Search results for: long bone

Authors: Zhuang Yiwen

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The paper examines the challenges facing the Singapore healthcare system related to the tracking and traceability of medical devices. One of the major challenges identified is the lack of a standard coding system for medical devices, which makes it difficult to track them effectively. The paper suggests the use of the Unique Device Identifier (UDI) as a single standard for medical devices to improve tracking and reduce errors. The paper also explores the use of barcoding and image recognition to identify and document medical devices in nursing practices. In nursing practices, the use of barcodes for identifying medical devices is common. However, the information contained in these barcodes is often inconsistent, making it challenging to identify which segment contains the model identifier. Moreover, the use of barcodes may be improved with the use of UDI, but many subsidized accessories may still lack barcodes. The paper suggests that the readiness for UDI and barcode standardization requires standardized information, fields, and logic in electronic medical record (EMR), operating theatre (OT), and billing systems, as well as barcode scanners that can read various formats and selectively parse barcode segments. Nursing workflow and data flow also need to be taken into account. The paper also explores the use of image recognition, specifically the Tesseract OCR engine, to identify and document implants in public hospitals due to limitations in barcode scanning. The study found that the solution requires an implant information database and checking output against the database. The solution also requires customization of the algorithm, cropping out objects affecting text recognition, and applying adjustments. The solution requires additional resources and costs for a mobile/hardware device, which may pose space constraints and require maintenance of sterile criteria. The integration with EMR is also necessary, and the solution require changes in the user's workflow. The paper suggests that the long-term use of Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) as a supporting terminology to improve clinical documentation and data exchange in healthcare. SNOMED CT provides a standardized way of documenting and sharing clinical information with respect to procedure, patient and device documentation, which can facilitate interoperability and data exchange. In conclusion, the paper highlights the challenges facing the Singapore healthcare system related to the tracking and traceability of medical devices. The paper suggests the use of UDI and barcode standardization to improve tracking and reduce errors. It also explores the use of image recognition to identify and document medical devices in nursing practices. The paper emphasizes the importance of standardized information, fields, and logic in EMR, OT, and billing systems, as well as barcode scanners that can read various formats and selectively parse barcode segments. These recommendations could help the Singapore healthcare system to improve tracking and traceability of medical devices and ultimately enhance patient safety.

Keywords: medical device tracking, unique device identifier, barcoding and image recognition, systematized nomenclature of medicine clinical terms

Procedia PDF Downloads 45

Authors: Grant Bifolchi

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As global environmental problems continue to have highly adverse effects, finding long-term, sustainable solutions to combat ecological distress are of growing paramount concern. Ghost Gear—also known as abandoned, lost or otherwise discarded fishing gear (ALDFG) and derelict fishing gear (DFG)—represents one of the greatest threats to the world’s oceans, posing a significant hazard to human health, livelihoods, and global food security. In fact, according to the UN Food and Agriculture Organization (FAO), abandoned, lost and discarded fishing gear represents approximately 10% of marine debris by volume. Around the world, many governments, governmental and non-profit organizations are doing their best to manage the reporting and retrieval of nets, lines, ropes, traps, floats and more from their respective bodies of water. However, these organizations’ ability to effectively manage files and documents about the environmental problem further complicates matters. In Ghost Gear monitoring and management, organizations face additional complexities. Whether it’s data ingest, industry regulations and standards, garnering actionable insights into the location, security, and management of data, or the application of enforcement due to disparate data—all of these factors are placing massive strains on organizations struggling to save the planet from the dangers of Ghost Gear. In this 90-minute educational session, globally recognized Ghost Gear technology expert Grant Bifolchi CET, BBA, Bcom, will provide real-world insight into how governments currently manage Ghost Gear and the technology that can accelerate success in combatting ALDFG and DFG. In this session, attendees will learn how to: • Identify specific technologies to solve the ingest and management of Ghost Gear data categories, including type, geo-location, size, ownership, regional assignment, collection and disposal. • Provide enhanced access to authorities, fisheries, independent fishing vessels, individuals, etc., while securely controlling confidential and privileged data to globally recognized standards. • Create and maintain processing accuracy to effectively track ALDFG/DFG reporting progress—including acknowledging receipt of the report and sharing it with all pertinent stakeholders to ensure approvals are secured. • Enable and utilize Business Intelligence (BI) and Analytics to store and analyze data to optimize organizational performance, maintain anytime-visibility of report status, user accountability, scheduling, management, and foster governmental transparency. • Maintain Compliance Reporting through highly defined, detailed and automated reports—enabling all stakeholders to share critical insights with internal colleagues, regulatory agencies, and national and international partners.

Keywords: ghost gear, ALDFG, DFG, abandoned, lost or otherwise discarded fishing gear, data, technology

Procedia PDF Downloads 71

Authors: Maria C. Proença, Maria T. Rebelo, Marília Antunes, Maria J. Alves, Hugo Osório, Sofia Cunha, REVIVE team

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The environment of the mosquitoes complex Culex pipiens sl. in Portugal mainland is evaluated based in its abundance, using a data set georeferenced, collected during seven years (2006-2012) from May to October. The suitability of the different regions can be delineated using the relative abundance areas; the suitablility index is directly proportional to disease transmission risk and allows focusing mitigation measures in order to avoid outbreaks of vector-borne diseases. The interest in the Culex pipiens complex is justified by its medical importance: the females bite all warm-blooded vertebrates and are involved in the circulation of several arbovirus of concern to human health, like West Nile virus, iridoviruses, rheoviruses and parvoviruses. The abundance of Culex pipiens mosquitoes were documented systematically all over the territory by the local health services, in a long duration program running since 2006. The environmental factors used to characterize the vector habitat are land use/land cover, distance to cartographed water bodies, altitude and latitude. Focus will be on the mosquito females, which gonotrophic cycle mate-bloodmeal-oviposition is responsible for the virus transmission; its abundance is the key for the planning of non-aggressive prophylactic countermeasures that may eradicate the transmission risk and simultaneously avoid chemical ambient degradation. Meteorological parameters such as: air relative humidity, air temperature (minima, maxima and mean daily temperatures) and daily total rainfall were gathered from the weather stations network for the same dates and crossed with the standardized females’ abundance in a geographic information system (GIS). Mean capture and percentage of above average captures related to each variable are used as criteria to compute a threshold for each meteorological parameter; the difference of the mean capture above/below the threshold was statistically assessed. The meteorological parameters measured at the net of weather stations all over the country are averaged by month and interpolated to produce raster maps that can be segmented according to the meaningful thresholds for each parameter. The intersection of the maps of all the parameters obtained for each month show the evolution of the suitable meteorological conditions through the mosquito season, considered as May to October, although the first and last month are less relevant. In parallel, mean and above average captures were related to the physiographic parameters – the land use/land cover classes most relevant in each month, the altitudes preferred and the most frequent distance to water bodies, a factor closely related with the mosquito biology. The maps produced with these results were crossed with the meteorological maps previously segmented, in order to get an index of suitability for the complex Culex pipiens evaluated all over the country, and its evolution from the beginning to the end of the mosquitoes season.

Keywords: suitability index, Culex pipiens, habitat evolution, GIS model

Procedia PDF Downloads 552

Authors: Christina Drosou, Konstantina E. Kyriakopoulou, Andreas Bimpilas, Dimitrios Tsimogiannis, Magdalini C. Krokida

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Rationale: Agiorgitiko is one of the most widely-grown and commercially well-established red wine varieties in Greece. Each year viticulture industry produces a large amount of waste consisting of grape skins and seeds (pomace) during a short period. Grapes contain polyphenolic compounds which are partially transferred to wine during winemaking. Therefore, winery wastes could be an alternative cheap source for obtaining such compounds with important antioxidant activity. Specifically, red grape waste contains anthocyanins and flavonols which are characterized by multiple biological activities, including cardioprotective, anti-inflammatory, anti-carcinogenic, antiviral and antibacterial properties attributed mainly to their antioxidant activity. Ultrasound assisted extraction (UAE) is considered an effective way to recover phenolic compounds, since it combines the advantage of mechanical effect with low temperature. Moreover, green solvents can be used in order to recover extracts intended for used in the food and nutraceutical industry. Apart from the extraction, pre-treatment process like drying can play an important role on the preservation of the grape pomace and the enhancement of its antioxidant capacity. Objective: The aim of this study is to recover natural extracts from winery waste with high antioxidant capacity using green solvents so they can be exploited and utilized as enhancers in food or nutraceuticals. Methods: Agiorgitiko grape pomace was dehydrated by air drying (AD) and accelerated solar drying (ASD) in order to explore the effect of the pre-treatment on the recovery of bioactive compounds. UAE was applied in untreated and dried samples using water and water: ethanol (1:1) as solvents. The total antioxidant potential and phenolic content of the extracts was determined using the 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging assay and Folin-Ciocalteu method, respectively. Finally, the profile of anthocyanins and flavonols was specified using HPLC-DAD analysis. The efficiency of processes was determined in terms of extraction yield, antioxidant activity, phenolic content and the anthocyanins and flavovols profile. Results & Discussion: The experiments indicated that the pre-treatment was essential for the recovery of highly nutritious compounds from the pomace as long as the extracts samples showed higher phenolic content and antioxidant capacity. Water: ethanol (1:1) was considered a more effective solvent on the recovery of phenolic compounds. Moreover, ASD grape pomace extracted with the solvent system exhibited the highest antioxidant activity (IC50=0.36±0.01mg/mL) and phenolic content (TPC=172.68±0.01mgGAE/g dry extract), followed by AD and untreated pomace. The major compounds recovered were malvidin3-O-glucoside and quercetin3-O-glucoside according to the HPLC analysis. Conclusions: Winery waste can be exploited for the recovery of nutritious compounds using green solvents such as water or ethanol. The pretreatment of the pomace can significantly affect the concentration of phenolic compounds, while UAE is considered a highly effective extraction process.

