Search results for: congestive heart failure

Authors: Jelena Nedeljković Trailović, Marko Vasiljević, Jog Raj, Hunor Farkaš, Branko Petrujkić, Stamen Radulović, Gorana Popvić

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The experiment was performed on a total of 99 one-day-old broilers of Cob 500 provenance, which were divided into IX equal groups. Broilers of the E-I group were fed 0.25 mg T-2 toxin/kg feed, E-II and E-III groups 0.25 mg T-2 toxin/kg feed with the addition of 1 kg/t and 3 kg/t of the mycotoxin detoxification agent MDA, respectively. The E-IV group received 1 mg of T-2 toxin/kg of feed, and the broilers of E-V and E-VI groups received 1 mg of T-2 toxin/kg of feed with the addition of 1 kg/t and 3 kg/t of the MDA detoxification preparation, respectively. The E-VII group received commercial feed without toxins and additives, the E-VIII and E-IX groups received feed with 1kg/t and 3kg/t of the MDA detoxification preparation. The trial lasted 42 days. Observing the results obtained on the 42nd day of the experiment, we can conclude that the change in the absolute mass of the spleen occurred in the broilers of the E-IV group (1.66±0.14)g, which was statistically significantly lower compared to the broilers of the E-V and E-VI groups (2.58±0.15 and 2.68±0.23)g. Heart mass was significantly statistically lower in broilers of group E-IV (9.1±0.38)g compared to broilers of group E-V and E-VI (12.23±0.5 and 11.43±0.51)g. It can be concluded that the broilers that received 1 kg/t and 3 kg/t of the detoxification preparation had an absolute mass of organs within physiological limits. Broilers of the E-IV group achieved the lowest BM during the experiment (on the 42nd day of the experiment 1879±52.73)g, they were significantly statistically lower than the BW of broilers of all experimental groups. This trend is observed from the beginning to the end of the experiment. The protective effect of the detoxification preparation can be seen in broilers of the E-V group, that had a significantly statistically higher BM on the 42nd day of the experiment (2225±58.81)g compared to broilers of group E-IV. Broilers of E-VIII group (2452±46.71) g, which received commercial feed with the addition of 1 kg/t MDA preparation, had the highest BMI at the end of the experiment. At the end of the trial on the 42nd day, blood samples were collected from broilers of the experimental groups that received T-2 toxin and MR detoxification preparations in different concentrations. Also, liver and breast musculature samples were collected for testing for the presence and content of T-2 toxin, HT-2 toxin, T-2 tetraol and T-2 triol. Due to very rapid elimination from the blood, no remains of T-2 toxin and its metabolites were detected in the blood of broilers of groups E-I to E-VI. In the breast muscles, T-2 toxin residues below LoQ < 0.2 (μg/kg) were detected in all groups that received T-2 toxin in food, the highest value was recorded in the E-IV group (0.122 μg/kg and the lowest in E -VI group 0.096 μg/kg). No T-2 toxin residues were detected in the liver. Remains of HT-2 were detected in the breast muscles and livers of broilers from E-IV, E-V and E-VI groups, LoQ < 1 (μg/kg); for the breast muscles: 0.054, 0.044 and 0.041 μg/kg, and for the liver: 0.473, 0.231 and 0.185 μg/kg. Summing up all the results, a partial protective effect of the detoxification preparation, added to food in the amount of 1kg/t, can be seen.

Keywords: T-2 toxin, bloiler, MDA, mycotoxuns

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Authors: Opemiposi Adegbulu

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Conflicts of interest is an elusive, diverse and engaging subject, a cross-cutting problem of governance; all levels of governance, ranging from local to global, public to corporate or financial sectors. In all these areas, its mismanagement could lead to the distortion of decision-making processes, corrosion of trust and the weakening of administration. According to Professor Peters, an expert in the area, conflict of interest, a problem at the root of many scandals has “become a pervasive ethical concern in our professional, organisational, and political life”. Conflicts of interest corrode trust, and like in the public sector, trust is mandatory for the market, consumers/clients, shareholders and other stakeholders in the private sector. However, conflicts of interest in the private sector are distinct and must be treated in like manner when regulatory efforts are made to address them. The research looks at identifying conflicts of interest in the private sector and differentiating them from those in the public sector. The public interest is submitted as a criterion which allows for such differentiation. This is significant because it would for the use of tailor-made or sector-specific approaches to addressing this complex issue. This is conducted through extensive review of literature and theories on the definition of conflicts of interest. This study will employ theoretical, doctrinal and comparative methods. The nature of conflicts of interest in the private sector will be explored, through an analysis of the public sector where the notion of conflicts of interest appears more clearly identified, reasons, why they are of business ethics concern, will be advanced, and then, once again, looking at public sector solutions and other solutions, the study will identify ways of mitigating and managing conflicts in the private sector. An exploration of public sector conflicts of interest and solutions will be carried out because the typologies of conflicts of interest in both sectors appear very similar at the core and thus, lessons can be learnt with regards to the management of these issues in the private sector. Conflicts of interest corrode trust, and like in the public sector, trust is mandatory for the market, consumers/clients, shareholders and other stakeholders in the private sector. This research will then focus on some specific challenges to understanding and identifying conflicts of interest in the private sector; origin, diverging theories, the psychological barrier to the definition, similarities with public sector conflicts of interest due to the notions of corrosion of trust, ‘being in a particular kind of situation,’ etc. The notion of public interest will be submitted as a key element at the heart of the distinction between public sector and private sector conflicts of interests. It will then be proposed that the appreciation of the notion of conflicts of interest differ according to sector, country to country, based on the public interest test, using the United Kingdom (UK), the United States of America (US), France and the Philippines as illustrations.

