Search results for: job pressure

Authors: Gregor Kosec

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Simple and robust numerical approach for solving flow problems is presented, where involved physical fields are represented through the local approximation functions, i.e., the considered field is approximated over a local support domain. The approximation functions are then used to evaluate the partial differential operators. The type of approximation, the size of support domain, and the type and number of basis function can be general. The solution procedure is formulated completely through local computational operations. Besides local numerical method also the pressure velocity is performed locally with retaining the correct temporal transient. The complete locality of the introduced numerical scheme has several beneficial effects. One of the most attractive is the simplicity since it could be understood as a generalized Finite Differences Method, however, much more powerful. Presented methodology offers many possibilities for treating challenging cases, e.g. nodal adaptivity to address regions with sharp discontinuities or p-adaptivity to treat obscure anomalies in physical field. The stability versus computation complexity and accuracy can be regulated by changing number of support nodes, etc. All these features can be controlled on the fly during the simulation. The presented methodology is relatively simple to understand and implement, which makes it potentially powerful tool for engineering simulations. Besides simplicity and straightforward implementation, there are many opportunities to fully exploit modern computer architectures through different parallel computing strategies. The performance of the method is presented on the lid driven cavity problem, backward facing step problem, de Vahl Davis natural convection test, extended also to low Prandtl fluid and Darcy porous flow. Results are presented in terms of velocity profiles, convergence plots, and stability analyses. Results of all cases are also compared against published data.

Keywords: fluid flow, meshless, low Pr problem, natural convection

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Authors: Rico Herrero

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The study looked into the different lived experiences of senior high school to work immersion and how they were able to cope up in the transition stage from being classroom students into immersion students in work immersion site. The participants of the study were the ten senior high school students from Punta Integrated School. Using interview guide questions, the researchers motivated the participants to reveal their thoughts, feelings, and experiences in the interviews via video recording. The researchers utilized the qualitative research design, but the approach used was grounded theory. The findings revealed the participants’ lived experiences on how to cope or overcome the transition stage during the work immersion program. They unanimously responded to the interview questions. And based on the themes that emerged from the testimonies of the Senior High School students, the classroom learners benefited a lot from authentic learning opportunity of immersion program. Work immersion provides the students the opportunity to learn and develop their skills/ competencies related to the field of specialization. The hands-on training provides them simulation of work. They realized that theoretical learning in school is not enough to be equipped to work. Immersion program also provides venue for values and standard transformation. Senior High School students felt a high demand of self-confidence at the beginning of their race. Good thing, self-esteem of an individual helps bring out one’s potential at its best. Students find it challenging to get along with people in all ages. But, the endeavour absolutely helps them to grow maturely. Participants also realized that it’s not easy to deal with time pressure. Hence, the immersion program taught them to learn about time management. Part of the best training is to expose the learners to the harsh reality. Despite of the things that the school had taught them, still, students realized that they are not yet ready to deal with the demands of work. Furthermore, they also found out that they need to develop an interpersonal skill to improve their human relationships.

Keywords: grounded theory, lived experiences, senior high school, work immersion

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Authors: Komal Vig

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Cardiovascular disease (CVD)-related deaths occur in 17.3 million people globally each year, accounting for 30% of all deaths worldwide, with a predicted annual incidence of deaths to reach 23.3 million globally by 2030. Autologous bypass grafts remain an important therapeutic option for the treatment of CVD, but the poor quality of the donor patient’s blood vessels, the invasiveness of the resection surgery, and postoperative movement restrictions create issues. The present study is aimed to improve the endothelialization of intimal surface of graft by using low temperature plasma (LTP) to increase the cell attachment and proliferation. Polytetrafluoroethylene (PTFE) was treated with LTP. Air was used as the feed-gas, and the pressure in the plasma chamber was kept at 800 mTorr. Scaffolds were also modified with gelatin and collagen by dipping method. Human umbilical vein endothelial cells (HUVEC) were plated on the developed scaffolds, and cell proliferation was determined by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay and by microscopy. mRNA expressions levels of different cell markers were investigated using quantitative real-time PCR (qPCR). XPS confirmed the introduction of oxygenated functionalities from LTP. HUVEC cells showed 80% seeding efficiency on the scaffold. Microscopic and MTT assays indicated increase in cell viability in LTP treated scaffolds, especially when treated with gelatin or collagen, compared to untreated scaffolds. Gene expression studies shows enhanced expression of cell adhesion marker Integrin- α 5 gene after LTP treatment. LTP treated scaffolds exhibited better cell proliferation and viability compared to untreated scaffolds. Protein treatment of scaffold increased cell proliferation. Based on our initial results, more scaffolds alternatives will be developed and investigated for cell growth and vascularization studies. Acknowledgments: This work is supported by the NSF EPSCoR RII-Track-1 Cooperative Agreement OIA-2148653.

Keywords: LTP, HUVEC cells, vascular graft, endothelialization

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Authors: Rahaf Mandura

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Background: Idiopathic intracranial hypertension (IIH) is a disorder with elevated intracranial pressure (ICP) more than 250 mm H₂O, without evidence of meningeal inflammation, space-occupying lesion, or venous thrombosis. The aim of this research is to study the clinical profile, evaluation, management, and visual outcome in a hospital-based population of IIH cases in Jeddah. Methodology: This is a retrospective observational study that included the medical records of all patients referred to neuro-ophthalmology service for evaluation of papilledema. The medical records have been reviewed from October 2018 to February 2020 at Jeddah Eye Hospital (JEH), Saudi Arabia. A total of fifty-one patients presented with papilledema in the studied period. Forty-seven patients met our inclusion criteria and were included in the study. Results: Most of the patients were females (43, 91.5%) with a mean age of presentation of 30.83±11.40 years. The most common presenting symptom was headache (40 patients, 85.1%), followed by transient visual obscuration (20 patients, 42.6%), and reduced visual acuity (15 patients, 31.9%). All 47 patients were started on medical treatment with oral acetazolamide with four patients (8.5%) shifted to topiramate because of the lack of response or intolerance to acetazolamide while four patients (8.5%) underwent lumbar-peritoneal shunt because of inadequate control of the disease despite the treatment with medical therapy. For both eyes, the change in visual acuity across all assessment points was statistically significant. Nevertheless, there were no significant changes in the visual field findings among all of the compared assessment points. Conclusion: The present study has shown that IIH-related papilledema is common in young female patients with headaches, transient visual obscurations and reduced visual acuity. Those are the commonest symptoms in our IIH population. Medical treatment of IIH is significantly efficacious and should be considered in order to enhance the prognosis of IIH-related complications. Therefore, the visual status should be frequently monitored for these patients.

