Search results for: rate of recovery
6077 Influence of IL-1β on Hamster Blastocyst Hatching via Regulation of Hatching Associated Proteases
Authors: Madhulika Pathak, Polani Seshagiri, Vani Venkatappa
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Blastocyst hatching is an indispensable process for successful implantation. One of the major reasons for implantation failure in IVF clinic is poor quality of embryo, which are not development/hatching-competent. Therefore, attempts are required to develop or enhance the culture system with a molecule recapitulating the autocrine/paracrine factors containing the environment of in-vivo endometrial milieu. We have tried to explore the functional molecules involved in the hamster hatching phenomenon. Blastocyst hatching is governed by several molecules that are entwined and regulate this process, among which cytokines are known to be expressed and are still least explored. Two of such cytokines we have used for our study are IL-1β and its natural antagonist IL-1ra to understand the functional dynamics of cytokines involved in the hatching process. Using hamster, an intriguing experimental model for hatching behavior, we have shown the mRNA (qPCR) and protein (ICC) expression of IL-1β, IL-1ra and IL-1 receptor type 1 throughout all the stages of morula, blastocyst and hatched blastocyst. Post-asserting the expression, the functional role is shown by supplementation studies, where IL-1β supplementation showed enhancement in hatching level (IL-1β treated: 84.1 ± 4.2% vs control: 63.7 ± 3.1 %, N=11), further confirmed by the diminishing effect of IL-1ra on hatching rate (IL-1ra treated: 27.5 ± 11.1% vs control: 67.9 ± 3.1%). The exogenous supplementation of IL-1ra decreased the survival rate of embryos and affected the viability in dose-dependent manner, establishing the importance of IL-1β in blastocyst cell survival. Previously, the cathepsin L and B were established as the proteases that were involved in the hamster hatching process. The inducing effect of IL-1β was correlated with enhanced mRNA level, as analyzed by qPCR, for both CAT L (by 1.9 ± 0.5 fold) and CAT B (by 3.5 ± 0.1) fold which was diminished in presence of IL-1ra (Cat L by 88 percent and Cat B by 94 percent. Moreover, using a specific fluorescent substrate-based assay kit, the enzymatic activity of these proteases was found to be increased in presence of IL-1β (Cat L by 2.1 ± 0.1 fold and CAT B by 2.3 ± 0.7 fold) and was curtailed in presence of IL-1ra. These observations provide functional insights with respect to the involvement of cytokines in the hatching process. This has implications in understanding the hatching biology and improving the embryo development quality in IVF clinics.Keywords: Blastocyst, Cytokines, Hatching, Interleukin
Procedia PDF Downloads 1446076 Jordanian Health Care Providers' Attitudes toward Overweigth and Obese Women during Childbirth
Authors: Salwa Obeisat
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Obesity had become a global issue and a major public health concern, because of its impact on the public health. Obstetric and midwifery evidences reported that maternal obesity an important issue, because of its associated complications like obstructed labors, infections, and hemorrhage. People who are obese are often stigmatized and blamed for their weight. Health care providers are not immune to obesity-related prejudice, and the literature features several examples of their negative attitudes towards obese patients. In Jordan, few studies were conducted to investigate obesity prevalence rate and its associated factors. The purposes of this study were to assess the health care providers' attitudes toward overweight and obese women during the childbirth in the North of Jordan and to investigate the relationships between health care providers' socio-demographic characteristics and their attitudes. A descriptive, cross-sectional design was utilized. A convenient sample was consisted of 95 midwives, 30 nurses and 62 obstetricians, who were working in the labor rooms. A self-administered questionnaire consisted of three sections: demographical data, Arabic version of Fat Phobia Scale (FPS), and Arabic version of Nurses' Attitudes toward Obesity and Obese Patients Scale (NATOOPS). Results: The study findings revealed that the majority of Jordanian health care providers held negative attitudes toward overweight and obese women during childbirth. Midwives held less negative attitudes than did obstetricians and nurses. The majority of participants were perceived the overweight and obese pregnant women during childbirth as overate people, shapeless, slow and unattractive. Age, specialty, education and years of experience were found to be associated with health care providers’ attitudes. The Conclusion: Health care providers negative attitudes toward overweight and obese pregnant women are a cause for concern. Therefore, maternal obesity was needed to be more adequately addressed in basic education courses, and in the continuing professional education classes of practicing health care providers.Keywords: attitudes, obesity, prevalence rate, nurses, midwives, obstetrician, childbirth
Procedia PDF Downloads 3296075 Use of Serum Creatinine as an Incentive to Increase Prep Uptake Among Key Population Groups in South-South Nigeria
Authors: Akhigbe Mark, Abang Roger, Mwoltu Nanaribet, Edet Blessing
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Introduction.: The introduction of pre- exposure prophylaxis (PrEP) as a biomedical prevention method for HIV/AIDS has been around for more than a decade since the first confirmed evidence of its effectiveness when used daily as an oral pill. It is now a very valuable addition for people who are at higher risk of contracting HIV. Although globalacceptanceof PrEP hasincreased, PrEP is still highly concentrated in a small number of countries and within a small sub-population, with Kenya and South Africa accounting for only 19% of people who have received PrEP in Africa region, there is still a significant regionGap in PrEP availability and use, with only 28% of the target of 3 million in low-and middle countries currently using PrEP. Description: The purpose of this study is to find out if serum creatinine could be used as an incentive to improve PrEP uptake among Key population.Numerous approaches to increasing the uptake ofPrEP as a prevention mechanism for HIV in KPs has beenemployed, and one of them is serum creatinine. This approach is a biomarker of renal function, which was used in study as an incentive to increase PrEP uptake among key population groups (female sex workers, men who have sex with men, persons who inject drugs, transgender) in 3 states from South-South Nigeria. Whole blood samples are collected from clients, analysis of the samples is done using the clinical chemistry analyzer before they are initiated onto PrEP. Lessons learned and Recommendations: Secondary data was extracted from 3 states of HALG Implementing facilities in Southern part of Nigeria, PrEP uptake before and afterthe introduction of serum creatinine between March 2020 and August 2020 among key populationsin Nigeria. A total of 5664 patients were initiated on PrEP before, and after the introduction of serum creatinine, the PrEP uptake rate before (March 2020 to May 2020) introduction of serum creatinine accounted for only 5% of the total onset, and after (June 2020 to August 2020) introduction of serum creatinine, the uptake rate accounted for 95% of the total onset. These finding shows that increased uptake of PrEP before/after serum creatineindicates that serum creatine may be an effective stimulus for promoting PrEP in key populations.Keywords: serum creatinine, incentives, PrEP, key populations, Nigeria
