Search results for: social work teaching methods
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 34087

Search results for: social work teaching methods

5497 Exploring Forest Biomass Changes in Romania in the Last Three Decades

Authors: Remus Pravalie, Georgeta Bandoc

Abstract:

Forests are crucial for humanity and biodiversity, through the various ecosystem services and functions they provide all over the world. Forest ecosystems are vital in Romania as well, through their various benefits, known as provisioning (food, wood, or fresh water), regulating (water purification, soil protection, carbon sequestration or control of climate change, floods, and other hazards), cultural (aesthetic, spiritual, inspirational, recreational or educational benefits) and supporting (primary production, nutrient cycling, and soil formation processes, with direct or indirect importance for human well-being) ecosystem services. These ecological benefits are of great importance in Romania, especially given the fact that forests cover extensive areas countrywide, i.e. ~6.5 million ha or ~27.5% of the national territory. However, the diversity and functionality of these ecosystem services fundamentally depend on certain key attributes of forests, such as biomass, which has so far not been studied nationally in terms of potential changes due to climate change and other driving forces. This study investigates, for the first time, changes in forest biomass in Romania in recent decades, based on a high volume of satellite data (Landsat images at high spatial resolutions), downloaded from the Google Earth Engine platform and processed (using specialized software and methods) across Romanian forestland boundaries from 1987 to 2018. A complex climate database was also investigated across Romanian forests over the same 32-year period, in order to detect potential similarities and statistical relationships between the dynamics of biomass and climate data. The results obtained indicated considerable changes in forest biomass in Romania in recent decades, largely triggered by the climate change that affected the country after 1987. Findings on the complex pattern of recent forest changes in Romania, which will be presented in detail in this study, can be useful to national policymakers in the fields of forestry, climate, and sustainable development.

Keywords: forests, biomass, climate change, trends, romania

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5496 Mapping Cultural Continuity and the Creation of a New Architectural Heritage in the 21st Century: The Case of Ksar Tafilelt, M’Zab Valley

Authors: Hadjer Messabih

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The M’zab architecture has preserved its identity that was able to endure for centuries conserving practically the same way of life and the same building techniques since the 11th century. Even more, the newly built ksar Tafilelt is also designed to meet the local tradition. In 1996, a community led project was initiated to build a “new ksar” named Tafilelt based on a traditional form of community-led cooperative housing. It is a unique experience in the field of community housing that reproduces traditional architectural patterns while addressing contemporary ways of life with their expected modern comfort. This research is based on the hypothesis that the process of producing ksar Tafilelt is culturally responsive to a conservative community that was characterized by certain values which were transmitted to this ksar manifesting as cultural continuity. It aims at investigating what type of cultural continuity manifests itself in the co-production of ksar Tafilelt and the way the settlement and its houses are produced and inhabited, as well as the new emerging values and adaptive transition in social relations. The research methodology is based on a combination of questionnaires, in depth interviews, photography, and site visit to record and demonstrate how these buildings respond to peoples’ needs. Post Occupancy Evaluation (POE) is also employed in order to understand the lessons that can be learned from this project. Finally, this study proves that the cultural continuity that was transmitted from the Ibadi community is sill manifested in ksar Tafilelt, which provided strong religious bonds and a strong sense of community. The research findings have resulted in a number of lessons and principles that can be learnt from the project of ksar Tafilelt which can inform future practices of housing provision and design in Algeria and other countries.

Keywords: community-led cooperative housing, conservative community, cultural continuity, post occupancy evaluation

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5495 Compare the Effectiveness of Web Based and Blended Learning on Paediatric Basic Life Support

Authors: Maria Janet, Anita David, P. Vijayasamundeeswarimaria

Abstract:

Introduction: The main purpose of this study is to compare the effectiveness of web-based and blended learning on Paediatric Basic Life Support on competency among undergraduate nursing students in selected nursing colleges in Chennai. Materials and methods: A descriptive pre-test and post-test study design were used for this study. Samples of 100 Fourth year B.Sc., nursing students at Sri Ramachandra Faculty of Nursing SRIHER, Chennai, 100 Fourth year B.Sc., nursing students at Apollo College of Nursing, Chennai, were selected by purposive sampling technique. The instrument used for data collection was Knowledge Questionnaire on Paediatric Basic Life Support (PBLS). It consists of 29 questions on the general expansion of Basic Life Support and Cardiopulmonary Resuscitation, Prerequisites of Basic Life Support, and Knowledge on Paediatric Basic Life Support in which each question has four multiple choices answers, each right answer carrying one mark and no negative scoring. This questionnaire was formed with reference to AHA 2020 (American Heart Association) revised guidelines. Results: After the post-test, in the web-based learning group, 58.8% of the students had an inadequate level of objective performance score, while 41.1% of them had an adequate level of objective performance score. In the blended learning group, 26.5% of the students had an inadequate level of an objective performance score, and 73.4% of the students had an adequate level of an objective performance score. There was an association between the post-test level of knowledge and the demographic variables of undergraduate nursing students undergoing blended learning. The age was significant at a p-value of 0.01, and the performance of BLS before was significant at a p-value of 0.05. The results show that there was a significant positive correlation between knowledge and objective performance score of undergraduate nursing students undergoing web-based learning on paediatric basic life support.

Keywords: basic life support, paediatric basic life support, web-based learning, blended learning

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5494 Queerness and Gender Representation Through the Lens of Five Ghanaian Artists

Authors: Sela Adjei

Abstract:

This research delves into the nuanced representations of queerness in Ghana, presented through photographs, illustrations, film and music videos on social media and streaming platforms. The study focuses on the works of five Ghanaian artists (Va-Bene Elikem Fiatsi, Angel Maxine, Josephine Kuuire, Bright Ackwerh and Philip Nee Whang) within the context of Ghana's evolving media landscape. Of primary concern is a need to uncover the various aspects of queerness captured within the distinct artistic expressions of these five creatives. This study adopts a qualitative approach by analyzing artistic expressions of queerness in Ghana’s digital media spaces. Content analysis and visual semiotics served as the guiding tools to discuss and decipher the nuanced messages embedded in their works, considering both the visual and narrative aspects. This dual approach takes into account both the visual aesthetics and narrative elements, enhancing our understanding of the complex interplay between queerness and gender representation in the media. This study's contribution is twofold. First, it enriches the discourse surrounding queerness as portrayed by artists within Ghana's vibrant media landscape and situates their works within the broader discourse of global gender identities. Secondly, analyzing the creative output of these five Ghanaian artists broadens our understanding of gender minorities and the various challenges they face in Ghana (currently debating in parliament to pass an anti-LGBTQ+ bill that criminalizes activities related to gender minority groups). While focusing on the intersection of queerness, art, and gender identities, the reflections in this study challenge existing narratives and offer fresh insights into how these artists navigate and challenge societal norms through their creative expressions.

