Search results for: final outcome
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4275

Search results for: final outcome

2175 Psychosocial Determinants of Quality of Life After Treatment for Breast Cancer - A Systematic Review

Authors: Lakmali Anthony, Madeline Gillies

Abstract:

Purpose: Decreasing mortality has led to increased focus on patient-reported outcomes such as quality of life (QoL) in breast cancer. Breast cancer patients often have decreased QoL even after treatment is complete. This systematic review of the literature aims to identify psychosocial factors associated with decreased QoL in post-treatment breast cancer patients. Methodology: This systematic review was performed in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. The search was conducted in MEDLINE, EMBASE, and PsychINFO using MeSH headings. The two authors screened studies for relevance and extracted data. Results: Seventeen studies were identified, including 3,150 total participants (mean = 197) with a mean age of 51.9 years. There was substantial heterogeneity in measures of QoL. The most common was the European Organisation for Research and Treatment of Cancer QLQ-C30 (n=7, 41.1%). Most studies (n=12, 70.5%) found that emotional distress correlated with poor QoL, while 3 found no significant association. The most common measure of emotional distress was the Hospital Anxiety and Depression Scale (n=12, 70.5%). Other psychosocial factors associated with QoL were unmet needs, problematic social support, and negative affect. Clinicopathologic determinants included mastectomy without reconstruction, stage IV disease, and adjuvant chemotherapy. Conclusion: This systematic review provides a summary of the psychosocial determinants of poor QoL in post-treatment breast cancer patients, as well as the most commonly reported measures of these. An understanding of these potentially modifiable determinants of poor outcome is pivotal to the provision of quality, patient-centred care in surgical oncology.

Keywords: breast cancer, quality of life, psychosocial determinants, cancer surgery

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2174 EFL Vocabulary Learning Strategies among Students in Greece, Their Preferences and Internet Technology

Authors: Theodorou Kyriaki, Ypsilantis George

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Vocabulary learning has attracted a lot of attention in recent years, contrary to the neglected part of the past. Along with the interest in finding successful vocabulary teaching strategies, many scholars focused on locating learning strategies used by language learners. As a result, more and more studies in the area of language pedagogy have been investigating the use of strategies in vocabulary learning by different types of learners. A common instrument in this field is the questionnaire, a tool of work that was enriched by questions involving current technology, and it was further implemented to a sample of 300 Greek students whose age varied from 9 and 17 years. Strategies located were grouped into the three categories of memory, cognitive, and compensatory type and associations between these dependent variables were investigated. In addition, relations between dependent and independent variables (such as age, sex, type of school, cultural background, and grade in English) were pursued to investigate the impact on strategy selection. Finally, results were compared to findings of other studies in the same field to contribute to a hypothesis of ethnic differences in strategy selection. Results initially discuss preferred strategies of all participants and further indicate that: a) technology affects strategy selection while b) differences between ethnic groups are not statistically significant. A number of successful strategies are presented, resulting from correlations of strategy selection and final school grade in English.

Keywords: acquisition of English, internet technology, research among Greek students, vocabulary learning strategies

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2173 The Effect of Emotion Self-Confidence and Perceived Social Support on Hong Kong Higher-Education Students' Suicide-Related Emotional Experiences

Authors: K. C. Ching

Abstract:

There is growing public concern over the increasing prevalence of student suicide in Hong Kong. Some identify the problem with insufficient social support, while some attribute it to the vast fluctuations in emotional experience and the hindrances to emotion-regulation, both typical of adolescence and emerging adulthood. This study is thus designed to explore the respective effect of perceived social support and emotion self-confidence, on positive emotions and negative emotions. Fifty-seven Hong Kong higher-education students (17 males, 40 females) aged between 18 and 25 (M = 21.78) responded to an online questionnaire consisted of self-reported measures of perceived social support, emotional self-confidence, positive emotions, and negative emotions. Hierarchical regression analysis revealed that emotional self-confidence positively associated with positive emotions and negatively with negative emotions, while perceived social support positively associated with positive emotions but was not related to negative emotions. Perceived social support and emotional self-confidence both predicted positive emotions, but did not interact to predict any emotional outcome. It is concluded that students’ positive and negative emotional experiences are closely related to their emotion-regulation process. But for social support, its effect is merely protective, meaning that although perceived social support generally promotes positive emotions, it alone does not suffice to alleviate students’ negative emotions. These conclusions carry profound implications to suicide prevention practices, including that most existing suicide prevention campaigns should advance from merely fostering mutual support to directly promoting adaptive coping of emotional negativity.

Keywords: emerging adulthood, emotional self-confidence, hong kong, perceived social support, suicide prevention

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2172 Determinants of Corporate Social Responsibility in Indonesia

Authors: Bela Sulistyaguna, Yuli Chomsatu Samrotun, Endang Masitoh Wahyuningsih

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The purpose of this research was to analyze the influence of company size, liquidity, profitability, leverage, company age, industry type, board of director, board of commissioner, audit committee and public ownership on the corporate social responsibility disclosure. The grand theories of this research are agency theory, stakeholders theory, and legitimacy theory. Analysis of data using multiple linear regression method with SPSS 22.0 for mac. The sample consists of companies listed on the Indonesia Stock Exchange (IDX) and disclosed the Global Reporting Initiative (GRI) sustainability reports from 2013 to 2018. The final sample of this research was 19 companies that obtained by purposive sampling. The results of the research showed that, simultaneously, company size, liquidity, profitability, leverage, company age, industry type, board of director, board of commissioner, audit committee and public ownership has an influence on the corporate social responsibility disclosure. Partially, the results showed that liquidity and leverage has an influence on the corporate social responsibility disclosure. Meanwhile, company size, profitability, company age, industry type, board of director, board of commissioner, audit committee and public ownership has no influence on corporate social responsibility disclosure.

