Search results for: returned traveller
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 251

Search results for: returned traveller

131 Clinical Outcomes of Mild Traumatic Brain Injury with Acute Traumatic Intracranial Hemorrhage on Initial Emergency Ward Neuroimaging

Authors: S. Shafiee Ardestani, A. Najafi, N. Valizadeh, E. Payani, H. Karimian

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Objectives: Treatment of mild traumatic brain injury in emergency ward patients with any type of traumatic intracranial hemorrhage is flexible. The aim of this study is to assess the clinical outcomes of mild traumatic brain injury patients who had acute traumatic intracranial hemorrhage on initial emergency ward neuroimaging. Materials-Methods: From March 2011 to November 2012 in a retrospective cohort study we enrolled emergency ward patients with mild traumatic brain injury with Glasgow Coma Scale (GCS) scores of 14 or 15 and who had stable vital signs. Patients who had any type of intracranial hemorrhage on first head CT and repeat head CT within 24 hours were included. Patients with initial GCS < 14, injury > 24 hours old, pregnancy, concomitant non-minor injuries, and coagulopathy were excluded. Primary endpoints were neurosurgical procedures and/or death and for discharged patients, return to the emergency ward during one week. Results: Among 755 patients who were referred to the emergency ward and underwent two head CTs during first 24 hours, 302 (40%) were included. The median interval between CT scans was 6 hours (ranging 4 to 8 hours). Consequently, 135 (45%) patients had subarachnoid hemorrhage, 124 (41%) patients had subdural hemorrhage, 15 (5%) patients had epidural hemorrhage, 28 (9%) patients had cerebral contusions, and 54 (18%) patients had intra-parenchymal hemorrhage. Six of 302 patients died within 15 days of injury. 200 patients (66%) have been discharged from the emergency ward, 25 (12%) of whom returned to the emergency ward after one week. Conclusion: Discharge of the head trauma patients after a repeat head CT and brief period of observation in the emergency ward lead to early discharge of mild traumatic brain injury patients with traumatic ICH without adverse events.

Keywords: clinical outcomes, emergency ward, mild traumatic intracranial hemorrhage, Glasgow Coma Scale (GCS)

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130 Influence of Social, Economic, Political and Legal Environment of Sport Organizations on Sport Development in Zone Ten (10) of National Zonal Sport Offices in Nigeria

Authors: Ejeh Benjamin Ijuo

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The purpose of this study was to investigate the influence of social, economic, political, and legal environment of sport organizations on sport development in zone ten (10) national zonal sport offices in Nigeria (Plateau, Nasarawa, Benue and F.C.T Abuja). To achieve this purpose, a structured 26 item questionnaire (ISEPLESOQ) designed by the researcher was used for this study. Related literature to this study was reviewed. 311 copies of questionnaire were administered to randomly selected respondents. Out of this number, 306 was dully completed and returned representing 98.4%. The respondents included: Athletes, games masters/ mistresses, coaches in state sport councils, zonal sport coordinators, team managers, directors of state sports council. Four research questions were answered using the mean and standard deviation, while the inferential statistics of chi-square(x2) test of goodness of fit was used to test the four hypotheses at 0.05 alpha levels. The findings of this study revealed that the social, economic, political and legal environment of sport organizations significantly influenced sport development in zone ten (10) national zonal sport offices in Nigeria. It was also established that the general environment of sport organizations influences people’s participation in sport, funding and sponsorship of sports, sitting of equipment and facilities at different locations, selection of athletes. It was therefore, recommended among other things that government should privatize and commercialized sport programmes to enable corporate organizations and individuals participation. Lt was further suggested that the federal government should harness her social, economic, political and legal environment to improve sport development in Nigeria.

Keywords: sport organization, sport development, sport environment, zonal sport offices

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129 Optimization Method of the Number of Berth at Bus Rapid Transit Stations Based on Passenger Flow Demand

Authors: Wei Kunkun, Cao Wanyang, Xu Yujie, Qiao Yuzhi, Liu Yingning

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The reasonable design of bus parking spaces can improve the traffic capacity of the station and reduce traffic congestion. In order to reasonably determine the number of berths at BRT (Bus Rapid Transit) stops, it is based on the actual bus rapid transit station observation data, scheduling data, and passenger flow data. Optimize the number of station berths from the perspective of optimizing the balance of supply and demand at the site. Combined with the classical capacity calculation model, this paper first analyzes the important factors affecting the traffic capacity of BRT stops by using SPSS PRO and MATLAB programming software, namely the distribution of BRT stops and the distribution of BRT stop time. Secondly, the method of calculating the number of the classic human capital management (HCM) model is optimized based on the actual passenger demand of the station, and the method applicable to the actual number of station berths is proposed. Taking Gangding Station of Zhongshan Avenue Bus Rapid Transit Corridor in Guangzhou as an example, based on the calculation method proposed in this paper, the number of berths of sub-station 1, sub-station 2 and sub-station 3 is 2, which reduces the road space of the station by 33.3% compared with the previous berth 3 of each sub-station, and returns to social vehicles. Therefore, under the condition of ensuring the passenger flow demand of BRT stations, the road space of the station is reduced, and the road is returned to social vehicles, the traffic capacity of social vehicles is improved, and the traffic capacity and efficiency of the BRT corridor system are improved as a whole.

Keywords: urban transportation, bus rapid transit station, HCM model, capacity, number of berths

Procedia PDF Downloads 75
128 Experimental and Numerical Evaluation of a Shaft Failure Behaviour Using Three-Point Bending Test

Authors: Bernd Engel, Sara Salman Hassan Al-Maeeni

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A substantial amount of natural resources are nowadays consumed at a growing rate, as humans all over the world used materials obtained from the Earth. Machinery manufacturing industry is one of the major resource consumers on a global scale. Even though the incessant finding out of the new material, metals, and resources, it is urgent for the industry to develop methods to use the Earth's resources intelligently and more sustainable than before. Re-engineering of machine tools regarding design and failure analysis is an approach whereby out-of-date machines are upgraded and returned to useful life. To ensure the reliable future performance of the used machine components, it is essential to investigate the machine component failure through the material, design, and surface examinations. This paper presents an experimental approach aimed at inspecting the shaft of the rotary draw bending machine as a case to study. The testing methodology, which is based on the principle of the three-point bending test, allows assessing the shaft elastic behavior under loading. Furthermore, the shaft elastic characteristics include the maximum linear deflection, and maximum bending stress was determined by using an analytical approach and finite element (FE) analysis approach. In the end, the results were compared with the ones obtained by the experimental approach. In conclusion, it is seen that the measured bending deflection and bending stress were well close to the permissible design value. Therefore, the shaft can work in the second life cycle. However, based on previous surface tests conducted, the shaft needs surface treatments include re-carburizing and refining processes to ensure the reliable surface performance.