Keywords: conflicts of interest, corporate governance, global governance, public interest

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Authors: Matthew Ocheleka Itodo, Ogo Agbo Ogo, Agnes Ogbene Abutu, Bawa Inalegwu

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Hyperlipidemia is characterised by elevated serum total cholesterol and low density and very low-density lipoprotein cholesterol and decreased high-density lipoprotein are the risk factor for coronary heart diseases. There are claims by traditional medicine practitioners in Nigeria that Moringa oleifera plants are used for the treatment of cardiovascular diseases, but it appears there is no scientific research and, publication or documented work to verify these claims. This study aimed to determine the effect of methanol root extracts of Moringa oleifera on Lipid profile, Atherogenic indices and 3 hydroxyl 3 methylglutaryl Coenzyme A reductase activity of poloxamer 407-induced hyperlipidemic rats. The animals were grouped into 8; Group 1: Normal control, Group 2: Hyperlipidemic control. Groups 2 to 8 were induced with Poloxamer 407 1000 mg/Kg body weight. However, group 3 were treated with standard drugs (atorvastatin). Group 4 was treated with crude extract, and groups 5 to 8 were treated with purified fractions from column chromatography. The preliminary antihyperlipidemic study showed Methanol root extract at 200 mg/kg body weight significantly (p≤0.05) decreased total cholesterol, low-density lipoprotein, triacylglyceride, 3 hydroxyls 3 methylglutaryl Coenzyme A reductase, and increase high-density lipoprotein of hyperlipidemic treated groups. Screening the extracts for the most potent anti-hyperlipidemic activity reveals that fraction 1 of Total Cholesterol and Fraction 3 of Triacylglyceride have the highest percentage reduction of 56% and 51%, respectively. The atherogenic risk factor of all induced treated rats shows a significant (p<0.05) decrease in levels of Castelli’s risk index II, atherogenic index of plasma and a significant (p<0.05) higher level of Castelli’s risk index I ratio. The study shows that the methanol extract of root possesses antihyperlipidemic effects and may explain why it has been found to be useful in the management of cardiovascular diseases by traditional medicine practitioners.

Keywords: hyperlipidemia, moringa oleifera, poloxamer 407, lipid profile

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Authors: Misha Nedeljkovich

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In the film’s famous scene (Roma città aperta-1945), Pina (Anna Magnani) collapses in the street when machined-gunned by a German soldier. Her son Marcello (Vito Annchiarico) tries to revive her. Her death is signaling not closure, but the cycle of life; Marcello saves Francesco with the shawl taken from his mother’s corpse. One pivotal scene in Brief Encounter (1945) occurs in the apartment of Alec’s (Trevor Howard) friend Stephen (Valentine Dyall), when Stephen returns to catch Alec and Laura (Celia Johnson) together alone. David Lean directs this scene using her shawl as a sign of in flagrante delicto. In La Strada (1954), Gelsomina (Giulietta Masina) was waving good bye when her mother sensing impending doom changed her mind and desperately tried to stop her waving back with her shawl: Don’t go my daughter! Your shawl! Your shawl! Gelsomina refuses to return, waving back: It’s time to go! Stanley Kubrick’s tale of a boxer who crosses a mobster to win the heart of a lady, Killer’s Kiss (1955), reminds us that Times Square used to contain sweaty boxing gyms and dance halls. The film’s longest Times Square interlude is its oddest: the boxer Davie Gordon played by Jamie Smith has his shawl stolen by two playful men in Shriners’ hats who are silent except for one who blows a harmonica, faintly heard over honking cabs and overheard conversations. This long sequence appears to be joining in on directors’ shawl conversations with Kubrick’s own twist. Principle characters will never know why all this happened to them that evening. Love, death, happiness and everlasting misery all of that is caused by Dave’s shawl. Finally, the decade of cinematic shawl conversations conclude in Betolucci’s Before the Revolution (Prima della rivoluzione–1964). One of his character’s lifts up a shawl asking if this was a Rossellini’s shawl. I argue that exploring complimentary allusions in a film where directors are acknowledging their own great debt to another film or filmmaker will further our knowledge of film history adding both depth and resonance to the great works in cinema.

Keywords: allusions, Bertolucci, Fellini, homage, Kubrick, lean, Rossellini

Procedia PDF Downloads 396

Authors: Shang-Sin Shiu, Shu-I Chin, Hsiu-Ju Chen, Ru-Yu Lien

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The Hospice and Palliative Care Act has undergone three revisions, making it less challenging for terminal patients to withdraw life support systems. However, the adequacy of care before withdraw is a crucial factor in end-of-life medical treatment. The author observed that intensive care unit (ICU) nursing staff often rely on simple flowcharts or word of mouth, leading to inadequate preparation and failure to meet patient needs before withdraw. This results in confusion or hesitation among those executing the process. Therefore, there is a motivation to improve the withdraw of patient care processes, establish standardized procedures, ensure the accuracy of removal execution, enhance end-of-life care self-efficacy for nursing staff, and improve the overall quality of care. The investigation identified key issues: the lack of applicable guidelines for ICU care for withdraw from life-sustaining, insufficient education and training on withdraw and end-of-life care, scattered locations of withdraw-related tools, and inadequate self-efficacy in withdraw from life-sustaining care. Solutions proposed include revising withdraw care processes and guidelines, integrating tools and locations, conducting educational courses, and forming support groups. After the project implementation, the accuracy of removal cognition improved from 78% to 96.5%, self-efficacy in end-of-life care after removal increased from 54.7% to 93.1%, and the correctness of care behavior progressed from 27.7% to 97.8%. It is recommended to regularly conduct courses on removing life support system care and grief consolation to enhance the quality of end-of-life care.

Keywords: the intensive care unit (ICU) patients, nursing staff, withdraw life support systems, self-efficacy

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Authors: Drutika Upadhyay

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Rape is one of the most heinous crimes committed against the body of a woman violating her privacy and dignity. The Right to Privacy and the Right to Live with Dignity constitute the very essence of the Right to Life and Personal Liberty, a Fundamental Right guaranteed under Article 21 of the Indian Constitution. The study is conducted with the primary objective of analyzing the efficacy of rape laws in India. The study begins by explaining the origin, meaning, and kinds of rape recognised under Indian jurisprudence. Further, it explains various statutory and penal provisions relating to rape and the loopholes in such provisions. It focuses on the procedure followed during investigation and trial and also aims at developing an understanding of the rights of the victim and the sentence in cases of rape. The study also throws some light upon the amendments made to the criminal law and the recommendations of the Law Commission of India to meet the demands of the changing criminal justice delivery system. The outcome of the study suggests that the laws relating to rape have proved to be a major failure owing to the lack of proper implementation. Also, the lack of education among the masses leads to gender biasness, which is the ultimate cause for the commission of such crime. At last, the author concludes that the present criminal law system of the country contains various lacunae that need to be filled in so as to make the criminal justice system more stringent. Further, the scope of the definition of ‘rape’ needs to be widened in order to include such other acts of non-consensual and sexual nature that are currently not included in the definition. The author has adopted a non-doctrinal and analytical approach and relied upon the secondary sources of data for the purpose of the study. The scope of the study is limited to the crime committed against women.