Keywords: idiopathic intracranial hypertension, intracranial hypertension, papilledema, headache

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Authors: Milenko Košutić, Jelena Filipović, Zvonko Nježić

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Extrusion technology is thermal processing that is applied to improve the nutritional, hygienic, and physical-chemical characteristics of the raw material. Overall, the extrusion process is an efficient method for the production of a wide range of food products. It combines heat, pressure, and shear to transform raw materials into finished goods with desired textures, shapes, and nutritional profiles. The extruded products’ quality is remarkably dependent upon feed material composition, barrel temperature profile, feed moisture content, screw speed, and other extrusion system parameters. Given consumer expectations for snack foods, a high expansion index and low bulk density, in addition to crunchy texture and uniform microstructure, are desired. This paper investigates the effects of simultaneous different types of corn (white corn, yellow corn, red corn, and black corn) addition and different screw speed (350, 500, 650 rpm) on the physical, technological, and functional properties of flakes products. Black corn flour and screw speed at 350 rpm positively influenced physical, technological characteristics, mineral composition, and antioxidant properties of flake products with the best total score analysis of 0,59. Overall, the combination of Tukey's HSD test and PCA enables a comprehensive analysis of the observed corn products, allowing researchers to identify them. This research aims to analyze the influence of different types of corn flour (white corn, yellow corn, red corn, and black corn) on the nutritive and sensory properties of the product (quality, texture, and color), as well as the acceptance of the new product by consumers on the territory of Novi Sad. The presented data point that investigated corn flakes from black corn flour at 350 rpm is a product with good physical-technological and functional properties due to a higher level of antioxidant activity.

Keywords: corn types, flakes product, nutritive quality, acceptability

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Authors: P. Mandree, S. O. Ramchuran, F. O'Brien, L. Sethunya, S. Khumalo

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South Africa is identified as one of the five emerging waste management markets, globally. The waste sector in South Africa influences the areas of energy, water and food at an economic and social level. Recently, South African industries have focused on waste valorization and diversification of the current product offerings in an attempt to reduce industrial waste, target a zero waste-to-landfill initiative and recover energy. South Africa has a number of waste streams including industrial and agricultural biomass, municipal waste and marine waste. Large volumes of agricultural and forestry residues, in particular, are generated which provides significant opportunity for production of bio-based fuels and chemicals. This could directly impact development of a rural economy. One of the largest agricultural industries is the sugar industry, which contributes significantly to the country’s economy and job creation. However, the sugar industry is facing challenges due to fluctuations in sugar prices, increasing competition with low-cost global sugar producers, increasing energy and agricultural input costs, lower consumption and aging facilities. This study is aimed at technology development for the production of various bio-based chemicals using feedstock from the sugar refining process. Various indigenous bacteria and yeast species were assessed for the potential to produce platform chemicals in flask studies and at 30 L fermentation scale. Quantitative analysis of targeted bio-based chemicals was performed using either gas chromatography or high pressure liquid chromatography to assess production yields and techno-economics in order to compare performance to current commercial benchmark processes. The study also creates a decision platform for the research direction that is required for strain development using Industrial Synthetic Biology.

Keywords: bio-based chemicals, biorefinery, industrial synthetic biology, waste valorization

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Authors: S. P. Rana

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Objectives: For the manufacture of a very thin strip or a strip with a high-quality finish, the stainless steel sheet that is called billet is re-rolled in re-rolling mill to make stainless steel sheet of 18 gauges. The rolls of re-rolling mill exert tremendous pressure over the sheet and there is likely chance of breaking of stainless steel strip from the sheet. The objective of the study was to minimise the number of accidents in steel re-rolling mills due to ejection of stainless steel strip and to minimize the pollution caused by the pickling process used in these units. Methods: Looking into the high rate of frequency and severity of accidents as well as pollution hazard in re-rolling and pickling mills, it becomes essential to make necessary arrangements for prevention of accidents in such type of industry. The author carried out survey/inspections of a large number of re-rolling and pickling mills and allied units. During the course of inspection, the working of these steel re-rolling and pickling mills was closely studied and monitored. A number of accidents involving re-rolling mills were investigated and subsequently remedial measures to prevent the occurrence of such accidents were suggested. Assessment of occupational safety and health system of these units was carried out and compliance level of the statutory requirements was checked. The workers were medically examined and monitored to ascertain their health conditions. Results: Proper use of safety gadgets by workers, machine guarding and regular training brought down the risk to an acceptable level and discharged effluent pollution was brought down to permissible limits. The fatal accidents have been reduced by 83%. Conclusions: Effective enforcement and implementation of the directions/suggestions given to the managements of such units brought down the no. of accidents to a rational level. The number of fatal accidents has reduced by 83% during the study period. The effective implementation of pollution control device curtailed the pollution level to an acceptable level.

Keywords: re-rolling mill, hazard, accident, health hazards

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Authors: V. E. Messerle, A. B. Ustimenko, O. A. Lavrichshev

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A large amount of manure and its irrational use negatively affect the environment. As compared with biomass fermentation, plasma processing of manure enhances makes it possible to intensify the process of obtaining fuel gas, which consists mainly of synthesis gas (CO + H₂), and increase plant productivity by 150–200 times. This is achieved due to the high temperature in the plasma reactor and a multiple reduction in waste processing time. This paper examines the plasma processing of biomass using the example of dried mixed animal manure (dung with a moisture content of 30%). Characteristic composition of dung, wt.%: Н₂О – 30, С – 29.07, Н – 4.06, О – 32.08, S – 0.26, N – 1.22, P₂O₅ – 0.61, K₂O – 1.47, СаО – 0.86, MgO – 0.37. The thermodynamic code TERRA was used to numerically analyze dung plasma gasification and pyrolysis. Plasma gasification and pyrolysis of dung were analyzed in the temperature range 300–3,000 K and pressure 0.1 MPa for the following thermodynamic systems: 100% dung + 25% air (plasma gasification) and 100% dung + 25% nitrogen (plasma pyrolysis). Calculations were conducted to determine the composition of the gas phase, the degree of carbon gasification, and the specific energy consumption of the processes. At an optimum temperature of 1,500 K, which provides both complete gasification of dung carbon and the maximum yield of combustible components (99.4 vol.% during dung gasification and 99.5 vol.% during pyrolysis), and decomposition of toxic compounds of furan, dioxin, and benz(a)pyrene, the following composition of combustible gas was obtained, vol.%: СО – 29.6, Н₂ – 35.6, СО₂ – 5.7, N₂ – 10.6, H₂O – 17.9 (gasification) and СО – 30.2, Н₂ – 38.3, СО₂ – 4.1, N₂ – 13.3, H₂O – 13.6 (pyrolysis). The specific energy consumption of gasification and pyrolysis of dung at 1,500 K is 1.28 and 1.33 kWh/kg, respectively. An installation with a DC plasma torch with a rated power of 100 kW and a plasma reactor with a dung capacity of 50 kg/h was used for dung processing experiments. The dung was gasified in an air (or nitrogen during pyrolysis) plasma jet, which provided a mass-average temperature in the reactor volume of at least 1,600 K. The organic part of the dung was gasified, and the inorganic part of the waste was melted. For pyrolysis and gasification of dung, the specific energy consumption was 1.5 kWh/kg and 1.4 kWh/kg, respectively. The maximum temperature in the reactor reached 1,887 K. At the outlet of the reactor, a gas of the following composition was obtained, vol.%: СO – 25.9, H₂ – 32.9, СO₂ – 3.5, N₂ – 37.3 (pyrolysis in nitrogen plasma); СO – 32.6, H₂ – 24.1, СO₂ – 5.7, N₂ – 35.8 (air plasma gasification). The specific heat of combustion of the combustible gas formed during pyrolysis and plasma-air gasification of agricultural waste is 10,500 and 10,340 kJ/kg, respectively. Comparison of the integral indicators of dung plasma processing showed satisfactory agreement between the calculation and experiment.