Keywords: deflection, FE analysis, shaft, stress, three-point bending

Procedia PDF Downloads 124
127 Ecological and Biological Effects of Pollution and Dredging Activities on Fisheries and Fisheries Products in Niger Delta Ecological Zone

Authors: Ikpesu, Thomas Ohwofasa, Babtunde Ilesanmi

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The effects of anthropogenic activities on fish and fisheries products in Niger Delta water bodies were investigated. The rivers were selected based on their close proximity to contaminants and dredging activities. Three stations were chosen per river. The stations chosen to depicting downstream and upstream stations were visited and samples collected on monthly basis. The down streams stations are the polluted and heavily dredged sites, where the upstream station is far, without any evidence of pollution or human activities. During these periods, the fishes of the same species were collected and analyzed for morphological and physiological changes, after which they were returned back to the rivers. The physico-chemicals parameters of these stations were also taken. Morphological changes such as skin ulcerations and other lesions, as well as fungi infections were observed in the down streams fishes. The fish in up streams look healthier and bigger (though the age could not be affirmed) than the downstream fishes. The physico-chemical parameters between the up streams and down streams stations vary significantly (p < 0.01). These anthropogenic effects must have interfere with the normal migration pattern of these fishes, because there were changes in the composition of population and species diversity in the samples sites, with the upstream having true species diversity. The release of pollutants into the water in the Niger Delta areas may triggers off naturally occurring bio toxicity cycles and other fish poisoning. There is risk of biomagnifications of these poisons along the tropic level. This makes the normally valuable food resource dangerous for human consumption and thereby instances of human death caused by such poisoning.

Keywords: anthropogenic, dredging, fisheries, niger delta, pollution, rivers

Procedia PDF Downloads 284
126 Green Supply Chain Network Optimization with Internet of Things

Authors: Sema Kayapinar, Ismail Karaoglan, Turan Paksoy, Hadi Gokcen

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Green Supply Chain Management is gaining growing interest among researchers and supply chain management. The concept of Green Supply Chain Management is to integrate environmental thinking into the Supply Chain Management. It is the systematic concept emphasis on environmental problems such as reduction of greenhouse gas emissions, energy efficiency, recycling end of life products, generation of solid and hazardous waste. This study is to present a green supply chain network model integrated Internet of Things applications. Internet of Things provides to get precise and accurate information of end-of-life product with sensors and systems devices. The forward direction consists of suppliers, plants, distributions centres and sales and collect centres while, the reverse flow includes the sales and collects centres, disassembled centre, recycling and disposal centre. The sales and collection centre sells the new products are transhipped from factory via distribution centre and also receive the end-of life product according their value level. We describe green logistics activities by presenting specific examples including “recycling of the returned products and “reduction of CO2 gas emissions”. The different transportation choices are illustrated between echelons according to their CO2 gas emissions. This problem is formulated as a mixed integer linear programming model to solve the green supply chain problems which are emerged from the environmental awareness and responsibilities. This model is solved by using Gams package program. Numerical examples are suggested to illustrate the efficiency of the proposed model.

Keywords: green supply chain optimization, internet of things, greenhouse gas emission, recycling

Procedia PDF Downloads 300
125 Teachers' Knowledge, Perceptions, and Attitudes towards Renewable Energy Policy in Malaysia

Authors: Kazi Enamul Hoque

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Initiatives on sustainable development are currently aggressively pursued throughout the world. The Malaysian government has developed key policies and strategies for over 30 years to achieve the nation’s policy objectives which are designed to mitigate the issues of security, energy efficiency and environmental impact to meet the rising energy demand. Malaysia’s current focus is on developing effective policies on renewable energy (RE) in order to reduce dependency on fossil fuel and contribute towards mitigating the effects of climate change. In this light mass awareness should be considered as the highest priority to protect the environment and to escape disaster due to climate change. Schools can be the reliable and effective foundation to prepare students to get familiar with environmental issues such as renewable and non-renewable energy sources. Teachers can play a vital role to create awareness among students about the advantages and disadvantages of using different renewable and nonrenewable energy resources. Thus, this study aims to investigate teachers’ knowledge, perceptions and attitudes towards renewable energy through a survey aiming a sustainable energy future. Five hundred sets of questionnaires were distributed to the school teachers in Malaysia. Total 420 questionnaires were returned of which 410 were complete to analyze. Finding shows that teachers are very familiar with the renewable energy like solar, wind and also geothermal. Most teachers were not sure about the Photovoltaics and biodiesel. Furthermore, teachers are also aware that primary energy in Malaysia is imported fossil fuels. Most teachers heard about the renewable energy in Malaysia and only few claims that they did not hear of such things and the others said that they never heard of it. The outcomes of the study will assist the energy policy makers to use teachers to create mass awareness of energy usages for future planning.

Keywords: Malaysia, non-renewable energy, renewable energy, school teacher

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124 Economics of Open and Distance Education in the University of Ibadan, Nigeria

Authors: Babatunde Kasim Oladele

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One of the major objectives of the Nigeria national policy on education is the provision of equal educational opportunities to all citizens at different levels of education. With regards to higher education, an aspect of the policy encourages distance learning to be organized and delivered by tertiary institutions in Nigeria. This study therefore, determines how much of the Government resources are committed, how the resources are utilized and what alternative sources of funding are available for this system of education. This study investigated the trends in recurrent costs between 2004/2005 and 2013/2014 at University of Ibadan Distance Learning Centre (DLC). A descriptive survey research design was employed for the study. Questionnaire was the research instrument used for the collection of data. The population of the study was 280 current distance learning education students, 70 academic staff and 50 administrative staff. Only 354 questionnaires were correctly filled and returned. Data collected were analyzed and coded using the frequencies, ratio, average and percentages were used to answer all the research questions. The study revealed that staff salaries and allowances of academic and non-academic staff represent the most important variable that influences the cost of education. About 55% of resources were allocated to this sector alone. The study also indicates that costs rise every year with increase in enrolment representing a situation of diseconomies of scale. This study recommends that Universities who operates distance learning program should strive to explore other internally generated revenue option to boost their revenue. University of Ibadan, being the premier university in Nigeria, should be given foreign aid and home support, both financially and materially, to enable the institute to run a formidable distance education program that would measure up in planning and implementation with those of developed nation.

