Search results for: tax compliance
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 775

Search results for: tax compliance

535 Bi-Directional Evolutionary Topology Optimization Based on Critical Fatigue Constraint

Authors: Khodamorad Nabaki, Jianhu Shen, Xiaodong Huang

Abstract:

This paper develops a method for considering the critical fatigue stress as a constraint in the Bi-directional Evolutionary Structural Optimization (BESO) method. Our aim is to reach an optimal design in which high cycle fatigue failure does not occur for a specific life time. The critical fatigue stress is calculated based on modified Goodman criteria and used as a stress constraint in our topology optimization problem. Since fatigue generally does not occur for compressive stresses, we use the p-norm approach of the stress measurement that considers the highest tensile principal stress in each point as stress measure to calculate the sensitivity numbers. The BESO method has been extended to minimize volume an object subjected to the critical fatigue stress constraint. The optimization results are compared with the results from the compliance minimization problem which shows clearly the merits of our newly developed approach.

Keywords: topology optimization, BESO method, p-norm, fatigue constraint

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534 Seizure Effects of FP Bearings on the Seismic Reliability of Base-Isolated Systems

Authors: Paolo Castaldo, Bruno Palazzo, Laura Lodato

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This study deals with the seizure effects of friction pendulum (FP) bearings on the seismic reliability of a 3D base-isolated nonlinear structural system, designed according to Italian seismic code (NTC08). The isolated system consists in a 3D reinforced concrete superstructure, a r.c. substructure and the FP devices, described by employing a velocity dependent model. The seismic input uncertainty is considered as a random variable relevant to the problem, by employing a set of natural seismic records selected in compliance with L’Aquila (Italy) seismic hazard as provided from NTC08. Several non-linear dynamic analyses considering the three components of each ground motion have been performed with the aim to evaluate the seismic reliability of the superstructure, substructure, and isolation level, also taking into account the seizure event of the isolation devices. Finally, a design solution aimed at increasing the seismic robustness of the base-isolated systems with FPS is analyzed.

Keywords: FP devices, seismic reliability, seismic robustness, seizure

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533 Analysis of Bending Abilities of Soft Pneumatic Actuator

Authors: Jeevan Balaji, Shreyas Chigurupati

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Pneumatic gripper use compressed air to operate its actuators (fingers). Unlike the conventional metallic gripper, a soft pneumatic actuator (SPA) can be used for relocating fragile objects. An added advantage for this gripper is that the pressure exerted on the object can be varied by changing the dimensions of the air chambers and also by the number of chambers. SPAs have many benefits over conventional robots in the military, medical fields because of their compliance nature and are easily produced using the 3D printing process. In the paper, SPA is proposed to perform pick and place tasks. A design was developed for the actuators, which is convenient for gripping any fragile objects. Thermoplastic polyurethane (TPU) is used for 3D printing the actuators. The actuator model behaves differently as the parameters such as its chamber height, number of chambers change. A detailed FEM model of the actuator is drafted for different pressure inputs using ABAQUS CAE software, and a safe loading pressure range is found.

Keywords: soft robotics, pneumatic actuator, design and modelling, bending analysis

Procedia PDF Downloads 166
532 Knowledge, Attitude and Beliefs Towards Polypharmacy Amongst Older People Attending Family Medicine Clinic at the Aga Khan University Hospital, Nairobi, Kenya (AKUHN) Sub-Saharan Africa-Qualitative Study

Authors: Maureen Kamau, Gulnaz Mohamoud, Adelaide Lusambili, Njeri Nyanja

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Life expectancy has increased over the last century amongst older individuals, and in particular, those 60 years and over. The World Health Organization estimates that the world's population of persons over 60 years will rise to 22 per cent by the year 2050. Ageing is associated with increasing disability, multiple chronic conditions, and an increase in the use of health services. These multiple chronic conditions are managed with polypharmacy. Polypharmacy has numerous adverse effects including non-adherence, poor compliance to the various medications, reduced appetite, and risk of fall. Studies on polypharmacy and ageing are few and poorly understood especially in low and middle - income countries. The aim of this study was to explore the knowledge, attitudes and beliefs of older people towards polypharmacy. A qualitative study of 15 patients aged 60 years and above, taking more than five medications per day were conducted at the Aga Khan University using Semi-structured in-depth interviews. Three interviews were pilot interviews, and data analysis was performed on 12 interviews. Data were analyzed using NVIVO 12 software. A thematic qualitative analysis was carried out guided by Braun and Clarke (2006) framework. Themes identified; - knowledge of their co-morbidities and of the medication that older persons take, sources of information about medicines, and storage of the medication, experiences and attitudes of older patients towards polypharmacy both positive and negative, older peoples beliefs and their coping mechanisms with polypharmacy. The study participants had good knowledge on their multiple co-morbidities, and on the medication they took. The patients had positive attitudes towards medication as it enhanced their health and well-being, and enabled them to perform their activities of daily living. There was a strong belief among older patients that the medications were necessary for their health. All these factors enhanced compliance to the multiple medication. However, some older patients had negative attitudes due to the pill burden, side effects of the medication, and stigma associated with being ill. Cost of healthcare was a concern, with most of the patients interviewed relying on insurance to cover the cost of their medication. Older patients had accepted that the medication they were prescribed were necessary for their health, as it enabled them to complete their activities of daily living. Some concerns about the side effects of the medication arose, and brought about the need for patient education that would ensure that the patients are aware of the medications they take, and potential side effects. The effect that the COVID 19 pandemic had in the healthcare of the older patients was evident by the number of the older patients avoided coming to the hospital during the period of the pandemic. The relationship with the primary care physician and the older patients is an important one, especially in LMICs such as Kenya, as many of the older patients trusted the doctors wholeheartedly to make the best decision about their health and about their medication. Prescription review is important to avoid the use of potentially inappropriate medication.