Keywords: agricultural waste, experiment, plasma gasification, thermodynamic calculation

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Authors: Xin Wu, Yongfeng Zhao, Qingxiang Meng

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In China, quite low proportion of crop residues were used as feedstuff because of its poor palatability and low digestibility. Steam explosion is a physical and chemical feed processing technology which has great potential to improve sapidity and digestibility of crop residues. To investigate the effect of the steam explosion on chemical compositions and efficient energy values, crop residues (rice straw, wheat straw and maize stover) were processed by steam explosion (steam temperature 120-230°C, steam pressure 2-26kg/cm², 40min). Steam-exploded crop residues were regarded as treatment groups and untreated ones as control groups, nutritive compositions were analyzed and effective energy values were calculated by prediction model in INRA (1988, 2010) for both groups. Results indicated that the interaction between treatment and variety has a significant effect on chemical compositions of crop residues. Steam explosion treatment of crop residues decreased neutral detergent fiber (NDF) significantly (P < 0.01), and compared with untreated material, NDF content of rice straw, wheat straw, and maize stover lowered 21.46%, 32.11%, 28.34% respectively. Acid detergent lignin (ADL) of crop residues increased significantly after the steam explosion (P < 0.05). The content of crude protein (CP), ether extract (EE) and Ash increased significantly after steam explosion (P < 0.05). Moreover, predicted effective energy values of each steam-exploded residue were higher than that of untreated ones. The digestible energy (DE), metabolizable energy (ME), net energy for maintenance (NEm) and net energy for gain (NEg)of steam-exploded rice straw were 3.06, 2.48, 1.48and 0.29 MJ/kg respectively and increased 46.21%, 46.25%, 49.56% and 110.92% compared with untreated ones(P < 0.05). Correspondingly, the energy values of steam-exploded wheat straw were 2.18, 1.76, 1.03 and 0.15 MJ/kg, which were 261.78%, 261.29%, 274.59% and 1014.69% greater than that of wheat straw (P < 0.05). The above predicted energy values of steam exploded maize stover were 5.28, 4.30, 2.67 and 0.82 MJ/kg and raised 109.58%, 107.71%, 122.57% and 332.64% compared with the raw material(P < 0.05). In conclusion, steam explosion treatment could significantly decrease NDF content, increase ADL, CP, EE, Ash content and effective energy values of crop residues. The effect of steam explosion was much more obvious for wheat straw than the other two kinds of residues under the same condition.

Keywords: chemical compositions, crop residues, efficient energy values, steam explosion

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Authors: Farzaneh Tahmoorian, Bijan Samali, John Yeaman

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Road networks are expanding all over the world during the past few decades to meet the increasing freight volumes created by the population growth and industrial development. At the same time, the rate of generation of solid wastes in the society is increasing with the population growth, technological development, and changes in the lifestyle of people. Thus, the management of solid wastes has become an acute problem. Accordingly, there is a need for greater efficiency in the construction and maintenance of road networks, in reducing the overall cost, especially the utilization of natural materials such as aggregates. An efficient means to reduce construction and maintenance costs of road networks is to replace natural (virgin) materials by secondary, recycled materials. Recycling will also help to reduce pressure on landfills and demand for extraction of natural virgin materials thus ensuring sustainability. Application of solid wastes in asphalt layer reduces not only environmental issues associated with waste disposal but also the demand for virgin materials which will subsequently result in sustainability. Therefore, this research aims to investigate the feasibility of the application of some of the waste materials such as glass, construction and demolition wastes, etc. as alternative materials in pavement construction, particularly flexible pavements. To this end, various combination of different waste materials in certain percentages is considered in designing the asphalt mixture. One of the goals of this research is to determine the optimum percentage of all these materials in the mixture. This is done through a series of tests to evaluate the volumetric properties and resilient modulus of the mixture. The information and data collected from these tests are used to select the adequate samples for further assessment through advanced tests such as triaxial dynamic test and fatigue test, in order to investigate the asphalt mixture resistance to permanent deformation and also cracking. This paper presents the results of these investigations on the application of waste materials in asphalt mixture for production of a sustainable asphalt mix.

Keywords: asphalt, glass, pavement, recycled aggregate, sustainability

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Authors: V. Karthickeyan

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The demand for energy is anticipated to increase, due to growing urbanization, industrialization, upgraded living standards and cumulatively increasing human population. The general public is becoming gradually aware of the diminishing fossil fuel resources along with the environmental issues, and it has become clear that biofuel is intended to make significant support to the forthcoming energy needs of the native and industrial sectors. Nowadays, the investigation on biofuels obtained from peels of fruits and vegetables have gained the consideration as an environment-friendly alternative to diesel. In the present work, biofuel was produced from non-edible Lemon Oil (LO) using steam distillation process. LO is characterized by its beneficial aspects like low kinematic viscosity and enhanced calorific value which provides better fuel atomization and evaporation. Furthermore, the heating values of the biofuels are approximately equal to diesel. A single cylinder, four-stroke diesel engine was used for this experimentation. An engine modification technique namely Thermal Barrier Coating (TBC) was attempted. Combustion chamber components were thermally coated with ceramic material namely partially stabilized zirconia (PSZ). The benefit of thermal barrier coating is to diminish the heat loss from engine and transform the collected heat into piston work. Performance characteristics like Brake Thermal Efficiency (BTE) and Brake Specific Fuel Consumption (BSFC) were analyzed. Combustion characteristics like in-cylinder pressure and heat release rate were analyzed. In addition, the following engine emissions namely nitrogen oxide (NO), carbon monoxide (CO), hydrocarbon (HC), and smoke were measured. The acquired performance combustion and emission characteristics of uncoated engine were compared with PSZ coated engine. From the results, it was perceived that the LO biofuel may be considered as the prominent alternative in the near prospect with thermal barrier coating technique to enrich the performance, combustion and emission characteristics of diesel engine.

