Search results for: healthcare waste disposal
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4439

Search results for: healthcare waste disposal

1829 Embodied Empowerment: A Design Framework for Augmenting Human Agency in Assistive Technologies

Authors: Melina Kopke, Jelle Van Dijk

Abstract:

Persons with cognitive disabilities, such as Autism Spectrum Disorder (ASD) are often dependent on some form of professional support. Recent transformations in Dutch healthcare have spurred institutions to apply new, empowering methods and tools to enable their clients to cope (more) independently in daily life. Assistive Technologies (ATs) seem promising as empowering tools. While ATs can, functionally speaking, help people to perform certain activities without human assistance, we hold that, from a design-theoretical perspective, such technologies often fail to empower in a deeper sense. Most technologies serve either to prescribe or to monitor users’ actions, which in some sense objectifies them, rather than strengthening their agency. This paper proposes that theories of embodied interaction could help formulating a design vision in which interactive assistive devices augment, rather than replace, human agency and thereby add to a persons’ empowerment in daily life settings. It aims to close the gap between empowerment theory and the opportunities provided by assistive technologies, by showing how embodiment and empowerment theory can be applied in practice in the design of new, interactive assistive devices. Taking a Research-through-Design approach, we conducted a case study of designing to support independently living people with ASD with structuring daily activities. In three iterations we interlaced design action, active involvement and prototype evaluations with future end-users and healthcare professionals, and theoretical reflection. Our co-design sessions revealed the issue of handling daily activities being multidimensional. Not having the ability to self-manage one’s daily life has immense consequences on one’s self-image, and also has major effects on the relationship with professional caregivers. Over the course of the project relevant theoretical principles of both embodiment and empowerment theory together with user-insights, informed our design decisions. This resulted in a system of wireless light units that users can program as a reminder for tasks, but also to record and reflect on their actions. The iterative process helped to gradually refine and reframe our growing understanding of what it concretely means for a technology to empower a person in daily life. Drawing on the case study insights we propose a set of concrete design principles that together form what we call the embodied empowerment design framework. The framework includes four main principles: Enabling ‘reflection-in-action’; making information ‘publicly available’ in order to enable co-reflection and social coupling; enabling the implementation of shared reflections into an ‘endurable-external feedback loop’ embedded in the persons familiar ’lifeworld’; and nudging situated actions with self-created action-affordances. In essence, the framework aims for the self-development of a suitable routine, or ‘situated practice’, by building on a growing shared insight of what works for the person. The framework, we propose, may serve as a starting point for AT designers to create truly empowering interactive products. In a set of follow-up projects involving the participation of persons with ASD, Intellectual Disabilities, Dementia and Acquired Brain Injury, the framework will be applied, evaluated and further refined.

Keywords: assistive technology, design, embodiment, empowerment

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1828 Object Detection Based on Plane Segmentation and Features Matching for a Service Robot

Authors: António J. R. Neves, Rui Garcia, Paulo Dias, Alina Trifan

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With the aging of the world population and the continuous growth in technology, service robots are more and more explored nowadays as alternatives to healthcare givers or personal assistants for the elderly or disabled people. Any service robot should be capable of interacting with the human companion, receive commands, navigate through the environment, either known or unknown, and recognize objects. This paper proposes an approach for object recognition based on the use of depth information and color images for a service robot. We present a study on two of the most used methods for object detection, where 3D data is used to detect the position of objects to classify that are found on horizontal surfaces. Since most of the objects of interest accessible for service robots are on these surfaces, the proposed 3D segmentation reduces the processing time and simplifies the scene for object recognition. The first approach for object recognition is based on color histograms, while the second is based on the use of the SIFT and SURF feature descriptors. We present comparative experimental results obtained with a real service robot.

Keywords: object detection, feature, descriptors, SIFT, SURF, depth images, service robots

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1827 Proposal for Sustainable Construction of a New College Hostel Building

Authors: Reshma Raskar-Phule, Abhay Shinde, Manesh Konkani, Rohit Nighot, Shrirang Mahajan, Viraj Thorat

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Sustainability in construction projects can be considered from three dimensions - environment, economy and society. Key concepts of sustainable construction include the protection of the natural environment, choice of non-toxic materials, reduction and reuse of resources, waste minimization, and life cycle analysis. The present paper attempts to identify and analyze the use of sustainable construction materials for a new college hostel building in terms of sustainability development indices (SDIs). Low SDI materials, say as composite fiberglass reinforcement (SDI 4074.96), compressed earth blocks (SDI 0.47), and fiber-reinforced doors (SDI 0.13) are the proposed sustainable materials for the hostel building. Indian Green Building Certification (IGBC) is applied for the hostel building and it earns 5 points out of total 16 points for criterion 5 – Building Materials and Resources of IGBC.

Keywords: sustainable development, construction materials, IGBC, hostel building

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1826 Engineering Packaging for a Sustainable Food Chain

