Search results for: outpatient treatment efficiency
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 14040

Search results for: outpatient treatment efficiency

11160 Intracellular Strategies for Gene Delivery into Mammalian Cells Using Bacteria as a Vector

Authors: Kumaran Narayanan, Andrew N. Osahor

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E. coli has been engineered by our group and by others as a vector to deliver DNA into cultured human and animal cells. However, so far conditions to improve gene delivery using this vector have not been investigated, resulting in a major gap in our understanding of the requirements for this vector to function optimally. Our group recently published novel data showing that simple addition of the DNA transfection reagent Lipofectamine increased the efficiency of the E. coli vector by almost 3-fold, providing the first strong evidence that further optimization of bactofection is possible. This presentation will discuss advances that demonstrate the effects of several intracellular strategies that improve the efficiency of this vector. Conditions that promote endosomal escape of internalized bacteria to evade lysosomal destruction after entry in the cell, a known obstacle limiting this vector, are elucidated. Further, treatments that increase bacterial lysis so that the vector can release its transgene into the mammalian environment for expression will be discussed. These experiments will provide valuable new insight to advance this E. coli system as an important class of vector technology for genetic correction of human disease models in cells and whole animals.

Keywords: DNA, E. coli, gene expression, vector

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11159 Development of Gold Nanoparticles-Antibody System for the Selective Photothermal Destruction of Multidrug Resistant Bacteria

Authors: Teodora Mocan, Lucian Mocan, Cornel Iancu, Flaviu A. Tabaran, Bartos Dana, Matea Cristian

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Antimicrobial resistance, which threatens the efficacy of the existing antibiotics represents a worldwide public health issue. At the current time, vancomycin is the only responsive treatment although has significant cytotoxicity, is partially effective and it is poorly retained by infected tissues. From a clinical point of view, attractive alternative approaches for treating such Meticillin-Resistant Staphylococcus Aureus (MRSA) strains would be using agents that cause physical damage to the bacteria. Modular nanopharmaceuticals systems are being designed to address all of these multifunctional capabilities for the ideal bacterial treatment, with the ability to mix and match appropriate functions. Here we present a novel method of selective laser photothermal ablation of MRSA bacteria mediated by gold nanoparticles bound to PBP antibody against PBP protein located on the MRSA surface.

Keywords: MRSA, laser, nanoparticle, antibody

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11158 Using Artificial Vision Techniques for Dust Detection on Photovoltaic Panels

Authors: Gustavo Funes, Eduardo Peters, Jose Delpiano

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It is widely known that photovoltaic technology has been massively distributed over the last decade despite its low-efficiency ratio. Dust deposition reduces this efficiency even more, lowering the energy production and module lifespan. In this work, we developed an artificial vision algorithm based on CIELAB color space to identify dust over panels in an autonomous way. We performed several experiments photographing three different types of panels, 30W, 340W and 410W. Those panels were soiled artificially with uniform and non-uniform distributed dust. The algorithm proposed uses statistical tools to provide a simulation with a 100% soiled panel and then performs a comparison to get the percentage of dirt in the experimental data set. The simulation uses a seed that is obtained by taking a dust sample from the maximum amount of dust from the dataset. The final result is the dirt percentage and the possible distribution of dust over the panel. Dust deposition is a key factor for plant owners to determine cleaning cycles or identify nonuniform depositions that could lead to module failure and hot spots.

Keywords: dust detection, photovoltaic, artificial vision, soiling

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11157 Healthcare Social Entrepreneurship: A Positive Theory Applied to the Case of YOU Foundation in Nepal

Authors: Simone Rondelli, Damiano Rondelli, Bishesh Poudyal, Juan Jose Cabrera-Lazarini

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One of the main obstacles for Social Entrepreneurship is to find a business model that is financially sustainable. In other words, the captured value generates enough cash flow to ensure business continuity and reinvestment for growth. Providing Health Services in poor countries for the uninsured population affected by a high-cost chronical disease is not the exception for this challenge. As a prime example, cancer has become a high impact on a global disease not only because of the high morbidity but also of the financial impact on both the patient family and health services in underdeveloped countries. Therefore, it is relevant to find a Social Entrepreneurship Model that provides affordable treatment for this disease while maintaining healthy finances not only for the patient but also for the organization providing the treatment. Using the methodology of Constructive Research, this paper applied a Positive Theory and four business models of Social Entrepreneurship to a case of a Private Foundation model whose mission is to address the challenge previously described. It was found that the Foundation analyzed, in this case, is organized as an Embedded Business Model and complies with the four propositions of the Positive Theory considered. It is recommended for this Private Foundation to explore implementing the Integrated Business Model to ensure more robust sustainability in the long term. It evolves as a scalable model that can attract investors interested in contributing to expanding this initiative globally.

Keywords: affordable treatment, global healthcare, social entrepreneurship theory, sustainable business model

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11156 The Bespoke ‘Hybrid Virtual Fracture Clinic’ during the COVID-19 Pandemic: A Paradigm Shift?