Keywords: ceramic material, thermal barrier coating, biofuel and diesel engine

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Authors: Diogo Pereira, Maria Moura, Joana Campos, João Nunes

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As the Ukraine war highlights the European Economic Area’s vulnerability and external dependence on feed and food, agriculture gains significant importance. Transformative change is necessary to reach a sustainable and resilient agricultural sector. Agriculture is an important drive for bioeconomy and the equilibrium and survival of society and rural fires resilience. The pressure of (1) water stress, (2) nutrient cycle, and (3) social demographic evolution towards 70% of the population in Urban systems and the aging of the rural population, combined with climate change, exacerbates the problem and paradigm of rural and wildfires, especially in Portugal. The Portuguese territory is characterized by (1) 28% of marginal land, (2) the soil quality of 70% of the territory not being appropriate for agricultural activity, (3) a micro smallholding, with less than 1 ha per proprietor, with mainly familiar and traditional agriculture in the North and Centre regions, and (4) having the most vulnerable areas for rural fires in these same regions. The most important difference between the South, North and Centre of Portugal, referring to rural and wildfires, is the agricultural activity, which has a higher level in the South. In Portugal, rural and wildfires represent an average annual economic loss of around 800 to 1000 million euros. The WinBio model is an agrienvironmental metabolism design, with the capacity to create a new agri-food metabolism through Agricultural Organized Areas, a privatepublic partnership. This partnership seeks to grow agricultural activity in regions with (1) abandoned territory, (2) micro smallholding, (3) water and nutrient management necessities, and (4) low agri-food literacy. It also aims to support planning and monitoring of resource use efficiency and sustainability of territories, using agriculture as a barrier for rural and wildfires in order to protect rural population.

Keywords: agricultural organized areas, residues, climate change, drought, nutrients, rural and wild fires

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Authors: Nia Mair Fry, Matthew Profit, Chenfeng Li

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This work focuses on the development and implementation of a fully implicit-implicit, coupled mechanical deformation and porous flow, finite element software tool. The fully implicit software accurately predicts classical fundamental analytical solutions such as the Terzaghi consolidation problem. Furthermore, it can capture other analytical solutions less well known in the literature, such as Gibson’s sedimentation rate problem and Coussy’s problems investigating wellbore stability for poroelastic rocks. The mechanical volume strains are transferred to the porous flow governing equation in an implicit framework. This will overcome some of the many current industrial issues, which use explicit solvers for the mechanical governing equations and only implicit solvers on the porous flow side. This can potentially lead to instability and non-convergence issues in the coupled system, plus giving results with an accountable degree of error. The specification of a fully monolithic implicit-implicit coupled porous media code sees the solution of both seepage-mechanical equations in one matrix system, under a unified time-stepping scheme, which makes the problem definition much easier. When using an explicit solver, additional input such as the damping coefficient and mass scaling factor is required, which are circumvented with a fully implicit solution. Further, improved accuracy is achieved as the solution is not dependent on predictor-corrector methods for the pore fluid pressure solution, but at the potential cost of reduced stability. In testing of this fully monolithic porous media code, there is the comparison of the fully implicit coupled scheme against an existing staggered explicit-implicit coupled scheme solution across a range of geotechnical problems. These cases include 1) Biot coefficient calculation, 2) consolidation theory with Terzaghi analytical solution, 3) sedimentation theory with Gibson analytical solution, and 4) Coussy well-bore poroelastic analytical solutions.

Keywords: coupled, implicit, monolithic, porous media

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Authors: Ruqayya Naheed Khan, Romaisa Shamim, Awais Amjad Malik, Awais Naeem, Amina Iqbal Khan, Asad Parvaiz

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Objective: Patients undergoing axillary lymph node dissection (ALND) for metastatic lymph nodes in our hospital usually have drains placed in their axilla for a period of 6-10 days. We evaluated the post-op course of patients who underwent breast conservation surgery (BCS) along with ALND. Methods: A prospective cohort study was conducted at Shaukat Khanam Memorial Cancer Hospital from April 2017 to August 2017 including all lymph node positive breast cancer patients undergoing BCS with ALND. Patients were divided into two groups. Group A had no axillary drain while in Group B a drain was placed in axilla. Results: A total of 76 patients were included. 41 patients were included in group A and 35 patients in Group B. Median number of LNs dissected in group A was 17 and in group B was 15 (p value 0.443). Median operative time in group A was 84 min and in group B was 79 min (p value 0.223). Median hospital stay in both groups was 1 day (p value 0.78). At 2 weeks all patients in group A developed seroma as compared to none in group B (p value < 0.001). 3 of these patients in group A required aspiration of seroma due to pressure effects. Rest were managed conservatively. At 6 weeks only 50% patients had a seroma radiologically in Group A as compared to 33% in group B (p value 0.023). No intervention was required in any patients at week 6. QOL at 2 weeks was much better in Group A (7/41 patients had unsatisfactory response) as compared to group B (10/31 had unsatisfactory response). Results were statistically significant (p value 0.045). However, there wasn’t much difference in QOL at 6 weeks. Only 1 patient in group A had an unsatisfactory response. Average pain score at 2 weeks was similar in both groups (4.2 v/s 4.1 p value 0.73). Infection was seen in 1 patient in each group at 2 weeks (p value 0.668) and in only 1 patient in group A at 6 weeks (p value 0.067). Conclusion: We conclude from our study that there isn’t much difference in drain and no drain group in terms of wound infection and pain scores. No drain group is however associated with a better QOL in early post-op period.

Keywords: axillary drainage, axillary lymph node dissection, breast cancer, no drain in axilla

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Authors: Kurias George, Ildefonso Cuesta Romeo, Clara Salueña Pérez, Jordi Sole Olle

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With the growing prevalence of wind energy there is a need, for modeling techniques to evaluate the impact of wind farms on meteorology and oceanography. This study presents an approach that utilizes the WRF (Weather Research and Forecasting )with that include a Wind Farm Parametrization model to simulate the dynamics around Parc Tramuntana project, a offshore wind farm to be located near the Gulf of Roses off the coast of Barcelona, Catalonia. The model incorporates parameterizations for wind turbines enabling a representation of the wind field and how it interacts with the infrastructure of the wind farm. Current results demonstrate that the model effectively captures variations in temeperature, pressure and in both wind speed and direction over time along with their resulting effects on power output from the wind farm. These findings are crucial for optimizing turbine placement and operation thus improving efficiency and sustainability of the wind farm. In addition to focusing on atmospheric interactions, this study delves into the wake effects within the turbines in the farm. A range of meteorological parameters were also considered to offer a comprehensive understanding of the farm's microclimate. The model was tested under different horizontal resolutions and farm layouts to scrutinize the wind farm's effects more closely. These experimental configurations allow for a nuanced understanding of how turbine wakes interact with each other and with the broader atmospheric and oceanic conditions. This modified approach serves as a potent tool for stakeholders in renewable energy, environmental protection, and marine spatial planning. environmental protection and marine spatial planning. It provides a range of information regarding the environmental and socio economic impacts of offshore wind energy projects.