Authors: Ezekiel Olukayode Akintunde

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There is a high level of inadequate methods at all levels of food supply in the global food industry. The inadequacies have led to vast wastages of food. Hence there is a need to curb the wastages that can later affect natural resources, water resources, and energy to avoid negative impacts on the climate and the environment. There is a need to engage multifaceted engineering packaging approaches for a sustainable food chain to ensure active packaging, intelligent packaging, new packaging materials, and a sustainable packaging system. Packaging can be regarded as an indispensable component approach that can be applied to solve major problems of sustainable food consumption globally; this is about controlling the environmental impact of packed food. The creative innovation will ensure that packaged foods are free from food-borne diseases and food chemical pollution. This paper evaluates the key shortcomings that must be addressed by innovative food packaging to ensure a safe, natural environment that will preserve energy and sustain water resources. Certain solutions, including fabricating microbial biodegradable chemical compounds/polymers from agro-food waste remnants, appear a bright path to ensure a strong and innovative waste-based food packaging system. Over the years, depletion in the petroleum reserves has brought about the emergence of biodegradable polymers as a proper replacement for traditional plastics; moreover, the increase in the production of traditional plastics has raised serious concerns about environmental threats. Biodegradable polymers have proven to be biocompatible, which can also be processed for other useful applications. Therefore, this study will showcase a workable guiding framework for designing a sustainable food packaging system that will not constitute a danger to our present society and that will surely preserve natural water resources. Various assessment methods will be deployed at different stages of the packaging design to enhance the package's sustainability. Every decision that will be made must be facilitated with methods that will be engaged per stage to allow for corrective measures throughout the cycle of the design process. Basic performance appraisal of packaging innovations. Food wastage can result in inimical environmental impacts, and ethical practices must be carried out for food loss at home. An examination in West Africa quantified preventable food wastage over the entire food value chain at almost 180kg per person per year. That is preventable food wastage, 35% of which originated at the household level. Many food losses reported, which happened at the harvesting, storage, transportation, and processing stages, are not preventable and are without much environmental impact because such wastage can be used for feeding. Other surveys have shown that 15%-20% of household food losses can be traced to food packaging. Therefore, new innovative packaging systems can lessen the environmental effect of food wastage to extend shelf‐life to lower food loss in the process distribution chain and at the household level.

Keywords: food packaging, biodegradable polymer, intelligent packaging, shelf-life

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1825 Contemplating Preference Ratings of Corporate Social Responsibility Practices for Supply Chain Performance System Implementation

Authors: Mohit Tyagi, Pradeep Kumar

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The objective of this research work is to identify and analyze the significant corporate social responsibility (CSR) practices with an aim to improve the supply chain performance of automobile industry located at National Capital Region (NCR) of India. To achieve the objective, 6 CSR practices have been considered and analyzed using expert’s preference rating (EPR) approach. The considered CSR practices are namely, Top management and employee awareness about CSR (P1), Employee involvement in social and environmental problems (P2), Protection of human rights (P3), Waste reduction, energy saving and water conservation (P4), Proper visibility of CSR guidelines (P5) and Broad perception towards CSR initiatives (P6). The outcomes of this research may help mangers in decision making processes and framing polices for SCP implementation under CSR context.

Keywords: supply chain performance, corporate social responsibility, CSR practices, expert’s preference rating approach

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1824 Production and Mechanical Properties of Alkali–Activated Inorganic Binders Made from Wastes Solids

Authors: Sonia Vanessa Campos Moreira

Abstract:

The aim of this research is the production and mechanical properties of Alkali-Activated Inorganic Binders (AAIB) made from The Basic Oxygen Furnace Slag (BOF Slag) and Thin Film Transistor Liquid Crystal Display (TFT-LCD), glass powder (waste and industrial by-products). Many factors have an influence on the production of AAIB like the glass powder finesses, the alkaline equivalent content (AE %), water binder ratios (w/b ratios) and the differences curing process. The findings show different behavior in the AAIB related to the factors mentioned, the best results are given with a glass powder fineness of 4,500 cm²/g, w/b=0.30, a curing temperature of 70 ℃, curing duration of 4 days and an aging duration of 14 days results in the highest compressive strength of 18.51 MPa.

Keywords: alkaline activators, BOF slag, glass powder fineness, TFT-LCD, w/b ratios

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1823 Rheological Properties of Polysulfone-Sepiolite Nanocomposites

Authors: Nilay Tanrıver, Birgül Benli, Nilgün Kızılcan

Abstract:

Polysulfone (PSU) is a specialty engineering polymer having various industrial applications. PSU is especially used in waste water treatment membranes due to its good mechanical properties, structural and chemical stability. But it is a hydrophobic material and therefore its surface aim to pollute easily. In order to resolve this problem and extend the properties of membrane, PSU surface is rendered hydrophilic by addition of the sepiolite nanofibers. Sepiolite is one of the natural clays, which is a hydrate magnesium silicate fiber, also one of the well known layered clays of the montmorillonites where has several unique channels and pores within. It has also moisture durability, strength and low price. Sepiolite channels give great capacity of absorption and good surface properties. In this study, nanocomposites of commercial PSU and Sepiolite were prepared by solvent mixing method. Different organic solvents and their mixtures were used. Rheological characteristics of PSU-Sepiolite solvent mixtures were analyzed, the solubility of nanocomposite content in those mixtures were studied.

Keywords: nanocomposite, polysulfone, rheology, sepiolite, solution mixing

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1822 Physical Activity Interventions and Maternal Health Outcomes in Nigeria: A Meta-Analysis of Randomized Controlled Trials

Authors: Jamilu Lawal Ajiya

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Background: Physical activity is essential for improving maternal health outcomes, particularly in low- and middle-income countries like Nigeria. Objective: The aim is to evaluate the effectiveness of physical activity interventions on maternal health outcomes among Nigerian pregnant women. Methods: Systematic review and meta-analysis of randomized controlled trials (RCTs) conducted in Nigeria, published in English, and focusing on physical activity and maternal health outcomes. Results: Ten RCTs (N=1,200) were included. Physical activity interventions significantly reduced the risk of gestational diabetes, hypertension and preterm birth. Also, the study found that brisk walking and aerobic exercise were more effective than yoga. Conclusion: Physical activity interventions improve maternal health outcomes among Nigerian pregnant women. Policy changes and public health programs should prioritize physical activity promotion during pregnancy. This study informs healthcare providers, policymakers, and researchers on the effectiveness of physical activity interventions in improving maternal health outcomes in Nigeria.

