Search results for: advance%20technology
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 644

Search results for: advance%20technology

254 Efficacy of Light-Emitting Diode-Mediated Photobiomodulation in Tendon Healing in a Murine Model

Authors: Sukwoong Kang

Abstract:

Background: The application of light-emitting diode (LED)-dependent photobiomodulation (PBM) in promoting post-tendon injury healing has been recently reported. Despite the establishment of a theoretical basis for ligament restoration through PBM, the lack of any empirical evidence deems this therapeutic strategy contentious. Therefore, the aim of this study was to investigate the potency of LED-based PBM in facilitating tendon healing in a murine model. Methods: Migration kinetics were analyzed at two specific wavelengths: 630 and 880 nm. The Achilles tendon in the hind limbs of Balb/c mice was severed via Achilles tendon transection. Subsequently, the mice were randomized into LED non-irradiation and LED irradiation groups. Mice with intact tendons were employed as healthy controls. The wounds were LED-irradiated for 20 min daily for two days. Histological properties, tendon healing mediators, and inflammatory mediators were screened on day 14. Results: The roundness of the nuclei and fiber structure, indicating the degree of infiltrated inflammatory cells and severity of fiber fragmentation, respectively, were considerably lower in the LED irradiation group than in the LED non-irradiation group. Immunohistochemical analysis depicted an increase in tenocytes (SCX+ cells) and a recovery of wounds with reduced fibrosis (lower collagen 3 and TGF-β1) in the LED irradiation group during healing; conversely, the LED non-irradiation group exhibited tissue fibrosis. The ratio of M2 macrophages to total macrophages was higher in the LED irradiation group than in the injured group. Conclusion: LED-based PBM in the Achilles tendon rupture murine model effectuated a rapid restoration of histological and immunochemical outcomes. The aforementioned findings suggest that LED-based PBM presents remarkable potential as an adjunct therapeutic for tendon healing and warrants further research to standardize various parameters to advance and establish it as a reliable treatment regime.

Keywords: photobiomodulation, light-emitting diode, tendon, regeneration

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253 Short Text Classification Using Part of Speech Feature to Analyze Students' Feedback of Assessment Components

Authors: Zainab Mutlaq Ibrahim, Mohamed Bader-El-Den, Mihaela Cocea

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Students' textual feedback can hold unique patterns and useful information about learning process, it can hold information about advantages and disadvantages of teaching methods, assessment components, facilities, and other aspects of teaching. The results of analysing such a feedback can form a key point for institutions’ decision makers to advance and update their systems accordingly. This paper proposes a data mining framework for analysing end of unit general textual feedback using part of speech feature (PoS) with four machine learning algorithms: support vector machines, decision tree, random forest, and naive bays. The proposed framework has two tasks: first, to use the above algorithms to build an optimal model that automatically classifies the whole data set into two subsets, one subset is tailored to assessment practices (assessment related), and the other one is the non-assessment related data. Second task to use the same algorithms to build an optimal model for whole data set, and the new data subsets to automatically detect their sentiment. The significance of this paper is to compare the performance of the above four algorithms using part of speech feature to the performance of the same algorithms using n-grams feature. The paper follows Knowledge Discovery and Data Mining (KDDM) framework to construct the classification and sentiment analysis models, which is understanding the assessment domain, cleaning and pre-processing the data set, selecting and running the data mining algorithm, interpreting mined patterns, and consolidating the discovered knowledge. The results of this paper experiments show that both models which used both features performed very well regarding first task. But regarding the second task, models that used part of speech feature has underperformed in comparison with models that used unigrams and bigrams.

Keywords: assessment, part of speech, sentiment analysis, student feedback

Procedia PDF Downloads 111
252 Millennial Teachers of Canada: Innovation within the Boxed-In Constraints of Tradition

Authors: Lena Shulyakovskaya

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Every year, schools aim to develop and adopt new technology and pedagogy as a way to equip today's students with the needed 21st Century skills. However, the field of primary and secondary education may not be as open to embracing change in reality. Despite the drive to reform and innovation, the field of education in Canada is still very much steeped in tradition and uses many of the practices that came into effect over 50 years ago. Among those are employment and retention practices. Millennials are the youngest generation of professionals entering the workplace at this time and the ones leaving their jobs within just a few years. Almost half of new teachers leave Canadian schools within their first five years on the job. This paper discusses one of the contributing factors that lead Canadian millennial teachers to either leave or stay in the profession - standardized education system. Using an exploratory case study approach, in-depth interviews with former and current millennial teachers were conducted to learn about their experiences within the K-12 system. Among the findings were the young teachers' concerns about the constant changes to teaching practices and technological implementations that claimed to advance teaching and learning, and yet in reality only disguised and reiterated the same traditional, outdated, and standardized practices that already existed. Furthermore, while many millennial teachers aspired to be innovative with their curriculum and teaching practices, they felt trapped and helpless in the hands of school leaders who were very reluctant to change. While many new program ideas and technological advancements are being made openly available to teachers on a regular basis, it is important to consider the education field as a whole and how it plays into the teachers' ability to realistically implement changes. By the year 2025, millennials will make up approximately 75% of the North American workforce. It is important to examine generational differences among teachers and understand how millennial teachers may be shaping the future of primary and secondary schools, either by staying or leaving the profession.

Keywords: 21st century skills, millennials, teacher attrition, tradition

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251 Formal Institutions and Women's Electoral Participation in Four European Countries

Authors: Sophia Francesca D. Lu

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This research tried to produce evidence that formal institutions, such as electoral and internal party quotas, can advance women’s active roles in the public sphere using the cases of four European countries: Belgium, Germany, Italy, and the Netherlands. The quantitative dataset was provided by the University of Chicago and the Inter-University Consortium of Political and Social Research based on a two-year study (2008-2010) of political parties. Belgium engages in constitutionally mandated electoral quotas. Germany, Italy and the Netherlands, on the other hand, have internal party quotas, which are voluntarily adopted by political parties. In analyzing each country’s chi-square and Pearson’s r correlation, Belgium, having an electoral quota, is the only country that was analyzed for electoral quotas. Germany, Italy and the Netherlands’ internal voluntary party quotas were correlated with women’s descriptive representations. Using chi-square analysis, this study showed that the presence of electoral quotas is correlated with an increase in the percentage of women in decision-making bodies as well as with an increase in the percentage of women in decision-making bodies. Likewise, using correlational analysis, a higher number of political parties employing internal party voluntary quotas is correlated with an increase in the percentage of women occupying seats in parliament as well as an increase in the percentage of women nominees in electoral lists of political parties. In conclusion, gender quotas, such as electoral quotas or internal party quotas, are an effective policy tool for greater women’s representation in political bodies. Political parties and governments should opt to have gender quotas, whether electoral or internal party quotas, to address the underrepresentation of women in parliament, decision-making bodies, and policy-formulation.