Keywords: weather research and forecasting, wind turbine wake effects, environmental impact, wind farm parametrization, sustainability analysis

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Authors: Heri Hermansyah, Annisa Kurnia, A. Vania Anisya, Adi Surjosatyo, Yopi Sunarya, Rita Arbianti, Tania Surya Utami

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Lipase is one of biocatalyst which is applied commercially for the process in industries, such as bioenergy, food, and pharmaceutical industry. Nowadays, biocatalysts are preferred in industries because they work in mild condition, high specificity, and reduce energy consumption (high pressure and temperature). But, the usage of lipase for industry scale is limited by economic reason due to the high price of lipase and difficulty of the separation system. Immobilization of lipase is one of the solutions to maintain the activity of lipase and reduce separation system in the process. Therefore, we conduct a study about lipase immobilization with the adsorption-cross linking method using glutaraldehyde because this method produces high enzyme loading and stability. Lipase is immobilized on different kind of resin with the various functional group. Highest enzyme loading (76.69%) was achieved by lipase immobilized on anion macroporous which have anion functional group (OH^‑). However, highest activity (24,69 U/g support) through olive oil emulsion method was achieved by lipase immobilized on anion macroporous-chitosan which have amino (NH₂) and anion (OH^-) functional group. In addition, it also success to produce biodiesel until reach yield 50,6% through interesterification reaction and after 4 cycles stable 63.9% relative with initial yield. While for Aspergillus, niger lipase immobilized on anion macroporous-kitosan have unit activity 22,84 U/g resin and yield biodiesel higher than commercial lipase (69,1%) and after 4 cycles stable reach 70.6% relative from initial yield. This shows that optimum functional group on support for immobilization with adsorption-cross linking is the support that contains amino (NH₂) and anion (OH^-) functional group because they can react with glutaraldehyde and binding with enzyme prevent desorption of lipase from support through binding lipase with a functional group on support.

Keywords: adsorption-cross linking, immobilization, lipase, resin

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Authors: Trianasari, Gede Adi Yuniarta

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The tourism industry has been widely recognized as one of the world’s largest industries and is expected to have continuous growth. While it has positive impacts especially on the job markets and economic aspect, this industry also brings serious environmental impacts that may not be neglected. As such, the tourism industry is faced with increasing demands and challenges to deal with the environmental issues. Corporate Social Responsibility (CSR) is a way to show the firms’ concern on the societal and environmental aspects. In line with the increasing pressure on such responsibilities, a growing number of firms have involved in CSR activities. In Bali, the majority of both chained and locally owned hotels have shown their efforts on CSR practices. However, little is known about what and how they perform or implement such program especially within the environmental aspect. The importance of understanding what they focus on lays in the identification of areas that have received sufficient treatment and those that require more attention. Furthermore, also, it is especially essential considering that Bali is one of the worldly known destinations that have been facing numerous crucial issues on environment that may threaten the sustainability of the island and its people. This paper reports on the results of a study exploring the practices of CSR in hotels in Bali. Data were collected from 49 hotel managers and human resource managers in Bali across four major tourist areas, using semi structured interview method. The analysis was conducted qualitatively. The results showed that all hotels under study have implemented CSR activities in which environment was found to be the second key aspect, following the activities directly related to community aspect. Moreover, there were five major types of environmental action identified: beach cleaning, replantation, marine conservation, turtle conservation, mangrove, and garbage management. These findings suggest that hotels in Bali under study have shown their concern on the environment, however, less attention was given on attempt to reduce the environmental impacts of their operations. Mapping the types of environmental related CSR activities enhances the knowledge of and gives lights into the CSR literature especially from the perspective of Eastern practice.

Keywords: CSR, exploratory study, sustainable tourism, tourist object

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Authors: Naser Ebadati

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introductory statement: Drilling operations in oil wells often involve significant risks due to varying azimuths, slopes, and the passage through layers with different lithological properties. As a result, maintaining well stability is crucial. Instability in wells can lead to costly well losses, interrupted drilling operations, and halted production from reservoirs. Objective: One of the key challenges in drilling operations is ensuring the stability of the wellbore, particularly in loose and low-resistance formations. These factors make the analysis and evaluation of well stability essential. Therefore, building a geo mechanical model for a hydrocarbon field or reservoir requires both a stress field model and a mechanical properties model of the geological formations. Numerous studies have focused on analyzing the stability of well walls, an issue known as well instability. This study aims to analyze the stability and the safe mud weight window for drilling in one of the oil fields in southern Iran. Methodology: In wellbore stability analysis, it is essential to consider the stress field model, which includes values and directions of the three principal stresses, and the mechanical properties model, which covers elastic properties and rock fracture characteristics. Wellbore instability arises from mechanical failure of the rock. Well stability can be maintained by adjusting the drilling mud weight. This study investigates wellbore stability using field data. The lithological characteristics of the well mainly consist of limestone, dolomite, and shale, as determined from log data. Wellbore logging was conducted throughout the well to calculate the required drilling mud pressure using the Mohr-Coulomb criterion. Findings: The results indicate that the safe and stable drilling mud window ranges between 17.13 MPa and 27.80 MPa. By comparing and calculating induced stresses, it was determined that the wellbore wall primarily exhibits shear fractures in the form of wide shear fractures and tensile fractures in the form of radial tensile fractures.

Keywords: drilling mud weight, formation evaluation, sheer strees, safe window

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Authors: Alfathony Krisnabudhi, Syahli Reza Ananda, M. Edo Marshal, M. Maaruf Mukti

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This study investigates the kinematics and basin development of pull-apart basin Sunda Strait based on palinspastic reconstructions of new acquired seismic reflection data to unravel hydrocarbon exploration opportunity in frontier area, fore-arc basin western Indonesia. We use more than 780 km seismic reflection data that cover whole basin. Structural patterns in Sunda Strait are dominated by northwest-southeast trending planar and listric-normal faults which appear to be graben and half-graben system. The main depocentre of this basin is East Semangko graben and West Semangko graben that are formed by overstepping of Sumatra Fault Zone and Ujungkulon Fault Zone. In father east, another depocentre is recognized as the Krakatau graben. The kinematic evolution started in Middle Miocene, characterized by the initiation of basement faulting with 0% to 7.00% extension. Deposition stratigraphic unit 1 and unit 2 started at 7.00% to 10.00% extension in Late Miocene and recognized as pre-transtensional deposit. The Plio-Pleistocene unit 3 and 4 were deposited as syn-transtensional deposit with 10.00% to 17.00% extension contemporaneously with the initiation of uplift NW-SE trending ridges due to the evolution of cross-basin fault in central basin and the development of en-echelon basin margin in a transtensional system. The control of sedimentation rate and basin subsidence cause the Neogene sediment to be very thick. We suggest that both controls allow thermal and pressure to generate hydrocarbon habitats in the pre-transtensional deposits. It is reinforced by stable kinematic evolution and interpretation of the deposition environment of pre-transtensional deposits that are deposited in the marine environment.