Keywords: physical activity, maternal health, Nigeria, randomized controlled trials

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1821 Treatment of Leaden Sludge of Algiers Refinery by Electrooxidation

Authors: K. Ighilahriz, M. Taleb Ahmed, R. Maachi

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Oil industries are responsible for most cases of contamination of our ecosystem by oil and heavy metals. They are toxic and considered carcinogenic and dangerous even when they exist in trace amounts. At Algiers refinery, production, transportation, and refining of crude oil generate considerable waste in storage tanks; these residues result from the gravitational settling. The composition of these residues is essentially a mixture of hydrocarbon and lead. We propose in this work the application of electrooxidation treatment for the leachate of the leaden sludge. The effect of pH, current density and the electrolysis time were studied, the effectiveness of the processes is evaluated by measuring the chemical oxygen demand (COD). The dissolution is the best way to mobilize pollutants from leaden mud, so we conducted leaching before starting the electrochemical treatment. The process was carried out in batch mode using graphite anode and a stainless steel cathode. The results clearly demonstrate the compatibility of the technique used with the type of pollution studied. In fact, it allowed COD removal about 80%.

Keywords: electrooxidation, leaching, leaden sludge, oil industry

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1820 Investigation of Norovirus Genogroups (GI, GII and GIV) in Stool of Pet Dogs with Diarrhea

Authors: S. Sokel, M. Kale

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Norovirus (NoV) infection is effective and contagious in humans and many animals such as calves, pigs, dogs, cats, monkeys. There is not enough evidence about the zoonotic transmission of NoV between humans and animals. However, the fact that contamination of foods and environment by animal/human waste happens in indirect way leads to consideration of the agent as a zoonotic character. In our study, we aim to search the presence of NoV infection, which is a major public health problem, in possessed dogs showing diarrhea symptoms, to detect its genotype and to study nutrition and life conditions. We searched the existence of human NoV GI, GII and GIV in the stool of 128 pet dogs in Burdur Province with diarrhoea in various sex, age and breed by using Real-Time PCR method. Human NoV GII was found in only 5 of the 128 dog stool samples (3.91%). In the study, it was determined that the owners of the dogs with NoV GII are middle aged or elderly people most of whom are male and that there were no children in their houses. As these dogs are treated like the owner’s child, it is assumed that they could be transmitted with NoV GII as a result of close interaction with their owner.

Keywords: dog, human, norovirus, Real-Time PCR, stool

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1819 A Framework and Case Study for Sustainable Development of Urban Areas

Authors: Yasaman Zeinali, Farid Khosravikia

Abstract:

This paper presents a multi-objective framework for sustainable urban development. The proposed framework aims to address different aspects of sustainability in urban development planning. These aspects include, but are not limited to education, health, job opportunities, architecture, culture, environment, mobility, energy, water, waste, and so on. Then, the proposed framework is applied to the Brackenridge Tract (an area in downtown Austin, Texas), to redevelop that area in a sustainable way. The detail of the implementation process is presented in this paper. The ultimate goal of this paper is to develop a sustainable area in downtown Austin with ensuring that it locally meets the needs of present and future generations with respect to economic, social, environmental, health as well as cultural aspects. Moreover, it helps the city with the population growth problem by accommodating more people in that area.

Keywords: urban planning, sustainability, sustainable urban development, environmental impacts of human activities

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1818 An Enhanced Connectivity Aware Routing Protocol for Vehicular Ad Hoc Networks

Authors: Ahmadu Maidorawa, Kamalrulnizam Abu Bakar

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This paper proposed an Enhanced Connectivity Aware Routing (ECAR) protocol for Vehicular Ad hoc Network (VANET). The protocol uses a control broadcast to reduce the number of overhead packets needed in a route discovery process. It is also equipped with an alternative backup route that is used whenever a primary path to destination failed, which highly reduces the frequent launching and re-launching of the route discovery process that waste useful bandwidth and unnecessarily prolonging the average packet delay. NS2 simulation results show that the performance of ECAR protocol outperformed the original connectivity aware routing (CAR) protocol by reducing the average packet delay by 28%, control overheads by 27% and increased the packet delivery ratio by 22%.

Keywords: alternative path, primary path, protocol, routing, VANET, vehicular ad hoc networks

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1817 Lung Disease Detection from the Chest X Ray Images Using Various Transfer Learning

Authors: Aicha Akrout, Amira Echtioui, Mohamed Ghorbel

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Pneumonia remains a significant global health concern, posing a substantial threat to human lives due to its contagious nature and potentially fatal respiratory complications caused by bacteria, fungi, or viruses. The reliance on chest X-rays for diagnosis, although common, often necessitates expert interpretation, leading to delays and potential inaccuracies in treatment. This study addresses these challenges by employing transfer learning techniques to automate the detection of lung diseases, with a focus on pneumonia. Leveraging three pre-trained models, VGG-16, ResNet50V2, and MobileNetV2, we conducted comprehensive experiments to evaluate their performance. Our findings reveal that the proposed model based on VGG-16 demonstrates superior accuracy, precision, recall, and F1 score, achieving impressive results with an accuracy of 93.75%, precision of 94.50%, recall of 94.00%, and an F1 score of 93.50%. This research underscores the potential of transfer learning in enhancing pneumonia diagnosis and treatment outcomes, offering a promising avenue for improving healthcare delivery and reducing mortality rates associated with this debilitating respiratory condition.