Keywords: queer, film, representation, streaming, media, gender

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5493 The Role of Cultural Expectations in Emotion Regulation among Nepali Adolescents

Authors: Martha Berg, Megan Ramaiya, Andi Schmidt, Susanna Sharma, Brandon Kohrt

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Nepali adolescents report tension and negative emotion due to perceived expectations of both academic and social achievement. These societal goals, which are internalized through early-life socialization, drive the development of self-regulatory processes such as emotion regulation. Emotion dysregulation is linked with adverse psychological outcomes such as depression, self-harm, and suicide, which are public health concerns for organizations working with Nepali adolescents. This study examined the relation among socialization, internalized cultural goals, and emotion regulation to inform interventions for reducing depression and suicide in this population. Participants included 102 students in grades 7 through 9 in a post-earthquake school setting in rural Kathmandu valley. All participants completed a tablet-based battery of quantitative measures, comprising transculturally adapted assessments of emotion regulation, depression, and self-harm/suicide ideation and behavior. Qualitative measures included two focus groups and semi-structured interviews with 22 students and 3 parents. A notable proportion of the sample reported depression symptoms in the past 2 weeks (68%), lifetime self-harm ideation (28%), and lifetime suicide attempts (13%). Students who lived with their nuclear family reported lower levels of difficulty than those who lived with more distant relatives (z=2.16, p=.03), which suggests a link between family environment and adolescent emotion regulation, potentially mediated by socialization and internalization of cultural goals. These findings call for further research into the aspects of nuclear versus extended family environments that shape the development of emotion regulation.

Keywords: adolescent mental health, emotion regulation, Nepal, socialization

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5492 In Vitro Antibacterial Activity of Some Medicinal Plants Against Biofilm-Forming Methicillin-Resistant Staphylococcus aureus

Authors: Tesleem Adewale Ibrahim

Abstract:

Introduction: The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) has been slowly rising in Nigeria for the past few decades. Therefore, novel classes of antibiotics are indispensable to combat the increased incidence of newly emerging multidrug-resistant bacteria like MRSA. Plants have been commonly used in popular medicine of most cultures for the treatment of disease. The in vitro antibacterial activity of some Nigerian common medicinal plants used in traditional medicine has been reported. The aim of this study was to investigate the antibacterial and anti-biofilm of these native plants (Entada abysinnica (leaves), Croton macrostachyus (leaves), Bridelia speciosa (seeds, bark), and Aframomum melegueta (leaves, seeds, and stem) collected in Southwestern Nigeria against a panel of seven biofilm-forming MRSA. Methods: Minimum inhibitory concentrations (MIC) and minimum bactericidal concentrations (MBC) of the plant extracts against MRSA were determined by the broth dilution method, and the anti-biofilm assay of the most potent plant extract was performed. Result: The results revealed that, of the four plants, water extracts of leaves of Entada abysinnica, leaves of Croton macrostachyus, seeds and bark Bridelia speciosa, and seeds of Aframomum melegueta exhibited significant antibacterial activity. Based on the MIC/MBC ratio, the extracts of these plants were determined to be bacteriostatic in nature. Anti-biofilm assay showed that the extract of seeds of Aframomum melegueta and leaves of Croton macrostachyus fairly inhibited the growth of MRSA in the preformed biofilm matrix. Conclusion: These four medicinal plant species may represent a source of alternative drugs derived from plant extracts based on folklore use and ethnobotanical knowledge from southwest Nigeria.

Keywords: extract, MRSA, antibacterial, biofilm, medicinal plants

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5491 Osteoarticular Manifestations and Abnormalities of Bone Metabolism in Celiac Disease

Authors: Soumaya Mrabet, Imen Akkari, Amira Atig, Elhem Ben Jazia

Abstract:

Introduction: Celiac disease (CD) is a chronic autoimmune inflammatory enteropathy caused by gluten. The clinical presentation is very variable. Malabsorption in the MC is responsible for an alteration of the bone metabolism. Our purpose is to study the osteoarticular manifestations related to this condition. Material and methods: It is a retrospective study of 41 cases of CD diagnosed on clinical, immunological, endoscopic and histological arguments, in the Internal Medicine and Gastroenterology Department of Farhat Hached Hospital between September 2005 and January 2016. Results: Osteoarticular manifestations were found in 9 patients (22%) among 41 patients presenting CD. These were 7 women and 2 men with an average age of 35.7 years (25 to 67 years). These manifestations were revelatory of CD in 3 cases. Abdominal pain and diarrhea were present in 6 cases. Inflammatory polyarthralgia of wrists and knees has been reported in 7 patients. Mechanical mono arthralgia was noted in 2 patients. Biological tests revealed microcytic anemia by iron deficiency in 7 cases, hypocalcemia in 5 cases, Hypophosphatemia in 3 cases and elevated alkaline phosphatases in 3 cases. Upper gastrointestinal endoscopy with duodenal biopsy found villous atrophy in all cases. In immunology, Anti-transglutaminase antibodies were positive in all patients, Anti-endomysium in 7 cases. Measurement of bone mineral density (BMD) by biphotonic X-ray absorptiometer with evaluation of the T-score and the Z-score was performed in Twenty patients (48.8%). It was normal in 7 cases (33%) and showed osteopenia in 5 patients (25%) and osteoporosis in 2 patients (10%). All patients were treated with a Gluten-free diet associated with vitamin D and calcium substitution in 5 cases. The evolution was favorable in all cases with reduction of bone pain and normalization of the phosphocalcic balance. Conclusion: The bone impact of CD is frequent but often asymptomatic. Patients with CD should be evaluated by the measurement of bone mineral density and monitored for calcium and vitamin D deficiencies.

Keywords: bone mineral density, celiac disease, osteoarticular manifestations, vitamin D and calcium

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5490 Statistical Approach to Identify Stress and Biases Impairing Decision-Making in High-Risk Industry

Authors: Ph. Fauquet-Alekhine

Abstract:

Decision-making occurs several times an hour when working in high risk industry and an erroneous choice might have undesirable outcomes for people and the environment surrounding the industrial plant. Industrial decisions are very often made in a context of acute stress. Time pressure is a crucial stressor leading decision makers sometimes to boost up the decision-making process and if it is not possible then shift to the simplest strategy. We thus found it interesting to update the characterization of the stress factors impairing decision-making at Chinon Nuclear Power Plant (France) in order to optimize decision making contexts and/or associated processes. The investigation was based on the analysis of reports addressing safety events over the last 3 years. Among 93 reports, those explicitly addressing decision-making issues were identified. Characterization of each event was undertaken in terms of three criteria: stressors, biases impairing decision making and weaknesses of the decision-making process. The statistical analysis showed that biases were distributed over 10 possibilities among which the hypothesis confirmation bias was clearly salient. No significant correlation was found between criteria. The analysis indicated that the main stressor was time pressure and highlights an unexpected form of stressor: the trust asymmetry principle of the expert. The analysis led to the conclusion that this stressor impaired decision-making from a psychological angle rather than from a physiological angle: it induces defensive bias of self-esteem, self-protection associated with a bias of confirmation. This leads to the hypothesis that this stressor can intervene in some cases without being detected, and to the hypothesis that other stressors of the same kind might occur without being detected too. Further investigations addressing these hypotheses are considered. The analysis also led to the conclusion that dealing with these issues implied i) decision-making methods being well known to the workers and automated and ii) the decision-making tools being well known and strictly applied. Training was thus adjusted.

