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Authors: Alireza Karimi

Abstract:

Artificial Intelligence (AI) is reshaping various industries, and accounting is no exception. With the ability to process vast amounts of data quickly and accurately, AI is revolutionizing how financial professionals manage, analyze, and report financial information. In this article, we will explore the diverse applications of AI in accounting and its profound impact on the field. Automation of Repetitive Tasks: One of the most significant contributions of AI in accounting is automating repetitive tasks. AI-powered software can handle data entry, invoice processing, and reconciliation with minimal human intervention. This not only saves time but also reduces the risk of errors, leading to more accurate financial records. Pattern Recognition and Anomaly Detection: AI algorithms excel at pattern recognition. In accounting, this capability is leveraged to identify unusual patterns in financial data that might indicate fraud or errors. AI can swiftly detect discrepancies, enabling auditors and accountants to focus on resolving issues rather than hunting for them. Real-Time Financial Insights: AI-driven tools, using natural language processing and computer vision, can process documents faster than ever. This enables organizations to have real-time insights into their financial status, empowering decision-makers with up-to-date information for strategic planning. Fraud Detection and Prevention: AI is a powerful tool in the fight against financial fraud. It can analyze vast transaction datasets, flagging suspicious activities and reducing the likelihood of financial misconduct going unnoticed. This proactive approach safeguards a company's financial integrity. Enhanced Data Analysis and Forecasting: Machine learning, a subset of AI, is used for data analysis and forecasting. By examining historical financial data, AI models can provide forecasts and insights, aiding businesses in making informed financial decisions and optimizing their financial strategies. Artificial Intelligence is fundamentally transforming the accounting profession. From automating mundane tasks to enhancing data analysis and fraud detection, AI is making financial processes more efficient, accurate, and insightful. As AI continues to evolve, its role in accounting will only become more significant, offering accountants and finance professionals powerful tools to navigate the complexities of modern finance. Embracing AI in accounting is not just a trend; it's a necessity for staying competitive in the evolving financial landscape.

Keywords: artificial intelligence, accounting automation, financial analysis, fraud detection, machine learning in finance

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Authors: Wing Mui Winnie So, Tian Luo, Zeyu Han

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To fully explore and develop the potentials of gifted students systematically and strategically by providing them with opportunities to receive education at appropriate levels, schools in Hong Kong are encouraged to adopt the "Three-Tier Implementation Model" to plan and implement the school-based gifted education, with Level Three refers to the provision of learning opportunities for the exceptionally gifted students in the form of specialist training outside the school setting by post-secondary institutions, non-government organisations, professional bodies and technology enterprises. Due to the growing concern worldwide about low interest among students in pursuing STEM (Science, Technology, Engineering, and Mathematics) careers, cultivating and boosting STEM career interest has been an emerging research focus worldwide. Although numerous studies have explored its critical contributors, little research has examined the effectiveness of comprehensive interventions such as “Studying with STEM professional”. This study aims to examine the effect on gifted students’ career interest during their participation in an off-school support programme designed and supervised by a team of STEM educators and STEM professionals from a university. Gifted students were provided opportunities and tasks to experience STEM career topics that are not included in the school syllabus, and to experience how to think and work like a STEM professional in their learning. Participants involved 40 primary school students joining the intervention programme outside the normal school setting. Research methods included adopting the STEM career interest survey and drawing tasks supplemented with writing before and after the programme, as well as interviews before the end of the programme. The semi-structured interviews focused on students’ views regarding STEM professionals; what’s it like to learn with a STEM professional; what’s it like to work and think like a STEM professional; and students’ STEM identity and career interest. The changes in gifted students’ STEM career interest and its well-recognised significant contributors, for example, STEM stereotypes, self-efficacy for STEM activities, and STEM outcome expectation, were collectively examined from the pre- and post-survey using T-test. Thematic analysis was conducted for the interview records to explore how studying with STEM professional intervention can help students understand STEM careers; build STEM identity; as well as how to think and work like a STEM professional. Results indicated a significant difference in STEM career interest before and after the intervention. The influencing mechanism was also identified from the measurement of the related contributors and the analysis of drawings and interviews. The potential of off-school support programme supervised by STEM educators and professionals to develop gifted students’ STEM career interest is argued to be further unleashed in future research and practice.

Keywords: gifted students, STEM career, STEM education, STEM professionals

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Authors: Ludmila Vucolova

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The thought is a process that underlies consciousness and cognition and understanding its origin and processes is a longstanding goal of many academic disciplines. By integrating over twenty novel ideas and hypotheses of this theoretical proposal, we can speculate that thought is an emergent property of coded neural events, translating the electro-chemical interactions of the body with its environment—the objects of sensory stimulation, X, and Y. The latter is a self- generated feedback entity, resulting from the arbitrary pattern of the motion of a body’s motor repertory (M). A culmination of these neural events gives rise to a thought: a state of identity between an observed object X and a symbol Y. It manifests as a “state of awareness” or “state of knowing” and forms our perception of the physical world. The values of the variables of a construct—X (object), S1 (sense for the perception of X), Y (object), S2 (sense for perception of Y), and M (motor repertory that produces Y)—will specify the particular conscious percept at any given time. The proposed principle of interaction between the elements of a construct (X, Y, S1, S2, M) is universal and applies for all modes of communication (normal, deaf, blind, deaf and blind people) and for various language systems (Chinese, Italian, English, etc.). The particular arrangement of modalities of each of the three modules S1 (5 of 5), S2 (1 of 3), and M (3 of 3) defines a specific mode of communication. This multifaceted paradigm demonstrates a predetermined pattern of relationships between X, Y, and M that passes from generation to generation. The presented analysis of a cognitive experience encompasses the key elements of embodied cognition theories and unequivocally accords with the scientific interpretation of cognition as the mental action or process of acquiring knowledge and understanding through thought, experience, and the senses, and cognition means thinking and awareness. By assembling the novel ideas presented in twelve sections, we can reveal that in the invisible “chaos”, there is an order, a structure with landmarks and principles of operations and mental processes (thoughts) are physical and have a biological basis. This innovative proposal explains the phenomenon of mental imagery; give the first insight into the relationship between mental states and brain states, and support the notion that mind and body are inseparably connected. The findings of this theoretical proposal are supported by the current scientific data and are substantiated by the records of the evolution of language and human intelligence.

Keywords: agent, awareness, cognitive, element, experience, feedback, first person, imagery, language, mental, motor, object, sensory, symbol, thought

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Authors: Maisa Haj-Tas, Jehad Alaraifi

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The significance of the study: This retrospective study examined the speech and language profiles of patients who received clinical services at the University of Jordan Hearing and Speech Clinic (UJ-HSC) from 2009 to 2014. The UJ-HSC clinic is located in the capital Amman and was established in the late 1990s. It is the first hearing and speech clinic in Jordan and one of first speech and hearing clinics in the Middle East. This clinic provides services to an annual average of 2000 patients who are diagnosed with different communication disorders. Examining the speech and language profiles of patients in this clinic could provide an insight about the most common disorders seen in patients who attend similar clinics in Jordan. It could also provide information about community awareness of the role of speech therapists in the management of speech and language disorders. Methodology: The researchers examined the clinical records of 1140 patients (797 males and 343 females) who received clinical services at the UJ-HSC between the years 2009 and 2014 for the purpose of data analysis for this study. The main variables examined in the study were disorder type and gender. Participants were divided into four age groups: children, adolescents, adults, and older adults. The examined disorders were classified as either speech disorders, language disorders, or dysphagia (i.e., swallowing problems). The disorders were further classified as childhood language impairments, articulation disorders, stuttering, cluttering, voice disorders, aphasia, and dysphagia. Results: The results indicated that the prevalence for language disorders was the highest (50.7%) followed by speech disorders (48.3%), and dysphagia (0.9%). The majority of patients who were seen at the JU-HSC were diagnosed with childhood language impairments (47.3%) followed consecutively by articulation disorders (21.1%), stuttering (16.3%), voice disorders (12.1%), aphasia (2.2%), dysphagia (0.9%), and cluttering (0.2%). As for gender, the majority of patients seen at the clinic were males in all disorders except for voice disorders and cluttering. Discussion: The results of the present study indicate that the majority of examined patients were diagnosed with childhood language impairments. Based on this result, the researchers suggest that there seems to be a high prevalence of childhood language impairments among children in Jordan compared to other types of speech and language disorders. The researchers also suggest that there is a need for further examination of the actual prevalence data on speech and language disorders in Jordan. The fact that many of the children seen at the UJ-HSC were brought to the clinic either as a result of parental concern or teacher referral indicates that there seems to an increased awareness among parents and teachers about the services speech pathologists can provide about assessment and treatment of childhood speech and language disorders. The small percentage of other disorders (i.e., stuttering, cluttering, dysphasia, aphasia, and voice disorders) seen at the UJ-HSC may indicate a little awareness by the local community about the role of speech pathologists in the assessment and treatment of these disorders.