Keywords: polypharmacy, older patients, multiple chronic conditions, Kenya, Africa, qualitative study, indepth interviews, primary care

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531 Algorithmic Obligations: Proactive Liability for AI-Generated Content and Copyright Compliance

Authors: Aleksandra Czubek

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As AI systems increasingly shape content creation, existing copyright frameworks face significant challenges in determining liability for AI-generated outputs. Current legal discussions largely focus on who bears responsibility for infringing works, be it developers, users, or entities benefiting from AI outputs. This paper introduces a novel concept of algorithmic obligations, proposing that AI developers be subject to proactive duties that ensure their models prevent copyright infringement before it occurs. Building on principles of obligations law traditionally applied to human actors, the paper suggests a shift from reactive enforcement to proactive legal requirements. AI developers would be legally mandated to incorporate copyright-aware mechanisms within their systems, turning optional safeguards into enforceable standards. These obligations could vary in implementation across international, EU, UK, and U.S. legal frameworks, creating a multi-jurisdictional approach to copyright compliance. This paper explores how the EU’s existing copyright framework, exemplified by the Copyright Directive (2019/790), could evolve to impose a duty of foresight on AI developers, compelling them to embed mechanisms that prevent infringing outputs. By drawing parallels to GDPR’s “data protection by design,” a similar principle could be applied to copyright law, where AI models are designed to minimize copyright risks. In the UK, post-Brexit text and data mining exemptions are seen as pro-innovation but pose risks to copyright protections. This paper proposes a balanced approach, introducing algorithmic obligations to complement these exemptions. AI systems benefiting from text and data mining provisions should integrate safeguards that flag potential copyright violations in real time, ensuring both innovation and protection. In the U.S., where copyright law focuses on human-centric works, this paper suggests an evolution toward algorithmic due diligence. AI developers would have a duty similar to product liability, ensuring that their systems do not produce infringing outputs, even if the outputs themselves cannot be copyrighted. This framework introduces a shift from post-infringement remedies to preventive legal structures, where developers actively mitigate risks. The paper also breaks new ground by addressing obligations surrounding the training data of large language models (LLMs). Currently, training data is often treated under exceptions such as the EU’s text and data mining provisions or U.S. fair use. However, this paper proposes a proactive framework where developers are obligated to verify and document the legal status of their training data, ensuring it is licensed or otherwise cleared for use. In conclusion, this paper advocates for an obligations-centered model that shifts AI-related copyright law from reactive litigation to proactive design. By holding AI developers to a heightened standard of care, this approach aims to prevent infringement at its source, addressing both the outputs of AI systems and the training processes that underlie them.

Keywords: ip, technology, copyright, data, infringement, comparative analysis

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530 Legal Basis for Water Resources Management in Brazil: Case Study of the Rio Grande Basin

Authors: Janaína F. Guidolini, Jean P. H. B. Ometto, Angélica Giarolla, Peter M. Toledo, Carlos A. Valera

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The water crisis, a major problem of the 21st century, occurs mainly due to poor management. The central issue that should govern the management is the integration of the various aspects that interfere with the use of water resources and their protection, supported by legal basis. A watershed is a unit of water interacting with the physical, biotic, social, economic and cultural variables. The Brazilian law recognized river basin as the territorial management unit. Based on the diagnosis of the current situation of the water resources of the Rio Grande Basin, a discussion informed in the Brazilian legal basis was made to propose measures to fight or mitigate damages and environmental degradation in the Basin. To manage water resources more efficiently, conserve water and optimize their multiple uses, the integration of acquired scientific knowledge and management is essential. Moreover, it is necessary to monitor compliance with environmental legislation.

Keywords: conservation of soil and water, environmental laws, river basin, sustainability

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529 Fulfillment of Models of Prenatal Care in Adolescents from Mexico and Chile

Authors: Alejandra Sierra, Gloria Valadez, Adriana Dávalos, Mirliana Ramírez

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For years, the Pan American Health Organization/World Health Organization and other organizations have made efforts to the improve access and the quality of prenatal care as part of comprehensive programs for maternal and neonatal health, the standards of care have been renewed in order to migrate from a medical perspective to a holistic perspective. However, despite the efforts currently antenatal care models have not been verified by a scientific evaluation in order to determine their effectiveness. The teenage pregnancy is considered as a very important phenomenon since it has been strongly associated with inequalities, poverty and the lack of gender quality; therefore it is important to analyze the antenatal care that’s been given, including not only the clinical intervention but also the activities surrounding the advertising and the health education. In this study, the objective was to describe if the previously established activities (on the prenatal care models) are being performed in the care of pregnant teenagers attending prenatal care in health institutions in two cities in México and Chile during 2013. Methods: Observational and descriptive study, of a transversal cohort. 170 pregnant women (13-19 years) were included in prenatal care in two health institutions (100 women from León-Mexico and 70 from Chile-Coquimbo). Data collection: direct survey, perinatal clinical record card which was used as checklists: WHO antenatal care model WHO-2003, Official Mexican Standard NOM-007-SSA2-1993 and Personalized Service Manual on Reproductive Process- Chile Crece Contigo; for data analysis descriptive statistics were used. The project was approved by the relevant ethics committees. Results: Regarding the fulfillment of interventions focused on physical, gynecological exam, immunizations, monitoring signs and biochemical parameters in both groups was met by more than 84%; the activities of guidance and counseling pregnant teenagers in Leon compliance rates were below 50%, on the other hand, although pregnant women in Coquimbo had a higher percentage of compliance, no one reached 100%. The topics that less was oriented were: family planning, signs and symptoms of complications and labor. Conclusions: Although the coverage of the interventions indicated in the prenatal care models was high, there were still shortcomings in the fulfillment of activities to orientation, education and health promotion. Deficiencies in adherence to prenatal care guidelines could be due to different circumstances such as lack of registration or incomplete filling of medical records, lack of medical supplies or health personnel, absences of people at prenatal check-up appointments, among many others. Therefore, studies are required to evaluate the quality of prenatal care and the effectiveness of existing models, considering the role of the different actors (pregnant women, professionals and health institutions) involved in the functionality and quality of prenatal care models, in order to create strategies to design or improve the application of a complete process of promotion and prevention of maternal and child health as well as sexual and reproductive health in general.

Keywords: adolescent health, health systems, maternal health, primary health care

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528 Evaluation of the Effectiveness of a HAWK Signal on Compliance in Las Vegas Nevada

Authors: A. Paz, M. Khadka, N. Veeramisti, B. Morris

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There is a continuous large number of crashes involving pedestrians in Nevada despite the numerous safety mechanisms currently used at roadway crossings. Hence, additional as well as more effective mechanisms are required to reduce crashes in Las Vegas, in particular, and Nevada in general. A potential mechanism to reduce conflicts between pedestrians and vehicles is a High-intensity Activated crossWalK (HAWK) signal. This study evaluates the effects of such signals at a particular site in Las Vegas. Video data were collected using two cameras, facing the eastbound and westbound traffic. One week of video data before and after the deployment of the signal were collected to capture the behavior of both pedestrians and drivers. T-test analyses of pedestrian waiting time at the curb, curb-to-curb crossing time, total crossing time, jaywalking events, and near-crash events show that the HAWK system provides significant benefits.