Keywords: amendment, criminal law, fundamental right, personal liberty, privacy, rape

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Authors: Abdallah Abu Madi, Dongmei Cao, Alexeis Garcia-Perez, Qile He

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The failure of Enterprise Resource Planning (ERP) implementation in higher education institutions (HEIs) worldwide is much higher in comparison to other sectors, such as banking or manufacturing, to our knowledge limited research has been conducted on this issue. To date, prior literature has identified some key success factors (KSFs) mostly either in the domain of information and system (IS) or in the industrial context. However, evidence of ERP implementation in the higher education sector has had little attention in the extant literature. Hence, this paper identifies and categories KSFs of ERP implementation in HEIs. Semi-structured face-to-face interviews were conducted with technicians and managers from three Jordanian HEIs. From these case studies, three new sector- and context-specific KSFs were identified and categorized according to two dimensions: organizational and technical. The first new KSF is the selection of the ERP system, which is an influential factor in the organizational dimension. Results show that an ERP solution that is suitable to one context may be disastrous in another. The second new KSF, which falls under the technical dimension, is the relationship between vendors and HEIs. This must be fair and impartial to enable successful decision-making and thus the achievement of pre-defined goals. Also within the technical dimension is the third factor: in-house maintenance. Once an appropriate system is selected and a strong relationship is established, the ERP system requires continuous maintenance for effective operation. HEIs should ensure that qualified IT support is in place and in-house to avoid excessive running expenses.

Keywords: Enterprise Resource Planning (ERP)implementation, key success factors, higher education institutions, Jordanian higher education

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Authors: Yang Zhao, Feng Zhang, Xuanchu Duan

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Trans-differentiation of human Tenon fibroblasts (HTFs) to myo-fibroblasts and fibrosis of episcleral tissue are the most common reasons for the failure of glaucoma filtration surgery, with limited treatment options like antimetabolites which always have side-effects such as leakage of filter bulb, infection, hypotony, and endophthalmitis. Rosiglitazone, a specific thiazolidinedione is a synthetic high-affinity ligand for PPAR-r, which has been used in the treatment of type2 diabetes, and found to have pleiotropic functions against inflammatory response, cell proliferation and tissue fibrosis and to benefit to a variety of diseases in animal myocardium models, steatohepatitis models, etc. Here, in vitro we cultured primary HTFs and stimulated with TGF- β to induced myofibrogenic, then treated cells with Rosiglitazone to assess for fibrogenic response. In vivo, we used rabbit glaucoma model to establish the formation of post- trabeculectomy scarring. Then we administered subconjunctival injection with Rosiglitazone beside the filtering bleb, later protein, mRNA and immunofluorescence of fibrogenic markers are checked, and filtering bleb condition was measured. In vitro, we found Rosiglitazone could suppressed proliferation and migration of fibroblasts through macroautophagy via TGF- β /Smad signaling pathway. In vivo, on postoperative day 28, the mean number of fibroblasts in Rosiglitazone injection group was significantly the lowest and had the least collagen content and connective tissue growth factor. Rosiglitazone effectively controlled human and rabbit fibroblasts in vivo and in vitro. Its subconjunctiiva application may represent an effective, new avenue for the prevention of scarring after glaucoma surgery.

Keywords: fibrosis, glaucoma, macroautophagy, rosiglitazone

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Authors: Pranjal Johri, Misbah Ul-Islam

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Power Transformers are one of the most critical and failure prone entities in an electrical power system. It is an established practice that each design of a power transformer has to undergo numerous type tests for design validation and routine tests are performed on each and every power transformer before dispatch from manufacturer’s works. Different countries follow different standards for testing the transformers. Most common and widely followed standard for Power Transformers is IEC 60076 series. Though these standards put up a strict testing requirements for power transformers, however, few aspects of transformer characteristics and guaranteed parameters can be ensured by some additional tests. Based on certain observations during routine test of a transformer and analyzing the data of a large fleet of transformers, three propositions have been discussed and put forward to be included in test schedules and standards. The observations in the routine test raised questions on design flux density of transformer. In order to ensure that flux density in any part of the core & yoke does not exceed 1.9 tesla at 1.1 pu as well, following propositions need to be followed during testing:  From the data studied, it was evident that generally NLC at 1.1 pu is apporx. 3 times of No Load Current at 1 pu voltage.  During testing the power factor at 1.1 pu excitation, it must be comparable to calculated values from the Cold Rolled Grain Oriented steel material curves, including building factor.  A limit of 3 % to be extended for higher than rated voltages on difference in Vavg and Vrms, during no load testing.  Extended over excitation test to be done in case above propositions are observed to be violated during testing.

Keywords: power transfoemrs, no load current, DGA, power factor

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Authors: Philipp Stehle, Dragoljub Vrankovic, Montaha Anjass

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Due to its high availability and extremely high specific capacity, silicon (Si) is the most promising anode material for next generation lithium-ion batteries (LIBs). However, Si anodes are suffering from high volume changes during cycling causing unstable solid-electrolyte interface (SEI). One approach for mitigation of these effects is to embed Si particles into a carbon matrix to create silicon/carbon composites (Si/C). These typically show more stable electrochemical performance than bare silicon materials. Nevertheless, the same failure mechanisms mentioned earlier appear in a less pronounced form. In this work, we further improved the cycling performance of two commercially available Si/C materials by coating thin metal oxide films of different thicknesses on the powders via Atomic Layer Deposition (ALD). The coated powders were analyzed via ICP-OES and AFM measurements. Si/C-graphite anodes with automotive-relevant loadings (~3.5 mAh/cm2) were processed out of the materials and tested in half coin cells (HCCs) and full pouch cells (FPCs). During long-term cycling in FPCs, a significant improvement was observed for some of the ALD-coated materials. After 500 cycles, the capacity retention was already up to 10% higher compared to the pristine materials. Cycling of the FPCs continued until they reached a state of health (SOH) of 80%. By this point, up to the triple number of cycles were achieved by ALD-coated compared to pristine anodes. Post-mortem analysis via various methods was carried out to evaluate the differences in SEI formation and thicknesses.

