Search results for: reducing sugar

Authors: Cherng-Jye Jeng, Ming-Feng Hou, Hsing-Yuan Liu, Chuan-Feng Chang, Lih-Rong Wang, Yen-Chin Lin

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Introduction: The incidence of breast cancer has gradually increased in Taiwan, and the characteristic of younger ages impact these women in their middle age, and may also cause challenges in terms of family, work, and illness. Breasts are symbols of femininity, as well as of sex. For women, breasts are important organs for the female identity and sexual expression. Losing breasts not only affects the female role, but would also affect sexual attraction and sexual desire. Thus, women with breast cancer who have need for mastectomies experience physical incompletion, which affects women’s self-confidence, physical image, and self-orientation. Purposes: 1. To understand the physical experience of women with breast cancer. 2. To explore the issue of sexual issues on the health effects of women with breast cancer. 3. To construct a domestic sex life issue group model for domestic women with breast cancer. 4. To explore the accompaniment experiences and sexual relationship adjustments of spouses when women have breast cancer. Method: After the research plan passes IRB review, participants will be recruited at breast surgery clinic in the affiliated hospital, to screen suitable subjects for entry into the group. Between March and May 2015, two sexual health and sex life consultation groups were conducted, which were (1) 10 in postoperative groups for women with cancer; (2) 4 married couples group for postoperative women with cancer. After sharing experiences and dialogue, women can achieve mutual support and growth. Data organization and analysis underwent descriptive analysis in qualitative research, and the group process was transcribed into transcripts for overall-content and category-content analysis. Results: Ten women with breast cancer believed that participating in group can help them exchange experiences, and elevate sexual health. The main issues include: (1) after breast cancer surgery, patients generally received chemotherapy or estrogen suppressants, causing early menopause; in particular, vaginal dryness can cause pain or bleeding in intercourse, reducing their desire for sexual activity; (2) breast cancer accentuates original spousal or family and friend relationships; some people have support and care from their family, and spouses emphasize health over the appearance of breasts; however, some people do not have acceptance and support from their family, and some even hear spousal sarcasm about loss of breasts; (3) women with breast cancer have polarized expressions of optimism and pessimism in regards to their emotions, beliefs, and body image regarding cancer; this is related to the women’s original personalities, attribution of causes of cancer, and extent of worry about relapse. Conclusion: The research results can be provided as a reference to medical institutions or breast cancer volunteer teams, to pay attention to maintaining the health of women with breast cancer.

Keywords: women with breast cancer, experiences of objectifying the body, quality of sex life, sexual health

Procedia PDF Downloads 319

Authors: Daniel Martin Fellows, Sean P. Walton, Jennifer Thompson, Oubay Hassan, Ella Quigley, Kevin Tinkham

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Fire performance is a crucial aspect to consider when designing cladding products, and testing this performance is extremely expensive. Appropriate use of numerical simulation of fire performance has the potential to reduce the total number of fire tests required when designing a product by eliminating poor-performing design ideas early in the design phase. Due to the complexity of fire and the large spectrum of failures it can cause, multi-disciplinary models are needed to capture the complex fire behavior and its structural effects on its surroundings. Working alongside Tata Steel U.K., the authors have focused on completing a coupled CFD-FEA simulation model suited to test Polyisocyanurate (PIR) based sandwich panel products to gain confidence before costly experimental standards testing. The sandwich panels are part of a thermally insulating façade system primarily for large non-domestic buildings. The work presented in this paper compares two coupling methodologies of a replicated physical experimental standards test LPS 1181-1, carried out by Tata Steel U.K. The two coupling methodologies that are considered within this research are; one-way and two-way. A one-way coupled analysis consists of importing thermal data from the CFD solver into the FEA solver. A two-way coupling analysis consists of continuously importing the updated changes in thermal data, due to the fire's behavior, to the FEA solver throughout the simulation. Likewise, the mechanical changes will also be updated back to the CFD solver to include geometric changes within the solution. For CFD calculations, a solver called Fire Dynamic Simulator (FDS) has been chosen due to its adapted numerical scheme to focus solely on fire problems. Validation of FDS applicability has been achieved in past benchmark cases. In addition, an FEA solver called ABAQUS has been chosen to model the structural response to the fire due to its crushable foam plasticity model, which can accurately model the compressibility of PIR foam. An open-source code called FDS-2-ABAQUS is used to couple the two solvers together, using several python modules to complete the process, including failure checks. The coupling methodologies and experimental data acquired from Tata Steel U.K are compared using several variables. The comparison data includes; gas temperatures, surface temperatures, and mechanical deformation of the panels. Conclusions are drawn, noting improvements to be made on the current coupling open-source code FDS-2-ABAQUS to make it more applicable to Tata Steel U.K sandwich panel products. Future directions for reducing the computational cost of the simulation are also considered.

Keywords: fire engineering, numerical coupling, sandwich panels, thermo fluids

Procedia PDF Downloads 90

Authors: Lei Li, Ping Yin, Haneen Khreis

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Stroke is the second leading cause of death and a third leading cause of death and disability worldwide in 2019. Given the significant role of environmental factors in stroke development and progression, it is essential to investigate the effect of air pollution on stroke occurrence while considering the modifying effects of meteorological variables. This study aimed to evaluate the association between short-term exposure to air pollution and the incidence of stroke subtypes in Shenzhen, China, and to explore the potential interactions of meteorological factors with air pollutants. The study analyzed data from January 1, 2006, to December 31, 2014, including 88,214 cases of ischemic stroke and 30,433 cases of hemorrhagic stroke among residents of Shenzhen. Using a time-stratified case–crossover design with conditional quasi-Poisson regression, the study estimated the percentage changes in stroke morbidity associated with short-term exposure to nitrogen dioxide (NO₂), sulfur dioxide (SO₂), particulate matter less than 10 mm in aerodynamic diameter (PM10), carbon monoxide (CO), and ozone (O₃). A five-day moving average of air pollution was applied to capture the cumulative effects of air pollution. The estimates were further stratified by sex, age, education level, and season. The additive and multiplicative interaction between air pollutants and meteorologic variables were assessed by the relative excess risk due to interaction (RERI) and adding the interactive term into the main model, respectively. The study found that NO₂ was positively associated with ischemic stroke occurrence throughout the year and in the cold season (November through April), with a stronger effect observed among men. Each 10 μg/m³ increment in the five-day moving average of NO₂ was associated with a 2.38% (95% confidence interval was 1.36% to 3.41%) increase in the risk of ischemic stroke over the whole year and a 3.36% (2.04% to 4.69%) increase in the cold season. The harmful effect of CO on ischemic stroke was observed only in the cold season, with each 1 mg/m³ increment in the five-day moving average of CO increasing the risk by 12.34% (3.85% to 21.51%). There was no statistically significant additive interaction between individual air pollutants and temperature or relative humidity, as demonstrated by the RERI. The interaction term in the model showed a multiplicative antagonistic effect between NO₂ and temperature (p-value=0.0268). For hemorrhagic stroke, no evidence of the effects of any individual air pollutants was found in the whole population. However, the RERI indicated a statistically additive and multiplicative interaction of temperature on the effects of PM10 and O₃ on hemorrhagic stroke onset. Therefore, the insignificant conclusion should be interpreted with caution. The study suggests that environmental NO₂ and CO might increase the morbidity of ischemic stroke, particularly during the cold season. These findings could help inform policy decisions aimed at reducing air pollution levels to prevent stroke and other health conditions. Additionally, the study provides valuable insights into the interaction between air pollution and meteorological variables, which underscores the need for further research into the complex relationship between environmental factors and health.