Authors: Anirudh Sharma

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Introduction: The Covid-19 pandemic necessitated a change in the manner outpatient fracture clinics are conducted due to the need to reduce footfall in hospital. While studies regarding virtual fracture clinics have shown these to be useful and effective, they focus exclusively on remote consultations. However, our service was bespoke to the patient – either a face-to-face or telephone consultation depending on patient need – a ‘hybrid virtual clinic (HVC).’ We report patient satisfaction and outcomes with this novel service. Methods: Patients booked onto our fracture clinics during the first 2 weeks of national lockdown were retrospectively contacted to assess the mode of consultations (virtual, face-to-face, or hybrid), patient experience, and outcome. Patient experience was assessed using the net promoter (NPS), customer effort (CES) and customer satisfaction scores (CSS), and their likelihood of using the HVC in the absence of a pandemic. Patient outcomes were assessed using the components of the EQ5D score. Results: Of 269 possible patients, 140 patients responded to the questionnaire. Of these, 66.4% had ‘hybrid’ consultations, 27.1% had only virtual consultations, and 6.4% had only face-to-face consultations. The mean overall NPS, CES, and CSS (on a scale of 1-10) were 7.27, 7.25, and 7.37, respectively. The mean likelihood of patients using the HVC in the absence of a pandemic was 6.5/10. Patients who had ‘hybrid’ consultations showed better effort scores and greater overall satisfaction than those with virtual consultations only and also reported superior EQ5D outcomes (mean 79.27 vs. 72.7). Patients who did not require surgery reported increased satisfaction (mean 7.51 vs. 7.08) and were more likely to use the HVC in the absence of a pandemic. Conclusion: Our study indicates that a bespoke HVC has good overall patient satisfaction and outcomes and is a better format of fracture clinic service than virtual consultations alone. It may be the preferred mode for fracture clinics in similar situations in the future. Further analysis needs to be conducted in order to explore the impact on resources and clinician experience of HVC in order to appreciate this new paradigm shift.

Keywords: hybrid virtual clinic, coronavirus, COVID-19, fracture clinic, remote consultation

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11155 Refining Waste Spent Hydroprocessing Catalyst and Their Metal Recovery

Authors: Meena Marafi, Mohan S. Rana

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Catalysts play an important role in producing valuable fuel products in petroleum refining; but, due to feedstock’s impurities catalyst gets deactivated with carbon and metal deposition. The disposal of spent catalyst falls under the category of hazardous industrial waste that requires strict agreement with environmental regulations. The spent hydroprocessing catalyst contains Mo, V and Ni at high concentrations that have been found to be economically significant for recovery. Metal recovery process includes deoiling, decoking, grinding, dissolving and treatment with complexing leaching agent such as ethylene diamine tetra acetic acid (EDTA). The process conditions have been optimized as a function of time, temperature and EDTA concentration in presence of ultrasonic agitation. The results indicated that optimum condition established through this approach could recover 97%, 94% and 95% of the extracted Mo, V and Ni, respectively, while 95% EDTA was recovered after acid treatment.

Keywords: atmospheric residue desulfurization (ARDS), deactivation, hydrotreating, spent catalyst

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11154 Short Term Tests on Performance Evaluation of Water-Washed and Dry-Washed Biodiesel from Used Cooking Oil

Authors: Shumani Ramuhaheli, Christopher C. Enweremadu, Hilary L. Rutto

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In this study, biodiesel from used cooking oil was produced as purified by washing with water (water wash) and amberlite (dry wash). The work presents the results of short term tests on performance characteristics of diesel engine using both biodiesel-fuel samples. In this investigation, the water wash biodiesel and dry wash biodiesel and diesel were compared for performance using a four-cylinder diesel engine. The torque, brake power, specific fuel consumption and brake thermal efficiency were analyzed. The tests showed that in all cases, dry wash biodiesel performed marginally poorer compared to water wash biodiesel. Except for brake thermal efficiency, diesel fuel had better engine performance characteristics compared to the biodiesel-fuel samples. According to these results, dry washing of biodiesel has a marginal effect on engine performance.

Keywords: biodiesel, engine performance, used cooking oil, water wash, dry wash

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11153 Adopting Precast Insulated Concrete Panels for Building Envelope in Hot Climate Zones

Authors: Mohammed Sherzad

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The absorbedness of solar radiation within the concrete building is higher than other buildings type, especially in hot climate zones. However, one of the primary issues of architects and the owners in hot climate zones is the building’s exterior plastered and painted finishing which is commonly used are fading and peeling adding a high cost on maintenance. Case studies of different exterior finishing’ treatments used in vernacular and contemporary dwellings in the United Arab Emirates were surveyed. The traditional plastered façade treatment was more sustainable than new buildings. In addition, using precast concrete insulated sandwich panels with the exposed colored aggregate surface in contemporary designed dwellings sustained the extensive heat reducing the overall cost of maintenance and contributed aesthetically to the buildings’ envelope in addition to its thermal insulation property.

Keywords: precast concrete panels, façade treatment, hot climate

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11152 Mental Disorders and Physical Illness in Geriatric Population

Authors: Vinay Kumar, M. Kishor, Sathyanarayana Rao Ts

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Background: Growth of elderly people in the general population in recent years is termed as ‘greying of the world’ where there is a shift from high mortality & fertility to low mortality and fertility, resulting in an increased proportion of older people as seen in India. Improved health care promises longevity but socio-economic factors like poverty, joint families and poor services pose a psychological threat. Epidemiological data regarding the prevalence of mental disorders in geriatric population with physical illness is required for proper health planning. Methods: Sixty consecutive elderly patients aged 60 years or above of both sexes, reporting with physical illness to general outpatient registration counter of JSS Medical College and Hospital, Mysore, India, were considered for the Study. With informed consent, they were screened with General Health Questionnaire (GHQ-12) and were further evaluated for diagnosing mental disorders according to WHO International Classification of Diseases (ICD-10) criteria. Results: Mental disorders were detected in 48.3%, predominantly depressive disorders, nicotine dependence, generalized anxiety disorder, alcohol dependence and least was dementia. Most common physical illness was cardiovascular disease followed by metabolic, respiratory and other diseases. Depressive disorders, substance dependence and dementia were more associated with cardiovascular disease compared to metabolic disease and respiratory diseases were more associated with nicotine dependence. Conclusions: Depression and Substance use disorders among elderly population is of concern, which needs to be further studied with larger population. Psychiatric morbidity will adversely have an impact on physical illness which needs proper assessment and management. This will enhance our understanding and prioritize our planning for future.