Keywords: chest x-ray, lung diseases, transfer learning, pneumonia detection

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1816 Recovery of Boron as Homogeneous Perborate Particles from Synthetic Wastewater by Integrating Chemical Oxo-Precipitation with Fluidized-Bed Homogeneous Granulation

Authors: Chiung-Chin Huang, Jui-Yen Lin, Yao-Hui Huang

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Among current techniques of boron removal from wastewater with high boron concentration, chemical oxo-precipitation (COP) is one of the promising methods due to its milder condition. COP uses H2O2 to transform boric acid to perborates which can easily precipitate with barium ions at room temperature. However, the generation of the waste sludge that requires sludge/water separation and sludge dewatering is troublesome. This work presents an innovative technology which integrates chemical oxo-precipitation (COP) with fluidized-bed homogeneous granulation (FBHG) to reclaim boron as homogeneous perborate particles. By conducting COP in a fluidized-bed reactor, the barium perborate can be granulated to form homogeneous particles (>1.0 mm) with low water content (< 10%). Under the suitable condition, more than 70% of boron can be recovered from 600 ppm of boron solution and the residual boron is lower than 100 ppm.

Keywords: barium, perborate, chemical oxo-precipitation, boron removal, fluidized-bed, granulation

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1815 Utilization of Fishbone for the Removal of Nickel Ions from Aqueous Media

Authors: Bukunola A.Oguntade, Abdul- Azeez A. Oderinde

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Fishbone is a type of waste generated from food and food processing industries. Fishbone wastes are usually treated as the source of organic matter for the by-production. It is a rich source of hydroxyapatite (HAP). In this study, the adsorption behavior of fishbone was examined in a batch system as an economically viable adsorbent for the removal of Ni⁺² ions from aqueous solution. The powdered fishbone was characterized using Fourier Transform Infrared (FT-IR) spectrophotometer and Scanning Electron microscope (SEM). The study investigated the influence of adsorbent dosage, solution pH, contact time, and initial metal concentration on the removal of Nickel (II) ions at room temperature. The batch kinetics study showed that the optimum adsorption of Ni(II) was 98% at pH 7, metal ion concentration of 30 mg/L. The results obtained from the experimental work showed that fishbone can be used as an adsorbent for the removal of Ni(II) ions from aqueous solution.

Keywords: adsorption, aqueous media, fishbone, kinetic study

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1814 Psychotraumatology: The Relationship Between Posttraumatic Stress Disorder and Criminal Justice Involvement in Vietnam War Veterans

Authors: Danielle Page

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Foregoing studies, statistics, and medical evaluations have established a relationship between Posttraumatic stress disorder (PTSD) and criminal justice involvement in Vietnam veterans. War is highly trauma inducing and can leave combat veterans with mental disorders ranging from psychopathic thoughts to suicidal ideation. The majority of those suffering are unaware that they have PTSD, and as a coping mechanism, they often turn to self isolation. Beyond isolation, many veterans with symptomatic PTSD turn to aggression and substance abuse to cope with their internal agony. The most common crimes committed by veterans with PTSD fall into the assault and drug/alcohol abuse categories. Thus, a relationship is established between veteran populations and the criminal justice system. This dissertation aims to define the relationship between PTSD and criminal justice involvement in veterans, explore the mediating factors in this relationship, and analyze numerous court cases in this subject area. Further, it will examine the ways in which crime rates can be reduced for veterans with symptoms of PTSD. This ranges from the improvement of healthcare systems to the implementation of special courts to handle veteran cases.

Keywords: psychotraumatology, forensic psychology, PTSD, vietnam veterans

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1813 Preliminary Study of Sediment-Derived Plastiglomerate: Proposal to Classification

Authors: Agung Rizki Perdana, Asrofi Mursalin, Adniwan Shubhi Banuzaki, M. Indra Novian

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The understanding about sediment-derived plastiglomerate has a wide-range of merit in the academic realm. It can cover discussions about the Anthropocene Epoch in the scope of geoscience knowledge to even provide a solution for the environmental problem of plastic waste. Albeit its importance, very few research has been done regarding this issue. This research aims to create a classification as a pioneer for the study of sediment-derived plastiglomerate. This research was done in Bantul Regency, Daerah Istimewa Yogyakarta Province as an analogue of plastic debris sedimentation process. Observation is carried out in five observation points that shows three different depositional environments, which are terrestrial, fluvial, and transitional environment. The resulting classification uses three parameters and forms in a taxonomical manner. These parameters are composition, degree of lithification, and abundance of matrix respectively in advancing order. There is also a compositional ternary diagram which should be followed before entering the plastiglomerate nomenclature classification.

Keywords: plastiglomerate, classification, sedimentary mechanism, microplastic

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1812 Heroin Withdrawal, Prison and Multiple Temporalities

Authors: Ian Walmsley

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The aim of this paper is to explore the influence of time and temporality on the experience of coming off heroin in prison. The presentation draws on qualitative data collected during a small-scale pilot study of the role of self-care in the process of coming off drugs in prison. Time and temporality emerged as a key theme in the interview transcripts. Drug dependent prisoners experience of time in prison has not been recognized in the research literature. Instead, the literature on prison time typically views prisoners as a homogenous group or tends to focus on the influence of aging and gender on prison time. Furthermore, there is a tendency in the literature on prison drug treatment and recovery to conceptualize drug dependent prisoners as passive recipients of prison healthcare, rather than active agents. In building on these gaps, this paper argues that drug dependent prisoners experience multiple temporalities which involve an interaction between the body-times of the drug dependent prisoner and the economy of time in prison. One consequence of this interaction is the feeling that they are doing, at this point in their prison sentence, double prison time. The second part of the argument is that time and temporality were a means through which they governed their withdrawing bodies. In addition, this paper will comment on the challenges of prison research in England.

