotine. Twenty four female Balb/C were subjected to either subcutaneous (sc) injection of 0.9% NaCl; sc injection of 3.0 mg/kg bw/day nicotine; sc injection of 3.0 mg/kg bw/day nicotine + oral gavage (OG) of 60 mg/kg bw/day TRF; or OG of 60 mg/kg bw/day TRF for 7 consecutive days. After superovulation and mating, animals were euthanized. 2-cell developing embryos were retrieved. 50% of the retrieved embryos were visualized under confocal laser staining microscopy (CLSM) for alterations of actin and tubulin. The remaining amount of embryos was cultured in vitro until 8-cell stage followed by CLSM visualization. Blood plasma was subjected to OS assays. Plasma malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) were determined and analysed accordingly. At both 2- and 8-cell developing stages, actin intensities were significantly reduced in the nicotine group (p<0.001). After the intervention, actin intensity was significantly increased compared to that of the nicotine group (p<0.001). The same trend was seen in tubulin at both cell stages. TRF has minimized the deleterious effects of nicotine in actin and tubulin of both 2- and 8-cell developmental stages during pre-implantation embryonic development in mice in vitro. Levels of endogenous anti-oxidative enzymes were sustained close to control accompanied by decreased levels of OS biomarker.

Keywords: actin, nicotine, pre-implantation embryos, tocotrienol rich fraction, tubulin

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944 Audit of Post-Caesarean Section Analgesia

Authors: Rachel Ashwell, Sally Millett

Abstract:

Introduction: Adequate post-operative pain relief is a key priority in the delivery of caesarean sections. This improves patient experience, reduces morbidity and enables optimal mother-infant interaction. Recommendations outlined in the NICE guidelines for caesarean section (CS) include offering peri-operative intrathecal/epidural diamorphine and post-operative opioid analgesics; offering non-steroidal anti-inflammatory drugs (NSAIDs) unless contraindicated and taking hourly observations for 12 hours following intrathecal diamorphine. Method: This audit assessed the provision of post-CS analgesia in 29 women over a two-week period. Indicators used were the use of intrathecal/epidural opioids, use of post-operative opioids and NSAIDs, frequency of observations and patient satisfaction with pain management on post-operative days 1 and 2. Results: All women received intrathecal/epidural diamorphine, 97% were prescribed post-operative opioids and all were prescribed NSAIDs unless contraindicated. Hourly observations were not maintained for 12 hours following intrathecal diamorphine. 97% of women were satisfied with their pain management on post-operative day 1 whereas only 75% were satisfied on day 2. Discussion: This service meets the proposed standards for the provision of post-operative analgesia, achieving high levels of patient satisfaction 1 day after CS. However, patient satisfaction levels are significantly lower on post-operative day 2, which may be due to reduced frequency of observations. The lack of an official audit standard for patient satisfaction on postoperative day 2 may result in reduced incentive to prioritise pain management at this stage.

Keywords: Caesarean section, analgesia, postoperative care, patient satisfaction

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943 Sudanese Dietitian’s Role in the Provision of Parenteral Nutrition: The Past, Present, and Future

Authors: Reem Osama Yousif Ali, Osama Yousif Ali Al Gibali

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Introduction: Balanced nutrition is undeniably essential for maintaining health, body functions, and integrity of cell metabolism; however, some sick patients cannot tolerate oral or enteral feeding to meet their nutritional needs, so partial or total parenteral nutrition (PN) may be the most suitable alternative route in such situations. Dietitians are fundamental personnel among the medical team to ensure the proper provision of PN service, which was introduced in Sudan in the 1980s. Objective: The study aimed to recognize the dietitians' awareness of parenteral nutrition and their role in providing this service in Sudan – Khartoum State. Methodology: Formulated questionnaire forms composed of twelve questions were distributed to the dietitians working in four tertiary level hospitals. Results: The majority (75%) of the responded dietitians had reasonable knowledge about the importance of PN, its advantages, and its indications. Sixty percent of them were mindful of the PN side effects. Most of the dietitians were aware of the different assessment measurements and PN calculations and were exposed in their clinical practice to patients who were in need of PN, but only a few of them (about 30%) had the actual chance to participate in the formulation and application of PN therapy. The unavailability of the multidisciplinary team, lack of the required equipment and financial support, and associated complications were basic obstacles to the provision of long-term PN service in Khartoum state hospitals. Conclusion: Although dietitians in Khartoum state hospitals have good information about PN definition, indications, accesses, and assessment measures, they do not have enough knowledge and clinical exposure that make them confident to provide the PN service. Establishing a few models of parenteral nutrition units in tertiary hospitals will be of great help, as well as providing the dietitian's training in the area of parenteral nutrition. Further study can explore more requirements to run this service.