Keywords: air pollution, meteorological variables, interactive effect, seasonal pattern, stroke

Procedia PDF Downloads 88

Authors: Mohammad Moezzibadi, Isabelle Charpentier, Adrien Wanko, Robert Mosé

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The calibration of hydrodynamic parameters for subsurface constructed wetlands (CWs) is a sensitive process since highly non-linear equations are involved in unsaturated flow modeling. CW systems are engineered systems designed to favour natural treatment processes involving wetland vegetation, soil, and their microbial flora. Their significant efficiency at reducing the ecological impact of urban runoff has been recently proved in the field. Numerical flow modeling in a vertical variably saturated CW is here carried out by implementing the Richards model by means of a mixed hybrid finite element method (MHFEM), particularly well adapted to the simulation of heterogeneous media, and the van Genuchten-Mualem parametrization. For validation purposes, MHFEM results were compared to those of HYDRUS (a software based on a finite element discretization). As van Genuchten-Mualem soil hydrodynamic parameters depend on water content, their estimation is subject to considerable experimental and numerical studies. In particular, the sensitivity analysis performed with respect to the van Genuchten-Mualem parameters reveals a predominant influence of the shape parameters α, n and the saturated conductivity of the filter on the piezometric heads, during saturation and desaturation. Modeling issues arise when the soil reaches oven-dry conditions. A particular attention should also be brought to boundary condition modeling (surface ponding or evaporation) to be able to tackle different sequences of rainfall-runoff events. For proper parameter identification, large field datasets would be needed. As these are usually not available, notably due to the randomness of the storm events, we thus propose a simple, robust and low-cost numerical method for the inverse modeling of the soil hydrodynamic properties. Among the methods, the variational data assimilation technique introduced by Le Dimet and Talagrand is applied. To that end, a variational data assimilation technique is implemented by applying automatic differentiation (AD) to augment computer codes with derivative computations. Note that very little effort is needed to obtain the differentiated code using the on-line Tapenade AD engine. Field data are collected for a three-layered CW located in Strasbourg (Alsace, France) at the water edge of the urban water stream Ostwaldergraben, during several months. Identification experiments are conducted by comparing measured and computed piezometric head by means of the least square objective function. The temporal variability of hydrodynamic parameter is then assessed and analyzed.

Keywords: automatic differentiation, constructed wetland, inverse method, mixed hybrid FEM, sensitivity analysis

Procedia PDF Downloads 164

Authors: Luphumlo Ncanywa, Paul Watts

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Malaria is a disease that kills approximately one million people annually. Children and pregnant women in sub-Saharan Africa lost their lives due to malaria. Malaria continues to be one of the major causes of death, especially in poor countries in Africa. Decrease the burden of malaria and save lives is very essential. There is a major concern about malaria parasites being able to develop resistance towards antimalarial drugs. People are still dying due to lack of medicine affordability in less well-off countries in the world. If more people could receive treatment by reducing the cost of drugs, the number of deaths in Africa could be massively reduced. There is a shortage of pharmaceutical manufacturing capability within many of the countries in Africa. However one has to question how Africa would actually manufacture drugs, active pharmaceutical ingredients or medicines developed within these research programs. It is quite likely that such manufacturing would be outsourced overseas, hence increasing the cost of production and potentially limiting the full benefit of the original research. As a result the last few years has seen major interest in developing more effective and cheaper technology for manufacturing generic pharmaceutical products. Micro-reactor technology (MRT) is an emerging technique that enables those working in research and development to rapidly screen reactions utilizing continuous flow, leading to the identification of reaction conditions that are suitable for usage at a production level. This emerging technique will be used to develop antimalarial drugs. It is this system flexibility that has the potential to reduce both the time was taken and risk associated with transferring reaction methodology from research to production. Using an approach referred to as scale-out or numbering up, a reaction is first optimized within the laboratory using a single micro-reactor, and in order to increase production volume, the number of reactors employed is simply increased. The overall aim of this research project is to develop and optimize synthetic process of antimalarial drugs in the continuous processing. This will provide a step change in pharmaceutical manufacturing technology that will increase the availability and affordability of antimalarial drugs on a worldwide scale, with a particular emphasis on Africa in the first instance. The research will determine the best chemistry and technology to define the lowest cost manufacturing route to pharmaceutical products. We are currently developing a method to synthesize Lumefantrine in continuous flow using batch process as bench mark. Lumefantrine is a dichlorobenzylidine derivative effective for the treatment of various types of malaria. Lumefantrine is an antimalarial drug used with artemether for the treatment of uncomplicated malaria. The results obtained when synthesizing Lumefantrine in a batch process are transferred into a continuous flow process in order to develop an even better and reproducible process. Therefore, development of an appropriate synthetic route for Lumefantrine is significant in pharmaceutical industry. Consequently, if better (and cheaper) manufacturing routes to antimalarial drugs could be developed and implemented where needed, it is far more likely to enable antimalarial drugs to be available to those in need.

Keywords: antimalarial, flow, lumefantrine, synthesis

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Authors: Gasto Lyakurwa, Glory Bakari, Edwin Sabuhoro

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Wildlife Management Areas (WMAs) are established to promote and act as a remedy to the protection of wildlife resources outside the core protected area. WMAs aim to address issues of poverty, ensure sustainable use of wildlife resources, and share benefits from wildlife with the member villages. Successfully managed WMA in Tanzania improves local livelihood and conserves local biodiversity through tourism revenues and the protection of wildlife, respectively. Benefits accrued at household levels as a result of conservation activities in WMA can positively influence attitudes towards wildlife conservation. This research intends to assess the positive socio-economic impacts of WMA benefits on households in Burunge WMA in Tanzania. A questionnaire survey was conducted among four randomly selected villages in the ten villages forming the Burunge WMA to explore the household-level benefits of conservation activities. An example of a question item was whether household heads feel that they are benefiting from WMA and if they could remember some of the benefits. Interviews with leaders from WMA and member villages combined the survey to capture aspects of benefit distribution to households. A total of 80 households were used as samples of the recruited study sites. Moreover, the four WMA leaders and the eight village leaders of the respective study villages were interviewed. The study findings revealed that the shared benefit has mostly reached the community level and is less likely to reach the household level. Economic activities such as agriculture and livestock keeping were found to be more important for households than conservation-related economic activities. Conservation-related economic activities generate marginal direct benefits from WMA benefits to households, with ecotourism accounting for only 19.5%. The study also indicates that a direct share of financial benefits from WMA to households is lacking. Wildlife conservation benefits are less likely to reach household levels in WMAs, with the implication of reducing people's conservation attitudes and impeding community conservation success. WMA can utilize the finances from tourism fees and concessions to establish a Community Considerations Bank, which can lend money to some individuals at no or low interest rates. Considering the importance of education and health to households, WMA stands in a good position to provide health insurance premiums and student scholarships to motivate household participation in conservation activities. Community-based organizations and governments responsible for wildlife conservation should create mechanisms to channel conservation benefits to households in order to ensure the achievement of wildlife conservation objectives through WMA. These findings are expected to contribute to forming more WMAs with enhanced mechanisms for sharing conservation benefits to benefit the conservation of natural resources outside of the core protected areas. Motivated households are expected to respect wildlife and are less likely to engage in illegal activities such as poaching and harvesting conserved natural resources while coexisting with wildlife.