Keywords: clinic, disorders, language, profile, speech

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Authors: Terefe Fuge, George Tsourtos , Emma Miller

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Objectives: Maintaining optimal adherence and viral suppression in people living with HIV (PLWHA) is essential to ensure both preventative and therapeutic benefits of antiretroviral therapy (ART). Prisoners bear a particularly high burden of HIV infection and are highly likely to transmit to others during and after incarceration. However, the level of adherence and viral suppression, as well as its associated factors in incarcerated populations in low-income countries is unknown. This study aimed to determine the prevalence of non-adherence and viral failure, and contributing factors to this amongst prisoners in South Ethiopia. Methods: A prospective cohort study was conducted between June 1, 2019 and July 31, 2020 to compare the level of adherence and viral suppression between incarcerated and non-incarcerated PLWHA. The study involved 74 inmates living with HIV (ILWHA) and 296 non-incarcerated PLWHA. Background information including sociodemographic, socioeconomic, psychosocial, behavioural, and incarceration-related characteristics was collected using a structured questionnaire. Adherence was determined based on participants’ self-report and pharmacy refill records, and plasma viral load measurements which were undertaken within the study period were prospectively extracted to determine viral suppression. Various univariate and multivariate regression models were used to analyse data. Results: Self-reported dose adherence was approximately similar between ILWHA and non-incarcerated PLWHA (81% and 83% respectively), but ILWHA had a significantly higher medication possession ratio (MPR) (89% vs 75%). The prevalence of viral failure (VF) was slightly higher (6%) in ILWHA compared to non-incarcerated PLWHA (4.4%). The overall dose non-adherence (NA) was significantly associated with missing ART appointments, level of satisfaction with ART services, patient’s ability to comply with a specified medication schedule and types of methods used to monitor the schedule. In ILWHA specifically, accessing ART services from a hospital compared to a health centre, an inability to always attend clinic appointments, experience of depression and a lack of social support predicted NA. VF was significantly higher in males, people of age 31-35 years and in those who experienced social stigma, regardless of their incarceration status. Conclusions: This study revealed that HIV-infected prisoners in South Ethiopia were more likely to be non-adherent to doses and so to develop viral failure compared to their non-incarcerated counterparts. A multitude of factors was found to be responsible for this requiring multilevel intervention strategies focusing on the specific needs of prisoners.

Keywords: Adherence , Antiretroviral therapy, Incarceration, South Ethiopia, Viral suppression

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Authors: Radu Deju, Carmen Mustata

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The VVR-S nuclear research reactor owned by Horia Hubulei National Institute of Physics and Nuclear Engineering (IFIN-HH) was designed for research and radioisotope production, being permanently shut-down in 2002, after 40 years of operation. All amount of the nuclear spent fuel S-36 and EK-10 type was returned to Russian Federation (first in 2009 and last in 2012), and the radioactive waste resulted from the reprocessing of it will remain permanently in the Russian Federation. The decommissioning strategy chosen is immediate dismantling. At this moment, the radionuclides with half-life shorter than 1 year have a minor contribution to the contamination of materials and equipment used in reactor department. The decommissioning of the reactor has started in 2010 and is planned to be finalized in 2020, being the first nuclear research reactor that has started the decommissioning project from the South-East of Europe. The management system applied in the decommissioning of the VVR-S research reactor integrates all common elements of management: nuclear safety, occupational health and safety, environment, quality- compliance with the requirements for decommissioning activities, physical protection and economic elements. This paper presents the application of integrated management system in decommissioning of systems, structures, equipment and components (SSEC) from pumps room, including the management of the resulted radioactive waste. The primary cooling system of this type of reactor includes circulation pumps, heat exchangers, degasser, filter ion exchangers, piping connection, drainage system and radioactive leaks. All the decommissioning activities of primary circuit were performed in stage 2 (year 2014), and they were developed and recorded according to the applicable documents, within the requirements of the Regulatory Body Licenses. In the presentation there will be emphasized how the integrated management system provisions are applied in the dismantling of the primary cooling system, for elaboration, approval, application of necessary documentation, records keeping before, during and after the dismantling activities. Radiation protection and economics are the key factors for the selection of the proper technology. Dedicated and advanced technologies were chosen to perform specific tasks. Safety aspects have been taken into consideration. Resource constraints have also been an important issue considered in defining the decommissioning strategy. Important aspects like radiological monitoring of the personnel and areas, decontamination, waste management and final characterization of the released site are demonstrated and documented.

Keywords: decommissioning, integrated management system, nuclear reactor, waste management

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Authors: Daniela Magalhaes, Jorge Pedro, Pedro Souteiro, Joao S. Neves, Sofia Castro-Oliveira, Vanessa Guerreiro, Rita Bettencourt- Silva, Maria M. Costa, Ana Varela, Joana Queiros, Paula Freitas, Davide Carvalho

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Introduction: Obesity is an independent risk factor for renal dysfunction. Our aims were: (1) evaluate the impact of bariatric surgery (BS) on renal function; (2) clarify the factors determining the postoperative evolution of the glomerular filtration rate (GFR); (3) access the occurrence of oxalate-mediated renal complications. Methods: We investigated a cohort of 1448 obese patients who underwent bariatric surgery. Those with basal GFR (GFR0) < 30mL/min or without information about the GFR 2-year post-surgery (GFR2) were excluded. Results: We included 725 patients, of whom 647 (89.2%) women, with 41 (IQR 34-51) years, a median weight of 112.4 (IQR 103.0-125.0) kg and a median BMI of 43.4 (IQR 40.6-46.9) kg/m2. Of these, 459 (63.3%) performed gastric bypass (RYGB), 144 (19.9%) placed an adjustable gastric band (AGB) and 122 (16.8%) underwent vertical gastrectomy (VG). At 2-year post-surgery, excess weight loss (EWL) was 60.1 (IQR 43.7-72.4) %. There was a significant improve of metabolic and inflammatory status, as well as a significant decrease in the proportion of patients with diabetes, arterial hypertension and dyslipidemia (p < 0.0001). At baseline, 38 (5.2%) of subjects had hyperfiltration with a GFR0 ≥ 125mL/min/1.73m2, 492 (67.9%) had a GFR0 90-124 mL/min/1.73m2, 178 (24.6%) had a GFR0 60-89 mL/min/1.73m2, and 17 (2.3%) had a GFR0 < 60 mL/min/1.73m2. GFR decreased in 63.2% of patients with hyperfiltration (ΔGFR=-2.5±7.6), and increased in 96.6% (ΔGFR=22.2±12.0) and 82.4% (ΔGFR=24.3±30.0) of the subjects with GFR0 60-89 and < 60 mL/min/1.73m2, respectively ( p < 0.0001). This trend was maintained when adjustment was made for the type of surgery performed. Of 321 patients, 10 (3.3%) had a urinary albumin excretion (UAE) > 300 mg/dL (A3), 44 (14.6%) had a UAE 30-300 mg/dL (A2) and 247 (82.1%) has a UAE < 30 mg/dL (A1). Albuminuria decreased after surgery and at 2-year follow-up only 1 (0.3%) patient had A3, 17 (5.6%) had A2 and 283 (94%) had A1 (p < 0,0001). In multivariate analysis, the variables independently associated with ΔGFR were BMI (positively) and fasting plasma glucose (negatively). During the 2-year follow-up, only 57 of the 725 patients had transient urinary excretion of calcium oxalate crystals. None has records of oxalate-mediated renal complications at our center. Conclusions: The evolution of GFR after BS seems to depend on the initial renal function, as it decreases in subjects with hyperfiltration, but tends to increase in those with renal dysfunction. Our results suggest that BS is associated with improvement of renal outcomes, without significant increase of renal complications. So, apart the clear benefits in metabolic and inflammatory status, maybe obese adults with nondialysis-dependent CKD should be referred for bariatric surgery evaluation.