Keywords: Geriatric, mental disorders, physical illness, psychiatry

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11151 Maximum Power Point Tracking for Small Scale Wind Turbine Using Multilayer Perceptron Neural Network Implementation without Mechanical Sensor

Authors: Piyangkun Kukutapan, Siridech Boonsang

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The article proposes maximum power point tracking without mechanical sensor using Multilayer Perceptron Neural Network (MLPNN). The aim of article is to reduce the cost and complexity but still retain efficiency. The experimental is that duty cycle is generated maximum power, if it has suitable qualification. The measured data from DC generator, voltage (V), current (I), power (P), turnover rate of power (dP), and turnover rate of voltage (dV) are used as input for MLPNN model. The output of this model is duty cycle for driving the converter. The experiment implemented using Arduino Uno board. This diagram is compared to MPPT using MLPNN and P&O control (Perturbation and Observation control). The experimental results show that the proposed MLPNN based approach is more efficiency than P&O algorithm for this application.

Keywords: maximum power point tracking, multilayer perceptron netural network, optimal duty cycle, DC generator

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11150 Maintenance Wrench Time Improvement Project

Authors: Awadh O. Al-Anazi

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As part of the organizational needs toward successful maintaining activities, a proper management system need to be put in place, ensuring the effectiveness of maintenance activities. The management system shall clearly describes the process of identifying, prioritizing, planning, scheduling, execution, and providing valuable feedback for all maintenance activities. Completion and accuracy of the system with proper implementation shall provide the organization with a strong platform for effective maintenance activities that are resulted in efficient outcomes toward business success. The purpose of this research was to introduce a practical tool for measuring the maintenance efficiency level within Saudi organizations. A comprehensive study was launched across many maintenance professionals throughout Saudi leading organizations. The study covered five main categories: work process, identification, planning and scheduling, execution, and performance monitoring. Each category was evaluated across many dimensions to determine its current effectiveness through a five-level scale from 'process is not there' to 'mature implementation'. Wide participation was received, responses were analyzed, and the study was concluded by highlighting major gaps and improvement opportunities within Saudi organizations. One effective implementation of the efficiency enhancement efforts was deployed in Saudi Kayan (one of Sabic affiliates). Below details describes the project outcomes: SK overall maintenance wrench time was measured at 20% (on average) from the total daily working time. The assessment indicates the appearance of several organizational gaps, such as a high amount of reactive work, poor coordination and teamwork, Unclear roles and responsibilities, as well as underutilization of resources. Multidiscipline team was assigned to design and implement an appropriate work process that is capable to govern the execution process, improve the maintenance workforce efficiency, and maximize wrench time (targeting > 50%). The enhanced work process was introduced through brainstorming and wide benchmarking, incorporated with a proper change management plan and leadership sponsorship. The project was completed in 2018. Achieved Results: SK WT was improved to 50%, which resulted in 1) reducing the Average Notification completion time. 2) reducing maintenance expenses on OT and manpower support (3.6 MSAR Actual Saving from Budget within 6 months).

Keywords: efficiency, enhancement, maintenance, work force, wrench time

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11149 Effects of Corruption and Logistics Performance Inefficiencies on Container Throughput: The Latin America Case

Authors: Fernando Seabra, Giulia P. Flores, Karolina C. Gomes

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Trade liberalizations measures, as import tariff cuts, are not a sufficient trigger for trade growth. Given that price margins are narrow, traders and cargo operators tend to opt out of markets where the process of goods clearance is slow and costly. Excess paperwork and slow customs dispatch not only lead to institutional breakdowns and corruption but also to increasing transaction cost and trade constraints. The objective of this paper is, therefore, two-fold: First, to evaluate the relationship between institutional and infrastructural performance indexes and trade growth in container throughput; and, second, to investigate the causes for differences in container demurrage and detention fees in Latin American countries (using other emerging countries as benchmarking). The analysis is focused on manufactured goods, typically transported by containers. Institutional and infrastructure bottlenecks and, therefore, the country logistics efficiency – measured by the Logistics Performance Index (LPI, World Bank-WB) – are compared with other indexes, such as the Doing Business index (WB) and the Corruption Perception Index (Transparency International). The main results based on the comparison between Latin American countries and the others emerging countries point out in that the growth in containers trade is directly related to LPI performance. It has also been found that the main hypothesis is valid as aspects that more specifically identify trade facilitation and corruption are significant drivers of logistics performance. The exam of port efficiency (demurrage and detention fees) has demonstrated that not necessarily higher level of efficiency is related to lower charges; however, reductions in fees have been more significant within non-Latin American emerging countries.

Keywords: corruption, logistics performance index, container throughput, Latin America

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11148 Batch Adsorption Studies for the Removal of Textile Dyes from Aqueous Solution on Three Different Pine Bark

Authors: B. Cheknane, F. Zermane

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The main objective of the present study is the valorization of natural raw materials of plant origin for the treatment of textile industry wastewater. Selected bark was: maritime (MP), pinyon (PP) and Aleppo pine (AP) bark. The efficiency of these barks were tested for the removal of three dye; rhodamine B (RhB), Green Malachite (GM) and X Methyl Orange (MO). At the first time we focus to study the different parameters which can influence the adsorption processes such as: nature of the adsorbents, nature of the pollutants (dyes) and the effect of pH. Obtained results reveals that the speed adsorption is strongly influencing by the pH medium and the comparative study show that adsorption is favorable in the acidic medium with amount adsorbed of (Q=40mg/g) for rhodamine B and (Q=46mg/g) for orange methyl. Results of adsorption kinetics reveals that the molecules of GM are adsorbed better (Q=48mg/g) than the molecules of RhB (Q=46mg/g) and methyl orange (Q=18mg/g), with equilibrium time of 6 hours. The results of adsorption isotherms show clearly that the maritime pine bark is the most effective adsorbents with adsorbed amount of (QRhB=200mg/g) and (QMO=88mg/g) followed by pinyon pine (PP) with (QRhB=184mg/g) and (QMO=56mg/g) and finally Aleppo pine (AP) bark with (QRhB=131mg/g) and (QMO= 46mg/g). The different obtained isotherms were modeled using the Langmuir and Freundlich models and according to the adjustment coefficient values R2, the obtained isotherms are well represented by Freundlich model.