Keywords: electoral quota, Europe, formal institutions, institutional feminism, internal party quota, women’s electoral participation

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250 Failure Analysis: Solid Rocket Motor Type “Candy” - Explosion in a Static Test

Authors: Diego Romero, Fabio Rojas, J. Alejandro Urrego

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The sounding rockets are aerospace vehicles that were developed in the mid-20th century, and Colombia has been involved in research that was carried out with the aim of innovating with this technology. The rockets are university research programs with the collaboration of the local government, with a simple strategy, develop and reduce the greatest costs associated with the production of a kind type of technology. In this way, in this document presents the failure analysis of a solid rocket motor, with the real compatibly to reach the thermosphere with a low-cost fuel. This solid rocket motor is the latest development of the Uniandes Aerospace Project (PUA for its Spanish acronym), an undergraduate and postgraduate research group at Universidad de los Andes (Bogotá, Colombia), dedicated to incurring in this type of technology. This motor has been carried out on Candy-type solid fuel, which is a compound of potassium nitrate and sorbitol, and the investigation has allowed the production of solid motors powerful enough to reach space, and which represents a unique technological advance in Latin America and an important development in experimental rocketry.To outline the main points the explosion in a static test is an important to explore and demonstrate the ways to develop technology, methodologies, production and manufacturing, being a solid rocket motor with 30 kN of thrust. In conclusion, this analysis explores different fields such as: design, manufacture, materials, production, first fire and more, with different engineering tools with principal objective find root failure. Following the engineering analysis methodology, was possible to design a new version of motor, with learned lessons new manufacturing specification, therefore, when publishing this project, it is intended to be a reference for future research in this field and benefit the industry.

Keywords: candy propellant, candy rockets, explosion, failure analysis, static test, solid rocket motor

Procedia PDF Downloads 139
249 The Service Appraisal of Soldiers of the Army of the Czech Republic in the Context of Personal Expenses

Authors: Tereza Dolečková

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Following article provides the comparison of international norms and standards formulating personal expenses, and then it illustrates the national concept of personal expenses of the Ministry of Defence. Then a new salary system of soldiers and the importance of the service appraisal in the context of personal expenses of the Ministry of Defence are explained. The first part of the article includes formulation of the approach to the definition of personal expenses within the international norms and standards and also within the Ministry of Defence of the Czech Republic. The structure of employees of the Ministry of Defence of the Czech Republic in years 2012 – 2014 and the amount of military expenses and the share of salary expenses of the Ministry of total expenses of the Ministry are clarified there, also the comparison of the amount of military expenses in chosen member states of the North Atlantic Treaty Organization is done. The salary system of professional soldiers in connection with the amendment of the Act No. 221/1999 Coll. on Professional Soldiers is clarified in the second part of this article. The amendment significantly regulates the salary items of soldiers but changes are also in the service appraisal of soldiers which reflects one of seven salary items of soldiers – the performance bonus. The aim of this article is to clarify different approach to define personal expenses with emphasis on the Ministry of Defence of the Czech Republic which overlaps to the service appraisal of soldiers of the Army of the Czech Republic and their salary system in connection with personal expenses of the Ministry of Defence of the Czech Republic. The efficient and objective system of the service appraisal and the use of its results are connected to the principles of the career advancement; only the best soldiers can advance in the system of the service careers to higher positions. That is why it is necessary to improve the service appraisal so it would provide the maximum information about the performance of a soldier and it would also motivate the soldier in his development. The attention should be paid to the service appraisal of the soldiers of the Army of the Czech Republic to achieve as much objectivity as possible.

Keywords: career, human resource management and development, personal expenses, salary system of soldiers, service appraisal of soldiers, the Army of the Czech Republic

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248 The Impact of Organizational Culture on Internet Marketing Adoption

Authors: Hafiz Mushtaq Ahmad, Syed Faizan Ali Shah, Bushra Hussain, Muneeb Iqbal

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Purpose: The purpose of this study is to investigate the impact of organizational culture on internet marketing adoption. Moreover, the study intends to explore the role of organizational culture in the internet marketing adoption that helps business to achieve organizational growth and augmented market share. Background: With the enormous expansion of technology, organizations now need technology-based marketing paradigm in order to capture larger group of customers. Organizational culture plays a dominant and prominent role in the internet marketing adoption. Changes in the world economy have demolished current organizational competition and generating new technology standards and strategies. With all the technological advances, e-marketing has become one of the essential part of marketing strategies. Organizations require advance internet marketing strategies in order to compete in a global market. Methodology: The population of this study consists of telecom sector organizations of Pakistan. The sample size consists of 200 telecom sector employees. Data were gathered through the questionnaire instrument. The research strategy of this study is survey. The study uses a deductive approach. The sampling technique of this study is convenience sampling. Tentative Results: The study reveals that organizational culture played a vital role in the internet marketing adoption. The results show that there is a strong association between the organizational culture and internet marketing adoption. The results further show that flexible organizational culture helps organization to easily adopt internet marketing. Conclusion: The study discloses that flexible organizational culture helps organizations to easily adopt e-marketing. The study guides decision-makers and owners of organizations to recognize the importance of internet marketing strategy and help them to increase market share by using e-marketing. The study offers solution to the managers to develop flexible organizational culture that helps in internet marketing adoption.

Keywords: internet technology, internet marketing, marketing paradigm, organizational culture

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247 Trends, Status, and Future Directions of Artificial Intelligence in Human Resources Disciplines: A Bibliometric Analysis

Authors: Gertrude I. Hewapathirana, Loi A. Nguyen, Mohammed M. Mostafa

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Artificial intelligence (AI) technologies and tools are swiftly integrating into many functions of all organizations as a competitive drive to enhance innovations, productivity, efficiency, faster and precise decision making to keep up with rapid changes in the global business arena. Despite increasing research on AI technologies in production, manufacturing, and information management, AI in human resource disciplines is still lagging. Though a few research studies on HR informatics, recruitment, and HRM in general, how to integrate AI in other HR functional disciplines (e.g., compensation, training, mentoring and coaching, employee motivation) is rarely researched. Many inconsistencies of research hinder developing up-to-date knowledge on AI in HR disciplines. Therefore, exploring eight research questions, using bibliometric network analysis combined with a meta-analysis of published research literature. The authors attempt to generate knowledge on the role of AI in improving the efficiency of HR functional disciplines. To advance the knowledge for the benefit of researchers, academics, policymakers, and practitioners, the study highlights the types of AI innovations and outcomes, trends, gaps, themes and topics, fast-moving disciplines, key players, and future directions.AI in HR informatics in high tech firms is the dominant theme in many research publications. While there is increasing attention from researchers and practitioners, there are many gaps between the promise, potential, and real AI applications in HR disciplines. A higher knowledge gap raised many unanswered questions regarding legal, ethical, and morale aspects of AI in HR disciplines as well as the potential contributions of AI in HR disciplines that may guide future research directions. Though the study provides the most current knowledge, it is limited to peer-reviewed empirical, theoretical, and conceptual research publications stored in the WoS database. The implications for theory, practice, and future research are discussed.