Keywords: pedestrian crashes, HAWK signal, traffic safety, pedestrian danger index

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527 Sustainable Building Law - The Legal Issues Abound

Authors: Richard J. Sobelsohn

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Green Building and Sustainable Development help fight climate change, and protects the ozone, animal habitats, air quality, and ground water. The myriad of reasons to go Green has multiplied to the point that a developer that is building a ground-up or renovating/retrofitting a property has a plethora of choices to get to the green goal post. Sustainability not affects the bottom line but satisfies corporate mandates (ESG), consumer demand, market requirements, and the many laws dictating green building practices. The good news is that there are many paths a property owner can take to become green. The bad news is that there are many paths a property owner can take to become green, and they need to choose which direction to take. Certification of a building used to be the highest achievement in the Green building world. Now there are so many variables and laws with which a property owner must comply, and the legal analysis has mushroomed. Operation and Maintenance have also become one of the most important functions for a prudent Green Building owner. So adding to the “development/retrofit” parties involved in the sustainable building legal world, we now need to include all those people who keep the building green, and there are a lot of them!

Keywords: green building, sustainable development, legal issues, greenwashing, green cleaning, compliance, ESQ

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526 Hydrogen Purity: Developing Low-Level Sulphur Speciation Measurement Capability

Authors: Sam Bartlett, Thomas Bacquart, Arul Murugan, Abigail Morris

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Fuel cell electric vehicles provide the potential to decarbonise road transport, create new economic opportunities, diversify national energy supply, and significantly reduce the environmental impacts of road transport. A potential issue, however, is that the catalyst used at the fuel cell cathode is susceptible to degradation by impurities, especially sulphur-containing compounds. A recent European Directive (2014/94/EU) stipulates that, from November 2017, all hydrogen provided to fuel cell vehicles in Europe must comply with the hydrogen purity specifications listed in ISO 14687-2; this includes reactive and toxic chemicals such as ammonia and total sulphur-containing compounds. This requirement poses great analytical challenges due to the instability of some of these compounds in calibration gas standards at relatively low amount fractions and the difficulty associated with undertaking measurements of groups of compounds rather than individual compounds. Without the available reference materials and analytical infrastructure, hydrogen refuelling stations will not be able to demonstrate compliance to the ISO 14687 specifications. The hydrogen purity laboratory at NPL provides world leading, accredited purity measurements to allow hydrogen refuelling stations to evidence compliance to ISO 14687. Utilising state-of-the-art methods that have been developed by NPL’s hydrogen purity laboratory, including a novel method for measuring total sulphur compounds at 4 nmol/mol and a hydrogen impurity enrichment device, we provide the capabilities necessary to achieve these goals. An overview of these capabilities will be given in this paper. As part of the EMPIR Hydrogen co-normative project ‘Metrology for sustainable hydrogen energy applications’, NPL are developing a validated analytical methodology for the measurement of speciated sulphur-containing compounds in hydrogen at low amount fractions pmol/mol to nmol/mol) to allow identification and measurement of individual sulphur-containing impurities in real samples of hydrogen (opposed to a ‘total sulphur’ measurement). This is achieved by producing a suite of stable gravimetrically-prepared primary reference gas standards containing low amount fractions of sulphur-containing compounds (hydrogen sulphide, carbonyl sulphide, carbon disulphide, 2-methyl-2-propanethiol and tetrahydrothiophene have been selected for use in this study) to be used in conjunction with novel dynamic dilution facilities to enable generation of pmol/mol to nmol/mol level gas mixtures (a dynamic method is required as compounds at these levels would be unstable in gas cylinder mixtures). Method development and optimisation are performed using gas chromatographic techniques assisted by cryo-trapping technologies and coupled with sulphur chemiluminescence detection to allow improved qualitative and quantitative analyses of sulphur-containing impurities in hydrogen. The paper will review the state-of-the art gas standard preparation techniques, including the use and testing of dynamic dilution technologies for reactive chemical components in hydrogen. Method development will also be presented highlighting the advances in the measurement of speciated sulphur compounds in hydrogen at low amount fractions.

Keywords: gas chromatography, hydrogen purity, ISO 14687, sulphur chemiluminescence detector

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525 Multiparticulate SR Formulation of Dexketoprofen Trometamol by Wurster Coating Technique

Authors: Bhupendra G. Prajapati, Alpesh R. Patel

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The aim of this research work is to develop sustained release multi-particulates dosage form of Dexketoprofen trometamol, which is the pharmacologically active isomer of ketoprofen. The objective is to utilization of active enantiomer with minimal dose and administration frequency, extended release multi-particulates dosage form development for better patience compliance was explored. Drug loaded and sustained release coated pellets were prepared by fluidized bed coating principle by wurster coater. Microcrystalline cellulose as core pellets, povidone as binder and talc as anti-tacking agents were selected during drug loading while Kollicoat SR 30D as sustained release polymer, triethyl citrate as plasticizer and micronized talc as an anti-adherent were used in sustained release coating. Binder optimization trial in drug loading showed that there was increase in process efficiency with increase in the binder concentration. 5 and 7.5%w/w concentration of Povidone K30 with respect to drug amount gave more than 90% process efficiency while higher amount of rejects (agglomerates) were observed for drug layering trial batch taken with 7.5% binder. So for drug loading, optimum Povidone concentration was selected as 5% of drug substance quantity since this trial had good process feasibility and good adhesion of the drug onto the MCC pellets. 2% w/w concentration of talc with respect to total drug layering solid mass shows better anti-tacking property to remove unnecessary static charge as well as agglomeration generation during spraying process. Optimized drug loaded pellets were coated for sustained release coating from 16 to 28% w/w coating to get desired drug release profile and results suggested that 22% w/w coating weight gain is necessary to get the required drug release profile. Three critical process parameters of Wurster coating for sustained release were further statistically optimized for desired quality target product profile attributes like agglomerates formation, process efficiency, and drug release profile using central composite design (CCD) by Minitab software. Results show that derived design space consisting 1.0 to 1.2 bar atomization air pressure, 7.8 to 10.0 gm/min spray rate and 29-34°C product bed temperature gave pre-defined drug product quality attributes. Scanning Image microscopy study results were also dictate that optimized batch pellets had very narrow particle size distribution and smooth surface which were ideal properties for reproducible drug release profile. The study also focused on optimized dexketoprofen trometamol pellets formulation retain its quality attributes while administering with common vehicle, a liquid (water) or semisolid food (apple sauce). Conclusion: Sustained release multi-particulates were successfully developed for dexketoprofen trometamol which may be useful to improve acceptability and palatability of a dosage form for better patient compliance.