Keywords: social economic benefits, individuals, wildlife management areas, biodiversity, community

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Authors: Ayesha Anjum, Arbaz Basha

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Active Galactic Nuclei (AGN) are the actively accreting centers of the galaxies that host supermassive black holes. AGN emits radiation in all wavelengths and also shows variability across all the wavelength bands. The analysis of flux variability tells us about the morphology of the site of emission radiation. Some of the major classifications of AGN are (a) Blazars, with featureless spectra. They are subclassified as BLLacertae objects, Flat Spectrum Radio Quasars (FSRQs), and others; (b) Seyferts with prominent emission line features are classified into Broad Line, Narrow Line Seyferts of Type 1 and Type 2 (c) quasars, and other types. Sloan Digital Sky Survey (SDSS) is an optical telescope based in Mexico that has observed and classified billions of objects based on automated photometric and spectroscopic methods. A sample of blazars is obtained from the third Fermi catalog. For variability analysis, we searched for light curves for these objects in Wide-Field Infrared Survey Explorer (WISE) and Near Earth Orbit WISE (NEOWISE) in two bands: W1 (3.4 microns) and W2 (4.6 microns), reducing the final sample to 256 objects. These objects are also classified into 155 BLLacs, 99 FSRQs, and 2 Narrow Line Seyferts, namely, PMNJ0948+0022 and PKS1502+036. Mid-infrared variability studies of these objects would be a contribution to the literature. With this as motivation, the present work is focused on studying a final sample of 256 objects in general and the Seyferts in particular. Owing to the fact that the classification is automated, SDSS has miclassified these objects into quasars, galaxies, and stars. Reasons for the misclassification are explained in this work. The variability analysis of these objects is done using the method of flux amplitude variability and excess variance. The sample consists of observations in both W1 and W2 bands. PMN J0948+0022 is observed between MJD from 57154.79 to 58810.57. PKS 1502+036 is observed between MJD from 57232.42 to 58517.11, which amounts to a period of over six years. The data is divided into different epochs spanning not more than 1.2 days. In all the epochs, the sources are found to be variable in both W1 and W2 bands. This confirms that the object is variable in mid-infrared wavebands in both long and short timescales. Also, the sources are observed for color variability. Objects either show a bluer when brighter trend (BWB) or a redder when brighter trend (RWB). The possible claim for the object to be BWB (present objects) is that the longer wavelength radiation emitted by the source can be suppressed by the high-energy radiation from the central source. Another result is that the smallest radius of the emission source is one day since the epoch span used in this work is one day. The mass of the black holes at the centers of these sources is found to be less than or equal to 108 solar masses, respectively.

Keywords: active galaxies, variability, Seyfert galaxies, SDSS, WISE

Procedia PDF Downloads 129

Authors: Sibghat Mansoor Rana, Muhammad Islam, Hamid Saeed, Hummera Rafique, Muhammad Majid, Muhammad Tahir Aqeel, Fariha Imtiaz, Zaman Ashraf

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The 1,3,4-oxadiazole derivatives Ox-6a-f have been synthesized by incorporating flur- biprofen moiety with the aim to explore the potential of target molecules to decrease the oxidative stress. The title compounds Ox-6a-f were prepared by simple reactions in which a flurbiprofen –COOH group was esterified with methanol in an acid-catalyzed medium, which was then reacted with hydrazine to afford the corresponding hydrazide. The acid hydrazide was then cyclized into 1,3,4-oxadiazole-2-thiol by reacting with CS2 in the presence of KOH. The title compounds Ox-6a-f were synthesized by the reaction of an –SH group with various alkyl/aryl chlorides, which involves an S-alkylation reaction. The structures of the synthesized Ox-6a-f derivatives were ascer- tained by spectroscopic data. The in silico molecular docking was performed against target proteins cyclooxygenase-2 COX-2 (PDBID 5KIR) and cyclooxygenase-1 COX-1 (PDBID 6Y3C) to determine the binding affinity of the synthesized compounds with these structures. It has been inferred that most of the synthesized compounds bind well with an active binding site of 5KIR compared to 6Y3C, and especially compound Ox-6f showed excellent binding affinity (7.70 kcal/mol) among all synthesized compounds Ox-6a-f. The molecular dynamic (MD) simulation has also been performed to check the stability of docking complexes of ligands with COX-2 by determining their root mean square deviation and root mean square fluctuation. Little fluctuation was observed in case of Ox-6f, which forms the most stable complex with COX-2. The comprehensive antioxidant potential of the synthesized compounds has been evaluated by determining their free radical scavenging activity, including DPPH, OH, nitric oxide (NO), and iron chelation assay. The derivative Ox-6f showed promising results with 80.23% radical scavenging potential at a dose of 100 μg/mL while ascorbic acid exhibited 87.72% inhibition at the same dose. The anti-inflammatory activity of the final products has also been performed, and inflammatory markers were assayed, such as a thiobarbituric acid-reducing substance, nitric oxide, interleukin-6 (IL-6), and COX-2. The derivatives Ox-6d and Ox-6f displayed higher anti-inflammatory activity, exhibiting 70.56% and 74.16% activity, respectively. The results were compared with standard ibuprofen, which showed 84.31% activity at the same dose, 200 μg/mL. The anti-inflammatory potential has been performed by following the carrageen-induced hind paw edema model, and results showed that derivative Ox-6f exhibited 79.83% reduction in edema volume compared to standard ibuprofen, which reduced 84.31% edema volume. As dry lab and wet lab results confirm each other, it has been deduced that derivative Ox-6f may serve as the lead structure to design potent compounds to address oxidative stress.

Keywords: synthetic chemistry, pharmaceutical chemistry, oxadiazole derivatives, anti-inflammatory, anti-cancer compounds

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Authors: Yoshino Murakami, Takeshi Hashimoto, Steve Cole

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The autonomic nervous system (ANS), particularly the sympathetic (SNS) and parasympathetic (PNS) branches, plays a vital role in modulating immune function and physiological homeostasis. In recent years, the Conserved Transcriptional Response to Adversity (CTRA) has emerged as a key marker of the body's response to chronic stress. This gene expression profile is characterized by SNS-mediated upregulation of pro-inflammatory genes (such as IL1B and TNF) and downregulation of antiviral response genes (e.g., IFI and MX families). CTRA has been observed in individuals exposed to prolonged stressors like loneliness, social isolation, and bereavement. Some research suggests that PNS activity, as indicated by heart rate variability (HRV), may help counteract the CTRA. However, previous PNS-CTRA studies have focused on Western populations, raising questions about the generalizability of these findings across different cultural and ethnic backgrounds. This study aimed to examine the relationship between HRV and CTRA gene expression in young, healthy adults in Japan. We hypothesized that HRV would be inversely related to CTRA gene expression, similar to patterns observed in previous Western studies. A total of 49 participants aged 20 to 39 were recruited, and after data exclusions, 26 participants' HRV and CTRA data were analyzed. HRV was measured using an electrocardiogram (ECG), and two time-domain indices were utilized: the root mean square of successive differences (RMSSD) and the standard deviation of NN intervals (SDNN). Blood samples were collected for gene expression analysis, focusing on a standard set of 47 CTRA indicator gene transcripts. it findings revealed a significant inverse relationship between HRV and CTRA gene expression, with higher HRV correlating with reduced pro-inflammatory gene activity and increased antiviral response. These results are consistent with findings from Western populations and demonstrate that the relationship between ANS function and immune response generalizes to an East Asian population. The study highlights the importance of HRV as a biomarker for psychophysiological health, reflecting the body's ability to buffer stress and maintain immune balance. These findings have implications for understanding how physiological systems interact across different cultures and ethnicities. Given the influence of chronic stress in promoting inflammation and disease risk, interventions aimed at improving HRV, such as mindfulness-based practices or physical exercise, could provide significant health benefits. Future research should focus on larger sample sizes and experimental interventions to better understand the causal pathways linking HRV to CTRA gene expression, and determine whether improving HRV may help mitigate the harmful effects of stress on health by reducing inflammation.