Keywords: artificial intelligence, human resources, bibliometric analysis, research directions

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246 Scoping Review of Biological Age Measurement Composed of Biomarkers

Authors: Diego Alejandro Espíndola-Fernández, Ana María Posada-Cano, Dagnóvar Aristizábal-Ocampo, Jaime Alberto Gallo-Villegas

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Background: With the increase in life expectancy, aging has been subject of frequent research, and therefore multiple strategies have been proposed to quantify the advance of the years based on the known physiology of human senescence. For several decades, attempts have been made to characterize these changes through the concept of biological age, which aims to integrate, in a measure of time, structural or functional variation through biomarkers in comparison with simple chronological age. The objective of this scoping review is to deepen the updated concept of measuring biological age composed of biomarkers in the general population and to summarize recent evidence to identify gaps and priorities for future research. Methods: A scoping review was conducted according to the five-phase methodology developed by Arksey and O'Malley through a search of five bibliographic databases to February 2021. Original articles were included with no time or language limit that described the biological age composed of at least two biomarkers in those over 18 years of age. Results: 674 articles were identified, of which 105 were evaluated for eligibility and 65 were included with information on the measurement of biological age composed of biomarkers. Articles from 1974 of 15 nationalities were found, most observational studies, in which clinical or paraclinical biomarkers were used, and 11 different methods described for the calculation of the composite biological age were informed. The outcomes reported were the relationship with the same measured biomarkers, specified risk factors, comorbidities, physical or cognitive functionality, and mortality. Conclusions: The concept of biological age composed of biomarkers has evolved since the 1970s and multiple methods of its quantification have been described through the combination of different clinical and paraclinical variables from observational studies. Future research should consider the population characteristics, and the choice of biomarkers against the proposed outcomes to improve the understanding of aging variables to direct effective strategies for a proper approach.

Keywords: biological age, biological aging, aging, senescence, biomarker

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245 Implications of Humanizing Pedagogy on Learning Design in a Technology-Enhanced Language Learning Environment: Critical Reflections on Student Identity and Agency

Authors: Mukhtar Raban

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Nelson Mandela University subscribes to a humanizing pedagogy (HP), as housed under broader critical pedagogy, that underpins and informs learning and teaching activities at the institution. The investigation sought to explore the implications of humanizing and critical pedagogical considerations for a technology-enhanced language learning (TELL) environment in a university course. The paper inquires into the design of a learning resource in an online learning environment of an English communication module, that applied HP principles. With an objective of creating agentive spaces for foregrounding identity, student voice, critical self-reflection, and recognition of others’ humanity; a flexible and open 'My Presence' feature was added to the TELL environment that allowed students and lecturers to share elements of their backgrounds in a ‘mutually vulnerable’ manner as a way of establishing digital identity and a more ‘human’ presence in the online language learning encounter, serving as a catalyst for the recognition of the ‘other’. Following a qualitative research design, the study adopted an auto-ethnographic approach, complementing the critical inquiry nature embedded into the activity’s practices. The study’s findings provide critical reflections and deductions on the possibilities of leveraging digital human expression within a humanizing pedagogical framework to advance the realization of HP-adoption in language learning and teaching encounters. It was found that the consideration of humanizing pedagogical principles in the design of online learning was more effective when the critical outcomes were explicated to students and lecturers prior to the completion of the activities. The integration of humanizing pedagogy also led to a contextual advancement of ‘affective’ language learning. Upon critical reflection and analysis, student identity and agency can flourish in a technology-enhanced learning environment when humanizing, and critical pedagogy influences the learning design.

Keywords: critical reflection, humanizing pedagogy, student identity, technology-enhanced language learning

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244 Examining Private Law's Role in Promoting Human Rights: Prospects, Obstacles, and Safeguarding Challenges

Authors: Laura Cami Vorpsi

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This research paper examines the potential of private law as a means to promote and safeguard human rights while also addressing the associated challenges and limitations of adopting such an approach. Historically, private law mechanisms, namely contract law, tort law, and property law, have been employed to govern and oversee private relationships and transactions. Nevertheless, it is increasingly acknowledged that private law can also assume a significant role in safeguarding and advancing human rights, particularly in circumstances where the safeguards provided by public law are insufficient or inaccessible. This study assesses the benefits associated with the utilization of private law as a complementary measure to public law safeguards. These advantages encompass enhanced efficacy and efficiency of remedies, as well as the capacity to customize solutions to suit the unique requirements and circumstances of individuals. Nevertheless, the present study also considers the constraints associated with private law mechanisms, such as the financial and procedural intricacies of legal proceedings, the possibility of imbalanced negotiation power, and the potential to worsen pre-existing disparities and systemic inequities. The paper posits that the adoption of a private law-based approach to human rights necessitates a meticulous design and implementation process in order to mitigate potential risks and optimize the advantages. In conclusion, this study examines the ramifications of these discoveries on policy and practice, highlighting the necessity for heightened awareness and education regarding the capacity of private law to advance and safeguard human rights. Additionally, it underscores the significance of establishing efficient and easily accessible mechanisms for upholding human rights within the private domain. The paper concludes by providing recommendations for future research in this domain, specifically emphasizing the necessity for additional empirical investigations to assess the efficacy and consequences of private law-oriented strategies in safeguarding human rights.

Keywords: private law, human rights, promoting, protecting, access to justice

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243 Integrating Best Practices for Construction Waste in Quality Management Systems

Authors: Paola Villoria Sáez, Mercedes Del Río Merino, Jaime Santa Cruz Astorqui, Antonio Rodríguez Sánchez

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The Spanish construction industry generates large volumes of waste. However, despite the legislative improvements introduced for construction and demolition waste (CDW), construction waste recycling rate remains well below other European countries and also below the target set for 2020. This situation can be due to many difficulties. i.e.: The difficulty of onsite segregation or the estimation in advance of the total amount generated. Despite these difficulties, the proper management of CDW must be one of the main aspects to be considered by the construction companies. In this sense, some large national companies are implementing Integrated Management Systems (IMS) including not only quality and safety aspects, but also environment issues. However, although this fact is a reality for large construction companies still the vast majority of companies need to adopt this trend. In short, it is common to find in small and medium enterprises a decentralized management system: A single system of quality management, another for system safety management and a third one for environmental management system (EMS). In addition, the EMSs currently used address CDW superficially and are mainly focus on other environmental concerns such as carbon emissions. Therefore, this research determines and implements a specific best practice management system for CDW based on eight procedures in a Spanish Construction company. The main advantages and drawbacks of its implementation are highlighted. Results of this study show that establishing and implementing a CDW management system in building works, improve CDW quantification as the company obtains their own CDW generation ratio. This helps construction stakeholders when developing CDW Management Plans and also helps to achieve a higher adjustment of CDW management costs. Finally, integrating this CDW system with the EMS of the company favors the cohesion of the construction process organization at all stages, establishing responsibilities in the field of waste and providing a greater control over the process.