Keywords: agiorgitico grape pomace, antioxidants, phenolic compounds, ultrasound assisted extraction

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Authors: Breanna Wright, Peter Bragge

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Diagnostic error rates in healthcare are approximately 10% of cases. Diagnostic errors can cause patient harm due to inappropriate, inadequate or delayed treatment, and such errors contribute heavily to medical liability claims globally. Therefore, addressing diagnostic error is a high priority. In most cases, diagnostic errors are the result of faulty information synthesis rather than lack of knowledge. Specifically, the majority of diagnostic errors involve cognitive factors, and in particular, cognitive biases. Emergency Departments are an environment with heightened risk of diagnostic error due to time and resource pressures, a frequently chaotic environment, and patients arriving undifferentiated and with minimal context. This project aimed to develop a behavioural, evidence-informed intervention to reduce diagnostic error in Emergency Departments through co-design with emergency physicians, insurers, researchers, hospital managers, citizens and consumer representatives. The Forum Process was utilised to address this aim. This involves convening a small (4 – 6 member) expert panel to guide a focused literature and practice review; convening of a 10 – 12 person citizens panel to gather perspectives of laypeople, including those affected by misdiagnoses; and a 18 – 22 person structured stakeholder dialogue bringing together representatives of the aforementioned stakeholder groups. The process not only provides in-depth analysis of the problem and associated behaviours, but brings together expertise and insight to facilitate identification of a behaviour change intervention. Informed by the literature and practice review, the Citizens Panel focused on eliciting the values and concerns of those affected or potentially affected by diagnostic error. Citizens were comfortable with diagnostic uncertainty if doctors were honest with them. They also emphasised the importance of open communication between doctors and patients and their families. Citizens expect more consistent standards across the state and better access for both patients and their doctors to patient health information to avoid time-consuming re-taking of long patient histories and medication regimes when re-presenting at Emergency Departments and to reduce the risk of unintentional omissions. The structured Stakeholder Dialogue focused on identifying a feasible behavioural intervention to review diagnoses in Emergency Departments. This needed to consider the role of cognitive bias in medical decision-making; contextual factors (in Victoria, there is a legislated 4-hour maximum time between ED triage and discharge / hospital admission); resource availability; and the need to ensure the intervention could work in large metropolitan as well as small rural and regional ED settings across Victoria. The identified behavioural intervention will be piloted in approximately ten hospital EDs across Victoria, Australia. This presentation will detail the findings of all review and consultation activities, describe the behavioural intervention developed and present results of the pilot trial.

Keywords: behavioural intervention, cognitive bias, decision-making, diagnostic error

Procedia PDF Downloads 103

Authors: Srijata Mitra, Mobina Parveen, Pranab Roy, Narayan Chandra Chattopadhyay

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Chlorinated hydrocarbon can be a major pollution problem in groundwater as well as soil. Many people interact with these chemicals on daily accidentally or by professionally in the laboratory. One of the most common sources for Chlorinated hydrocarbon contamination of soil and groundwater are industrial effluents. The wide use and discharge of Trichloroethylene (TCE), a volatile chlorohydrocarbon from chemical industry, led to major water pollution in rural areas. TCE is an mainly used as an industrial metal degreaser in industries. Biotransformation of TCE to the potent carcinogen vinyl chloride (VC) by consortia of anaerobic bacteria might have role for the above purpose. For these reasons, the aim of current study was to isolate and characterized the genes involved in TCE metabolism and also to investigate the in silico study of those genes. To our knowledge, only one aromatic dioxygenase system, the toluene dioxygenase in Pseudomonas putida F1 has been shown to be involved in TCE degradation. This is first instance where Bacillus cereus group being used in biodegradation of trichloroethylene. A novel bacterial strain 2479 was isolated from oil depot site at Rajbandh, Durgapur (West Bengal, India) by enrichment culture technique. It was identified based on polyphasic approach and ribotyping. The bacterium was gram positive, rod shaped, endospore forming and capable of degrading trichloroethylene as the sole carbon source. On the basis of phylogenetic data and Fatty Acid Methyl Ester Analysis, strain 2479 should be placed within the genus Bacillus and species cereus. However, the present isolate (strain 2479) is unique and sharply different from the usual Bacillus strains in its biodegrading nature. Fujiwara test was done to estimate that the strain 2479 could degrade TCE efficiently. The gene for TCE biodegradation was PCR amplified from genomic DNA of Bacillus cereus 2479 by using todC1 gene specific primers. The 600bp amplicon was cloned into expression vector pUC I8 in the E. coli host XL1-Blue and expressed under the control of lac promoter and nucleotide sequence was determined. The gene sequence was deposited at NCBI under the Accession no. GU183105. In Silico approach involved predicting the physico-chemical properties of deduced Tce1 protein by using ProtParam tool. The tce1 gene contained 342 bp long ORF encoding 114 amino acids with a predicted molecular weight 12.6 kDa and the theoretical pI value of the polypeptide was 5.17, molecular formula: C559H886N152O165S8, total number of atoms: 1770, aliphatic index: 101.93, instability index: 28.60, Grand Average of Hydropathicity (GRAVY): 0.152. Three differentially expressed proteins (97.1, 40 and 30 kDa) were directly involved in TCE biodegradation, found to react immunologically to the antibodies raised against TCE inducible proteins in Western blot analysis. The present study suggested that cloned gene product (TCE1) was capable of degrading TCE as verified chemically.

Keywords: cloning, Bacillus cereus, in silico analysis, TCE

Procedia PDF Downloads 369

Authors: Md. Afroz Ansari

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The Bengal basin is a spectacular example of a peripheral foreland basin formed by the convergence of the Indian plate beneath the Eurasian and Burmese plates. The basin is embraced on three sides; north, west and east by different fault-controlled tectonic features whereas released in the south where the rivers are drained into the Bay of Bengal. The Bengal basin in the eastern part of the Indian subcontinent constitutes the largest fluvio-deltaic to shallow marine sedimentary basin in the world today. This continental basin coupled with the offshore Bengal Fan under the Bay of Bengal forms the biggest sediment dispersal system. The continental basin is continuously receiving the sediments by the two major rivers Ganga and Brahmaputra (known as Jamuna in Bengal), and Meghna (emerging from the point of conflux of the Ganga and Brahmaputra) and large number of rain-fed, small tributaries originating from the eastern Indian Shield. The drained sediments are ultimately delivered into the Bengal fan. The significance of the present study is to delineate the variations in thicknesses of the sediments, different crustal structures, and the mantle lithosphere throughout the onshore-offshore Bengal basin. In the present study, the different crustal/geological units and the shallower mantle lithosphere were delineated by analyzing the Bouguer Gravity Anomaly (BGA) data along two long traverses South-North (running from Bengal fan cutting across the transition offshore-onshore of the Bengal basin and intersecting the Main Frontal Thrust of India-Himalaya collision zone in Sikkim-Bhutan Himalaya) and West-East (running from the Peninsular Indian Shield across the Bengal basin to the Chittagong–Tripura Fold Belt). The BGA map was derived from the analysis of topex data after incorporating Bouguer correction and all terrain corrections. The anomaly map was compared with the available ground gravity data in the western Bengal basin and the sub-continents of India for consistency of the data used. Initially, the anisotropy associated with the thicknesses of the different crustal units, crustal interfaces and moho boundary was estimated through spectral analysis of the gravity data with varying window size over the study area. The 2D density sections along the traverses were finalized after a number of iterations with the acceptable root mean square (RMS) errors. The estimated thicknesses of the different crustal units and dips of the Moho boundary along both the profiles are consistent with the earlier results. Further the results were encouraged by examining the earthquake database and focal mechanism solutions for better understanding the geodynamics. The earthquake data were taken from the catalogue of US Geological Survey, and the focal mechanism solutions were compiled from the Harvard Centroid Moment Tensor Catalogue. The concentrations of seismic events at different depth levels are not uncommon. The occurrences of earthquakes may be due to stress accumulation as a result of resistance from three sides.

Keywords: anisotropy, interfaces, seismicity, spectrum analysis

Procedia PDF Downloads 243

Authors: Dahna Alkahtani, Faryal Suraya, Fadah Alanazi

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Background: Buccal mucosal graft for urethral augmentation has surpassed other grafting options, and is now considered the standard of choice for substitution Urethroplasty. The graft has gained its popularity due to its excellent short and long-term results, easy harvesting as well as its ability in withstanding wet environments. However, although Buccal mucosal grafts are an excellent option, it is not free of complications, potential intraoral complications are bleeding, pain, swelling, injury to the nerve resulting in numbness, lip deviation or retraction. Objectives: The current study aims to evaluate the intraoral complications of buccal mucosa grafts harvested from one cheek, and used in Augmentation Urethroplasty. Methodology: The study was conducted retrospectively using the medical records of patients who underwent open augmentation urethroplasty with a buccal mucosa graft at King Khalid University Hospital, Saudi Arabia. Data collection of demographics included the type of graft used, presence or absence of strictures and its etiological factors. Pre-operative and post-operative evaluations were carried out on the subjects including the medical history, physical examination, uroflowmetry, retrograde urethrography, voiding cystourethrography and urine cultures were also noted. Further, the quality of life and complications of the procedure including the presence or occurrence of bleeding within 3-days post-procedure, the severity of pain, oral swelling after grafting, length of return to normal daily diet, painful surgical site, intake of painkillers, presence or absence of speech disturbance, numbness in the cheeks and lips were documented. Results: Thirty-two male subjects with ages ranging from 15 years to 72 years were included in the current study. Following the procedure, a hundred percent of the subjects returned to their normal daily diet by the sixth postoperative day. Further, the majority of the patients reported experiencing mild pain accounting for 61.3%, and 90.3% of the subjects reported using painkillers to control the pain. Surgical wound Pain was reportedly more common at the perineal site as 48.4% of the subjects experienced it; on the other hand, 41.9% of the patients experienced pain in the oral mucosa. The presence of speech disorders, as assessed through medical history, was found to be present in 3.2% of patients. The presence of numbness in the cheeks and lips was found in 3.2% of patients. Other complications such as parotid duct injury, delayed wound healing, non-healing wound and suture granuloma were rare as 90.3% of the subjects denied experiencing any of them, there were nonetheless reports of parotid duct injury by 6.5% of the patients, and non-healing wound by the 3.2% of patients. Conclusion: Buccal Mucosa Graft in Augmentation Urethroplasty is an ideal source of allograft, although not entirely painless; it is considerably safe with minimal intra-oral complication and undetectable strain on the patients’ quality of life.