Keywords: albuminuria, bariatric surgery, glomerular filtration rate, renal function

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Authors: Vanlounni Sibounheuang, Wanarat Anusornsangiam, Pattarin Kittiboonyakun, Chanthanom Manithip

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In worldwide, one of the most common use of oral anticoagulant is warfarin. Its margin between therapeutic inhibition of clot formation and bleeding complications is narrow. Mahosot Hospital, warfarin clinic had not been established yet. The descriptive study was conducted by investigating drug-related problems of outpatients using warfarin, the value of the international normalized ratio (INR) higher than normal ranges (25.40 % of the total 272 outpatients) were mostly identified at Lao-Luxembourg Heart Centre, Mahosot Hospital, Lao PDR. This result led to the present study conducting qualitative interviews in order to help establish a warfarin clinic at Mahosot Hospital for the better outcomes of patients using warfarin. The purpose of this study was to explore perspectives of healthcare professional providing services for outpatients using warfarin. The face to face, in-depth interviews were undertaken among nine healthcare professionals (doctor=3, nurse=3, pharmacist=3) working at out-patient clinic, Lao-Luxembourg Heart Centre, Mahosot Hospital, Lao PDR. The interview guides were developed, and they were validated by the experts in the fields of qualitative research. Each interview lasted approximately 20 minutes. Three major themes emerged; healthcare professional’s experiences of current practice problems with warfarin therapy, healthcare professionals’ views of medical problems related to patients using warfarin, and healthcare professionals’ perspectives on ways of service improvement. All healthcare professionals had the same views that it’s difficult to achieve INR goal for individual patients because of some important patient barriers especially lack of knowledge about to use warfarin properly and safety, patients not regularly follow-up due to problems with transportations and financial support. Doctors and nurses agreed to have a pharmacist running a routine warfarin clinic and provided counselling to individual patients on the following points: how to take drug properly and safety, drug-drug and food-drug interactions, common side effects and how to manage them, lifestyle modifications. From the interviews, some important components of the establishment of a warfarin clinic included financial support, increased human resources, improved the system of keeping patients’ medical records, short course training for pharmacists. This study indicated the acceptance of healthcare professionals on the important roles of pharmacists and the feasibility of setting up warfarin clinic by working together with the multidisciplinary health care team in order to help improve health outcomes of patients using warfarin at Mahosot Hospital, Lao PDR.

Keywords: perspectives, healthcare professional, warfarin therapy, Mahosot Hospital

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Authors: Yael Wolff Sagy, Yiska Loewenberg Weisband, Vered Kaufman Shriqui, Michal Krieger, Arie Ben Yehuda, Ronit Calderon Margalit

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Background: Obesity is both a risk factor and common comorbidity of diabetes. Obesity impedes the achievement of glycemic control, and enhances damage caused by hyperglycemia to blood vessels; thus it increases diabetes-related complications. This study assessed the prevalence of obesity and morbid obesity among Israeli adults with diabetes, and estimated disparities associated with sex and socioeconomic position (SEP). Methods: A cross-sectional study was conducted in the setting of the Israeli National Program for Quality Indicators in Community Healthcare. Data on all the Israeli population is retrieved from electronic medical records of the four health maintenance organizations (HMOs). The study population included all Israeli patients with diabetes aged 20-64 with documented body mass index (BMI) in 2016 (N=180,451). Diabetes was defined as the existence of one or more of the following criteria: (a) Plasma glucose level >200 mg% in at least two tests conducted at least one month apart in the previous year; (b) HbA1c>6.5% at least once in the previous year (c) at least three prescriptions of diabetes medications were dispensed during the previous year. Two measures were included: the prevalence of obesity (defined as last BMI≥ 30 kg/m2 and <35 kg/m2) and the prevalence of morbid obesity (defined as last BMI≥ 35 kg/m2) in individuals aged 20-64 with diabetes. The cut-off value for morbid obesity was set in accordance with the eligibility criteria for bariatric surgery in diabetics. Data were collected by the HMOs and aggregated by age, sex and SEP. SEP was based on statistical areas ranking by the Israeli Central Bureau of Statistics and divided into 4 categories, ranking from 1 (lowest) to 4 (highest). Results: BMI documentation among adults with diabetes was 84.9% in 2016. The prevalence of obesity in the study population was 30.5%. Although the overall rate was similar in both sexes (30.8% in females, 30.3% in males), SEP disparities were stronger in females (32.7% in SEP level 1 vs. 27.7% in SEP level 4; 18.1% relative difference) compared to males (30.6% in SEP level 1 vs. 29.3% in SEP level 4; 4.4% relative difference). The overall prevalence of morbid obesity in this population was 20.8% in 2016. The rate among females was almost double compared to the rate in males (28.1% and 14.6%, respectively). In both sexes, the prevalence of morbid obesity was strongly associated with lower SEP. However, in females, disparities between SEP levels were much stronger (34.3% in SEP level 1 vs. 18.7% in SEP level 4; 83.4% relative difference) compared to SEP-disparities in males (15.7% in SEP level 1 vs. 12.3% in SEP level 4; 27.6% relative difference). Conclusions: The overall prevalence of BMI≥ 30 kg/m2 among adults with diabetes in Israel exceeds 50%; and the prevalence of morbid obesity suggests that 20% meet the BMI-criteria for bariatric surgery. Prevalence rates show major SEP- and sex-disparities; especially strong SEP disparities in morbid obesity among females. These findings highlight the need for greater consideration of different population groups when implementing interventions.

Keywords: diabetes, health disparities, health policy, obesity, socio-economic position

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Authors: Shaine Mehta, Neelam Parmar, Patrick White, Mark Ashworth

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Patients with a history of substance have a high prevalence of comorbidities, including asthma and chronic obstructive pulmonary disease (COPD). Mortality rates are higher than that of the general population and the link to respiratory disease is reported. Randomised controlled trials (RCTs) support opioid substitution therapy as an effective means for harm reduction. However, whilst a high proportion of patients receiving opioid substitution therapy are smokers, to the author’s best knowledge there have been no studies of respiratory disease and smoking intensity in these patients. A cross sectional prevalence study was conducted using an anonymised patient-level database in primary care, Lambeth DataNet (LDN). We included patients aged 18 years and over who had records of ever having been prescribed methadone in primary care. Patients under 18 years old or prescribed buprenorphine (because of uncertainty about the prescribing indication) were excluded. Demographic, smoking, alcohol and asthma and COPD coding data were extracted. Differences between methadone and non-methadone users were explored with multivariable analysis. LDN contained data on 321, 395 patients ≥ 18 years; 676 (0.16%) had a record of methadone prescription. Patients prescribed methadone were more likely to be male (70.7% vs. 50.4%), older (48.9yrs vs. 41.5yrs) and less likely to be from an ethnic minority group (South Asian 2.1% vs. 7.8%; Black African 8.9% vs. 21.4%). Almost all those prescribed methadone were smokers or ex-smokers (97.3% vs. 40.9%); more were non-alcohol drinkers (41.3% vs. 24.3%). We found a high prevalence of COPD (12.4% vs 1.4%) and asthma (14.2% vs 4.4%). Smoking intensity data shows a high prevalence of ≥ 20 cigarettes per day (21.5% vs. 13.1%). Risk of COPD, adjusted for age, gender, ethnicity and deprivation, was raised in smokers: odds ratio 14.81 (95%CI 11.26, 19.47), and in the methadone group: OR 7.51 (95%CI: 5.78, 9.77). Furthermore, after adjustment for smoking intensity (number of cigarettes/day), the risk was raised in methadone group: OR 4.77 (95%CI: 3.13, 7.28). High burden of respiratory disease compounded by the high rates of smoking is a public health concern. This supports an integrated approach to health in patients treated for opiate dependence, with access to smoking cessation support. Further work may evaluate the current structure and commissioning of substance misuse services, including smoking cessation. Regression modelling highlights that methadone as a ‘risk factor’ was independently associated with COPD prevalence, even after adjustment for smoking intensity. This merits further exploration, as the association may be related to unexplored aspects of smoking (such as the number of years smoked) or may be related to other related exposures, such as smoking heroin or crack cocaine.

Keywords: methadone, respiratory disease, smoking cessation, substance misuse

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Authors: Subhankar Kumar Sarkar

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Scarab beetles composing the family Scarabaeidae is one of the largest families in the order Coleoptera. The family is comprised of 11 subfamilies. Of these, the subfamily Scarabaeinae includes 13 tribes globally. Indian species are however considered within 2 tribes Scarabaeini and Coprini. Scarab beetles under this subfamily also known as Coprophagus beetles play an indispensable role in forestry and agriculture. Both adults and larvae of these beetles do a remarkable job of carrying excrement into the soil thus enriching the soil to a great extent. Eastern and North Eastern states of India are heavily rich in diversity of organisms as this region exhibits the tropical rain forests of the eastern Himalayas, which exhibits one of the 18 biodiversity hotspots of the world and one of the three of India. Buxa Tiger Reserve located in Dooars between latitudes 26°30” to 26°55” North & longitudes 89°20” to 89°35” East is one such fine example of rain forests of the eastern Himalayas. Despite this, the subfamily is poorly known, particularly from this part of the globe and demands serious revisionary studies. It is with this background; the attempt is being made to assess the Scarabaeinae fauna of the forest. Both extensive and intensive surveys were conducted in different beats under different ranges of Buxa Tiger Reserve. For collection sweep nets, bush beating and collection in inverted umbrella, hand picking techniques were used. Several pit fall traps were laid in the collection localities of the Reserve to trap ground dwelling scarabs. Dung of various animals was also examined to make collections. In the evening hours UV light, trap was used to collect nocturnal beetles. The collected samples were studied under Stereozoom Binocular Microscopes Zeiss SV6, SV11 and Olympus SZ 30. The faunistic investigation of the forest revealed in the recognition of 19 species under 6 genera distributed over 2 tribes. Of these Heliocopris tyrannus Thomson, 1859 was recorded new from the Country, while Catharsius javanus Lansberge, 1886, Copris corpulentus Gillet, 1910, C. doriae Harold, 1877 and C. sarpedon Harold, 1868 from the state. 4 species are recorded as endemic to India. The forest is dominated by the members of the Genus Onthophagus, of which Onthophagus (Colobonthophagus) dama (Fabricius, 1798) is represented by highest number of individuals. Their seasonal distribution is most during Premonsoon followed by Monsoon and Postmonsoon. Zoogeographically all the recorded species are of oriental distribution.