Keywords: construction and demolition waste, waste management, best practices, waste minimization, building, quality management systems

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242 Effects of pH, Load Capacity and Contact Time in the Sulphate Sorption onto a Functionalized Mesoporous Structure

Authors: Jaime Pizarro, Ximena Castillo

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The intensive use of water in agriculture, industry, human consumption and increasing pollution are factors that reduce the availability of water for future generations; the challenge is to advance in sustainable and low-cost solutions to reuse water and to facilitate the availability of the resource in quality and quantity. The use of new low-cost materials with sorbent capacity for pollutants is a solution that contributes to the improvement and expansion of water treatment and reuse systems. Fly ash, a residue from the combustion of coal in power plants that is produced in large quantities in newly industrialized countries, contains a high amount of silicon oxides and aluminum oxides, whose properties can be used for the synthesis of mesoporous materials. Properly functionalized, this material allows obtaining matrixes with high sorption capacity. The mesoporous materials have a large surface area, thermal and mechanical stability, uniform porous structure, and high sorption and functionalization capacities. The goal of this study was to develop hexagonal mesoporous siliceous material (HMS) for the adsorption of sulphate from industrial and mining waters. The silica was extracted from fly ash after calcination at 850 ° C, followed by the addition of water. The mesoporous structure has a surface area of 282 m2 g-1 and a size of 5.7 nm and was functionalized with ethylene diamine through of a self-assembly method. The material was characterized by Diffuse Reflectance Infrared Fourier Transform Spectroscopy (DRIFTS). The capacity of sulphate sorption was evaluated according to pH, maximum load capacity and contact time. The sulphate maximum adsorption capacity was 146.1 mg g-1, which is three times higher than commercial sorbents. The kinetic data were fitted according to a pseudo-second order model with a high coefficient of linear regression at different initial concentrations. The adsorption isotherm that best fitted the experimental data was the Freundlich model.

Keywords: fly ash, mesoporous siliceous, sorption, sulphate

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241 Studying the Photodegradation Behavior of Microplastics Released from Agricultural Plastic Products to the Farmland

Authors: Maryam Salehi, Gholamreza Bonyadinejad

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The application of agricultural plastic products like mulch, greenhouse covers, and silage films is increasing due to their economic benefits in providing an early and better-quality harvest. In 2015, the 4 million tons (valued a 10.6 million USD) global market for agricultural plastic films was estimated to grow by 5.6% per year through 2030. Despite the short-term benefits provided by plastic products, their long-term sustainability issues and negative impacts on soil health are not well understood. After their removal from the field, some plastic residuals remain in the soil. Plastic residuals in farmlands may fragment to small particles called microplastics (d<5mm). The microplastics' exposure to solar radiation could alter their surface chemistry and make them susceptible to fragmentation. Thus, this study examined the photodegradation of low density polyethylene as the model microplastics that are released to the agriculture farmland. The variation of plastic’s surface chemistry, morphology, and bulk characteristics were studied after accelerated UV-A radiation experiments and sampling from an agricultural field. The Attenuated Total Reflectance Fourier Transform Spectroscopy (ATR-FTIR) and X-ray Photoelectron Spectroscopy (XPS) demonstrated the formation of oxidized surface functional groups onto the microplastics surface due to the photodegradation. The Differential Scanning Calorimetry (DSC) analysis revealed an increased crystallinity for the photodegraded microplastics compared to the new samples. The gel permeation chromatography (GPC) demonstrated the reduced molecular weight for the polymer due to the photodegradation. This study provides an important opportunity to advance understanding of soil pollution. Understanding the plastic residuals’ variations as they are left in the soil is providing a critical piece of information to better estimate the microplastics' impacts on environmental biodiversity, ecosystem sustainability, and food safety.

Keywords: soil health, plastic pollution, sustainability, photodegradation

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240 Factors Adversely Associated with Breastfeeding among Obese Mothers in Malaysia

Authors: Syahrul Bariah Abdul Hamid, Colin W. Binns, Jun Hui Chih

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The total of obese mothers is growing throughout Asia. Breastfeeding provides the perfect nutrition for infants, by promoting a higher IQ and protecting against childhood and adult diseases. A prospective cohort study was carried out of mothers attending eight antenatal clinics run by the Ministry of Health in Selangor, Malaysia to document the prevalence of obesity and its relationship with breastfeeding outcomes. Mothers were enrolled during the antenatal period and followed up until 6 months postpartum to document breastfeeding outcomes. A total of 652 Malay mothers were recruited for the study a response rate of 93.1 %. The pre-pregnancy body mass index (BMI) of the mothers showed that 36.5% of the mothers were overweight or obese. There were a total of 78 obese mothers in the sample and 41 (52.6%) of these mothers were able to initiate breastfeeding within one hour of birth compared to 238/337 (70.6 %, χ² 9.35, p<0.001) of those with a normal BMI. At 6 months, 23.1 % of obese mothers were exclusively breastfeeding their infants, compared to 56.0 % of the normal BMI mothers. On the other hand, the rate of infant formula feeding was higher in the obese mothers by 53.8 % compared to 19.0 % among normal weight mothers, χ² 37.6, p<0.001). Further analysis suggested these factors were found to be positively associated with discontinued exclusive breastfeeding at 6 months among obese mothers; mothers whom delayed breastfeeding initiation, had health problems during pregnancy, caesarean delivery, reported had insufficient colostrum/milk and babies had sucking problems at or before 4 weeks. Besides that, mothers who perceived their biological mothers had preference towards formula feeding or were ambivalent about the feeding method and had biological mothers without experience in breastfeeding for more than 1 month also were more likely to discontinue exclusive breastfeeding at 6 months. These findings suggested that the greater the pre-pregnant BMI, the earlier the cessation of exclusive breastfeeding and they were also less likely to initiate breastfeeding and have less adequate milk supply. Future investigations of the effects of maternal obesity on breastfeeding outcomes should be conducted along with effective interventions to advance the care of obese women at reproductive age and their children.