Keywords: dexketoprofen trometamol, pellets, fluid bed technology, central composite design

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524 The Modified WBS Based on LEED Rating System in Decreasing Energy Consumption and Cost of Buildings

Authors: Mehrab Gholami Zangalani, Siavash Rajabpour

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In compliance with the Statistical Centre of Iran (SCI)’s results, construction and housing section in Iran is consuming 40% of energy, which is 5 times more than the world average consumption. By considering the climate in Iran, the solutions in terms of design, construction and exploitation of the buildings by utilizing the LEED rating system (LRS) is presented, regarding to the reasons for the high levels of energy consumption during construction and housing in Iran. As a solution, innovative Work Break Structure (WBS) in accordance with LRS and Iranian construction’s methods is unveiled in this research. Also, by amending laws pertaining to the construction in Iran, the huge amount of energy and cost can be saved. Furthermore, with a scale-up of these results to the scale of big cities such as Tehran (one of the largest metropolitan areas in the middle east) in which the license to build more than two hundred and fifty units each day is issued, the amount of energy and cost that can be saved is estimated.

Keywords: costs reduction, energy statistics, leed rating system (LRS), work brake structure (WBS)

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523 European Electromagnetic Compatibility Directive Applied to Astronomical Observatories

Authors: Oibar Martinez, Clara Oliver

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The Cherenkov Telescope Array Project (CTA) aims to build two different observatories of Cherenkov Telescopes, located in Cerro del Paranal, Chile, and La Palma, Spain. These facilities are used in this paper as a case study to investigate how to apply standard Directives on Electromagnetic Compatibility to astronomical observatories. Cherenkov Telescopes are able to provide valuable information from both Galactic and Extragalactic sources by measuring Cherenkov radiation, which is produced by particles which travel faster than light in the atmosphere. The construction requirements demand compliance with the European Electromagnetic Compatibility Directive. The largest telescopes of these observatories, called Large Scale Telescopes (LSTs), are high precision instruments with advanced photomultipliers able to detect the faint sub-nanosecond blue light pulses produced by Cherenkov Radiation. They have a 23-meter parabolic reflective surface. This surface focuses the radiation on a camera composed of an array of high-speed photosensors which are highly sensitive to the radio spectrum pollution. The camera has a field of view of about 4.5 degrees and has been designed for maximum compactness and lowest weight, cost and power consumption. Each pixel incorporates a photo-sensor able to discriminate single photons and the corresponding readout electronics. The first LST is already commissioned and intends to be operated as a service to Scientific Community. Because of this, it must comply with a series of reliability and functional requirements and must have a Conformité Européen (CE) marking. This demands compliance with Directive 2014/30/EU on electromagnetic compatibility. The main difficulty of accomplishing this goal resides on the fact that Conformité Européen marking setups and procedures were implemented for industrial products, whereas no clear protocols have been defined for scientific installations. In this paper, we aim to give an answer to the question on how the directive should be applied to our installation to guarantee the fulfillment of all the requirements and the proper functioning of the telescope itself. Experts in Optics and Electromagnetism were both needed to make these kinds of decisions and match tests which were designed to be made over the equipment of limited dimensions on large scientific plants. An analysis of the elements and configurations most likely to be affected by external interferences and those that are most likely to cause the maximum disturbances was also performed. Obtaining the Conformité Européen mark requires knowing what the harmonized standards are and how the elaboration of the specific requirement is defined. For this type of large installations, one needs to adapt and develop the tests to be carried out. In addition, throughout this process, certification entities and notified bodies play a key role in preparing and agreeing the required technical documentation. We have focused our attention mostly on the technical aspects of each point. We believe that this contribution will be of interest for other scientists involved in applying industrial quality assurance standards to large scientific plant.

Keywords: CE marking, electromagnetic compatibility, european directive, scientific installations

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522 Is Materiality Determination the Key to Integrating Corporate Sustainability and Maximising Value?

Authors: Ruth Hegarty, Noel Connaughton

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Sustainability reporting has become a priority for many global multinational companies. This is associated with ever-increasing expectations from key stakeholders for companies to be transparent about their strategies, activities and management with regard to sustainability issues. The Global Reporting Initiative (GRI) encourages reporters to only provide information on the issues that are really critical in order to achieve the organisation’s goals for sustainability and manage its impact on environment and society. A key challenge for most reporting organisations is how to identify relevant issues for sustainability reporting and prioritise those material issues in accordance with company and stakeholder needs. A recent study indicates that most of the largest companies listed on the world’s stock exchanges are failing to provide data on key sustainability indicators such as employee turnover, energy, greenhouse gas emissions (GHGs), injury rate, pay equity, waste and water. This paper takes an indepth look at the approaches used by a select number of international sustainability leader corporates to identify key sustainability issues. The research methodology involves performing a detailed analysis of the sustainability report content of up to 50 companies listed on the 2014 Dow Jones Sustainability Indices (DJSI). The most recent sustainability report content found on the GRI Sustainability Disclosure Database is then compared with 91 GRI Specific Standard Disclosures and a small number of GRI Standard Disclosures. Preliminary research indicates significant gaps in the information disclosed in corporate sustainability reports versus the indicator content specified in the GRI Content Index. The following outlines some of the key findings to date: Most companies made a partial disclosure with regard to the Economic indicators of climate change risks and infrastructure investments, but did not focus on the associated negative impacts. The top Environmental indicators disclosed were energy consumption and reductions, GHG emissions, water withdrawals, waste and compliance. The lowest rates of indicator disclosure included biodiversity, water discharge, mitigation of environmental impacts of products and services, transport, environmental investments, screening of new suppliers and supply chain impacts. The top Social indicators disclosed were new employee hires, rates of injury, freedom of association in operations, child labour and forced labour. Lesser disclosure rates were reported for employee training, composition of governance bodies and employees, political contributions, corruption and fines for non-compliance. The reporting on most other Social indicators was found to be poor. In addition, most companies give only a brief explanation on how material issues are defined, identified and ranked. Data on the identification of key stakeholders and the degree and nature of engagement for determining issues and their weightings is also lacking. Generally, little to no data is provided on the algorithms used to score an issue. Research indicates that most companies lack a rigorous and thorough methodology to systematically determine the material issues of sustainability reporting in accordance with company and stakeholder needs.