Keywords: buxa tiger reserve, diversity, India, new records, scarabaeinae, scarabaeidae

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Authors: Yasser R. Tawfic, Mohamed A. Eid

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Foundation differential settlement and supported structure tilting is an occasionally occurred engineering problem. This may be caused by overloading, changes in ground soil properties or unsupported nearby excavations. Engineering thinking points directly toward the logic solution for such problem by uplifting the settled side. This can be achieved with deep foundation elements such as micro-piles and macro-piles™, jacked piers and helical piers, jet grouted soil-crete columns, compaction grout columns, cement grouting or with chemical grouting, or traditional pit underpinning with concrete and mortar. Although, some of these techniques offer economic, fast and low noise solutions, many of them are quite the contrary. For tilted structures, with limited inclination, it may be much easier to cause a balancing settlement on the less-settlement side which shall be done carefully in a proper rate. This principal has been applied in Leaning Tower of Pisa stabilization with soil extraction from the ground surface. In this research, the authors attempt to introduce a new solution with a different point of view. So, micro-tunneling technique is presented in here as an intended ground deformation cause. In general, micro-tunneling is expected to induce limited ground deformations. Thus, the researchers propose to apply the technique to form small size ground unsupported holes to produce the target deformations. This shall be done in four phases: •Application of one or more micro-tunnels, regarding the existing differential settlement value, under the raised side of the tilted structure. •For each individual tunnel, the lining shall be pulled out from both sides (from jacking and receiving shafts) in slow rate. •If required, according to calculations and site records, an additional surface load can be applied on the raised foundation side. •Finally, a strengthening soil grouting shall be applied for stabilization after adjustment. A finite element based numerical model is presented to simulate the proposed construction phases for different tunneling positions and tunnels group. For each case, the surface settlements are calculated and induced plasticity points are checked. These results show the impact of the suggested procedure on the tilted structure and its feasibility. Comparing results also show the importance of the position selection and tunnels group gradual effect. Thus, a new engineering solution is presented to one of the structural and geotechnical engineering challenges.

Keywords: differential settlement, micro-tunneling, soil-structure interaction, tilted structures

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Authors: Anastasia Constantinou, Panayiotis Laouris, Stephen Morris

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Background: Climate change has been reported as one of the worst threats to healthcare. The healthcare sector is a significant contributor to greenhouse gas emissions with primary care being responsible for 23% of the NHS’ total carbon footprint. Digital interventions, primarily focusing on telemedicine, offer a route to change. This systematic review aims to quantify and characterize the carbon footprint savings associated with the implementation of digital interventions in the setting of primary care. Methods: A systematic review of published literature was conducted according to PRISMA (Preferred Reporting Item for Systematic Reviews and Meta-Analyses) guidelines. MEDLINE, PubMed, and Scopus databases as well as Google scholar were searched using key terms relating to “carbon footprint,” “environmental impact,” “sustainability”, “green care”, “primary care,”, and “general practice,” using citation tracking to identify additional articles. Data was extracted and analyzed in Microsoft Excel. Results: Eight studies were identified conducted in four different countries between 2010 and 2023. Four studies used interventions to address primary care services, three studies focused on the interface between primary and specialist care, and one study addressed both. Digital interventions included the use of mobile applications, online portals, access to electronic medical records, electronic referrals, electronic prescribing, video-consultations and use of autonomous artificial intelligence. Only one study carried out a complete life cycle assessment to determine the carbon footprint of the intervention. It estimate that digital interventions reduced the carbon footprint at primary care level by 5.1 kgCO2/visit, and at the interface with specialist care by 13.4 kg CO₂/visit. When assessing the relationship between travel-distance saved and savings in emissions, we identified a strong correlation, suggesting that most of the carbon footprint reduction is attributed to reduced travel. However, two studies also commented on environmental savings associated with reduced use of paper. Patient savings in the form of reduced fuel cost and reduced travel time were also identified. Conclusion: All studies identified significant reductions in carbon footprint following implementation of digital interventions. In the future, controlled, prospective studies incorporating complete life cycle assessments and accounting for double-consulting effects, use of additional resources, technical failures, quality of care and cost-effectiveness are needed to fully appreciate the sustainable benefit of these interventions

Keywords: carbon footprint, environmental impact, primary care, sustainable healthcare

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Authors: Rawan K. Al-Duaij, Salem A. Al-Salem

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Projects, the unique and temporary process of achieving a set of requirements have always been challenging; Planning the schedule and budget, managing the resources and risks are mostly driven by a similar past experience or the technical consultations of experts in the matter. With that complexity of Projects in Scope, Time, and execution environment, Adjustment Orders are tools to reflect changes to the original project parameters after Contract signature. Adjustment Orders are the official/legal amendments to the terms and conditions of a live Contract. Reasons for issuing Adjustment Orders arise from changes in Contract scope, technical requirement and specification resulting in scope addition, deletion, or alteration. It can be as well a combination of most of these parameters resulting in an increase or decrease in time and/or cost. Most business leaders (handling projects in the interest of the owner) refrain from using Adjustment Orders considering their main objectives of staying within budget and on schedule. Success in managing the changes results in uninterrupted execution and agreed project costs as well as schedule. Nevertheless, this is not always practically achievable. In this paper, a detailed study through utilizing Industrial Engineering & Systems Management tools such as Six Sigma, Data Analysis, and Quality Control were implemented on the organization’s five years records of the issued Adjustment Orders in order to investigate their prevalence, and time and cost impact. The analysis outcome revealed and helped to identify and categorize the predominant causations with the highest impacts, which were considered most in recommending the corrective measures to reach the objective of minimizing the Adjustment Orders impacts. Data analysis demonstrated no specific trend in the AO frequency in past five years; however, time impact is more than the cost impact. Although Adjustment Orders might never be avoidable; this analysis offers’ some insight to the procedural gaps, and where it is highly impacting the organization. Possible solutions are concluded such as improving project handling team’s coordination and communication, utilizing a blanket service contract, and modifying the projects gate system procedures to minimize the possibility of having similar struggles in future. Projects in the Oil and Gas sector are always evolving and demand a certain amount of flexibility to sustain the goals of the field. As it will be demonstrated, the uncertainty of project parameters, in adequate project definition, operational constraints and stringent procedures are main factors resulting in the need for Adjustment Orders and accordingly the recommendation will be to address that challenge.

Keywords: adjustment orders, data analysis, oil and gas sector, systems management

Procedia PDF Downloads 132

Authors: Amin Asgarian, Ghyslaine McClure

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Proper seismic evaluation of Non-Structural Components (NSCs) mandates an accurate estimation of floor seismic demands (i.e. acceleration and displacement demands). Most of the current international codes incorporate empirical equations to calculate equivalent static seismic force for which NSCs and their anchorage system must be designed. These equations, in general, are functions of component mass and peak seismic acceleration to which NSCs are subjected to during the earthquake. However, recent studies have shown that these recommendations are suffered from several shortcomings such as neglecting the higher mode effect, tuning effect, NSCs damping effect, etc. which cause underestimation of the component seismic acceleration demand. This work is aimed to circumvent the aforementioned shortcomings of code provisions as well as improving them by proposing a simplified, practical, and yet accurate approach to generate acceleration Floor Design Spectra (FDS) directly from corresponding Uniform Hazard Spectra (UHS) (i.e. design spectra for structural components). A database of 27 Reinforced Concrete (RC) buildings in which Ambient Vibration Measurements (AVM) have been conducted. The database comprises 12 low-rise, 10 medium-rise, and 5 high-rise buildings all located in Montréal, Canada and designated as post-disaster buildings or emergency shelters. The buildings are subjected to a set of 20 compatible seismic records and Floor Response Spectra (FRS) in terms of pseudo acceleration are derived using the proposed approach for every floor of the building in both horizontal directions considering 4 different damping ratios of NSCs (i.e. 2, 5, 10, and 20% viscous damping). Several effective parameters on NSCs response are evaluated statistically. These parameters comprise NSCs damping ratios, tuning of NSCs natural period with one of the natural periods of supporting structure, higher modes of supporting structures, and location of NSCs. The entire spectral region is divided into three distinct segments namely short-period, fundamental period, and long period region. The derived roof floor response spectra for NSCs with 5% damping are compared with the 5% damping UHS and procedure are proposed to generate roof FDS for NSCs with 5% damping directly from 5% damped UHS in each spectral region. The generated FDS is a powerful, practical, and accurate tool for seismic design and assessment of acceleration-sensitive NSCs particularly in existing post-critical buildings which have to remain functional even after the earthquake and cannot tolerate any damage to NSCs.