Keywords: heroin withdrawal, time and temporality, prison, body

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1811 Cement Matrix Obtained with Recycled Aggregates and Micro/Nanosilica Admixtures

Authors: C. Mazilu, D. P. Georgescu, A. Apostu, R. Deju

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Cement mortars and concretes are some of the most used construction materials in the world, global cement production being expected to grow to approx. 5 billion tons, until 2030. But, cement is an energy intensive material, the cement industry being responsible for cca. 7% of the world's CO2 emissions. Also, natural aggregates represent non-renewable resources, exhaustible, which must be used efficiently. A way to reduce the negative impact on the environment is the use of additional hydraulically active materials, as a partial substitute for cement in mortars and concretes and/or the use of recycled concrete aggregates (RCA) for the recovery of construction waste, according to EU Directive 2018/851. One of the most effective active hydraulic admixtures is microsilica and more recently, with the technological development on a nanometric scale, nanosilica. Studies carried out in recent years have shown that the introduction of SiO2 nanoparticles into cement matrix improves the properties, even compared to microsilica. This is due to the very small size of the nanosilica particles (<100nm) and the very large specific surface, which helps to accelerate cement hydration and acts as a nucleating agent to generate even more calcium hydrosilicate which densifies and compacts the structure. The cementitious compositions containing recycled concrete aggregates (RCA) present, in generally, inferior properties compared to those obtained with natural aggregates. Depending on the degree of replacement of natural aggregate, decreases the workability of mortars and concretes with RAC, decrease mechanical resistances and increase drying shrinkage; all being determined, in particular, by the presence to the old mortar attached to the original aggregate from the RAC, which makes its porosity high and the mixture of components to require more water for preparation. The present study aims to use micro and nanosilica for increase the performance of some mortars and concretes obtained with RCA. The research focused on two types of cementitious systems: a special mortar composition used for encapsulating Low Level radioactive Waste (LLW); a composition of structural concrete, class C30/37, with the combination of exposure classes XC4+XF1 and settlement class S4. The mortar was made with 100% recycled aggregate, 0-5 mm sort and in the case of concrete, 30% recycled aggregate was used for 4-8 and 8-16 sorts, according to EN 206, Annex E. The recycled aggregate was obtained from a specially made concrete for this study, which after 28 days was crushed with the help of a Retsch jaw crusher and further separated by sieving on granulometric sorters. The partial replacement of cement was done progressively, in the case of the mortar composition, with microsilica (3, 6, 9, 12, 15% wt.), nanosilica (0.75, 1.5, 2.25% wt.), respectively mixtures of micro and nanosilica. The optimal combination of silica, from the point of view of mechanical resistance, was later used also in the case of the concrete composition. For the chosen cementitious compositions, the influence of micro and/or nanosilica on the properties in the fresh state (workability, rheological characteristics) and hardened state (mechanical resistance, water absorption, freeze-thaw resistance, etc.) is highlighted.

Keywords: cement, recycled concrete aggregates, micro/nanosilica, durability

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1810 Predictive Factors of Prognosis in Acute Stroke Patients Receiving Traditional Chinese Medicine Therapy: A Retrospective Study

Authors: Shaoyi Lu

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Background: Traditional Chinese medicine has been used to treat stroke, which is a major cause of morbidity and mortality. There is, however, no clear agreement about the optimal timing, population, efficacy, and predictive prognosis factors of traditional Chinese medicine supplemental therapy. Method: In this study, we used a retrospective analysis with data collection from stroke patients in Stroke Registry In Chang Gung Healthcare System (SRICHS). Stroke patients who received traditional Chinese medicine consultation in neurology ward of Keelung Chang Gung Memorial Hospital from Jan 2010 to Dec 2014 were enrolled. Clinical profiles including the neurologic deficit, activities of daily living and other basic characteristics were analyzed. Through propensity score matching, we compared the NIHSS and Barthel index before and after the hospitalization, and applied with subgroup analysis, and adjusted by multivariate regression method. Results: Totally 115 stroke patients were enrolled with experiment group in 23 and control group in 92. The most important factor for prognosis prediction were the scores of National Institutes of Health Stroke Scale and Barthel index right before the hospitalization. Traditional Chinese medicine intervention had no statistically significant influence on the neurological deficit of acute stroke patients, and mild negative influence on daily activity performance of acute hemorrhagic stroke patient. Conclusion: Efficacy of traditional Chinese medicine as a supplemental therapy for acute stroke patients was controversial. The reason for this phenomenon might be complex and require more research to comprehend. Key words: traditional Chinese medicine, acupuncture, Stroke, NIH stroke scale, Barthel index, predictive factor. Method: In this study, we used a retrospective analysis with data collection from stroke patients in Stroke Registry In Chang Gung Healthcare System (SRICHS). Stroke patients who received traditional Chinese medicine consultation in neurology ward of Keelung Chang Gung Memorial Hospital from Jan 2010 to Dec 2014 were enrolled. Clinical profiles including the neurologic deficit, activities of daily living and other basic characteristics were analyzed. Through propensity score matching, we compared the NIHSS and Barthel index before and after the hospitalization, and applied with subgroup analysis, and adjusted by multivariate regression method. Results: Totally 115 stroke patients were enrolled with experiment group in 23 and control group in 92. The most important factor for prognosis prediction were the scores of National Institutes of Health Stroke Scale and Barthel index right before the hospitalization. Traditional Chinese medicine intervention had no statistically significant influence on the neurological deficit of acute stroke patients, and mild negative influence on daily activity performance of acute hemorrhagic stroke patient. Conclusion: Efficacy of traditional Chinese medicine as a supplemental therapy for acute stroke patients was controversial. The reason for this phenomenon might be complex and require more research to comprehend.