Keywords: identification of key stakeholders, material issues, sustainability reporting, transparency

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521 Kinetics, Equilibrium and Thermodynamics of the Adsorption of Triphenyltin onto NanoSiO₂/Fly Ash/Activated Carbon Composite

Authors: Olushola S. Ayanda, Olalekan S. Fatoki, Folahan A. Adekola, Bhekumusa J. Ximba, Cecilia O. Akintayo

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In the present study, the kinetics, equilibrium and thermodynamics of the adsorption of triphenyltin (TPT) from TPT-contaminated water onto nanoSiO2/fly ash/activated carbon composite was investigated in batch adsorption system. Equilibrium adsorption data were analyzed using Langmuir, Freundlich, Temkin and Dubinin–Radushkevich (D-R) isotherm models. Pseudo first- and second-order, Elovich and fractional power models were applied to test the kinetic data and in order to understand the mechanism of adsorption, thermodynamic parameters such as ΔG°, ΔSo and ΔH° were also calculated. The results showed a very good compliance with pseudo second-order equation while the Freundlich and D-R models fit the experiment data. Approximately 99.999 % TPT was removed from the initial concentration of 100 mg/L TPT at 80oC, contact time of 60 min, pH 8 and a stirring speed of 200 rpm. Thus, nanoSiO2/fly ash/activated carbon composite could be used as effective adsorbent for the removal of TPT from contaminated water and wastewater.

Keywords: isotherm, kinetics, nanoSiO₂/fly ash/activated carbon composite, tributyltin

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520 Applying an Automatic Speech Intelligent System to the Health Care of Patients Undergoing Long-Term Hemodialysis

Authors: Kuo-Kai Lin, Po-Lun Chang

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Research Background and Purpose: Following the development of the Internet and multimedia, the Internet and information technology have become crucial avenues of modern communication and knowledge acquisition. The advantages of using mobile devices for learning include making learning borderless and accessible. Mobile learning has become a trend in disease management and health promotion in recent years. End-stage renal disease (ESRD) is an irreversible chronic disease, and patients who do not receive kidney transplants can only rely on hemodialysis or peritoneal dialysis to survive. Due to the complexities in caregiving for patients with ESRD that stem from their advanced age and other comorbidities, the patients’ incapacity of self-care leads to an increase in the need to rely on their families or primary caregivers, although whether the primary caregivers adequately understand and implement patient care is a topic of concern. Therefore, this study explored whether primary caregivers’ health care provisions can be improved through the intervention of an automatic speech intelligent system, thereby improving the objective health outcomes of patients undergoing long-term dialysis. Method: This study developed an automatic speech intelligent system with healthcare functions such as health information voice prompt, two-way feedback, real-time push notification, and health information delivery. Convenience sampling was adopted to recruit eligible patients from a hemodialysis center at a regional teaching hospital as research participants. A one-group pretest-posttest design was adopted. Descriptive and inferential statistics were calculated from the demographic information collected from questionnaires answered by patients and primary caregivers, and from a medical record review, a health care scale (recorded six months before and after the implementation of intervention measures), a subjective health assessment, and a report of objective physiological indicators. The changes in health care behaviors, subjective health status, and physiological indicators before and after the intervention of the proposed automatic speech intelligent system were then compared. Conclusion and Discussion: The preliminary automatic speech intelligent system developed in this study was tested with 20 pretest patients at the recruitment location, and their health care capacity scores improved from 59.1 to 72.8; comparisons through a nonparametric test indicated a significant difference (p < .01). The average score for their subjective health assessment rose from 2.8 to 3.3. A survey of their objective physiological indicators discovered that the compliance rate for the blood potassium level was the most significant indicator; its average compliance rate increased from 81% to 94%. The results demonstrated that this automatic speech intelligent system yielded a higher efficacy for chronic disease care than did conventional health education delivered by nurses. Therefore, future efforts will continue to increase the number of recruited patients and to refine the intelligent system. Future improvements to the intelligent system can be expected to enhance its effectiveness even further.

Keywords: automatic speech intelligent system for health care, primary caregiver, long-term hemodialysis, health care capabilities, health outcomes

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519 Attributes of Ethical Leadership and Ethical Guidelines in Malaysian Public Sector

Authors: M. Norazamina, A. Azizah, Y. Najihah Marha, A. Suraya

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Malaysian Public Sector departments or agencies are responsible to provide efficient public services with zero corruption. However, corruption continues to occur due to the absence of ethical leadership and well-execution of ethical guidelines. Thus, the objective of this paper is to explore the attributes of ethical leadership and ethical guidelines. This study employs a qualitative research by analyzing data from interviews with key informers of public sector using conceptual content analysis (NVivo11). The study reveals eight attributes of ethical leadership which are role model, attachment, ethical support, knowledgeable, discipline, leaders’ spirituality encouragement, virtue values and shared values. Meanwhile, five attributes (guidelines, communication, check and balance, concern on stakeholders and compliance) of ethical guidelines are identified. These identified attributes should become the ethical identity and ethical direction of Malaysian Public Sector. This could enhance the public trust as well as the international community trust towards the public sector.

Keywords: check and balance, ethical guidelines, ethical leadership, public sector, spirituality encouragement

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518 Acoustic and Thermal Compliance from the Execution Theory

Authors: Saou Mohamed Amine

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The construction industry has been identified as a user of substantial amount of materials and energy resources that has an enormous impact on environment. The energy efficient in refurbishment project is being considered as one of the approaches to achieve sustainability in construction industry. The increasing concern for environment has made building owners and designers to incorporate the energy efficiency features into their building projects. However, an overwhelming issue of existing non-energy efficient buildings which exceeds the number of new building could be ineffective if the buildings are not refurbished through the energy efficient measures. Thus, energy efficient in refurbishment project is being considered as one of the approaches to achieve sustainability that offers significant opportunities for reducing global energy consumption and greenhouse gas emissions. However, the quality of design team attributes and the characteristics of the refurbishment building projects have been argued to be the main factors that determine the energy efficiency performance of the building.