Keywords: earthquake engineering, operational and functional components (OFCs), operational modal analysis (OMA), seismic assessment and design

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Authors: Totok Suhardijanto, Ninie Susanti Tedjowasono

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This paper discusses the relationship between the distribution of Ancient Malay inscriptions and Spice Trade Route, especially in the relation with material cultures that accompany them, to understand how Malay could spread out around the archipelago beyond its original native-speakers’ region. The archipelago was known as the Spice Islands from the very beginning of the first century due to mace, cloves, and nutmeg that were originally exclusively found there. According to the Indian record, since the 2nd century, there has been a contact established between Indian and Indonesian people. A Chinese document from 3rd Century has mentioned Wangka (now widely known as Bangka) an island near Sumatra where some Chinese expeditions had visited. All of these records supported the existence of a maritime trade system and route between the archipelago and other countries during the first millennium. This paper will discuss first the Ancient Malay inscription spread around the archipelago from the perspectives of language variation and writing system style. Analyzing language variations of inscriptions certainly is not as easy as studying current spoken language variations in modern sociolinguistics. A huge amount of data is available for such kind of studies. On the contrary, in language variation research with inscription texts as an object, data is insufficient. Other resources will be needed to support the linguistic analysis. For this reason, this research made use of epigraphical evidence in the surrounding areas of the inscriptions to explain the variation of language and writing style. The research next expands the analysis to figure out the relationship between language variation and inscriptions distribution to the Spice Trade Route that spreads from the Molucca Sea to Mediterranian Sea. Data in this research consists of six different inscriptions: Kedukan Bukit, Koto Kapur, Dapunta Salendra, Sang Hyang Wintang, Ligor, and Laguna from the 7th-9th Century and found in Sumatra, Jawa, and the Philippines. In addition, as a comparative resource, this research also used Hikayat Tanjung Tanah, the first-founded Ancient Malay manuscript. In language analysis, we conduct a sociolinguistic method to explore the language variation and writing style of the inscriptions. For dealing with archaeological data, we conducted a hermeneutic method to analyze the possible meaning and social uses of the data. Language variations and writing system style in this research can be classified into two main groups. The language, epigraphical, and archaeological evidence explain that Ancient Malay had been widely used in the Eastern area of Spice Trade Route because it played an important role in the region as a lingua franca between people from different ethnic groups with different languages.

Keywords: Ancient Malay, Spice trade route, language variation, writing system variation

Procedia PDF Downloads 159

Authors: Mohamed Gaafar, Evan Davies

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Many municipalities within Canada and abroad use chloramination to disinfect drinking water so as to avert the production of the disinfection by-products (DBPs) that result from conventional chlorination processes and their consequential public health risks. However, the long-lasting monochloramine disinfectant (NH2Cl) can pose a significant risk to the environment. As, it can be introduced into stormwater sewers, from different water uses, and thus freshwater sources. Little research has been undertaken to monitor and characterize the decay of NH2Cl and to study the parameters affecting its decomposition in stormwater networks. Therefore, the current study was intended to investigate this decay starting by building a stormwater model and validating its hydraulic and hydrologic computations, and then modelling water quality in the storm sewers and examining the effects of different parameters on chloramine decay. The presented work here is only the first stage of this study. The 30th Avenue basin in Southern Edmonton was chosen as a case study, because the well-developed basin has various land-use types including commercial, industrial, residential, parks and recreational. The City of Edmonton has already built a MIKE-URBAN stormwater model for modelling floods. Nevertheless, this model was built to the trunk level which means that only the main drainage features were presented. Additionally, this model was not calibrated and known to consistently compute pipe flows higher than the observed values; not to the benefit of studying water quality. So the first goal was to complete modelling and updating all stormwater network components. Then, available GIS Data was used to calculate different catchment properties such as slope, length and imperviousness. In order to calibrate and validate this model, data of two temporary pipe flow monitoring stations, collected during last summer, was used along with records of two other permanent stations available for eight consecutive summer seasons. The effect of various hydrological parameters on model results was investigated. It was found that model results were affected by the ratio of impervious areas. The catchment length was tested, however calculated, because it is approximate representation of the catchment shape. Surface roughness coefficients were calibrated using. Consequently, computed flows at the two temporary locations had correlation coefficients of values 0.846 and 0.815, where the lower value pertained to the larger attached catchment area. Other statistical measures, such as peak error of 0.65%, volume error of 5.6%, maximum positive and negative differences of 2.17 and -1.63 respectively, were all found in acceptable ranges.

Keywords: stormwater, urban drainage, simulation, validation, MIKE URBAN

Procedia PDF Downloads 268

Authors: Nadjet Mekaouche, Hanane Zitouni, Fatma Boudia, Habiba Fetati, A. Saleh, A. Lardjam, H. Geniaux, A. Coubret, H. Toumi

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Medicines have undeniably played a major role in prolonging shelf life and improving quality. The absolute efficacy of the drug remains a lever for innovation, its benefit/risk balance is not always assured and it does not always have the expected effects. Prior to marketing, knowledge about adverse drug reactions is incomplete. Once on the market, phase IV drug studies begin. For years, the drug was prescribed with less care to a large number of very heterogeneous patients and often in combination with other drugs. It is at this point that previously unknown adverse effects may appear, hence the need for the implementation of a pharmacovigilance system. Pharmacovigilance represents all methods for detecting, evaluating, informing and preventing the risks of adverse drug reactions. The most severe adverse events occur frequently in hospital and that a significant proportion of adverse events result in hospitalizations. In addition, the consequences of hospital adverse events in terms of length of stay, mortality and costs are considerable. It, therefore, appears necessary to develop ‘hospital pharmacovigilance’ aimed at reducing the incidence of adverse reactions in hospitals. The most widely used monitoring method in pharmacovigilance is spontaneous notification. However, underreporting of adverse drug reactions is common in many countries and is a major obstacle to pharmacovigilance assessment. It is in this context that this study aims to describe the experience of the pharmacovigilance service at the University Hospital of Oran (EHUO). This is a retrospective study extending from 2011 to 2017, carried out on archived records of declarations collected at the level of the EHUO Pharmacovigilance Department. Reporting was collected by two methods: ‘spontaneous notification’ and ‘active pharmacovigilance’ targeting certain clinical services. We counted 217 statements. It involved 56% female patients and 46% male patients. Age ranged from 5 to 78 years with an average of 46 years. The most common adverse reaction was drug toxidermy. For the drugs in question, they were essentially according to the ATC classification of anti-infectives followed by anticancer drugs. As regards the evolution of declarations by year, a low rate of notification was noted in 2011. That is why we decided to set up an active approach at the level of some services where a resident of reference attended the staffs every week. This has resulted in an increase in the number of reports. The declarations came essentially from the services where the active approach was installed. This highlights the need for ongoing communication between all relevant health actors to stimulate reporting and secure drug treatments.

Keywords: adverse drug reactions, hospital, pharmacovigilance, spontaneous notification

Procedia PDF Downloads 141

Authors: Olusegun Oguntoke, Aramide Y. Tijani, Olayide R. Adetunji

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Environmental noise has become a major threat to the quality of human life, and it is generally more severe in cities. This study assessed the level of environmental noise, mapped the spatial pattern at different times of the day and examined the association with morbidity of auditory ailments in Abeokuta metropolis. The entire metropolis was divided into 80 cells (areas) of 1000 m by 1000 m; out of which 33 were randomly selected for noise levels assessment. Portable noise meter (AR824) was used to measure noise level, and Global Positioning System (Garmin GPS-72H) was employed to take the coordinates of the sample sites for mapping. Risk map of the noise levels was produced using Kriging interpolation techniques based on the spatial spread of measured noise values across the study area. Data on cases of hearing impairments were collected from four major hospitals in the city. Data collected from field measurements and medical records were subjected to descriptive (frequency and percentage) and inferential (mean, ANOVA and correlation) statistics using SPSS (version 20.0). ArcMap 10.1 was employed for spatial analysis and mapping. Results showed mean noise levels range at morning (42.4 ± 4.14 – 88.2 ± 15.1 dBA), afternoon (45.0 ± 6.72– 86.4 ± 12.5 dBA) and evening (51.0 ± 6.55–84.4 ± 5.19 dBA) across the study area. The interpolated maps identified Kuto, Okelowo, Isale-Igbein, and Sapon as high noise risk areas. These are the central business district and nucleus of Abeokuta metropolis where commercial activities, high traffic volume, and clustered buildings exist. The monitored noise levels varied significantly among the sampled areas in the morning, afternoon and evening (p < 0.05). A significant correlation was found between diagnosed cases of auditory ailments and noise levels measured in the morning (r=0.39 at p < 0.05). Common auditory ailments found across the metropolis included impaired hearing (25.8%), tinnitus (16.4%) and otitis (15.0%). The most affected age groups were between 11-30 years while the male gender had more cases of hearing impairments (51.2%) than the females. The study revealed that environmental noise levels exceeded the recommended standards in the morning, afternoon and evening in 60.6%, 61% and 72.7% of the sampled areas respectively. Summarily, environmental noise in the study area is high and contributes to the morbidity of auditory ailments. Areas identified as hot spots of noise pollution should be avoided in the location of noise sensitive activities while environmental noise monitoring should be included as part of the mandate of the regulatory agencies in Nigeria.