Keywords: nutrition support, dietitian, Sudan, parenteral nutrition, nutrition support team

Procedia PDF Downloads 87
942 Formulation and in vitro Evaluation of Transdermal Delivery of Articaine

Authors: Dinakaran Venkatachalam, Paul Chambers, Kavitha Kongara, Preet Singh

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The objective of this study is to formulate different topical preparations containing articaine and to investigate their permeation through goat skin. Initially, articaine and its hydrochloride salt were compared for in vitro permeation using Franz cell model. Goat skin samples were collected after euthanizing male goat kids purchased from the dairy goat farmers. Subcutaneous fat was removed and the skin was mounted on the donor chamber (orifice area 1.00 cm²) and drugs were applied onto the epidermis. Phosphate buffer saline (pH 7.4) was used to maintain sink condition in the receptor chamber (8 ml) of the Franz cell. Samples (0.4 ml) were collected at various intervals over 24 hours after each sampling equal volume of PBS was replaced in the receptor chamber. Articaine in the collected samples were quantified using LC/MS. The results suggested that articaine free base permeates better than its hydrochloride salt through goat skin. This study results support the fact that local anesthetics in its base form are lipophilic and thus penetrates faster through cell membranes than their salts. Later, articaine free base was formulated either using ethanol and octyl salicylate or dimethyl sulfoxide (DMSO) as penetration enhancers and was compared for in vitro permeation. The transdermal flux of articaine in the formulation containing DMSO was approximately 3.8 times higher than that of the formulation containing ethanol and octyl salicylate. Further studies to evaluate the local anesthetic efficacy of the topical formulation containing articaine for dermal anesthesia in animals have been planned.

Keywords: articaine, dermal anesthesia, local anesthetic, transdermal

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941 An International Analysis of Career Development and Management Programs for High-Performance Athletes: A Perspective of Organizational Support

Authors: H. J. Hong

Abstract:

Sporting organizations are arguably responsible for encouraging high-performance athletes to balance their life and identity during their sporting career; sporting organizations can establish the motivational climate for high-performance athletes using athlete career development and management programs. The purpose of this article to provide an overview of career development and management programs in 20 countries and to examine the following seven features of the programs: (1) Which government-funded sporting organizations provide career development and management programs? (2) Which athletes are eligible to access the programs? (3) What are the aims and objectives of the programs? (4) What are the activities and content of the programs? (5) Who is responsible for the delivery of the programs within organizations (e.g., advisors, coordinators, service providers, counsellors, etc.)? (6) Do the sporting organizations have training and development programs for support services providers? and (7) Do the sporting organizations assess the programs in terms of the programs’ impact on high-performance athletes’ career development and management skills? Web-based data collection was conducted first. The author contacted the sporting organizations to clarify information as required by requesting further information via emails, international calls, video calls on Skype, and by visiting the sporting organizations and meeting with the practitioners (Fiji, Ireland, Korea, Scotland, Singapore, and Spain). By selecting comparable career development and management programs, the present study reviews programs across the world, identifying similarities, differences, and difficulties, so that sporting organizations and practitioners may enhance the quality of their programs. Since international comparisons of career development and management programs remain scarce, the findings deepen the knowledge of high-performance athletes’ career development, management, and transitions in the areas of organizational support programs.

Keywords: athletes' career development and management, athletes' psychological preparation, organizational support, sport career transition

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940 Factors Affecting Adequate Utilisation of Ante-natal Health Care Services among Pregnant Women in Dutsin-Ma Local Government Area of Katsina State

Authors: Ilim Moses Msughter

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The study was carried out to examine the availability of Ante-natal care services and the socio-cultural factors affecting the utilization of these services in Dutsin-Ma Local Government Area of Katsina State. Four specific objectives were outlined as thus to examine the availability of antenatal care services in Dutsin-Ma local government area, to identify the socio-cultural factors affecting the utilisation of ante-natal care services, to ascertain the challenges affecting utilisation of ante-natal care services and suggest strategies to improve efficiency in ante-natal service delivery and utilisation of same services. Data were collected from 110 respondents using a questionnaire and through the use of the interview. Data were analysed quantitatively and qualitatively. The findings revealed that ante-natal care services are available in the study area, but access to such services is hindered by several factors, which include religious and traditional beliefs, cost of services and poor attitudes of health care workers which has an adverse effect on people’s desire to visit ante-natal centres. The study recommended that Traditional Birth Attendants (TBA) need to be trained on how to handle pregnancy-related complications. It is also recommended that essential ante-natal drugs and services should be subsidised or made free by the government, and this must be closely monitored to ensure efficiency. Finally, human relation training should be organised for nurses and midwives to improve their attitudes towards patients during ante-natal visits.

Keywords: utilisation, religion, traditional birth attendant, ante-natal

Procedia PDF Downloads 154
939 Digital Interventions for Older People Experiencing Homelessness (OPEH): A Systematic Scoping Review

Authors: Emily Adams, Eddie Donaghy, David Henderson, Lauren Ng, Caroline Sanders, Rowena Stewart, Maria Wolters, Stewart Mercer

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Ongoing review abstract: Older People Experiencing Homelessness (OPEH) can have mental and physical indicators of aging 10–20 years earlier than the general population and experience premature mortality due to age-related chronic conditions. Emerging literature suggests digital interventions could positively impact PEH’s well-being. However, the increased reliance on digital delivery may also perpetuate digital inequalities for socially excluded groups, including PEH. The potential triple disadvantage of being older, homeless, and digitally excluded creates a uniquely problematic situation that warrants further research. This scoping review aims to investigate and synthesise the range and type of digital interventions available to OPEH and the organisations that support OPEH. The following databases were searched on 28th July 2023: Medline, Scopus, International Bibliography of the Social Sciences (IBSS)‎, Applied Social Sciences Index & Abstracts (ASSIA)‎, Association for Computing Machinery Digital Library (ACMDL) and Policy commons. A search strategy was developed in collaboration with an academic librarian. The presentation will include: An introduction to OPEH and digital exclusion Overview of the results of this review: OPEH usage of digital platforms Current digital interventions available The role of support organisations Current gaps in the evidence, future research and recommendations for policy and practice