Keywords: bias, expert, high risk industry, stress.

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5489 A Qualitative Analysis of People Views of Microfinance in Lebanon

Authors: Ali Abu Ali, Mohammad Salhab

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Introduction: In the Middle East and North Africa (MENA) microfinance struggles to find momentum. The Lebanese economy has been struggling through the years due to domestic and external, political and social instability. Although as of 2014 there are around 23 MFIs that are mainly subsidized by the USAID, operating in the country, the Lebanese microfinance market is mostly dominated by three microfinance institutions: Al Majmoua, Vitas, and Al Quard Al Hassan Association. Methodology: A quantitative approach using a standardized questionnaire would analyse the perception of the average Lebanese towards microfinance. A questionnaire was designed and validated. Results: Almost half of the respondents earn a monthly income ranged between $100 and $600. Almost 52% of the respondents were university graduates, around 25% finished secondary and high school, and 12% hold a masters or MBA degree. Topic understanding towards microfinance differs across Lebanese areas. The highest percentage of respondents who claim that microfinance offers financial services to low income people are the residents of Beirut (35.1%), Bekaa (30.8%), and South of Lebanon (24.7%). Higher levels of topic understanding were associated with lower levels of age range. Al Quard el Hassan foundation was regarded as the most known micro financial institution operating in Lebanon. In general, Lebanese people tend to believe that microfinance can play an important role in reducing unemployment rates and poverty levels in Lebanon. When people were asked what would motivate you to get a loan from MFIs, most of the respondent (57.4%) across all the Lebanese region claimed that it was the need for money to satisfy a need such as paying back a loan, to fix something at home, or for self-consideration like buying a car. Conclusion: Our findings showed that in general Lebanese tend to have a positive perception towards microfinance. However, most Lebanese perceive microfinance as the process of just providing loans without specifying for whom it is intended. We advise that government introduces laws to regulate the microfinance market.

Keywords: microfinance, economics, finance, business, analysis, theory

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5488 Development of an Integrated System for the Treatment of Rural Domestic Wastewater: Emphasis on Nutrient Removal

Authors: Prangya Ranjan Rout, Puspendu Bhunia, Rajesh Roshan Dash

Abstract:

In a developing country like India, providing reliable and affordable wastewater treatment facilities in rural areas is a huge challenge. With the aim of enhancing the nutrient removal from rural domestic wastewater while reducing the cost of treatment process, a novel, integrated treatment system consisting of a multistage bio-filter with drop aeration and a post positioned attached growth carbonaceous denitrifying-bioreactor was designed and developed in this work. The bio-filter was packed with ‘dolochar’, a sponge iron industry waste, as an adsorbent mainly for phosphate removal through physiochemical approach. The Denitrifying bio-reactor was packed with many waste organic solid substances (WOSS) as carbon sources and substrates for biomass attachment, mainly to remove nitrate in biological denitrification process. The performance of the modular system, treating real domestic wastewater was monitored for a period of about 60 days and the average removal efficiencies during the period were as follows: phosphate, 97.37%; nitrate, 85.91%, ammonia, 87.85%, with mean final effluent concentration of 0.73, 9.86, and 9.46 mg/L, respectively. The multistage bio-filter played an important role in ammonium oxidation and phosphate adsorption. The multilevel drop aeration with increasing oxygenation, and the special media used, consisting of certain oxides were likely beneficial for nitrification and phosphorus removal, respectively, whereas the nitrate was effectively reduced by biological denitrification in the carbonaceous bioreactor. This treatment system would allow multipurpose reuse of the final effluent. Moreover, the saturated dolochar can be used as nutrient suppliers in agricultural practices and the partially degraded carbonaceous substances can be subjected to composting, and subsequently used as an organic fertilizer. Thus, the system displays immense potential for treating domestic wastewater significantly decreasing the concentrations of nutrients and more importantly, facilitating the conversion of the waste materials into usable ones.

Keywords: nutrient removal, denitrifying bioreactor, multi-stage bio-filter, dolochar, waste organic solid substances

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5487 Inactivation of Semicarbazide-Sensitive Amine Oxidase Induces the Phenotypic Switch of Smooth Muscle Cells and Aggravates the Development of Atherosclerotic Lesions

Authors: Miao Zhang, Limin Liu, Feng Zhi, Panpan Niu, Mengya Yang, Xuemei Zhu, Ying Diao, Jun Wang, Ying Zhao

Abstract:

Background and Aims: Clinical studies have demonstrated that serum semicarbazide-sensitive amine oxidase (SSAO) activities positively correlate with the progression of atherosclerosis. The aim of the present study is to investigate the effect of SSAO inactivation on the development of atherosclerosis. Methods: Female LDLr knockout (KO) mice were given the Western-type diet for 6 and 9 weeks to induce the formation of early and advanced lesions, and semicarbazide (SCZ, 0.125%) was added into the drinking water to inactivate SSAO in vivo. Results: Despite no impact on plasma total cholesterol levels, abrogation of SSAO by SCZ not only resulted in the enlargement of both early (1.5-fold, p=0.0043) and advanced (1.8-fold, p=0.0013) atherosclerotic lesions, but also led to reduced/increased lesion contents of macrophages/smooth muscle cells (SMCs) (macrophage: ~0.74-fold, p=0.0002(early)/0.0016(advanced); SMC: ~1.55-fold, p=0.0003(early) /0.0001(advanced)), respectively. Moreover, SSAO inactivation inhibited the migration of circulating monocytes into peripheral tissues and reduced the amount of circulating Ly6Chigh monocytes (0.7-fold, p=0.0001), which may account for the reduced macrophage content in lesions. In contrast, the increased number of SMCs in lesions of SCZ-treated mice is attributed to an augmented synthetic vascular SMC phenotype switch as evidenced by the increased proliferation of SMCs and accumulation of collagens in vivo. Conclusion: SSAO inactivation by SCZ promotes the phenotypic switch of SMCs and the development of atherosclerosis. The enzymatic activity of SSAO may thus represent a potential target in the prevention and/or treatment of atherosclerosis.

Keywords: atherosclerosis, phenotype switch of smooth muscle cells, SSAO/VAP-1, semicarbazide

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5486 Food Insecurity Assessment, Consumption Pattern and Implications of Integrated Food Security Phase Classification: Evidence from Sudan

Authors: Ahmed A. A. Fadol, Guangji Tong, Wlaa Mohamed

Abstract:

This paper provides a comprehensive analysis of food insecurity in Sudan, focusing on consumption patterns and their implications, employing the Integrated Food Security Phase Classification (IPC) assessment framework. Years of conflict and economic instability have driven large segments of the population in Sudan into crisis levels of acute food insecurity according to the (IPC). A substantial number of people are estimated to currently face emergency conditions, with an additional sizeable portion categorized under less severe but still extreme hunger levels. In this study, we explore the multifaceted nature of food insecurity in Sudan, considering its historical, political, economic, and social dimensions. An analysis of consumption patterns and trends was conducted, taking into account cultural influences, dietary shifts, and demographic changes. Furthermore, we employ logistic regression and random forest analysis to identify significant independent variables influencing food security status in Sudan. Random forest clearly outperforms logistic regression in terms of area under curve (AUC), accuracy, precision and recall. Forward projections of the IPC for Sudan estimate that 15 million individuals are anticipated to face Crisis level (IPC Phase 3) or worse acute food insecurity conditions between October 2023 and February 2024. Of this, 60% are concentrated in Greater Darfur, Greater Kordofan, and Khartoum State, with Greater Darfur alone representing 29% of this total. These findings emphasize the urgent need for both short-term humanitarian aid and long-term strategies to address Sudan's deepening food insecurity crisis.