Keywords: augmentation, buccal, graft, oral

Procedia PDF Downloads 150

Authors: Jonardan Koner, Avinash Purandare

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In today’s globalized world international business is a very key area for the country's growth. Some of the strategic areas for holding up a country’s international business to grow are in the areas of connecting Ports, Road Network, and Rail Network. India’s International Business is booming both in Exports as well as Imports. Ports play a very central part in the growth of international trade and ensuring competitive ports is of critical importance. India has a long coastline which is a big asset for the country as it has given the opportunity for development of a large number of major and minor ports which will contribute to the maritime trades’ development. The National Economic Development of India requires a well-functioning seaport system. To know the comparative strength of Indian ports over South-east Asian similar ports, the study is considering the objectives of (I) to identify the key parameters of an international mega container port, (II) to compare the five selected container ports (JNPT, Chennai, Singapore, Dubai, and Colombo Ports) according to user of the ports and iii) to measure the growth of selected five container ports’ throughput over time and their comparison. The study is based on both primary and secondary databases. The linear time trend analysis is done to show the trend in quantum of exports, imports and total goods/services handled by individual ports over the years. The comparative trend analysis is done for the selected five ports of cargo traffic handled in terms of Tonnage (weight) and number of containers (TEU’s). The comparative trend analysis is done between containerized and non-containerized cargo traffic in the five selected five ports. The primary data analysis is done comprising of comparative analysis of factor ratings through bar diagrams, statistical inference of factor ratings for the selected five ports, consolidated comparative line charts of factor rating for the selected five ports, consolidated comparative bar charts of factor ratings of the selected five ports and the distribution of ratings (frequency terms). The linear regression model is used to forecast the container capacities required for JNPT Port and Chennai Port by the year 2030. Multiple regression analysis is carried out to measure the impact of selected 34 explanatory variables on the ‘Overall Performance of the Port’ for each of the selected five ports. The research outcome is of high significance to the stakeholders of Indian container handling ports. Indian container port of JNPT and Chennai are benchmarked against international ports such as Singapore, Dubai, and Colombo Ports which are the competing ports in the neighbouring region. The study has analysed the feedback ratings for the selected 35 factors regarding physical infrastructure and services rendered to the port users. This feedback would provide valuable data for carrying out improvements in the facilities provided to the port users. These installations would help the ports’ users to carry out their work in more efficient manner.

Keywords: throughput, twenty equivalent units, TEUs, cargo traffic, shipping lines, freight forwarders

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Authors: K. S. Rao, Ankesh Kumar

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The search for alternative energy sources to petroleum has increased these days because of increase in need and depletion of petroleum reserves. Therefore the importance of oil shales as an economically viable substitute has increased many folds in last 20 years. The technologies like hydro-fracturing have opened the field of oil extraction from these unconventional rocks. Oil shale is a compact laminated rock of sedimentary origin containing organic matter known as kerogen which yields oil when distilled. Oil shales are formed from the contemporaneous deposition of fine grained mineral debris and organic degradation products derived from the breakdown of biota. Conditions required for the formation of oil shales include abundant organic productivity, early development of anaerobic conditions, and a lack of destructive organisms. These rocks are not gown through the high temperature and high pressure conditions in Mother Nature. The most common approach for oil extraction is drastically breaking the bond of the organics which involves retorting process. The two approaches for retorting are surface retorting and in-situ processing. The most environmental friendly approach for extraction is In-situ processing. The three steps involved in this process are fracturing, injection to achieve communication, and fluid migration at the underground location. Upon heating (retorting) oil shale at temperatures in the range of 300 to 400°C, the kerogen decomposes into oil, gas and residual carbon in a process referred to as pyrolysis. Therefore it is very important to understand the physico-mechenical behavior of such rocks, to improve the technology for in-situ extraction. It is clear from the past research and the physical observations that these rocks will behave as an anisotropic rock so it is very important to understand the mechanical behavior under high pressure at different orientation angles for the economical use of these resources. By knowing the engineering behavior under above conditions will allow us to simulate the deep ground retorting conditions numerically and experimentally. Many researchers have investigate the effect of organic content on the engineering behavior of oil shale but the coupled effect of organic and inorganic matrix is yet to be analyzed. The favourable characteristics of Assam coal for conversion to liquid fuels have been known for a long time. Studies have indicated that these coals and carbonaceous shale constitute the principal source rocks that have generated the hydrocarbons produced from the region. Rock cores of the representative samples are collected by performing on site drilling, as coring in laboratory is very difficult due to its highly anisotropic nature. Different tests are performed to understand the petrology of these samples, further the chemical analyses are also done to exactly quantify the organic content in these rocks. The mechanical properties of these rocks are investigated by considering different anisotropic angles. Now the results obtained from petrology and chemical analysis are correlated with the mechanical properties. These properties and correlations will further help in increasing the producibility of these rocks. It is well established that the organic content is negatively correlated to tensile strength, compressive strength and modulus of elasticity.

Keywords: oil shale, producibility, hydro-fracturing, kerogen, petrology, mechanical behavior

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Authors: Christabel Ihedike, John Mooney, Monica Price

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Summary: This study aims to critically evaluate effect of photochemical smog on respiratory health in Nigeria. Cohort of chronic obstructive pulmonary disease (COPD) patients was recruited from two large hospitals in Abuja Nigeria. Respiratory health questionnaires, daily diaries, dyspnoea scale and lung function measurement were used to obtain health data and investigate the relationship with air quality data (principally ozone, NOx and particulate pollution). Concentrations of air pollutants were higher than WHO and Nigerian air quality standard. The result suggests a correlation between measured air quality and exacerbation of respiratory illness. Introduction: Photochemical smog is a significant health challenge in most cities and its effect on respiratory health is well acknowledged. This type of pollution is most harmful to the elderly, children and those with underlying respiratory disease. This study aims to investigate impact of increasing temperature and photo-chemically generated secondary air pollutants on respiratory health in Abuja Nigeria. Method and Result: Health data was collected using spirometry to measure lung function on routine attendance at the clinic, daily diaries kept by patients and information obtained using respiratory questionnaire. Questionnaire responses (obtained using an adapted and internally validated version of St George’s Hospital Respiratory Questionnaire), shows that ‘time of wheeze’ showed an association with participants activities: 30% had worse wheeze in the morning: 10% cannot shop, 15% take long-time to get washed, 25% walk slower, 15% if hurry have to stop and 5% cannot take-bath. There was also a decrease in Forced expiratory volume in the first second and Forced Vital Capacity, and daily change in the afternoon–morning may be associated with the concentration level of pollutants. Also, dyspnoea symptoms recorded that 60% of patients were on grade 3, 25% grade 2 and 15% grade 1. Daily frequency of the number of patients in the cohort that cough /brought sputum is 78%. Air pollution in the city is higher than Nigerian and WHO standards with NOx and PM10 concentrations of 693.59ug/m-3 and 748ugm-3 being measured respectively. The result shows that air pollution may increase occurrence and exacerbation of respiratory disease. Conclusion: High temperature and local climatic conditions in urban Nigeria encourages formation of Ozone, the major constituent of photochemical smog, resulting also in the formation of secondary air pollutants associated with health challenges. In this study we confirm the likely potency of the pattern of secondary air pollution in exacerbating COPD symptoms in vulnerable patient group in urban Nigeria. There is need for better regulation and measures to reduce ozone, particularly when local climatic conditions favour development of photochemical smog in such settings. Climate change and likely increasing temperatures add impetus and urgency for better air quality standards and measures (traffic-restrictions and emissions standards) in developing world settings such as Nigeria.