Keywords: silicon anodes, li-ion batteries, atomic layer deposition, silicon-carbon composites, surface coatings

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Authors: Behnaz Sohani, Sahand Shahalinezhad, Amir Rahmani, Aliyu Aliyu

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Recently, medical imaging and specifically medical image processing is becoming one of the most dynamically developing areas of medical science. It has led to the emergence of new approaches in terms of the prevention, diagnosis, and treatment of various diseases. In the process of diagnosis of lung cancer, medical professionals rely on computed tomography (CT) scans, in which failure to correctly identify masses can lead to incorrect diagnosis or sampling of lung tissue. Identification and demarcation of masses in terms of detecting cancer within lung tissue are critical challenges in diagnosis. In this work, a segmentation system in image processing techniques has been applied for detection purposes. Particularly, the use and validation of a novel lung cancer detection algorithm have been presented through simulation. This has been performed employing CT images based on multilevel thresholding. The proposed technique consists of segmentation, feature extraction, and feature selection and classification. More in detail, the features with useful information are selected after featuring extraction. Eventually, the output image of lung cancer is obtained with 96.3% accuracy and 87.25%. The purpose of feature extraction applying the proposed approach is to transform the raw data into a more usable form for subsequent statistical processing. Future steps will involve employing the current feature extraction method to achieve more accurate resulting images, including further details available to machine vision systems to recognise objects in lung CT scan images.

Keywords: lung cancer detection, image segmentation, lung computed tomography (CT) images, medical image processing

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Authors: Aneta Maćczak, Bożena Bukowska, Jaromir Michałowicz

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Bisphenols are one of the most widely used chemical compounds worldwide. They are used in the manufacturing of polycarbonates, epoxy resins and thermal paper which are applied in plastic containers, bottles, cans, newspapers, receipt and other products. Among these compounds, bisphenol A (BPA) is produced in the highest amounts. There are concerns about endocrine impact of BPA and its other toxic effects including hepatotoxicity, neurotoxicity and carcinogenicity on human organism. Moreover, BPA is supposed to increase the incidence the obesity, diabetes and heart disease. For this reason the use of BPA in the production of plastic infant feeding bottles and some other consumers products has been restricted in the European Union and the United States. Nowadays, BPA analogues like bisphenol F (BPF) and bisphenol S (BPS) have been developed as alternative compounds. The replacement of BPA with other bisphenols contributed to the increase of the exposure of human population to these substances. Toxicological studies have mainly focused on BPA. In opposite, a small number of studies concerning toxic effects of BPA analogues have been realized, which makes impossible to state whether those substituents are safe for human health. Up to now, the mechanism of bisphenols action on the erythrocytes has not been elucidated. That is why, the aim of this study was to assess the effect of BPA and its selected analogues such as BPF and BPS on the activity of antioxidant enzymes, i.e. catalase (EC 1.11.1.6.), glutathione peroxidase (E.C.1.11.1.9) and superoxide dismutase (EC.1.15.1.1) in human erythrocytes. Red blood cells in respect to their function (transport of oxygen) and very well developed enzymatic and non-enzymatic antioxidative system, are useful cellular model to assess changes in redox balance. Erythrocytes were incubated with BPA, BPF and BPS in the concentration ranging from 0.5 to 100 µg/ml for 24 h. The activity of catalase was determined by the method of Aebi (1984). The activity of glutathione peroxidase was measured according to the method described by Rice-Evans et al. (1991), while the activity of superoxide dismutase (EC.1.15.1.1) was determined by the method of Misra and Fridovich (1972). The results showed that BPA and BPF caused changes in the antioxidative enzymes activities. BPA decreased the activity of examined enzymes in the concentration of 100 µg/ml. We also noted that BPF decreased the activity of catalase (5-100 µg/ml), glutathione peroxidase (50-100 µg/ml) and superoxide dismutase (25-100 µg/ml), while BPS did not cause statistically significant changes in investigated parameters. The obtained results suggest that BPA and BPF disrupt redox balance in human erythrocytes but the observed changes may occur in human organism only during occupational or subacute exposure to these substances.

Keywords: antioxidant enzymes, bisphenol A, bisphenol a analogues, human erythrocytes

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Authors: Firas Al-Mahmoud, Jean-Michel Mechling, Mohamed Shaban

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The long-term durability of fibre reinforced polymer (FRP) composites is often stated as being the main reason for the use of these materials. Indeed, structures externally or Near Surface Mounted (NSM) reinforced with Carbon Fibre Reinforcement Polymer CFRP are often in contact with temperature cycles and salt water immersion and other environmental conditions that reduce the expected durability of the system. Bond degradation is a frequent cause of premature failure of structural elements and environmental conditions are known to relate to such failures. The purpose of this study is to investigate the effect of environmental exposure on the bond for different CFRP strengthening systems. Bending tests were conducted to evaluate the bond with and without environmental exposure. The specimens were strengthened with CFRP sheets, CFRP plates and NSM CFRP rods embedded in two filling materials: epoxy resin and mortar. Then, they were exposed to up to 300 freeze–thaw cycles. One freeze–thaw cycle consisted of four stages according to ASTM or immersed in 3.5% salted tap water. A total of thirty-six specimens were prepared for this purpose. Results showed a decrease in ultimate bond strength for specimens strengthened by CFRP sheets that were immersed in salt water for 120 days, while a reduction was shown for CFRP sheet and plate bonded specimens that were subjected to 300 freeze–thaw cycles. Exposing NSM CFRP rod strengthened specimens, embedded in resin or mortar, to freeze–thaw cycles or to immersion in salt water does not affect the bond strength.

Keywords: durability, strengthening, FRP, bond, freeze–thaw

Procedia PDF Downloads 350

Authors: Jaballah Jamil

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KLD (Peter Kinder, Steve Lydenberg and Amy Domini) research & analytics is an independent intermediary of social performance information that adopts an investor-pay model. KLD rating agency does not have an explicit monitoring on the rated firm which suggests that KLD ratings may not include private informations. Moreover, the incapacity of KLD to predict accurately the extra-financial rating of Enron casts doubt on the reliability of KLD ratings. Therefore, we first investigate whether KLD ratings affect investors' perception by studying the effect of KLD rating changes on firms' financial performances. Second, we study the impact of the Enron scandal on investors' perception of KLD rating changes by comparing the effect of KLD rating changes on firms' financial performances before and after the failure of Enron. We propose an empirical study that relates a number of equally-weighted portfolios returns, excess stock returns and book-to-market ratio to different dimensions of KLD social responsibility ratings. We first find that over the last two decades KLD rating changes influence significantly and negatively stock returns and book-to-market ratio of rated firms. This finding suggests that a raise in corporate social responsibility rating lowers the firm's risk. Second, to assess the Enron scandal's effect on the perception of KLD ratings, we compare the effect of KLD rating changes before and after the Enron scandal. We find that after the Enron scandal this significant effect disappears. This finding supports the view that the Enron scandal annihilates the KLD's effect on Socially Responsible Investors. Therefore, our findings may question results of recent studies that use KLD ratings as a proxy for Corporate Social Responsibility behavior.