Keywords: homeless, digital exclusion, aging, technology

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938 Surface Modified Quantum Dots for Nanophotonics, Stereolithography and Hybrid Systems for Biomedical Studies

Authors: Redouane Krini, Lutz Nuhn, Hicham El Mard Cheol Woo Ha, Yoondeok Han, Kwang-Sup Lee, Dong-Yol Yang, Jinsoo Joo, Rudolf Zentel

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To use Quantum Dots (QDs) in the two photon initiated polymerization technique (TPIP) for 3D patternings, QDs were modified on the surface with photosensitive end groups which are able to undergo a photopolymerization. We were able to fabricate fluorescent 3D lattice structures using photopatternable QDs by TPIP for photonic devices such as photonic crystals and metamaterials. The QDs in different diameter have different emission colors and through mixing of RGB QDs white light fluorescent from the polymeric structures has been created. Metamaterials are capable for unique interaction with the electrical and magnetic components of the electromagnetic radiation and for manipulating light it is crucial to have a negative refractive index. In combination with QDs via TPIP technique polymeric structures can be designed with properties which cannot be found in nature. This makes these artificial materials gaining a huge importance for real-life applications in photonic and optoelectronic. Understanding of interactions between nanoparticles and biological systems is of a huge interest in the biomedical research field. We developed a synthetic strategy of polymer functionalized nanoparticles for biomedical studies to obtain hybrid systems of QDs and copolymers with a strong binding network in an inner shell and which can be modified in the end through their poly(ethylene glycol) functionalized outer shell. These hybrid systems can be used as models for investigation of cell penetration and drug delivery by using measurements combination between CryoTEM and fluorescence studies.

Keywords: biomedical study models, lithography, photo induced polymerization, quantum dots

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937 Mudlogging, a Key Tool in Effective Well Delivery: A Case Study of Bisas Field Niger Delta, Nigeria

Authors: Segun Steven Bodunde

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Mudlogging is the continuous analysis of rock cuttings and drilling fluids to ascertain the presence or absence of oil and gas from the formation penetrated by the drilling bit. This research highlighted a case study of Well BSS-99ST from ‘Bisas Field’, Niger Delta, with depth extending from 1950m to 3640m (Measured Depth). It was focused on identifying the lithologies encountered at specified depth intervals and to accurately delineate the targeted potential reservoir on the field and prepare the lithology and Master log. Equipment such as the Microscope, Fluoroscope, spin drier, oven, and chemicals, which includes: hydrochloric acid, chloroethene, and phenolphthalein, were used to check the cuttings for their calcareous nature, for oil show and for the presence of Cement respectively. Gas analysis was done using the gas chromatograph and the Flame Ionization Detector, which was connected to the Total Hydrocarbon Analyzer (THA). Drilling Parameters and Gas concentration logs were used alongside the lithology log to predict and accurately delineate the targeted reservoir on the field. The result showed continuous intercalation of sand and shale, with the presence of small quantities of siltstone at a depth of 2300m. The lithology log was generated using Log Plot software. The targeted reservoir was identified between 3478m to 3510m after inspection of the gas analysis, lithology log, electric logs, and the drilling parameters. Total gas of about 345 units and five Alkane Gas components were identified in the specific depth range. A comparative check with the Gamma ray log from the well further confirmed the lithologic sequence and the accurate delineation of the targeted potential reservoir using mudlogging.

Keywords: mudlogging, chromatograph, drilling fluids, calcareous

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936 Preparation and Functional Properties of Synbiotic Yogurt Fermented with Lactobacillus brevis PML1 Derived from a Fermented Cereal-Dairy Product

Authors: Farideh Tabatabei-Yazdi, Fereshteh Falah, Alireza Vasiee

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Nowadays, production of functional foods has become very essential. Inulin is one of the most functional hydrocolloid compounds used in such products. In the present study, the production of a synbiotic yogurt containing 1, 2.5, and 5% (w/v) inulin has been investigated. The yogurt was fermented with Lactobacillus brevis PML1 derived from Tarkhineh, an Iranian cereal-dairy fermented food. Furthermore, the physicochemical properties, antioxidant activity, sensory attributes, and microbial viability properties were investigated on the 0th, 7th, and 14th days of storage after fermentation. The viable cells of L. brevis PML1 reached 108 CFU/g, and the product resisted to simulated digestive juices. Moreover, the synbiotic yogurt impressively increased the production of antimicrobial compounds and had the most profound antimicrobial effect on S. typhimurium. The physiochemical properties were in the normal range, and the fat content of the synbiotic yogurt was reduced remarkably. The antioxidant capacity of the fermented yogurt was significantly increased (p<0:05), which was equal to those of DPPH (69:18±1:00%) and BHA (89:16±2:00%). The viability of L. brevis PML1 was increased during storage. Sensory analysis showed that there were significant differences in terms of the impressive parameters between the samples and the control (p<0:05). Addition of 2.5% inulin not only improved the physical properties but also retained the viability of the probiotic after 14 days of storage, in addition to the viability of L. brevis with a viability count above 6 log CFU/g in the yogurt. Therefore, a novel synbiotic product containing L. brevis PML1, which can exert the desired properties, can be used as a suitable carrier for the delivery of the probiotic strain, exerting its beneficial health effects.