Keywords: autonomic nervous activity, neuroendocrine system, inflammation, Japan

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Authors: Ming-Chan Chung, Wen-Ming Huang, Yi-Chu Liu, Li-Hui Yang, Ming-Jyh Chen

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introduction: Hospital buildings require considerable energy, including air conditioning, lighting, elevators, heating, and medical equipment. Energy consumption in hospitals is expected to increase significantly due to innovative equipment and continuous development plans. Consequently, the environment and climate will be adversely affected. Hospitals should therefore consider transforming from their traditional role of saving lives to being at the forefront of global efforts to reduce carbon dioxide emissions. As healthcare providers, it is our responsibility to provide a high-quality environment while using as little energy as possible. Purpose / Methods: Compare the energy-saving benefits of solar photovoltaic systems and solar hot water systems. The proportion of electricity consumption effectively reduced after the installation of solar photovoltaic systems. To comprehensively assess the potential benefits of utilizing solar energy for both photovoltaic (PV) and solar thermal applications in hospitals, a solar PV system was installed covering a total area of 28.95 square meters in 2021. Approval was obtained from the Taiwan Power Company to integrate the system into the hospital's electrical infrastructure for self-use. To measure the performance of the system, a dedicated meter was installed to track monthly power generation, which was then converted into area output using an electric energy conversion factor. This research aims to compare the energy efficiency of solar PV systems and solar thermal systems. Results: Using the conversion formula between electrical and thermal energy, we can compare the energy output of solar heating systems and solar photovoltaic systems. The comparative study draws upon data from February 2021 to February 2023, wherein the solar heating system generated an average of 2.54 kWh of energy per panel per day, while the solar photovoltaic system produced 1.17 kWh of energy per panel per day, resulting in a difference of approximately 2.17 times between the two systems. Conclusions: After conducting statistical analysis and comparisons, it was found that solar thermal heating systems offer higher energy and greater benefits than solar photovoltaic systems. Furthermore, an examination of literature data and simulations of the energy and economic benefits of solar thermal water systems and solar-assisted heat pump systems revealed that solar thermal water systems have higher energy density values, shorter recovery periods, and lower power consumption than solar-assisted heat pump systems. Through monitoring and empirical research in this study, it has been concluded that a heat pump-assisted solar thermal water system represents a relatively superior energy-saving and carbon-reducing solution for medical institutions. Not only can this system help reduce overall electricity consumption and the use of fossil fuels, but it can also provide more effective heating solutions.

Keywords: sustainable development, energy conservation, carbon reduction, renewable energy, heat pump system

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Authors: Mozamil Mohamed Ali

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Understanding the relationship between law and democratic governance, this research, titled “The Role of Law in Enhancing Democratic Governance: A Comparative Study of Political Systems in Developing Countries,” focuses on examining the impact of legal frameworks on strengthening democratic practices within developing nations. Democratic governance requires transparency and institutional accountability to meet citizens’ needs, which necessitates legal frameworks that ensure compliance with governance standards. These frameworks hold greater significance in developing countries, where challenges such as corruption, weak public institutions, and socio-political conflicts affect their ability to achieve sustainable democratic governance. In this context, the research explores how laws influence these aspects. The study compares various developing countries that have experienced different levels of success and difficulty in enhancing democratic governance, focusing on the legal frameworks and public policies each country has implemented to improve transparency, accountability, and strengthen the role of public institutions. This comparative analysis aims to reveal the effectiveness of legal systems in supporting democratic governance and to identify the factors that lead to the success or failure of these legal frameworks in different contexts. For example, the study includes cases from countries in Asia, Africa, and Latin America, analyzing the legal and institutional policies and their roles in achieving justice and reducing corruption. It examines the impact of legislation that promotes freedom of the press, human rights, and judicial independence as fundamental elements for transparent and democratic governance. Additionally, the research discusses how anti-corruption policies and laws governing electoral competition contribute to improving government responsiveness to public demands. The hypothesis of the research centers on the idea that developing transparent and fair laws contributes to achieving sustainable democratic governance. The analyses show that applying laws equally and impartially strengthens citizens’ trust in public institutions and encourages political participation. At the same time, the research highlights the importance of local adaptation to global legal frameworks, as it may be necessary to consider local socio-political and economic contexts to ensure the success of these frameworks. In conclusion, this research underscores the importance of legal frameworks as a pivotal factor in the success of democratic governance. It provides recommendations related to enhancing judicial independence, enforcing anti-corruption laws, and improving access to information as essential steps for strengthening democratic governance in developing countries. The findings suggest that laws respected and carefully implemented can form a solid foundation for building more transparent and effective government institutions, contributing to sustainable development and social justice in these nations.

Keywords: impact of legislation, role of institutions in controlling power, community participation, role of the judiciary

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Authors: Tomohiko Utsuki, Kyoka Sato

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In emergency medicine, it is recognized that brain resuscitation is very important for the reduction of mortality rate and neurological sequelae. Especially, the control of brain temperature (BT), intracranial pressure (ICP), and cerebral blood flow (CBF) are most required for stabilizing brain’s physiological state in the treatment for such as brain injury, stroke, and encephalopathy. However, the manual control of BT, ICP, and CBF frequently requires the decision and operation of medical staff, relevant to medication and the setting of therapeutic apparatus. Thus, the integration and the automation of the control of those is very effective for not only improving therapeutic effect but also reducing staff burden and medical cost. For realizing such integration and automation, a mathematical model of brain physiological state is necessary as the controlled object in simulations, because the performance test of a prototype of the control system using patients is not ethically allowed. A model of cerebral blood circulation has already been constructed, which is the most basic part of brain physiological state. Also, a migration model of extracellular fluid in brain has been constructed, however the condition that the total volume of intracranial cavity is almost changeless due to the hardness of cranial bone has not been considered in that model. Therefore, in this research, the dynamic migration model of extracellular fluid in brain was constructed on the consideration of the changelessness of intracranial cavity’s total volume. This model is connectable to the cerebral blood circulation model. The constructed model consists of fourteen compartments, twelve of which corresponds to perfused area of bilateral anterior, middle and posterior cerebral arteries, the others corresponds to cerebral ventricles and subarachnoid space. This model enable to calculate the migration of tissue fluid from capillaries to gray matter and white matter, the flow of tissue fluid between compartments, the production and absorption of cerebrospinal fluid at choroid plexus and arachnoid granulation, and the production of metabolic water. Further, the volume, the colloid concentration, and the tissue pressure of/in each compartment are also calculable by solving 40-dimensional non-linear simultaneous differential equations. In this research, the obtained model was analyzed for its validation under the four condition of a normal adult, an adult with higher cerebral capillary pressure, an adult with lower cerebral capillary pressure, and an adult with lower colloid concentration in cerebral capillary. In the result, calculated fluid flow, tissue volume, colloid concentration, and tissue pressure were all converged to suitable value for the set condition within 60 minutes at a maximum. Also, because these results were not conflict with prior knowledge, it is certain that the model can enough represent physiological state of brain under such limited conditions at least. One of next challenges is to integrate this model and the already constructed cerebral blood circulation model. This modification enable to simulate CBF and ICP more precisely due to calculating the effect of blood pressure change to extracellular fluid migration and that of ICP change to CBF.

Keywords: dynamic model, cerebral extracellular migration, brain resuscitation, automatic control

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Authors: Benedict Ofori, Kwabena Sarpong, Stephen Antwi

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Background: Medicinal plants are utilized all around the world and are becoming increasingly important economically. The WHO notes that ‘inappropriate use of traditional medicines or practices can have negative or dangerous effects and that future research is needed to ascertain the efficacy and safety of such practices and medicinal plants used by traditional medicine systems. The poor around the world have limited access to palliative care or pain relief. Pharmacologists have been focused on developing safe and effective anti-inflammatory drugs. Most of the issues related to their use have been linked to the fact that numerous traditional and herbal treatments are classified in different nations as meals or dietary supplements. As a result, there is no need for evidence of the quality, efficacy, or safety of these herbal formulations before they are marketed. The fact that access to drugs meant for pain relief is limited in low-income countries means advanced studies should be done on home drugs meant for inflammation to close the gap. Methods: The ethanolic extracts of the plant were screened for the presence of 10 phytochemicals. The Pierce BCA Protein Assay Kit was used for the determination of the protein concentration of the egg white. The rats were randomly selected and put in 6 groups. The egg white was sub-plantar injected into the right-hand paws of the rats to induce inflammation. The animals were treated with the three plant extracts obtained from the root bark, stem, and leaves of the plant. The control groups were treated with normal saline, while the standard groups were treated with standard drugs indomethacin and celecoxib. Plethysmometer was used to measure the change in paw volume of the animals over the course of the experiment. Results: The results of the phytochemical screening revealed the presence of reducing sugars and saponins. Alkaloids were present in only R.L.S (1:1:1), and phytosterols were found in R.L(1:1) and R.L.S (1:1:1). The estimated protein concentration was found to be 103.75 mg/ml. The control group had an observable increase in paw volume, which indicated that inflammation was induced during the 5 hours. The increase in paw volume for the control group peaked at the 1st hour and decreased gradually throughout the experiment, with minimal changes in the paw volumes. The 2nd and 3rd groups were treated with 20 mg/kg of indomethacin and celecoxib. The anti-inflammatory activities of indomethacin and celecoxib were calculated to be 21.4% and 4.28%, respectively. The remaining 3 groups were treated with 2 dose levels of 200mg/kg plant extracts. R.L.S, R.L, and S.R.L had anti-inflammatory activities of 22.3%, 8.2%, and 12.07%, respectively. Conclusions: Egg albumin-induced paw model in rats can be used to evaluate the anti-inflammatory activity of herbs that might have potential anti-inflammatory activity. Herbal medications have potential anti-inflammatory activities and can be used to manage various inflammatory conditions if their efficacy and side effects are well studied. The three extracts all possessed anti-inflammatory activity, with R.L.S having the highest anti-inflammatory activity.