Keywords: kinematics, palinspastic, Sunda Strait, hydrocarbon exploration, fore-arc basin

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Authors: Mustafa Al Sukar, Azzam Sleit, Abdullatif Abu-Dalhoum, Bassam Al-Kasasbeh

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Use and abuse of drugs by teens is very common and can have dangerous consequences. The drugs contribute to physical and sexual aggression such as assault or rape. Some teenagers regularly use drugs to compensate for depression, anxiety or a lack of positive social skills. Teen resort to smoking should not be minimized because it can be "gateway drugs" for other drugs (marijuana, cocaine, hallucinogens, inhalants, and heroin). The combination of teenagers' curiosity, risk taking behavior, and social pressure make it very difficult to say no. This leads most teenagers to the questions: "Will it hurt to try once?" Nowadays, technological advances are changing our lives very rapidly and adding a lot of technologies that help us to track the risk of drug abuse such as smart phones, Wireless Sensor Networks (WSNs), Internet of Things (IoT), etc. This technique may help us to early discovery of drug abuse in order to prevent an aggravation of the influence of drugs on the abuser. In this paper, we have developed a Decision Support System (DSS) for detecting the drug abuse using Artificial Neural Network (ANN); we used a Multilayer Perceptron (MLP) feed-forward neural network in developing the system. The input layer includes 50 variables while the output layer contains one neuron which indicates whether the person is a drug addict. An iterative process is used to determine the number of hidden layers and the number of neurons in each one. We used multiple experiment models that have been completed with Log-Sigmoid transfer function. Particularly, 10-fold cross validation schemes are used to access the generalization of the proposed system. The experiment results have obtained 98.42% classification accuracy for correct diagnosis in our system. The data had been taken from 184 cases in Jordan according to a set of questions compiled from Specialists, and data have been obtained through the families of drug abusers.

Keywords: drug addiction, artificial neural networks, multilayer perceptron (MLP), decision support system

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Authors: Fiona Bei Na Tan, Glen Wen Kiat Ho, Ee Leen Liow, Li Yin Tan, Sean Wei Loong Ho

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Background: Shoulder arthroscopy is an increasingly common procedure. Pneumothorax post-shoulder arthroscopy is a rare complication. Objectives: Our aim is to highlight a case report of pneumothorax post shoulder arthroscopy and to conduct a literature review to evaluate the possible risk factors associated with developing a pneumothorax during or after shoulder arthroscopy. Case Report: We report the case of a 75-year-old male non-smoker who underwent left shoulder arthroscopy without regional anaesthesia and in the left lateral position. The general anaesthesia and surgery were uncomplicated. The patient was desaturated postoperatively and was found to have a pneumothorax on examination and chest X-ray. A chest tube drain was inserted promptly into the right chest. He had an uncomplicated postoperative course. Methods: PubMed Medline and Cochrane database search was carried out using the terms shoulder arthroplasty, pneumothorax, pneumomediastinum, and subcutaneous emphysema. We selected full-text articles written in English. Results: Thirty-two articles were identified and thoroughly reviewed. Based on our inclusion and exclusion criteria, 14 articles, which included 20 cases of pneumothorax during or after shoulder arthroscopy, were included. Eighty percent (16/20) of pneumothoraxes occurred postoperatively. In the articles that specify the side of pneumothorax, 91% (10/11) occur on the ipsilateral side of the arthroscopy. Eighty-eight percent (7/8) of pneumothoraxes occurred when subacromial decompression was performed. Fifty-six percent (9/16) occurred in patients placed in the lateral decubitus position. Only 30% (6/20) occurred in current or ex-smokers, and only 25% (5/20) had a pre-existing lung condition. Overall, of the articles that posit a mechanism, 75% (9/12) deem the pathogenesis to be multifactorial. Conclusion: The exact mechanism of pneumothorax is currently unknown. Awareness of this complication and timely recognition are important to prevent life-threatening sequelae. Surgeons should have a low threshold to obtain diagnostic plain radiographs in the event of clinical suspicion.

Keywords: rotator cuff repair, decompression, pressure, complication

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Authors: Waqas Ahmed Khan Afridi, Subhas Chandra Mukhopadhyay, Bandita Mainali

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The research paper presents a unique approach to evapotranspiration (ET) prediction using a Support Vector Machine (SVM) learning algorithm. The study leverages real-time sensor node data to develop an accurate and adaptable prediction model, addressing the inherent challenges of traditional ET estimation methods. The integration of the SVM algorithm with real-time sensor node data offers great potential to improve spatial and temporal resolution in ET predictions. In the model development, key input features are measured and computed using mathematical equations such as Penman-Monteith (FAO56) and soil water balance (SWB), which include soil-environmental parameters such as; solar radiation (Rs), air temperature (T), atmospheric pressure (P), relative humidity (RH), wind speed (u2), rain (R), deep percolation (DP), soil temperature (ST), and change in soil moisture (∆SM). The one-year field data are split into combinations of three proportions i.e. train, test, and validation sets. While kernel functions with tuning hyperparameters have been used to train and improve the accuracy of the prediction model with multiple iterations. This paper also outlines the existing methods and the machine learning techniques to determine Evapotranspiration, data collection and preprocessing, model construction, and evaluation metrics, highlighting the significance of SVM in advancing the field of ET prediction. The results demonstrate the robustness and high predictability of the developed model on the basis of performance evaluation metrics (R2, RMSE, MAE). The effectiveness of the proposed model in capturing complex relationships within soil and environmental parameters provide insights into its potential applications for water resource management and hydrological ecosystem.