Keywords: traditional Chinese medicine, complementary and alternative medicine, stroke, acupuncture

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1809 The Role of NAD+ and Nicotinamide (Vitamin B3) in Glaucoma: A Literature Review

Authors: James Pietris

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Glaucoma is a collection of irreversible optic neuropathies which, if left untreated, lead to severe visual field loss. These diseases are a leading cause of blindness across the globe and are estimated to affect approximately 80 million people, particularly women and people of Asian descent.1This represents a major burden on healthcare systems worldwide. Recently, there has been increasing interest in the potential of nicotinamide (vitamin B3) as a novel option in the management of glaucoma. This review aims to analyse the currently available literature to determine whether there is evidence of an association between nicotinamide adenine dinucleotide (NAD+) and glaucomatous optic neuropathy and whether nicotinamide has the potential to prevent or reverse these effects. The literature showed a strong connection between reduced NAD+ levels and retinal ganglion cell dysfunction through multiple different studies. There is also evidence of the positive effect of nicotinamide supplementation on retinal ganglion cell function in models of mouse glaucoma and in a study involving humans. Based on the literature findings, a recommendation has been made that more research into the efficacy, appropriate dosing, and potential side effects of nicotinamide supplementation is needed before it can be definitively determined whether it is appropriate for widespread prophylactic and therapeutic use against glaucoma in humans.

Keywords: glaucoma, nicotinamide, vitamin B3, optic neuropathy

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1808 Medical Decision-Making in Advanced Dementia from the Family Caregiver Perspective: A Qualitative Study

Authors: Elzbieta Sikorska-Simmons

Abstract:

Advanced dementia is a progressive terminal brain disease that is accompanied by a syndrome of difficult to manage symptoms and complications that eventually lead to death. The management of advanced dementia poses major challenges to family caregivers who act as patient health care proxies in making medical treatment decisions. Little is known, however, about how they manage advanced dementia and how their treatment choices influence the quality of patient life. This prospective qualitative study examines the key medical treatment decisions that family caregivers make while managing advanced dementia. The term ‘family caregiver’ refers to a relative or a friend who is primarily responsible for managing patient’s medical care needs and legally authorized to give informed consent for medical treatments. Medical decision-making implies a process of choosing between treatment options in response to patient’s medical care needs (e.g., worsening comorbid conditions, pain, infections, acute medical events). Family caregivers engage in this process when they actively seek treatments or follow recommendations by healthcare professionals. Better understanding of medical decision-making from the family caregiver perspective is needed to design interventions that maximize the quality of patient life and limit inappropriate treatments. Data were collected in three waves of semi-structured interviews with 20 family caregivers for patients with advanced dementia. A purposive sample of 20 family caregivers was recruited from a senior care center in Central Florida. The qualitative personal interviews were conducted by the author in 4-5 months intervals. The ethical approval for the study was obtained prior to the data collection. Advanced dementia was operationalized as stage five or higher on the Global Deterioration Scale (GDS) (i.e., starting with the GDS score of five, patients are no longer able survive without assistance due to major cognitive and functional impairments). Information about patients’ GDS scores was obtained from the Center’s Medical Director, who had an in-depth knowledge of each patient’s health and medical treatment history. All interviews were audiotaped and transcribed verbatim. The qualitative data analysis was conducted to answer the following research questions: 1) what treatment decisions do family caregivers make while managing the symptoms of advanced dementia and 2) how do these treatment decisions influence the quality of patient life? To validate the results, the author asked each participating family caregiver if the summarized findings accurately captured his/her experiences. The identified medical decisions ranged from seeking specialist medical care to end-of-life care. The most common decisions were related to arranging medical appointments, medication management, seeking treatments for pain and other symptoms, nursing home placement, and accessing community-based healthcare services. The most challenging and consequential decisions were related to the management of acute complications, hospitalizations, and discontinuation of treatments. Decisions that had the greatest impact on the quality of patient life and survival were triggered by traumatic falls, worsening psychiatric symptoms, and aspiration pneumonia. The study findings have important implications for geriatric nurses in the context of patient/caregiver-centered dementia care. Innovative nursing approaches are needed to support family caregivers to effectively manage medical care needs of patients with advanced dementia.

Keywords: advanced dementia, family caregiver, medical decision-making, symptom management

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1807 Human Trafficking in Your Backyard: Know the Signs and How to Help

Authors: Jessie Fazel, Kristen Smith

Abstract:

Human trafficking is a multi-billion-dollar criminal industry that affects 24.9 million people around the world. There are several different types of trafficking, the most common being sex trafficking, labor trafficking, and domestic servitude. Survival sex is common in the pediatric population, as they engage in sex for food, a place to sleep, or other basic needs. Statistics show that health care workers are at a unique advantage to help identify victims and get them the help they need, as 88% of trafficked victims encounter a health care worker while being trafficked. Unfortunately, victims don’t usually self-identify that they are being trafficked and the situations they face can vary dramatically. It is imperative to remember that traditional red flags are not always present in the pediatric population. Risk factors and red flags with their history and physical exam are one of the best indicators that health care providers need to be vigilant in looking at. There are numerous barriers for disclosure in the healthcare setting. Periods of time before and after disclosure are often emotionally difficult and could be dangerous for the victim. It is extremely important to have a plan in place for intervention if the victim does disclose trafficking. A trauma informed approach to medical and mental health interventions, that focus on safety, are vital in this population. This is happening where you live and you can make a difference in their lives.