Procedia PDF Downloads 966074 Molecular Docking Assessment of Pesticides Binding to Bacterial Chitinases
Authors: Diana Larisa Vladoiu, Vasile Ostafe, Adriana Isvoran
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Molecular docking calculations reveal that pesticides provide favorable interactions with the bacterial chitinases. Pesticides interact with both hydrophilic and aromatic residues involved in the active site of the enzymes, their positions partially overlapping the substrate and the inhibitors locations. Molecular docking outcomes, in correlation with experimental literature data, suggest that the pesticides may be degraded or having an inhibitor effect on the activity of these enzymes, depending of the application dose and rate.Keywords: chitinases, inhibition, molecular docking, pesticides
Procedia PDF Downloads 5516073 Multi-Objective Optimization of Run-of-River Small-Hydropower Plants Considering Both Investment Cost and Annual Energy Generation
Authors: Amèdédjihundé H. J. Hounnou, Frédéric Dubas, François-Xavier Fifatin, Didier Chamagne, Antoine Vianou
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This paper presents the techno-economic evaluation of run-of-river small-hydropower plants. In this regard, a multi-objective optimization procedure is proposed for the optimal sizing of the hydropower plants, and NSGAII is employed as the optimization algorithm. Annual generated energy and investment cost are considered as the objective functions, and number of generator units (n) and nominal turbine flow rate (QT) constitute the decision variables. Site of Yeripao in Benin is considered as the case study. We have categorized the river of this site using its environmental characteristics: gross head, and first quartile, median, third quartile and mean of flow. Effects of each decision variable on the objective functions are analysed. The results gave Pareto Front which represents the trade-offs between annual energy generation and the investment cost of hydropower plants, as well as the recommended optimal solutions. We noted that with the increase of the annual energy generation, the investment cost rises. Thus, maximizing energy generation is contradictory with minimizing the investment cost. Moreover, we have noted that the solutions of Pareto Front are grouped according to the number of generator units (n). The results also illustrate that the costs per kWh are grouped according to the n and rise with the increase of the nominal turbine flow rate. The lowest investment costs per kWh are obtained for n equal to one and are between 0.065 and 0.180 €/kWh. Following the values of n (equal to 1, 2, 3 or 4), the investment cost and investment cost per kWh increase almost linearly with increasing the nominal turbine flowrate while annual generated. Energy increases logarithmically with increasing of the nominal turbine flowrate. This study made for the Yeripao river can be applied to other rivers with their own characteristics.Keywords: hydropower plant, investment cost, multi-objective optimization, number of generator units
Procedia PDF Downloads 1576072 On Cold Roll Bonding of Polymeric Films
Authors: Nikhil Padhye
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Recently a new phenomenon for bonding of polymeric films in solid-state, at ambient temperatures well below the glass transition temperature of the polymer, has been reported. This is achieved by bulk plastic compression of polymeric films held in contact. Here we analyze the process of cold-rolling of polymeric films via finite element simulations and illustrate a flexible and modular experimental rolling-apparatus that can achieve bonding of polymeric films through cold-rolling. Firstly, the classical theory of rolling a rigid-plastic thin-strip is utilized to estimate various deformation fields such as strain-rates, velocities, loads etc. in rolling the polymeric films at the specified feed-rates and desired levels of thickness-reduction(s). Predicted magnitudes of slow strain-rates, particularly at ambient temperatures during rolling, and moderate levels of plastic deformation (at which Bauschinger effect can be neglected for the particular class of polymeric materials studied here), greatly simplifies the task of material modeling and allows us to deploy a computationally efficient, yet accurate, finite deformation rate-independent elastic-plastic material behavior model (with inclusion of isotropic-hardening) for analyzing the rolling of these polymeric films. The interfacial behavior between the roller and polymer surfaces is modeled using Coulombic friction; consistent with the rate-independent behavior. The finite deformation elastic-plastic material behavior based on (i) the additive decomposition of stretching tensor (D = De + Dp, i.e. a hypoelastic formulation) with incrementally objective time integration and, (ii) multiplicative decomposition of deformation gradient (F = FeFp) into elastic and plastic parts, are programmed and carried out for cold-rolling within ABAQUS Explicit. Predictions from both the formulations, i.e., hypoelastic and multiplicative decomposition, exhibit a close match. We find that no specialized hyperlastic/visco-plastic model is required to describe the behavior of the blend of polymeric films, under the conditions described here, thereby speeding up the computation process .Keywords: Polymer Plasticity, Bonding, Deformation Induced Mobility, Rolling
Procedia PDF Downloads 1896071 Numerical Simulations for Nitrogen Flow in Piezoelectric Valve
Authors: Pawel Flaszynski, Piotr Doerffer, Jan Holnicki-Szulc, Grzegorz Mikulowski
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Results of numerical simulations for transonic flow in a piezoelectric valve are presented. The valve is the main part of an adaptive pneumatic shock absorber. Flow structure in the valve domain and the influence of the flow non-uniformity in the valve on a mass flow rate is investigated. Numerical simulation results are compared with experimental data.Keywords: pneumatic valve, transonic flow, numerical simulations, piezoelectric valve