Keywords: inflammation, capparis erythrocarpos, anti-inflammatory activity, herbal medicine, paw volume, egg albumin

Procedia PDF Downloads 89

Authors: Anthony Nyamekeh-Armah Adjei, Toshiaki Aoki

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The unreliable and poor efficiency of electricity distribution leading to frequent power outages and high losses are the major challenge facing the power distribution sector in Ghana. Distribution system routes electricity from the power generating station at a higher voltage through the transmission grid and steps it down through the low voltage lines to end users. Approximately all electricity problems and disturbances that have increased the call for renewable and sustainable energy in recent years have their roots in the distribution system. Therefore, sustaining electricity distribution efficiency can potentially contribute to the reserve of natural energy resources use in power generation, reducing greenhouse gas emission (GHG), decreasing tariffs for consumers and effective human security. Human Security is a people-centered approach where individual human being is the principal object of concern, focuses on protecting the vital core of all human lives in ways for meeting basic needs that enhance the safety and protection of individuals and communities. The vulnerability is the diminished capacity of an individual or group to anticipate, resist and recover from the effect of natural, human-induced disaster. The research objectives are to explore the causes of frequent power outages to consumers, high losses in the distribution network and the effect of poor electricity distribution efficiency on the vulnerable (poor and ordinary) people that mostly depend on electricity for their daily activities or life to survive. The importance of the study is that in a developing country like Ghana where raising a capital for new infrastructure project is difficult, it would be beneficial to enhance the efficiency that will significantly minimize the high energy losses, reduce power outage, to ensure safe and reliable delivery of electric power to consumers to secure the security of people’s livelihood. The methodology used in this study is both interview and questionnaire survey to analyze the response from the respondents on causes of power outages and high losses facing the electricity company of Ghana (ECG) and its effect on the livelihood on the vulnerable people. Among the outcome of both administered questionnaire and the interview survey from the field were; poor maintenance of existing sub-stations, use of aging equipment, use of poor distribution infrastructure and poor metering and billing system. The main observation of this paper is that the poor network efficiency (high losses and power outages) affects the livelihood of the vulnerable people. Therefore, the paper recommends that policymakers should insist on all regulation guiding electricity distribution to improve system efficiency. In conclusion, there should be decentralization of off-grid solar PV technologies to provide a sustainable and cost-effective, which can increase daily productivity and improve the quality of life of the vulnerable people in the rural communities.

Keywords: electricity efficiency, high losses, human security, power outage

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Authors: Giacoma Pace

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The research seeks to evaluate whether students with impairments can achieve enhanced academic progress by actively engaging in collaborative problem-solving activities with teachers and peers, to overcome the obstacles rooted in socio-economic disparities. Furthermore, the research underscores the significance of fostering students' self-awareness regarding their learning process and encourages teachers to adopt a more interactive teaching approach. The research also posits that reducing conventional face-to-face lessons can motivate students to explore alternative learning methods, such as collaborative teamwork and peer education within the classroom. To address socio-cultural barriers it is imperative to assess their internet access and possession of technological devices, as these factors can contribute to a digital divide. The research features a case study of a Flipped Classroom Learning Unit, administered to six third-year high school classes: Scientific Lyceum, Technical School, and Vocational School, within the city of Turin, Italy. Data are about teachers and the students involved in the case study, some impaired students in each class, level of entry, students’ performance and attitude before using Flipped Classrooms, level of motivation, family’s involvement level, teachers’ attitude towards Flipped Classroom, goal obtained, the pros and cons of such activities, technology availability. The selected schools were contacted; meetings for the English teachers to gather information about their attitude and knowledge of the Flipped Classroom approach. Questionnaires to teachers and IT staff were administered. The information gathered, was used to outline the profile of the subjects involved in the study and was further compared with the second step of the study made up of a study conducted with the classes of the selected schools. The learning unit is the same, structure and content are decided together with the English colleagues of the classes involved. The pacing and content are matched in every lesson and all the classes participate in the same labs, use the same materials, homework, same assessment by summative and formative testing. Each step follows a precise scheme, in order to be as reliable as possible. The outcome of the case study will be statistically organised. The case study is accompanied by a study on the literature concerning EFL approaches and the Flipped Classroom. Document analysis method was employed, i.e. a qualitative research method in which printed and/or electronic documents containing information about the research subject are reviewed and evaluated with a systematic procedure. Articles in the Web of Science Core Collection, Education Resources Information Center (ERIC), Scopus and Science Direct databases were searched in order to determine the documents to be examined (years considered 2000-2022).

Keywords: flipped classroom, impaired, inclusivity, peer instruction

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Authors: Sundaram Chandrasekaran, Seung Hyun Hur

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Exploring strategies for oxygen vacancy engineering under mild conditions and understanding the relationship between dislocations and photoelectrochemical (PEC) cell performance are challenging issues for designing high performance PEC devices. Therefore, it is very important to understand that how the oxygen vacancies (VO) or other defect states affect the performance of the photocatalyst in photoelectric transfer. So far, it has been found that defects in nano or micro crystals can have two possible significances on the PEC performance. Firstly, an electron-hole pair produced at the interface of photoelectrode and electrolyte can recombine at the defect centers under illumination of light, thereby reducing the PEC performances. On the other hand, the defects could lead to a higher light absorption in the longer wavelength region and may act as energy centers for the water splitting reaction that can improve the PEC performances. Even if the dislocation growth of ZnO has been verified by the full density functional theory (DFT) calculations and local density approximation calculations (LDA), it requires further studies to correlate the structures of ZnO and PEC performances. Exploring the hybrid structures composed of graphene oxide (GO) and ZnO nanostructures offer not only the vision of how the complex structure form from a simple starting materials but also the tools to improve PEC performances by understanding the underlying mechanisms of mutual interactions. As there are few studies for the ZnO growth with other materials and the growth mechanism in those cases has not been clearly explored yet, it is very important to understand the fundamental growth process of nanomaterials with the specific materials, so that rational and controllable syntheses of efficient ZnO-based hybrid materials can be designed to prepare nanostructures that can exhibit significant PEC performances. Herein, we fabricated various ZnO nanostructures such as hollow sphere, bucky bowl, nanorod and triangle, investigated their pH dependent growth mechanism, and correlated the PEC performances with them. Especially, the origin of well-controlled dislocation-driven growth and its transformation mechanism of ZnO nanorods to triangles on the GO surface were discussed in detail. Surprisingly, the addition of GO during the synthesis process not only tunes the morphology of ZnO nanocrystals and also creates more oxygen vacancies (oxygen defects) in the lattice of ZnO, which obviously suggest that the oxygen vacancies be created by the redox reaction between GO and ZnO in which the surface oxygen is extracted from the surface of ZnO by the functional groups of GO. On the basis of our experimental and theoretical analysis, the detailed mechanism for the formation of specific structural shapes and oxygen vacancies via dislocation, and its impact in PEC performances are explored. In water splitting performance, the maximum photocurrent density of GO-ZnO triangles was 1.517mA/cm-2 (under UV light ~ 360 nm) vs. RHE with high incident photon to current conversion Efficiency (IPCE) of 10.41%, which is the highest among all samples fabricated in this study and also one of the highest IPCE reported so far obtained from GO-ZnO triangular shaped photocatalyst.