Keywords: maritime pine bark (MP), pinyon pine bark (PP), Aleppo pine (AP) bark, adsorption, dyes

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11147 Observation of the Orthodontic Tooth's Long-Term Movement Using Stereovision System

Authors: Hao-Yuan Tseng, Chuan-Yang Chang, Ying-Hui Chen, Sheng-Che Chen, Chih-Han Chang

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Orthodontic tooth treatment has demonstrated a high success rate in clinical studies. It has been agreed upon that orthodontic tooth movement is based on the ability of surrounding bone and periodontal ligament (PDL) to react to a mechanical stimulus with remodeling processes. However, the mechanism of the tooth movement is still unclear. Recent studies focus on the simple principle compression-tension theory while rare studies directly measure tooth movement. Therefore, tracking tooth movement information during orthodontic treatment is very important in clinical practice. The aim of this study is to investigate the mechanism responses of the tooth movement during the orthodontic treatments. A stereovision system applied to track the tooth movement of the patient with the stamp brackets. The system was established by two cameras with their relative position calibrate. And the orthodontic force measured by 3D printing model with the six-axis load cell to determine the initial force application. The result shows that the stereovision system accuracy revealed the measurement presents a maximum error less than 2%. For the study on patient tracking, the incisor moved about 0.9 mm during 60 days tracking, and half of movement occurred in the first few hours. After removing the orthodontic force in 100 hours, the distance between before and after position incisor tooth decrease 0.5 mm consisted with the release of the phenomenon. Using the stereovision system can accurately locate the three-dimensional position of the teeth and superposition of 3D coordinate system for all the data to integrate the complex tooth movement.

Keywords: orthodontic treatment, tooth movement, stereovision system, long-term tracking

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11146 A Policy Strategy for Building Energy Data Management in India

Authors: Shravani Itkelwar, Deepak Tewari, Bhaskar Natarajan

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The energy consumption data plays a vital role in energy efficiency policy design, implementation, and impact assessment. Any demand-side energy management intervention's success relies on the availability of accurate, comprehensive, granular, and up-to-date data on energy consumption. The Building sector, including residential and commercial, is one of the largest consumers of energy in India after the Industrial sector. With economic growth and increasing urbanization, the building sector is projected to grow at an unprecedented rate, resulting in a 5.6 times escalation in energy consumption till 2047 compared to 2017. Therefore, energy efficiency interventions will play a vital role in decoupling the floor area growth and associated energy demand, thereby increasing the need for robust data. In India, multiple institutions are involved in the collection and dissemination of data. This paper focuses on energy consumption data management in the building sector in India for both residential and commercial segments. It evaluates the robustness of data available through administrative and survey routes to estimate the key performance indicators and identify critical data gaps for making informed decisions. The paper explores several issues in the data, such as lack of comprehensiveness, non-availability of disaggregated data, the discrepancy in different data sources, inconsistent building categorization, and others. The identified data gaps are justified with appropriate examples. Moreover, the paper prioritizes required data in order of relevance to policymaking and groups it into "available," "easy to get," and "hard to get" categories. The paper concludes with recommendations to address the data gaps by leveraging digital initiatives, strengthening institutional capacity, institutionalizing exclusive building energy surveys, and standardization of building categorization, among others, to strengthen the management of building sector energy consumption data.

Keywords: energy data, energy policy, energy efficiency, buildings

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11145 Advanced Digital Manufacturing: Case Study

Authors: Abdelrahman Abdelazim

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Most industries are looking for technologies that are easy to use, efficient and fast to accomplish. To implement these, factories tend to use advanced systems that could alter complicity to simplicity and rudimentary to advancement. Cloud Manufacturing is a new movement that aims to mirror and integrate cloud computing into manufacturing. Amongst cloud manufacturing various advantages are decreasing the human involvements and increasing the dependency on automated machines, which in turns decreases human errors and increases efficiency. A reliable and extraordinary performance processes with minimum errors are highly desired factors of today’s manufacturers. At the glance it seems to be the best alternative, however, the implementation of a cloud system can be very challenging. This work investigates cloud manufacturing in details, it outlines its advantages and disadvantages by converting a local factory in Kuwait to a cloud-ready system. Initially the flow of the factory’s manufacturing process has been analyzed identifying the bottlenecks and illustrating how cloud manufacturing can eliminate them. Following this an automation process has been analyzed and implemented. A comparison between the process before and after the adaptation has been carried out showing the effects on the cost, the output and the efficiency of the process.

Keywords: cloud manufacturing, automation, Kuwait industrial sector, advanced digital manufacturing

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11144 Hybrid Deep Learning and FAST-BRISK 3D Object Detection Technique for Bin-Picking Application

Authors: Thanakrit Taweesoontorn, Sarucha Yanyong, Poom Konghuayrob

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Robotic arms have gained popularity in various industries due to their accuracy and efficiency. This research proposes a method for bin-picking tasks using the Cobot, combining the YOLOv5 CNNs model for object detection and pose estimation with traditional feature detection (FAST), feature description (BRISK), and matching algorithms. By integrating these algorithms and utilizing a small-scale depth sensor camera for capturing depth and color images, the system achieves real-time object detection and accurate pose estimation, enabling the robotic arm to pick objects correctly in both position and orientation. Furthermore, the proposed method is implemented within the ROS framework to provide a seamless platform for robotic control and integration. This integration of robotics, cameras, and AI technology contributes to the development of industrial robotics, opening up new possibilities for automating challenging tasks and improving overall operational efficiency.