Procedia PDF Downloads 5146070 A Posterior Predictive Model-Based Control Chart for Monitoring Healthcare
Authors: Yi-Fan Lin, Peter P. Howley, Frank A. Tuyl
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Quality measurement and reporting systems are used in healthcare internationally. In Australia, the Australian Council on Healthcare Standards records and reports hundreds of clinical indicators (CIs) nationally across the healthcare system. These CIs are measures of performance in the clinical setting, and are used as a screening tool to help assess whether a standard of care is being met. Existing analysis and reporting of these CIs incorporate Bayesian methods to address sampling variation; however, such assessments are retrospective in nature, reporting upon the previous six or twelve months of data. The use of Bayesian methods within statistical process control for monitoring systems is an important pursuit to support more timely decision-making. Our research has developed and assessed a new graphical monitoring tool, similar to a control chart, based on the beta-binomial posterior predictive (BBPP) distribution to facilitate the real-time assessment of health care organizational performance via CIs. The BBPP charts have been compared with the traditional Bernoulli CUSUM (BC) chart by simulation. The more traditional “central” and “highest posterior density” (HPD) interval approaches were each considered to define the limits, and the multiple charts were compared via in-control and out-of-control average run lengths (ARLs), assuming that the parameter representing the underlying CI rate (proportion of cases with an event of interest) required estimation. Preliminary results have identified that the BBPP chart with HPD-based control limits provides better out-of-control run length performance than the central interval-based and BC charts. Further, the BC chart’s performance may be improved by using Bayesian parameter estimation of the underlying CI rate.Keywords: average run length (ARL), bernoulli cusum (BC) chart, beta binomial posterior predictive (BBPP) distribution, clinical indicator (CI), healthcare organization (HCO), highest posterior density (HPD) interval
Procedia PDF Downloads 2016069 Effects of Indole on Aerobic Biodegradation of Butanoic Acid by Pseudomonas aeruginosa and Serratia marcescens
Authors: J. B. J. Njalam’mano, E. M. N. Chirwa
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In low resource settings in Africa and other developing regions, pit latrines remain the dominant basic minimum acceptable form of sanitation. However, unpleasant smells-malodours emitted from faecal sludge in the pit latrines, which elicit disgusting or repulsive response, are one of the factors that thwart people to use latrines and instead opt for open defecation as an alternative. This provides an important but often overlooked major impediment, dissuading people from adopting and using the pit latrines hence affecting successful, effective sanitation promotion. The malodours are primarily attributed to four odorants: butanoic acid (C₄H₈O₂), dimethyl trisulphide (C₂H₆S₃), indole (C₈H₇N) and para-cresol (C₇H₈O). Several pit latrine deodorisation methods such as addition of carbonous materials, use of ventilation systems and urine separation are available, and they continue to occupy their niche, but social, economic, environmental and technological shortfalls remain. Bioremediation has been gaining popularity because it is inexpensive, simple to operate and environmentally friendly. Recently, the biodegradation of butanoic acid as individual odorant has been studied. However, to the best of our knowledge, there have been no kinetic studies of the butanoic acid in the presence of other key odorous compounds. In this study, a series of experiments were conducted to investigate the effects of indole on the removal of butanoic acid under aerobic conditions using indigenous bacteria strains, Pseudomonas aeruginosa, and Serratia marcescens isolated from faecal sludge as pure cultures as well as mixed cultures. In this purpose, butanoic acid removal was performed in a batch reactor containing the bacterial strains in mineral salt medium (MSM) amended with 3000 ppm of butanoic acid at the temperature of 30°C, under continuous stirring rate of 150 rpm and the concentration of indole was varied from 50-200 ppm. The initial pH of the solution was in the range of 6.0-7.2. Overall, there were significant differences in the bacterial growth rate and total butanoic acid removal dependent on the concentration of indole in the solution.Keywords: biodegradation, butanoic acid, indole, pit latrine
Procedia PDF Downloads 1956068 Multicenter Evaluation of the ACCESS Anti-HCV Assay on the DxI 9000 ACCESS Immunoassay Analyzer, for the Detection of Hepatitis C Virus Antibody
Authors: Dan W. Rhodes, Juliane Hey, Magali Karagueuzian, Florianne Martinez, Yael Sandowski, Vanessa Roulet, Mahmoud Badawi, Mohammed-Amine Chakir, Valérie Simon, Jérémie Gautier, Françoise Le Boulaire, Catherine Coignard, Claire Vincent, Sandrine Greaume, Isabelle Voisin
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Background: Beckman Coulter, Inc. (BEC) has recently developed a fully automated second-generation anti-HCV test on a new immunoassay platform. The objective of this multicenter study conducted in Europe was to evaluate the performance of the ACCESS anti-HCV assay on the recently CE-marked DxI 9000 ACCESS Immunoassay Analyzer as an aid in the diagnosis of HCV (Hepatitis C Virus) infection and as a screening test for blood and plasma donors. Methods: The clinical specificity of the ACCESS anti-HCV assay was determined using HCV antibody-negative samples from blood donors and hospitalized patients. Sample antibody status was determined by a CE-marked anti-HCV assay (Abbott ARCHITECTTM anti-HCV assay or Abbott PRISM HCV assay) with an additional confirmation method (Immunoblot testing with INNO-LIATM HCV Score - Fujirebio), if necessary, according to pre-determined testing algorithms. The clinical sensitivity was determined using known HCV antibody-positive samples, identified positive by Immunoblot testing with INNO-LIATM HCV Score - Fujirebio. HCV RNA PCR or genotyping was available on all Immunoblot positive samples for further characterization. The false initial reactive rate was determined on fresh samples from blood donors and hospitalized patients. Thirty (30) commercially available seroconversion panels were tested to assess the sensitivity for early detection of HCV infection. The study was conducted from November 2019 to March 2022. Three (3) external sites and one (1) internal site participated. Results: Clinical specificity (95% CI) was 99.7% (99.6 – 99.8%) on 5852 blood donors and 99.0% (98.4 – 99.4%) on 1527 hospitalized patient samples. There were 15 discrepant samples (positive on ACCESS anti-HCV assay and negative on both ARCHITECT and Immunoblot) observed with hospitalized patient samples, and of note, additional HCV RNA PCR results showed five (5) samples had positive HCV RNA PCR results despite the absence of HCV antibody detection by ARCHITECT and Immunoblot, suggesting a better sensitivity of the ACCESS anti-HCV assay with these five samples compared to the ARCHITECT and Immunoblot anti-HCV assays. Clinical sensitivity (95% CI) on 510 well-characterized, known HCV antibody-positive samples was 100.0% (99.3 – 100.0%), including 353 samples with known HCV genotypes (1 to 6). The overall false initial reactive rate (95% CI) on 6630 patient samples was 0.02% (0.00 – 0.09%). Results obtained on 30 seroconversion panels demonstrated that the ACCESS anti-HCV assay had equivalent sensitivity performances, with an average bleed difference since the first reactive bleed below one (1), compared to the ARCHITECTTM anti-HCV assay. Conclusion: The newly developed ACCESS anti-HCV assay from BEC for use on the DxI 9000 ACCESS Immunoassay Analyzer demonstrated high clinical sensitivity and specificity, equivalent to currently marketed anti-HCV assays, as well as a low false initial reactive rate.Keywords: DxI 9000 ACCESS Immunoassay Analyzer, HCV, HCV antibody, Hepatitis C virus, immunoassay
Procedia PDF Downloads 1006067 Examining Resilience, Social Supports, and Self-Esteem as Predictors of the Quality of Life of ODAPUS (Orang Dengan Lupus)
Authors: Yulmaida Amir, Fahrul Rozi, Insany C. Kamil, Fanny Aryani
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ODAPUS (Orang dengan Lupus) is an Indonesian term for people with Lupus, a chronic autoimmune disease in which immune system of the body becomes hyperactive and attacks normal tissue. The number of ODAPUS indicate an increase in Indonesia, thereby helping to improve their quality of life to be important to help their recovery. This study aims to examine the effect of resilience, self-esteem, and social support on the quality of life of women who had been diagnosed as having Lupus. Data were collected from 64 ODAPUS in Indonesia, using the World Health Organization Quality of Life (WHOQOL), Resilience Scale from Wagnil and Young (1993), self-esteem scale (developed from Coopersmith’s theory), and Social Support Questioner from Northouse (1988). Regression data analysis showed that resilience, social support, and self-esteem predict the quality of life of the ODAPUS simultaneously. If the variable was analysed individually, self-esteem did not significantly contribute to the quality of life. Resilience contributed most significantly to the quality of life, followed by social support. Of five sources of social supports included in the research, support from family members (parents and brother/sisters) has the most significant contribution to the quality of life, followed by support from spouse, and from friends. Interestingly, social support from medical personnel (medical doctors and nurses) had not a significant contribution to the quality of life of ODAPUS. As a conclusion, this research showed that the ability of ODAPUS to cope with difficulty in life, and support from family members, spouse, and friends were the significant predictors for their quality of life.Keywords: quality of life, resilience, self-esteem, social supports
Procedia PDF Downloads 1686066 Simulation Approach for Analyzing Transportation Energy System in South Korea
Authors: Sungjun Hong, Youah Lee, Jongwook Kim
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In the last COP21 held in Paris on 2015, Korean government announced that Intended Nationally Determined Contributions (INDC) was 37% based on BAU by 2030. The GHG reduction rate of the transportation sector is the strongest among all sectors by 2020. In order to cope with Korean INDC, Korean government established that 3rd eco-friendly car deployment national plans at the end of 2015. In this study, we make the energy system model for estimating GHG emissions using LEAP model.Keywords: INDC, greenhouse gas, LEAP, transportation
Procedia PDF Downloads 2056065 Field Prognostic Factors on Discharge Prediction of Traumatic Brain Injuries
Authors: Mohammad Javad Behzadnia, Amir Bahador Boroumand
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Introduction: Limited facility situations require allocating the most available resources for most casualties. Accordingly, Traumatic Brain Injury (TBI) is the one that may need to transport the patient as soon as possible. In a mass casualty event, deciding when the facilities are restricted is hard. The Extended Glasgow Outcome Score (GOSE) has been introduced to assess the global outcome after brain injuries. Therefore, we aimed to evaluate the prognostic factors associated with GOSE. Materials and Methods: In a multicenter cross-sectional study conducted on 144 patients with TBI admitted to trauma emergency centers. All the patients with isolated TBI who were mentally and physically healthy before the trauma entered the study. The patient’s information was evaluated, including demographic characteristics, duration of hospital stays, mechanical ventilation on admission laboratory measurements, and on-admission vital signs. We recorded the patients’ TBI-related symptoms and brain computed tomography (CT) scan findings. Results: GOSE assessments showed an increasing trend by the comparison of on-discharge (7.47 ± 1.30), within a month (7.51 ± 1.30), and within three months (7.58 ± 1.21) evaluations (P < 0.001). On discharge, GOSE was positively correlated with Glasgow Coma Scale (GCS) (r = 0.729, P < 0.001) and motor GCS (r = 0.812, P < 0.001), and inversely with age (r = −0.261, P = 0.002), hospitalization period (r = −0.678, P < 0.001), pulse rate (r = −0.256, P = 0.002) and white blood cell (WBC). Among imaging signs and trauma-related symptoms in univariate analysis, intracranial hemorrhage (ICH), interventricular hemorrhage (IVH) (P = 0.006), subarachnoid hemorrhage (SAH) (P = 0.06; marginally at P < 0.1), subdural hemorrhage (SDH) (P = 0.032), and epidural hemorrhage (EDH) (P = 0.037) were significantly associated with GOSE at discharge in multivariable analysis. Conclusion: Our study showed some predictive factors that could help to decide which casualty should transport earlier to a trauma center. According to the current study findings, GCS, pulse rate, WBC, and among imaging signs and trauma-related symptoms, ICH, IVH, SAH, SDH, and EDH are significant independent predictors of GOSE at discharge in TBI patients.Keywords: field, Glasgow outcome score, prediction, traumatic brain injury.