Keywords: exclusive breastfeeding, body mass index (BMI), breastfeeding discontinuation, maternal obesity

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239 Cationic Copolymer-Functionalized Nanodiamonds Stabilizes Silver Nanoparticles with Dual Antibacterial Activity and Lower Cytotoxicity

Authors: Weiwei Cao, Xiaodong Xing

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In order to effectively resolve the microbial pollution and contamination, synthetic nano-antibacterial materials are widely used in daily life. Among them, nanodiamonds (NDs) have recently been demonstrated to hold promise as useful materials in biomedical applications due to their high specific surface area and biocompatibility. In this work, the copolymer, poly(4-vinylpyridine-co-2-hydroxyethyl methacrylate) was applied for the surface functionalization of NDs to produce the quaternized poly(4-vinylpyridine-co-2-hydroxyethyl methacrylate)-functionalized NDs (QNDs). Then, QNDs were used as a substrate for silver nanoparticles (AgNPs) to produce a QND@Ag hybrid. The composition and morphology of the resultant nanostructures were confirmed by Fourier transform infrared spectra (FT-IR), transmission electron microscope (TEM), X-ray diffraction (XRD), and thermogravimetric analysis (TGA). The mass fraction of AgNPs in the nanocomposites was about 35.7%. The antibacterial performances of the prepared nanocomposites were evaluated with Gram-negative Escherichia coli and Gram-positive Staphylococcus aureus by minimum inhibitory concentration (MIC), inhibition zone testing and time-kill study. As a result, due to the synergistic antibacterial activity of QND and AgNPs, this hybrid showed substantially higher antibacterial activity than QND and polyvinyl pyrrolidone (PVP)-stabilized AgNPs, and the AgNPs on QND@Ag were more stable than the Ag NPs on PVP, resulting in long-term antibacterial effects. More importantly, this hybrid showed excellent water solubility and low cytotoxicity, suggesting the great potential application in biomedical applications. The present work provided a simple strategy that successfully turned NDs into nanosized antibiotics with simultaneous superior stability and biocompatibility, which would broaden the applications of NDs and advance the development of novel antibacterial agents.

Keywords: cationic copolymer, nanodiamonds, silver nanoparticles, dual antibacterial activity, lower cytotoxicity

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238 Fast Prototyping of Precise, Flexible, Multiplexed, Printed Electrochemical Enzyme-Linked Immunosorbent Assay System for Point-of-Care Biomarker Quantification

Authors: Zahrasadat Hosseini, Jie Yuan

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Point-of-care (POC) diagnostic devices based on lab-on-a-chip (LOC) technology have the potential to revolutionize medical diagnostics. However, the development of an ideal microfluidic system based on LOC technology for diagnostics purposes requires overcoming several obstacles, such as improving sensitivity, selectivity, portability, cost-effectiveness, and prototyping methods. While numerous studies have introduced technologies and systems that advance these criteria, existing systems still have limitations. Electrochemical enzyme-linked immunosorbent assay (e-ELISA) in a LOC device offers numerous advantages, including enhanced sensitivity, decreased turnaround time, minimized sample and analyte consumption, reduced cost, disposability, and suitability for miniaturization, integration, and multiplexing. In this study, we present a novel design and fabrication method for a microfluidic diagnostic platform that integrates screen-printed electrochemical carbon/silver chloride electrodes on flexible printed circuit boards with flexible, multilayer, polydimethylsiloxane (PDMS) microfluidic networks to accurately manipulate and pre-immobilize analytes for performing electrochemical enzyme-linked immunosorbent assay (e-ELISA) for multiplexed quantification of blood serum biomarkers. We further demonstrate fast, cost-effective prototyping, as well as accurate and reliable detection performance of this device for quantification of interleukin-6-spiked samples through electrochemical analytics methods. We anticipate that our invention represents a significant step towards the development of user-friendly, portable, medical-grade, POC diagnostic devices.

Keywords: lab-on-a-chip, point-of-care diagnostics, electrochemical ELISA, biomarker quantification, fast prototyping

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237 Fast Prototyping of Precise, Flexible, Multiplexed, Printed Electrochemical Enzyme-Linked Immunosorbent Assay Platform for Point-of-Care Biomarker Quantification

Authors: Zahrasadat Hosseini, Jie Yuan

Abstract:

Point-of-care (POC) diagnostic devices based on lab-on-a-chip (LOC) technology have the potential to revolutionize medical diagnostics. However, the development of an ideal microfluidic system based on LOC technology for diagnostics purposes requires overcoming several obstacles, such as improving sensitivity, selectivity, portability, cost-effectiveness, and prototyping methods. While numerous studies have introduced technologies and systems that advance these criteria, existing systems still have limitations. Electrochemical enzyme-linked immunosorbent assay (e-ELISA) in a LOC device offers numerous advantages, including enhanced sensitivity, decreased turnaround time, minimized sample and analyte consumption, reduced cost, disposability, and suitability for miniaturization, integration, and multiplexing. In this study, we present a novel design and fabrication method for a microfluidic diagnostic platform that integrates screen-printed electrochemical carbon/silver chloride electrodes on flexible printed circuit boards with flexible, multilayer, polydimethylsiloxane (PDMS) microfluidic networks to accurately manipulate and pre-immobilize analytes for performing electrochemical enzyme-linked immunosorbent assay (e-ELISA) for multiplexed quantification of blood serum biomarkers. We further demonstrate fast, cost-effective prototyping, as well as accurate and reliable detection performance of this device for quantification of interleukin-6-spiked samples through electrochemical analytics methods. We anticipate that our invention represents a significant step towards the development of user-friendly, portable, medical-grade POC diagnostic devices.

Keywords: lab-on-a-chip, point-of-care diagnostics, electrochemical ELISA, biomarker quantification, fast prototyping

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236 Improving Chest X-Ray Disease Detection with Enhanced Data Augmentation Using Novel Approach of Diverse Conditional Wasserstein Generative Adversarial Networks

Authors: Malik Muhammad Arslan, Muneeb Ullah, Dai Shihan, Daniyal Haider, Xiaodong Yang

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Chest X-rays are instrumental in the detection and monitoring of a wide array of diseases, including viral infections such as COVID-19, tuberculosis, pneumonia, lung cancer, and various cardiac and pulmonary conditions. To enhance the accuracy of diagnosis, artificial intelligence (AI) algorithms, particularly deep learning models like Convolutional Neural Networks (CNNs), are employed. However, these deep learning models demand a substantial and varied dataset to attain optimal precision. Generative Adversarial Networks (GANs) can be employed to create new data, thereby supplementing the existing dataset and enhancing the accuracy of deep learning models. Nevertheless, GANs have their limitations, such as issues related to stability, convergence, and the ability to distinguish between authentic and fabricated data. In order to overcome these challenges and advance the detection and classification of CXR normal and abnormal images, this study introduces a distinctive technique known as DCWGAN (Diverse Conditional Wasserstein GAN) for generating synthetic chest X-ray (CXR) images. The study evaluates the effectiveness of this Idiosyncratic DCWGAN technique using the ResNet50 model and compares its results with those obtained using the traditional GAN approach. The findings reveal that the ResNet50 model trained on the DCWGAN-generated dataset outperformed the model trained on the classic GAN-generated dataset. Specifically, the ResNet50 model utilizing DCWGAN synthetic images achieved impressive performance metrics with an accuracy of 0.961, precision of 0.955, recall of 0.970, and F1-Measure of 0.963. These results indicate the promising potential for the early detection of diseases in CXR images using this Inimitable approach.