Keywords: dislocation driven growth, zinc oxide, graphene oxide, water splitting

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Authors: Soumyadeep Bhaduri, Rahul Ghosh, Rahul Shukla, Manaswini Behera

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The textile industry consumes a substantial amount of water throughout the processing and production of textile fabrics. The water eventually turns into wastewater, where it acts as an immense damaging nuisance due to its dye content. Wastewater streams contain a percentage ranging from 2.0% to 50.0% of the total weight of dye used, depending on the dye class. The management of dye effluent in textile industries presents a formidable challenge to global sustainability. The current focus is on implementing wastewater treatment technology that enable the recycling of wastewater, reduce energy usage and offset carbon emissions. Microbial fuel cell (MFC) is a device that utilizes microorganisms as a bio-catalyst to effectively treat wastewater while also producing electricity. The MFC harnesses the chemical energy present in wastewater by oxidizing organic compounds in the anodic chamber and reducing an electron acceptor in the cathodic chamber, thereby generating electricity. This research investigates the potential of MFCs to tackle this challenge of azo dye removal with simultaneously generating electricity. Although MFCs are well-established for wastewater treatment, their application in dye decolorization with concurrent electricity generation remains relatively unexplored. This study aims to address this gap by assessing the effectiveness of MFCs as a sustainable solution for treating wastewater containing azo dyes. By harnessing microorganisms as biocatalysts, MFCs offer a promising avenue for environmentally friendly dye effluent management. The performance of MFCs in treating azo dyes and generating electricity was evaluated by optimizing the Chemical Oxygen Demand (COD) and Hydraulic Retention Time (HRT) of influent. COD and HRT values ranged from 1600 mg/L to 2400 mg/L and 5 to 9 days, respectively. Results showed that the maximum open circuit voltage (OCV) reached 648 mV at a COD of 2400 mg/L and HRT of 5 days. Additionally, maximum COD removal of 98% and maximum color removal of 98.91% were achieved at a COD of 1600 mg/L and HRT of 9 days. Furthermore, the study observed a maximum power density of 19.95 W/m3 at a COD of 2400 mg/L and HRT of 5 days. Electrochemical analysis, including linear sweep voltammetry (LSV), cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS) were done to find out the response current and internal resistance of the system. To optimize pH and dye concentration, pH values were varied from 4 to 10, and dye concentrations ranged from 25 mg/L to 175 mg/L. The highest voltage output of 704 mV was recorded at pH 7, while a dye concentration of 100 mg/L yielded the maximum output of 672 mV. This study demonstrates that MFCs offer an efficient and sustainable solution for treating azo dyes in textile industry wastewater, while concurrently generating electricity. These findings suggest the potential of MFCs to contribute to environmental remediation and sustainable development efforts on a global scale.

Keywords: textile wastewater treatment, microbial fuel cell, renewable energy, sustainable wastewater treatment

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Authors: Nutthan Inkhong, Sutthiphong Ruangchante

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Chiang Rai province is located at the northern border of Thailand. Most of the geography there is the northern continental highlands, and the population has many types of inhabitants, including Thai people, immigrants and ethnic groups such as Akha, Lahu, Lisu, Yao, etc. Most of these ethnic groups migrated from neighbouring countries such as Myanmar, Laos, China, etc. and settled in the mountains. Each ethnic group has their unique traditions, culture, and ways of life, including the musical culture that the ancestors of each ethnic group brought with them. In the present, the Akha have the largest population in the region and still live together in numerous villages in many districts. Thus, Akha musical culture still appears in the community traditions and cultural events of Chiang Rai province regularly. This article presents the situations of Akha musical culture in the present and the predictions for the future. The study method involves the analysis of music information and the related social contexts, which were collected from the fieldwork of ethnomusicological methodology by in-depth interviews, observations, audio and visual recordings, and related documents. The results found that the important persons who are related with Akha musical culture include (1) a musical instrument maker (lives in Mae Chan district) who produces various Akha musical instruments, including gourd mouth organs, Akha drums, two-way flutes, three-hole flutes, Jew’s harps (the sound of teenage love), buffalo horns (the sound symbol of hunting) and bird call instruments (the imitation of bird sounds), (2) a folk philosopher (lives in Mae Pha Luang district) who can teach music to the new generation of Akha people as well as lecture and demonstrate music to academics and tourists, and (3) a community leader (lives in Mae Chan district) who conserves Akha performances, singing and music through various activities of the students in an informal school. Because of the changes to the social contexts and ways of life of the Akha people, such as the educational system, religion, social media, etc., including the popularity of both Thai and international popular music among the new generation of Akha people, changes to and the fading away of Akha musical culture in the future may likely occur. Therefore, the conservation and inheritance of Akha music is an issue that should be resolved quickly. This primary study leads to the next step of the ethnomusicological work and plays a part in preventing or reducing the problems impacting Akha musical culture survival by the recording of Akha music in all of its dimensions, such as producing musical instruments, playing musical instruments, analysis of tuning systems, recording Akha music as musical notation using symbols, researching related social contexts, etc. and the transcription of this information to create lessons that can be returned to the Akha community.

Keywords: Akha music, Chiang Rai, ethnic music in Thailand, ethnomusicology

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Authors: Ekaterina A. Savchenko, Elena N. Velichko, Evgenii T. Aksenov

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The development of pathological processes, such as cardiovascular and oncological diseases, are accompanied by changes in molecular parameters in cells, tissues, and serum. The study of the behavior of protein molecules in solutions is of primarily importance for diagnosis of such diseases. Various physical and chemical methods are used to study molecular systems. With the advent of the laser and advances in electronics, optical methods, such as scanning electron microscopy, sedimentation analysis, nephelometry, static and dynamic light scattering, have become the most universal, informative and accurate tools for estimating the parameters of nanoscale objects. The electrophoretic light scattering is the most effective technique. It has a high potential in the study of biological solutions and their properties. This technique allows one to investigate the processes of aggregation and dissociation of different macromolecules and obtain information on their shapes, sizes and molecular weights. Electrophoretic light scattering is an analytical method for registration of the motion of microscopic particles under the influence of an electric field by means of quasi-elastic light scattering in a homogeneous solution with a subsequent registration of the spectral or correlation characteristics of the light scattered from a moving object. We modified the technique by using the regime of total internal reflection with the aim of increasing its sensitivity and reducing the volume of the sample to be investigated, which opens the prospects of automating simultaneous multiparameter measurements. In addition, the method of total internal reflection allows one to study biological fluids on the level of single molecules, which also makes it possible to increase the sensitivity and the informativeness of the results because the data obtained from an individual molecule is not averaged over an ensemble, which is important in the study of bimolecular fluids. To our best knowledge the study of electrophoretic light scattering in the regime of total internal reflection is proposed for the first time, latex microspheres 1 μm in size were used as test objects. In this study, the total internal reflection regime was realized on a quartz prism where the free electrophoresis regime was set. A semiconductor laser with a wavelength of 655 nm was used as a radiation source, and the light scattering signal was registered by a pin-diode. Then the signal from a photodetector was transmitted to a digital oscilloscope and to a computer. The autocorrelation functions and the fast Fourier transform in the regime of Brownian motion and under the action of the field were calculated to obtain the parameters of the object investigated. The main result of the study was the dependence of the autocorrelation function on the concentration of microspheres and the applied field magnitude. The effect of heating became more pronounced with increasing sample concentrations and electric field. The results obtained in our study demonstrated the applicability of the method for the examination of liquid solutions, including biological fluids.