Procedia PDF Downloads 756064 20th-Century River Course Changes and Their Relation to Sediment Carbon Distribution Patterns in the Yellow River Delta
Authors: Dongxue Li, Zhonghua Ning, Yi’na Li, Baoshan Cui, Wasner Daniel, Sebastian Dötterl
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Most of the world's coastal alluvial plains can be significant carbon (C) eservoirs in which upland sediments are deposited and bury former topsoil, thereby contributing to soil C preservation, especially in river-controlled deltas like the Yellow River Delta, China. These deltas are affected by the continuous large amount of sediment transport and strong river dynamics from the upper reaches, which makes the river course in the deltas change frequently. However, the impact of varying river course changes on C stocks in these estuary wetlands is unclear. To investigate this, we drilled five 2 m cores along a sediment deposition sequence of the Yellow River Delta, which shifted its main course flow in the delta several times throughout the 20th century. Covering 80 years of sediment deposition, we explored both soil C stocks and their potential sources, and identified key soil physicochemical and hydrometeorological variables that correlate to C density and deposition rate. Further, the spatiotemporal C distribution and its relationship with these variables was examined. Our results showed that sediments at a soil depth of 200 cm in the main courses of the Yellow River corresponded to deposition ages ranging from 1942 to 1989. The oldest course has the lowest C stocks and showed C-enriched compared with younger courses. Contributions of soil C stemming from fresh particulate organic carbon from deposited upstream sources were significantly higher than local, in-situ vegetation. In addition, the carbon of the oldest and relatively young courses tends to be affected by interaction effects of hydrometeorological and physiochemical varibales, and that of the middle courses tends to be affected by independent variables. Our findings can help prioritize conservation efforts across different river courses and provide quantitative support for global carbon emission reduction by assessing sediment carbon reservoirs.Keywords: alluvial plains, coastal wetland, core drilling, course diversion, organic carbon, sediment deposition rate, soil deposition
Procedia PDF Downloads 276063 Treating Global Trauma: Pandemic, Wars and Beyond. Somatically Based Psychotherapy Interventions as a “Bottom-Up” Approach to Improving the Effectiveness of PTSD Treatment While Preventing Clinicians’ Burnout
Authors: Nina Kaufmans
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Traditional therapies, utilizing spoken narratives as a primary source of intervention, are proven to be limited in effectively treating post traumatic stress disorder. Following the effects of the global pandemic of COVID-19, an increasing number of mental health consumers are beginning to experience somatically-based distress in addition to existing mental health symptoms. Moreover, the aftermath of the rapid increase in demand for mental health services has caused significant burnout in mental health professionals. This paper explores the ramifications of recent changes and challenges in the mental health demands and subsequent response and its consequences for mental health workers. We will begin by investigating the neurobiological mechanisms involved in traumatic experiences, then discuss the premises for "bottom-up" or somatically oriented psychotherapy approaches, and finally offer clinical skills and interventions for clients diagnosed with post traumatic stress disorder. In addition, we will discuss how somatically-based psychotherapy interventions implemented in sessions may decrease burnout and improve the well-being of clinicians. We will discuss how the integration of somatically-based interventions into counseling would increase the effectiveness of mental health recovery and sustain remission while simultaneously providing opportunities for self-care for mental health professionals.Keywords: somatic psychotherapy interventions, trauma counseling, preventing and treating burnout, adults with PTSD, bottom-up skills, the effectiveness of trauma treatment
Procedia PDF Downloads 806062 Corrosion of Fe-(9~37) Wt%Cr Alloys at 700-800 °C in N₂-H₂O-H₂S Mixed Gas
Authors: Min Jung Kim
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Fe-(9, 19, 28, 37) wt%Cr alloys were corroded at 700 and 800 °C for 70 h under 1 atm of N₂, 1 atm of N₂/3.2%H₂O-mixed gas, and 1 atm of N₂/3.1%H₂O/2.42%H₂S-mixed gas. The corrosion rate of Fe-9Cr alloy increased with the addition of H₂O and increased further with the addition of H₂S in N₂/H₂O gas. Fe-9Cr alloy was non-protective in all gas types. In contrast, Fe-(19, 28, 37) wt%Cr alloys were protective in N₂ and N₂/H₂O-mixed gas because of the formation of the Cr₂O₃ layer. They were, however, non-protective in N₂/H₂O/H₂S-mixed gas because sulfidation dominated, forming the outer FeS layer and the inner Cr₂S₃ layer containing some FeCr₂S₄.Keywords: Fe-(9, 19, 28, 37) wt%Cr alloys, corrosion, sulfidation, FeS
Procedia PDF Downloads 4326061 Thermoluminescence Investigations of Tl2Ga2Se3S Layered Single Crystals
Authors: Serdar Delice, Mehmet Isik, Nizami Hasanli, Kadir Goksen
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Researchers have donated great interest to ternary and quaternary semiconductor compounds especially with the improvement of the optoelectronic technology. The quaternary compound Tl2Ga2Se3S which was grown by Bridgman method carries the properties of ternary thallium chalcogenides group of semiconductors with layered structure. This compound can be formed from TlGaSe2 crystals replacing the one quarter of selenium atom by sulfur atom. Although Tl2Ga2Se3S crystals are not intentionally doped, some unintended defect types such as point defects, dislocations and stacking faults can occur during growth processes of crystals. These defects can cause undesirable problems in semiconductor materials especially produced for optoelectronic technology. Defects of various types in the semiconductor devices like LEDs and field effect transistor may act as a non-radiative or scattering center in electron transport. Also, quick recombination of holes with electrons without any energy transfer between charge carriers can occur due to the existence of defects. Therefore, the characterization of defects may help the researchers working in this field to produce high quality devices. Thermoluminescence (TL) is an effective experimental method to determine the kinetic parameters of trap centers due to defects in crystals. In this method, the sample is illuminated at low temperature by a light whose energy is bigger than the band gap of studied sample. Thus, charge carriers in the valence band are excited to delocalized band. Then, the charge carriers excited into conduction band are trapped. The trapped charge carriers are released by heating the sample gradually and these carriers then recombine with the opposite carriers at the recombination center. By this way, some luminescence is emitted from the samples. The emitted luminescence is converted to pulses by using an experimental setup controlled by computer program and TL spectrum is obtained. Defect characterization of Tl2Ga2Se3S single crystals has been performed by TL measurements at low temperatures between 10 and 300 K with various heating rate ranging from 0.6 to 1.0 K/s. The TL signal due to the luminescence from trap centers revealed one glow peak having maximum temperature of 36 K. Curve fitting and various heating rate methods were used for the analysis of the glow curve. The activation energy of 13 meV was found by the application of curve fitting method. This practical method established also that the trap center exhibits the characteristics of mixed (general) kinetic order. In addition, various heating rate analysis gave a compatible result (13 meV) with curve fitting as the temperature lag effect was taken into consideration. Since the studied crystals were not intentionally doped, these centers are thought to originate from stacking faults, which are quite possible in Tl2Ga2Se3S due to the weakness of the van der Waals forces between the layers. Distribution of traps was also investigated using an experimental method. A quasi-continuous distribution was attributed to the determined trap centers.Keywords: chalcogenides, defects, thermoluminescence, trap centers
Procedia PDF Downloads 2826060 Model Based Design and Development of Horticultural Produce Crate from Bamboo
Authors: Sisay Wondmagegn Molla, Mulugeta Admasu Delele, Tadelle Nigusu Mekonen