Keywords: human trafficking, public health, emergency medicine, sexual health

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1806 Improved Active Constellation Extension for the PAPR Reduction of FBMC-OQAM Signals

Authors: Mounira Laabidi, Rafik Zayani, Ridha Bouallegue, Daniel Roviras

Abstract:

The Filter Bank multicarrier with Offset Quadrature Amplitude Modulation (FBMC-OQAM) has been introduced to overcome the poor spectral characteristics and the waste in both bandwidth and energy caused by the use of the cyclic prefix. However, the FBMC-OQAM signals suffer from the high Peak to Average Power Ratio (PAPR) problem. Due to the overlapping structure of the FBMC-OQAM signals, directly applying the PAPR reduction schemes conceived for the OFDM one turns out to be ineffective. In this paper, we address the problem of PAPR reduction for FBMC-OQAM systems by suggesting a new scheme based on an improved version of Active Constellation Extension scheme (ACE) of OFDM. The proposed scheme, named Rolling Window ACE, takes into consideration the overlapping naturally emanating from the FBMC-OQAM signals.

Keywords: ACE, FBMC, OQAM, OFDM, PAPR, rolling-window

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1805 Integrating AI into Breast Cancer Diagnosis: Aligning Perspectives for Effective Clinical Practice

Authors: Mehrnaz Mostafavi, Mahtab Shabani, Alireza Azani, Fatemeh Ghafari

Abstract:

Artificial intelligence (AI) can transform breast cancer diagnosis and therapy by providing sophisticated solutions for screening, imaging interpretation, histopathological analysis, and treatment planning. This literature review digs into the many uses of AI in breast cancer treatment, highlighting the need for collaboration between AI scientists and healthcare practitioners. It emphasizes advances in AI-driven breast imaging interpretation, such as computer-aided detection and diagnosis (CADe/CADx) systems and deep learning algorithms. These have shown significant potential for improving diagnostic accuracy and lowering radiologists' workloads. Furthermore, AI approaches such as deep learning have been used in histopathological research to accurately predict hormone receptor status and categorize tumor-associated stroma from regular H&E stains. These AI-powered approaches simplify diagnostic procedures while providing insights into tumor biology and prognosis. As AI becomes more embedded in breast cancer care, it is crucial to ensure its ethical, efficient, and patient-focused implementation to improve outcomes for breast cancer patients ultimately.

Keywords: breast cancer, artificial intelligence, cancer diagnosis, clinical practice

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1804 Global Indicators of Successful Remote Monitoring Adoption Applying Diffusion of Innovation Theory

Authors: Danika Tynes

Abstract:

Innovations in technology have implications for sustainable development in health and wellness. Remote monitoring is one innovation for which the evidence-base has grown to support its viability as a quality healthcare delivery adjunct. This research reviews global data on telehealth adoption, in particular, remote monitoring, and the conditions under which its success becomes more likely. System-level indicators were selected to represent four constructs of DoI theory (relative advantage, compatibility, complexity, and observability) and assessed against 5 types of Telehealth (Teleradiology, Teledermatology, Telepathology, Telepsychology, and Remote Monitoring) using ordinal logistic regression. Analyses include data from 84 countries, as extracted from the World Health Organization, World Bank, ICT (Information Communications Technology) Index, and HDI (Human Development Index) datasets. Analyses supported relative advantage and compatibility as the strongest influencers of remote monitoring adoption. Findings from this research may help focus on the allocation of resources, as a sustainability concern, through consideration of systems-level factors that may influence the success of remote monitoring adoption.

Keywords: remote monitoring, diffusion of innovation, telehealth, digital health

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1803 Development of Composite Material for Thermal and Electrical Insulation

Authors: Elmo Thiago Lins Cöuras Ford, Valentina Alessandra Carvalho do Vale, Rubens Maribondo do Nascimento, José Ubiragi de Lima Mendes

Abstract:

Recycling has been greatly stimulated by the market. There are already several products that are produced with recycled materials and various wastes have been studied in various forms of applications. The vast majority of insulation applications in domestic, commercial and industrial systems in the range of low and medium temperatures (up to 180 ° C), using the aggressive nature materials such as glass wool, rock wool, polyurethane, polystyrene. Such materials, while retaining the effectiveness of the heat flux, are disposed as expensive and take years too absorbed by nature. Thus, trying to adapt to a global policy on the preservation of the environment, a study in order to develop an insulating compound of natural / industrial waste and biodegradable materials conducted. Thus, this research presents the development of a composite material based zest tire and latex for thermal and electrical insulation.

Keywords: composite, latex, scrapes tire, insulation, electrical

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1802 Experimental Characterization of the Shear Behavior of Fiber Reinforced Concrete Beam Elements in Chips

Authors: Djamal Atlaoui, Youcef Bouafia

Abstract:

This work deals with the experimental study of the mechanical behavior, by shear tests (fracture shear), elements of concrete beams reinforced with fibers in chips. These fibers come from the machining waste of the steel parts. The shear tests are carried out on prismatic specimens of dimensions 10 x 20 x 120 cm3. The fibers are characterized by mechanical resistance and tearing. The optimal composition of the concrete was determined by the workability test. Two fiber contents are selected for this study (W = 0.6% and W = 0.8%) and a BT control concrete (W = 0%) of the same composition as the matrix is developed to serve as a reference with a sand-to-gravel ratio (S/G) of concrete matrix equal to 1. The comparison of the different results obtained shows that the chips fibers confer a significant ductility to the material after cracking of the concrete. Also, the fibers used limit diagonal cracks in shear and improve strength and rigidity.