Keywords: food insecurity, consumption patterns, logistic regression, random forest analysis

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5485 Return to Bowel Function after Right versus Extended Right Hemicolectomy: A Retrospective Review

Authors: Zak Maas, Daniel Carson, Rachel McIntyre, Mark Omundsen, Teresa Holm

Abstract:

Aim: After hemicolectomy a period of obligatory bowel dysfunction is expected, termed postoperative ileus (POI). Prolonged postoperative ileus (PPOI), typically four or more days, is associated with higher morbidity and extended inpatient stay. This leads to significant financial and resource-related burdens on healthcare systems. Several studies including a meta-analysis have compared rates of PPOI in left vs right hemicolectomy, which suggest that right-sided resections may be more likely to result in PPOI. Our study aims to further investigate whether significant differences in PPOI and obligatory POI exist between right versus extended right hemicolectomy. Methods: This is a retrospective review assessing rates of PPOI in patients who underwent right vs extended right hemicolectomy at Tauranga Hospital. Patients were divided and compared depending on approach (open versus laparoscopic) and acuity (acute versus elective). Exclusion criteria included synchronous major operations and patients preoperatively on parenteral nutrition. Primary outcome was PPOI as pre-defined in contemporary literature. Secondary outcomes were time to passage of flatus, passage of stool, toleration of oral diet and rate of complications. Results: There were 669 patients identified for analysis (507 laparoscopic vs 162 open; 194 acute vs 475 elective). Early analysis indicates rates of PPOI was significantly increased in patients undergoing extended right hemicolectomy. Factors including age, gender, ethnicity, preoperative haemaglobin, preoperative albumin and diagnosis of inflammatory bowel disease were examined by multivariate analysis to determine correlation with PPOI. Conclusion: PPOI is a common complication of hemicolectomy surgery. Higher rates of PPOI in extended right vs right hemicolectomy warrants further research into determining the cause. This study examines some other factors which may contribute to PPOI.

Keywords: hemicolectomy, colorectal, complications, postoperative ileus

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5484 Agricultural Cooperative Model: A Panacea for Economic Development of Small Scale Business Famers in Ilesha, Osun State, Nigeria

Authors: Folasade Adegbaju, Olusola Arowolo, Olufisayo Onawumi

Abstract:

Owolowo ile – ege garri processing industry which is a small scale cassava processing industry, located in Ilesha, Osun State was purposively selected as a case study because it is a cooperative business. This industry was established in 1991 by eight men (8) who were mostly retirees. A researcher made questionnaire was used to collect information from thirty (30) respondents: the manager, four official staffs and 25 randomly selected processors in the industry. The study found that within twelve years of the utilization of their self raised initial capital of N240, 000 naira (Two hundred and forty thousand naira) this cassava – based industry had impacted on and attracted the involvement of many more people because within the period of the study (i.e. 2007-2011) the processors had quadrupled in number (e.g. 8 to 30), the facilities (equipment) in use had increased from one machine and a frying pot to many, this translated into being able to produce large quantities of fried garri, fufu and also starch for marketing to the people in Ilesha and neighbouring cities like Ibadan, Lagos, etc. This is indicative of economic growth. The industry also became a source of employment for community members in the sense that, as at the time of study four staffs were employed to work and coordinate the industry. It was observed that despite all odds of small-scale industry and the problem of people migrating from rural to urban area, this agro-based industry still existed successfully in the community, and many of such industry can be replicated by such agricultural cooperative groups nationwide so as to further boost the productivity as well as the economy of the area and nation at large. However, government and individual still have major roles to play in ensuring the growth and development of the nation in this respect.The local agricultural cooperative groups should form regional cooperative consortium with more networking for the farmers, in order to create more jobs for the young ones and to increase agricultural productivity in the country thus resulting in a better and more sustainable economy.

Keywords: agricultural cooperative, cassava processing industry, model, small scale enterprise

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5483 A Correlational Study between Sexual Awareness, Behaviour and Sources of Sexual Knowledge among Youth in Context of Bihar

Authors: Kanika Naresh Singh, Uday Shankar

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Background: Human behaviours are influenced by drives. Sexual drive is one of them. Education regarding sexual behaviour plays a great role in shaping one’s attitude towards it. These days after attaining the age of puberty, adolescents are confused and feel shy to talk about it. In order to get information, they refer to various types of sources and these sources play a greater role in spreading awareness in the mass adolescent population. Sometimes it also leads to the building of myths and misconceptions. Due to increasing incidences of HIV/AIDS, RTIs/STIs and teenage pregnancies, there is a rising need to impart sex education. Aim: The aim of this research was to study the level of sexual awareness among the youth of Bihar and also study their sexual behaviour and sources of influence. It also aims to study the correlation between sexual awareness, behaviour and sources of sexual knowledge among youth in Bihar. Methods: The sample size for the project was 50 youth consisting of both boys and girls, in between the age group of 18 to 23 years from urban and semi-urban areas. The purposive sampling method was used in the research. The tools used were the Sexual Awareness Questionnaire and Sexual Behavior and Sources of Influence (SBSI) scale. The sexual Awareness Questionnaire was developed by Snell, having 35 items. A socio-demographic data sheet was also used. Results: The youth had poor sexual awareness. Internet and Friends were found to be the major source for gathering information. The youth of Bihar were less inclined towards resolving their doubts with their parents. There was a positive correlation between sexual awareness, behaviour and sources of knowledge. Conclusion: The youth of Bihar has poor sexual knowledge. Internet and Friends are major sources of information. Sex Education should be promoted as suggested by various institutions like World Health Organization United Nations. Psychiatrists and psychologists have a key leadership role in introducing these potentially emotionally challenging issues to the youth with consideration of psychosocial and cultural factors.