Keywords: construction industry, design team attributes, energy efficient performance, refurbishment projects characteristics

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517 Ontology-Driven Generation of Radiation Protection Procedures

Authors: Chamseddine Barki, Salam Labidi, Hanen Boussi Rahmouni

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In this article, we present the principle and suitable methodology for the design of a medical ontology that highlights the radiological and dosimetric knowledge, applied in diagnostic radiology and radiation-therapy. Our ontology, which we named «Onto.Rap», is the subject of radiation protection in medical and radiology centers by providing a standardized regulatory oversight. Thanks to its added values of knowledge-sharing, reuse and the ease of maintenance, this ontology tends to solve many problems. Of which we name the confusion between radiological procedures a practitioner might face while performing a patient radiological exam. Adding to it, the difficulties they might have in interpreting applicable patient radioprotection standards. Here, the ontology, thanks to its concepts simplification and expressiveness capabilities, can ensure an efficient classification of radiological procedures. It also provides an explicit representation of the relations between the different components of the studied concept. In fact, an ontology based-radioprotection expert system, when used in radiological center, could implement systematic radioprotection best practices during patient exam and a regulatory compliance service auditing afterwards.

Keywords: knowledge, ontology, radiation protection, radiology

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516 Audit Management of Constipation According to National Institute for Health and Care Excellence Guideline

Authors: Areej Makeineldein Mustafa

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The study evaluates the management processes and healthcare provider compliance with the National Institute for Health and Care Excellence recommendations for constipation management. We aimed to evaluate the adherence to National Institute for Health and Care Excellence guidelines in the management of constipation during the period from February to June 2023. We collected data from a random sample ( 51 patients) over 4 months with inclusion criteria for patients above 60 who were just admitted to the care of the elderly department during this period. Patient age, sex, medical records for constipation, acute or chronic constipation, or opioid-induced constipation, and treatment options were used to identify constipation and the type of treatment given. Our findings indicate that there is a gap between practice and National Institute for Health and Care Excellence guideline steps; only 3 patient was given medications according to National Institute for Health and Care Excellence guidelines in order of combination or steps of escalation. Addressing these gaps could potentially lead to enhanced patient outcomes and an overall improvement in the quality of care provided to individuals suffering from constipation.

Keywords: constipation, elderly, management, patient

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515 Abortion Care Education in U.S. Accreditation Commission for Midwifery Education Certified Nurse Midwifery Programs: A Call For Expansion

Authors: Maggie Hall, Haley O'Neill

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The U.S. faces a severe shortage of abortion providers, exacerbated by the June 2022 Dobbs v. Jackson Women’s Health Organization decision. Midwives, especially certified nurse midwives, are well-positioned to fill this gap in abortion care. However, a lack of clinical education and training prevents midwives from exercising their full scope of practice. National and international organizations that set obstetrics and midwifery education standards, including the International Confederation of Midwives, American College of Obstetricians and Gynecologists, and American Public Health Association, call for expansion of midwifery-managed abortion care through the first trimester. In the U.S., midwifery programs are accredited based on compliance with ACME standards and compliance is a prerequisite for the American Midwifery Certification Board exams. We conducted a literature review of studies in the last five years regarding abortion didactic and clinical education barriers via CINAHL, EBSCO and PubMed database reviews. We gave preference for primary sources within the last five years; however, due to the rapid changes in abortion education and access, we also included literature from 2012-2022. We evaluated ACME-accredited programs in relation to their geography within abortion-protected or restricted states and assessed state-specific barriers to abortion care education and provision as clinical students. There are 43 AMCB-accredited midwifery schools in 28 states across the U.S. Twenty schools (47%) are in the 15 states in which advanced practice clinicians can provide non-surgical abortion care, such as medication abortion and MVA procedures. Twenty-four schools (56%) are in the 16 states in which abortion care provision is restricted to Licensed Physicians and cannot offer in-state clinical training opportunities for midwifery students. Six schools are in the five states in which abortion is completely banned and are geographically concentrated in the southernmost region of the U.S., including Alabama, Kentucky, Louisiana, Tennessee, and Texas. Subsequently, these programs cannot offer in-state clinical training opportunities for midwifery students. Notably, there are seven ACME programs in six states that do not restrict abortion access by gestational age, including Colorado, Connecticut, Washington, D.C., New Jersey, New Mexico, and Oregon. These programs may be uniquely positioned for midwifery involvement in abortion care beyond the first trimester. While the following states don’t house ACME programs, abortion care can be provided by advanced practice clinicians in Rhode Island, Delaware, Hawaii, Maine, Maryland, Montana, New Hampshire, and Vermont, offering clinical placement and/or new ACME program development opportunities. We identify existing barriers to clinical education and training opportunities for midwifery-managed abortion care, which are both geographic and institutional in nature. We recommend expansion and standardization of clinical education and training opportunities for midwifery-managed abortion care in ACME-accredited programs to improve access to abortion care. Midwifery programs and teaching hospitals need to expand education, training, and residency opportunities for midwifery students to strengthen access to midwife-managed abortion care. ACNM and ACME should re-evaluate accreditation criteria and the implications of ACME programs in states where students are not able to learn abortion care in clinical contexts due to state-specific abortion restrictions.

Keywords: midwifery education, abortion, abortion education, abortion access

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514 Comparative study of the technical efficiency of the cotton farms in the towns of Banikoara and Savalou

Authors: Boukari Abdou Wakilou

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Benin is one of West Africa's major cotton-producing countries. Cotton is the country's main source of foreign currency and employment. But it is also one of the sources of soil degradation. The search for good agricultural practices is therefore, a constant preoccupation. The aim of this study is to measure the technical efficiency of cotton growers by comparing those who constantly grow cotton on the same land with those who practice crop rotation. The one-step estimation approach of the stochastic production frontier, including determinants of technical inefficiency, was applied to a stratified random sample of 261 cotton producers. Overall, the growers had a high average technical efficiency level of 90%. However, there was no significant difference in the level of technical efficiency between the two groups of growers studied. All the factors linked to compliance with the technical production itinerary had a positive influence on the growers' level of efficiency. It is, therefore, important to continue raising awareness of the importance of respecting the technical production itinerary and of integrated soil fertility management techniques.

Keywords: technical efficiency, soil fertility, cotton, crop rotation, benin

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513 Distributed Energy System - Microgrid Integration of Hybrid Power Systems

Authors: Pedro Esteban

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Planning a hybrid power system (HPS) that integrates renewable generation sources, non-renewable generation sources and energy storage, involves determining the capacity and size of various components to be used in the system to be able to supply reliable electricity to the connected load as required. Nowadays it is very common to integrate solar photovoltaic (PV) power plants for renewable generation as part of HPS. The solar PV system is usually balanced via a second form of generation (renewable such as wind power or using fossil fuels such as a diesel generator) or an energy storage system (such as a battery bank). Hybrid power systems can also provide other forms of power such as heat for some applications. Modern hybrid power systems combine power generation and energy storage technologies together with real-time energy management and innovative power quality and energy efficiency improvement functionalities. These systems help customers achieve targets for clean energy generation, they add flexibility to the electrical grid, and they optimize the installation by improving its power quality and energy efficiency.