Keywords: corporate social responsibility, CSR disclosure, Indonesia

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2171 Corticomotor Excitability after Two Different Repetitive Transcranial Magnetic Stimulation Protocols in Ischemic Stroke Patients

Authors: Asrarul Fikri Abu Hassan, Muhammad Hafiz bin Hanafi, Jafri Malin Abdullah

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This study is to compare the motor evoked potential (MEP) changes using different settings of repetitive transcranial magnetic stimulation (rTMS) in the post-haemorrhagic stroke patient which treated conservatively. The goal of the study is to determine changes in corticomotor excitability and functional outcome after repetitive transcranial magnetic stimulation (rTMS) therapy regime. 20 post-stroke patients with upper limb hemiparesis were studied due to haemorrhagic stroke. One of the three settings; (I) Inhibitory setting, or (II) facilitatory setting, or (III) control group, no excitatory or inhibitory setting have been applied randomly during the first meeting. The motor evoked potential (MEP) were recorded before and after application of the rTMS setting. Functional outcomes were evaluated using the Barthel index score. We found pre-treatment MEP values of the lesional side were lower compared to post-treatment values in both settings. In contrast, we found that the pre-treatment MEP values of the non-lesional side were higher compared to post-treatment values in both settings. Interestingly, patients with treatment, either facilitatory setting and inhibitory setting have faster motor recovery compared to the control group. Our data showed both settings might improve the MEP of the upper extremity and functional outcomes in the haemorrhagic stroke patient.

Keywords: Barthel index, corticomotor excitability, motor evoked potential, repetitive transcranial magnetic stimulation, stroke

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2170 Parametric Urbanism: A Climate Responsive Urban Form for the MENA Region

Authors: Norhan El Dallal

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The MENA region is a challenging, rapid urbanizing region, with a special profile; culturally, socially, economically and environmentally. Despite the diversity between different countries of the MENA region they all share similar urban challenges where extensive interventions are crucial. A climate sensitive region as the MENA region requires special attention for development, adaptation and mitigation. Integrating climatic and environmental parameters into the planning process to create a responsive urban form is the aim of this research in which “Parametric Urbanism” as a trend serves as a tool to reach a more sustainable urban morphology. An attempt to parameterize the relation between the climate and the urban form in a detailed manner is the main objective of the thesis. The aim is relating the different passive approaches suitable for the MENA region with the design guidelines of each and every part of the planning phase. Various conceptual scenarios for the network pattern and block subdivision generation based on computational models are the next steps after the parameterization. These theoretical models could be applied on different climatic zones of the dense communities of the MENA region to achieve an energy efficient neighborhood or city with respect to the urban form, morphology, and urban planning pattern. A final criticism of the theoretical model is to be conducted showing the feasibility of the proposed solutions economically. Finally some push and pull policies are to be proposed to help integrate these solutions into the planning process.

Keywords: parametric urbanism, climate responsive, urban form, urban and regional studies

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2169 “Referral for re-submission” – The Case of EFL Applied Linguistics Doctoral Defense Sessions

Authors: Alireza Jalilifar, Nadia Mayahi

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An oral defense is the examination of a doctoral program in which the candidates display their academic capacity through sharing and disseminating the findings of their study and defending their position. In this challenging criticism-generating context, the examiners evaluate the PhD dissertation critically so as to confirm its scholarly merit or lack of it. To identify the examiners’ expectations of the viva, this study used a conversation analytic approach for analyzing the data. The research is inductive in that it seeks to develop theory that is grounded in the data. The data comprised transcripts of the question and answer section of two applied linguistics doctoral defense sessions from two accredited Iranian state universities in 2019, both of which are among the top Iranian universities on the list of Times Higher Education World University Rankings. In spite of the similar shortcomings and deficiencies, for instance, in terms of innovation, development, sampling, and treatment, raised by the examiners, one of these defenses passed with distinction while the other was referred for re-submission. It seems that the outcome of a viva, in an EFL context, not only depends on adherence to the rules and regulations of doctoral research but is also influenced to a certain extent by the strictness of the examiners and the candidates’ language proficiency and effective negotiation and communication skills in this confrontational communicative event. The findings of this study provide evidence for the issues determining the success or failure of PhD candidates in displaying their claims of scholarship during their defense sessions. This study has implications for both applied linguistics doctoral students and academics in EFL contexts who try to prove and authenticate the doctorateness of a dissertation.

Keywords: academic discourse, conversation analysis, doctoral defense, doctorateness, EFL

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2168 Substitution of Fish Meal by Local Vegetable Raw Materials in the Feed of Juvenile Nile Tilapia (Oreochromis Niloticus, Linne, 1758) in Senegal

Authors: Mamadou Sileye Niang

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The study is a contribution to the development of a feed for juvenile tilapia Oreochromis niloticus, from local raw materials in order to reduce the cost of feeding farmed tilapia in Senegal. Three feeds were formulated from local raw materials. The basic composition of the tested feeds is as follows: A1 (peanut meal, rice bran, millet bran, maize meal and no fish meal); A2 (peanut meal, rice bran, millet bran, maize meal and 10% fish meal) and A3 (peanut meal, rice bran, millet bran, maize meal and 25% fish meal). All feeds contain 31% protein. The trial compared three batches, in 2 replicates, with different diets. The initial weight of the juveniles was 0.37± 0.5g. The daily ration was distributed at 9 am and 4 pm. After 90 days of the experiment, the final mean weights were 2.45 ± 0.5g; 2.75±0.5g; and 4.67 ± 0.5g for A1, A2, and A3, respectively. A performance test, of which the objective was to compare growth parameters, was conducted. The results of the growth parameters of juveniles fed A3 were significantly higher (p < 0.05) than those fed A1 and A2. The weight growth study shows similar growth during the first month. However, from this date onwards, juveniles fed A3 show a faster growth, which is maintained throughout the experiment. On the other hand, the Protein Efficiency Coefficient and the Survival Rate showed no significant difference. The zootechnical parameters are not significantly different (p > 0.05) between the two tanks for the same feed treatment.