Keywords: robotic vision, image processing, applications of robotics, artificial intelligent

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11143 Preparation and Characterization of Poly (ε-caprolactone) Loaded with Layered Double Hydroxide Nanohybrid Intercalated with Alendronate for Osteoporosis Treatment

Authors: Seyedeh Faranak Baniahmad, Soroor Yousefi

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Osteoporosis is a bone disease which increases the bone fracture risk, reduces the bone mineral density (BMD) and alters the amount and variety of proteins in bones. Antiresorptive therapy is one the most popular Osteoporosis treatment methods. In this method the bisphosphonates, hormones, calcitonin or the selective estrogen receptor modulators is replaced. In order to reduce undesirable effects and to increase the bioavailability of drug agents, the controlled drug delivery systems have been utilized. In current study, the controlled release of Alendronate from LDH-PCL with (0, 5, 10, 15 % wt. of LDH) was investigated. The results showed that the release of alendronate from the lamellar LDH incorporated into the PCL matrix is much slower than the release of alendronate from the PCL. Therefore such systems are very promising, in which the antiresorptive drug has to remain in the matrix for longer time and can be released in controlled manner.

Keywords: osteoporosis, alendronate, poly (ε–caprolactone), layered double hydroxide

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11142 Cost-Conscious Treatment of Basal Cell Carcinoma

Authors: Palak V. Patel, Jessica Pixley, Steven R. Feldman

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Introduction: Basal cell carcinoma (BCC) is the most common skin cancer worldwide and requires substantial resources to treat. When choosing between indicated therapies, providers consider their associated adverse effects, efficacy, cosmesis, and function preservation. The patient’s tumor burden, infiltrative risk, and risk of tumor recurrence are also considered. Treatment cost is often left out of these discussions. This can lead to financial toxicity, which describes the harm and quality of life reductions inflicted by high care costs. Methods: We studied the guidelines set forth by the American Academy of Dermatology for the treatment of BCC. A PubMed literature search was conducted to identify the costs of each recommended therapy. We discuss costs alongside treatment efficacy and side-effect profile. Results: Surgical treatment for BCC can be cost-effective if the appropriate treatment is selected for the presenting tumor. Curettage and electrodesiccation can be used in low-grade, low-recurrence tumors in aesthetically unimportant areas. The benefits of cost-conscious care are not likely to be outweighed by the risks of poor cosmesis or tumor return ($471 BCC of the cheek). When tumor burden is limited, MMS offers better cure rates and lower recurrence rates than surgical excision, and with comparable costs (MMS $1263; SE $949). Surgical excision with permanent sections may be indicated when tumor burden is more extensive or if molecular testing is necessary. The utility of surgical excision with frozen sections, which costs substantially more than MMS without comparable outcomes, is less clear (SE with frozen sections $2334-$3085). Less data exists on non-surgical treatments for BCC. These techniques cost less, but recurrence-risk is high. Side-effects of nonsurgical treatment are limited to local skin reactions, and cosmesis is good. Cryotherapy, 5-FU, and MAL-PDT are all more affordable than surgery, but high recurrence rates increase risk of secondary financial and psychosocial burden (recurrence rates 21-39%; cost $100-270). Radiation therapy offers better clearance rates than other nonsurgical treatments but is associated with similar recurrence rates and a significantly larger financial burden ($2591-$3460 BCC of the cheek). Treatments for advanced or metastatic BCC are extremely costly, but few patients require their use, and the societal cost burden remains low. Vismodegib and sonidegib have good response rates but substantial side effects, and therapy should be combined with multidisciplinary care and palliative measures. Expert-review has found sonidegib to be the less expensive and more efficacious option (vismodegib $128,358; sonidegib $122,579). Platinum therapy, while not FDA-approved, is also effective but expensive (~91,435). Immunotherapy offers a new line of treatment in patients intolerant of hedgehog inhibitors ($683,061). Conclusion: Dermatologists working within resource-compressed practices and with resource-limited patients must prudently manage the healthcare dollar. Surgical therapies for BCC offer the lowest risk of recurrence at the most reasonable cost. Non-surgical therapies are more affordable, but high recurrence rates increase the risk of secondary financial and psychosocial burdens. Treatments for advanced BCC are incredibly costly, but the low incidence means the overall cost to the system is low.

Keywords: nonmelanoma skin cancer, basal cell skin cancer, squamous cell skin cancer, cost of care

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11141 Study on the Effect Cabbage (Brassica oleracea) and Ginger (Zingiber officinale) Extracts on Rat Liver Injuries Induced by Carbon tetrachloride (CCl4)

Authors: Asmaa F. Hamouda, Randa M Shrourou

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Cabbage (Brassica oleracea) and Ginger (Zingiber officinale) constitute apportion of regular human diet. The effect of Cabbage(CE) and Ginger extracts(GE) separately on liver nitric oxide (NO), malondialdehyde (MDA), as well as serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin, total cholesterol(TC), triglyceride(T.G), high density lipoprotein(HDL cholesterol), low density lipoprotein (LDL cholesterol), thyroid-stimulating hormone (TSH), Triiodothyronine (T3), Thyroxine (T4) in rats treated and untreated with carbon tetrachloride (CCl4) was studied. The levels of NO, MDA, as well as serum AST, ALT, total bilirubin, TC, T.G, LDLand TSH showed an elevation and decline in HDL, T3, and T4 in rats treated with CCl4 as compared to control. Treatment of rats with GE pre, during, and post CCl4 administration improved NO, MDA, as well as serum AST, ALT, total bilirubin, TC, T.G, HDL, LDL, TSH, T3, T4 as compared to CCl4, indicates that GE improve thyroid function and reduced oxidative stress as well as injuries induced by CCl4. Treatment of rats with CE pre, during, and post CCl4 administration did not improved in the thyroid hormones and lipid profile levels as compared to CCl4. These findings suggest that ginger treatment exerts a protective effect on metabolic disorders by decreasing oxidative stress.