Keywords: CNN, classification, deep learning, GAN, Resnet50

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235 Service Evaluation of Consent for Hand and Wrist Surgery and Formulation of Evidence-Based Guidelines

Authors: Parsa Keyvani, Alistair Phillips, David Warwick

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Background: The current process for gaining patient consent for hand and wrist surgery at University Hospital Southampton (UHS) is paper-based and makes use of generic forms provided by the NHS and no patient information leaflet is available relating to hand and wrist surgery. Aims: To evaluate the process of obtaining clinical consent and suggest ways in which the service can be improved. Methods: A log-book review of four orthopaedic surgeons at UHS was carried out over a three-month period in order to identify the 10 most common types of elective hand and wrist surgeries performed. A literature review was carried out to identify the complications of these surgeries. The surgeries were then divided into 6 types: nerve, bone, ligament, joint, tendon and dupuytren’s surgery. A digitised consent form was created covering the complications of all 6 surgery types. Finally, the surgeons at the orthopaedic department of UHS were asked whether they prefer the old paper-based or the digitised consent form. Results: All of the surgeons felt that the procedure type-based form was easier to read, use and understand. Conclusion: This research highlights a number of problems related to the use of current NHS consent forms. The proposed solution is to use a set of digitised, procedure type-based consent forms. Digital consent forms can be filled in in advance and sent to the patient electronically along with any relevant information leaflets, thus giving them time to absorb the information and come up with any questions before they have their pre-procedure discussion with their doctor. This would allow the doctor to focus the consultation on the patient rather than writing out the consent form and would ultimately be a step forward in making the NHS a global digital leader and fully embrace the opportunity offered by technology.

Keywords: digitised consent form, elective surgery, hand surgery complications, informed consent, procedure type-based consent form

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234 Wasting Human and Computer Resources

Authors: Mária Csernoch, Piroska Biró

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The legends about “user-friendly” and “easy-to-use” birotical tools (computer-related office tools) have been spreading and misleading end-users. This approach has led us to the extremely high number of incorrect documents, causing serious financial losses in the creating, modifying, and retrieving processes. Our research proved that there are at least two sources of this underachievement: (1) The lack of the definition of the correctly edited, formatted documents. Consequently, end-users do not know whether their methods and results are correct or not. They are not aware of their ignorance. They are so ignorant that their ignorance does not allow them to realize their lack of knowledge. (2) The end-users’ problem-solving methods. We have found that in non-traditional programming environments end-users apply, almost exclusively, surface approach metacognitive methods to carry out their computer related activities, which are proved less effective than deep approach methods. Based on these findings we have developed deep approach methods which are based on and adapted from traditional programming languages. In this study, we focus on the most popular type of birotical documents, the text-based documents. We have provided the definition of the correctly edited text, and based on this definition, adapted the debugging method known in programming. According to the method, before the realization of text editing, a thorough debugging of already existing texts and the categorization of errors are carried out. With this method in advance to real text editing users learn the requirements of text-based documents and also of the correctly formatted text. The method has been proved much more effective than the previously applied surface approach methods. The advantages of the method are that the real text handling requires much less human and computer sources than clicking aimlessly in the GUI (Graphical User Interface), and the data retrieval is much more effective than from error-prone documents.

Keywords: deep approach metacognitive methods, error-prone birotical documents, financial losses, human and computer resources

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233 Psychopathy Evaluation for People with Intellectual Disability Living in Institute Using Chinese Version of the Psychopathology Inventory

Authors: Lin Fu-Gong

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Background: As WHO announced, people with intellectual disability (ID) were vulnerable to mental health problems. And there were few custom-made mental health scales for those people to monitor their mental health. Those people with mental problems often accompanied worse prognosis and usually became to be a heavier burden on the caregivers. Purpose: In this study, we intend to develop a psychopathy scale as a practical tool for monitoring the mental health for people with ID living in institute. Methods: In this study, we adopt the Psychopathology Inventory for Mentally Retarded Adults developed by professor Matson with certified reliability and validity in Western countries with Dr. Matson’s agreement in advance. We first translated the inventory into Chinese validated version considering the domestic culture background in the past year. And the validity and reliability evaluation of mental health status using this inventory among the people with intellectual living in the institute were done. Results: The inventory includes eight psychiatric disorder scales as schizophrenic, affective, psychosexual, adjustment, anxiety, somatoform, personality disorders and inappropriate mental adjustment. Around 83% of 40 invested people, who randomly selected from the institute, were found to have at least one disorder who were recommended with medical help by two evaluators. Among the residents examined, somatoform disorder and inappropriate mental adjustment were most popular with 60% and 78% people respectively. Conclusion: The result showed the prevalence psychiatric disorders were relatively high among people with ID in institute and the mental problems need to be further cared and followed for their mental health. The results showed that the psychopathology inventory was a useful tool for institute caregiver, manager and for long-term care policy to the government. In the coming stage, we plan to extend the use of the valid Chinese version inventory among more different type institutes for people with ID to establish their dynamic mental health status including medical need, relapse and rehabilitation to promote their mental health.