Keywords: open education, distance education, University of Ibadan, Nigeria, cost of education

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123 Prevalence of Barodontalgia among Aircrews Working in Kingdom of Saudi Arabia and Knowledge of Dental Interns about This Phenomena

Authors: Ali Saleh Al-Rafedah, Ahmed Mohammed Al-Quthami, Tariq Jalal Al-Ashawi, Talal Nasser Motar Al-Enez

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Introduction: Barodontalgia is essentially dental pain provoked by changes in atmospheric pressure which usually disappear when the affected person reaches normal pressure zone. Barodontalgia has been recognized as a potential cause of aircrew-member vertigo and sudden incapacitation, which could jeopardize the safety of flight. Objective: The current study aimed to investigate the incidence of this phenomena among aircrews in Kingdom of Saudi Arabia. It also aimed to assess the knowledge of dental interns toward this phenomena. Material and Method: A 120 questionnaire consists of 17 questions were distributed to different of Aircrews working in commercial and governmental centers in different areas of KSA. Another questionnaire also distributed to 240 interns in different institutes in KSA. Results: Out of 120 questionnaire distributed to aircrews, 48 has been returned back (40%) and the participants were mainly pilots. The results showed that about 33% of the participants had this pain at least once during flying and the incidence of this pain was not associated with any age group. Most of the pain experience were during descending and at altitude between 10.000-20.000 feet (63%). The pain completely relieved after landing in most of the cases. Regarding pain scores, the majority of the participants reported moderate scores of severity (%65) and about 85% of them had visited the physician or dentist to investigate the existing oral problem. Among dental interns in KSA, our finding indicated lack of knowledge regarding this phenomena since only 23 % of the participants have an idea about this phenomena. Conclusion and recommendation: The incidence of Barodontalgia among aircrews in Saudi Arabia is considerably high and further studies should be carried out for better understanding of this phenomena. Significant lack of knowledge among dental interns about the Barodontalgia has been highlighted and inclusion of it in the teaching of clinical and preclinical curriculum is recommended.

Keywords: Barodontalgia/dental, atmospheric pressure, incapacitation, Saudi Arabia

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122 Receptiveness of Market Segmentation Towards Online Shopping Attitude: A Quality Management Strategy for Online Passenger Car Market

Authors: Noor Hasmini Abdghani, Nik Kamariah Nikmat, Nor Hayati Ahmad

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Rapid growth of the internet technology led to changes in the consumer lifestyles. This involved customer buying behaviour-based internet that create new kind of buying strategy. Hence, it has summoned many of world firms including Malaysia to generate new quality strategy in preparation to face new customer buying lifestyles. Particularly, this study focused on identifying online customer segment of automobile passenger car customers. Secondly, the objective is to understand online customer’s receptiveness towards internet technologies. This study distributed 700 questionnaires whereby 582 were returned representing 83% response rate. The data were analysed using factor and regression analyses. The result from the factor analysis precipitates four online passenger car segmentations in Malaysia, which are: Segment (1)- Automobile Online shopping Preferences, Segment (2)- Automobile Online Brand Comparison, Segment (3)- Automobile Online Information Seeking and Segment (4)- Automobile Offline Shopping Preferences. In understanding the online customer’s receptiveness towards internet, the regression result shows that there is significant relationship between each of four segments of online passenger car customer with attitude towards automobile online shopping. This implies that, for online customers to have receptiveness toward internet technologies, he or she must have preferences toward online shopping or at least prefer to browse any related information online even if the actual purchase is made at the traditional store. With this proposed segmentation strategy, the firms especially the automobile firms will be able to understand their online customer behavior. At least, the proposed segmentation strategy will help the firms to strategize quality management approach for their online customers’ buying decision making.

Keywords: Automobile, Market Segmentation, Online Shopping Attitude, Quality Management Strategy

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121 The Direct Drivers of Ethnocentric Consumer, Intention and Actual Purchasing Behavior in Malaysia

Authors: Nik Kamariah Nikmat, Noor Hasmini Abdghani

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The Malaysian government had consistently revived its campaign for “Buy Malaysian Goods” from time to time. The purpose of the campaign is to remind consumers to be ethnocentric and patriotic when purchasing product and services. This is necessary to ensure high demand for local products and services compared to foreign products. However, the decline of domestic investment in 2012 has triggered concern for the Malaysian economy. Hence, this study attempts to determine the drivers of actual purchasing behavior, intention to purchase domestic products and ethnocentrism. The study employs the cross-sectional primary data, self-administered on household, selected using stratified random sampling in four Malaysian regions. A nine factor driver of actual domestic purchasing behavior (culture openness, conservatism, collectivism, patriotism, control belief, interest in foreign travel, attitude, ethnocentrism and intention) were measured utilizing 60 items, using 7-point Likert-scale. From 1000 questionnaires distributed, a sample of 486 were returned representing 48.6 percent response rate. From the fit generated structural model (SEM analysis), it was found that the drivers of actual purchase behavior are collectivism, cultural openness and patriotism; the drivers of intention to purchase domestic product are attitude, control belief, collectivism and conservativeness; and drivers of ethnocentrism are cultural openness, control belief, foreign travel and patriotism. It also shows that Malaysian consumers scored high in ethnocentrism and patriotism. The findings are discussed in the perspective of its implication to Malaysian National Agenda.

Keywords: actual purchase, ethnocentrism, patriotism, culture openness, conservatism

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120 The Value of Study Abroad for Māori and Pasifika Learners: In Relation to the Tertiary Education Strategy in New Zealand

Authors: Easter Faasoo-Tuilagi

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Study abroad has become a significant aspect of the tertiary system for New Zealand tertiary institutions and has been having a valuable contribution to student achievement and completion rate. The purpose of this doctoral study was to explore the significance and value of study abroad at an individual (learner), institutional (university), and national (government) level, with a focus on Māori and Pasifika learners. Previous research had conducted on the values and benefits of study abroad; however, there is a gap in knowledge on how study abroad can contribute to the educational experience of Māori and Pasifika students in tertiary studies in New Zealand. This study’s main focus aimed to explore the current participation and history of involvement of Māori and Pasifika students with study abroad using the University of Auckland and the University of Otago as case studies. It analysed the experiences of Māori and Pasifika students who were interested in study abroad or have returned from a study abroad. This research also explored how study abroad had become a significant aspect of the tertiary system in New Zealand, focusing on Tertiary Education Strategies. These questions were analysed using a range of methodologies, including a literature review to review how various institutions and nations, in particular New Zealand, were approaching study abroad, semi-structured interviews with Māori and Pasifika students on their experiences expressing interest in study abroad, and case studies of current/ returning Māori and Pasifika students who have had a study abroad experience. The anticipated results from this research will address several gaps in the existing literature and provide ways to better support Māori and Pasifika students who want to have a study abroad experience. This study will also inform education policy at an institutional and national level to boost the achievement of Māori and Pasifika students aligning with the Tertiary Education Strategy priorities.