Keywords: Abuja-Nigeria, effect, photochemical smog, respiratory health

Procedia PDF Downloads 192

Authors: Feyi Olorunshola

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Over the last few years, the senior travel market has been noted for its potential in the wider tourism industry. The tourism sector includes the hotel and hospitality, travel, transportation, and several other subdivisions to make it economically viable. In particular, the hotel attracts a substantial part of the expenditure in tourism activities as when people plan to travel, suitable accommodation for relaxation, dining, entertainment and so on is paramount to their decision-making. The global retail value of the hotel as of 2018 was significant for tourism. But, despite indications of the hotel to the tourism industry at large, very few empirical studies are available to establish how this sector can leverage on the senior demographic to achieve competitive advantage. Predominantly, studies on the mature market have focused on destination tourism, with a limited investigation on the hotel which makes a significant contribution to tourism. Also, several scholarly studies have demonstrated the importance of the senior travel market to the hotel, yet there is very little empirical research in the field which has explored the driving factors that will become the accepted new normal for this niche segment post-pandemic. Giving that the hotel already operates in a highly saturated business environment, and on top of this pre-existing challenge, the ongoing global health outbreak has further put the sector in a vulnerable position. Therefore, the hotel especially the full-service luxury category must evolve rapidly for it to survive in the current business environment. The hotel can no longer rely on corporate travelers to generate higher revenue since the unprecedented wake of the pandemic in 2020 many organizations have invented a different approach of conducting their businesses online, therefore, the hotel needs to anticipate a significant drop in business travellers. However, the rooms and the rest of the facilities must be occupied to keep their business operating. The way forward for the hotel lies in the leisure sector, but the question now is to focus on the potential demographics of travelers, in this case, the seniors who have been repeatedly recognized as the lucrative market because of increase discretionary income, availability of time and the global population trends. To achieve the study objectives, a mixed-method approach will be utilized drawing on both qualitative (netnography) and quantitative (survey) methods, cognitive and decision-making theories (means-end chain) and competitive theories to identify the salient drivers explaining senior hotel choice and its influence on their decision-making. The target population are repeated seniors’ age 65 years and over who are UK resident, and from the top tourist market to the UK (USA, Germany, and France). Structural equation modelling will be employed to analyze the datasets. The theoretical implication is the development of new concepts using a robust research design, and as well as advancing existing framework to hotel study. Practically, it will provide the hotel management with the latest information to design a competitive marketing strategy and activities to target the mature market post-pandemic and over a long period.

Keywords: competitive advantage, covid-19, full-service hotel, five-star, luxury hotels

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Authors: Kiana Taheri

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Rural tourism has garnered significant attention as a catalyst for rural development and sustainability, particularly in regions like Tuscany, Italy, where the convergence of cultural heritage, picturesque landscapes, and agricultural traditions provides a fertile ground for tourism activities. This paper investigates the pivotal role of women entrepreneurs in driving sustainable rural tourism development, with a specific focus on Tuscany. Drawing upon a synthesis of literature on rural tourism, entrepreneurship, and gender studies, this research offers insights into how women entrepreneurs contribute to the economic, social, and environmental dimensions of rural tourism in Tuscany. The conceptual framework of this study is rooted in the evolving landscape of rural development, shaped by shifting paradigms in agricultural policies, such as the Common Agricultural Policy (CAP) of the European Union. This framework underscores the transition from traditional agrarian economies to dynamic rural tourism destinations characterized by a consumer-centric approach and a focus on sustainable development. Against this backdrop, the study delves into the multifaceted contributions of women entrepreneurs within the rural tourism sector. Central to the analysis is the recognition of rural tourism as a nexus of social, cultural, economic, and environmental interactions, wherein women entrepreneurs play a pivotal role in leveraging local resources, preserving cultural heritage, and fostering community engagement. By capitalizing on their unique perspectives, skills, and networks, women entrepreneurs drive innovation, diversification, and inclusivity within the tourism sector, thereby enhancing its resilience and long-term viability. Moreover, the study highlights the symbiotic relationship between rural tourism development and women's empowerment, as evidenced by the increasing prominence of women entrepreneurs in Tuscany's rural economy. Through their leadership roles in small and medium enterprises (SMEs) and agritourism ventures, women entrepreneurs not only contribute to economic growth but also challenge traditional gender norms and empower local communities. A key empirical focus of this research is a comprehensive case study of Tuscany, renowned for its successful rural tourism model and vibrant entrepreneurial ecosystem. Through qualitative interviews, surveys, and archival analysis, the study elucidates the strategies, challenges, and impacts of women entrepreneurs on sustainable rural tourism development in Tuscany. By examining the experiences of women entrepreneurs across diverse sectors of rural tourism, including hospitality, gastronomy, and cultural heritage, the study offers nuanced insights into their contributions to regional development and empowerment. In conclusion, this research contributes to the burgeoning scholarship on rural tourism, entrepreneurship, and gender studies by shedding light on the transformative role of women entrepreneurs in driving sustainable development agendas in rural areas. By elucidating the interplay between gender dynamics, entrepreneurial activities, and tourism development, this study seeks to inform policy interventions and strategic initiatives aimed at fostering inclusive and sustainable rural tourism ecosystems.

Keywords: rural tourism, women empowerment, entrepreneurship, sustainable development, small and medium-sized enterprises (SMEs)

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Authors: Michal Pachocki

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This study investigates the effects of mobility in the context of a different environment and work culture through analysing the learners perception of their international work experience. Since this kind of professional training abroad is becoming more popular in Europe, mainly due to the EU funding opportunities, it is of paramount importance to assess its long-term impact on educational and career paths of former students. Moreover, the tracer study aimed at defining what professional, social and intercultural competencies were gained or developed by the interns and to which extent those competences proved to be useful meeting the labor market requirements. Being a populous EU member state which actively modernizes its vocational education system (also with European funds), Poland can serve as an illustrative case study to investigate the above described research problems. However, the examined processes are most certainly universal, wherever mobility is included in the learning process. The target group of this research was the former mobility participants and the study was conducted using quantitative and qualitative methods, such as the online survey with over 2 600 questionnaires completed by the former mobility participants; -individual in-depth interviews (IDIs) with 20 Polish graduates already present in the labour market; - 5 focus group interviews (FGIs) with 60 current students of the Polish vocational schools, who have recently returned from the training abroad. As the adopted methodology included a data triangulation, the collected findings have also been supplemented with data obtained by the desk research (mainly contextual information and statistical summary of mobility implementation). The results of this research – to be presented in full scope within the conference presentation – include the participants’ perception of their work mobility. The vast majority of graduates agrees that such an experience has had a significant impact on their professional careers and claims that they would recommend training abroad to persons who are about to enter the labor market. Moreover, in their view, such form of practical training going beyond formal education provided them with an opportunity to try their hand in the world of work. This allowed them – as they accounted for them – to get acquainted with a work system and context different from the ones experienced in Poland. Although the work mobility becomes an important element of the learning process in the growing number of Polish schools, this study reveals that many sending institutions suffer from a lack of the coherent strategy for planning domestic and foreign training programmes. Nevertheless, the significant number of graduates claims that such a synergy improves the quality of provided training. Despite that, the research proved that the transnational mobilities exert an impact on their future careers and personal development. However, such impact is, in their opinion, dependant on other factors, such as length of the training period, the nature and extent of work, recruitment criteria and the quality of organizational arrangement and mentoring provided to learners. This may indicate the salience of the sending and receiving institutions organizational capacity to deal with mobility.

Keywords: learning mobility, transnational training, vocational education and training graduates, tracer study

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Authors: Blaga Alexandra Cristina, Kloetzer Lenuta, Bompa Amalia Stela, Galaction Anca Irina, Cascaval Dan

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Vitamin B9 is an important member of vitamins B group, being a growth factor, important for making genetic material as DNA and RNA, red blood cells, for building muscle tissues, especially during periods of infancy, adolescence and pregnancy. Its production by biosynthesis is based on the high metabolic potential of mutant Bacillus subtilis, due to a superior biodisponibility compared to that obtained by chemical pathways. Pertraction, defined as the extraction and transport through liquid membranes consists in the transfer of a solute between two aqueous phases of different pH-values, phases that are separated by a solvent layer of various sizes. The pertraction efficiency and selectivity could be significantly enhanced by adding a carrier in the liquid membrane, such as organophosphoric compounds, long chain amines or crown-ethers etc., the separation process being called facilitated pertraction. The aim of the work is to determine the impact of the presence of two extractants/carriers in the bulk liquid membrane, i.e. di(2-ethylhexyl) phosphoric acid (D2EHPA) and lauryltrialkylmetilamine (Amberlite LA2) on the transport kinetics of vitamin B9. The experiments have been carried out using two pertraction equipments for a free liquid membrane or bulk liquid membrane. One pertraction cell consists on a U-shaped glass pipe (used for the dichloromethane membrane) and the second one is an H-shaped glass pipe (used for h-heptane), having 45 mm inner diameter of the total volume of 450 mL, the volume of each compartment being of 150 mL. The aqueous solutions are independently mixed by means of double blade stirrers with 6 mm diameter and 3 mm height, having the rotation speed of 500 rpm. In order to reach high diffusional rates through the solvent layer, the organic phase has been mixed with a similar stirrer, at a similar rotation speed (500 rpm). The area of mass transfer surface, both for extraction and for reextraction, was of 1.59x10-³ m2. The study on facilitated pertraction with the mixture of two carriers, namely D2EHPA and Amberlite LA-2, dissolved in two solvents with different polarities: n-heptane and dichloromethane, indicated the possibility to obtain the synergic effect. The synergism has been analyzed by considering the vitamin initial and final mass flows, as well as the permeability factors through liquid membrane. The synergic effect has been observed at low D2EHPA concentrations and high Amberlite LA-2 concentrations, being more important for the low-polar solvent (n-heptane). The results suggest that the mechanism of synergic pertraction consists on the reaction between the organophosphoric carrier and vitamin B9 at the interface between the feed and membrane phases, while the aminic carrier enhances the hydrophobicity of this compound by solvation. However, the formation of this complex reduced the reextraction rate and, consequently, affects the synergism related to the final mass flows and permeability factor. For describing the influences of carriers concentrations on the synergistic coefficients, some equations have been proposed by taking into account the vitamin mass flows or permeability factors, with an average deviations between 4.85% and 10.73%.