Keywords: microgrids, hybrid power systems, energy storage, grid code compliance

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512 The Economic Implications of Cryptocurrency and Its Potential to Disrupt Traditional Financial Systems as a Store of Value

Authors: G. L. Rithika, Arvind B. S., Akash R., Ananda Vinayak, Hema M. S.

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Cryptocurrencies were first launched in the year 2009 and have been a great asset to own. Cryptocurrencies are a representation of a completely distinct decentralization model for money. They also contribute to the elimination of currency monopolies and the liberation of money from control. The fact that no government agency can determine a coin's value or flow is what cryptocurrency advocates believe makes them safe and secure. The aim of this paper is to analyze the economic implications of cryptocurrency and how it would disrupt traditional financial systems. This paper analyses the growth of Cryptocurrency over the years and the potential threats of cryptocurrency to financial systems. Our analysis shows that although the DeFi design, like the traditional financial system, may have the ability to lower transaction costs, there are multiple layers where rents might build up because of endogenous competition limitations. The permissionless and anonymous design of DeFi poses issues for ensuring tax compliance, anti-money laundering laws and regulations, and preventing financial misconduct.

Keywords: cryptocurrencies, bitcoin, blockchain technology, traditional financial systems, decentralisation, regulatory framework

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511 Inventory Management to Minimize Storage Costs and Improve Delivery Time in a Pharmaceutical Industry

Authors: Israel Becerril Rosales, Manuel González De La Rosa, Gerardo Villa Sánchez

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In this work, the effects that produce not having a good inventory management is analyzed, in addition of the way that how it affects the storage costs. The research began conducting the historical analysis about stored products, its storage capacity, and distribution. The results were not optimal, since in all its raw materials (RM) have overstocking, the warehouse capacity is only used by 61%, does not have a specific place for each of its RM, causing that the delivery times increases and makes difficult a cyclical inventory. These shortcomings allowed to view and select as design alternatives the inventory ABC, so that depending on the consumption of each RM would be redistributed by using economic amount requested. Also, the Delphi method to ensure the practical applicability of the proposed tool was used, taking in account comments and suggestions of the involved experts, as well as the compliance of NOM-059-SSA1-2015 good manufacturing practices of drug. With the actions implemented, the utilization rate drops of 61% to 32% capacity, it shows that the warehouse was not designed properly due to there is not an industrial engineering area.

Keywords: lead time, improve delivery, storage costs, inventory management

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510 Material Parameter Identification of Modified AbdelKarim-Ohno Model

Authors: Martin Cermak, Tomas Karasek, Jaroslav Rojicek

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The key role in phenomenological modelling of cyclic plasticity is good understanding of stress-strain behaviour of given material. There are many models describing behaviour of materials using numerous parameters and constants. Combination of individual parameters in those material models significantly determines whether observed and predicted results are in compliance. Parameter identification techniques such as random gradient, genetic algorithm, and sensitivity analysis are used for identification of parameters using numerical modelling and simulation. In this paper genetic algorithm and sensitivity analysis are used to study effect of 4 parameters of modified AbdelKarim-Ohno cyclic plasticity model. Results predicted by Finite Element (FE) simulation are compared with experimental data from biaxial ratcheting test with semi-elliptical loading path.

Keywords: genetic algorithm, sensitivity analysis, inverse approach, finite element method, cyclic plasticity, ratcheting

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509 Numerical Modelling of a Vacuum Consolidation Project in Vietnam

Authors: Nguyen Trong Nghia, Nguyen Huu Uy Vu, Dang Huu Phuoc, Sanjay Kumar Shukla, Le Gia Lam, Nguyen Van Cuong

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This paper introduces a matching scheme for selection of soil/drain properties in analytical solution and numerical modelling (axisymmetric and plane strain conditions) of a ground improvement project by using Prefabricated Vertical Drains (PVD) in combination with vacuum and surcharge preloading. In-situ monitoring data from a case history of a road construction project in Vietnam was adopted in the back-analysis. Analytical solution and axisymmetric analysis can approximate well the field data meanwhile the horizontal permeability need to be adjusted in plane strain scenario to achieve good agreement. In addition, the influence zone of the ground treatment was examined. The residual settlement was investigated to justify the long-term settlement in compliance with the design code. Moreover, the degree of consolidation of non-PVD sub-layers was also studied by means of two different approaches.

Keywords: numerical modelling, prefabricated vertical drains, vacuum consolidation, soft soil

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508 Assessing the Clinicians’ Perspectives on Formulation with Minoxidil, Finasteride, and Capixyl™ in Androgenetic Alopecia: A Nationwide Dermatologist Survey

Authors: Sharma Aseem, Dhurat Rachita, Pawar Varsha, Khalse Manisha

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Introduction: Androgenetic alopecia (AGA) is a prevalent condition characterized by progressive hair thinning driven by genetic and androgen-related factors. The current FDA-approved treatments include oral finasteride and topical minoxidil, though many patients seek combination therapies to enhance results. This study aims to evaluate the effectiveness of a combination therapy involving Minoxidil, Finasteride, and Capixyl™ based on feedback from dermatologists. Methodology: A survey, validated by experts, was distributed to 29 leading dermatologists across India (in Tier 1 and 2 cities). The survey examined real-world clinical experiences, focusing on patient outcomes and the overall effectiveness of the mentioned formulation. Results: Among the surveyed dermatologists, 41.4% identified women aged 35-40 as the most frequently diagnosed with female pattern hair loss. The combination therapy with Minoxidil, Finasteride, and Capixyl™ was utilized by 34.5% of dermatologists for over 60 patients per month. The majority highlighted the benefits of this combination therapy, which acts via multiple mechanisms, such as vasodilation and dihydrotestosterone (DHT) receptor blockade, resulting in improved hair regrowth. Additionally, patients demonstrated better clinical outcomes, enhanced compliance, and fewer side effects. Demographically, younger patients, particularly those with AGA for less than 10 years, responded more positively to the treatment. Early intervention led to quicker and more significant results. Overall satisfaction among dermatologists was high, with 86.2% expressing positive feedback on the therapy. In terms of treatment outcomes, 51.7% of dermatologists observed visible results within 4-6 months, while 34.5% noticed a significant reduction in hair fall within 8-12 weeks. Improvements in scalp health were reported by 48.3%, and 51.7% saw an increased hair density within 3-4 months. Despite mild side effects such as scalp irritation, dryness, flaking, and occasional issues like folliculitis, headaches, itching, and redness, patient satisfaction remained high. Dermatologists reported that 93.1% of patients experienced faster and better hair regrowth with Capixyl™ compared to Minoxidil alone. Suggestions for improving the formulation included incorporating peptides like Saw Palmetto and enhancing product packaging to better meet patient needs. Discussion: The combination of Minoxidil, Finasteride, and Capixyl™ yielded positive clinical outcomes, especially in improving hair density, scalp health, and overall patient satisfaction. Dermatologists found that Capixyl™ peptides enhanced the therapeutic effect, promoting hair regrowth and improving compliance. While side effects were generally mild, there were suggestions to further improve the formulation by adding additional peptides like Saw Palmetto. Conclusion: The combination of Minoxidil and Finasteride fortified with Capixyl™ presents a promising therapeutic option for managing AGA. Dermatologists reported significant improvements in hair density, scalp health, and patient satisfaction. With its favorable efficacy and manageable side effects, this formulation proves to be a valuable addition to the treatment landscape for AGA.