Keywords: KLD social rating agency, investors' perception, investment decision, financial performance

Procedia PDF Downloads 439

Authors: Samira K. Al-Nasser, Siamak Noroozi, Roya Haratian, Adrian Harvey

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A total knee replacement (TKR) is a surgical procedure necessary when there is severe pain and/or loss of function in the knee. Surgeons balance the load in the knee and the surrounding soft tissue by feeling the tension at different ranges of motion. This method can be unreliable and lead to early failure of the joint. The ideal kinematics and load distribution have been debated significantly based on previous biomechanical studies surrounding both TKRs and normal knees. Intraoperative sensors like VERASENSE and eLibra have provided a method for the quantification of the load indicating a balanced knee. A review of the literature written about intraoperative sensors and tension/stability of the knee was done. Studies currently debate the quantification of the load in medial and lateral compartments specifically. However, most research reported that following a TKR the medial compartment was loaded more heavily than the lateral compartment. In several cases, these results were shown to increase the success of the surgery because they mimic the normal kinematics of the knee. In conclusion, most research agrees that an intercompartmental load differential of between 10 and 20 pounds, where the medial load was higher than the lateral, and an absolute load of less than 70 pounds was ideal. However, further intraoperative sensor development could help improve the accuracy and understanding of the load distribution on the surgical outcomes in a TKR. A reduction in early revision surgeries for TKRs would provide an improved quality of life for patients and reduce the economic burden placed on both the National Health Service (NHS) and the patient.

Keywords: intraoperative sensors, joint load forces, kinematics, load balancing, and total knee replacement

Procedia PDF Downloads 136

Authors: Devendra Gupta, Sushilk K. Agarwal, Amit Kesari, P. K. Singh

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Objectives: Pediatric patients often may experience persistent respiratory failure that requires tracheostomy placement in Pediatric ICU. We have designed a technique of tracheostomy in pediatric patients with S-shaped incision on the tracheal wall with higher success rate and lower complication rate. Technique: Following general anesthesia and positioning of the patient, the trachea was exposed in midline by a vertical skin incision. In order to make S-shaped tracheostoma, second tracheal ring was identified. The conventional vertical incision was made in second tracheal ring and then extended at both its ends laterally in the inter-cartilaginous space parallel to the tracheal cartilage in the opposite direction to make the incision S-shaped. The trachea was dilated with tracheal dilator and appropriate size of tracheostomy tube was then placed into the trachea. Results: S-shaped tracheostomy was performed in 20 children with mean age of 6.25 years (age range is 2-7) requiring tracheostomy placement. The tracheostomy tubes were successfully placed in all the patients in single attempt. There was no incidence of significant intra-operative bleeding, subcutaneous emphysema, vocal cord palsy or pneumothorax. Two patients developed pneumonia and expired within a year. However, there was no incidence of tracheo-esophageal fistula, suprastomal collapse or difficulty in decannulation on one year of follow up related to our technique. One patient developed late trachietis managed conservatively. Conclusion: S-shaped tracheoplasty was associated with high success rate, reduced risk of the early and late complications in pediatric patients requiring tracheostomy.

Keywords: peatrics, tracheostomy, ICU, tracheostoma

Procedia PDF Downloads 264

Authors: Ewa Mojs, Katarzyna Wiechec, Maia Kubiak, Wlodzimierz Samborski

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Interactions between mother’s psychological condition and child’s health status are complex and derive from the nature of the mother-child relationship. The aim of the study was to analyze the issue of anxiety amongst mothers of short children in the aspect of growth hormone therapy. The study was based on a group of 101 mothers of originally short-statured children – 70 with growth hormone deficiency (GHD) treated with recombinant human growth hormone (rhGH) and 31 undergoing the diagnostic process, without any treatment. Collected medical data included child's gender, height and weight, chronological age, bone age delay, and rhGH therapy duration. For all children, the height SDS and BMI SDS were calculated. To evaluate anxiety in mothers, the Spielberger State-Trait Anxiety Inventory (STAI) was used. Obtained results revealed low trait anxiety levels, with no statistically significant differences between the groups. State anxiety levels were average when mothers of all children were analyzed together, but when divided into groups, statistical differences appeared. Mothers of children without diagnosis and treatment had significantly higher levels of state anxiety than mothers of children with GHD receiving appropriate therapy. These results show, that the occurrence of growth failure in children is not related to high maternal trait anxiety, but the lack of diagnosis and lack of appropriate treatment generates higher levels of maternal state anxiety than the process of rh GH therapy in the offspring. Commencement of growth hormone therapy induce a substantial reduction of the state anxiety in mothers, and the duration of treatment causes its further decrease.

Keywords: anxiety, development, growth hormone deficiency, motherhood

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Authors: Megersa Dugasa Fite

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This paper analyses regulatory and supervisory issues in the Ethiopian micro finance sector, which caters to the needs of those who have been excluded from the formal financial sector. Micro-finance has received increased importance in development because of its grand goal to give credits to the poor to raise their economic and social well-being and improve the quality of lives. The micro-finance at present has been moving towards a credit-plus period through covering savings and insurance functions. It thus helps in reducing the rate of financial exclusion and social segregation, alleviating poverty and, consequently, stimulating development. The Ethiopian micro finance policy has been generally positive and developmental but major regulatory and supervisory limitations such as the absolute prohibition of NGOs to participate in micro credit functions, higher risks for depositors of micro-finance institutions, lack of credit information services with research and development, the unmet demand, and risks of market failures due to over-regulation are disappointing. Therefore, to remove the limited reach and high degree of problems typical in the informal means of financial intermediation plus to deal with the failure of formal banks to provide basic financial services to a significant portion of the country’s population, more needs to be done on micro finance. Certain key regulatory and supervisory revisions hence need to be taken to strengthen the Ethiopian micro finance sector so that it can practically provide majority poor access to a range of high quality financial services that help them work their way out of poverty and the incapacity it imposes.