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It is common to observe quality deterioration and mechanical injury of horticulture products as a result of suboptimal design and handling of the packaging systems. Society uses the old and primitive way of handling horticulture products, which is produced through trial and error This method is known to have many limitations on quality, environmental pollution, labor and cost. Ethiopia stands first in bamboo resources in Africa, which is 67 % of the African and 7 % of the world's bamboo resources. The purpose of this project was to design and develop bamboo-based ventilated horticultural produce crates using validated computational fluid dynamics (CFD). The model was used to predict the airflow and temperature distribution inside the loaded crate. The study included: sizing, collection of the thermo-physical properties, and designing and developing a CFD model of the bamboo-based ventilated horticultural crate. The designed crate (40×30×25cm) had a capacity of about 18 kg, and cold air temperature (130C) was used for cooling the fruit. Airflow in the loaded crate is far from uniform. There is a relatively high-velocity flow at the top, near inlet and near outlet sections, and a relatively low airflow near the center of the loaded crate. The predicted velocity variation within the bulk of the produce was relatively large, it was in the range of 0.04-7m/s. The vented produce package contributed the highest cooling airflow resistance. Similar to the airflow, the cooling characteristics of the product were not uniform. There was a difference in the cooling rate of the produce in the airflow direction and from the top to the bottom section of the loaded crate. The products that were located near the inlet side and top of the bulk showed a faster cooling rate than the rest of the bulk. The result showed that the produced volume average temperature was 17.9°C after a cooling period of 3 hr. It was reduced by 12.05°C. The result showed the potential of the CFD modeling approach in developing the bamboo-based design of horticultural produce crates in terms of airflow and heat transfer characteristics.Keywords: bamboo, modeling, cooling, horticultural, packaging
Procedia PDF Downloads 256059 Random Variation of Treated Volumes in Fractionated 2D Image Based HDR Brachytherapy for Cervical Cancer
Authors: R. Tudugala, B. M. A. I. Balasooriya, W. M. Ediri Arachchi, R. W. M. W. K. Rathnayake, T. D. Premaratna
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Brachytherapy involves placing a source of radiation near the cancer site which gives promising prognosis for cervical cancer treatments. The purpose of this study was to evaluate the effect of random variation of treated volumes in between fractions in the 2D image based fractionated high dose rate brachytherapy for cervical cancer at National Cancer Institute Maharagama, Sri Lanka. Dose plans were analyzed for 150 cervical cancer patients with orthogonal radiographs (2D) based brachytherapy. ICRU treated volumes was modeled by translating the applicators with the help of “Multisource HDR plus software”. The difference of treated volumes with respect to the applicator geometry was analyzed by using SPSS 18 software; to derived patient population based estimates of delivered treated volumes relative to ideally treated volumes. Packing was evaluated according to bladder dose, rectum dose and geometry of the dose distribution by three consultant radiation oncologist. The difference of treated volumes depends on types of the applicators, which was used in fractionated brachytherapy. The means of the “Difference of Treated Volume” (DTV) for “Evenly activated tandem (ET)” length” group was ((X_1)) -0.48 cm3 and ((X_2)) 11.85 cm3 for “Unevenly activated tandem length (UET) group. The range of the DTV for ET group was 35.80 cm3 whereas UET group 104.80 cm3. One sample T test was performed to compare the DTV with “Ideal treatment volume difference (0.00cm3)”. It is evident that P value was 0.732 for ET group and for UET it was 0.00 moreover independent two sample T test was performed to compare ET and UET groups and calculated P value was 0.005. Packing was evaluated under three categories 59.38% used “Convenient Packing Technique”, 33.33% used “Fairly Packing Technique” and 7.29% used “Not Convenient Packing” in their fractionated brachytherapy treatments. Random variation of treated volume in ET group is much lower than UET group and there is a significant difference (p<0.05) in between ET and UET groups which affects the dose distribution of the treatment. Furthermore, it can be concluded nearly 92.71% patient’s packing were used acceptable packing technique at NCIM, Sri Lanka.Keywords: brachytherapy, cervical cancer, high dose rate, tandem, treated volumes
Procedia PDF Downloads 2016058 Recurrence of Pterygium after Surgery and the Effect of Surgical Technique on the Recurrence of Pterygium in Patients with Pterygium
Authors: Luksanaporn Krungkraipetch
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A pterygium is an eye surface lesion that begins in the limbal conjunctiva and progresses to the cornea. The lesion is more common in the nasal limbus than in the temporal, and it has a distinctive wing-like aspect. Indications for surgery, in decreasing order of significance, are grown over the corneal center, decreased vision due to corneal deformation, documented growth, sensations of discomfort, and aesthetic concerns. Recurrent pterygium results in the loss of time, the expense of therapy, and the potential for vision impairment. The objective of this study is to find out how often the recurrence of pterygium after surgery occurs, what effect the surgery technique has, and what causes them to come back in people with pterygium. Materials and Methods: Observational case control in retrospect: the study involves a retrospective analysis of 164 patient samples. Data analysis is descriptive statistics analysis, i.e., basic data details about pterygium surgery and the risk of recurrent pterygium. For factor analysis, the inferential statistics odds ratio (OR) and 95% confidence interval (CI) ANOVA are utilized. A p-value of 0.05 was deemed statistically important. Results: The majority of patients, according to the results, were female (60.4%). Twenty-four of the 164 (14.6%) patients who underwent surgery exhibited recurrent pterygium. The average age is 55.33 years old. Postoperative recurrence was reported in 19 cases (79.3%) of bare sclera techniques and five cases (20.8%) of conjunctival autograft techniques. The recurrence interval is 10.25 months, with the most common (54.17 percent) being 12 months. In 91.67 percent of cases, all follow-ups are successful. The most common recurrence level is 1 (25%). A surgical complication is a subconjunctival hemorrhage (33.33 percent). Comparing the surgeries done on people with recurrent pterygium didn't show anything important (F = 1.13, p = 0.339). Age significantly affected the recurrence of pterygium (95% CI, 6.79-63.56; OR = 20.78, P 0.001). Conclusion: This study discovered a 14.6% rate of pterygium recurrence after pterygium surgery. Across all surgeries and patients, the rate of recurrence was four times higher with the bare sclera method than with conjunctival autograft. The researchers advise selecting a more conventional surgical technique to avoid a recurrence.Keywords: pterygium, recurrence pterygium, pterygium surgery, excision pterygium
Procedia PDF Downloads 886057 Growth of Droplet in Radiation-Induced Plasma of Own Vapour
Authors: P. Selyshchev
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The theoretical approach is developed to describe the change of drops in the atmosphere of own steam and buffer gas under irradiation. It is shown that the irradiation influences on size of stable droplet and on the conditions under which the droplet exists. Under irradiation the change of drop becomes more complex: the not monotone and periodical change of size of drop becomes possible. All possible solutions are represented by means of phase portrait. It is found all qualitatively different phase portraits as function of critical parameters: rate generation of clusters and substance density.Keywords: irradiation, steam, plasma, cluster formation, liquid droplets, evolution
Procedia PDF Downloads 4416056 Investigation of Performance of Organic Acids on Carbonate Rocks (Experimental Study in Ahwaz Oilfield)
Authors: Azad Jarrahian, Ehsan Heidaryan
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Matrix acidizing treatments can yield impressive production increase if properly applied. In this study, carbonate samples taken from Ahwaz Oilfield have undergone static solubility, sludge, emulsion, and core flooding tests. In each test interaction of acid and rock is reported and at the end it has been shown that how initial permeability and type of acid affects the overall treatment efficiency.Keywords: carbonate acidizing, organic acids, spending rate, acid penetration, incomplete spending.