Keywords: light scattering, electrophoretic light scattering, electrophoresis, total internal reflection

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Authors: Oli Sophie Meredith, Jacquelyn Osborne, Sarah Verdon, Jane Frawley

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PROJECT OVERVIEW AND BACKGROUND: Over one million Australians are affected by ADHD at an economic and social cost of over $20 billion per annum. Despite health outcomes being significantly worse compared with men, women have historically been overlooked in ADHD diagnosis and treatment. While research suggests physical activity and other non-prescription options can help with ADHD symptoms, the frontline response to ADHD remains expensive stimulant medications that can have adverse side effects. By interviewing women with ADHD, this research will examine women’s self-directed approaches to managing symptoms, including alternatives to prescription medications. It will investigate barriers and affordances to potentially helpful approaches and identify any concerning strategies pursued in lieu of diagnosis. SIGNIFICANCE AND INNOVATION: Despite the economic and societal impact of ADHD on women, research investigating how women manage their symptoms is scant. This project is significant because although women’s ADHD symptoms are markedly different to those of men, mainstream treatment has been based on the experiences of men. Further, it is thought that in developing nuanced coping strategies, women may have masked their symptoms. Thus, this project will highlight strategies which women deem effective in ‘thriving’ rather than just ‘hiding’. By investigating the health service use, self-care and physical activity of women with ADHD, this research aligns with a priority research areas as identified by the November 2023 senate ADHD inquiry report. APPROACH AND METHODS: Semi-structured interviews will be conducted with up to 20 women with ADHD. Interviews will be conducted in person and online to capture experience across rural and metropolitan Australia. Participants will be recruited in partnership with the peak representative body, ADHD Australia. The research will use an intersectional framework, and data will be analysed thematically. This project is led by an interdisciplinary and cross-institutional team of women with ADHD. Reflexive interviewing skills will be employed to help interviewees feel more comfortable disclosing their experiences, especially where they share common ground ENGAGEMENT, IMPACT AND BENEFIT: This research will benefit women with ADHD by increasing knowledge of strategies and alternative treatments to prescription medications, reducing the social and economic burden of ADHD on Australia and on individuals. It will also benefit women by identifying risks involved with some self-directed approaches in lieu of medical advice. The project has an accessible impact plan to directly benefit end-users, which includes the development of a podcast and a PDF resource translating findings. The resources will reach a wide audience through ADHD Australia’s extensive national networks. We will collaborate with Charles Sturt’s Accessibility and Inclusion Division of Safety, Security and Well-being to create a targeted resource for students with ADHD.

Keywords: ADHD, women's health, self-directed strategies, health service use, physical activity, public health

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Authors: Shivakumar M, Leslie Edward S Lewis, Shashikala Devadiga, Sonia Khurana

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Introduction: Methylxanthines are used for the treatment of AOP, to facilitate extubation and as a prophylactic agent to prevent apnea. Though the popularity of Caffeine has risen, it is expensive in a resource constrained developing countries like India. Objective: To evaluate the cost-effectiveness of Caffeine compared with Aminophylline treatment for AOP with respect to additional ventilatory resource utilized in different birth weight categorization. Design, Settings and Participants – Single centered, retrospective economic evaluation was done. Participants included preterm newborns with < 34 completed weeks of gestation age that were recruited under an Indian Council of Medical Research funded randomized clinical trial. Per protocol data was included from Neonatal Intensive Care Unit, Kasturba Hospital, Manipal, India between April 2012 and December 2014. Exposure: Preterm neonates were randomly allocated to either Caffeine or Aminophylline as per the trial protocol. Outcomes and Measures – We assessed surfactant requirement, duration of Invasive and Non-Invasive Ventilation, Total Methylxanthine cost and additional cost for respiratory support bared by the payers per day during hospital stay. For the purpose of this study Newborns were stratified as Category A – < 1000g, Category B – 1001 to 1500g and Category C – 1501 to 2500g. Results: Total 146 (Caffeine -72 and Aminophylline – 74) babies with Mean ± SD gestation age of 29.63 ± 1.89 weeks were assessed. 32.19% constitute of Category A, 55.48% were B and 12.33% were C. The difference in median duration of additional NIV and IMV support was statistically insignificant. However 60% of neonates who received Caffeine required additional surfactant therapy (p=0.02). The total median (IQR) cost of Caffeine was significantly high with Rs.10535 (Q3-6317.50, Q1-15992.50) where against Aminophylline cost was Rs.352 (Q3-236, Q1-709) (p < 0.001). The additional costs spent on respiratory support per day in neonates on either Methylxanthines were found to be statistically insignificant in the entire weight based category of our study. Whereas in Category B, the median O2 charges per day were found to have more in Caffeine treated newborns (p=0.05) with border line significance. In category A, providing one day NIV or IMV support significantly increases the unit log cost of Caffeine by 13.6% (CI – 95% ranging from 4 to 24; p=0.005) over log cost of Aminophylline. Conclusion: Cost of Caffeine is expensive than Aminophylline. It was found to be equally efficacious in reducing the number duration of NIV or IMV support. However adjusted with the NIV and IMV days of support, neonates fall in category A and category B who were on Caffeine pays excess amount of respiratory charges per day over aminophylline. In perspective of resource poor settings Aminophylline is cost saving and economically approachable.

Keywords: methylxanthines include caffeine and aminophylline, AOP (apnea of prematurity), IMV (invasive mechanical ventilation), NIV (non invasive ventilation), category a – <1000g, category b – 1001 to 1500g and category c – 1501 to 2500g

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Authors: Ahlam Said Al Azkawi, Nallusamy Sivakumar, Saif Nasser Al Bahri

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Diverse approaches and pathways are under development with the determination to develop cellulosic biofuels and other bio-products eventually at commercial scale in “bio-refineries”; however, the key challenge is mainly the high level of complexity in processing the feedstock which is complicated and energy consuming. To overcome the complications in utilizing the naturally occurring lignocellulose biomass, using waste paper as a feedstock for bio-production may solve the problem. Besides being abundant and cheap, bioprocessing of waste paper has evolved in response to the public concern from rising landfill cost from shrinking landfill capacity. Cardboard (CB) is one of the major components of municipal solid waste and one of the most important items to recycle. Although 50-70% of cardboard constitute is known to be cellulose and hemicellulose, the presence of lignin around them cause hydrophobic cross-link which physically obstructs the hydrolysis by rendering it resistant to enzymatic cleavage. Therefore, pretreatment is required to disrupt this resistance and to enhance the exposure of the targeted carbohydrates to the hydrolytic enzymes. Several pretreatment approaches have been explored, and the best ones would be those can influence cellulose conversion rates and hydrolytic enzyme performance with minimal or less cost and downstream processes. One of the promising strategies in this field is the application of surfactants, especially non-ionic surfactants. In this study, triton-X 100 was used as surfactants to treat cardboard prior enzymatic hydrolysis and compare it with acid treatment using 0.1% H2SO4. The effect of the surfactant enhancement was evaluated through its effect on hydrolysis rate in respect to time in addition to evaluating the structural changes and modification by scanning electron microscope (SEM) and X-ray diffraction (XRD) and through compositional analysis. Further work was performed to produce ethanol from CB treated with triton-X 100 via separate hydrolysis and fermentation (SHF) and simultaneous saccharification and fermentation (SSF). The hydrolysis studies have demonstrated enhancement in saccharification by 35%. After 72 h of hydrolysis, a saccharification rate of 98% was achieved from CB enhanced with triton-X 100, while only 89 of saccharification achieved from acid pre-treated CB. At 120 h, the saccharification % exceeded 100 as reducing sugars continued to increase with time. This enhancement was not supported by any significant changes in the cardboard content as the cellulose, hemicellulose and lignin content remained same after treatment, but obvious structural changes were observed through SEM images. The cellulose fibers were clearly exposed with very less debris and deposits compared to cardboard without triton-X 100. The XRD pattern has also revealed the ability of the surfactant in removing calcium carbonate, a filler found in waste paper known to have negative effect on enzymatic hydrolysis. The cellulose crystallinity without surfactant was 73.18% and reduced to 66.68% rendering it more amorphous and susceptible to enzymatic attack. Triton-X 100 has proved to effectively enhance CB hydrolysis and eventually had positive effect on the ethanol yield via SSF. Treating cardboard with only triton-X 100 was a sufficient treatment to enhance the enzymatic hydrolysis and ethanol production.