Keywords: study abroad, Māori and Pasifika learners, international education, tertiary education strategy

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119 Place of Radiotherapy in the Treatment of Intracranial Meningiomas: Experience of the Cancer Center Emir Abdelkader of Oran Algeria

Authors: Taleb L., Benarbia M., Boutira F. M., Allam H., Boukerche A.

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Introduction and purpose of the study: Meningiomas are the most common non-glial intracranial tumors in adults, accounting for approximately 30% of all central nervous system tumors. The aim of our study is to determine the epidemiological, clinical, therapeutic, and evolutionary characteristics of a cohort of patients with intracranial meningioma treated with radiotherapy at the Emir Abdelkader Cancer Center in Oran. Material and methods: This is a retrospective study of 44 patients during the period from 2014 to 2020. The overall survival and relapse-free survival curves were calculated using the Kaplan-Meier method. Results and statistical analysis: The median age of the patients was 49 years [21-76 years] with a clear female predominance (sex ratio=2.4). The average diagnostic delay was seven months [2 to 24 months], the circumstances of the discovery of which were dominated by headaches in 54.5% of cases (n=24), visual disturbances in 40.9% (n=18), and motor disorders in 15.9% (n=7). The seat of the tumor was essentially at the level of the base of the skull in 52.3% of patients (n=23), including 29.5% (n=13) at the level of the cavernous sinus, 27.3% (n=12) at the parasagittal level and 20.5% (n=9) at the convexity. The diagnosis was confirmed surgically in 36 patients (81.8%) whose anatomopathological study returned in favor of grades I, II, and III in respectively 40.9%, 29.5%, and 11.4% of the cases. Radiotherapy was indicated postoperatively in 45.5% of patients (n=20), exclusive in 27.3% (n=12) and after tumor recurrence in 27.3% of cases (n=18). The irradiation doses delivered were as follows: 50 Gy (20.5%), 54 Gy (65.9%), and 60 Gy (13.6%). With a median follow-up of 69 months, the probabilities of relapse-free survival and overall survival at three years are 93.2% and 95.4%, respectively, whereas they are 71.2% and 80.7% at five years. Conclusion: Meningiomas are common primary brain tumors. Most often benign but can also progress aggressively. Their treatment is essentially surgical, but radiotherapy retains its place in specific situations, allowing good tumor control and overall survival.

Keywords: diagnosis, meningioma, surgery, radiotherapy, survival

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118 Extraction, Synthesis, Characterization and Antioxidant Properties of Oxidized Starch from an Abundant Source in Nigeria

Authors: Okafor E. Ijeoma, Isimi C. Yetunde, Okoh E. Judith, Kunle O. Olobayo, Emeje O. Martins

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Starch has gained interest as a renewable and environmentally compatible polymer due to the increase in its use. However, starch by itself could not be satisfactorily applied in industrial processes due to some inherent disadvantages such as its hydrophilic character, poor mechanical properties, its inability to withstand processing conditions such as extreme temperatures, diverse pH, high shear rate, freeze-thaw variation and dimensional stability. The range of physical properties of parent starch can be enlarged by chemical modification which invariably enhances their use in a number of applications found in industrial processes and food manufacture. In this study, Manihot esculentus starch was subjected to modification by oxidation. Fourier Transmittance Infra- Red (FTIR) and Raman spectroscopies were used to confirm the synthesis while Scanning Electron Microscopy (SEM) and X- Ray Diffraction (XRD) were used to characterize the new polymer. DPPH (2, 2-diphenyl-1-picryl-hydrazyl-hydrate) free radical assay was used to determine the antioxidant property of the oxidized starch. Our results show that the modification had no significant effect on the foaming capacity as well as on the emulsion capacity. Scanning electron microscopy revealed that oxidation did not alter the predominantly circular-shaped starch granules, while the X-ray pattern of both starch, native and modified were similar. FTIR results revealed a new band at 3007 and 3283cm-1. Differential scanning calorimetry returned two new endothermic peaks in the oxidized starch with an improved gelation capacity and increased enthalpy of gelatinization. The IC50 of oxidized starch was notably higher than that of the reference standard, ascorbic acid.

Keywords: antioxidant activity, DPPH, M. esculentus, oxidation, starch

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117 The Effect of Corporate Social Responsibility in the National Commercial Bank in Saudi Arabia

Authors: Nada Azhar

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The aim of the paper is to investigate the effect of corporate social responsibility (CSR) CSR on the National Commercial Bank (NCB) in Saudi Arabia. In order to achieve this, a case study was made of the CSR activities of this bank from the perspective of its branch managers. The NCB was chosen as it was one of the first Saudi banks to engage in CSR and currently has a wide range of CSR initiatives. A qualitative research method was used. Open-ended questionnaires were administered to eighty branch managers of the NCB, with fifty-five usable questionnaires returned and twenty managers were interviewed as part of the primary research. Data from both questionnaires and interviews were analysed using qualitative content analysis. Six themes emerged from the questionnaire findings were used to develop the interview questions. These themes are the following: Awareness of employees about CSR in the NCB; CSR activities as a type of investment; Government and media support; Increased employee loyalty in the NCB; Prestige and profit to the NCB; and View of CSR in Islam. This paper makes a theoretical contribution in that it investigates and increases understanding of the effect of CSR on the NCB in Saudi Arabia. In addition, it makes a practical contribution by making recommendations which can support the development of CSR in the NCB. A limitation of the paper is that it is a case study of only one bank. It is therefore recommended that future research could be conducted with other banks in Saudi Arabia, or indeed, with a range of other types of firm within the financial services area in Saudi Arabia. In this way, the same issues could be explored but with a greater potential generalisability of findings of CSR within the Saudi Arabian financial services industry. In addition, this paper takes a qualitative approach and it is suggested that future research be carried out using mixed methods, which could provide a greater depth of analysis.