Keywords: evapotranspiration, FAO56, KNIME, machine learning, RStudio, SVM, sensors

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Authors: Da-Eun Kim, Heon-Seock Cynn, Sil-Ah Choi, A-Reum Shin

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Bridging exercise in supine position with the hips and knees flexed have been commonly performed as one of the therapeutic exercises and is a comfortable and pain-free position to most individuals with chronic low back pain (CLBP). Many previous studies have investigated the beneficial way of performing bridging exercises to improve activation of abdominal and gluteal muscle and reduce muscle activity of hamstrings (HAM) and erector spinae (ES) and compensatory lumbopelvic motion. The purpose of this study was to compare the effects of three different bridging exercises on the HAM, ES, gluteus maximus (Gmax), gluteus medius (Gmed), and transverse abdominis/internal abdominis oblique (TrA/IO) activities and anterior pelvic tilt angle in subjects with CLBP. Seventeen subjects with CLBP participated in this study. They performed bridging under three different conditions (with 30° hip abduction, isometric hip abduction, and isometric hip adduction). Surface electromyography was used to measure muscle activity, and the ImageJ software was used to calculate anterior pelvic tilt angle. One-way repeated-measures analysis of variance was used to assess the statistical significance of the measured variables. HAM activity was significantly lower in bridging with 30° hip abduction and isometric hip abduction than in bridging with isometric hip adduction. Gmax and Gmed activities were significantly greater in bridging with isometric hip abduction than in bridging with 30° hip abduction and isometric hip adduction. TrA/IO muscle activity was significantly greater and anterior pelvic tilt angle was significantly lower in bridging with isometric hip adduction than in bridging with 30° hip abduction and isometric hip abduction. Bridging with isometric hip abduction using Thera-Band can effectively reduce HAM activity, and increase Gmax and Gmed activities in subjects with CLBP. Bridging with isometric hip adduction using a pressure biofeedback unit can be a beneficial exercise to improve TrA/IO activity and minimize anterior pelvic tilt in subjects with CLBP.

Keywords: bridging exercise, electromyography, low back pain, lower limb exercise

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Authors: Magdy Danial Riad

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Introduction: The ability of our world to support the expanding population after 2050 is at risk due to the food system's global role in poor health, climate change, and resource depletion. Healthy, equitable, and sustainable food systems must be achieved from the point of production through consumption in order to meet several of the sustainable development goals (SDG) targets. There is evidence that changing the local food environment can effectively change dietary habits in a community. The purpose of this article is to outline the policy initiatives taken by local governments to support environmentally friendly eating habits. Methods: Five databases were searched for peer-reviewed articles that described local government authorities' implementation of environmentally sustainable eating habits, were located in cities that had signed the Milan Urban Food Policy Pact, were published after 2015, were available in English, and described policy interventions. Data extraction was a two-step approach that started with extracting information from the included study and ended with locating information unique to policies in the grey literature. Results: 45 papers that described a variety of policy initiatives from low-, middle-, and high-income countries met the inclusion criteria. A variety of desired dietary behaviors were the focus of policy action, including reducing food waste, procuring food locally and in season, boosting breastfeeding, avoiding overconsumption, and consuming more plant-based meals and fewer items derived from animals. Conclusions: In order to achieve SDG targets, local governments are under pressure to implement evidence-based interventions. This study can help direct local governments toward evidence-based policy measures to improve regional food systems and support ecologically friendly eating habits.

Keywords: meals, planet, poor health, eating habits

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Authors: Matheus Müller, Delma Vidal

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The present paper aims to expose two techniques of dewatering for sludge, analyzing its operations and dewatering processes, aiming at improving the conditions of disposal of residues with high liquid content. It describes the field tests performed on two geotextile systems, a closed geotextile tube and an open geotextile drying bed, both of which are submitted to two filling cycles. The sludge used in the filling cycles for the field trials is from the water treatment plant of the Technological Center of Aeronautics – CTA, in São José dos Campos, Brazil. Data about volume and height abatement due to the dewatering and consolidation were collected per time, until it was observed constancy. With the laboratory analysis of the sludge allied to the data collected in the field, it was possible to perform a critical comparative study between the observed and the scientific literature, in this way, this paper expresses the data obtained and compares them with the bibliography. The tests were carried out on three fronts: field tests, including the filling cycles of the systems with the sludge from CTA, taking measurements of filling time per cycle and maximum filling height per cycle, heights against the abatement by dewatering of the systems over time; tests carried out in the laboratory, including the characterization of the sludge and removal of material samples from the systems to ascertain the solids content within the systems per time and; comparing the data obtained in the field and laboratory tests with the scientific literature. Through the study, it was possible to perceive that the process of densification of the material inside a closed system, such as the geotextile tube, occurs faster than the observed in the drying bed system. This process of accelerated densification can be brought about by the pumping pressure of the sludge in its filling and by the confinement of the residue through the permeable geotextile membrane (allowing water to pass through), accelerating the process of densification and dewatering by its own weight after the filling with sludge.

Keywords: consolidation, dewatering, geotextile drying bed, geotextile tube

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Authors: Y. Vásquez, F. Reyes, P. Oyola, M. Rubio, J. Muñoz, E. Lissi

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In several cities in Chile, there is significant urban pollution, particularly in Santiago and in cities in the south where biomass is used as fuel in heating and cooking in a large proportion of homes. This has generated interest in knowing what factors can be modulated to control the level of pollution. In this project was conditioned and set up a photochemical chamber (14m3) equipped with gas monitors e.g. CO, NOX, O3, others and PM monitors e.g. dustrack, DMPS, Harvard impactors, etc. This volume could be exposed to UVA lamps, producing a spectrum similar to that generated by the sun. In this chamber, PM and gas emissions associated with biomass burning were studied in the presence and absence of radiation. From the comparative analysis of wood stove (eucalyptus globulus) and pellet (radiata pine), it can be concluded that, in the first approximation, 9-nitroanthracene, 4-nitropyrene, levoglucosan, water soluble potassium and CO present characteristics of the tracers. However, some of them show properties that interfere with this possibility. For example, levoglucosan is decomposed by radiation. The 9-nitroanthracene, 4-nitropyrene are emitted and formed under radiation. The 9-nitroanthracene has a vapor pressure that involves a partition involving the gas phase and particulate matter. From this analysis, it can be concluded that K+ is compound that meets the properties known to be tracer. The PM2.5 emission measured in the automatic pellet stove that was used in this thesis project was two orders of magnitude smaller than that registered by the manual wood stove. This has led to encouraging the use of pellet stoves in indoor heating, particularly in south-central Chile. However, it should be considered, while the use of pellet is not without problems, due to pellet stove generate high concentrations of Nitro-HAP's (secondary organic contaminants). In particular, 4-nitropyrene, compound of high toxicity, also primary and secondary particulate matter, associated with pellet burning produce a decrease in the size distribution of the PM, which leads to a depth penetration of the particles and their toxic components in the respiratory system.