Keywords: characterization, chips fibers, cracking mode, ductility, undulation, shear

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1801 Efficiently Dispersed MnOx on Mesoporous 3D Cubic Support for Cyclohexene Epoxidation

Authors: G. Imran, A. Pandurangan

Abstract:

Epoxides constitute important intermediates for the production of fine and bulk chemicals as well as valuable building blocks for the synthesis of a variety of bioactive molecules. Manganese oxides are used as selective catalyst for various redox type reactions and also effectively used in the field of catalytic disposal of pollutants. Non-toxic, cost efficient factor and more over existence of wide range of oxidation state (+2 to +7) makes catalyst more interesting for both academic research and industrial applications. However, the serious drawback lying is the lower surface area. Exceedingly dispersed manganese oxide grafted over mesoporous solid material KIT-6 through ALD (Atomic Layer Deposition) technique effectively catalyze cyclohexene with H2O2 (30% in water) to corresponding epoxides. Highly selective epoxide >99% with 55.7% conversion of cyclohexene was achieved using huge dispersed active sites of MnOx species containing catalysts. Various weight percent such as (1, 3, 5, 7 & 10 wt %) of manganese (II) acetylacetonate complex was employed as Mn source to post-graft via active silanol groups of KIT-6 and are designated as (Mn-G-KIT-6). XRD, N2 sorption, HR-TEM, DRS-UV-VIS, EPR and H2-TPR were employed for structural and textural properties. Immense Mn species of about 95% proportion on silica matrix obtained was evident from ICP-OES.The resulting materials exhibited Type IV adsorption isotherms indiacting mesopore in nanorange. Si-KIT-6 and Mn-G-KIT-6 materials exhibited surface area of 519-289 m2/g and with decrease in pore volume of 0.96-0.49 cm3/g with pore diameter ranging 7.9- 7.2 with increase in wt%. DRS-UV-VIS spectroscopy and EPR studies reveal that manganese coexists as Mn2+/3+ species as extra-framework sites and frame-work sites that result in dispersion on surface of silica matrix of KIT-6 and incorporated manganese sites with silanol groups along with small sized MnO cluster, evident from HR-TEM which increase with Mn content. Conventional production of epoxides by the intramolecular etherification of chlorohydrins formed by the reaction of alkenes with hypochlorous acid is the major drawbacks obtained recently. The most efficient synthesis of oxiranes (epoxides) is obtained by mesoporous catalysts (Mn-G-KIT-6) are presented here and discussed.

Keywords: ALD, epoxidation, mesoporous, MnOx

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1800 Facilitating Primary Care Practitioners to Improve Outcomes for People With Oropharyngeal Dysphagia Living in the Community: An Ongoing Realist Review

Authors: Caroline Smith, Professor Debi Bhattacharya, Sion Scott

Abstract:

Introduction: Oropharyngeal Dysphagia (OD) effects around 15% of older people, however it is often unrecognised and under diagnosed until they are hospitalised. There is a need for primary care healthcare practitioners (HCPs) to assume a proactive role in identifying and managing OD to prevent adverse outcomes such as aspiration pneumonia. Understanding the determinants of primary care HCPs undertaking this new behaviour provides the intervention targets for addressing. This realist review, underpinned by the Theoretical Domains Framework (TDF), aims to synthesise relevant literature and develop programme theories to understand what interventions work, how they work and under what circumstances to facilitate HCPs to prevent harm from OD. Combining realist methodology with behavioural science will permit conceptualisation of intervention components as theoretical behavioural constructs, thus informing the design of a future behaviour change intervention. Furthermore, through the TDF’s linkage to a taxonomy of behaviour change techniques, we will identify corresponding behaviour change techniques to include in this intervention. Methods & analysis: We are following the five steps for undertaking a realist review: 1) clarify the scope 2) Literature search 3) appraise and extract data 4) evidence synthesis 5) evaluation. We have searched Medline, Google scholar, PubMed, EMBASE, CINAHL, AMED, Scopus and PsycINFO databases. We are obtaining additional evidence through grey literature, snowball sampling, lateral searching and consulting the stakeholder group. Literature is being screened, evaluated and synthesised in Excel and Nvivo. We will appraise evidence in relation to its relevance and rigour. Data will be extracted and synthesised according to its relation to Initial programme theories (IPTs). IPTs were constructed after the preliminary literature search, informed by the TDF and with input from a stakeholder group of patient and public involvement advisors, general practitioners, speech and language therapists, geriatricians and pharmacists. We will follow the Realist and Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) quality and publication standards to report study results. Results: In this ongoing review our search has identified 1417 manuscripts with approximately 20% progressing to full text screening. We inductively generated 10 IPTs that hypothesise practitioners require: the knowledge to spot the signs and symptoms of OD; the skills to provide initial advice and support; and access to resources in their working environment to support them conducting these new behaviours. We mapped the 10 IPTs to 8 TDF domains and then generated a further 12 IPTs deductively using domain definitions to fulfil the remaining 6 TDF domains. Deductively generated IPTs broadened our thinking to consider domains such as ‘Emotion,’ ‘Optimism’ and ‘Social Influence’, e.g. If practitioners perceive that patients, carers and relatives expect initial advice and support, then they will be more likely to provide this, because they will feel obligated to do so. After prioritisation with stakeholders using a modified nominal group technique approach, a maximum of 10 IPTs will progress to test against the literature.

Keywords: behaviour change, deglutition disorders, primary healthcare, realist review

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