Keywords: nutrition, feed, fingerlings, Oreochromis, local raw materials, feed cost

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2167 Radiation Protection Assessment of the Emission of a d-t Neutron Generator: Simulations with MCNP Code and Experimental Measurements in Different Operating Conditions

Authors: G. M. Contessa, L. Lepore, G. Gandolfo, C. Poggi, N. Cherubini, R. Remetti, S. Sandri

Abstract:

Practical guidelines are provided in this work for the safe use of a portable d-t Thermo Scientific MP-320 neutron generator producing pulsed 14.1 MeV neutron beams. The neutron generator’s emission was tested experimentally and reproduced by MCNPX Monte Carlo code. Simulations were particularly accurate, even generator’s internal components were reproduced on the basis of ad-hoc collected X-ray radiographic images. Measurement campaigns were conducted under different standard experimental conditions using an LB 6411 neutron detector properly calibrated at three different energies, and comparing simulated and experimental data. In order to estimate the dose to the operator vs. the operating conditions and the energy spectrum, the most appropriate value of the conversion factor between neutron fluence and ambient dose equivalent has been identified, taking into account both direct and scattered components. The results of the simulations show that, in real situations, when there is no information about the neutron spectrum at the point where the dose has to be evaluated, it is possible - and in any case conservative - to convert the measured value of the count rate by means of the conversion factor corresponding to 14 MeV energy. This outcome has a general value when using this type of generator, enabling a more accurate design of experimental activities in different setups. The increasingly widespread use of this type of device for industrial and medical applications makes the results of this work of interest in different situations, especially as a support for the definition of appropriate radiation protection procedures and, in general, for risk analysis.

Keywords: instrumentation and monitoring, management of radiological safety, measurement of individual dose, radiation protection of workers

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2166 Diffusion Mechanism of Aroma Compound (2-Acetyl-1-Pyrroline) in Rice During Storage

Authors: Mary Ann U. Baradi, Arnold R. Elepaño, Manuel Jose C. Regalado

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Aromatic rice has become popular and continues to command higher price than ordinary rice because of its distinctive scent that makes it special. Freshly harvested aromatic rice exhibits strong aromatic scent but decreases with time and conditions during storage. Of the many volatile compounds in aromatic rice, 2-acetyl-1-pyrroline (2AP) is a major compound that gives rice its popcorn-like aroma. The diffusion mechanism of 2AP in rice was investigated. Semi-empirical models explaining 2AP diffusion as affected by temperature and duration were developed. Storage time and temperature affected 2AP loss via diffusion. The amount of 2AP in rice decreased with time. Free 2AP, being volatile, is lost due to diffusion. Storage experiment indicated rapid 2AP loss during the first five weeks and subsequently leveled off afterwards; attaining level of starch bound 2AP. Decline of 2AP during storage followed exponential equation and exhibited four stages; i.e. the initial, second, third and final stage. Free 2AP is easily lost while bound 2AP is left, only to be released upon exposure to high temperature such as cooking. Both free and bound 2AP is found in endosperm while free 2AP is in the bran. Around 63–67% of total 2AP was lost in brown and milled rice of MS 6 paddy kept at ambient. Samples stored at higher temperature (27°C) recorded higher 2AP loss than those kept at lower temperature (15°C). The study should be able to guide processors in understanding and controlling parameters in storage to produce high quality rice.

Keywords: 2-acetyl-1-pyrroline, aromatic rice, diffusion mechanism, storage

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2165 Spatio-Temporal Changes of Rainfall in São Paulo, Brazil (1973-2012): A Gamma Distribution and Cluster Analysis

Authors: Guilherme Henrique Gabriel, Lucí Hidalgo Nunes

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An important feature of rainfall regimes is the variability, which is subject to the atmosphere’s general and regional dynamics, geographical position and relief. Despite being inherent to the climate system, it can harshly impact virtually all human activities. In turn, global climate change has the ability to significantly affect smaller-scale rainfall regimes by altering their current variability patterns. In this regard, it is useful to know if regional climates are changing over time and whether it is possible to link these variations to climate change trends observed globally. This study is part of an international project (Metropole-FAPESP, Proc. 2012/51876-0 and Proc. 2015/11035-5) and the objective was to identify and evaluate possible changes in rainfall behavior in the state of São Paulo, southeastern Brazil, using rainfall data from 79 rain gauges for the last forty years. Cluster analysis and gamma distribution parameters were used for evaluating spatial and temporal trends, and the outcomes are presented by means of geographic information systems tools. Results show remarkable changes in rainfall distribution patterns in São Paulo over the years: changes in shape and scale parameters of gamma distribution indicate both an increase in the irregularity of rainfall distribution and the probability of occurrence of extreme events. Additionally, the spatial outcome of cluster analysis along with the gamma distribution parameters suggest that changes occurred simultaneously over the whole area, indicating that they could be related to remote causes beyond the local and regional ones, especially in a current global climate change scenario.

Keywords: climate change, cluster analysis, gamma distribution, rainfall

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2164 Value Creation of Public Financial Management Reforms through Their Long-Term Impacts

Authors: Christoph Schuler, Oriana Ponta

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Public Financial Management (PFM) reforms are promoted by various international organizations such as the International Monetary Fund (IMF) or the World Bank, local development banks and the donor country community to strengthen governance and accountability in developing countries across the world. Reform efforts undertaken are often systematically measured against international best practice by the application of standardized analytical instruments such as the Public Expenditure and Financial Accountability Framework (PEFA) or the Poverty Reduction Action Plan (PARP). While those instruments analyze direct achievements of PFM reforms, the long-term benefits of such reforms for society remain untapped. This gives rise to the question why the concept of impact evaluation with its experimental or quasi-experimental settings in the form of randomized control trials has rarely been applied in the context of PFM reforms. To close this gap, this study provides examples where the concept of impact evaluation can be applied to PFM reforms and thereby shifting the focus from outcome towards a long-term impact. As it is a new approach, this study does not attempt to conduct a fully flagged impact evaluation of a certain PFM reform. However, it will outline, as a form of pre-test the applicability of the impact evaluation methodology in this context, for example, by more closely analyzing the commonly used indicators (for example within PEFA or PARP). This would mean to scrutinize these indicators as to how they were designed and how they are related to the long-term impact, they should be producing. The analysis of PFM reform indicators and their relation to long-term impacts should provide practitioners and scholars alike with new insights on how to strengthen the accountability of public service delivery through successful and sustainable PFM reforms.