Keywords: micro-finance, micro-finance regulation and supervision, micro-finance institutions, financial access, social segregation, poverty alleviation, development, Ethiopia

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Authors: Ema Vitória Fonseca Lavrador

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In this work, we intend to explore the impact that the film "Lightyear" (2022) had on the social context of its production, distribution, and reception. This film, produced by Walt Disney Animation Studios and Pixar Animation Studios, depicts the story of Buzz Lightyear, a Space Ranger from which the character of the same name in the "Toy Story" film franchise is based. This prequel was predicted to be the blockbuster of the year, but it was a financial fiasco and the subject of numerous controversies, which also caused it to be drowned out by the film "Minions: The Rise of Gru" (2022). The reason for its failure is not based on the film's narrative or quality but on its controversial context for being a commitment to LGBTQIA+ representation in an unexpected way, by featuring a same-sex couple and showing a kiss shared by them. This representation cost Disney distribution in countries against LGBTQIA+ representation in media and involved Disney in major disagreements with fans and politicians, especially for being a direct opposition to the Florida House Bill 1557, also called the “Don't Say Gay” bill. Many major companies have taken a stand against this law because it jeopardizes the safety of the LGBTQIA+ community, and, although Disney initially cut the kiss off the film, pressure from the staff and audience resulted in unprecedented progress. For featuring a brief homosexual kiss, its exhibition was banned in several countries and discouraged by the same public that was previously the focus of Disney's attention, as this is a conservative “family-friendly” branded company. We believe it is relevant to study the case of "Lightyear" because it is a work that raises awareness and promotes representation of communities affected during the dark times while less legislation is being approved to protect the rights and safety of queer people.

Keywords: Don’t Say Gay” bill, gender stereotypes, LGBTQIA+ representation, lightyear, Disney/Pixar

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Authors: Rozeena Shaikh, Syed M Shahid, Jamil Ahmad, Qaisar Mansoor, Muhammad Ismail, Abid Azhar

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Introduction: Diabetes mellitus (DM) is a prevalent non-communicable disease worldwide. In most high-income countries as well as middle-income and low- income countries. DM is among the top causes of deaths. DM may lead to many vascular complications like hypertension, nephropathy, retinopathy, neuropathy, and foot. Diabetic nephropathy (DN) characterized by persistent albuminuria is a leading cause of end stage renal failure (ESRF). Pathogenesis of diabetic nephropathy is implicated by the polymorphisms in genes encoding the components of reninangiotensin- aldosteron system (RAAS) which include angiotensinogen (AGT), angiotensin-II receptor and particularly angiotensin converting enzyme (ACE) gene. Method: Study subjects include 110 control, 110 patients with DM without hypertension, 110 patients with DM with hypertension and 110 patients with DN. Blood samples were collected for Biochemical analysis and PCR and sequencing for the specific region of both genes. Results: The frequency of DD genotype and D allele of ACE (I/D) was significantly (p<0.05) high in DM normotensive, DM hypertensive and DN patients when compared to control. The ACE G2350A genotypes and allele frequencies were significantly different (p<0.05) in DM hypertensive patients as compared to control and DN, while no difference was observed between DM normotensive and DN when compared to control. The genotypes and alleles of AGT (M268T) polymorphism were significantly different (p<0.05) in DM normotensive, DM hypertensive and DN when compared to control. Conclusion: The DD genotype and D allele of ACE (I/D), GG genotype and G allele of ACE (G2350A) and the TT genotype and T allele of AGT (M268T) polymorphism have shown a significant difference in genotype and allele frequencies between controls and patients.

Keywords: genetic variations, ACE, AGT, diabetes mellitus, diabetic nephropathy, Pakistan

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Authors: Dachuan Shi, M. Hecht, Y. Ye

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With the trend of digitalization in railway freight transport, a large number of freight wagons in Germany have been equipped with telematics devices, commonly placed on the wagon body. A telematics device contains a GPS module for tracking and a 3-axis accelerometer for shock detection. Besides these basic functions, it is desired to use the integrated accelerometer for condition monitoring without any additional sensors. Wheel flats as a common type of failure on wheel tread cause large impacts on wagons and infrastructure as well as impulsive noise. A large wheel flat may even cause safety issues such as derailments. In this sense, this paper proposes a machine learning approach for wheel flat detection by using car body accelerations. Due to suspension systems, impulsive signals caused by wheel flats are damped significantly and thus could be buried in signal noise and disturbances. Therefore, it is very challenging to detect wheel flats using car body accelerations. The proposed algorithm considers the envelope spectrum of car body accelerations to eliminate the effect of noise and disturbances. Subsequently, a 1-D convolutional neural network (CNN), which is well known as a deep learning method, is constructed to automatically extract features in the envelope-frequency domain and conduct classification. The constructed CNN is trained and tested on field test data, which are measured on the underframe of a tank wagon with a wheel flat of 20 mm length in the operational condition. The test results demonstrate the good performance of the proposed algorithm for real-time fault detection.

Keywords: fault detection, wheel flat, convolutional neural network, machine learning

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Authors: Han Xiao, Zhang Lei, Huang Hai, Lv Shizeng

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Space environment simulator is a device for spacecraft test. KM8 large space environment simulator built in Tianjing Space City is the largest as well as the most advanced space environment simulator in China. Large deviation of spacecraft level will lead to abnormally work of the thermal control device in spacecraft during the thermal vacuum test. In order to avoid thermal vacuum test failure, level adjusting mechanism system is developed in the KM8 large space environment simulator as one of the most important subsystems. According to the level adjusting requirements of spacecraft’s thermal vacuum tests, the four fulcrums adjusting model is established. By means of collecting level instruments and displacement sensors data, stepping motors controlled by PLC drive four supporting legs simultaneous movement. In addition, a PID algorithm is used to control the temperature of supporting legs and level instruments which long time work under the vacuum cold and black environment in KM8 large space environment simulator during thermal vacuum tests. Based on the above methods, the data acquisition and processing, the analysis and calculation, real time adjustment and fault alarming of the level adjusting mechanism system are implemented. The level adjusting accuracy reaches 1mm/m, and carrying capacity is 20 tons. Debugging showed that the level adjusting mechanism system of KM8 large space environment simulator can meet the thermal vacuum test requirement of the new generation spacecraft. The performance and technical indicators of the level adjusting mechanism system which provides important support for the development of spacecraft in China have been ahead of similar equipment in the world.