Keywords: noise pollution, associative analysis, auditory impairment, urban, human exposure

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Authors: Phillipa Evans, Christopher Trotter

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Aims: This study aims to examine the effectiveness of a practice skills framework implemented in three youth detention centres in Juvenile Justice in New South Wales (NSW), Australia. The study is supported by a grant from and Australian Research Council and NSW Juvenile Justice. Recent years have seen a number of incidents in youth detention centres in Australia and other places. These have led to inquiries and reviews with some suggesting that detention centres often do not even meet basic human rights and do little in terms of providing opportunities for rehabilitation of residents. While there is an increasing body of research suggesting that community based supervision can be effective in reducing recidivism if appropriate skills are used by supervisors, there has been less work considering worker skills in youth detention settings. The research that has been done, however, suggest that teaching interpersonal skills to youth officers may be effective in enhancing the rehabilitation culture of centres. Positive outcomes have been seen in a UK detention centre for example, from teaching staff to do five-minute problem-solving interventions. The aim of this project is to examine the effectiveness of training and coaching youth detention staff in three NSW detention centres in interpersonal practice skills. Effectiveness is defined in terms of reductions in the frequency of critical incidents and improvements in the well-being of staff and young people. The research is important as the results may lead to the development of more humane and rehabilitative experiences for young people. Method: The study involves training staff in core effective practice skills and supporting staff in the use of those skills through supervision and de-briefing. The core effective practice skills include role clarification, pro-social modelling, brief problem solving, and relationship skills. The training also addresses some of the background to criminal behaviour including trauma. Data regarding critical incidents and well-being before and after the program implementation are being collected. This involves interviews with staff and young people, the completion of well-being scales, and examination of departmental records regarding critical incidents. In addition to the before and after comparison a matched control group which is not offered the intervention is also being used. The study includes more than 400 young people and 100 youth officers across 6 centres including the control sites. Data collection includes interviews with workers and young people, critical incident data such as assaults, use of lock ups and confinement and school attendance. Data collection also includes analysing video-tapes of centre activities for changes in the use of staff skills. Results: The project is currently underway with ongoing training and supervision. Early results will be available for the conference.

Keywords: custody, practice skills, training, youth workers

Procedia PDF Downloads 77

Authors: Amit Kumar Verma

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The present study deals with fire prediction model in Terai Arc Landscape, one of the most dramatic ecosystems in Asia where large, wide-ranging species such as tiger, rhinos, and elephant will thrive while bringing economic benefits to the local people. Forest fires cause huge economic and ecological losses and release considerable quantities of carbon into the air and is an important factor inflating the global burden of carbon emissions. Forest fire is an important factor of behavioral cum ecological habit of tiger in wild. Post fire changes i.e. micro and macro habitat directly affect the tiger habitat or land. Vulnerability of fire depicts the changes in microhabitat (humus, soil profile, litter, vegetation, grassland ecosystem). Microorganism like spider, annelids, arthropods and other favorable microorganism directly affect by the forest fire and indirectly these entire microorganisms are responsible for the development of tiger (Panthera tigris) habitat. On the other hand, fire brings depletion in prey species and negative movement of tiger from wild to human- dominated areas, which may leads the conflict i.e. dangerous for both tiger & human beings. Early forest fire prediction through mapping the risk zones can help minimize the fire frequency and manage forest fires thereby minimizing losses. Satellite data plays a vital role in identifying and mapping forest fire and recording the frequency with which different vegetation types are affected. Thematic hazard maps have been generated by using IDW technique. A prediction model for fire occurrence is developed for TAL. The fire occurrence records were collected from state forest department from 2000 to 2014. Disciminant function models was used for developing a prediction model for forest fires in TAL, random points for non-occurrence of fire have been generated. Based on the attributes of points of occurrence and non-occurrence, the model developed predicts the fire occurrence. The map of predicted probabilities classified the study area into five classes very high (12.94%), high (23.63%), moderate (25.87%), low(27.46%) and no fire (10.1%) based upon the intensity of hazard. model is able to classify 78.73 percent of points correctly and hence can be used for the purpose with confidence. Overall, also the model works correctly with almost 69% of points. This study exemplifies the usefulness of prediction model of forest fire and offers a more effective way for management of forest fire. Overall, this study depicts the model for conservation of tiger’s natural habitat and forest conservation which is beneficial for the wild and human beings for future prospective.

Keywords: fire prediction model, forest fire hazard, GIS, landsat, MODIS, TAL

Procedia PDF Downloads 325

Authors: Amel Fayed, Shaden AlSubaih, Nouf Al-Qahtani, Asmaa Gosty, Asma Aljuhaimi

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Introduction: Sleep difficulties are vastly predominant among adults and affect different aspects of their life. Many literatures found out that females are more liable to suffer from sleeping problems. College students are typical example of people dealing with daily pressure and stress to fulfill the daily tasks and responsibilities. In addition to their ultimate goal of achieving excellent academic records which require their full concentration and effort. Consequently, many of them start complaining of sleep deprivations which can undesirably affect their academic achievements. This study was aiming to investigate how prevalent is sleeping disorders among different colleges in the university and its relation their academic achievements. Methods: A cross-sectional study of female university students at Princess Norah Bint Abdulrahman University using self-administered questionnaire was conducted. Insomnia Severity Index (ISI) was used to assess different grades of insomnia. Students were requested to answer the questions evaluating their sleeping habits over the last two weeks. Participants reported their latest Grade Point Average (GPA). According to ISI, insomnia severity is reported as ‘No clinically significant’, ‘Subthreshold ‘,’ Clinical moderate insomnia’ and ‘Clinical severe’. Results: In the current study, 228 students participated; 172(75.4%) from medical colleges and 56 (24.6%) from non-medical colleges. About 80% of them claimed to have never taken any medications to help them sleep while only three students confirmed their regular use of sleep-inducing medications. About 16% of the students drink milk or other hot drinks to help them fall asleep. None of the students was suspected of having obstructive sleep apnea or apparent psychiatric disorder. According to ISI, 182 (79.8%) students suffered from subthreshold insomnia, 37 (16.2%) had clinical insomnia (moderate severity) and 9 (3.9%) of students had sleeping problems of non-clinically significance level. However, none of students was found to have severe clinical insomnia. Clinical moderate insomnia was reported in 15.1% of medical students and 19.6% of non-medical students. Moreover, about 82% of medical students suffered from subthreshold insomnia compared to 73.2% of non-medical students. This difference was not statistically significant (P=0.24). About 63% of medical students and 48% of non-medical students believed that high percentage of their colleagues are suffering from insomnias (p-value 0.08) The association between GPA and insomnia revealed that; 19.5% of low GPA group compared to 9.3% of high GPA group had clinical moderate insomnia. This association was not statistically significant (p=0.15). The correlation between the GPA and the ISI score was negative but not conclusive (r=-0.08, p-value = 0.29). More than 92% of all students agreed that sleeping problems affect their academic achievement to varying degrees. Conclusion: our results suggest that insomnia is commonly prevalent among female university students and might affect the students’ achievement. This study provides preliminary data about the quality of sleep among medical and non-medical university students which may be used to promote the healthy sleeping habits among female students.

Keywords: academic achievement, females, insomnia, university student

Procedia PDF Downloads 310

Authors: Jihede Haj Messaoud, Hamdi Omar, Hela Fakhfakh Ben Jemia, Chokri Yaich

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The Upper Lutetian alternating marl–limestone succession of Reineche Member was deposited over a warm shallow carbonate platform that permits Nummulites proliferation. High-resolution studies of 30 meters thick Nummulites-bearing Reineche Member, cropping out in Central Tunisia (Jebel Siouf), have been undertaken, regarding pronounced cyclical sedimentary sequences, in order to investigate the periodicity of cycles and their related orbital-scale oceanic and climatic changes. The palaeoenvironmental and palaeoclimatic data are preserved in several proxies obtainable through high-resolution sampling and laboratories measurement and analysis as magnetic susceptibility (MS) and carbonates contents in conjunction with a wireline logging tools. The time series analysis of proxies permits to establish cyclicity orders present in the studied intervals which could be linked to the orbital cycles. MS records provide high-resolution proxies for relative sea level change in Late Lutetian strata. The spectral analysis of MS fluctuations confirmed the orbital forcing by the presence of the complete suite of orbital frequencies in the precession of 23 ka, the obliquity of 41 ka, and notably the two modes of eccentricity of 100 and 405 ka. Regarding the two periodic sedimentary cycles detected by wavelet analysis of proxy fluctuations which coincide with the long-term 405 ka eccentricity cycle, the Reineche Member spanned 0,8 Myr. Wireline logging tools as gamma ray and sonic were used as a proxies to decipher cyclicity and trends in sedimentation and contribute to identifying and correlate units. There are used to constraint the highest frequency cyclicity modulated by a long term wavelength cycling apparently controlled by clay content. Interpreted as a result of variations in carbonate productivity, it has been suggested that the marl-limestone couplets, represent the sedimentary response to the orbital forcing. The calculation of cycle durations through Reineche Member, is used as a geochronometer and permit the astronomical calibration of the geologic time scale. Furthermore, MS coupled with carbonate contents, and fossil occurrences provide strong evidence for combined detrital inputs and marine surface carbonate productivity cycles. These two synchronous processes were driven by the precession index and ‘fingerprinted’ in the basic marl–limestone couplets, modulated by orbital eccentricity.