Keywords: branch managers, corporate social responsibility, national commercial bank, Saudi Arabia

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116 A Case of Mantle Cell Lymphoma Presenting With GI Symptoms and Noted to Have Extranodal Involvement of the Stomach and Colon on Presentation

Authors: Saba Amreen Syeda, Summaiah Asim, Syeda, Hafsa, Essam Quraishi

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Mantle Cell Lymphoma (MCL) is a relatively uncommon type of lymphoma that comprises approximately 7 percent of non hodgkin's lymphomas (NHL), Classic MCL presents mostly in lymph nodes and occasionally in extranodal sites. About 26 % of MCL is present primarily in the Gastrointestinal tract. While both the upper GI tract and the lower GI tract could be involved, it is rare to present with concurrent upper and lower GI involvement with MCL. We present the case of a 51-year-old Asian Indian male that presented to our clinic with complaints of chronic diarrhea for the last one year, progressively worsening over the past three months. The Patient also reported black stool as well as bright red blood per rectum. Patient reported severe fatigue on minimal exertion. On a physical exam, the patient was noted to have matted lymphadenopathy in the neck. Patient was noted to be anemic with a hemoglobin to be 8 g/dl. Esophagogastroduodenoscopy and colonoscopy was performed. EGD showed a large 4 cm ulcer in the gastric antrum with thick heaped up edges. There was bleeding on contact. Colonoscopy showed a large 35 mm multilobulated polyp in the ascending colon, which was biopsied. The patient was also noted to have nodular proctitis in the mid rectum. This was localized and extended to about 5 cm. This area was biopsied as well. Biopsies from the stomach, colon, as well as the rectum, returned with findings of mantle cell lymphoma on pathology. Lymphoid cells in the biopsy were stained strongly positive for CD 20, cyclin D1, and CD 5. There was the absence of stain for CD 3 and CD 10. The IHC stain for CD 23 was negative. Biopsies from neck LAD were obtained and were also positive for MCL. The patient was referred to oncology for staging and treatment.

Keywords: mantle cell lymphoma, GI bleed, diarrhea, gastric ulcer, colon polyp

Procedia PDF Downloads 122
115 Biogas from Cover Crops and Field Residues: Effects on Soil, Water, Climate and Ecological Footprint

Authors: Manfred Szerencsits, Christine Weinberger, Maximilian Kuderna, Franz Feichtinger, Eva Erhart, Stephan Maier

Abstract:

Cover or catch crops have beneficial effects for soil, water, erosion, etc. If harvested, they also provide feedstock for biogas without competition for arable land in regions, where only one main crop can be produced per year. On average gross energy yields of approx. 1300 m³ methane (CH4) ha-1 can be expected from 4.5 tonnes (t) of cover crop dry matter (DM) in Austria. Considering the total energy invested from cultivation to compression for biofuel use a net energy yield of about 1000 m³ CH4 ha-1 is remaining. With the straw of grain maize or Corn Cob Mix (CCM) similar energy yields can be achieved. In comparison to catch crops remaining on the field as green manure or to complete fallow between main crops the effects on soil, water and climate can be improved if cover crops are harvested without soil compaction and digestate is returned to the field in an amount equivalent to cover crop removal. In this way, the risk of nitrate leaching can be reduced approx. by 25% in comparison to full fallow. The risk of nitrous oxide emissions may be reduced up to 50% by contrast with cover crops serving as green manure. The effects on humus content and erosion are similar or better than those of cover crops used as green manure when the same amount of biomass was produced. With higher biomass production the positive effects increase even if cover crops are harvested and the only digestate is brought back to the fields. The ecological footprint of arable farming can be reduced by approx. 50% considering the substitution of natural gas with CH4 produced from cover crops.

Keywords: biogas, cover crops, catch crops, land use competition, sustainable agriculture

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114 Diplomatic Assurances in International Law

Authors: William Thomas Worster

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Diplomatic assurances issued by states declaring that they will not mistreat individuals returned to them occupy a strange middle ground between being legal and non-legal obligations. States assert that they are non-binding, yet at other times that they are binding. However, this assertion may not be the end of the discussion. The International Court of Justice and other tribunals have concluded that similar instruments were binding, states have disagreed that certain similar instruments were binding, and the Vienna Convention on the Law of Treaties and its travaux prépératoires do not appear to contemplate non-binding instruments. This paper is a case study of diplomatic assurances but, by necessity, touches on the delicate question of whether certain texts are treaties, promises, or non-binding political statements. International law, and law in general, requires a binary approach to obligation. All communications must be binding or not, even if the fit is not precise. Through this study, we will find that some of the obligations in certain assurances can be understood as legal and some not. We will attempt to state the current methodology for determining which obligations are legal under the law of treaties and law on binding unilateral promises. The paper begins with some background of the legal environment of diplomatic assurances and their use in cases of expulsion. The paper then turns to discuss the legal nature of diplomatic assurances, proceeding to address various possibilities for legal value as treaties and as binding unilateral statements. This paper will not examine the legal value of diplomatic assurances solely under customary international law other than the way in which customary international law might further refine the treaty definition. In order to identify whether any assurances are contained in legal acts, this study identifies a pool of relevant assurances and qualitatively analyzes whether any of those are contained in treaties or binding unilateral statements. To the author’s best knowledge, this study is the first large-scale, qualitative qualitative analysis of assurances as a group of instruments that accounts for their heterogenous nature. It is also the first study to identify the indicators of whether an instrument is a treaty or promise.

Keywords: diplomatic assurances, deportation, extradition, expulsion, non-refoulement, torture, persecution, death penalty, human rights, memorandum of understanding, promises, secret, monitoring, compliance, enforcement

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113 Integrated Risk Management in The Supply Chain of Essential Medicines in Zambia

Authors: Mario M. J. Musonda

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Access to health care is a human right, which includes having timely access to affordable and quality essential medicines at the right place and in sufficient quantity. However, inefficient public sector supply chain management contributes to constant shortages of essential medicines at health facilities. Literature review involved a desktop study of published research studies and reports on risk management, supply chain management of essential medicines and their integration to increase the efficiency of the latter. The research was conducted on a sample population of offices under Ministry of Health Headquarters, Lusaka Provincial and District Offices, selected health facilities in Lusaka, Medical Stores Limited, Zambia Medicines Regulatory Authority and Cooperating Partners. Individuals involved in study were selected judgmentally by their functions under selection and quantification, regulation, procurement, storage, distribution, quality assurance, and dispensing of essential medicines. Structured interviews and discussions were held with selected experts and self-administered questionnaires were distributed. Collected and analysed data of 35 returned and usable questionnaires from the 50 distributed. The highest prioritised risks were; inadequate and inconsistent fund disbursements, weak information management systems, weak quality management systems and insufficient resources (HR and infrastructure) among others. The results for this research can be used to increase the efficiency of the public sector supply chain of essential medicines and other pharmaceuticals. The results of the study showed that there is need to implement effective risk management systems by participating institutions and organisations to increase the efficiency of the entire supply chain in order to avoid and/or reduce shortages of essential medicines at health facilities.