Keywords: accountability, impact evaluation, PFM reforms, public financial management

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2163 Effect of Ginger (Zingiber Officinale) And Garlic (Allium Sativum) Mixture on Growth Performance, Feed Utilization and Survival of Clarias Gariepinus Fingerlings

Authors: Maryam I. Abdullahi, Suleiman Aliyu, Armaya'u Hamisu Bichi

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The study was conducted at the University Fish Farm, Federal University Dutsinma. The aim of the study was to determine the effects of dietary supplementation of Allium sativum and Zingiber officinale mixture on growth performance, feed utilization and survival of C. gariepinus fingerling reared in tank system. The experimental setup comprised of four treatment (4) groups labeled as T1, T2, T3 and T4, each treatment replicated 3 times with ten (10) fingerlings in each replicate respectively. Treatment 1 contained 0.5% of Zingiber officinale and 0.5% of Allium sativum (ZO-AS: 1.0%), Treatment 2 contained 0.75% Zingiber officinale, and 0.75% garlic (ZO-AS: 1.5%) while T3 contained 1% ginger and 1% Allium sativum (ZO-AS: 2.0%) respectively. The experiment lasted for twelve (12) weeks (84 days). The survival rate ranges from 90% - 100%. With a higher Final Mean Weight (893.10) and Percentage Mean Weight (942.65) as compared to the control group and others. There was no significant difference (p > 0.05) in the FMW (893.10) of the fish fed 1.5g/kg of Garlic and Ginger diets than the control (687.00). The SGR (1.20) of fish-fed Zingiber officinale and Allium sativum fortified diets shows that there is no significant difference between treatments fed 1.5g/kg Zingiber officinale and Allium sativum and the control group. Generally, there was an increased survival rate in the experimental fish-fed Zingiber officinale and Allium sativum-supplemented diets as compared to the control.

Keywords: clarias gariepinus, zingiber officinale, allium sativum, fingerlings

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2162 The Value of Dynamic Magnetic Resonance Defecography in Assessing the Severity of Defecation Disorders

Authors: Ge Sun, Monika Trzpis, Robbert J. de Haas, Paul M. A. Broens

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Introduction: Dynamic magnetic resonance defecography is frequently used to assess defecation disorders. We aimed to investigate the usefulness of dynamic magnetic resonance defecography for assessing the severity of defecation disorder. Methods: We included patients retrospectively from our tertiary referral hospital who had undergone dynamic magnetic resonance defecography, anorectal manometry, and anal electrical sensitivity tests to assess defecation disorders between 2014 and 2020. The primary outcome was the association between the dynamic magnetic resonance defecography variables and the severity of defecation disorders. We assessed the severity of fecal incontinence and constipation with the Wexner incontinence and Agachan constipation scores. Results: Out of the 32 patients included, 24 completed the defecation questionnaire. During defecation, the M line length at magnetic resonance correlated with the Agachan score (r = 0.45, p = 0.03) and was associated with anal sphincter pressure (r=0.39, p=0.03) just before defecation. During rest and squeezing, the H line length at imaging correlated with the Wexner incontinence score (r=0.49, p=0.01 and r=0.69, p< 0.001, respectively). H line length also correlated positively with the anal electrical sensation threshold during squeezing (r=0.50, p=0.004) and during rest (r= 0.42, p=0.02). Conclusions: The M and H line lengths at dynamic magnetic resonance defecography can be used to assess the severity of constipation and fecal incontinence respectively and reflect anatomic changes of the pelvic floor. However, as these anatomic changes are generally late-stage and irreversible, anal manometry seems a better diagnostic approach to assess early and potentially reversible changes in patients with defecation disorders.

Keywords: defecation disorders, dynamic magnetic resonance defecography, anorectal manometry, anal electrical sensitivity tests, H line, M line

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2161 Student Project on Using a Spreadsheet for Solving Differential Equations by Euler's Method

Authors: Andriy Didenko, Zanin Kavazovic

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Engineering students often have certain difficulties in mastering major theoretical concepts in mathematical courses such as differential equations. Student projects were proposed to motivate students’ learning and can be used as a tool to promote students’ interest in the material. Authors propose a student project that includes the use of Microsoft Excel. This instructional tool is often overlooked by both educators and students. An integral component of the experimental part of such a project is the exploration of an interactive spreadsheet. The aim is to assist engineering students in better understanding of Euler’s method. This method is employed to numerically solve first order differential equations. At first, students are invited to select classic equations from a list presented in a form of a drop-down menu. For each of these equations, students can select and modify certain key parameters and observe the influence of initial condition on the solution. This will give students an insight into the behavior of the method in different configurations as solutions to equations are given in numerical and graphical forms. Further, students could also create their own equations by providing functions of their own choice and a variety of initial conditions. Moreover, they can visualize and explore the impact of the length of the time step on the convergence of a sequence of numerical solutions to the exact solution of the equation. As a final stage of the project, students are encouraged to develop their own spreadsheets for other numerical methods and other types of equations. Such projects promote students’ interest in mathematical applications and further improve their mathematical and programming skills.

Keywords: student project, Euler's method, spreadsheet, engineering education

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2160 Social Media Diffusion And Implications For Opinion Leadership In Northcentral Nigeria

Authors: Chuks Odiegwu-Enwerem

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The classical notion of opinion leadership presupposes that the media is at the center of an effective and successful opinion leadership. Under this idea, an opinion leader is an active media user who consumes, understands, digests and interprets the messages for the understanding and acceptance/adoption by lower-end media users – whose access and understanding of media content are supposedly low. Because of their unique access to and presumed understanding of media functions and their content, opinion leaders are typically esteemed by those who look forward to and accept their opinions. Lazarsfeld and Katz’s two-step flow of communication theory is the basis of opinion leadership – propelled by limited access to the media. With the emergence and spread of social media and its unlimited access by all and sundry, however, the study interrogates the relevance and application of opinion leaders and, by implication, the two-step flow communication theory in Nigeria’s Northcentral region. It seeks to determine whether opinion leaders still exist in the picture and if they still exert considerable influence, especially in matters of political conversations and decision-making among the citizens of this area. It further explores whether the diffusion of social media is a reality and how the ‘low-end’ media users react to the new-found freedom of access to media, and how they are using it to inform their decisions on important matters as well as examines if they are still glued to their opinion leaders. This study explores the empirical dimensions of the two-step flow hypothesis in relation to the activities of social media to determine if a change has occurred and in what direction, using mixed methos of Survey and in-depth interviews. Our understanding and belief in some theoretical assumptions may be enhanced or challenged by the study outcome.