Keywords: space environment simulator, thermal vacuum test, level adjusting, spacecraft, parallel mechanism

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Authors: Fabiana Souza Orlandi, Juliana Gomes Duarte, Gabriela Dutra Gesualdo

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Chronic renal disease (CKD), accompanied by hemodialysis, causes chronic renal failure in a number of situations that compromises not only physical, personal and environmental aspects, but also psychological, social and family aspects. Objective: To verify the level of cognitive impairment of chronic renal patients on hemodialysis. Methodology: This is a descriptive, cross-sectional study. The present study was performed in a Dialysis Center of a city in the interior of the State of São Paulo. The inclusion criteria were: being 18 years or older; have a medical diagnosis of CKD; being in hemodialysis treatment in this unit; and agree to participate in the research, with the signature of the Informed Consent (TCLE). A total of 115 participants were evaluated through the Participant Characterization Instrument and the Addenbrooke Cognitive Exam - Revised Version (ACE-R), being scored from 0 to 100, stipulating the cut-off note for the complete battery <78 and subdivided into five domains: attention and guidance; memory; fluency; language; (66.9%) and caucasian (54.7%), 53.7 (±14.8) years old. Most of the participants were retired (74.7%), with incomplete elementary schooling (36.5%) and the average time of treatment was 46 months. Most of the participants (61.3%) presented impairment in the area of attention and orientation, 80.4% in the spatial visual domain. Regarding the total ACE-R score, 75.7% of the participants presented scores below the established cut grade. Conclusion: There was a high percentage (75.7%) below the cut-off score established for ACE-R, suggesting that there may be some cognitive impairment among these participants, since the instrument only performs a screening on cognitive health. The results of the study are extremely important so that possible interventions can be traced in order to minimize impairment, thus improving the quality of life of chronic renal patients.

Keywords: cognition, chronic renal insufficiency, adult health, dialysis

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Authors: M. Sirajul Islam Molla

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Noise pollution has been a continuous and an increasing threat to human health in urban population all over the world. The situation in Bangladesh particularly in major cities has been dangerously aggravating. Despite the government of Bangladesh have laws in its hand to curb the noise pollution the authority’s reluctance in enforcing it, is making the situation worse. We do not see any difference in some other major cities of the South Asian Regional Countries like Delhi and Kathmandu, both of the cities are facing the same situation like Dhaka. With the expansion of technology-based township all over the world, the noise pollution has been an emerging threat to urban health. The information for this review has been derived from websites of GOs, NGOs, peer-reviewed papers, seminars and symposia. The worse situation of noise pollution results in people’s irritation and protest, but in many cases, the protesters are facing the wrath of the polluters. Two such consequences in Bangladesh have resulted in killing the protesters by the polluters – one happened in Dhaka city and the other in a rural town. The law-enforcing agencies proactively do not attempt to impose the law. Noise pollution has been increasing so rapidly that it has become a burden on human health in urban populations. Prolonged exposure to higher noise causes mental stress, sleeplessness, high blood pressure, cardiac failure, respiratory disorder, miscarriage and breaks attention of students to their studies and also irritates their behavior. The noise pollution-caused mortality has also been increasing all over the world. Recommendations from the international conferences such as ICUH should be forwarded to the United Nations. The UN then should pass it on to the concerned countries. The UN should also keenly monitor if the countries have appropriate plan to curb noise pollution to meet the sustainable development goals.

Keywords: decibel, environment, noise, pollution

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Authors: Walid Al-Qerem, Ruba Zumot

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Background: The rise of obesity among children and adolescents remains a primary challenge for healthcare providers globally and in the Middle East. The aim of the present study is to determine the prevalence of obesity among 5-20 years old Jordanians based on CDC criteria. Method: A total of 5722 Jordanians (37% males; 63% females) aged 5-20 years data were retrieved from the Jordanian Ministry of Health electronic database (Hakeem). As per the CDC selection criteria, the chosen data pertains exclusively to healthy Jordanian children and adolescents who are medically sound, not suffering from health conditions, and not undergoing any treatments that could hinder normal growth patterns, such as severe infection, chronic kidney disease (CKD), Down’s syndrome, attention deficit hyperactivity disorder, cancer, heart disease, lung disease, cystic fibrosis, Crohn’s disease, type 1 diabetes, hormonal disturbances, any stress-related conditions, hormonal therapy such as corticosteroids, Growth hormones (GHS) or gonadotropin-releasing hormone agonists, insulin, and amphetamines or any other stimulants. In addition, participants with missing or invalid data values for anthropometric measurements were excluded from the study. Weight for age and body mass index for age were analyzed comparatively for Jordanian children and adolescents against the international growth standards. The Z-score for each record was computed based on CDC equations. As per CDC classifications, BMI for age percentiles, values ≥85th and < 95th are classified as overweight, and value at ≥ 95th is classified as obesity. Results: The average age of the evaluated sample was 12.33 ±4.39 years (10.79 ±3.39 for males and 13.23 ± 4.66 for females). The mean weight for males and females were 33.16±14.17 Kg and 133.54±17.17 cm for males, 43.86 ±18.82 Kg, and 142.19±18.35 for females, while for BMI the mean was for boys and girls 17.81±3.88 and 20.52±5.03 respectively. The results indicated that based on CDC criteria, 8.9% of males were classified as children/adolescents with overweight, and 9.7% were classified as children/adolescents with obesity, while in females, 17.8% were classified as children/adolescents with overweight and 10.2% were classified as children/adolescents with obesity. Discussion: The high prevalence of obesity reported in the present study emphasizes the importance of applying different strategies to prevent childhood obesity, including encouraging physical activity, promoting healthier food options, and behavioral changes. Conclusion: The results presented in this study indicated the high prevalence of overweight/obesity among Jordanian adolescents and children, which must be tagged by healthcare planners and providers.

Keywords: CDC, obesity, childhood, Jordan

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Authors: Ali Mortazavi

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The main objective of this research project is to delve into a multitude of geomechanical risks associated with various mining methods employed within the underground mining industry. Controlling geotechnical design parameters and operational factors affecting the selection of suitable mining techniques for a given underground mining condition will be considered from a risk assessment point of view. Important geomechanical challenges will be investigated as appropriate and relevant to the commonly used underground mining methods. Given the complicated nature of rock mass in-situ and complicated boundary conditions and operational complexities associated with various underground mining methods, the selection of a safe and economic mining operation is of paramount significance. Rock failure at varying scales within the underground mining openings is always a threat to mining operations and causes human and capital losses worldwide. Geotechnical design is a major design component of all underground mines and basically dominates the safety of an underground mine. With regard to uncertainties that exist in rock characterization prior to mine development, there are always risks associated with inappropriate design as a function of mining conditions and the selected mining method. Uncertainty often results from the inherent variability of rock masse, which in turn is a function of both geological materials and rock mass in-situ conditions. The focus of this research is on developing a methodology which enables a geomechanical risk assessment of given underground mining conditions. The outcome of this research is a geotechnical risk analysis algorithm, which can be used as an aid in selecting the appropriate mining method as a function of mine design parameters (e.g., rock in-situ properties, design method, governing boundary conditions such as in-situ stress and groundwater, etc.).