Keywords: essential medicine, risk assessment, risk management, supply chain, supply chain risk management

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112 When Journalism Becomes a Burden: Practical Effect of Journalism Practices in Nigeria’s Developing Democracy under Muhammadu Buhari

Authors: Israel Oguche

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Journalism practice has faced several challenges across the globe, particularly in developing countries such as Nigeria. While Nigeria has thrived under democratic experiment for twenty years since the return to democracy in 1999, there is still a great lacuna in freedom of expression, such that the presidents, though elected democratically, have had the tendencies to use military might in clamping down on journalism practices across the country. Under Muhammadu Buhari, it seems Nigeria has returned to the military era when powers were used against who says what, on a media, so today, in Nigeria, there are obvious cases of outright human rights violations and detention of journalists whose offenses were not spelled out. From Abiri Jones to Abba Jalingo and Omoyele Sowore, Nigeria journalists have been placed under the cocoon of the tyrannical administration of Muhammadu Buhari, the president, with subsequent clamping down on the instruments of freedoms such as access to justice and fair hearing. This paper gave vivid analytical and empirical perspectives of journalism practice under the dark days of Muhammadu Buhari as Nigeria’s president. The objectives include; examining the core cases of attacks on journalists since 2015 to date, determining the burden of practicing journalism in a tyrannical government, reeling out the effects of restrictive practices of journalism on freedom of expression among Nigerians and proffering solutions for improvement in the years ahead. Using the cognitive dissonance theory, the survey method was used for the study, with qualitative research analysis as a tool for data presentation. In the findings, the number of journalists in jail for publishing objectively under the Buhari administration remains high while the government has clamped down on freedom of expression among the people. The study concluded that there is a need for repelling of laws made by the Nigeria government in order to save the Nigerian journalism industry from total collapse.

Keywords: communication, developing democracy, press freedom, journalism practices

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111 Examining the Role of Brand Equity and Explore the Influence of Consumers' Brand Relationship Quality

Authors: Jim Shih-Chiao Chin , Tsai Lin Hsu, Shui Lien Chen

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This article extends the relation between company’s employee and customers in market. According to the previous researches, most researchers analyzed and focused on customers’ brand perception. In the recently, some scholars star to explore the brand management from company viewpoint. The aim of this study is to explore whether consumers perception would be affected by the firm brand. This research would like to examine the relationship between individual consumers and corporate brands in the business-to-consumers sector. First, the study develops a framework that the connection with consumer and company. Second, this article uses three dimensions, brand knowledge, brand commitment, and brand equity to measure employees’ loyalty of brand and applies brand relationship quality to gauge the level of brand’s importance in consumer’s mind. This paper uses SPSS 20.0 and AMOS 20.0 to test consumers’ minds toward the brand equity which the company provides. There are totally 862 valid questionnaires returned, and 431 participants are consumers; the other 431 participants are employees. Those questionnaires are one-by-one to consumer and employee so those are 431 pairs questionnaires. Based on 431 pairs of consumers and company’s employees, analyzed results show that brand knowledge and brand commitment play important roles influencing brand equity. The results also demonstrate the extra-role brand equity positively impact on the brand relationship quality of consumers. In addition, the findings reveal that the company can improve brand relationship quality of consumers by enhancing extra-role brand equity. There is a sufficient evidence denote that brand relationship quality not only shows about the brand of customers’ thought but also implies company how to build the brand to impress on consumers. These findings provide the degree of the brand in consumers’ cognition. The brand-owner employee can reference the conclusion to creative new strategic to the next time or can be one of the company’s competitive advantages. Those results and conclusions are contributed to management practice and future.

Keywords: brand knowledge, brand commitment, brand equity, brand relationship quality

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110 Film Dosimetry – An Asset for Collaboration Between Cancer Radiotherapy Centers at Established Institutions and Those Located in Low- and Middle-Income Countries

Authors: A. Fomujong, P. Mobit, A. Ndlovu, R. Teboh

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Purpose: Film’s unique qualities, such as tissue equivalence, high spatial resolution, near energy independence and comparatively less expensive dosimeter, ought to make it the preferred and widely used in radiotherapy centers in low and middle income countries (LMICs). This, however, is not always the case, as other factors that are often maybe taken for granted in advanced radiotherapy centers remain a challenge in LMICs. We explored the unique qualities of film dosimetry that can make it possible for one Institution to benefit from another’s protocols via collaboration. Methods: For simplicity, two Institutions were considered in this work. We used a single batch of films (EBT-XD) and established a calibration protocol, including scan protocols and calibration curves, using the radiotherapy delivery system at Institution A. We then proceeded and performed patient-specific QA for patients treated on system A (PSQA-A-A). Films from the same batch were then sent to a remote center for PSQA on radiotherapy delivery system B. Irradiations were done at Institution B and then returned to Institution A for processing and analysis (PSQA-B-A). The following points were taken into consideration throughout the process (a) A reference film was irradiated to a known dose on the same system irradiating the PSQA film. (b) For calibration, we utilized the one-scan protocol and maintained the same scan orientation of the calibration, PSQA and reference films. Results: Gamma index analysis using a dose threshold of 10% and 3%/2mm criteria showed a gamma passing rate of 99.8% and 100% for the PSQA-A-A and PSQA-B-A, respectively. Conclusion: This work demonstrates that one could use established film dosimetry protocols in one Institution, e.g., an advanced radiotherapy center and apply similar accuracies to irradiations performed at another institution, e.g., a center located in LMIC, which thus encourages collaboration between the two for worldwide patient benefits.

Keywords: collaboration, film dosimetry, LMIC, radiotherapy, calibration

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109 Disentangling an Ethnographic Study of the Imagined Inca: How the Yale-Peruvian Expedition of 1911 Created an Inca Heritage

Authors: Charlotte Williams

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Yale University Professor Hiram Bingham’s discovery of Machu Picchu in 1911 spurred an international interest in the Inca Empire, and with it, a dispute with the Peruvian government over who had rightful jurisdiction and curatorship over Inca history. By 2011, the Peruvian government initiated a legal battle for the return of artifacts that Bingham had removed from Machu Picchu, successfully returning them not to the site of Machu Picchu, but to Cusco, employing the rationale that the ancient Inca capital housed descendants of the Inca empire. This conflation of the past and present can be traced to a largely unanalyzed study that accompanied Bingham’s expedition: an ethnographic analysis of Inca descendants, which at the time portrayed indigenous Peruvian Andean peoples as remnants of a lost civilization, using Cusco as an assumed repository for people with 'Inca' characteristics. This study draws from the original Yale Peruvian Expedition archives, the Cusco Library archives, and in-depth interviews with curators of the Inca Museum and Machu Picchu Museum to analyze both the political conflict that emerged as a reaction to the ethnographic study, and how the study articulated with an inflating tourism market attempting to define what it meant to be Inca to an international public. The construction of the modern Inca as both directors of tourism management and purveyors of their archaeological material culture points to a unique case in which modern Peruvian citizens could claim heritage to an Inca past despite a lack of recognition as a legally defined group. The result has far-reaching implications, since Bingham’s artifacts returned not necessarily to a traditional nation-state, but to an imagined one, broadening the conditions under which informal repatriations can occur.