Procedia PDF Downloads 4376055 Comparison of Soil Test Extractants for Determination of Available Soil Phosphorus
Authors: Violina Angelova, Stefan Krustev
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The aim of this work was to evaluate the effectiveness of different soil test extractants for the determination of available soil phosphorus in five internationally certified standard soils, sludge and clay (NCS DC 85104, NCS DC 85106, ISE 859, ISE 952, ISE 998). The certified samples were extracted with the following methods/extractants: CaCl₂, CaCl₂ and DTPA (CAT), double lactate (DL), ammonium lactate (AL), calcium acetate lactate (CAL), Olsen, Mehlich 3, Bray and Kurtz I, and Morgan, which are commonly used in soil testing laboratories. The phosphorus in soil extracts was measured colorimetrically using Spectroquant Pharo 100 spectrometer. The methods used in the study were evaluated according to the recovery of available phosphorus, facility of application and rapidity of performance. The relationships between methods are examined statistically. A good agreement of the results from different soil test was established for all certified samples. In general, the P values extracted by the nine extraction methods significantly correlated with each other. When grouping the soils according to pH, organic carbon content and clay content, weaker extraction methods showed analogous trends; also among the stronger extraction methods, common tendencies were found. Other factors influencing the extraction force of the different methods include soil: solution ratio, as well as the duration and power of shaking the samples. The mean extractable P in certified samples was found to be in the order of CaCl₂ < CAT < Morgan < Bray and Kurtz I < Olsen < CAL < DL < Mehlich 3 < AL. Although the nine methods extracted different amounts of P from the certified samples, values of P extracted by the different methods were strongly correlated among themselves. Acknowledgment: The financial support by the Bulgarian National Science Fund Projects DFNI Н04/9 and DFNI Н06/21 are greatly appreciated.Keywords: available soil phosphorus, certified samples, determination, soil test extractants
Procedia PDF Downloads 1516054 Hydration Matters: Impact on 3 km Running Performance in Trained Male Athletes Under Heat Conditions
Authors: Zhaoqi He
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Research Context: Endurance performance in hot environments is influenced by the interplay of hydration status and physiological responses. This study aims to investigate how dehydration, up to 2.11% body weight loss, affects the 3 km running performance of trained male athletes under conditions mimicking high temperatures. Methodology: In a randomized crossover design, five male athletes participated in two trials – euhydrated (EU) and dehydrated (HYPO). Both trials included a 70-minute preload run at 55-60% VO2max in 32°C and 50% humidity, followed by a 3-kilometer time trial. Fluid intake was restricted in HYPO to induce a 2.11% body weight loss. Physiological metrics, including heart rate, core temperature, and oxygen uptake, were measured, along with perceptual metrics like perceived exertion and thirst sensation. Findings: The 3-kilometer run completion times showed no significant differences between EU and HYPO trials (p=0.944). Physiological indicators, including heart rate, core temperature, and oxygen uptake, did not significantly vary (p>0.05). Thirst sensation was markedly higher in HYPO (p=0.013), confirming successful induction of dehydration. Other perceptual metrics and gastrointestinal comfort remained consistent. Conclusion: Contrary to the hypothesis, the study reveals that dehydration, inducing up to 2.11% body weight loss, does not significantly impair 3 km running performance in trained male athletes under hot conditions. Thirst sensation was notably higher in the dehydrated state, emphasizing the importance of considering perceptual factors in hydration strategies. The findings suggest that trained runners can maintain performance despite moderate dehydration, highlighting the need for nuanced hydration guidelines in hot-weather running.Keywords: hypohydration, euhydration, hot environment, 3km running time trial, endurance performance, trained athletes, perceptual metrics, dehydration impact, physiological responses, hydration strategies
Procedia PDF Downloads 666053 The Effect of Newspaper Reporting on COVID-19 Vaccine Hesitancy: A Randomised Controlled Trial
Authors: Anna Rinaldi, Pierfrancesco Dellino
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COVID-19 vaccine hesitancy can be observed at different rates in different countries. In June 2021, 1,068 people were surveyed in France and Italy to inquire about individual potential acceptance, focusing on time preferences in a risk-return framework: having the vaccination today, in a month, and in 3 months; perceived risks of vaccination and COVID-19; and expected benefit of the vaccine. A randomized controlled trial was conducted to understand how everyday stimuli like fact-based news about vaccines impact an audience's acceptance of vaccination. The main experiment involved two groups of participants and two different articles about vaccine-related thrombosis taken from two Italian newspapers. One article used a more abstract description and language, and the other used a more anecdotal description and concrete language; each group read only one of these articles. Two other groups were assigned categorization tasks; one was asked to complete a concrete categorization task, and the other an abstract categorization task. Individual preferences for vaccination were found to be variable and unstable over time, and individual choices of accepting, refusing, or delaying could be affected by the way news is written. In order to understand these dynamic preferences, the present work proposes a new model based on seven categories of human behaviors that were validated by a neural network. A treatment effect was observed: participants who read the articles shifted to vaccine hesitancy categories more than participants assigned to other treatments and control. Furthermore, there was a significant gender effect, showing that the type of language leading to a lower hesitancy rate for men is correlated with a higher hesitancy rate for women and vice versa. This outcome should be taken into consideration for an appropriate gender-based communication campaign aimed at achieving herd immunity. The trial was registered at ClinicalTrials.gov NCT05582564 (17/10/2022).Keywords: vaccine hesitancy, risk elicitation, neural network, covid19
Procedia PDF Downloads 846052 An Experience Report on Course Teaching in Information Systems
Authors: Carlos Oliveira
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This paper is a criticism of the traditional model of teaching and presents alternative teaching methods, different from the traditional lecture. These methods are accompanied by reports of experience of their application in a class. It was concluded that in the lecture, the student has a low learning rate and that other methods should be used to make the most engaging learning environment for the student, contributing (or facilitating) his learning process. However, the teacher should not use a single method, but rather a range of different methods to ensure the learning experience does not become repetitive and fatiguing for the student.Keywords: educational practices, experience report, IT in education, teaching methods
Procedia PDF Downloads 3976051 Digital Repository as a Service: Enhancing Access and Preservation of Cultural Heritage Artefacts
Authors: Lefteris Tsipis, Demosthenes Vouyioukas, George Loumos, Antonis Kargas, Dimitris Varoutas