Keywords: biomass burning, photochemical chamber, particulate matter, tracers

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Authors: Gul Jan

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It is the first quantitative ethno-botanical analysis and conservation issues of medicinal flora of Alpine and Sub-alpine, Hindikush region of Pakistan. The objective of the study aims to report, compare the uses and highlight the ethno-Botanical significance of medicinal plants for treatment of various diseases. A total of 250 (242 males and 8 females) local informants including 10 Local Traditional Healers were interviewed. Information was collected through semi-structured interviews, analyzed and compared by quantitative ethno-botanical indices such as Jaccard index (JI), Informant Consensus Factor (ICF), use value (UV) and Relative frequency of citation (RFC).Thorough survey indicated that 57 medicinal plants belongs to 43 families were investigated to treat various illnesses. The highest ICF is recorded for digestive system (0.69%), Circolatory system (0.61%), urinary tract system, (0.53%) and respiratory system (0.52%). Used value indicated that, Achillea mellefolium (UV = 0.68), Aconitum violaceum (UV = 0.69), Valeriana jatamansi (UV = 0.63), Berberis lyceum (UV = 0.65) and are exceedingly medicinal plant species used in the region. In comparison, highest similarity index is recorded in these studies with JI 17.72 followed by 16.41. According to DMR output, Pinus williciana ranked first due to multipurpose uses among all species and was found most threatened with higher market value. Unwise used of natural assets pooled with unsuitable harvesting practices have exaggerated pressure on plant species of the research region. The main issues causative to natural variety loss found were over grazing of animals, forest violation, wild animal hunting, fodder, plant collection as medicine, fuel wood, forest fire, and invasive species negatively affect the natural resources. For viable utilization, in situ and ex situ conservation, skillful collecting, and reforestation project may be the resolution. Further wide field management research is required.

Keywords: quantitative analysis, conservations issues, medicinal flora, alpine and sub-alpine, Hindukush region

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Authors: Yun-Chin Chung, Nileema Divate, Gen-Hung Chen, Pei-Ru Huang, Rupesh Divate

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Many environmental factors, such as glucose concentration, ethanol, temperature, osmotic pressure and pH, decrease the production rate of ethanol using yeast as a starter. Fermentation starters with high tolerance to various stresses are always demanded for brewing industry. Trehalose, a storage carbohydrate in cell wall of yeast, plays an important role in tolerance of environmental stress by preserving integrity of plasma membrane and stabilizing proteins. Furan aldehydes are toxic to yeast and the growth rate of yeast is significantly reduced if furan aldehydes were present in the fermentation medium. In yeast, aldehyde reductase is involved in the detoxification of reactive aldehydes and consequently the growth of yeast is improved. The aims of this study were to construct a genetic recombinant Saccharomyces cerevisiae or Pichia pastoris with furfural and HMF degrading and high ethanol tolerance capacities. Yeast strains were engineered by genetic recombination for overexpression of trehalose-6-phosphate synthase gene (tps1) and aldehyde reductase gene (ari1). TPS1 gene was cloned from S. cerevisiae by reverse transcription-polymerase chain reaction (RT-PCR) and then ligated with pGAPZαC vector. The constructed vector, pGAPZC-tps1, was transformed to recombinant yeasts strain with overexpression of ari1. The transformants with pGAPZC-tps1-ari1 were generated called STA (S. cerevisiae) and PTA (P. pastoris) with overexpression of tps1, ari1. PCR with tps1-specific primers and western blot with his-tag confirmed the gene insertion and protein expression of tps1 in the transformants, respectively. The neutral trehalase gene (nth1) of STA was successfully deleted and the novel strain STAΔN will be used for further study, including the measurement of trehalose concentration and ethanol, furfural tolerance assay.

Keywords: genetic recombinant, yeast, ethanol tolerance, trehalase, aldehyde reductase

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Authors: Syena Moltaji, Stephanie Posa, Sander Hitzig, Amanda Mayo, Heather Baltzer

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Purpose: To critically assess deficits following thumb amputation and delineate elements of an ideal thumb prosthesis from the end-user perspective. Methods: This was a qualitative study based on grounded theory. End-user stakeholder groups of thumb amputees and prosthetists were interviewed. Transcripts were reviewed whole first for familiarity. Data coding was then performed by two individual authors. Coded units were grouped by similarity and reviewed to reach a consensus. Codes were then analyzed for emergent themes by each author. A consensus meeting was held with all authors to finalize themes. Results: Three patients with traumatic thumb amputation and eight prosthetists were interviewed. Seven themes emerged. First was the significant impact of losing a thumb, in which codes of functional impact, mental impact, and occupational impact were included. The second theme was the unique nature of each thumb amputee, including goals, readiness for prosthesis, nature of the injury, and insurance. The third emergent theme was cost, surrounding government funding, insurability, and prosthetic pricing. The fourth theme was patient frustration, which included mismatches of prosthetic expectations and realities, activity limitations, and causes of devices abandonment. Themes five and six surrounded the strengths and weaknesses of current prosthetics, respectively. Theme seven was the ideal design for a thumb prosthetic, including abilities, suspension, and materials. Conclusions: Representative data from stakeholders mapped the current status of thumb prosthetics. Preferences for an ideal thumb prosthetic emerged, with suggestions for a simple, durable design. The ability to oppose, grasp and sense pressure was reported as functional priorities. Feasible cost and easy fitting emerged as systemic objectives. This data will be utilized in the development of a sensate thumb prosthetic.

Keywords: smart thumb, thumb prosthetic, sensate prosthetic, amputation

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Authors: Cóndor C. José, Rodrigues E. Camila, Noronha L. Irene, Dos Santos Fernando, Irigoyen M. Claudia, Andrade Lúcia

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Sepsis induces alterations in hemodynamics and autonomic nervous system (ASN). The autonomic activity can be calculated by measuring heart rate variability (HRV) that represents the complex interplay between ASN and cardiac pacemaker cells. Wharton’s jelly mesenchymal stem cells (WJ-MSCs) are known to express genes and secreted factors involved in neuroprotective and immunological effects, also to improve the survival in experimental septic animals. We hypothesized, that WJ-MSCs present an important role in the autonomic activity and in the hemodynamic effects in a cecal ligation and puncture (CLP) model of sepsis. Methods: We used flow cytometry to evaluate WJ-MSCs phenotypes. We divided Wistar rats into groups: sham (shamoperated); CLP; and CLP+MSC (106 WJ-MSCs, i.p., 6 h after CLP). At 24 h post-CLP, we recorded the systolic arterial pressure (SAP) and heart rate (HR) over 20 min. The spectral analysis of HR and SAP; also the spontaneous baroreflex sensitivity (measure by bradycardic and tachycardic responses) were evaluated after recording. The one-way ANOVA and the post hoc Student– Newman– Keuls tests (P< 0.05) were used to data comparison Results: WJ-MSCs were negative for CD3, CD34, CD45 and HLA-DR, whereas they were positive for CD73, CD90 and CD105. The CLP group showed a reduction in variance of overall variability and in high-frequency power of HR (heart parasympathetic activity); furthermore, there is a low-frequency reduction of SAP (blood vessels sympathetic activity). The treatment with WJ-MSCs improved the autonomic activity by increasing the high and lowfrequency power; and restore the baroreflex sensitive. Conclusions: WJ-MSCs attenuate the impairment of autonomic control of the heart and vessels and might therefore play a protective role in sepsis. (Supported by FAPESP).

Keywords: baroreflex response, heart rate variability, sepsis, wharton’s jelly-derived mesenchymal stem cells

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