Keywords: functional food, lactobacillus brevis, symbiotic yogurt, physiochemical properties

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935 The application of Gel Dosimeters and Comparison with other Dosimeters in Radiotherapy: A Literature Review

Authors: Sujan Mahamud

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Purpose: A major challenge in radiotherapy treatment is to deliver precise dose of radiation to the tumor with minimum dose to the healthy normal tissues. Recently, gel dosimetry has emerged as a powerful tool to measure three-dimensional (3D) dose distribution for complex delivery verification and quality assurance. These dosimeters act both as a phantom and detector, thus confirming the versatility of dosimetry technique. The aim of the study is to know the application of Gel Dosimeters in Radiotherapy and find out the comparison with 1D and 2D dimensional dosimeters. Methods and Materials: The study is carried out from Gel Dosimeter literatures. Secondary data and images have been collected from different sources such as different guidelines, books, and internet, etc. Result: Analyzing, verifying, and comparing data from treatment planning system (TPS) is determined that gel dosimeter is a very excellent powerful tool to measure three-dimensional (3D) dose distribution. The TPS calculated data were in very good agreement with the dose distribution measured by the ferrous gel. The overall uncertainty in the ferrous-gel dose determination was considerably reduced using an optimized MRI acquisition protocol and a new MRI scanner. The method developed for comparing measuring gel data with calculated treatment plans, the gel dosimetry method, was proven to be a useful for radiation treatment planning verification. In 1D and 2D Film, the depth dose and lateral for RMSD are 1.8% and 2%, and max (Di-Dj) are 2.5% and 8%. Other side 2D+ ( 3D) Film Gel and Plan Gel for RMSDstruct and RMSDstoch are 2.3% & 3.6% and 1% & 1% and system deviation are -0.6% and 2.5%. The study is investigated that the result fined 2D+ (3D) Film Dosimeter is better than the 1D and 2D Dosimeter. Discussion: Gel Dosimeters is quality control and quality assurance tool which will used the future clinical application.

Keywords: gel dosimeters, phantom, rmsd, QC, detector

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934 Real-Time Generative Architecture for Mesh and Texture

Authors: Xi Liu, Fan Yuan

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In the evolving landscape of physics-based machine learning (PBML), particularly within fluid dynamics and its applications in electromechanical engineering, robot vision, and robot learning, achieving precision and alignment with researchers' specific needs presents a formidable challenge. In response, this work proposes a methodology that integrates neural transformation with a modified smoothed particle hydrodynamics model for generating transformed 3D fluid simulations. This approach is useful for nanoscale science, where the unique and complex behaviors of viscoelastic medium demand accurate neurally-transformed simulations for materials understanding and manipulation. In electromechanical engineering, the method enhances the design and functionality of fluid-operated systems, particularly microfluidic devices, contributing to advancements in nanomaterial design, drug delivery systems, and more. The proposed approach also aligns with the principles of PBML, offering advantages such as multi-fluid stylization and consistent particle attribute transfer. This capability is valuable in various fields where the interaction of multiple fluid components is significant. Moreover, the application of neurally-transformed hydrodynamical models extends to manufacturing processes, such as the production of microelectromechanical systems, enhancing efficiency and cost-effectiveness. The system's ability to perform neural transfer on 3D fluid scenes using a deep learning algorithm alongside physical models further adds a layer of flexibility, allowing researchers to tailor simulations to specific needs across scientific and engineering disciplines.

Keywords: physics-based machine learning, robot vision, robot learning, hydrodynamics

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933 PRENACEL: Development and Evaluation of an M-Health Strategy to Improve Prenatal Care in Brazil

Authors: E. M. Vieira, C. S. Vieira, L. P. Bonifácio, L. M. de Oliveira Ciabati, A. C. A. Franzon, F. S. Zaratini, J. A. C. Sanchez, M. S. Andrade, J. P. Dias de Souza

Abstract:

The quality of prenatal care is key to reduce maternal morbidity and mortality. Communication between the health service and users can stimulate prevention and care. M-health has been an important and low cost strategy to health education. The PRENACEL programme (prenatal in the cell phone) was developed. It consists of a programme of information via SMS from the 20th week of pregnancy up to 12th week after delivery. Messages were about prenatal care, birth, contraception and breastfeeding. Communication of the pregnant woman asking questions about their health was possible. The objective of this study was to evaluate the implementation of PRENACEL as a useful complement to the standard prenatal care. Twenty health clinics were selected and randomized by cluster, 10 as the intervention group and 10 as the control group. In the intervention group, women and their partner were invited to participate. The control group received the standard prenatal care. All women were interviewed in the immediate post-partum and in the 12th and 24th week post-partum. Most women were married, had more than 8 years of schooling and visit the clinic more than 6 times during prenatal care. The intervention group presented lowest percentage of higher economic participants (5.6%), less single mothers and no drug user. It also presented more prenatal care visits than the control group and it was less likely to present Severe Acute Maternal Mortality when compared to control group as well as higher percentage of partners (75.4%) was present at the birth compared to control group. Although the study is still being carried out, preliminary data are showing positive results of the compliance of women to prenatal care.