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The employment of technology and digitization is crucial for cultural organizations to establish and sustain digital repositories for their cultural heritage artefacts. This utilization is also essential in facilitating the presentation of cultural works and exhibits to a broader audience. Consequently, in this work, we propose a digital repository that functions as Software as a Service (SaaS), primarily promoting the safe storage, display, and sharing of cultural materials, enhancing accessibility, and fostering a deeper understanding and appreciation of cultural heritage. Moreover, the proposed digital repository service is designed as a multitenant architecture, which enables organizations to expand their reach, enhance accessibility, foster collaboration, and ensure the preservation of their content. Specifically, this project aims to assist each cultural institution in organizing its digital cultural assets into collections and feeding other digital platforms, including educational, museum, pedagogical, and games, through appropriate interfaces. Moreover, the creation of this digital repository offers a cutting-edge and effective open-access laboratory solution. It allows organizations to have a significant influence on their audiences by fostering cultural understanding and appreciation. Additionally, it facilitates the connection between different digital repositories and national/European aggregators, promoting collaboration and information sharing. By embracing this solution, cultural institutions can benefit from shared resources and features, such as system updates, backup and recovery services, and data analytics tools, that are provided by the platform.Keywords: cultural technologies, gaming technologies, web sharing, digital repository
Procedia PDF Downloads 796050 Quality of Life Assessment across the Cancer Continuum: Understanding the Role of an Exercise Rehabilitation Programme
Authors: Bernat-Carles Serdà Ferrer, Arantza Del Valle Gómez
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The Quality of Life (QoL) paradigm is multidimensional, dynamic and modular and its definition differs across the cancer continuum. The challenge in the interpretation of QoL data in clinical research is that QoL is influenced by psychological phenomena such as adaptation to illness. This research aims to obtain a valid and sensitive assessment of QoL change over the continuum disease, and to evaluate a rehabilitation programme aimed at inverting the observed decrease in QoL when patients return to daily living activities. The sample comprised 66 men. Patients were first assessed to establish a baseline (P1-diagnosis). This was followed by a post-test (P2-discharge) and a then-test measurement (P3-retrospective evaluation) and after returning home patients were randomized in experimental and control groups. The experimental group attended a rehabilitation programme over 24 weeks (P4). Results show that from baseline to post-test, QoL decreased significantly. The recalibration then-test confirmed a low QoL in all periods evaluated. Significant differences between the experimental and control groups prove the positive effect of the Exercise Rehabilitation Programme (ERP) on QoL. Understanding the real dynamic of QoL over time would help to adapt rehabilitation programmes by improving sensitivity and efficacy and provide professionals with a more accurate perception of the impact of treatment and side effects on patients’ QoL. Our results underline the importance of changing the approach adopted by health professionals towards one of watchful waiting on patients’ QoL until their complete recovery in daily life.Keywords: exercise, prostate cancer, quality of life, rehabilitation programme, response shift
Procedia PDF Downloads 1676049 Optimization of Municipal Solid Waste Management in Peshawar Using Mathematical Modelling and GIS with Focus on Incineration
Authors: Usman Jilani, Ibad Khurram, Irshad Hussain
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Environmentally sustainable waste management is a challenging task as it involves multiple and diverse economic, environmental, technical and regulatory issues. Municipal Solid Waste Management (MSWM) is more challenging in developing countries like Pakistan due to lack of awareness, technology and human resources, insufficient funding, inefficient collection and transport mechanism resulting in the lack of a comprehensive waste management system. This work presents an overview of current MSWM practices in Peshawar, the provincial capital of Khyber Pakhtunkhwa, Pakistan and proposes a better and sustainable integrated solid waste management system with incineration (Waste to Energy) option. The diverted waste would otherwise generate revenue; minimize land fill requirement and negative impact on the environment. The proposed optimized solution utilizing scientific techniques (like mathematical modeling, optimization algorithms and GIS) as decision support tools enhances the technical & institutional efficiency leading towards a more sustainable waste management system through incorporating: - Improved collection mechanisms through optimized transportation / routing and, - Resource recovery through incineration and selection of most feasible sites for transfer stations, landfills and incineration plant. These proposed methods shift the linear waste management system towards a cyclic system and can also be used as a decision support tool by the WSSP (Water and Sanitation Services Peshawar), agency responsible for the MSWM in Peshawar.Keywords: municipal solid waste management, incineration, mathematical modeling, optimization, GIS, Peshawar
Procedia PDF Downloads 3766048 Developing a Health Promotion Program to Prevent and Solve Problem of the Frailty Elderly in the Community
Authors: Kunthida Kulprateepunya, Napat Boontiam, Bunthita Phuasa, Chatsuda Kankayant, Bantoeng Polsawat, Sumran Poontong
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Frailty is the thin line between good health and illness. The syndrome is more common in the elderly who transition from strong to weak. (Vulnerability). Fragility can prevent and promote healthy recovery before it goes into disability. This research and development aim to analyze the situation analysis of frailty of the elderly, develop a program, and evaluate the effect of a health promotion program to prevent and solve the problem of frailty among the elderly. The research consisted of 3 phases: 1) analysis of the frailty situation, 2) development of a model, 3) evaluation of the effectiveness of the model. Samples were 328, 122 elderlies using the multi-stage random sampling method. The research instrument was a frailty questionnaire use of the five symptoms, the main characteristics were muscle weakness, slow walking, low physical activity. Fatigue and unintentional weight loss, criteria frailty use more than or equal to three or more symptoms are frailty. Data were analyzed by descriptive and t-test dependent test statistics. The findings showed three parts. First, frailty in the elderly was 23.05 percentage and 56.70% pre-frailty. Second, it was development of a health promotion program to prevent and solve the problem of frailty the elderly with a combination of Nine-Square Exercise, Elastic Band Exercise, Elastic Coconut Shell. Third, evaluation of the effectiveness of the model by comparison of the elderly's get up and go test, the average time before using the program was 14.42 and after using the program was 8.57. It was statistically significant at the .05 level. In conclusion, the findings can used to develop guidelines to promote the health of the frailty elderly.Keywords: elderly, fragile, nine-square exercise, elastic coconut shell
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