Keywords: pertraction, synergism, vitamin B9, Amberlite LA-2, di(2-ethylhexyl) phosphoric acid

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Authors: Eleonora Di Salvo, Antonio Panebianco, Graziella Ziino

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Background: Vibrio parahaemolyticus is a human pathogen that is widely distributed in marine environments. It is frequently isolated from raw seafood, particularly shellfish. Consumption of raw or undercooked seafood contaminated with V. parahaemolyticus may lead to acute gastroenteritis. Vibrio spp. has excellent resistance to low temperatures so it can be found in frozen products for a long time. Recently, the viable but non-culturable state (VBNC) of bacteria has attracted great attention, and more than 85 species of bacteria have been demonstrated to be capable of entering this state. VBNC cells cannot grow in conventional culture medium but are viable and maintain metabolic activity, which may constitute an unrecognized source of food contamination and infection. Also V. parahaemolyticus could exist in VBNC state under nutrient starvation or low-temperature conditions. Aim: The aim of the present study was to optimize methods and investigate V. parahaemolyticus VBNC cells and their presence in frozen bivalve molluscs, regularly marketed. Materials and Methods: propidium monoazide (PMA) was integrated with real-time polymerase chain reaction (qPCR) targeting the tl gene to detect and quantify V. parahaemolyticus in the VBNC state. PMA-qPCR resulted highly specific to V. parahaemolyticus with a limit of detection (LOD) of 10-1 log CFU/mL in pure bacterial culture. A standard curve for V. parahaemolyticus cell concentrations was established with the correlation coefficient of 0.9999 at the linear range of 1.0 to 8.0 log CFU/mL. A total of 77 samples of frozen bivalve molluscs (35 mussels; 42 clams) were subsequently subjected to the qualitative (on alkaline phosphate buffer solution) and quantitative research of V. parahaemolyticus on thiosulfate-citrate-bile salts-sucrose (TCBS) agar (DIFCO) NaCl 2.5%, and incubation at 30°C for 24-48 hours. Real-time PCR was conducted on homogenate samples, in duplicate, with and without propidium monoazide (PMA) dye, and exposed for 45 min under halogen lights (650 W). Total DNA was extracted from cell suspension in homogenate samples according to bolliture protocol. The Real-time PCR was conducted with species-specific primers for V. parahaemolitycus. The RT-PCR was performed in a final volume of 20 µL, containing 10 µL of SYBR Green Mixture (Applied Biosystems), 2 µL of template DNA, 2 µL of each primer (final concentration 0.6 mM), and H2O 4 µL. The qPCR was carried out on CFX96 TouchTM (Bio-Rad, USA). Results: All samples were negative both to the quantitative and qualitative detection of V. parahaemolyticus by the classical culturing technique. The PMA-qPCR let us individuating VBNC V. parahaemolyticus in the 20,78% of the samples evaluated with a value between the Log 10-1 and Log 10-3 CFU/g. Only clams samples were positive for PMA-qPCR detection. Conclusion: The present research is the first evaluating PMA-qPCR assay for detection of VBNC V. parahaemolyticus in bivalve molluscs samples, and the used method was applicable to the rapid control of marketed bivalve molluscs. We strongly recommend to use of PMA-qPCR in order to identify VBNC forms, undetectable by the classic microbiological methods. A precise knowledge of the V.parahaemolyticus in a VBNC form is fundamental for the correct risk assessment not only in bivalve molluscs but also in other seafood.

Keywords: food safety, frozen bivalve molluscs, PMA dye, Real-time PCR, VBNC state, Vibrio parahaemolyticus

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Authors: Bruno Biagianti, Angela Tseng, Kathy Wannaviroj, Allison Corlett, Megan DuBois, Kyu Lee, Suma Jacob

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Background: ASD is characterized by pervasive Sensory Processing Abnormalities (SPA) and social cognitive deficits that persist throughout the course of the illness and have been linked to functional abnormalities in specific neural systems that underlie the perception, processing, and representation of sensory information. SPA and social cognitive deficits are associated with difficulties in interpersonal relationships, poor development of social skills, reduced social interactions and lower academic performance. Importantly, they can hamper the effects of established evidence-based psychological treatments—including PEERS (Program for the Education and Enrichment of Relationship Skills), a parent/caregiver-assisted, 16-weeks social skills intervention—which nonetheless requires a functional brain capable of assimilating and retaining information and skills. As a matter of fact, some adolescents benefit from PEERS more than others, calling for strategies to increase treatment response rates. Objective: We will present interim data on CICADAS (Care Improving Cognition for ADolescents on the Autism Spectrum)—a clinician-assisted, closed-loop technology mobile application for adolescents with ASD. Via ten mobile assessments, CICADAS captures data on sensory processing abnormalities and associated cognitive deficits. These data populate a machine learning algorithm that tailors the delivery of ten neuroplasticity-based social cognitive training (NB-SCT) exercises targeting sensory processing abnormalities. Methods: In collaboration with the Autism Spectrum and Neurodevelopmental Disorders Clinic at the University of Minnesota, we conducted a fully remote, three-arm, randomized crossover trial with adolescents with ASD to document the acceptability of CICADAS and evaluate its potential as a stand-alone treatment or as a treatment enhancer of PEERS. Twenty-four adolescents with ASD (ages 11-18) have been initially randomized to 16 weeks of PEERS + CICADAS (Arm A) vs. 16 weeks of PEERS + computer games vs. 16 weeks of CICADAS alone (Arm C). After 16 weeks, the full battery of assessments has been remotely administered. Results: We have evaluated the acceptability of CICADAS by examining adherence rates, engagement patterns, and exit survey data. We found that: 1) CICADAS is able to serve as a treatment enhancer for PEERS, inducing greater improvements in sensory processing, cognition, symptom reduction, social skills and behaviors, as well as the quality of life compared to computer games; 2) the concurrent delivery of PEERS and CICADAS induces greater improvements in study outcomes compared to CICADAS only. Conclusion: While preliminary, our results indicate that the individualized assessment and treatment approach designed in CICADAS seems effective in inducing adaptive long-term learning about social-emotional events. CICADAS-induced enhancement of processing and cognition facilitates the application of PEERS skills in the environment of adolescents with ASD, thus improving their real-world functioning.

Keywords: ASD, social skills, cognitive training, mobile app

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Authors: Nino Kupatadze, Mzevinar Bedinashvili, Tamar Memanishvili, Manana Gurielidze, David Tugushi, Ramaz Katsarava

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Bacteria easily colonize the surfaces of tissues, surgical devices (implants, orthopedics, catheters, etc.), and instruments causing surgical device related infections. Therefore, the battle against bacteria and the prevention of surgical devices from biofilm formation is one of the main challenges of biomedicine today. Our strategy to the solution of this problem consists in using antimicrobial polymeric coatings as effective “shields” to protect surfaces from bacteria’s colonization and biofilm formation. As one of the most promising approaches look be the use of antimicrobial bioerodible polymeric nanocomposites containing silver nanoparticles (AgNPs). We assume that the combination of an erodible polymer with a strong bactericide should put obstacles to bacteria to occupy the surface and to form biofilm. It has to be noted that this kind of nanocomposites are also promising as wound dressing materials to treat infected superficial wounds. Various synthetic and natural polymers were used for creating biocomposites containing AgNPs as both particles' stabilizers and matrices forming elastic films at surfaces. One of the most effective systems to fabricate AgNPs is an ethanol solution of polyvinylpyrrolidone(PVP) with dissolved AgNO3–ethanol serves as a AgNO3 reductant and PVP as AgNPs stabilizer (through the interaction of nanoparticles with nitrogen atom of the amide group). Though PVP is biocompatible and film-forming polymer, it is not a good candidate to design either "biofilm shield" or wound dressing material because of a high solubility in water – though the solubility of PVP provides the desirable release of AgNPs from the matrix, but the coating is easily washable away from the surfaces. More promising as matrices look water insoluble but bioerodible polymers that can provide the release of AgNPs and form long-lasting coatings at the surfaces. For creating bioerodible water-insoluble antimicrobial coatings containing AgNPs, we selected amino acid based biodegradable polymers(AABBPs)–poly(ester amide)s, poly(ester urea)s, their copolymers containing amide and related groups capable to stabilize AgNPs. Among a huge variety of AABBPs reported we selected the polymers soluble in ethanol. For preparing AgNPs containing nanocompositions AABBPs and AgNO3 were dissolved in ethanol and subjected to photochemical reduction using daylight-irradiation. The formation of AgNPs was observed visually by coloring the solutions in brownish-red. The obtained AgNPs were characterized by UV-spectroscopy, transmission electron microscopy(TEM), and dynamic light scattering(DLS). According to the UV and TEM data, the photochemical reduction resulted presumably in spherical AgNPs with rather high contribution of the particles below 10 nm that are known as responsible for the antimicrobial activity. DLS study showed that average size of nanoparticles formed after photo-reduction in ethanol solution ranged within 50 nm. The in vitro antimicrobial activity study of the new nanocomposite material is in progress now.