Keywords: archaeology of memory, imagined communities, Incanismo, repatriation

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108 The Relation of Motivation and Reward with Volunteer Satisfaction: Empirical Evidence from Omani Non-Profit Organization

Authors: Ali Al Shamli, Talal AlMamari

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Background: The relationship between motivation and satisfaction is posited to be mediated by reward. In this study, the motivation construct was measured by a motivation scale. The scale when factor analysed generated five factors. These factors were referred as; 1) leisure motivation, 2) egoistic motivation, 3) external motivation, 4) purposive, and 5) material motivation. The reward construct was measured by using a five-item scale whereas the satisfaction construct was measured by using a 13-item scale. The scale when factor analysed produced three factors which are referred as; 1) satisfaction A, 2) satisfaction B, and 3) satisfaction C. Objective: The main purpose of the present paper was to find out the relation of motivation and reward with volunteer satisfaction at national sports organizations (NPSOs) in Oman. Methods: This current study adopts a cross-sectional design as the data collection is done only once whereas the mode of administration was postal questionnaire where each questionnaire was posted, completed, and returned using the self-addressed envelope after its completion. The population of the study consisted of (160) boards and directors members of NPSOs (Non-Profit Sports Organization Services) in Oman from all 43 sports club. Results: The findings provided new empirical evidence that supported the argument of the relationship between motivation and satisfaction is indeed, mediated by reward. However, this study differs in that the relationship was tested based on the first-order constructs which were derived from the underlying dimensions of both motivation and satisfaction constructs. It was established that the relationships between motivation B and motivation C with satisfaction A are mediated by reward. Conclusion: In light of study findings, there is a direct relationship between developmental motivation and experiential satisfaction, a direct relationship between social motivation and relational satisfaction, as well as personal motivation and relational satisfaction, is mediated by reward. Therefore, Omani volunteers are less reliant on the reward as evidenced by the direct relationship between motivation A and satisfaction and between motivation C and satisfaction A. More tests in different settings will provide more understanding on volunteer motivation.

Keywords: non-profit sports organization, sport and reward, volunteers in sport, satisfaction in sport

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107 Static Application Security Testing Approach for Non-Standard Smart Contracts

Authors: Antonio Horta, Renato Marinho, Raimir Holanda

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Considered as an evolution of the Blockchain, the Ethereum platform, besides allowing transactions of its cryptocurrency named Ether, it allows the programming of decentralised applications (DApps) and smart contracts. However, this functionality into blockchains has raised other types of threats, and the exploitation of smart contracts vulnerabilities has taken companies to experience big losses. This research intends to figure out the number of contracts that are under risk of being drained. Through a deep investigation, more than two hundred thousand smart contracts currently available in the Ethereum platform were scanned and estimated how much money is at risk. The experiment was based in a query run on Google Big Query in July 2022 and returned 50,707,133 contracts published on the Ethereum platform. After applying the filtering criteria, the experimentgot 430,584 smart contracts to download and analyse. The filtering criteria consisted of filtering out: ERC20 and ERC721 contracts, contracts without transactions, and contracts without balance. From this amount of 430,584 smart contracts selected, only 268,103 had source codes published on Etherscan, however, we discovered, using a hashing process, that there were contracts duplication. Removing the duplicated contracts, the process ended up with 20,417 source codes, which were analysed using the open source SAST tool smartbugswith oyente and securify algorithms. In the end, there was nearly $100,000 at risk of being drained from the potentially vulnerable smart contracts. It is important to note that the tools used in this study may generate false positives, which may interfere with the number of vulnerable contracts. To address this point, our next step in this research is to develop an application to test the contract in a parallel environment to verify the vulnerability. Finally, this study aims to alert users and companies about the risk on not properly creating and analysing their smart contracts before publishing them into the platform. As any other application, smart contracts are at risk of having vulnerabilities which, in this case, may result in direct financial losses.

Keywords: blockchain, reentrancy, static application security testing, smart contracts

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106 Relative Importance of Contact Constructs to Acute Respiratory Illness in General Population in Hong Kong

Authors: Kin On Kwok, Vivian Wei, Benjamin Cowling, Steven Riley, Jonathan Read

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Background: The role of social contact behavior measured in different contact constructs in the transmission of respiratory pathogens with acute respiratory illness (ARI) remains unclear. We, therefore, aim to depict the individual pattern of ARI in the community and investigate the association between different contact dimensions and ARI in Hong Kong. Methods: Between June 2013 and September 2013, 620 subjects participated in the last two waves of recruitment of the population based longitudinal phone social contact survey. Some of the subjects in this study are from the same household. They are also provided with the symptom diaries to self-report any acute respiratory illness related symptoms between the two days of phone recruitment. Data from 491 individuals who were not infected on the day of phone recruitment and returned the symptom diaries after the last phone recruitment were used for analysis. Results: After adjusting different follow-up periods among individuals, the overall incidence rate of ARI was 1.77 per 100 person-weeks. Over 75% ARI episodes involve running nose, cough, sore throat, which are followed by headache (55%), malagia (35%) and fever (18%). Using a generalized estimating equation framework accounting for the cluster effect of subjects living in the same household, we showed that both daily number of locations visited with contacts and the number of contacts, explained the ARI incidence rate better than only one single contact construct. Conclusion: Our result suggests that it is the intertwining property of contact quantity (number of contacts) and contact intensity (ratio of subject-to-contact) that governs the infection risk by a collective set of respiratory pathogens. Our results provide empirical evidence that multiple contact constructs should be incorporated in the mathematical transmission models to feature a more realistic dynamics of respiratory disease.

Keywords: acute respiratory illness, longitudinal study, social contact, symptom diaries

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105 Evaluation of Adequacy of Caspofungin Prescription in a Tunisian Hospital Cohort

Authors: Mariem Meddeb Sidhom, Souhayel Hedfi, Rjaibia Houda, Mehdi Dridi, Mohamed Ali Yousfi, Sâadia Gargouri