Keywords: sexual awareness, sexual behavior, sources of influence, youths, Bihar, India

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5482 Analyzing Investors and Building Users Perception of Green Real Estate Development Projects: The Case of Bahrain

Authors: Fay A. Al-Khalifa, Fariel Khan, Anamika Jiwane

Abstract:

Responding to some governmentally enforced building sustainability criteria is today becoming an unavoidable challenge to the real estate development industry and is no longer an extra that allows developers to gain competitive advantages. Previous studies suggested that using green technologies, if done under the right circumstances, could lead to positive incentives, tax breaks, higher rents, cost savings and higher property values in the long run. This is all in addition to the marketing benefits of the green label. There are, however, still countries, mostly in the developing world, that lack the implementation of such sustainability guidelines and assessment tools. This research aspires to investigate the market’s readiness to implement such criteria, its perception of sustainable architecture and building users motivation to use and/or invest in sustainable buildings. The study showed via a survey administered to 385 inhabitants and investors in commercial real estate in Bahrain that the respondents have a limited understanding of the benefits of green buildings and are unlikely to want to occupy or invest in a green building under the current social, economic and industrial conditions. Reliability of green technology, effectiveness, price and the questionable long-term financial benefits were among the major concerns. The study suggests that the promotion of sustainable architecture should respond to the current market concerns in a more direct way to trigger an interest in investors and users of commercial real estate project. This stimulated attention should consequently encourage developers to consider incorporating sustainability measures, apply for green building assessment programs and invest in green technologies, all of which need higher capitals that are nonetheless financially justifiable on the long run.

Keywords: investment, real estate, sustainability, clients perception, Bahrain

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5481 Proof of Concept of Video Laryngoscopy Intubation: Potential Utility in the Pre-Hospital Environment by Emergency Medical Technicians

Authors: A. Al Hajeri, M. E. Minton, B. Haskins, F. H. Cummins

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The pre-hospital endotracheal intubation is fraught with difficulties; one solution offered has been video laryngoscopy (VL) which permits better visualization of the glottis than the standard method of direct laryngoscopy (DL). This method has resulted in a higher first attempt success rate and fewer failed intubations. However, VL has mainly been evaluated by experienced providers (experienced anesthetists), and as such the utility of this device for those whom infrequently intubate has not been thoroughly assessed. We sought to evaluate this equipment to determine whether in the hands of novice providers this equipment could prove an effective airway management adjunct. DL and two VL methods (C-Mac with distal screen/C-Mac with attached screen) were evaluated by simulating practice on a Laerdal airway management trainer manikin. Twenty Emergency Medical Technicians (basics) were recruited as novice practitioners. This group was used to eliminate bias, as these clinicians had no pre-hospital experience of intubation (although they did have basic airway skills). The following areas were assessed: Time taken to intubate, number of attempts required to successfully intubate, ease of use of equipment VL (attached screen) took on average longer for novice clinicians to successfully intubate and had a lower success rate and reported higher rating of difficulty compared to DL. However, VL (with distal screen) and DL were comparable on intubation times, success rate, gastric inflation rate and rating of difficulty by the user. This study highlights the routine use of VL by inexperienced clinicians would be of no added benefit over DL. Further studies are required to determine whether Emergency Medical Technicians (Paramedics) would benefit from this airway adjunct, and ascertain whether after initial mastery of VL (with a distal screen), lower intubation times and difficulty rating may be achievable.

Keywords: direct laryngoscopy, endotracheal intubation, pre-hospital, video laryngoscopy

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5480 Sexual Consent and Persons with Psychosocial Disabilities: Exploring Sexual Rights under Indian Laws

Authors: Sachin Sharma

Abstract:

Sexual consent is integral to every sexual relationship. It is a process to facilitate sexual autonomy and bodily integrity. It assures complete sexual personhood and allows an individual to explore her sexual expressions independently. But the said proposition is not true for people with psychosocial disabilities. Generally, they are considered seraphic or mephistophelic and denied access to sexual autonomy. This result in institutionalizing the sexuality of disabled persons, where the eugenics-ableist narrative defines assessment and access to consent. This way, sexuality and disability are distanced apart. It is primarily due to the stigmatized socio-cultural constructs of sexuality that define sex within a “standard” and “charmed” circle. Such stigmatized expression influences the law, as it considers people with psychosocial disabilities incapable of sexual consent. The approach of legal institutions is very narrow towards interpreting their sexual rights. It echoes the modernist-ableism and strangulates the sexual choices. This way, it reflects the repressive model of sex and denies space to people with psychosocial disabilities. Moreover, judicial courts follow old and conservative methods while dealing with sexual issues. For instance, courts still practice the “standardized” norm of intelligence quotient (IQ) for determining the credibility of persons with psychosocial disabilities. Further, there is still doubt about assistive communicative techniques. This paper will try to question the normative structure of sexual consent and related laws while specifically addressing the issues of sex as desire and abuse. Considering the commitment to the United Nations Convention on the Rights of Persons with Disabilities (herein referred to as UNCRPD) and common law experience, the paper will draw a comparative study on the legal position of sexual rights in India. The paper will also analyze the role of UNCRPD in addressing sexual rights. The author will examine the position of sexual rights of people with psychosocial disabilities after the drafting of UNCRPD and specific state laws. The paper primarily follows the doctrinal method.

Keywords: sexual autonomy, institutionalized choices, overregulated laws, violation of individuality

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5479 Mitigating Nitrous Oxide Production from Nitritation/Denitritation: Treatment of Centrate from Pig Manure Co-Digestion as a Model

Authors: Lai Peng, Cristina Pintucci, Dries Seuntjens, José Carvajal-Arroyo, Siegfried Vlaeminck

Abstract:

Economic incentives drive the implementation of short-cut nitrogen removal processes such as nitritation/denitritation (Nit/DNit) to manage nitrogen in waste streams devoid of biodegradable organic carbon. However, as any biological nitrogen removal process, the potent greenhouse gas nitrous oxide (N2O) could be emitted from Nit/DNit. Challenges remain in understanding the fundamental mechanisms and development of engineered mitigation strategies for N2O production. To provide answers, this work focuses on manure as a model, the biggest wasted nitrogen mass flow through our economies. A sequencing batch reactor (SBR; 4.5 L) was used treating the centrate (centrifuge supernatant; 2.0 ± 0.11 g N/L of ammonium) from an anaerobic digester processing mainly pig manure, supplemented with a co-substrate. Glycerin was used as external carbon source, a by-product of vegetable oil. Out-selection of nitrite oxidizing bacteria (NOB) was targeted using a combination of low dissolved oxygen (DO) levels (down to 0.5 mg O2/L), high temperature (35ºC) and relatively high free ammonia (FA) (initially 10 mg NH3-N/L). After reaching steady state, the process was able to remove 100% of ammonium with minimum nitrite and nitrate in the effluent, at a reasonably high nitrogen loading rate (0.4 g N/L/d). Substantial N2O emissions (over 15% of the nitrogen loading) were observed at the baseline operational condition, which were even increased under nitrite accumulation and a low organic carbon to nitrogen ratio. Yet, higher DO (~2.2 mg O2/L) lowered aerobic N2O emissions and weakened the dependency of N2O on nitrite concentration, suggesting a shift of N2O production pathway at elevated DO levels. Limiting the greenhouse gas emissions (environmental protection) from such a system could be substantially minimized by increasing the external carbon dosage (a cost factor), but also through the implementation of an intermittent aeration and feeding strategy. Promising steps forward have been presented in this abstract, yet at the conference the insights of ongoing experiments will also be shared.