Keywords: nanocomposites, silver nanoparticles, polymer, biodegradable

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Authors: Galatee Levadoux, Trevor Benson, Chris Worrall

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With the rise of public awareness on climate change comes an increasing demand for renewable sources of energy. As a result, the wind power sector is striving to manufacture longer, more efficient and reliable wind turbine blades. Currently, one of the leading causes of blade failure in service is improper cure of the resin during manufacture. The infusion process creating the main part of the composite blade structure remains a critical step that is yet to be monitored in real time. This stage consists of a viscous resin being drawn into a mould under vacuum, then undergoing a curing reaction until solidification. Successful infusion assumes the resin fills all the voids and cures completely. Given that the electrical properties of the resin change significantly during its solidification, both the filling of the mould and the curing reaction are susceptible to be followed using dieletrometry. However, industrially available dielectrics sensors are currently too small to monitor the entire surface of a wind turbine blade. The aim of the present research project is to scale up the dielectric sensor technology and develop a device able to monitor the manufacturing process of large composite structures, assessing the conformity of the blade before it even comes out of the mould. An array of flat copper wires acting as electrodes are embedded in a polymer matrix fixed in an infusion mould. A multi-frequency analysis from 1 Hz to 10 kHz is performed during the filling of the mould with an epoxy resin and the hardening of the said resin. By following the variations of the complex admittance Y*, the filling of the mould and curing process are monitored. Results are compared to numerical simulations of the sensor in order to validate a virtual cure-monitoring system. The results obtained by drawing glycerol on top of the copper sensor displayed a linear relation between the wetted length of the sensor and the complex admittance measured. Drawing epoxy resin on top of the sensor and letting it cure at room temperature for 24 hours has provided characteristic curves obtained when conventional interdigitated sensor are used to follow the same reaction. The response from the developed sensor has shown the different stages of the polymerization of the resin, validating the geometry of the prototype. The model created and analysed using COMSOL has shown that the dielectric cure process can be simulated, so long as a sufficient time and temperature dependent material properties can be determined. The model can be used to help design larger sensors suitable for use with full-sized blades. The preliminary results obtained with the sensor prototype indicate that the infusion and curing process of an epoxy resin can be followed with the chosen configuration on a scale of several decimeters. Further work is to be devoted to studying the influence of the sensor geometry and the infusion parameters on the results obtained. Ultimately, the aim is to develop a larger scale sensor able to monitor the flow and cure of large composite panels industrially.

Keywords: composite manufacture, dieletrometry, epoxy, resin infusion, wind turbine blades

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Authors: Liang Zhao, Chongquan Zhong

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Introduction: According to statistics, people spend 80% to 90% of time indoor, so indoor air quality, either at home or in the office, greatly impacts the quality of life, health and work efficiency. Therefore, indoor air quality is very important to human activities. With the acceleration of urbanization, people are spending more time in indoor activity. The time in indoor environment, the living space, and the frequency interior decoration are all increasingly increased. However, housing decoration materials contain formaldehyde and other harmful substances, causing environmental and air quality problems, which have brought serious damage to countless families and attracted growing attention. According to World Health Organization statistics, the indoor environments in more than 30% of buildings in China are polluted by poisonous and harmful gases. Indoor pollution has caused various health problems, and these widespread public health problems can lead to respiratory diseases. Long-term inhalation of low-concentration formaldehyde would cause persistent headache, insomnia, weakness, palpitation, weight loss and vomiting, which are serious impacts on human health and safety. On the other hand, as for offices, some surveys show that good indoor air quality helps to enthuse the staff and improve the work efficiency by 2%-16%. Therefore, people need to further understand the living and working environments. There is a need for easy-to-use indoor environment monitoring instruments, with which users only have to power up and monitor the environmental parameters. The corresponding real-time data can be displayed on the screen for analysis. Environment monitoring should have the sensitive signal alarm function and send alarm when harmful gases such as formaldehyde, CO, SO2, are excessive to human body. System design: According to the monitoring requirements of various gases, temperature and humidity, we designed a portable, light, real-time and accurate monitor for various environmental parameters, including temperature, humidity, formaldehyde, methane, and CO. This monitor will generate an alarm signal when a target is beyond the standard. It can conveniently measure a variety of harmful gases and provide the alarm function. It also has the advantages of small volume, convenience to carry and use. It has a real-time display function, outputting the parameters on the LCD screen, and a real-time alarm function. Conclusions: This study is focused on the research and development of a portable parameter monitoring instrument for indoor environment. On the platform of an STM32 development board, the monitored data are collected through an external sensor. The STM32 platform is for data acquisition and processing procedures, and successfully monitors the real-time temperature, humidity, formaldehyde, CO, methane and other environmental parameters. Real-time data are displayed on the LCD screen. The system is stable and can be used in different indoor places such as family, hospital, and office. Meanwhile, the system adopts the idea of modular design and is superior in transplanting. The scheme is slightly modified and can be used similarly as the function of a monitoring system. This monitor has very high research and application values.

Keywords: indoor air quality, gas concentration detection, embedded system, sensor

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Authors: Bensaid A., Mostephaoui T., Nedjai R.

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A considerable area of Algerian lands are threatened by the phenomenon of wind erosion. For a long time, wind erosion and its associated harmful effects on the natural environment have posed a serious threat, especially in the arid regions of the country. In recent years, as a result of increases in the irrational exploitation of natural resources (fodder) and extensive land clearing, wind erosion has particularly accentuated. The extent of degradation in the arid region of the Algerian Mécheriadepartment generated a new situation characterized by the reduction of vegetation cover, the decrease of land productivity, as well as sand encroachment on urban development zones. In this study, we attempt to investigate the potential of remote sensing and geographic information systems for detecting the spatial dynamics of the ancient dune cords based on the numerical processing of PlanetScope PSB.SB sensors images by September 29, 2021. As a second step, we prospect the use of a multi-scale geographic object-based image analysis (GEOBIA) approach to segment the high spatial resolution images acquired on heterogeneous surfaces that vary according to human influence on the environment. We have used the fractal net evolution approach (FNEA) algorithm to segment images (Baatz&Schäpe, 2000). Multispectral data, a digital terrain model layer, ground truth data, a normalized difference vegetation index (NDVI) layer, and a first-order texture (entropy) layer were used to segment the multispectral images at three segmentation scales, with an emphasis on accurately delineating the boundaries and components of the sand accumulation areas (Dune, dunes fields, nebka, and barkhane). It is important to note that each auxiliary data contributed to improve the segmentation at different scales. The silted areas were classified using a nearest neighbor approach over the Naâma area using imagery. The classification of silted areas was successfully achieved over all study areas with an accuracy greater than 85%, although the results suggest that, overall, a higher degree of landscape heterogeneity may have a negative effect on segmentation and classification. Some areas suffered from the greatest over-segmentation and lowest mapping accuracy (Kappa: 0.79), which was partially attributed to confounding a greater proportion of mixed siltation classes from both sandy areas and bare ground patches. This research has demonstrated a technique based on very high-resolution images for mapping sanded and degraded areas using GEOBIA, which can be applied to the study of other lands in the steppe areas of the northern countries of the African continent.

Keywords: land development, GIS, sand dunes, segmentation, remote sensing

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Authors: Jihong Liang, Huiling Feng, Linqing Ma, Tianjiao Qi

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Confucius is the first sage in Chinese culture. Confucianism, the theories represented by Confucius, has long been at the core of Chinese traditional society, as the dominating political ideology of centralized feudal monarchy for more than two thousand years. Confucius Worship Ceremony held in the Confucian Temple in Qufu (Confucius’s birthplace), which is dedicated to commemorate Confucius and other 170 elites in Confucianism with a whole set of formal rites, pertains to “Auspicious Rites”, which worship heaven and earth, humans and ghosts. It was first a medium-scaled ritual activity but then upgraded to the supreme one at national level in the Qing Dynasty. As a national event, it was celebrated by Emperor as well as common intellectuals in traditional China. The Ceremony can be solemn and respectful, with prescribed and complicated procedures, well-prepared utensil and matched offerings operated in rhythm with music and dances. Each participant has his place, and everyone follows the specified rules. This magnificent ritual Ceremony, while embedded with rich culture connotation, actually symbolizes the social acknowledgment for orthodox culture represented by Confucianism. Rites reflected in this Ceremony, is one of the most important features of Chinese culture, serving as the key bond in the identification and continuation of Chinese culture. These rites and ritual ceremonies, as culture memories themselves, are not only treasures of China, but of the whole world. However, while the ancient Chinese Rite has been one of the thorniest and most complicated topics for academics, the more regrettable is that due to their interruption in practice and historical changes, these rites and ritual ceremonies have already become a vague language in today’s academic discourse and strange terms of the past for common people. Luckily, we, today, by virtue of modern digital technology, may be able to reproduce these ritual ceremonies, as most of them can still be found in ancient manuscripts, through which Chinese ancestors tell the beauty and gravity of their dignified rites and more importantly, their spiritual pursuits with vivid language and lively pictures. This research, based on review and interpretation of the ancient literature, intends to construct the ancient ritual ceremonies, with the Confucius Worship Ceremony as a case and by use of digital technology. Using 3D technology, the spatial scenes in the Confucian Temple can be reconstructed by virtual reality; the memorial tablet exhibited in the temple by GIS and different rites in the ceremonies by animation technology. With reference to the lyrics, melodies and lively pictures recorded in ancient scripts, it is also possible to reproduce the live dancing site. Also, image rendering technology can help to show the life experience and accomplishments of Confucius. Finally, lining up all the elements in a multimedia narrative form, a complete digitalized Confucius Worship Ceremony can be reproduced, which will provide an excellent virtual experience that goes beyond time and space by bringing its audience back to that specific historical time. This digital project, once completed, will play an important role in the inheritance and dissemination of cultural heritage.