Keywords: Opinion Leadership, Active Media User, Two-Step-Flow, Social media, Northcentral Nigeria

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2159 Energy Transition and Investor-State Disputes: Scientific Knowledge as a Solution to the Burden for Climate Policy-Making

Authors: Marina E. Konstantinidi

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It is now well-established that the fight against climate change and its consequences, which are a threat to mankind and to life on the planet Earth, requires that global temperature rise be kept under 1,5°C. It is also well-established that this requires humanity to put an end to the use of fossil fuels in the next decades, at the latest. However, investors in the fossil energy sector have brought or threatened to bring investment arbitration claims against States which put an end to their activity for the purpose of reaching their climate change policies’ objectives. Examples of such claims are provided by the cases of WMH v. Canada, Lone Pine v. Canada, Uniper v. Netherlands and RWE v. Netherlands. Irrespective of the outcome of the arbitration proceedings, the risk of being ordered to pay very substantial damages may have a ‘chilling effect’ on States, meaning that they may hesitate to implement the energy transition measures needed to fight climate change and its consequences. Although mitigation action is a relatively recent phenomenon, knowledge about the negative impact of fossil fuels has existed for a long time ago. In this paper, it is argued that structured documentation of evidence of knowledge about climate change may influence the adjudication of investment treaty claims and, consequently, affect the content of energy transition regulations that will be implemented. For example, as concerns investors, evidence that change in the regulatory framework towards environmental protection could have been predicted would refute the argument concerning legitimate expectations for legislative stability. By reference to relevant case law, it attempted to explore how pre-existing knowledge about climate change can be used in the adjudication of investor-State disputes and resulting from green energy transition policies.

Keywords: climate change, energy transition, international investment law, knowledge

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2158 Effects of a Bioactive Subfraction of Strobilanthes Crispus on the Tumour Growth, Body Weight and Haematological Parameters in 4T1-Induced Breast Cancer Model

Authors: Yusha'u Shu'aibu Baraya, Kah Keng Wong, Nik Soriani Yaacob

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Strobilanthes crispus (S. crispus), is a Malaysian herb locally known as ‘Pecah kaca’ or ‘Jin batu’ which have demonstrated potent anticancer effects in both in vitro and in vivo models. In particular, S. crispus subfraction (SCS) significantly reduced tumor growth in N-methyl-N-Nitrosourea-induced breast cancer rat model. However, there is paucity of information on the effects of SCS in breast cancer metastasis. Thus, in this study, the antimetastatic effects of SCS (100 mg/kg) was investigated following 30 days of treatment in 4T1-induced mammary tumor (n = 5) model. The response to treatment was assessed based on the outcome of the tumour growth, body weight and hematological parameters. The results demonstrated that tumor bearing mice treated with SCS (TM-S) had significant (p<0.05) reduction in the mean tumor number and tumor volume as well as tumor weight compared to the tumor bearing mice (TM), i.e. tumor untreated group. Also, there was no secondary tumor formation or tumor-associated lesions in the major organs of TM-S compared to the TM group. Similarly, comparable body weights were observed among the TM-S, normal (uninduced) mice treated with SCS and normal (untreated/control) mice (NM) groups compared to the TM group (p<0.05). Furthermore, SCS administration does not cause significant changes in the hematological parameters as compared to the NM group, which indicates no sign of anemia and toxicity related effects. In conclusion, SCS significantly inhibited the overall tumor growth and metastasis in 4T1-induced breast cancer mouse model suggesting its promising potentials as therapeutic agent for breast cancer treatment.

Keywords: 4T1-cells, breast cancer, metastasis, Strobilanthes crispus

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2157 Numerical Investigation of Pressure Drop in Core Annular Horizontal Pipe Flow

Authors: John Abish, Bibin John

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Liquid-liquid flow in horizontal pipe is investigated in order to reveal the flow patterns arising from the co-existed flow of oil and water. The main focus of the study is to identify the feasibility of reducing the pumping power requirements of petroleum transportation lines by having an annular flow of water around the thick oil core. This idea makes oil transportation cheaper and easier. The present study uses computational fluid dynamics techniques to model oil-water flows with liquids of similar density and varying viscosity. The simulation of the flow is conducted using commercial package Ansys Fluent. Flow domain modeling and grid generation accomplished through ICEM CFD. The horizontal pipe is modeled with two different inlets and meshed with O-Grid mesh. The standard k-ε turbulence scheme along with the volume of fluid (VOF) multiphase modeling method is used to simulate the oil-water flow. Transient flow simulations carried out for a total period of 30s showed significant reduction in pressure drop while employing core annular flow concept. This study also reveals the effect of viscosity ratio, mass flow rates of individual fluids and ration of superficial velocities on the pressure drop across the pipe length. Contours of velocity and volume fractions are employed along with pressure predictions to assess the effectiveness of this proposed concept quantitatively as well as qualitatively. The outcome of the present study is found to be very relevant for the petrochemical industries.