Keywords: liver injuries, carbon tetrachloride (CCl4), cabbage (Brassica oleracea), ginger (Zingiber officinale), thyroid function

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11140 Dental Implant Survival in Patients with Osteoporosis

Authors: Mohammad ASadian, Samira RajiAsadabadi

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Osteoporosis is very common, particularly in post-menopausal women and is characterized by a decrease in bone mass and strength. Osteoporosis also affects the jawbone and it is considered a potential contraindication to the placement of dental implants. The present paper reviews the literature regarding the effect of osteoporosis on the osseointegration of implants. Experimental models have shown that osteoporosis affects the process of osseointegration, which can be reversed by treatment. However, studies in subjects with osteoporosis have shown no differences in the survival of the implants compared to healthy individuals. Therefore, osteoporosis cannot be considered a contraindication for implant placement. Oral bisphosphonates are the most commonly used pharmacological agents in the treatment of osteoporosis. Although there have been cases of osteonecrosis of the jaw in patients treated with bisphosphonates, they are very rare and it is more usually associated with intravenous bisphosphonates in patients with neoplasms or other serious diseases. Nevertheless, patients treated with bisphosphonates must be informed in writing about the possibility of this complication and must give informed consent. Ceasing to use of bisphosphonates before implant placement does not seem to be necessary.

Keywords: Osteoporosis, dental implant, bisphosphonates, survival

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11139 Limits of the Dot Counting Test: A Culturally Responsive Approach to Neuropsychological Evaluations and Treatment

Authors: Erin Curtis, Avraham Schwiger

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Neuropsychological testing and evaluation is a crucial step in providing patients with effective diagnoses and treatment while in clinical care. The variety of batteries used in these evaluations can help clinicians better understand the nuanced declivities in a patient’s cognitive, behavioral, or emotional functioning, consequently equipping clinicians with the insights to make intentional choices about a patient’s care. Despite the knowledge these batteries can yield, some aspects of neuropsychological testing remain largely inaccessible to certain patient groups as a result of fundamental cultural, educational, or social differences. One such battery includes the Dot Counting Test (DCT), during which patients are required to count a series of dots on a page as rapidly and accurately as possible. As the battery progresses, the dots appear in clusters that are designed to be easily multiplied. This task evaluates a patient’s cognitive functioning, attention, and level of effort exerted on the evaluation as a whole. However, there is evidence to suggest that certain social groups, particularly Latinx groups, may perform worse on this task as a result of cultural or educational differences, not reduced cognitive functioning or effort. As such, this battery fails to account for baseline differences among patient groups, thus creating questions surrounding the accuracy, generalizability, and value of its results. Accessibility and cultural sensitivity are critical considerations in the testing and treatment of marginalized groups, yet have been largely ignored in the literature and in clinical settings to date. Implications and improvements to applications are discussed.

Keywords: culture, latino, neuropsychological assessment, neuropsychology, accessibility

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11138 Targeting NLRP3 Inflammasome Activation: A New Mechanism Underlying the Protective Effects of Nafamostat Against Acute Pancreatitis

Authors: Jiandong Ren, Lijun Zhao, Peng Chen

Abstract:

Nafamostat (NA), a synthetic broad-spectrum serine protease inhibitor, has been routinely employed for the treatment of acute pancreatitis (AP) and other inflammatory-associated diseases in some East Asia countries. Although the potent inhibitory activity against inflammation-related proteases such as thrombin, trypsin, kallikrein, plasmin, coagulation factors and complement factors is generally considered to be responsible for the anti-inflammatory effects of NA, precise target and molecular mechanism underlying the anti-inflammatory activity in the treatment of AP remain largely unknown yet. As an intracellular inflammatory signaling platform, the NOD-like receptor protein 3 (NLRP3) inflammasome is recently identified to be involved in the development of AP. In present study, we have revealed that NA alleviated pancreatic injury in a caerulein-induced AP model by inhibiting the NLRP3 inflammasome activation in pancreas. Mechanistically, NA interacted with HDAC6, a cytoplasmic deacetylase implicated in the NLRP3 inflammasome pathway, and efficiently abrogated the function of HDAC6. This property enabled NA to influence HDAC6 dependent NF-κB transcriptional activity and thus block NF-κB-driven transcriptional priming of NLRP3 inflammasome. Moreover, NA exerted the potential to interfere HDAC6-mediated intracellular transport of NLRP3, thereby leading to the failure of NLRP3 inflammasome activation. Our current work has provided valuable insight into the molecular mechanism underlying the immunomodulatory effect of NA in treatment of AP, highlighting its promising application in prevention of NLRP3 inflammasome-associated inflammatory pathological damage.