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Considering the important increase in costs of caspofungin treatments and ahead the evolution of its indication, pharmacy department was prompted to realize a review of the adequacy of prescriptions in the medical intensive care units (ICU). A retrospective observational study was conducted in Tunis military hospital concerning ICU prescriptions of caspofungin from 2008 until 2013. A pharmacist had returned to the patient’s medical records to collect data and to the microbiology department for parasitological results. The adequacy of prescriptions was evaluated by a pharmacist and an infectiologist parasitologist, referring to predefined scale of criteria resuming the indications of the marketing authorization (MA) and grade AI-AII of the guidelines of the Infectious Diseases Society of America (IDSA). Sixty two ICU patients have been treated with caspofungin during the period of study; however, 8 files were lost. Thus, 54 patients were included in the study having received 55 prescriptions of caspofungin. Males were a majority with 64.8% of the population. Mean age was 51 years. Caspofungin was indicated in accordance with the IDSA recommendations in 43.6% of the cases. The most case of non respect to the guidelines was the indication of caspofungin as empirical treatment in non neutropenic patients. Caspofungin was utilized as a first line treatment in 9 cases where it was possible to give fluconazole first, as germs were fluconazole- sensitive. Caspofungin was indicated in 2 patients with good renal function and in which nor amphotericin B, liposomal ampho B neither itraconazole had been previously used, as indicates the MA. The posology of caspofungin was respected in all prescriptions with a loading dose of 70 mg in the first day and a maintenance dose of 50 mg daily. Seven patients had received a daily dose of 70 mg, the recommended dose for people weighing more than 80 Kg. Caspofungin prescriptions are far to be adequately done. There is a clear need of optimization in indicating this molecule and that must be done in collaboration between the pharmacy department, the ICUs and parasitology department.

Keywords: caspofungin, prescription, intensive care units, marketing authorization, Tunisian hospital cohort

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104 Organisational Factors and Total Quality Management Practice in Nigeria Manufacturing Industry: Evidence from Honeywell Flour Mills Plc

Authors: Cornelius Femi Popoola

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Nigerian manufacturing industry, particularly the flour producing firms play vital roles in Nigerian economy. This sector’s quality management practice is given a little attention along with organizational factors that hinder successful practice of total quality management which needs to be documented. Honeywell Flour Mills Plc operate in Nigeria with an appreciable number of products that serves this sector of the economy. Internal-external disposition of the company and total quality practice of the company deserve some elucidations. Hence, this study examined the influence of organizational factors on total quality management practice of Nigerian manufacturing industry, using Honeywell Flour Mills Plc as a case study. The study employed the correlational type of descriptive survey research design. The population consisted of 656 staff of Honeywell Flour Mills Plc, out of which 235 members were selected through scientific sampling method developed by Paler-Calmorin and Calmorin. A total of 235 copies of questionnaires titled 'Organisational Factors and Total Quality Management Practices (QF-TQM) Questionnaire' were administered with a response rate of 66 copies returned. The following variables were applied internal organisational factors (IOFs), external organizational factors (EOFs) and total quality management (TQM). Data generated were analysed using frequency distribution and regression analysis at 0.05 level. The findings revealed that IOFs positively and significantly related with TQM (r = .147**, N= 64, P(.000) < .01). Also, EOFs negatively and significantly related with TQM (r = -.117, N= 64, P(.000) < .01). Findings showed that internal and external organizational factors jointly influenced TQM practiced in F₍₂,₆₁₎=22.250; R²=.629; Adj.R²=.603; P(.000) < .05). The study concluded that organizational factors are determinants of TQM practice in Nigerian manufacturing industry. It is recommended that both internal and external organizational factors influencing TQM practices should be considered in the development of TQM strategies.

Keywords: external organizational factors, internal organisational factors, Nigerian manufacturing industry, total quality management

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103 Factors Affecting Women's Participation in Social, Political and Economic Decision-Making Positions at Kelemwollega Zone, Western Ethiopia

Authors: T. Aragaw, P. Gari

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In spite of social, political, and economic marginalization, women are still considered as the backbone of Ethiopia, one of the least developed countries in the world. The general purpose of this study was to assess factors that affect participation of women in politics, social and economic decisions at Kelem-Wollega Administrative Zone of Oromia Regional State, Ethiopia. Data used in this paper is mainly primary, and a few secondary data were incorporated. Respondents were selected using a systematic random sampling method and were placed questionnaires containing open-ended and closed-ended. Focus group discussion was also used for the study subjects in two offices. According to the information collected from the KWAZ Development and Social Service Office, a total of 18,473 tax-paying employees are present in the Zone, which is 14% of the total population of the Zone. Among the total number of employees in the Zone, 2,617 have been recruited for this study based on the criteria stated. This showed 1.8% of them were comprised of several churches and religious owned integrated development projects in the KWAZ. The 2,103 (80.34%) study participants responded personally, and they completed and returned the questionnaire to the researchers. The study revealed that in public institutions existed in KWAZ, the majority of women were having an educational status of diploma and lower, practicing lower non-decision making and leadership positions. Conclusion: Major barriers hindering women include: Socio-cultural attitudes, lack of necessary experience, education, the burden of domestic responsibilities, and lack of role models of women leaders in the Zone. Empowerment of women via social organizations, critical involvement of the government, and Affirmative action for women is critical. Further research is needed on the scope and challenges in implementing the strategies.

Keywords: women, affirmative action, leadership, empowerment, Ethiopia

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102 Effects of Different Types of Perioperative Analgesia on Minimal Residual Disease Development After Colon Cancer Surgery

Authors: Lubomir Vecera, Tomas Gabrhelik, Benjamin Tolmaci, Josef Srovnal, Emil Berta, Petr Prasil, Petr Stourac

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Cancer is the second leading cause of death worldwide and colon cancer is the second most common type of cancer. Currently, there are only a few studies evaluating the effect of postoperative analgesia on the prognosis of patients undergoing radical colon cancer surgery. Postoperative analgesia in patients undergoing colon cancer surgery is usually managed in two ways, either with strong opioids (morphine, piritramide) or epidural analgesia. In our prospective study, we evaluated the effect of postoperative analgesia on the presence of circulating tumor cells or minimal residual disease after colon cancer surgery. A total of 60 patients who underwent radical colon cancer surgery were enrolled in this prospective, randomized, two-center study. Patients were randomized into three groups, namely piritramide, morphine and postoperative epidural analgesia. We evaluated the presence of carcinoembryonic antigen (CEA) and cytokeratin 20 (CK-20) mRNA positive circulating tumor cells in peripheral blood before surgery, immediately after surgery, on postoperative day two and one month after surgery. The presence of circulating tumor cells was assessed by quantitative real-time reverse transcriptase-polymerase chain reaction (qRT-PCR). In the priritramide postoperative analgesia group, the presence of CEA mRNA positive cells was significantly lower on a postoperative day two compared to the other groups (p=0.04). The value of CK-20 mRNA positive cells was the same in all groups on all days. In all groups, both types of circulating tumor cells returned to normal levels one month after surgery. Demographic and baseline clinical characteristics were similar in all groups. Compared with morphine and epidural analgesia, piritramide significantly reduces the amount of CEA mRNA positive circulating tumor cells after radical colon cancer surgery.

Keywords: cancer progression, colon cancer, minimal residual disease, perioperative analgesia.

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