Keywords: mitigation, nitrous oxide, nitritation/denitritation, pig manure

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5478 Spring Water Quality Appraisement for Drinking and Irrigation Application in Nigeria: A Muliti-Criteria Approach

Authors: Hillary Onyeka Abugu, Valentine Chinakwugwo Ezea, Janefrances Ngozi Ihedioha, Nwachukwu Romanus Ekere

Abstract:

The study assessed the spring water quality in Igbo-Etiti, Nigeria, for drinking and irrigation application using Physico-chemical parameters, water quality index, mineral and trace elements, pollution indices and risk assessment. Standard methods were used to determine the physicochemical properties of the spring water in rainy and dry seasons. Trace metals such as Pb, Cd, Zn and Cu were determined with atomic absorption spectrophotometer. The results showed that most of the physicochemical properties studied were within the guideline values set by Nigeria Standard for Drinking Water Quality (NSDWQ), WHO and US EPA for drinking water purposes. However, pH of all the spring water (4.27- 4.73; and 4.95- 5.73), lead (Pb) (0.01-1.08 mg/L) and cadmium (Cd) (0.01-0.15 mg/L) concentrations were above the guideline values in both seasons. This could be attributed to the lithography of the study area, which is the Nsukka formation. Leaching of lead and sulphides from the embedded coal deposits could have led to the increased lead levels and made the water acidic. Two-way ANOVA showed significant differences in most of the parameters studied in dry and rainy seasons. Pearson correlation analysis and cluster analysis showed strong significant positive and negative correlations in some of the parameters studied in both seasons. The water quality index showed that none of the spring water had excellent water status. However, one spring (Iyi Ase) had poor water status in dry season and is considered unsafe for drinking. Iyi Ase was also considered not suitable for irrigation application as predicted by most of the pollution indices, while others were generally considered suitable for irrigation application. Probable cancer and non-cancer risk assessment revealed a probable risk associated with the consumption of the spring in the Igbo-Ettiti area, Nigeria.

Keywords: water quality, pollution index, risk assessment, physico-chemical parameters

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5477 Selecting The Contractor using Multi Criteria Decision Making in National Gas Company of Lorestan Province of Iran

Authors: Fatemeh Jaferi, Moslem Parsa, Heshmatolah Shams Khorramabadi

Abstract:

In this modern fluctuating world, organizations need to outsource some parts of their activities (project) to providers in order to show a quick response to their changing requirements. In fact, a number of companies and institutes have contractors do their projects and have some specific criteria in contractor selection. Therefore, a set of scientific tools is needed to select the best contractors to execute the project according to appropriate criteria. Multi-criteria decision making (MCDM) has been employed in the present study as a powerful tool in ranking and selecting the appropriate contractor. In this study, devolving second-source (civil) project to contractors in the National Gas Company of Lorestan Province (Iran) has been found and therefore, 5 civil companies have been evaluated. Evaluation criteria include executive experience, qualification of technical staff, good experience and company's rate, technical interview, affordability, equipment and machinery. Criteria's weights are found through experts' opinions along with AHP and contractors ranked through TOPSIS and AHP. The order of ranking contractors based on MCDM methods differs by changing the formula in the study. In the next phase, the number of criteria and their weights has been sensitivity analysed through using AHP. Adding each criterion changed contractors' ranking. Similarly, changing weights resulted in a change in ranking. Adopting the stated strategy resulted in the facts that not only is an appropriate scientific method available to select the most qualified contractors to execute gas project, but also a great attention is paid to picking needed criteria for selecting contractors. Consequently, executing such project is undertaken by most qualified contractors resulted in optimum use of limited resource, accelerating the implementation of project, increasing quality and finally boosting organizational efficiency.

Keywords: multi-criteria decision making, project, management, contractor selection, gas company

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5476 Analysing the Moderating Effect of Customer Loyalty on Long Run Repurchase Intentions

Authors: John Akpesiri Olotewo

Abstract:

One of the controversies in existing marketing literatures is on how to retain existing and new customers to have repurchase intention in the long-run; however, empirical answer to this question is scanty in existing studies. Thus, this study investigates the moderating effect of consumer loyalty on long-run repurchase intentions in telecommunication industry using Lagos State environs. The study adopted field survey research design using questionnaire to elicit responses from 250 respondents who were selected using random and stratified random sampling techniques from the telecommunication industry in Lagos State, Nigeria. The internal consistency of the research instrument was verified using the Cronbach’s alpha, the result of 0.89 implies the acceptability of the internal consistency of the survey instrument. The test of the research hypotheses were analyzed using Pearson Product Method of Correlation (PPMC), simple regression analysis and inferential statistics with the aid of Statistical Package for Social Science version 20.0 (SPSS). The study confirmed that customer satisfaction has a significant relationship with customer loyalty in the telecommunication industry; also Service quality has a significant relationship with customer loyalty to a brand; loyalty programs have a significant relationship with customer loyalty to a network operator in Nigeria and Customer loyalty has a significant effect on the long run repurchase intentions of the customer. The study concluded that one of the determinants of long term profitability of a business entity is the long run repurchase intentions of its customers which hinges on the level of brand loyalty of the customer. Thus, it was recommended that service providers in Nigeria should improve on factors like customer satisfaction, service quality, and loyalty programs in order to increase the loyalty of their customer to their brands thereby increasing their repurchase intentions.

Keywords: customer loyalty, long run repurchase intentions, brands, service quality and customer satisfaction

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5475 Identification of microRNAs in Early and Late Onset of Parkinson’s Disease Patient

Authors: Ahmad Rasyadan Arshad, A. Rahman A. Jamal, N. Mohamed Ibrahim, Nor Azian Abdul Murad

Abstract:

Introduction: Parkinson’s disease (PD) is a complex and asymptomatic disease where patients are usually diagnosed at late stage where about 70% of the dopaminergic neurons are lost. Therefore, identification of molecular biomarkers is crucial for early diagnosis of PD. MicroRNA (miRNA) is a short nucleotide non-coding small RNA which regulates the gene expression in post-translational process. The involvement of these miRNAs in neurodegenerative diseases includes maintenance of neuronal development, necrosis, mitochondrial dysfunction and oxidative stress. Thus, miRNA could be a potential biomarkers for diagnosis of PD. Objective: This study aim to identify the miRNA involved in Late Onset PD (LOPD) and Early Onset PD (EOPD) compared to the controls. Methods: This is a case-control study involved PD patients in the Chancellor Tunku Muhriz Hospital at the UKM Medical Centre. miRNA samples were extracted using miRNeasy serum/plasma kit from Qiagen. The quality of miRNA extracted was determined using Agilent RNA 6000 Nano kit in the Bioanalyzer. miRNA expression was performed using GeneChip miRNA 4.0 chip from Affymetrix. Microarray was performed in EOPD (n= 7), LOPD (n=9) and healthy control (n=11). Expression Console and Transcriptomic Analyses Console were used to analyze the microarray data. Result: miR-129-5p was significantly downregulated in EOPD compared to LOPD with -4.2 fold change (p = <0.050. miR-301a-3p was upregulated in EOPD compared to healthy control (fold = 10.3, p = <0.05). In LOPD versus healthy control, miR-486-3p (fold = 15.28, p = <0.05), miR-29c-3p (fold = 12.21, p = <0.05) and miR-301a-3p (fold = 10.01, p =< 0.05) were upregulated. Conclusion: Several miRNA have been identified to be differentially expressed in EOPD compared to LOPD and PD versus control. These miRNAs could serve as the potential biomarkers for early diagnosis of PD. However, these miRNAs need to be validated in a larger sample size.