Keywords: Confucius worship ceremony, multimedia narrative form, GIS, visual representation

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Authors: Rajasekar Elangopandian, Anand Shanmugam

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Now-a-days for surveillances unmanned aerial vehicle plays a vital role. Not only for surveillances, aerial photography disaster management and the notice of earth behavior UAV1s envisages meticulously. To reduce the maintenance and fuel nuclear powered Vehicles are greater support. The design consideration is much important for the UAV manufacturing industry and Research and development agency. Eventually design is looking like a pentagon shaped fuselage and black rubber coated paint in order to escape from the enemy radar and other targets. The pentagon shape fuselage has large space to keep the mini nuclear reactor inside and the material is carbon – carbon fiber specially designed by the software called cosmol and hyper mesh 14.2. So the weight consideration will produce the positive result for productivity. The walls of the fuselage are coated with lead and protective shield. A double layer of W/Bi sheet is proposed for radiation protection at the energy range of 70 Kev to 90 Kev. The designed W/bi sheet, only 0.14 mm thick and is 36% light. The properties of the fillers were determined from zeta potential and particle size measurements. The Exposes of the radiation can be attenuated by 3 ways such as minimizing exposure time, Maximizing distance from the radiation source and shielding the whole vehicle. The inside reactor will be switched ON when the UAV starts its cruise. The moderators and the control rods can be inserted by automation technique by newly developed software. The heat generated by the reactor will be used to run the turbine which is fixed inside the UAV called mini turbine with natural rubber composite Shaft radiation shield. Cooling system will be in two mode such as liquid and air cooled. Liquid coolant for the heat regeneration is ordinary water, liquid sodium, helium and the walls are made up of regenerative and radiation protective material. The other components like camera and arms bay will be located at the bottom of the UAV high are specially made products in order to escape from the radiation. They are coated with lead Pb and natural rubber composite material. This technique provides the long rang and endurance for eternal flight mission until we need any changeability of parts or product. This UAV has the special advantage of ` land on String` means it`ll land at electric line to charge the automated electronics. Then the fuel is enriched uranium (< 5% U - 235) contains hundreds of fuel pins. This technique provides eternal duty for surveillances and aerial photography. The landing of the vehicle is ease of operation likewise the takeoff is also easier than any other mechanism which present in nowadays. This UAV gives great immense and immaculate technology for surveillance and target detecting and smashing the target.

Keywords: mini turbine, liquid coolant for the heat regeneration, in order to escape from the radiation, eternal flight mission, it`ll land at electric line

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Authors: Omair Anas

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The Persian Gulf has been in turmoil for a long time since the colonial administration has handed over the role to the small and weak kings and emirs who were assured of protection in return of many economic and security promises to them. The regional order, Saudi Arabia evolved was a rentier regional order secured by an expansion of rentier economy and taking responsibility for much of the expenses of the regional order on behalf of relatively poor countries. The two oil booms helped the Saudi state to expand the 'rentier order' driven stability and bring the countries like Egypt, Jordan, Syria, and Palestine under its tutelage. The disruptive misadventure, however, came with Iran's proclamation of the Islamic Revolution in 1979 which it wanted to be exported to its 'un-Islamic and American puppet' Arab neighbours. For Saudi Arabia, even the challenge presented by the socialist-nationalist Arab dictators like Gamal Abdul Nasser and Hafez Al-Assad was not that much threatening to the Saudi Arabia’s then-defensive realism. In the Arab uprisings, the Gulf monarchies saw a wave of insecurity and Iran found it an opportune time to complete the revolutionary process it could not complete after 1979. An alliance of convenience and ideology between Iran and Islamist groups had the real potential to challenge both Saudi Arabia’s own security and its leadership in the region. The disruptive threat appeared at a time when the Saudi state had already sensed an impending crisis originating from the shifts in the energy markets. Low energy prices, declining global demands, and huge investments in alternative energy resources required Saudi Arabia to rationalize its economy according to changing the global political economy. The domestic Saudi reforms remained gradual until the death of King Abdullah in 2015. What is happening now in the region, the Qatar crisis, the Lebanon crisis and the Saudi-Iranian proxy war in Iraq, Syria, and Yemen has combined three immediate objectives, rationalising Saudi economy and most importantly, the resetting the Saudi royal power for Saudi Arabia’s longest-serving future King Mohammad bin Salman. The Saudi King perhaps has no time to wait and watch the power vacuum appearing because of Iran’s expansionist foreign policy. The Saudis appear to be employing an offensive realism by advancing a pro-active regional policy to counter Iran’s threatening influence amid disappearing Western security from the region. As the Syrian civil war is coming to a compromised end with ceding much ground to Iran-controlled militias, Hezbollah and Al-Hashad, the Saudi state has lost much ground in these years and the threat from Iranian proxies is more than a reality, more clearly in Bahrain, Iraq, Syria, and Yemen. This paper attempts to analyse the changing Saudi behaviour in the region, which, the author understands, is shaped by an offensive-realist approach towards finding a favourable security environment for the Saudi-led regional order, a post-rentier order perhaps.

Keywords: terrorism, Saudi Arabia, Rentier State, gulf crisis

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Authors: Timothy Gray

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This paper will present work and discuss lessons learned during a semester-long travel study based in Southeast Asia, which was run in the Spring Semester of 2019 and again in the summer of 2023. The first travel group consisted of fifteen students, and the second group consisted of twelve students ranging from second-year to graduate level, student participants majoring in either architecture or planning. Students worked in interdisciplinary teams, each team beginning their travel study, living together in a separate small town for over a month in (relatively) remote conditions in rural Thailand. Students became intimately familiar with these towns, forged strong personal relationships, and built reservoirs of knowledge one conversation at a time. Rather than impose external ideas and solutions, students were asked to learn from and be open to lessons from the people and the place. The following design statement was used as a point of departure for their investigations: It is our shared premise that architecture exists in small villages and towns of Southeast Asia in the ingenuity of the people, that architecture exists in a shared language of making, modifying, and reusing. It is a modest but vibrant architecture, an architecture that is alive and evolving, an architecture that is small in scale, accessible, and one that emerges from the people. It is an architecture that can exist in a modified bicycle, a woven bamboo bridge, or a self-built community. Students were challenged to engage in existing conditions as design professionals, both empowering and lending coherence to the energies that already existed in the place. As one of the student teams noted in their design narrative: “During our field study, we had the unique opportunity to tour a number of informal settlements and meet and talk to residents through interpreters. We found that many of the residents work in nearby factories for dollars a day. Others find employment in self-generated informal economies such as hand carving and textiles. Despite extreme poverty, we found these places to be vibrant and full of life as people navigate these challenging conditions to live lives with purpose and dignity.” Students worked together with local community members and colleagues to develop a series of varied proposals that emerged from their interrogations of place and partnered with community members and professional colleagues in the development of these proposals. Project partners included faculty and student colleagues Yangon University, the mayor's Office, Planning Department Officials and religious leaders in Sawankhalok, Thailand, and community leaders in Natonchan, Thailand, to name a few. This paper will present a series of student community-based design projects that emerged from these conditions. The paper will also discuss this model of travel study as a way of building an architecture which uses social and cultural issues as a catalyst for design. The paper will discuss lessons relative to sustainable development that the Western students learned through their travels in Southeast Asia.

Keywords: travel study, CAPasia, architecture of empowerment, modular housing

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Authors: Lucile Rapin, Cynthia El Hage, Rihab Gamaoun, Maria-Fernanda Arboleda, Erin Prosk

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Introduction: Sante Cannabis (SC), a Canadian group of clinics dedicated to medical cannabis, based in Montreal and in the province of Quebec, has served more than 8000 patients seeking cannabis-based treatment over the past five years. As randomized clinical trials with natural medical cannabis are scarce, real-world evidence offers the opportunity to fill research gaps between scientific evidence and clinical practice. Data on the use of medical cannabis products from SC patients were prospectively collected, leading to a large real-world database on the use of medical cannabis. The aim of this study was to report information on the profiles of both patients and prescribed medical cannabis products at SC clinics, and to assess the safety of medical cannabis among Canadian patients. Methods: This is an observational retrospective study of 1342 adult patients who were authorized with medical cannabis products between October 2017 and September 2019. Information regarding demographic characteristics, therapeutic indications for medical cannabis use, patterns in dosing and dosage form of medical cannabis and adverse effects over one-year follow-up (initial and 4 follow-up (FUP) visits) were collected. Results: 59% of SC patients were female, with a mean age of 56.7 (SD= 15.6, range= (19-97)). Cannabis products were authorized mainly for patients with a diagnosis of chronic pain (68.8% of patients), cancer (6.7%), neurological disorders (5.6%), and mood disorders (5.4 %). At initial visit, a large majority (70%) of patients were authorized exclusively medical cannabis products, 27% were authorized a combination of pharmaceutical cannabinoids and medical cannabis and 3% were prescribed only pharmaceutical cannabinoids. This pattern was recurrent over the one-year follow-up. Overall, oil was the preferred formulation (average over visits 72.5%) followed by a combination of oil and dry (average 19%), other routes of administration accounted for less than 4%. Patients were predominantly prescribed products with a balanced THC:CBD ratio (59%-75% across visits). 28% of patients reported at least one adverse effect (AE) at the 3-month follow-up visit and 12% at the six-month FUP visit. 84.8% of total AEs were mild and transient. No serious AE was reported. Overall, the most common side effects reported were dizziness (11.95% of total AEs), drowsiness (11.4%), dry mouth (5.5%), nausea (4.8%), headaches (4.6%), cough (4.4%), anxiety (4.1%) and euphoria (3.5%). Other adverse effects accounted for less than 3% of total AE. Conclusion: Our results confirm that the primary area of clinical use for medical cannabis is in pain management. Patients in this cohort are largely utilizing plant-based cannabis oil products with a balanced ratio of THC:CBD. Reported adverse effects were mild and included dizziness and drowsiness. This real-world data confirms the tolerable safety profile of medical cannabis and suggests medical indications not yet validated in controlled clinical trials. Such data offers an important opportunity for the investigation of the long-term effects of cannabinoid exposure in real-life conditions. Real-world evidence can be used to direct clinical trial research efforts on specific indications and dosing patterns for product development.