Keywords: acute pancreatitis, HDAC6, nafamostat, NLRP3 inflammasome

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11137 Mindfulness, Acceptance and Meaning in Life for Adults with Cancer

Authors: Fernanda F. Zimmermann, Beverley Burrell, Jennifer Jordan

Abstract:

Introduction: Supportive care for people affected by cancer is recognised as a priority for research but yet there is little solid evidence of the effectiveness of psychological treatments for those with advanced cancer. The literature suggests that mindfulness-based interventions may be acceptable and beneficial for this population. This study aims to develop a mindfulness intervention to provide emotional support for advanced cancer population. The treatment package includes mindfulness meditation, developing an acceptance attitude and reflections on meaning in life. Methods: This study design is a one-group pre-post test with a mixed methods approach. Participants are recruited through public and private hospitals in Christchurch, NZ. Quantitative measures are the Acceptance and Action Questionnaire-II, Mindful Coping Scale and, the Meaning in Life Questionnaire. Qualitative semi-structured interviews enquire about emotional support before and after the diagnosis, participants’ thoughts about meaning in life, expectations and reflections on the mindfulness training. Qualitative data will be analysed using thematic analysis. Treatment consists of one to one 30 minutes session weekly for 4 weeks using a pre-recorded CD/podcast of the mindfulness training. This research is part of the presenter’s PhD study. Findings: This project is currently underway. The presenter will provide preliminary data on the acceptability of the mindfulness training package being delivered to participants along with the recruitment strategies. We anticipate that this novel treatment used as a self-management tool will reduce psychological distress and enable better coping for patients with advanced cancer.

Keywords: acceptance, cancer, meaning in life, mindfulness

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11136 Tehran Province Water and Wastewater Company Approach on Energy Efficiency by the Development of Renewable Energy to Achieving the Sustainable Development Legal Principle

Authors: Mohammad Parvaresh, Mahdi Babaee, Bahareh Arghand, Roushanak Fahimi Hanzaee, Davood Nourmohammadi

Abstract:

Today, the intelligent network of water and wastewater as one of the key steps in realizing the smart city in the world. Use of pressure relief valves in urban water networks in order to reduce the pressure is necessary in Tehran city. But use these pressure relief valves lead to waste water, more power consumption, and environmental pollution because Tehran Province Water and Wastewater Co. use a quarter of industry 's electricity. In this regard, Tehran Province Water and Wastewater Co. identified solutions to reduce direct and indirect costs in energy use in the process of production, transmission and distribution of water because this company has extensive facilities and high capacity to realize green economy and industry. The aim of this study is to analyze the new project in water and wastewater industry to reach sustainable development.

Keywords: Tehran Province Water and Wastewater Company, water network efficiency, sustainable development, International Environmental Law

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11135 Reliability of Social Support Measurement Modification of the BC-SSAS among Women with Breast Cancer Who Undergone Chemotherapy in Selected Hospital, Central Java, Indonesia

Authors: R. R. Dewi Rahmawaty Aktyani Putri, Earmporn Thongkrajai, Dedy Purwito

Abstract:

There were many instruments have been developed to assess social support which has the different dimension in breast cancer patients. The Issue of measurement is a challenge to determining the component of dimensional concept, defining the unit of measurement, and establishing the validity and reliability of the measurement. However, the instruments where need to know how much support which obtained and perceived among women with breast cancer who undergone chemotherapy which it can help nurses to prevent of non-adherence in chemotherapy. This study aimed to measure the reliability of BC-SSAS instrument among 30 Indonesian women with breast cancer aged 18 years and above who undergone chemotherapy for six cycles in the oncological unit of Outpatient Department (OPD), Margono Soekardjo Hospital, Central Java, Indonesia. Data were collected during October to December 2015 by using modified the Breast Cancer Social Support Assessment (BC-SSAS). The Cronbach’s alpha analysis was carried out to measure internal consistency for reliability test of BC-SSAS instrument. This study used five experts for content validity index. The results showed that for content validity, I-CVI was 0.98 and S-CVI was 0.98; Cronbach’s alpha value was 0.971 and the Cronbach’s alpha coefficients for the subscales were high, with 0.903 for emotional support, 0.865 for informational support, 0.901 for tangible support, 0.897 for appraisal support and 0.884 for positive interaction support. The results confirmed that the BC-SSAS instrument has high reliability. BC-SSAS instruments were reliable and can be used in health care services to measure the social support received and perceived among women with breast cancer who undergone chemotherapy so that preventive interventions can be developed and the quality of health services can be improved.

Keywords: BC-SSAS, women with breast cancer, chemotherapy, Indonesia

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11134 The Study of Visible Light Active Bismuth Modified Nitrogen Doped Titanium Dioxide Photocatlysts

Authors: B. Benalioua, I. Benyamina, A. Bentouami, B. Boury

Abstract:

The objective of this study is based on the synthesis of a new photocatalyst based on TiO2 and its application in the photo-degradation of an acid dye under the visible light. The material obtained was characterized by different techniques like diffuse reflectance UV–Vis spectroscopy (DRS), X-ray diffraction (XRD) and scanning electron microscopy (SEM). The photocatalytic efficiency of the Bi, N co-doped TiO2 treated at 600°C for 1 h was tested on the Indigo Carmine under the irradiation of visible light and compared with that of the commercial titanium oxide TiO2-P25 (Degussa). The XRD characterization of the material Bi -N- TiO2 (600°C) revealed the presence of the anatase phase and the absence of the rutile phase in comparison of the TiO2 P25 diffractogram. Characterization by UV- visible diffuse reflection (DRS) material showed that the Bi-N-TiO2 exhibits redshift (move visible) relative to commercial titanium oxide TiO2-P25, this property promises a photocatalytic activity of Bi-N-TiO2 under visible light. Indeed, the efficiency of photocatalytic Bi-N-TiO2 as a visible light is shown by a complete discoloration of indigo carmine solution of 16 mg/L after 40 minutes, whereas with the P25-TiO2 discoloration is achieved after 90 minutes.