Keywords: early onset PD, late onset PD, microRNA (miRNA), microarray

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5474 NiFe-Type Catalysts for Anion Exchange Membrane (AEM) Electrolyzers

Authors: Boldin Roman, Liliana Analía Diaz

Abstract:

As the hydrogen economy continues to expand, reducing energy consumption and emissions while stimulating economic growth, the development of efficient and cost-effective hydrogen production technologies is critical. Among various methods, anion exchange membrane (AEM) water electrolysis stands out due to its potential for using non-noble metal catalysts. The exploration and enhancement of non-noble metal catalysts, such as NiFe-type catalysts, are pivotal for the advancement of AEM technology, ensuring its commercial viability and environmental sustainability. NiFe-type catalysts were synthesized through electrodeposition and characterized both electrochemically and physico-chemically. Various supports, including Ni foam and Ni mesh, were used as porous transport layers (PTLs) to evaluate the effective catalyst thickness and the influence of the PTL in a 5 cm² AEM electrolyzer. This methodological approach allows for a detailed assessment of catalyst performance under operational conditions typical of industrial hydrogen production. The study revealed that electrodeposited non-noble multi-metallic catalysts maintain stable performance as anodes in AEM water electrolysis. NiFe-type catalysts demonstrated superior activity, with the NiFeCoP alloy outperforming others by delivering the lowest overpotential and the highest current density. Furthermore, the use of different PTLs showed significant effects on the electrochemical behavior of the catalysts, indicating that PTL selection is crucial for optimizing performance and efficiency in AEM electrolyzers. Conclusion: The research underscores the potential of non-noble metal catalysts in enhancing efficiency and reducing the costs of AEM electrolysers. The findings highlight the importance of catalyst and PTL optimization in developing scalable and economically viable hydrogen production technologies. Continued innovation in this area is essential for supporting the growth of the hydrogen economy and achieving sustainable energy solutions.

Keywords: AEMWE, electrocatalyst, hydrogen production, water electrolysis.

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5473 Dosimetric Dependence on the Collimator Angle in Prostate Volumetric Modulated Arc Therapy

Authors: Muhammad Isa Khan, Jalil Ur Rehman, Muhammad Afzal Khan Rao, James Chow

Abstract:

Purpose: This study investigates the dose-volume variations in planning target volume (PTV) and organs-at-risk (OARs) using different collimator angles for smart arc prostate volumetric modulated arc therapy (VMAT). Awareness of the collimator angle for PTV and OARs sparing is essential for the planner because optimization contains numerous treatment constraints producing a complex, unstable and computationally challenging problem throughout its examination of an optimal plan in a rational time. Materials and Methods: Single arc VMAT plans at different collimator angles varied systematically (0°-90°) were performed on a Harold phantom and a new treatment plan is optimized for each collimator angle. We analyzed the conformity index (CI), homogeneity index (HI), gradient index (GI), monitor units (MUs), dose-volume histogram, mean and maximum doses to PTV. We also explored OARs (e.g. bladder, rectum and femoral heads), dose-volume criteria in the treatment plan (e.g. D30%, D50%, V30Gy and V38Gy of bladder and rectum; D5%,V14Gy and V22Gy of femoral heads), dose-volume histogram, mean and maximum doses for smart arc VMAT at different collimator angles. Results: There was no significance difference found in VMAT optimization at all studied collimator angles. However, if 0.5% accuracy is concerned then collimator angle = 45° provides higher CI and lower HI. Collimator angle = 15° also provides lower HI values like collimator angle 45°. It is seen that collimator angle = 75° is established as a good for rectum and right femur sparing. Collimator angle = 90° and collimator angle = 30° were found good for rectum and left femur sparing respectively. The PTV dose coverage statistics for each plan are comparatively independent of the collimator angles. Conclusion: It is concluded that this study will help the planner to have freedom to choose any collimator angle from (0°-90°) for PTV coverage and select a suitable collimator angle to spare OARs.

Keywords: VMAT, dose-volume histogram, collimator angle, organs-at-risk

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5472 Evaluation of the Spectrum of Cases of Perforation Peritonitis at Jawaharlal Nehru Medical College, Aligarh Muslim University

Authors: Mujahid Ali, Wasif Mohammed Ali, Meraj Ahmad

Abstract:

Background: Perforation peritonitis is the most common surgical emergency encountered by surgeons all over the world as well as in India. The etiology of perforation peritonitis in India continues to be different from its western counterparts. The aim of this study is to evaluate the spectrum of cases of perforation peritonitis at our hospital. Methods: A prospective study conducted includes three hundred thirtysix patients of perforation peritonitis at J. N. Medical College from October 2015 to July 2017. The patients were admitted, resuscitated and underwent emergency laparotomy. Data were collected in terms of demographic profile, clinical presentations, site of perforations, causes and surgical outcomes. Results: In this study, the most common cause of perforation peritonitis was peptic ulcer disease (43%), followed by enteric perforation (12.8%), tubercular perforation (12.5%), traumatic perforation (11.9%), appendicular perforation (9.8%), amoebic caecal perforation (3%), malignant perforation (1.5%), etc. The sites of perforations were stomach in majority (38.3%), ileum (31%), appendix (8%), duodenum (5.%), caecum (4.4%) ,colon (3%), jejunum (8.5%) and gall bladder (2%). The overall mortality was 21% in our study. Age >50 years (p= <0.0001, OR= 3.9260, CI= 2.2 to 6.9), organ failure (p= <0.0001, OR= 29.2, CI= 14.8 to 57.6), shock (p=<0.0001, OR=20.20, CI= 10.56 to 38.6), diffuse peritonitis (p<0.0015, OR= 6.8810, CI= 2.09 to 22.57) and faecal exudates (p<0.0001) were found to be significant factors affecting mortality. The most common complication associated was superficial wound infection (40%), followed by burst abdomen seen in 21% cases, intra-abdominal sepsis in 18% cases, electrolyte imbalances in 15% cases, anastomotic leak in 6% cases. Conclusion: In this study, stomach is the most common site of perforation with peptic ulcer disease being the most common etiology. Older age, presence of shock, organ failure and faecal peritonitis were the risk factors affecting the mortality of the patients. Early recognition, adequate resuscitation and referral of patients can influence outcome and reduces mortality as well as morbidity.