Keywords: computational fluid dynamics, core-annular flows, frictional flow resistance, oil transportation, pressure drop

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2156 Genotypic Response Differences among Faba Bean Accessions under Regular Deficit Irrigation (RDI)

Authors: M. Afzal, Salem Safer Alghamdi, Awais Ahmad

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Limited amount of irrigation water is an alarming threat to arid and semiarid agriculture. However, genotypic response differences to water deficit conditions within species have been reported frequently. Present study was conducted in order to measure the genotypic differences among faba bean accessions under Regular Deficit Irrigation (RDI). Five seeds from each accession were sown in 135 silt filled pots (30 x 24 cm). Experiment was planned under split plot arrangement and replicated thrice. Treatments consisted of three RDI levels (100% (control), 60% and 40% of the field capacity) and fifteen faba bean accessions (two local accessions as reference while thirteen from different sources around the world). Irrigation treatment was started from the very first day of sowing. Plant height, shoot dry weight, stomatal conductance and total chlorophyll contents (SPAD reading) were measured one month after germination. Irrigation, faba bean accessions and the all possible interactions has stood significantly high for all studied parameters. Regular deficient irrigation has hampered the plant growth and associated parameters in decreasing order (100% < 60% < 40%). Accessions have responded differently under regular deficient irrigation and some of them are even better than local accession. A highly significant correlation among all parameters has also been observed. It was concluded from results that above parameters could be used as markers to identify the genotypic differences for water deficit stress response. This outcome encouraged the use of superior faba bean genotypes in breeding programs for improved varieties to enhance water use efficiency under stress conditions.

Keywords: accessions, stomatal conductance, total chlorophyll contents, RDI, regular deficient irrigation

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2155 A Qualitative Meta-Synthesis of the Caregiving Experiences of Family Caregivers for Elderly Cancer Patients in China: Implications for Health Social Work

Authors: Longtao He, Han Wu

Abstract:

Summary: As the need for elder care increases in China due to a growing aging population and, in particular, rising cancer rates, it becomes increasingly important to also support family caregivers, who are often the main source of care. We used a qualitative meta-synthesis to systematically evaluate and integrate the caregiving experiences of family caregivers of elderly cancer patients as revealed by articles published in Chinese journals. Findings: Nine studies are included in the final analysis. The caregiver experiences they describe are synthesized into three primary themes: care needs, care burden, and care gains, with numerous secondary themes. Besides the findings that seem to align with other findings across cultures, we have highlighted three main discoveries from the synthesis that may be quite specific to the Chinese context: 1. more sub-themes related to specific caregiving skills caregivers of cancer patients; 2. a call for health professionals to improve their communication skills with family caregivers; 3. the important role of filial piety. Applications: Our findings can be used to help health social workers and relevant policymakers in China support family caregivers by identifying the education and training required for caregivers, ways to make the most of potential care gains, and ways to ease care burdens.

Keywords: cancer, Chinese family caregivers, caregiving skills, care burden, care gains, health social work

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2154 Healthcare Waste Management Practices in Bangladesh: A Case Study in Dhaka City, Bangladesh

Authors: H. M. Nuralam, Z. Xiao-lan, B. K. Dubey, D. Wen-Chuan

Abstract:

Healthcare waste (HCW) is one of the major concerns in environmental issues due to its infectious and hazardous nature that is requires specific treatment and systematic management prior to final disposal. This study aimed to assess HCW management system in Dhaka City (DC), Bangladesh, by investigating the present practices implemented by the city. In this study, five different healthcare establishments were selected in DC. Field visits and interviews with health personnel and staff who are concerned with the waste management were conducted. The information was gathered through questionnaire focus on the different aspect of HCW management like, waste segregation and collection, storage and transport, awareness as well. The results showed that a total of 7,215 kg/day (7.2 ton/day) of waste were generated, of which 79.36% (5.6 ton/day) was non-hazardous waste and 20.6% (1.5 ton/day) was hazardous waste. The rate of waste generation in these healthcare establishments (HCEs) was 2.6 kg/bed/day. There was no appropriate and systematic management of HCWs except at few private HCEs that segregate their hazardous waste. All the surveyed HCEs dumped their HCW together with the municipal waste, and some staff members were also found to be engaged in improper handling of the generated waste. Furthermore, the used sharp instruments, saline bags, blood bags and test tubes were collected for resale or reuse. Nevertheless, the lack of awareness, appropriate policy, regulation and willingness to act, were responsible for the improper management of HCW in DC. There was lack of practical training of concerned healthcare to handle the waste properly, while the nurses and staff were found to be aware of the health impacts of HCW.

Keywords: awareness, disposal, Dhaka city, healthcare waste management, waste generation

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2153 Mechanical Behavior of Recycled Mortars Manufactured from Moisture Correction Using the Halogen Light Thermogravimetric Balance as an Alternative to the Traditional ASTM C 128 Method

Authors: Diana Gomez-Cano, J. C. Ochoa-Botero, Roberto Bernal Correa, Yhan Paul Arias

Abstract:

To obtain high mechanical performance, the fresh conditions of a mortar are decisive. Measuring the absorption of aggregates used in mortar mixes is a fundamental requirement for proper design of the mixes prior to their placement in construction sites. In this sense, absorption is a determining factor in the design of a mix because it conditions the amount of water, which in turn affects the water/cement ratio and the final porosity of the mortar. Thus, this work focuses on the mechanical behavior of recycled mortars manufactured from moisture correction using the Thermogravimetric Balancing Halogen Light (TBHL) technique in comparison with the traditional ASTM C 128 International Standard method. The advantages of using the TBHL technique are favorable in terms of reduced consumption of resources such as materials, energy, and time. The results show that in contrast to the ASTM C 128 method, the TBHL alternative technique allows obtaining a higher precision in the absorption values of recycled aggregates, which is reflected not only in a more efficient process in terms of sustainability in the characterization of construction materials but also in an effect on the mechanical performance of recycled mortars.