Keywords: magnetic susceptibility, cyclostratigraphy, orbital forcing, spectral analysis, Lutetian

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Authors: Suteera Pradubwong, Pattama Surit, Sumalee Pongpagatip, Tharinee Pethchara, Bowornsilp Chowchuen

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Background: Cleft lip and palate (CLP) is a congenital anomaly of the lip and palate that is caused by several factors. It was found in approximately one per 500 to 550 live births depending on nationality and socioeconomic status. The Tawanchai Center and out-patients surgical room of Srinagarind Hospital are responsible for providing care to patients with CLP (starting from birth to adolescent) and their caregivers. From the observations and interviews with nurses working in these units, they reported that both patients and their caregivers confronted many problems which affected their physical and mental health. Based on the Soukup’s model (2000), the researchers used evidence triggers from clinical practice (practice triggers) and related literature (knowledge triggers) to investigate the problems. Objective: The purpose of this study was to investigate the problems of care for patients with CLP in the Tawanchai Center and out-patient surgical room of Srinagarind Hospital. Material and Method: The descriptive method was used in this study. For practice triggers, the researchers obtained the data from medical records of ten patients with CLP and from interviewing two patients with CLP, eight caregivers, two nurses, and two assistant workers. Instruments for the interview consisted of a demographic data form and a semi-structured questionnaire. For knowledge triggers, the researchers used a literature search. The data from both practice and knowledge triggers were collected between February and May 2016. The quantitative data were analyzed through frequency and percentage distributions, and the qualitative data were analyzed through a content analysis. Results: The problems of care gained from practice and knowledge triggers were consistent and were identified as holistic issues, including 1) insufficient feeding, 2) risks of respiratory tract infections and physical disorders, 3) psychological problems, such as anxiety, stress, and distress, 4) socioeconomic problems, such as stigmatization, isolation, and loss of income, 5)spiritual problems, such as low self-esteem and low quality of life, 6) school absence and learning limitation, 7) lack of knowledge about CLP and its treatments, 8) misunderstanding towards roles among the multidisciplinary team, 9) no available services, and 10) shortage of healthcare professionals, especially speech-language pathologists (SLPs). Conclusion: From evidence-triggers, the problems of care affect the patients and their caregivers holistically. Integrated long-term care by the multidisciplinary team is needed for children with CLP starting from birth to adolescent. Nurses should provide effective care to these patients and their caregivers by using a holistic approach and working collaboratively with other healthcare providers in the multidisciplinary team.

Keywords: evidence-triggers, cleft lip, cleft palate, problems of care

Procedia PDF Downloads 193

Authors: Birgit Rasmussen, Thomas Maribo, Bente S. Toft

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BACKGROUND: Cardiac rehabilitation is the standard treatment for ischemic heart disease. Cardiac rehabilitation improves quality of life, reduces mortality and the risk of readmission, and provides patients with valuable knowledge and encouragement from peers and staff. Still, less than half of eligible patients enroll. Face-to-face interventions have the potential to support patients' decision-making and increase enrolment in cardiac rehabilitation. However, we lack knowledge of the content and characteristics of interventions. AIM: The aim was to outline and evaluate the content and characteristics of studies that have reported on face-to-face interventions to encourage enrolment in cardiac rehabilitation in patients with ischemic heart disease. METHOD: This scoping review followed the Joanne Briggs Institute methodology. Based on an a-priori protocol that defined the systematic search criteria, six databases were searched for studies published between 2001 and 2023. Two reviewers independently screened and selected studies. All authors discussed the summarized data prior to the narrative presentation. RESULTS: After screening and full text review of 5583 records, 20 studies of heterogeneous design and content were included. Four studies described the key contents in face-to-face interventions to be education, support of autonomy, addressing reasons for change, and emotional and cognitive support while showing understanding. Two studies used motivational interviewing to target patients' experiences and address worries and anticipated difficulties. Four quantitative studies found associations between enrolment and intention to attend, cardiac rehabilitation barriers, exercise self-efficacy, and perceived control. When patients asked questions, enrolment rates were higher, while providing reassurance and optimism could lead to non-attendance if patients had a high degree of worry. In qualitative studies, support to overcome barriers and knowledge about health benefits from participation in cardiac rehabilitation facilitated enrolment. Feeling reassured that the cardiac condition was good could lead to non-attendance. DISCUSSION AND CONCLUSION: To support patients' enrolment in cardiac rehabilitation, it is recommended that interventions integrate a person-centered dialogue. Individual worries and barriers to cardiac rehabilitation should be jointly explored. When talking with patients for whom worries predominate, the recommendation is to focus on the patients' perspectives and avoid too much focus on reassurance and problem-solving. The patients' perspectives, the mechanisms of change, and the process evaluation of the intervention including person-centeredness are relevant to include in future studies.

Keywords: ischemic heart disease, cardiac rehabilitation, enrolment, person-centered, in-hospital interventions

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Authors: Sherly Shelton, Zhaohui Lin

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In recent decades, the inter-annual variability of summer precipitation over the India and Sri Lanka has intensified significantly with an increased frequency of both abnormally dry and wet summers. Therefore prediction of the inter-annual variability of summer precipitation is crucial and urgent for water management and local agriculture scheduling. However, none of the hypotheses put forward so far could understand the relationship to monsoon variability and related factors that affect to the South West Monsoon (SWM) variability in Sri Lanka. This study focused to identify the spatial and temporal variability of SWM rainfall events from June to September (JJAS) over Sri Lanka and associated trend. The monthly rainfall records covering 1980-2013 over the Sri Lanka are used for 19 stations to investigate long-term trends in SWM rainfall over Sri Lanka. The linear trends of atmospheric variables are calculated to understand the drivers behind the changers described based on the observed precipitation, sea surface temperature and atmospheric reanalysis products data for 34 years (1980–2013). Empirical orthogonal function (EOF) analysis was applied to understand the spatial and temporal behaviour of seasonal SWM rainfall variability and also investigate whether the trend pattern is the dominant mode that explains SWM rainfall variability. The spatial and stations based precipitation over the country showed statistically insignificant decreasing trends except few stations. The first two EOFs of seasonal (JJAS) mean of rainfall explained 52% and 23 % of the total variance and first PC showed positive loadings of the SWM rainfall for the whole landmass while strongest positive lording can be seen in western/ southwestern part of the Sri Lanka. There is a negative correlation (r ≤ -0.3) between SMRI and SST in the Arabian Sea and Central Indian Ocean which indicate that lower temperature in the Arabian Sea and Central Indian Ocean are associated with greater rainfall over the country. This study also shows that consistently warming throughout the Indian Ocean. The result shows that the perceptible water over the county is decreasing with the time which the influence to the reduction of precipitation over the area by weakening drawn draft. In addition, evaporation is getting weaker over the Arabian Sea, Bay of Bengal and Sri Lankan landmass which leads to reduction of moisture availability required for the SWM rainfall over Sri Lanka. At the same time, weakening of the SST gradients between Arabian Sea and Bay of Bengal can deteriorate the monsoon circulation, untimely which diminish SWM over Sri Lanka. The decreasing trends of moisture, moisture transport, zonal wind, moisture divergence with weakening evaporation over Arabian Sea, during the past decade having an aggravating influence on decreasing trends of monsoon rainfall over the Sri Lanka.