Keywords: medical cannabis, safety, real-world data, Canada

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Authors: Rosemary R. Carlton, Roxane Caron

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Almost three decades ago, bell hooks (1994) identified the classroom as “the most radical space of possibility in the academy”. A feminist scholar, educator, and activist, hooks urged educators to transgress the boundaries of what might be customary or considered acceptable in teaching, thus encouraging the pursuit of new ways of knowing and different strategies for sharing knowledge. This paper reflects upon a particular response to hooks’ still relevant call for transgression in teaching. Specifically, this paper reports on the design, implementation, and preliminary analysis of a social work course integrating active pedagogy and transnational exchange to encourage students’ critical thinking and autonomous learning in their development as social workers in a global context. The bachelor’s level course, Pratiques spécifiques: Projet international, was developed collaboratively across three francophone institutions of higher learning in Belgium, Canada, and France: the Haute École de Namur-Liège-Luxembourg (Hénallux); the Université de Montréal; and, the Institut d’enseignement supérieur et professionnel, l’IRTS Paris Île-de-France. The driving aims of the course are to promote autonomous learning and critical thinking through a lens of transnational understandings of social problems -competencies indispensable to students’ development as social workers. The course is offered to two paired cohorts, one addressing the subject of “migrations” (Canada/France) and the other the subject of “sexual exploitation” (Canada/Belgium). Through the adaptation of a critical pedagogy of problem-based learning, students are called upon to actively engage in acquiring and applying knowledge to respond to “real life” social issues relating to migration or sexual exploitation. At the conclusion of the course, each cohort of students is brought together for a week-long intensive period of transnational exchange either at the Université de Montréal in Canada or at Hénallux in Belgium. Extending the bounds of the classroom across international borders allows students novel opportunities to deepen and expand their understandings of issues relating to predefined social issues and to critically examine associated social work practices. The paper opens with a presentation of the social work course. Specifically, the authors will outline their adaptation of a pedagogy of problem-based learning integrating transnational exchange in the design and implementation of the course. Returning to hooks’ notion of transgression in teaching, the paper offers a preliminary analysis of how and with what effect the course provides opportunities to transgress hierarchical student-teacher relationships; transgress conventional modes of learning to explore diverse sources of knowledge and transgress the walls of the university to engage with and learn from local and global partners. The paper concludes with a consideration of the potential influence of such transgressions in teaching for students’ development of critical thinking in their practice of social work in global context.

Keywords: active learning, critical pedagogy, social work intervention, transnational learning

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Authors: Betty Chiyangwa

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The subject of second-generation migrant youth is under-researched in the context of South Africa. Thus, their opinions and views have been marginalised in social science research. This paper addresses this gap by exploring the complexities of second-generation Mozambican migrant youth’s lived experiences in how they construct their identities and develop a sense of belonging in post-apartheid South Africa, specifically in Bushbuckridge. Bushbuckridge was among the earliest districts to accommodate Mozambican refugees to South Africa in the 1970s and remains associated with large numbers of Mozambicans. Drawing on Crenshaw’s (1989) intersectionality approach, the study contributes to knowledge on South-to-South migration by demonstrating how this approach is operationalised to understand the complex lived experiences of a disadvantaged group in life and possibly in death. In conceptualising the notion of identity among second-generation migrant youth, this paper explores the history and present of first and second-generation Mozambican migrants in South Africa to reveal how being born to migrant parents and raised in a hosting country poses life-long complications in one’s identity and sense of belonging. In the quest to form their identities and construct a sense of belonging, migrant youth employ precariously means to navigate the terrane. This is a case study informed by semi-structured interviews and narrative data gathered from 22 second-generation Mozambican migrant youth between 18 and 34 years who were born to at least one Mozambican parent living in Bushbuckridge and raised in South Africa. Views of two key informants from the South African Department of Home Affairs and the local tribal authority provided additional perspectives on second-generation migrant youth’s lived experiences in Bushbuckridge, which were explored thematically and narratively through Braun and Clarke’s (2012) six-step framework for analysing qualitative data. In exploring the interdependency and interconnectedness of social categories and social systems in Bushbuckridge, the findings revealed that participants’ experiences of identity formation and development of a sense of belonging were marginalised in complex, intersectional and precarious ways where they constantly (re)negotiated their daily experiences, which were largely shaped by their paradoxical migrant status in a host country. This study found that, in the quest for belonging, migrant youths were not a perfectly integrated category but evolved from almost daily lived experiences of creating a living that gave them an identity and a sense of belonging in South Africa. The majority of them shared feelings of living in limbo since childhood and fear of possibly dying in limbo with no clear (solid) sense of belonging to either South Africa or Mozambique. This study concludes that there is a strong association between feelings of identity, sense of belonging and levels of social integration. It recommends the development and adoption of a multilayer comprehensive model for understanding second-generation migrant youth identity and belonging in South Africa which encourages a collaborative effort among individual migrant youth, their family members, neighbours, society, and regional and national institutional structures for migrants to enhance and harness their capabilities and improve their wellbeing in South Africa.

Keywords: bushbuckridge, limbo, mozambican migrants, second-generation

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Authors: Gabriela Prins, Quinette Louw, Dawn Ernstzen

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Background: Access to rehabilitation services is a major challenge globally, especially in low-and-middle income countries (LMICs) where resources and infrastructure are extremely limited. Telerehabilitation (TR) has emerged in recent decades as a highly promising method to dramatically expand accessibility to rehabilitation services globally. TR provides rehabilitation care remotely using communication technologies such as video conferencing, smartphones, and internet-connected devices. This boosts accessibility to underprivileged regions and allows for greater flexibility for patients. Despite this, TR is hindered by several factors, including limited technological resources, high costs, lack of digital access, and the unavailability of healthcare systems, which are major barriers to widespread adoption among LMIC patients. These barriers have collectively hindered the potential implementation and adoption of TR services in LMICs healthcare settings. Adoption of TR will also require the buy-in of end users and limited information is known on the perspectives of the SA population. Aim: The study aimed to understand patients' perspectives regarding the use of digital technology as part of their OA rehabilitation at a public community healthcare centre in the Cape Metropole Area. Methods: A qualitative descriptive study design was used on 10 OA patients from a public community rehabilitation centre in South Africa. Data collection included semi-structured interviews and patient-reported outcome measures (PSFS, ASES-8, and EuroQol EQ-5D-5L) on functioning and quality of life. Transcribed interview data were coded in Atlas.ti. 22.2 and analyzed using thematic analysis. The results were narratively documented. Results: Four themes arose from the interviews. The themes were Telerehabilitation awareness (Use of Digital Technology Information Sources and Prior Experience with Technology /TR), Telerehabilitation Benefits (Access to healthcare providers, Access to educational information, Convenience, Time and Resource Efficiency and Facilitating Family Involvement), Telerehabilitation Implementation Considerations (Openness towards TR Implementation, Learning about TR and Technology, Therapeutic relationship, and Privacy) and Future use of Telerehabilitation (Personal Preference and TR for the next generation). The ten participants demonstrated limited awareness and exposure to TR, as well as minimal digital literacy and skills. Skepticism was shown when comparing the effectiveness of TR to in-person rehabilitation and valued physical interactions with health professionals. However, some recognized potential benefits of TR for accessibility, convenience, family involvement and improving community health in the long term. Willingness existed to try TR with sufficient training. Conclusion: With targeted efforts addressing identified barriers around awareness, technological literacy, clinician readiness and resource availability, perspectives on TR may shift positively from uncertainty towards endorsement of this expanding approach for simpler rehabilitation access in LMICs.

Keywords: digital technology, osteoarthritis, primary health care, telerehabilitation

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Authors: Brian Bacia, Esther Githaiga, Teresia Kabucho, Paul Moses Ndegwa, Lucy Gichohi

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Purpose: The aim of the study is to ensure an appropriate mix of evidence-based prevention strategies geared towards the reduction of new HIV infections and the incidence of Sexually transmitted Illnesses Background: In Nakuru County, more than 90% of all HIV-infected patients are adults and on a single-dose medication-one pill that contains a combination of several different HIV drugs. Nakuru town has been identified as the hardest hit by HIV/Aids in the County according to the latest statistics from the County Aids and STI group, with a prevalence rate of 5.7 percent attributed to the high population and an active urban center. Method: 2 key studies were carried out to provide evidence for the effectiveness of antiretroviral therapy (ART) when used optimally on preventing sexual transmission of HIV. Discussions based on an examination, assessments of successes in planning, program implementation, and ultimate impact of prevention and treatment were undertaken involving health managers, health workers, community health workers, and people living with HIV/AIDS between February -August 2021. Questionnaires were carried out by a trained duo on ethical procedures at 15 HIV treatment clinics targeting patients on ARVs and caregivers on ARV prevention and treatment of pediatric HIV infection. Findings: Levels of AIDS awareness are extremely high. Advances in HIV treatment have led to an enhanced understanding of the virus, improved care of patients, and control of the spread of drug-resistant HIV. There has been a tremendous increase in the number of people living with HIV having access to life-long antiretroviral drugs (ARV), mostly on generic medicines. Healthcare facilities providing treatment are stressed challenging the administration of the drugs, which require a clinical setting. Women find it difficult to take a daily pill which reduces the effectiveness of the medicine. ART adherence can be strengthened largely through the use of innovative digital technology. The case management approach is useful in resource-limited settings. The county has made tremendous progress in mother-to-child transmission reduction through enhanced early antenatal care (ANC) attendance and mapping of pregnant women Recommendations: Treatment reduces the risk of transmission to the child during pregnancy, labor, and delivery. Promote research of medicines through patients and community engagement. Reduce the risk of transmission through breastfeeding. Enhance testing strategies and strengthen health systems for sustainable HIV service delivery. Need exists for improved antenatal care and delivery by skilled birth attendants. Develop a comprehensive maternal reproductive health policy covering equitability, efficient and effective delivery of services. Put in place referral systems.

Keywords: evidence-based prevention strategies, service delivery, human management, integrated approach

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