Keywords: POA, heterogeneous photocatalysis, TiO2, co-doping

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11133 The Impact of Motor Predispositions of Pilot-Cadets on Results in Aviation Synthetic Efficiency Test

Authors: Zbigniew Wochynski, Justyna Skrzynska, Robert Jedrys, Zdzislaw Kobos

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The aim of the study is to determine the types of motor skills and their impact on achieving results while undergoing Aviation Synthetic Efficiency Test (ASET). The study involved 59 cadets, 21 years-old on average, who are studying on first year for a pilot. The average weight of the respondents is 73.8 kg. The subjects were divided into two groups by weight: up to 73.8 kg -group A (n-30) and above 73,8kg -group B (n-29). All subjects underwent the following tests: running at 40m, 100m, 1000m, 2000m, pull-ups, ASET. In both groups, the cadets were divided into two motor skills types taking into advance 40 m running, pull-ups, 2000 meters running and then subjected to do ASET. There has been shown statistically significant increase in group B in body height, weight and BMI with p <0.0003, p <0.0001, p <0.0001 compared to group A. The results indicate that the dominant motor type in all subjects is the endurance-strength model, which reached the speed V = 1,42m/s in overcoming ASET. This is confirmed by the correlation between 2000m and pull-ups r = 0.37 (p <0.05). In group A, the results indicate that the dominant type of motor is a high-speed-endurance model (26.6%), which reached speed V = 1,42m/s in overcoming ASET. In Group B, there was type of motor speed-strength (20.6%), which reached speed of V = 1.45m/s in overcoming ASET. This confirms the correlation between ASET and pull-ups r = 0.56 (p <0.005). Examined cadets who were having one dominant characteristic achieved worse results is ASET. The best results from all examined cadets in overcoming ASET had the type of motor endurance-strength, in group A endurance-speed model and in group B type of speed-strength

Keywords: ASET, Aviation Synthetic Efficiency Test, motor skills, physical tests, pilot-cadets

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11132 The Maps of Meaning (MoM) Consciousness Theory

Authors: Scott Andersen

Abstract:

Perhaps simply and rather unadornedly, consciousness is having multiple goals for action and the continuously adjudication of such goals to implement action, referred to as the Maps of Meaning (MoM) Consciousness Theory. The MoM theory triangulates through three parallel corollaries, action (behavior), mechanism (morphology/pathophysiology), and goals (teleology). (1) An organism’s consciousness contains a fluid, nested goals. These goals are not intentionality, but intersectionality, embodiment meeting the world. i.e., Darwinian inclusive fitness or randomization, then survival of the fittest. These goals form via gradual descent under inclusive fitness, the goals being the abstraction of a ‘match’ between the evolutionary environment and organism. Human consciousness implements the brain efficiency hypothesis, genetics, epigenetics, and experience crystallize efficiencies, not necessitating best or objective but fitness, i.e., perceived efficiency based on one’s adaptive environment. These efficiencies are objectively arbitrary, but determine the operation and level of one’s consciousness, termed extreme thrownness. Since inclusive fitness drives efficiencies in physiologic mechanism, morphology and behavior (action) and originates one’s goals, embodiment is necessarily entangled to human consciousness as its the intersection of mechanism or action (both necessitating embodiment) occurring in the world that determines fitness. Perception is the operant process of consciousness and is the consciousness’ de facto goal adjudication process. Goal operationalization is fundamentally efficiency-based via one’s unique neuronal mapping as a byproduct of genetics, epigenetics, and experience. Perception involves information intake and information discrimination, equally underpinned by efficiencies of inclusive fitness via extreme thrownness. Perception isn’t a ‘frame rate,’ but Bayesian priors of efficiency based on one’s extreme thrownness. Consciousness and human consciousness is a modular (i.e., a scalar level of richness, which builds up like building blocks) and dimensionalized (i.e., cognitive abilities become possibilities as emergent phenomena at various modularities, like stratified factors in factor analysis). The meta dimensions of human consciousness seemingly include intelligence quotient, personality (five-factor model), richness of perception intake, and richness of perception discrimination, among other potentialities. Future consciousness research should utilize factor analysis to parse modularities and dimensions of human consciousness and animal models.

Keywords: consciousness, perception, prospection, embodiment

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11131 Estimation of Greenhouse Gas (GHG) Reductions from Solar Cell Technology Using Bottom-up Approach and Scenario Analysis in South Korea

Authors: Jaehyung Jung, Kiman Kim, Heesang Eum

Abstract:

Solar cell is one of the main technologies to reduce greenhouse gas (GHG). Thereby, accurate estimation of greenhouse gas reduction by solar cell technology is crucial to consider strategic applications of the solar cell. The bottom-up approach using operating data such as operation time and efficiency is one of the methodologies to improve the accuracy of the estimation. In this study, alternative GHG reductions from solar cell technology were estimated by a bottom-up approach to indirect emission source (scope 2) in Korea, 2015. In addition, the scenario-based analysis was conducted to assess the effect of technological change with respect to efficiency improvement and rate of operation. In order to estimate GHG reductions from solar cell activities in operating condition levels, methodologies were derived from 2006 IPCC guidelines for national greenhouse gas inventories and guidelines for local government greenhouse inventories published in Korea, 2016. Indirect emission factors for electricity were obtained from Korea Power Exchange (KPX) in 2011. As a result, the annual alternative GHG reductions were estimated as 21,504 tonCO2eq, and the annual average value was 1,536 tonCO2eq per each solar cell technology. Those results of estimation showed to be 91% levels versus design of capacity. Estimation of individual greenhouse gases (GHGs) showed that the largest gas was carbon dioxide (CO2), of which up to 99% of the total individual greenhouse gases. The annual average GHG reductions from solar cell per year and unit installed capacity (MW) were estimated as 556 tonCO2eq/yr•MW. Scenario analysis of efficiency improvement by 5%, 10%, 15% increased as much as approximately 30, 61, 91%, respectively, and rate of operation as 100% increased 4% of the annual GHG reductions.

Keywords: bottom-up approach, greenhouse gas (GHG), reduction, scenario, solar cell

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