Keywords: Arabian Sea, moisture flux convergence, South West Monsoon, Sri Lanka, sea surface temperature

Procedia PDF Downloads 102

Authors: Jeong-Min Son, Jeong-Hee Eum, Jin-Kyu Min, Uk-Je Sung, Ju-Eun Kim

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While various environmental problems are severe due to climate change, especially in cities where population and development are concentrated, urban thermal environment problems such as heat waves and tropical nights are particularly worsening. Accordingly, the Korean government provides basic data related to the urban thermal environment to support each local government in effectively establishing policies to cope with heat waves. However, the basic data related to the thermal environment provided by the government has limitations in establishing a regional thermal adaptation plan with a minimum unit of cities, counties, and districts. In addition, the urban heat environment perceived by people differs in each region and space. Therefore, it is necessary to prepare practical measures that can be used to establish regional-based policies for heat wave adaptation by identifying people’s heat perception in the entire city. This study aims to develop a mobile phone application (APP) to gather people’s thermal sensation information and create Korea’s first thermal map based on this information. In addition, through this APP, citizens directly propose thermal adaptation policies, and urban planners and policymakers accept citizens' opinions, so this study provides a tool to solve local thermal environment problems. To achieve this purpose, first, the composition and contents of the app were discussed by examining various existing apps and cases for citizen participation and collection of heat information. In addition, factors affecting human thermal comfort, such as spatial, meteorological, and demographic factors, were investigated to construct the APP system. Based on these results, the basic version of the APP was developed. Second, the living lab methodology was adopted to gather people’s heat perception using the developed app to conduct overall evaluation and feedback of people on the APP. The people participating in the living lab were selected as those living in Daegu Metropolitan City, which is located in South Korea and annually records high temperatures. The user interface was improved through the living lab to make the app easier to use and the thermal map was modified. This study expects to establish high-resolution thermal maps for effective policies and measures and to solve local thermal environmental problems using the APP. The collected information can be used to evaluate spatial, meteorological, and demographic characteristics that affect the perceived heat of citizens. In addition, it is expected that the research can be expanded by gathering thermal information perceived by citizens of foreign cities as well as other cities in South Korea through the APP developed in this study.

Keywords: mobile application, living lab, thermal map, climate change adaptation

Procedia PDF Downloads 62

Authors: Muhammad Qamar Masood, Syed Abbas Raza, Umar Yousaf Raja, Imran Hassan, Bilal Afzal, Muhammad Aleem Zahir, Atika Shaheer

Abstract:

Background: Cardiovascular disease (CVD) is a major burden among people with type 2 diabetes (T2D) with 1 in 3 reported to have CVD. Therefore, understanding real-world clinical characteristics and prescribing patterns could help in better care. Objective: The CONVERGE (Cardiovascular Outcomes and Value in the Real world with GLP-1RAs) study characterized demographics and medication usage patterns in T2D intensified (add-on to metformin) overall population. The data were further divided into subgroups {dipeptidyl peptidase-4 inhibitors (DPP-4is), sulfonylureas (SUs), insulins, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT-2is)}, according to the latest prescribed antidiabetic agent (ADA) in India/Pakistan/Thailand. Here, we report findings from Pakistan. Methods: A multi-center retrospective study utilized data from medical records between 13-Sep-2008 (post-market approval of GLP-1RAs) and 31-Dec-2017 in adults (≥18-year-old). The data for this study were collected from 05 centers / institutes located in major cities of Pakistan, including Karachi, Lahore, Islamabad, and Multan. These centers included National Hospital, Aga Khan University Hospital, Diabetes Endocrine Clinic Lahore, Shifa International Hospital, Mukhtar A Sheikh Hospital Multan. Data were collected at start of medical record and at 6 or 12-months prior to baseline based on variable type; analyzed descriptively. Results: Overall, 1,010 patients were eligible. At baseline, overall mean age (SD) was 51.6 (11.3) years, T2D duration was 2.4 (2.6) years, HbA1c was 8.3% (1.9) and 35% received ≥1CVD medications in the past 1-year (before baseline). Most frequently prescribed ADAs post-metformin were DPP-4is and SUs (~63%). Only 6.5% received GLP-1RAs and SGLT-2is were not available in Pakistan during the study period. Overall, it took a mean of 4.4 years and 5 years to initiate GLP-1RAs and SGLT-2is, respectively. In comparison to other subgroups, more patients from GLP-1RAs received ≥3 types of ADA (58%), ≥1 CVD medication (64%) and had higher body mass index (37kg/m2). Conclusions: Utilization of GLP-1RAs and SGLT-2is was low, took longer time to initiate and not before trying multiple ADAs. This may be due to lack of evidence for CV benefits for these agents during the study period. The planned phase 2 of the CONVERGE study can provide more insights into utilization and barriers to prescribe GLP-1RAs and SGLT-2is post 2018 in Pakistan.

Keywords: type 2 diabetes, GLP-1RA, treatment intensification, cardiovascular disease

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Authors: Maria E. V. Amarante, Carolina L. Cerdeira, Julia V. Cortes, Fiorita G. L. Mundim

Abstract:

Basal cell carcinoma (BCC) is the most prevalent type of skin cancer in humans. It arises from the basal cells of the epidermis and cutaneous appendages. The role of sunlight exposure as a risk factor for BCC is very well defined due to its power to influence genetic mutations, in addition to having a suppressor effect on the skin immune system. Despite showing low metastasis and mortality rates, the tumor is locally infiltrative, aggressive, and destructive. Considering the high prevalence rate of this carcinoma and the importance of early detection, a retrospective study was carried out in order to correlate the clinical data available on BBC, characterize it epidemiologically, and thus enable effective prevention measures for the population. Data on the period from January 2015 to December 2019 were collected from the medical records of patients registered at one pathology service located in the southeast region of Brazil, known as SVO, which delivers skin biopsy results. The study was aimed at correlating the variables, sex, age, and subtypes found. Data analysis was performed using the chi-square test at a nominal significance level of 5% in order to verify the independence between the variables of interest. Fisher's exact test was applied in cases where the absolute frequency in the cells of the contingency table was less than or equal to five. The statistical analysis was performed using the R® software. Ninety-three basal cell carcinoma were analyzed, and its frequency in the 31-to 45-year-old age group was 5.8 times higher in men than in women, whereas, from 46 to 59 years, the frequency was found 2.4 times higher in women than in men. Between the ages of 46 to 59 years, it should be noted that the sclerodermiform subtype appears more than the solid one, with a difference of 7.26 percentage points. Reversely, the solid form appears more frequently in individuals aged 60 years or more, with a difference of 8.57 percentage points. Among women, the frequency of the solid subtype was 9.93 percentage points higher than the sclerodermiform frequency. In males, the same percentage difference is observed, but sclerodermiform is the most prevalent subtype. It is concluded in this study that, in general, there is a predominance of basal cell carcinoma in females and in individuals aged 60 years and over, which demonstrates the tendency of this tumor. However, when rarely found in younger individuals, the male gender prevailed. The most prevalent subtype was the solid one. It is worth mentioning that the sclerodermiform subtype, which is more aggressive, was seen more frequently in males and in the 46-to 59-year-old range.

Keywords: basal cell carcinoma, epidemiology, sclerodermiform basal cell carcinoma, skin cancer, solar radiation, solid basal cell carcinoma

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Authors: Hamid Abbasi, Neda Jourabchi, Ranasadat Abedi, Kiarash Tajernarenj, Mehdi Farhoudi, Sarvin Sanaie

Abstract:

Background: Alpha lipoic acid (ALA), fat- and water-soluble, coenzyme with sulfuret content, has received considerable attention for its potential therapeutic role in diabetes, cardiovascular diseases, cancers, and central nervous disease. This investigation aims to evaluate the probable protective effects of ALA in stroke patients. Methods: Based on Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, This meta-analysis was performed. The PICO criteria for this meta-analysis were as follows: Population/Patients (P: stroke patients); Intervention (I: ALA); Comparison (C: control); Outcome (O: blood glucose, lipid profile, oxidative stress, inflammatory factors).In addition, Studies that were excluded from the analysis consisted of in vitro, in vivo, and ex vivo studies, case reports, quasi-experimental studies. Scopus, PubMed, Web of Science, EMBASE databases were searched until August 2023. Results: Of 496 records that were screened in the title/abstract stage, 9 studies were included in this meta-analysis. The sample sizes in the included studies vary between 28 and 90. The result of risk of bias was performed via risk of bias (RoB) in randomized-controlled trials (RCTs) based on the second version of the Cochrane RoB assessment tool. 8 studies had a definitely high risk of bias. Discussion: To the best of our knowledge, The present meta-analysis is the first study addressing the effectiveness of ALA supplementation in enhancing post-stroke metabolic markers, including lipid profile, oxidative stress, and inflammatory indices. It is imperative to acknowledge certain potential limitations inherent in this study. First of all, type of treatment (oral or intravenous infusion) could alter the bioavailability of ALA. Our study had restricted evidence regarding the impact of ALA supplementation on included outcomes. Therefore, further research is warranted to develop into the effects of ALA specifically on inflammation and oxidative stress. Funding: The research protocol was approved and supported by the Student Research Committee, Tabriz University of Medical Sciences (grant number: 72825). Registration: This study was registered in the International prospective register of systematic reviews (PROSPERO ID: CR42023461612).

Keywords: alpha-lipoic acid, lipid profile, blood glucose, inflammatory factors, oxidative stress, meta-analysis, post-stroke

Procedia PDF Downloads 31