Keywords: cellphone, health technology, prenatal care, prevention

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932 Cucurbita pepo L. Attenuates Diabetic Neuropathy by Targeting Oxidative Stress in STZ-Nicotinamide Induced Diabetic Rats

Authors: Navpreet Kaur, Randhir Singh

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Diabetic neuropathy is one of the most common microvascular complications of diabetes mellitus which affects more than 50% of diabetic patients. The present study targeted oxidative stress mediated nerve damage in diabetic rats using a hydro-alcohol extract of Cucurbita pepo L. (Family: Cucurbitaceae) and its potential in treatment of diabetic neuropathy. Diabetes neuropathy was induced in Wistar rats by injection of streptozotocin (65 mg/kg, i.p.) 15 min after Nicotinamide (230 mg/kg, i.p.) administration. Hydro-alcohol extract of C. pepo seeds was assessed by oral administration at 100, 200 and 400 mg/kg in STZ-nicotinamide induced diabetic rats. Thermal hyperalgesia (Eddy's hot plate and tail immersion), mechanical hyperalgesia (Randall-Selitto) and tactile allodynia (Von Frey hair tests) were evaluated in all groups of streptozotocin diabetic rats to assess the extent of neuropathy. Tissue (sciatic nerve) antioxidant enzymes (SOD, CAT, GSH and LPO) levels were measured along with the formation of AGEs in serum to assess the effect of hydro-alcohol extract of C. pepo in ameliorating oxidative stress. Diabetic rats exhibited significantly decreased tail-flick latency in the tail-immersion test and decreased paw withdrawal threshold in both Randall-Selitto and von-Frey hair test. A decrease in the nociceptive threshold was accompanied by significantly increased oxidative stress in sciatic nerve of diabetic rats. Treatment with the C. pepo hydro-alcohol extract significantly attenuated all the behavioral and biochemical alterations in a dose-dependent manner. C. pepo attenuated the diabetic condition and also reversed neuropathic pain through modulation of oxidative stress and thus it may find application as a possible therapeutic agent against diabetic neuropathy.

Keywords: advanced glycation end products, antioxidant enzymes, cucurbita pepo, hyperglycemia

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931 Towards Renewable Energy: A Qualitative Study of Biofuel Development Policy in Indonesia

Authors: Arie Yanwar Kapriadi

Abstract:

This research is aiming to develop deeper understanding of the scale of power that shaped the biofuel policy. This research is important for the following reasons. Firstly, this research will enrich the body of literature within the field of political ecology, scale and environmental governance. Secondly, by focussing on energy transition policies, this research offers a critical perspective on how government policy, aimed at delivering low carbon sustainable energy systems, being scaled and implemented through multi variate stakeholders. Finally, the research could help the government of Indonesia as a policy evaluation on delivering low carbon sustainable energy systems at the macro level that (possibility) being unable to be delivered at different scale and instead being perceived differently by different stakeholders. Qualitative method is applied particularly an in depth interview with government officials as well as policy stakeholders outside of government and people in positions of responsibility with regards to policy delivery. There are 4 field study location where interview took place as well as sites visit to some biofuel refining facilities. There are some major companies which involve on the production and distribution of biofuel and its relation with biofuel feedstock industry as the source of data. The research investigates how the government biofuel policies correlated with other policy issues such as land reclassification and carbon emission reduction which also influenced plantations expansion as well as its impact on the local people. The preliminary result shows tension of power between governing authorities caused the Indonesian biofuel policy being unfocused which led to failing to meet its mandatory blending target despite the abundance of its feedstock.

Keywords: biofuel, energy transition, renewable energy, political ecology

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930 The Aesthetic Manifestations of Nothingness in Contemporary Visual Arts Practice

Authors: Robyn Therese Munnick

Abstract:

This paper aims to report on a qualitative practice-based research study which explores the notion of nothingness and how it (nothingness) is the conceptual and theoretical foundation for artistic practice. Furthermore, this study explicates how the artist used their mother’s battle with cancer and the subsequent void it created as source material for the artistic expression of nothingness. The diagnosis which was followed by a physical and emotional absence of the matriarch of the artist family led to an emotional trauma that triggered a feeling of nothingness within the artist. The overarching problem in the study is thus: how this ‘nothingness’ could be expressed in visual art? Nothingness, as a product of expectation, is a notion which refers to where something used to be, should be or isn’t anymore, which attempts to grasp what is there by not being there. In attempting to express nothingness, the research aims to build on an exploration of various materials and modes utilized in order to underpin the research objectives. The primary mode of delivery for the art-making process is painting. However, through strengthening the messages and meaning of the hypothesis of nothingness within the art and research, the use of further modes and materials became pivotal. This involves the use of unconventional contrasting modes within a painting such as the cloth doily, thread, tubing, ceramics, food colour, spray paint, polyvinyl acetate paint, plaster, wooden boxes and fragments thereof. These materials and modes were vital in visualising and aestheticising the conceptual underpinnings of the research. As a result, this strengthened and emancipated the art from the traditional bounds of pure painting. Methods of data gathering took the form of artefacts, document analysis, and field notes in the form of photographic journaling. Ultimately the body of work and research validates that the idea of nothingness can be artistically explored.