Keywords: geomechanical risk assessment, rock mechanics, underground mining, rock engineering

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Authors: Ruttayaporn Ngasaman, Saowakon Indouang, Usa Chethanond

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Leptospirosis is a public health concern zoonosis in Thailand. Human and animals are often infected by contact with contaminated water. The infected animals play an important role in leptospira infection for both human and other hosts via urine. In humans, it can cause a wide range of symptoms, some of which may present mild flu-like symptoms including fever, vomiting, and jaundice. Without treatment, Leptospirosis can lead to kidney damage, meningitis, liver failure, respiratory distress, and even death. The prevalence of leptospirosis in stray animals in Thailand is unknown. The aim of this study was to investigate leptospira infection in stray animals including dogs and cats in Songkhla province, Thailand. Total of 434 blood samples were collected from 370 stray dogs and 64 stray cats during the population control program from 2014 to 2018. Screening test using latex agglutination for the detection of antibodies against Leptospira interrogans in serum samples shows 29.26% (127/434) positive. There were 120 positive samples of stray dogs and 7 positive samples of stray cats. Detection by polymerase chain reaction specific to LipL32 gene of Leptospira interrogans showed 1.61% (7/434) positive. Stray cats (5/64) show higher prevalence than stray dogs (2/370). Although active infection was low detected, but seroprevalence was high. This result indicated that stray animals were not active infection during sample collection but they use to get infected or in a latent period of infection. They may act as a reservoir for domestic animals and human in which stay in the same environment. In order to prevent and reduce the risk of leptospira infection in a human, stray animals should be done health checking, vaccination, and disease treatment.

Keywords: leptospirosis, stray animals, risk reduction, Thailand

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Authors: Mubarek Alpkiray, Tan Nguyen, Arild Saasen

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Geothermal drilling operations contain numerous challenges that are encountered to increase the well cost and nonproductive time. Fluid loss is one of the most undesirable troublesome that can cause well abandonment in geothermal drilling. Lost circulation can be seen due to natural fractures, high mud weight, and extremely high formation temperatures. This challenge may cause wellbore stability problems and lead to expensive drilling operations. Wellbore stability is the main domain that should be considered to mitigate or prevent fluid loss into the formation. This paper describes the causes of fluid loss in the Pamukoren geothermal field in Turkey. A geomechanics approach integration and assessment is applied to help the understanding of fluid loss problems. In geothermal drillings, geomechanics is primarily based on rock properties, in-situ stress characterization, the temperature of the rock, determination of stresses around the wellbore, and rock failure criteria. Since a high-temperature difference between the wellbore wall and drilling fluid is presented, temperature distribution through the wellbore is estimated and implemented to the wellbore stability approach. This study reviewed geothermal drilling data to analyze temperature estimation along the wellbore, the cause of fluid loss and stored electric capacity of the reservoir. Our observation demonstrates the geomechanical approach's significant role in understanding safe drilling operations on high-temperature wells. Fluid loss is encountered due to thermal stress effects around the borehole. This paper provides a wellbore stability analysis for a geothermal drilling operation to discuss the causes of lost circulation resulting in nonproductive time and cost.

Keywords: geothermal wells, drilling, wellbore stresses, drilling fluid loss, thermal stress

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Authors: Murad Gasanov, Shagen Danielyan, Ali Gasanov, Yuri Teterin, Peter Yartsev

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Background: Despite the advances made in modern surgery, the treatment of patients with esophageal injuries remains one of the most topical and complex issues. In recent years, high-technology minimally invasive methods, such as endoscopic vacuum therapy (EVT) in the treatment of esophageal injuries. The effectiveness of EVT has been sufficiently studied in case of failure of esophageal anastomoses, however the application of this method in case of mechanical esophageal injuries is limited by a small series of observations, indicating the necessity of additional study. Aim: The aim was to аnalyzed of own experience in the use of endoscopic vacuum therapy (EVT) in a comprehensive examination of patients with esophageal injuries. Methods: We analyzed the results of treatment of 24 patients with mechanical injuries of the esophagus for the period 2019-2021. Complex treatment of patients included the use of minimally invasive technologies, including percutaneous endoscopic gastrostomy (PEG), EVT and video-assisted thoracoscopic debridement. Evaluation of the effectiveness of treatment was carried out using multislice computed tomography (MSCT), endoscopy and laboratory tests. The duration of inpatient treatment and the duration of EVT, the number of system replacements, complications and mortality were taken into account. Result: EVT in patients with mechanical injuries of the esophagus allowed to achieve epithelialization of the esophageal defect in 21 patients (87.5%) in the form of linear scar on the site of perforation or pseudodiverticulum. Complications were noted in 4 patients (16.6%), including bleeding (2) and and esophageal stenosis in the perforation area (2). Lethal outcome was in one observation (4.2%). Conclusion. EVT may be the method of choice in complex treatment in patients with esophageal lesions.

Keywords: esophagus injuries, damage to the esophagus, perforation of the esophagus, spontaneous perforation of the esophagus, mediastinitis, endoscopic vacuum therapy

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Authors: Sevgi Karaca

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Since December 6, 2018, mediation has become mandatory for commercial disputes under the Turkish Commercial Code. Mandatory mediation became one of the “causes of action”, and being compulsory means starting the mediation process before going to court. As it contemplates looking at “the causes of the action”, the terminology may lead to misinterpretation of the core of the phrases. However, the terms pertain to a prerequisite for starting the lawsuit. The court will examine failure to comply with such requirements, and the case will be dismissed without further action. Türkiye’s use of obligatory mediation is highly unusual. It is neither judge-led nor judge-assisted mediation but rather a mediation conducted outside of court with the participation of a third party (mediators). What distinguishes it is the incorporation of obligatory mediation into the causes of actions listed in the Code of Civil Procedure. Being one of the causes of action in a legal case implies that the absence of any of them may result in the procedural dismissal of the case without any further action. The case must be presented to the mediator first, and if the parties are unable to reach an agreement, they must deliver the results of the mediation session. Other than submitting the minutes, parties are ineligible to file a lawsuit. However, despite a lengthy history of use in England and Wales, there are considerable reservations about making mediation mandatory. The Civil Procedure Code does not explicitly mention making mediation mandatory. For the time being, there is no Mediation Code, and case law limits the growth of obligatory mediation. Some renowned judges voiced their desire to re-evaluate the notion of required mediation, prompting the Civil Justice Council to release a study in 2021 on the significance of amending case law and the high value of mandatory mediation. By contrasting the approaches to mandatory mediation in England and Wales, the study will investigate the method of controlled mandatory mediation and its effects on the success of mediation in Türkiye.

Keywords: alternative dispute resolution, case law, cause of action, litigation process, mandatory mediation

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