Keywords: androgenetic alopecia, combination therapy, minoxidil, finasteride, capixyl

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507 Urban Slum Communities Engage in the Fight Against TB in Karnataka, South India

Authors: N. Rambabu, H. Gururaj, Reynold Washington, Oommen George

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Motivation: Under the USAID Strengthening Health Outcomes through Private Sector (SHOPS-TB) initiative, Karnataka Health Promotion Trust (KHPT) with technical support of Abt associates is implementing a TB prevention and care model in Karnataka State, South India. KHPT is the interface agency between the public and private sectors, and providers and the target community facilitating early TB case detection and enhancing treatment compliance through private health care providers (pHCP) engagement in RNTCP. The project coverage is 0.84 million urban poor from 663 slums in 12 districts of Karnataka. Problem Statement: India with the highest burden of global TB (26%) and two million cases annually, accounts for approximately one fifth of the global incidence. WHO estimates 300,000 people die from TB annually in India. India expanded the coverage of Directly Observed Treatment, Short-course chemotherapy (DOTS) to the entire country as early as 2006. However, the performance of RNTCP has not been uniform across states. While the national annual new smear-positive (NSP) case notification rate is 53, it is much lower at 47 in Karnataka. A third of TB patients in India reside in urban slums. Approach: Under SHOPS, KHPT actively engages with communities through key opinion leaders and community structures. Interpersonal communication, by Outreach workers through house-to-house visits and at aggregation points, is the primary method used for communication about TB and its management and to increase demand for sputum examination and DOTS. pHCP are mapped, trained and mentored by KHPT. ORWs also provide patient and family counseling on TB treatment, side effects and adherence, screen close contacts of index patients especially children under 6 years of age and screen co-morbidities including HIV, diabetes and malnutrition and risk factors including alcoholism, tobacco use, occupational hazards making appropriate accompanied or documented referrals. A treatment ‘buddy’ system for the patients involving close friends or family members, ICT-based support, DOTS Prerana (inspiration) groups of TB patients, family members and community, DOTS Mitra (friend) helpline services are also used for care and support services. Results: The intervention educated 39988 slum dwellers, referred 1731 chest symptomatics, tested 1061 patients and initiated 248 patients on anti-TB treatment within three months of intervention through continuous community engagement. Conclusions: The intervention’s potential to increase access to preferred health care providers, reduce patient and health system delays in diagnosis and initiation of treatment, improve health seeking behaviour and enhance compliance of pHCPs to standard treatment protocols is being monitored. Initial results are promising.

Keywords: DOTS, KHPT, health outcomes, public and private sector

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506 Leveraging Digital Cyber Technology for Self-Care and Improved Management of DMPA-SC Clients

Authors: Oluwaseun Adeleke, Grace Amarachi Omenife, Jennifer Adebambo, Mopelola Raji, Anthony Nwala, Mogbonjubade Adesulure

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Introduction: The incorporation of digital technology in healthcare systems is instrumental in transforming the delivery, management, and overall experience of healthcare and holds the potential to scale up access through over 200 million active mobile phones used in Nigeria. Digital tools enable increased access to care, stronger client engagement, progress in research and data-driven insights, and more effective promotion of self-care and do-it-yourself practices. The Delivering Innovation in Self-Care (DISC) project 2021 has played a pivotal role in granting women greater autonomy over their sexual and reproductive health (SRH) through a variety of approaches, including information and training to self-inject contraception (DMPA-SC). To optimize its outcomes, the project also leverages digital technology platforms like social media: Facebook, Instagram, and Meet Tina (Chatbot) via WhatsApp, Customer Relationship Management (CRM) applications Freshworks, and Viamo. Methodology: The project has been successful at optimizing in-person digital cyberspace interaction to sensitize individuals effectively about self-injection and provide linkages to SI services. This platform employs the Freshworks CRM software application, along with specially trained personnel known as Cyber IPC Agents and DHIS calling centers. Integration of Freshworks CRM software with social media allows a direct connection with clients to address emerging issues, schedule follow-ups, send reminders to improve compliance with self-injection schedules, enhance the overall user experience for self-injection (SI) clients, and generate comprehensive reports and analytics on client interactions. Interaction covers a range of topics, including – How to use SI, learning more about SI, side-effects and its management, accessing services, fertility, ovulation, other family planning methods, inquiries related to Sexual Reproductive Health as well as uses an address log to connect them with nearby facilities or online pharmaceuticals. Results: Between the months of March to September, a total of 5,403 engagements were recorded. Among these, 4,685 were satisfactorily resolved. Since the program's inception, digital advertising has created 233,633,075 impressions, reached 12,715,582 persons, and resulted in 3,394,048 clicks. Conclusion: Leveraging digital technology has proven to be an invaluable tool in client management and improving client experience. The use of Cyber technology has enabled the successful development and maintenance of client relationships, which have been effective at providing support, facilitating delivery and compliance with DMPA-SC self-injection services, and ensuring overall client satisfaction. Concurrently, providing qualitative data, including user experience feedback, has enabled the derivation of crucial insights that inform the decision-making process and guide in normalizing self-care behavior.

Keywords: selfcare, DMPA-SC self-injection, digital technology, cyber technology, freshworks CRM software

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