Keywords: conceptual, nothingness, modes, unconventional

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929 Bimetallic Cu/Au Nanostructures and Bio-Application

Authors: Si Yin Tee

Abstract:

Bimetallic nanostructures have received tremendous interests as a new class of nanomaterials which may have better technological usefulness with distinct properties from those of individual atoms and molecules or bulk matter. They excelled over the monometallic counterparts because of their improved electronic, optical and catalytic performances. The properties and the applicability of these bimetallic nanostructures not only depend on their size and shape, but also on the composition and their fine structure. These bimetallic nanostructures are potential candidates for bio-applications such as biosensing, bioimaging, biodiagnostics, drug delivery, targeted therapeutics, and tissue engineering. Herein, gold-incorporated copper (Cu/Au) nanostructures were synthesized through the controlled disproportionation of Cu⁺-oleylamine complex at 220 ºC to form copper nanowires and the subsequent reaction with Au³⁺ at different temperatures of 140, 220 and 300 ºC. This is to achieve their synergistic effect through the combined use of the merits of low-cost transition and high-stability noble metals. Of these Cu/Au nanostructures, Cu/Au nanotubes display the best performance towards electrochemical non-enzymatic glucose sensing, originating from the high conductivity of gold and the high aspect ratio copper nanotubes with high surface area so as to optimise the electroactive sites and facilitate mass transport. In addition to high sensitivity and fast response, the Cu/Au nanotubes possess high selectivity against interferences from other potential interfering species and excellent reproducibility with long-term stability. By introducing gold into copper nanostructures at a low level of 3, 1 and 0.1 mol% relative to initial copper precursor, a significant electrocatalytic enhancement of the resulting bimetallic Cu/Au nanostructures starts to occur at 1 mol%. Overall, the present fabrication of stable Cu/Au nanostructures offers a promising low-cost platform for sensitive, selective, reproducible and reusable electrochemical sensing of glucose.

Keywords: bimetallic, electrochemical sensing, glucose oxidation, gold-incorporated copper nanostructures

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928 Local Development and Community Participation in Owo Local Government Area of Ondo State, Nigeria

Authors: Tolu Lawal

Abstract:

The genuine development of the grassroots particularly in the developing societies depends largely on the participation of the rural populace in policy conception and implementation, especially in the area of development policies, fundamentally, the rural people play a vital and significance role in economic and political development of the nation. This is because the bulk of the economic produce as well as votes come from these areas. However, the much needed development has continued to elude the rural communities inspire of the various development policies carried out by successive governments in the state. The exclusion of rural communities from planning and implementation of facilities meant to benefit them, and the international debate on sustainable rural development led Ondo State government to re-think its rural development policy with a view to establishing more effective strategies for rural development. The 31s initiatives introduced in 2009 emphasizes the important role of communities in their own development. The paper therefore critically assessed the 31s initiative of the present government in Ondo State with a view to knowing its impact on rural people. The study adopted both primary and secondary data to source its information. Interviews were conducted with the key informants, and field survey (visit) was also part of method of collecting data. Documents, reports and records on 31s initiatives in the selected villages and from outside were also consulted. The paper submitted that 31s initiative has not impacted positively on the lives of rural dwellers in Ondo-State, most especially in the areas of infrastructure and integrated development. The findings also suggested that 31s initiatives is not hopeless, but needs a different kind of investment, for example introducing measures of accountability, addressing the politicization of the initiative and exploiting key principles of development and service delivery.

Keywords: development, infrastructure, rural development, participation

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927 [Keynote Talk]: Treatment Satisfaction and Safety of Sitagliptin versus Pioglitazone in Patients with Type 2 Diabetes Mellitus Inadequately Controlled on Metformin Monotherapy

Authors: Shahnaz Haque, Anand Shukla, Sunita Singh, Anil Kem

Abstract:

Introduction: Diabetes Mellitus is a chronic metabolic disease affecting millions worldwide. Metformin is the most commonly prescribed first line oral hypoglycemic drug for type 2 diabetes mellitus, but due to progressive worsening of blood glucose control during the natural history of type 2 diabetes, combination therapy usually becomes necessary. Objective: This study was designed to assess the treatment satisfaction between Sitagliptin versus Pioglitazone added to Metformin in patients with type 2 diabetes mellitus (T2DM). Methods: We conducted a prospective, open label, randomized, parallel group study in SIMS, Hapur, U.P. Eligible patients fulfilling inclusion criteria were randomized into two groups having 25 patients in each group using tab Sitagliptin 100mg, tab Pioglitazone 30mg added to ongoing tab Metformin (500mg) therapy for 16 weeks. The follow-up visits were on weeks 4,12 and 16. Result: 16 weeks later, addition of Sitagliptin 100mg compared to that of Pioglitazone 30 mg to ongoing Metformin therapy provided similar glycosylated hemoglobin (HbA1c) lowering efficacy in patients with T2DM with inadequate glycemic control on metformin monotherapy. Change in HbA1c in group1 was -0.656±0.21%(p<0.0001) whereas in group2 was -0.748±0.35%(p<0.0001). Hence decrease in HbA1c from baseline was more in group2. Both treatments were well tolerated with negligible risk of hypoglycaemia. Weight loss was observed with Sitagliptin in contrast to weight gain seen in Pioglitazone. Conclusion: In this study, Sitagliptin 100 mg along with metformin therapy in comparison to pioglitazone 30 mg plus metformin therapy was both effective, well-tolerated and improved glycemic control in both the groups. Addition of pioglitazone had cause oedema and weight gain to the patients whereas sitagliptin caused weight loss in its patients.