Keywords: alternative raw materials, halogen light, recycled mortar, resources optimization, water absorption

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2152 Early versus Late Percutaneous Tracheostomy in Critically Ill Adult Mechanically Ventilated Patients

Authors: Kamel Abd Elaziz Mohamed, Ahmed Yehia Mousa, Ahmed Samir ElSawy, Adel Mohamed Saleem

Abstract:

Introduction: Critically ill patients frequently require tracheostomy to simplify long term air way management. While tracheostomy indications have remained unchanged, the timing of elective tracheostomy for the ventilated patient has been questioned. Aim of the work: This study was performed to compare the differences between early and late percutaneous dilatational tracheostomy (PDT) regarding, mechanical ventilation duration (MVD), length of ICU stay, length of hospital stay, incidence of ventilator associated pneumonia and hospital outcome. Patients and methods: Forty patients who met the inclusion criteria were randomly divided into early PDT who had the tracheostomy within the first 10 days of mechanical ventilation (MV) and the late PDT who had the tracheostomy after 10 days of MV. On admission, demographic data and Acute Physiology and Chronic ill Health II and GCS were collected. The duration of mechanical ventilation, ICU length of stay (LOS) and hospital LOS were all calculated. Results: Total of 40 patients were randomized to either early PDT (n= 20) or late PDT (n= 20). There were no significant differences between both groups regarding demographic data or the scores: APACHE II (22.75± 7 vs 24.35 ± 8) and GCS (6.10 ±2 vs 7.10 ± 2.71). An early PDT showed fewer complications vs late procedure, however it was insignificant. There were significant differences between the two groups regarding mean (MVD) which was shorter in early PDT than the late PDT group (32.2± 10.5) vs (20.6 ± 13 days; p= 0.004). Mean ICU stay was shorter in early PDT than late PDT (21 .0± 513.4) vs (40.15 ±12.7 days; p 6 0.001). Mean hospital stay was shorter in early PDT than late PDT (34.60± 18.37) vs (55.60± 25.73 days; p=0.005). Patients with early PDT suffered less sepsis and VAP than late PDT, there was no difference regarding the mortality rate between the two groups. Conclusion: Early PDT is recommended for patients who require prolonged tracheal intubation in the ICU as outcomes like the duration of mechanical ventilation length of ICU stay and hospital stay were significantly shorter in early tracheostomy.

Keywords: intensive care unit, early PDT, late PDT, intubation

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2151 Evaluation of Food Safety and Security Practices in Midday Meal Programmes in Rural Areas of Beed District

Authors: Nuzhat Sultana M. B.

Abstract:

Children are high-risk population in terms of food born illnesses. Food safety and security are the most important aspect of the success of midday meal programmes. Improper holding temperatures, cross-contamination and poor personal hygiene of food handlers are the main causes for the prevalence of pathogenic microbes in the food servicing areas. Two hundred and fifty preschool children in the age of 3 to 6 years from urban and rural anganwadies (pre school center) of Beed district were selected. Nutritional status of preschool children were assessed by anthropometrical and clinical measurement. The study assessed the food safety and security with the help of personal hygiene and other safety measures maintained by the food personnel working for midday meal programme, supplying mid meals to children in govt. anganwadies (pre school center). The hygiene level, sanitary condition and microbial quality of food and water, pathological health examination of food handlers were assessed with the help of checklist. A questionnaire was designed to evaluate knowledge, attitude, and practices of food handlers. Results of the study show that the nutritional and health status of rural and urban preschool children was very poor. Many of the food handlers were not aware of general knowledge and hygiene practices to be followed during food preparation areas. An intervention programme of education and importing training at workplaces has shown a positive impact on the outcome of safety and security practices and safe, hygienic practices of food handlers at workplace.

Keywords: food, health, preschool children, safety, security

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2150 Study of Demographic, Hematological Profile and Risk Stratification in Chronic Myeloid Leukemia Patients

Authors: Rajandeep Kaur, Rajeev Gupta

Abstract:

Background: Chronic myeloid leukemia (CML) is the most common leukaemia in India. The annual incidence of chronic myeloid leukemia in India was originally reported to be 0.8 to 2.2 per 1,00,000 population. CML is a clonal disorder that is usually easily diagnosed because the leukemic cells of more than 95% of patients have a distinctive cytogenetic abnormality, the Philadelphia chromosome (Ph1). The approval of tyrosine kinase inhibitors (TKIs), which target BCR-ABL1 kinase activity, has significantly reduced the mortality rate associated with chronic myeloid leukemia (CML) and revolutionized treatment. Material and Methods: 80 diagnosed cases of CML were taken. Investigations were done. Bone marrow and molecular studies were also done and with EUTOS, patients were stratified into low and high-risk groups and then treatment with Imatinib was given to all patients and the molecular response was evaluated at 6 months and 12 months follow up with BCR-ABL by RT-PCR quantitative assay. Results: In the study population, out of 80 patients in the study population, 40 were females and 40 were males, with M: F is 1:1. Out of total 80 patients’ maximum patients (54) were in 31-60 years age group. Our study showed a most common symptom of presentation is abdominal discomfort followed by fever. Out of the total 80 patients, 25 (31.3%) patients had high EUTOS scores and 55 (68.8%) patients had low EUTOS scores. On 6 months follow up 36.3% of patients had Complete Molecular Response, 16.3% of patients had Major Molecular Response and 47.5% of patients had No Molecular Response but on 12 months follow up 71.3% of patients had Complete Molecular Response, 16.25% of patients had Major Molecular Response and 12.5% patients had No Molecular Response. Conclusion: In this study, we found a significant correlation between EUTOS score and Molecular response at 6 months and 12 months follow up after Imatinib therapy.

Keywords: chronic myeloid leukemia, European treatment and outcome study score, hematological response, molecular response, tyrosine kinase inhibitor

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2149 The Scope and Effectiveness of Interactive Voice Response Technologies in Post-Operative Care

Authors: Zanib Nafees, Amir Razaghizad, Ibtisam Mahmoud, Abhinav Sharma, Renzo Cecere

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More than one million surgeries are performed each year in Canada, resulting in more than 100,000 associated serious adverse events (SAEs) per year. These are defined as unintended injuries or complications that adversely affect the well-being of patients. In recent years, there has been a proliferation of digital health interventions that have the potential to assist, monitor, and educate patients—facilitating self-care following post-operative discharge. Among digital health, interventions are interactive-voice response technologies (IVRs), which have been shown to be highly effective in certain medical settings. Although numerous IVR-based interventions have been developed, their effectiveness and utility remain unclear, notably in post-operative settings. To the best of our knowledge, no systematic or scoping reviews have evaluated this topic to date. Thus, the objective of this scoping review protocol is to systematically map and explore the literature and evidence describing and examining IVR tools, implementation, evaluation, outcome, and experience for post-operative patients. The focus will be primarily on the evaluation of baseline performance status, clinical assessment, treatment outcomes, and patient management, including self-management and self-monitoring. The objective of this scoping review is to assess the extent of the literature to direct future research efforts by identifying gaps and limitations in the literature and to highlight relevant determinants of positive outcomes in the emerging field of IVR monitoring for health outcomes in post-operative patients.