Keywords: intellectual disability, psychiatric disorder, psychopathology inventory, mental health, the institute

Procedia PDF Downloads 243
232 Feasibility Study on Developing and Enhancing of Flood Forecasting and Warning Systems in Thailand

Authors: Sitarrine Thongpussawal, Dasarath Jayasuriya, Thanaroj Woraratprasert, Sakawtree Prajamwong

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Thailand grapples with recurrent floods causing substantial repercussions on its economy, society, and environment. In 2021, the economic toll of these floods amounted to an estimated 53,282 million baht, primarily impacting the agricultural sector. The existing flood monitoring system in Thailand suffers from inaccuracies and insufficient information, resulting in delayed warnings and ineffective communication to the public. The Office of the National Water Resources (OWNR) is tasked with developing and integrating data and information systems for efficient water resources management, yet faces challenges in monitoring accuracy, forecasting, and timely warnings. This study endeavors to evaluate the viability of enhancing Thailand's Flood Forecasting and Warning (FFW) systems. Additionally, it aims to formulate a comprehensive work package grounded in international best practices to enhance the country's FFW systems. Employing qualitative research methodologies, the study conducted in-depth interviews and focus groups with pertinent agencies. Data analysis involved techniques like note-taking and document analysis. The study substantiates the feasibility of developing and enhancing FFW systems in Thailand. Implementation of international best practices can augment the precision of flood forecasting and warning systems, empowering local agencies and residents in high-risk areas to prepare proactively, thereby minimizing the adverse impact of floods on lives and property. This research underscores that Thailand can feasibly advance its FFW systems by adopting international best practices, enhancing accuracy, and improving preparedness. Consequently, the study enriches the theoretical understanding of flood forecasting and warning systems and furnishes valuable recommendations for their enhancement in Thailand.

Keywords: flooding, forecasting, warning, monitoring, communication, Thailand

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231 Numerical Modelling of 3-D Fracture Propagation and Damage Evolution of an Isotropic Heterogeneous Rock with a Pre-Existing Surface Flaw under Uniaxial Compression

Authors: S. Mondal, L. M. Olsen-Kettle, L. Gross

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Fracture propagation and damage evolution are extremely important for many industrial applications including mining industry, composite materials, earthquake simulations, hydraulic fracturing. The influence of pre-existing flaws and rock heterogeneity on the processes and mechanisms of rock fracture has important ramifications in many mining and reservoir engineering applications. We simulate the damage evolution and fracture propagation in an isotropic sandstone specimen containing a pre-existing 3-D surface flaw in different configurations under uniaxial compression. We apply a damage model based on the unified strength theory and solve the solid deformation and damage evolution equations using the Finite Element Method (FEM) with tetrahedron elements on unstructured meshes through the simulation software, eScript. Unstructured meshes provide higher geometrical flexibility and allow a more accurate way to model the varying flaw depth, angle, and length through locally adapted FEM meshes. The heterogeneity of rock is considered by initializing material properties using a Weibull distribution sampled over a cubic grid. In our model, we introduce a length scale related to the rock heterogeneity which is independent of the mesh size. We investigate the effect of parameters including the heterogeneity of the elastic moduli and geometry of the single flaw in the stress strain response. The generation of three typical surface cracking patterns, called wing cracks, anti-wing cracks and far-field cracks were identified, and these depend on the geometry of the pre-existing surface flaw. This model results help to advance our understanding of fracture and damage growth in heterogeneous rock with the aim to develop fracture simulators for different industry applications.

Keywords: finite element method, heterogeneity, isotropic damage, uniaxial compression

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230 Pre-Experimental Research to Investigate the Retention of Basic and Advanced Life Support Measures Knowledge and Skills by Qualified Nurses Following a Course in Professional Development in a Tertiary Teaching Hospital

Authors: Ram Sharan Mehta, Gayanandra Malla, Anita Gurung, Anu Aryal, Divya Labh, Hricha Neupane

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Objectives: Lack of resuscitation skills of nurses and doctors in basic life support (BLS) and advanced life support (ALS) has been identified as a contributing factor to poor outcomes of cardiac arrest victims. The objective of this study was to examine retention of life support measures (BLS/ALS) knowledge and skills of nurses following education intervention programme. Materials and Methods: Pre-experimental research design was used to conduct the study among the nurses working in medical units of B.P Koirala Institute of Health Sciences, where CPR is very commonly performed. Using convenient sampling technique total of 20 nurses agreed to participate and give consent were included in the study. The theoretical, demonstration and re-demonstration were arranged involving the trained doctors and nurses during the three hours educational session. Post-test was carried out after two week of education intervention programme. The 2010 BLS & ALS guidelines were used as guide for the study contents. The collected data were analyzed using SPSS-15 software. Results: It was found that there is significant increase in knowledge after education intervention in the components of life support measures (BLS/ALS) i.e. ratio of chest compression to ventilation in BLS (P=0.001), correct sequence of CPR (p <0.001), rate of chest compression in ALS (P=0.001), the depth of chest compression in adult CPR (p<0.001), and position of chest compression in CPR (P=0.016). Nurses were well appreciated the programme and request to continue in future for all the nurses. Conclusions: At recent BLS/ALS courses (2010), a significant number of nurses remain without any such training. Action is needed to ensure all nurses receive BLS training and practice this skill regularly in order to retain their knowledge.

Keywords: pre-experimental, basic and advance life support, nurses, sampling technique

Procedia PDF Downloads 237
229 Comparative Analysis of Decentralized Financial Education Systems: Lessons From Global Implementations

Authors: Flex Anim

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The financial system is a decentralized studies system that was put into place in Ghana as a grassroots financial studies approach. Its main goal is to give people the precise knowledge, abilities, and training required for a given trade, business, profession, or occupation. In this essay, the question of how the financial studies system's devolution to local businesses results in responsible and responsive representation as well as long-term company learning is raised. It centers on two case studies, Asekwa Municipal and Oforikrom. The next question posed by the study is how senior high school students are rebuilding their livelihoods and socioeconomic well-being by creating new curriculum and social practices related to the finance and business studies system. The paper here concentrates on Kumasi District and makes inferences for the other two examples. The paper demonstrates how the financial studies system's establishment of representative groups creates the democratic space required for the successful representation of community goals. Nonetheless, the interests of a privileged few are advanced as a result of elite capture. The state's financial and business training programs do not adhere to the financial studies system's established policy procedures and do not transfer pertinent and discretionary resources to local educators. As a result, local educators are unable to encourage representation that is accountable and responsive. The financial studies system continues to pique the interest of rural areas, but this desire is skewed toward getting access to financial or business training institutions for higher education. Since the locals are not actively involved in financial education, the financial studies system serves just to advance the interests of specific populations. This article explains how rhetoric and personal benefits can be supported by the public even in the case of "failed" interventions.