Keywords: sitagliptin, pioglitazone, metformin, type 2 diabetes mellitus

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926 Combination of Diane-35 and Metformin to Treat Early Endometrial Carcinoma in PCOS Women with Insulin Resistance

Authors: Xin Li, Yan-Rong Guo, Jin-Fang Lin, Yi Feng, Håkan Billig, Ruijin Shao

Abstract:

Background: Young women with polycystic ovary syndrome (PCOS) have a high risk of developing endometrial carcinoma. There is a need for the development of new medical therapies that can reduce the need for surgical intervention so as to preserve the fertility of these patients. The aim of the study was to describe and discuss cases of PCOS and insulin resistance (IR) women with early endometrial carcinoma while being co-treated with Diane-35 and metformin. Methods: Five PCOS-IR women who were scheduled for diagnosis and therapy for early endometrial carcinoma were recruited. The hospital records and endometrial pathology reports were reviewed. All patients were co-treated with Diane-35 and metformin for 6 months to reverse the endometrial carcinoma and preserve their fertility. Before, during, and after treatment, endometrial biopsies and blood samples were obtained and oral glucose tolerance tests were performed. Endometrial pathology was evaluated. Body weight (BW), body mass index (BMI), follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone (TT), sex hormone-binding globulin (SHBG), free androgen index (FAI), insulin area under curve (IAUC), and homeostasis model assessment of insulin resistance (HOMA-IR) were determined. Results: Clinical stage 1a, low grade endometrial carcinoma was confirmed before treatment. After 6 months of co-treatment, all patients showed normal epithelia. No evidence of atypical hyperplasia or endometrial carcinoma was found. Co-treatment resulted in significant decreases in BW, BMI, TT, FAI, IAUC, and HOMA-IR in parallel with a significant increase in SHBG. There were no differences in the FSH and LH levels after co-treatment. Conclusions: Combined treatment with Diane-35 and metformin has the potential to revert the endometrial carcinoma into normal endometrial cells in PCOS-IR women. The cellular and molecular mechanisms behind this effect merit further investigation.

Keywords: PCOS, progesterone resistance, insulin resistance, steroid hormone receptors, endometrial carcinoma

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925 Basic Examination of Easily Distinguishable Tactile Symbols Attached to Containers and Packaging

Authors: T. Nishimura, K. Doi, H. Fujimoto, Y. Hoshikawa, T. Wada

Abstract:

In Japan, it is expected that reasonable accommodation for persons with disabilities will progress further. In particular, there is an urgent need to enhance information support for visually impaired persons who have difficulty accessing information. Recently, tactile symbols have been attached to various surfaces, such as the content labels of containers and packaging of various everyday products. The advantage of tactile symbols is that they are useful for visually impaired persons who cannot read Braille. The method of displaying tactile symbols is prescribed by the International Organization for Standardization (ISO). However, the quantitative data on the shapes and dimensions of tactile symbols is insufficient. In this study, through an evaluation experiments, we examine the easy-to-distinguish shapes and dimensions of tactile symbols used for various applications, including the content labels on containers and packaging. Visually impaired persons participated in the experiments. They used tactile symbols on a daily basis. The details and processes of the experiments were orally explained to the participants prior to the experiments, and the informed consent of the participants was obtained. They were instructed to touch the test pieces of tactile symbols freely with both hands. These tactile symbols were selected because they were likely to be easily distinguishable symbols on the content labels of top surfaces of containers and packaging based on a hearing survey that involved employees of an organization of visually impaired and a social welfare corporation, as well as academic experts of support technology for visually impaired. The participants then answered questions related to ease of distinguishing of tactile symbols on a scale of 5 (where 1 corresponded to ‘difficult to distinguish’ and 5 corresponded to ‘easy to distinguish’). Hearing surveys were also performed in an oral free answer manner with the participants after the experiments. This study revealed the shapes and dimensions regarding easily distinguishable tactile symbols attached to containers and packaging. We expect that this knowledge contributes to improvement of the quality of life of visually impaired persons.

Keywords: visual impairment, accessible design, tactile symbol, containers and packaging

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924 A Study on the Cultural Landscape of the Living Environment of Hoklo-Hakka: Case Study of Dacun

Authors: Meng-Li Lin, Shang-Hsuan Chiu

Abstract:

Taiwan is a country of diverse ethnic groups, the historical background of each ethnic group is different, and the conflict between them influence on each other, result in Taiwan's multi-culture. The Changhua County in Taiwan is the largest county of Hoklo-Hakka. Hakka people get along with Hoklo people for a long time. There are integration and conflict during that time and makes Hakka people gradually assimilated Hoklo-Hakka people. Today in Changhua Plain area, many Hoklo-Hakka people do not speak Hakka language. Therefore, it has been difficult to find information of Hakka from the Hakka language in the group of Hoklo-Hakka. But in the living space or culture to find relevant historical traces of life could be confirmed in Hakka Culture. In this paper, through the investigation of descent, life field, religion, language and other investigations of the Dacun, Changhua County residents to carry out the analysis of the process of assimilating Hoklo in living cultural landscape. First is through the local literature, the elderly and other oral history stories, to investigate the changes in Dacun field historical. Second, the comparison of collected traditional Hakka culture and the living cultural landscape of Hoklo-Haka are done to explore the differences between the living cultural landscape and the traditional Hakka culture. After analysis Hoklo-Hakka living cultural landscape, the significant differences, we proposed preservation strategy to provide recommendations to save the cultural life of Hoklo-Hakka landscape in future. Changhua Dacun traditional Hakka landscape is disappearing, in this study, we explore and investigate the data of Changhua Dacun Hoklo-Hakka living cultural landscape to analyze and to provide strategic advice to save. Here we have three study purposes. 1. Discuss the Hoklo-Hakka living cultural landscape of Changhua Dacun. 2. Investigate and record the Hoklo-Hakka living cultural landscape. 3. Propose a reserve strategy of the Hoklo-Hakka living cultural landscape in future.