Keywords: etiology, mortality, perforation, spectrum

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5471 Development of a Robust Protein Classifier to Predict EMT Status of Cervical Squamous Cell Carcinoma and Endocervical Adenocarcinoma (CESC) Tumors

Authors: ZhenlinJu, Christopher P. Vellano, RehanAkbani, Yiling Lu, Gordon B. Mills

Abstract:

The epithelial–mesenchymal transition (EMT) is a process by which epithelial cells acquire mesenchymal characteristics, such as profound disruption of cell-cell junctions, loss of apical-basolateral polarity, and extensive reorganization of the actin cytoskeleton to induce cell motility and invasion. A hallmark of EMT is its capacity to promote metastasis, which is due in part to activation of several transcription factors and subsequent downregulation of E-cadherin. Unfortunately, current approaches have yet to uncover robust protein marker sets that can classify tumors as possessing strong EMT signatures. In this study, we utilize reverse phase protein array (RPPA) data and consensus clustering methods to successfully classify a subset of cervical squamous cell carcinoma and endocervical adenocarcinoma (CESC) tumors into an EMT protein signaling group (EMT group). The overall survival (OS) of patients in the EMT group is significantly worse than those in the other Hormone and PI3K/AKT signaling groups. In addition to a shrinkage and selection method for linear regression (LASSO), we applied training/test set and Monte Carlo resampling approaches to identify a set of protein markers that predicts the EMT status of CESC tumors. We fit a logistic model to these protein markers and developed a classifier, which was fixed in the training set and validated in the testing set. The classifier robustly predicted the EMT status of the testing set with an area under the curve (AUC) of 0.975 by Receiver Operating Characteristic (ROC) analysis. This method not only identifies a core set of proteins underlying an EMT signature in cervical cancer patients, but also provides a tool to examine protein predictors that drive molecular subtypes in other diseases.

Keywords: consensus clustering, TCGA CESC, Silhouette, Monte Carlo LASSO

Procedia PDF Downloads 459
5470 Congenital Heart Defect(CHD) “The Silent Crises”; The Need for New Innovative Ways to Save the Ghanaian Child - A Retrospective Study

Authors: Priscilla Akua Agyapong

Abstract:

Background: In a country of nearly 34 million people, Ghana suffers from rapidly growing pediatric CHD cases and not enough pediatric specialists to attend to the burgeoning needs of these children. Most of the cases are either missed or diagnosed late, resulting in increased mortality. According to the National Cardiothoracic Centre, 1 in every 100,000 births in Ghana has CHD; however, there is limited data on the clinical presentation and its management, one of the many reasons I decided to do this case study coupled with the loss my 2 month old niece to multiple Ventricular Septal Defect 3 years ago due late diagnoses. Method: A retrospective cohort study was performed at the child health clinic of one of Ghana’s public tertiary Institutions using data from their electronic health record (EHR) from February 2021 to April 2022. All suspected or provisionally diagnosed cases were included in the analysis. Results: Records of over 3000 children were reviewed with an approximate male to female ratio of 1:1.53 cases diagnosed during the period of study, most of whom were less than 5 years of age. 25 cases had complete clinical records, with acyanotic septal defects being the most diagnosed. 62.5% of the cases were ventricular septal defects, followed by Patent Ductus Arteriosus (23%) and Atrial Septal Defects (4.5%). Tetralogy of Fallot was the most predominant and complex cyanotic CHD with 10%. Conclusion: The indeterminate coronary anatomy of infants makes it difficult to use only echocardiography and other conventional clinical methods in screening for CHDs. There are rising modernizations and new innovative ways that can be employed in Ghana for early detection, hence preventing the delay of a potential surgical repair. It is, therefore, imperative to create the needed awareness about these “SILENT CRISES” and help save the Ghanaian child’s life.

Keywords: congenital heart defect(CHD), ventricular septal defect(VSD), atrial septal defect(ASD), patent ductus arteriosus(PDA)

Procedia PDF Downloads 80
5469 Marketing Strategy and Marketing Mix for Rural Tour Package in Bali: Case Study of Munduk

Authors: Made Darmiati, Ni Putu Evi Wijayanti, Ni Ketut Wiwiek Agustina, Putu Gde Arie Yudhistira, Marcel Hardono

Abstract:

The establishment of tourist village has been the main concern for pro-poor tourism in Indonesia especially in Bali in order to create alternative tourist destination. The case study of this research was Munduk, a tourist village located in Buleleng Regency, Bali Province. Munduk has been unstable in terms of tourist visit in 2012 until 2016. The concept of marketing strategy and its marketing mix are concepts that suitable for application in Munduk as the prime owner of trekking and other rural tour packages to increase the number of visitor in particularly during low season. The research study aims to determine the internal factors (strengths and weaknesses) and external factors (opportunities and threats) impacting the number of tourist visit so that they could formulate appropriate marketing strategy for Munduk Tourist Village. Data has been obtained by observation, interviews with stakeholders, questionnaire to 100 participants and documentation. In addition, this research study uses descriptive qualitative methods and techniques known as SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis by internal factors and external factors impacting the level of tourist visit to Munduk Tourist Village in Buleleng Regency, Bali. The sampling was done by ‘accidental sampling technique’ to obtain the participants to analyse the results of the SWOT analysis. Further assessment of internal and external weights has resulted respectively (1.84 , 1.84) which are in the first quadrant of the diagram in which S-O (Strengths-Opportunities) Strategy. As the prime owner of the trekking and other rural tour packages in the village, Munduk should maximise its strengths and take other opportunities as possible to wrap and design trekking and other rural tour packages and then offer the package to travel agents in Bali.

Keywords: marketing mix, marketing strategy, rural tourism, SWOT matrix

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5468 Socio-Demographic Factors and Testing Practices Are Associated with Spatial Patterns of Clostridium difficile Infection in the Australian Capital Territory, 2004-2014

Authors: Aparna Lal, Ashwin Swaminathan, Teisa Holani

Abstract:

Background: Clostridium difficile infections (CDIs) have been on the rise globally. In Australia, rates of CDI in all States and Territories have increased significantly since mid-2011. Identifying risk factors for CDI in the community can help inform targeted interventions to reduce infection. Methods: We examine the role of neighbourhood socio-economic status, demography, testing practices and the number of residential aged care facilities on spatial patterns in CDI incidence in the Australian Capital Territory. Data on all tests conducted for CDI were obtained from ACT Pathology by postcode for the period 1st January 2004 through 31 December 2014. Distribution of age groups and the neighbourhood Index of Relative Socio-economic Advantage Disadvantage (IRSAD) were obtained from the Australian Bureau of Statistics 2011 National Census data. A Bayesian spatial conditional autoregressive model was fitted at the postcode level to quantify the relationship between CDI and socio-demographic factors. To identify CDI hotspots, exceedance probabilities were set at a threshold of twice the estimated relative risk. Results: CDI showed a positive spatial association with the number of tests (RR=1.01, 95% CI 1.00, 1.02) and the resident population over 65 years (RR=1.00, 95% CI 1.00, 1.01). The standardized index of relative socio-economic advantage disadvantage (IRSAD) was significantly negatively associated with CDI (RR=0.74, 95% CI 0.56, 0.94). We identified three postcodes with high probability (0.8-1.0) of excess risk. Conclusions: Here, we demonstrate geographic variations in CDI in the ACT with a positive association of CDI with socioeconomic disadvantage and identify areas with a high probability of elevated risk compared with surrounding communities. These findings highlight community-based risk factors for CDI.

Keywords: spatial, socio-demographic, infection, Clostridium difficile

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