Keywords: financial studies system, financial studies' devolution, local government, senior high schools and financial education, as well as community goals and representation

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228 Relearning to Learn: Approaching Sustainability by Incorporating Inuit Vernacular and Biomimicry Architecture Principles

Authors: Hakim Herbane

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Efforts to achieve sustainability in architecture must prove their effectiveness despite various methods attempted. Biomimicry, which looks to successful natural models to promote sustainability and innovation, faces obstacles in implementing sustainability despite its restorative approach to the relationship between humans and nature. In Nunavik, Inuit communities are exploring a sustainable production system that aligns with their aspirations and meets their demands of human, technological, technical, economic, and ecological factors. Biomimicry holds promise in line with Inuit philosophy, but its failure to implement sustainability requires further investigations to remedy its deficiencies. Our literature review underscores the importance of involving the community in defining sustainability and determining the best methods for its implementation. Additionally, vernacular architecture shows valuable orientations for achieving sustainability. Moreover, reintegrating Inuit communities and their traditional architectural practices, which have successfully balanced their built environment's diverse needs and constraints, could pave the way for a sustainable Inuit-built environment in Nunavik and advance architectural biomimicry principles simultaneously. This research aims at establishing a sustainability monitoring tool for Nordic architectural process by analyzing Inuit vernacular and biomimetic architecture, in addition to the input of stakeholders involved in Inuit architecture production in Nunavik, especially Inuit. The goal is to create a practical tool (an index) to aid in designing sustainable architecture, taking into account environmental, social, and economic perspectives. Furthermore, the study seeks to authenticate strong, sustainable design principles of vernacular and biomimetic architectures. The literature review uncovered challenges and identified new opportunities. The forthcoming discourse will focus on the careful and considerate incorporation of Inuit communities’ perceptions and indigenous building practices into our methodology and the latest findings of our research.

Keywords: sustainability, biomimicry, vernacular architecture, community involvement

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227 Industrial Prototype for Hydrogen Separation and Purification: Graphene Based-Materials Application

Authors: Juan Alfredo Guevara Carrio, Swamy Toolahalli Thipperudra, Riddhi Naik Dharmeshbhai, Sergio Graniero Echeverrigaray, Jose Vitorio Emiliano, Antonio Helio Castro

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In order to advance the hydrogen economy, several industrial sectors can potentially benefit from the trillions of stimulus spending for post-coronavirus. Blending hydrogen into natural gas pipeline networks has been proposed as a means of delivering it during the early market development phase, using separation and purification technologies downstream to extract the pure H₂ close to the point of end-use. This first step has been mentioned around the world as an opportunity to use existing infrastructures for immediate decarbonisation pathways. Among current technologies used to extract hydrogen from mixtures in pipelines or liquid carriers, membrane separation can achieve the highest selectivity. The most efficient approach for the separation of H₂ from other substances by membranes is offered from the research of 2D layered materials due to their exceptional physical and chemical properties. Graphene-based membranes, with their distribution of pore sizes in nanometers and angstrom range, have shown fundamental and economic advantages over other materials. Their combination with the structure of ceramic and geopolymeric materials enabled the synthesis of nanocomposites and the fabrication of membranes with long-term stability and robustness in a relevant range of physical and chemical conditions. Versatile separation modules have been developed for hydrogen separation, which adaptability allows their integration in industrial prototypes for applications in heavy transport, steel, and cement production, as well as small installations at end-user stations of pipeline networks. The developed membranes and prototypes are a practical contribution to the technological challenge of supply pure H₂ for the mentioned industries as well as hydrogen energy-based fuel cells.

Keywords: graphene nano-composite membranes, hydrogen separation and purification, separation modules, indsutrial prototype

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226 Ending Wars Over Water: Evaluating the Extent to Which Artificial Intelligence Can Be Used to Predict and Prevent Transboundary Water Conflicts

Authors: Akhila Potluru

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Worldwide, more than 250 bodies of water are transboundary, meaning they cross the political boundaries of multiple countries. This creates a system of hydrological, economic, and social interdependence between communities reliant on these water sources. Transboundary water conflicts can occur as a result of this intense interdependence. Many factors contribute to the sparking of transboundary water conflicts, ranging from natural hydrological factors to hydro-political interactions. Previous attempts to predict transboundary water conflicts by analysing changes or trends in the contributing factors have typically failed because patterns in the data are hard to identify. However, there is potential for artificial intelligence and machine learning to fill this gap and identify future ‘hotspots’ up to a year in advance by identifying patterns in data where humans can’t. This research determines the extent to which AI can be used to predict and prevent transboundary water conflicts. This is done via a critical literature review of previous case studies and datasets where AI was deployed to predict water conflict. This research not only delivered a more nuanced understanding of previously undervalued factors that contribute toward transboundary water conflicts (in particular, culture and disinformation) but also by detecting conflict early, governance bodies can engage in processes to de-escalate conflict by providing pre-emptive solutions. Looking forward, this gives rise to significant policy implications and water-sharing agreements, which may be able to prevent water conflicts from developing into wide-scale disasters. Additionally, AI can be used to gain a fuller picture of water-based conflicts in areas where security concerns mean it is not possible to have staff on the ground. Therefore, AI enhances not only the depth of our knowledge about transboundary water conflicts but also the breadth of our knowledge. With demand for water constantly growing, competition between countries over shared water will increasingly lead to water conflict. There has never been a more significant time for us to be able to accurately predict and take precautions to prevent global water conflicts.

Keywords: artificial intelligence, machine learning, transboundary water conflict, water management

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225 Ambulatory Care Utilization of Individuals with Cerebral Palsy in Taiwan- A Country with Universal Coverage and No Gatekeeper Regulation

Authors: Ming-Juei Chang, Hui-Ing Ma, Tsung-Hsueh Lu

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Introduction: Because of the advance of medical care (e.g., ventilation techniques and gastrostomy feeding), more and more children with CP can live to adulthood. However, little is known about the use of health care services from children to adults who have CP. The patterns of utilization of ambulatory care are heavily influenced by insurance coverage and primary care gatekeeper regulation. The purpose of this study was to examine patterns of ambulatory care utilization among individuals with CP in Taiwan, a country with universal coverage and no gatekeeper regulation. Methods: A representative sample of one million patients (about 1/23 of total population) covered by Taiwan’s National Health Insurance was used to analyze the ambulatory care utilization in individuals with CP. Data were analyzed by 3 different age groups (children, youth and adults) during 2000 to 2003. Participants were identified by the presence of CP diagnosis made by pediatricians or physicians of physical and rehabilitation medicine and stated at least three times in claims data. Results: Annual rates of outpatient physician visits were 31680 for children, 16492 for youth, and 28617 for adults with CP (per 1000 persons). Individuals with CP received over 50% of their outpatient care from hospital outpatient department. Higher use of specialist physician services was found in children (54.7%) than in the other two age groups (28.4% in youth and 18.8% in adults). Diseases of respiratory system were the most frequent diagnoses for visits in both children and youth with CP. Diseases of the circulatory system were the main reasons (24.3%) that adults with CP visited hospital outpatient care department or clinics. Conclusion: This study showed different patterns of ambulatory care utilization among different age groups. It appears that youth and adults with CP continue to have complex health issues and rely heavily on the health care system. Additional studies are needed to determine the factors which influence ambulatory care utilization among individuals with CP.

Keywords: cerebral palsy, health services, lifespan, universal coverage

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