Keywords: Hoklo-Hakka, Dacun, save policy, life Culture

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923 Overview of Pre-Analytical Lab Errors in a Tertiary Care Hospital at Rawalpindi, Pakistan

Authors: S. Saeed, T. Butt, M. Rehan, S. Khaliq

Abstract:

Objective: To determine the frequency of pre-analytical errors in samples taken from patients for various lab tests at Fauji Foundation Hospital, Rawalpindi. Material and Methods: All the lab specimens for diagnostic purposes received at the lab from Fauji Foundation hospital, Rawalpindi indoor and outdoor patients were included. Total number of samples received in the lab is recorded in the computerized program made for the hospital. All the errors observed for pre-analytical process including patient identification, sampling techniques, test collection procedures, specimen transport/processing and storage were recorded in the log book kept for the purpose. Results: A total of 476616 specimens were received in the lab during the period of study including 237931 and 238685 from outdoor and indoor patients respectively. Forty-one percent of the samples (n=197976) revealed pre-analytical discrepancies. The discrepancies included Hemolyzed samples (34.8%), Clotted blood (27.8%), Incorrect samples (17.4%), Unlabeled samples (8.9%), Insufficient specimens (3.9%), Request forms without authorized signature (2.9%), Empty containers (3.9%) and tube breakage during centrifugation (0.8%). Most of these pre-analytical discrepancies were observed in samples received from the wards revealing that inappropriate sample collection by the medical staff of the ward, as most of the outdoor samples are collected by the lab staff who are properly trained for sample collection. Conclusion: It is mandatory to educate phlebotomists and paramedical staff particularly performing duties in the wards regarding timing and techniques of sampling/appropriate container to use/early delivery of the samples to the lab to reduce pre-analytical errors.

Keywords: pre analytical lab errors, tertiary care hospital, hemolyzed, paramedical staff

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922 E-Portfolios as a Means of Perceiving Students’ Listening and Speaking Progress

Authors: Heba Salem

Abstract:

This paper aims to share the researcher’s experience of using e-Portfolios as an assessment tool to follow up on students’ learning experiences and performance throughout the semester. It also aims at highlighting the importance of students’ self-reflection in the process of language learning. The paper begins by introducing the advanced media course, with its focus on listening and speaking skills, and introduces the students’ profiles. Then it explains the students’ role in the e-portfolio process as they are given the option to choose a listening text they studied throughout the semester and to choose a recorded oral production of their collection of artifacts throughout the semester. Students showcase and reflect on their progress in both listening comprehension and speaking. According to the research, re-listening to work given to them and to their production is a means of reflecting on both their progress and achievement. And choosing the work students want to showcase is a means to promote independent learning as well as self-expression. Students are encouraged to go back to the class learning outcomes in the process of choosing the work. In their reflections, students express how they met the specific learning outcome. While giving their presentations, students expressed how useful the experience of returning and going over what they covered to select one and going over their production as well. They also expressed how beneficial it was to listen to themselves and literally see their progress in both listening comprehension and speaking. Students also reported that they grasped more details from the texts than they did when first having it as an assignment, which coincided with one of the class learning outcomes. They also expressed the fact that they had more confidence speaking as well as they were able to use a variety of vocabulary and idiomatic expressions that students have accumulated. For illustration, this paper includes practical samples of students’ tasks and instructions as well as samples of their reflections. The results of students’ reflections coincide with what the research confirms about the effectiveness of the e-portfolios as a means of assessment. The employment of e-Portfolios has two-folded benefits; students are able to measure the achievement of the targeted learning outcomes, and teachers receive constructive feedback on their teaching methods.

Keywords: e-portfolios, assessment, self assessment, listening and speaking progress, foreign language, reflection, learning out comes, sharing experience

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921 Anterior Tooth Misalignment: Orthodontics or Restorative Treatment

Authors: Maryam Firouzmandi, Moosa Miri

Abstract:

Smile is considered to be one of the most effective methods of influencing people. Increasing numbers of patients are requesting cosmetic dental procedures to achieve the perfect smile. Based on the patient’s age, oral and facial characteristics, and the dentist’s expertise, different concepts of treatment would be available. Orthodontics is the most conservative and the ideal treatment alternative for crowded anterior teeth; however, it may be rejected by patients due to occupational limitations of time, physical discomfort including pain and functional limitations, psychological discomfort, and appearance during treatment. In addition, orthodontic treatment will not resolve deficits of contour and color of the anterior teeth. In consequence, patients may demand restorative techniques to resolve their anterior mal-alignment instead, often called "instant orthodontics". Following its introduction, however, adhesive dentistry has suffered at times from overuse. Creating short-term attractive smiles at the expense of long-term dental health and optimal tooth biomechanics by using cosmetic techniques should not be considered an ethical approach. The objective of this narrative review was to investigate the literature for guidelines with regard to decision making and treatment planning for anterior tooth mal-alignment. In this regard, indications of orthodontic, restorative, combination of both treatments, and adjunctive periodontal surgery were discussed in clinical cases to achieve a proportional smile. Restorative modalities would include disking, cosmetic contouring, veneers, and crowns and were compared with limited or comprehensive orthodontic options. A rapid review was also presented on pros and cons of snap on smile to mask malalignments. Diagnostic tools such as mock up, wax up, and digital smile design were also considered to achieve more conservative and functional treatments with respect to biologic factors.

Keywords: crowding, misalignment, veneer, crown, orthodontics

Procedia PDF Downloads 110