Keywords: digital healthcare technologies, post-surgery, interactive voice technology, interactive voice response

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2148 Bio-Inspired Design Approach Analysis: A Case Study of Antoni Gaudi and Santiago Calatrava

Authors: Marzieh Imani

Abstract:

Antoni Gaudi and Santiago Calatrava have reputation for designing bio-inspired creative and technical buildings. Even though they have followed different independent approaches towards design, the source of bio-inspiration seems to be common. Taking a closer look at their projects reveals that Calatrava has been influenced by Gaudi in terms of interpreting nature and applying natural principles into the design process. This research firstly discusses the dialogue between Biomimicry and architecture. This review also explores human/nature discourse during the history by focusing on how nature revealed itself to the fine arts. This is explained by introducing naturalism and romantic style in architecture as the outcome of designers’ inclination towards nature. Reviewing the literature, theoretical background and practical illustration of nature have been included. The most dominant practical aspects of imitating nature are form and function. Nature has been reflected in architectural science resulted in shaping different architectural styles such as organic, green, sustainable, bionic, and biomorphic. By defining a set of common aspects of Gaudi and Calatrava‘s design approach and by considering biomimetic design categories (organism, ecosystem, and behaviour as the main division and form, function, process, material, and construction as subdivisions), Gaudi’s and Calatrava’s project have been analysed. This analysis explores if their design approaches are equivalent or different. Based on this analysis, Gaudi’s architecture can be recognised as biomorphic while Calatrava’s projects are literally biomimetic. Referring to these architects, this review suggests a new set of principles by which a bio-inspired project can be determined either biomorphic or biomimetic.

Keywords: biomimicry, Calatrava, Gaudi, nature

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2147 A Systematic Review and Meta-Analysis in Slow Gait Speed and Its Association with Worse Postoperative Outcomes in Cardiac Surgery

Authors: Vignesh Ratnaraj, Jaewon Chang

Abstract:

Background: Frailty is associated with poorer outcomes in cardiac surgery, but the heterogeneity in frailty assessment tools makes it difficult to ascertain its true impact in cardiac surgery. Slow gait speed is a simple, validated, and reliable marker of frailty. We performed a systematic review and meta-analysis to examine the effect of slow gait speed on postoperative cardiac surgical patients. Methods: PubMED, MEDLINE, and EMBASE databases were searched from January 2000 to August 2021 for studies comparing slow gait speed and “normal” gait speed. The primary outcome was in-hospital mortality. Secondary outcomes were composite mortality and major morbidity, AKI, stroke, deep sternal wound infection, prolonged ventilation, discharge to a healthcare facility, and ICU length of stay. Results: There were seven eligible studies with 36,697 patients. Slow gait speed was associated with an increased likelihood of in-hospital mortality (risk ratio [RR]: 2.32; 95% confidence interval [CI]: 1.87–2.87). Additionally, they were more likely to suffer from composite mortality and major morbidity (RR: 1.52; 95% CI: 1.38–1.66), AKI (RR: 2.81; 95% CI: 1.44–5.49), deep sternal wound infection (RR: 1.77; 95% CI: 1.59–1.98), prolonged ventilation >24 h (RR: 1.97; 95% CI: 1.48–2.63), reoperation (RR: 1.38; 95% CI: 1.05–1.82), institutional discharge (RR: 2.08; 95% CI: 1.61–2.69), and longer ICU length of stay (MD: 21.69; 95% CI: 17.32–26.05). Conclusion: Slow gait speed is associated with poorer outcomes in cardiac surgery. Frail patients are twofold more likely to die during hospital admission than non-frail counterparts and are at an increased risk of developing various perioperative complications.

Keywords: cardiac surgery, gait speed, recovery, frailty

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2146 The Associations between Self-Determined Motivation and Physical Activity in Patients with Coronary Heart Disease

Authors: I. Hua Chu, Hsiang-Chi Yu, Hsuan Su

Abstract:

Purpose: To examine the associations between self-determined motivation and physical activity in patients with coronary heart disease (CHD) in a longitudinal study. Methods: Patients with CHD were recruited for this study. Their motivations for exercise were measured by the Behavioral Regulation in Exercise Questionnaire-2 (BREQ-2). Physical activity was assessed using the 7-day physical activity recall questionnaire. Duration and energy expenditure of moderate to vigorous physical activity (MVPA) were used in data analysis. All outcome measures were assessed at baseline and 12 months follow up. Data were analyzed using Pearson correlation analysis and regression analysis. Results: The results of the 45 participants (mean age 60.24 yr; 90.2% male) revealed that there were significant negative correlations between amotivation at baseline and duration (r=-.295, p=.049) and energy expenditure (r=-.300, p=.045) of MVPA at 12 months. In contrast, there were significant positive correlations between calculated relative autonomy index (RAI) at baseline and duration (r=.377, p=.011) and energy expenditure (r=.382, p=.010) of MVPA at 12 months. There was no significant correlation between other subscales of the BREQ-2 and duration or energy expenditure of MVPA. Regression analyses revealed that RAI was a significant predictor of duration (p=.011) and energy expenditure (p=.010) of MVPA at 12 months follow-up. Conclusions: These results suggest that the relative degree of self-determined motivation could predict long-term MVPA behaviors in CHD patients. Physical activity interventions are recommended to target enhancing one’s identified and intrinsic motivation to increase the likelihood of physical activity participation in this population.

Keywords: self-determined motivation, physical activity, coronary heart disease, relative autonomy index (RAI)

Procedia PDF Downloads 428