Keywords: cardboard, enhancement, ethanol, hydrolysis, treatment, Triton-X 100

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Authors: Rebecca Dewfall, Mark Coleman, Vladimir Basabe

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Oxide scale growth is an inevitable byproduct of the high temperature processing of steel. Blister is a phenomenon that occurs due to oxide growth, where high temperatures result in the swelling of surface scale, producing a bubble-like feature. Blisters can subsequently become embedded in the steel substrate during hot rolling in the finishing mill. This rolled in scale defect causes havoc within industry, not only with wear on machinery but loss of customer satisfaction, poor surface finish, loss of material, and profit. Even though blister is a highly prevalent issue, there is still much that is not known or understood. The classic iron oxidation system is a complex multiphase system formed of wustite, magnetite, and hematite, producing multi-layered scales. Each phase will have independent properties such as thermal coefficients, growth rate, and mechanical properties, etc. Furthermore, each additional alloying element will have different affinities for oxygen and different mobilities in the oxide phases so that oxide morphologies are specific to alloy chemistry. Therefore, blister regimes can be unique to each steel grade resulting in a diverse range of formation mechanisms. Laboratory conditions were selected to simulate industrial hot rolling with temperature ranges approximate to the formation of secondary and tertiary scales in the finishing mills. Samples with composition: 0.15Wt% C, 0.1Wt% Si, 0.86Wt% Mn, 0.036Wt% Al, and 0.028Wt% Cr, were oxidised in a thermo-gravimetric analyser (TGA), with an air velocity of 10litresmin-1, at temperaturesof 800°C, 850°C, 900°C, 1000°C, 1100°C, and 1200°C respectively. Samples were held at temperature in an argon atmosphere for 10minutes, then oxidised in air for 600s, 60s, 30s, 15s, and 4s, respectively. Oxide morphology and Blisters were characterised using EBSD, WDX, nanoindentation, FIB, and FEG-SEM imaging. Blister was found to have both a nucleation and growth process. During nucleation, the scale detaches from the substrate and blisters after a very short period, roughly 10s. The steel substrate is then exposed inside of the blister and further oxidised in the reducing atmosphere of the blister, however, the atmosphere within the blister is highly dependent upon the porosity of the blister crown. The blister crown was found to be consistently between 35-40um for all heating regimes, which supports the theory that the blister inflates, and the oxide then subsequently grows underneath. Upon heating, two modes of blistering were identified. In Mode 1 it was ascertained that the stresses produced by oxide growth will increase with increasing oxide thickness. Therefore, in Mode 1 the incubation time for blister formation is shortened by increasing temperature. In Mode 2 increase in temperature will result in oxide with a high ductility and high oxide porosity. The high oxide ductility and/or porosity accommodates for the intrinsic stresses from oxide growth. Thus Mode 2 is the inverse of Mode 1, and incubation time is increased with temperature. A new phenomenon was reported whereby blister formed exclusively through cooling at elevated temperatures above mode 2.

Keywords: FEG-SEM, nucleation, oxide morphology, surface defect

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Authors: Dina Kon Mushid, Kabutakapua Kakanda, Dibu Dave Mbako

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The failure of material usually involves elastoplastic deformation and fracturing. Continuum mechanics can effectively deal with plastic deformation by using a yield function and the flow rule. At the same time, it has some limitations in dealing with the fracture problem since it is a theory based on the continuous field hypothesis. The lattice model can simulate the fracture problem very well, but it is inadequate for dealing with plastic deformation. Based on the discretized virtual internal bond model (DVIB), this paper proposes a lattice model that can account for plasticity. DVIB is a lattice method that considers material to comprise bond cells. Each bond cell may have any geometry with a finite number of bonds. The two-body or multi-body potential can characterize the strain energy of a bond cell. The two-body potential leads to the fixed Poisson ratio, while the multi-body potential can overcome the limitation of the fixed Poisson ratio. In the present paper, the modified Stillinger-Weber (SW), a multi-body potential, is employed to characterize the bond cell energy. The SW potential is composed of two parts. One part is the two-body potential that describes the interatomic interactions between particles. Another is the three-body potential that represents the bond angle interactions between particles. Because the SW interaction can represent the bond stretch and bond angle contribution, the SW potential-based DVIB (SW-DVIB) can represent the various Poisson ratios. To embed the plasticity in the SW-DVIB, the plasticity is considered in the two-body part of the SW potential. It is done by reducing the bond stiffness to a lower level once the bond reaches the yielding point. While before the bond reaches the yielding point, the bond is elastic. When the bond deformation exceeds the yielding point, the bond stiffness is softened to a lower value. When unloaded, irreversible deformation occurs. With the bond length increasing to a critical value, termed the failure bond length, the bond fails. The critical failure bond length is related to the cell size and the macro fracture energy. By this means, the fracture energy is conserved so that the cell size sensitivity problem is relieved to a great extent. In addition, the plasticity and the fracture are also unified at the bond level. To make the DVIB able to simulate different Poisson ratios, the three-body part of the SW potential is kept elasto-brittle. The bond angle can bear the moment before the bond angle increment is smaller than a critical value. By this method, the SW-DVIB can simulate the plastic deformation and the fracturing process of material with various Poisson ratios. The elastoplastic SW-DVIB is used to simulate the plastic deformation of a material, the plastic fracturing process, and the tunnel plastic deformation. It has been shown that the current SW-DVIB method is straightforward in simulating both elastoplastic deformation and plastic fracture.

Keywords: lattice model, discretized virtual internal bond, elastoplastic deformation, fracture, modified stillinger-weber potential

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Authors: Jonathan Sahu, Jill Aylott

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Individuals with Autism, Intellectual and Developmental disabilities (AIDD) are one of the most vulnerable groups in society, hampered not only by their own limitations to understand and interact with the wider society, but also societal limitations in perception and understanding. Communication to express their needs and wishes is fundamental to enable such individuals to live and prosper in society. This research project was designed as an organisational case study, in a large secondary health care hospital within the National Health Service (NHS), to assess the quality of care provided to people with AIDD and to review the role of advocacy to reduce health inequalities in these individuals. Methods: The research methodology adopted was as an “insider researcher”. Data collection included both quantitative and qualitative data i.e. a mixed method approach. A semi-structured interview schedule was designed and used to obtain qualitative and quantitative primary data from a wide range of interdisciplinary frontline health care workers to assess their understanding and awareness of systems, processes and evidence based practice to offer a quality service to people with AIDD. Secondary data were obtained from sources within the organisation, in keeping with “Case Study” as a primary method, and organisational performance data were then compared against national benchmarking standards. Further data sources were accessed to help evaluate the effectiveness of different types of advocacy that were present in the organisation. This was gauged by measures of user and carer experience in the form of retrospective survey analysis, incidents and complaints. Results: Secondary data demonstrate near compliance of the Organisation with the current national benchmarking standard (Monitor Compliance Framework). However, primary data demonstrate poor knowledge of the Mental Capacity Act 2005, poor knowledge of organisational systems, processes and evidence based practice applied for people with AIDD. In addition there was poor knowledge and awareness of frontline health care workers of advocacy and advocacy schemes for this group. Conclusions: A significant amount of work needs to be undertaken to improve the quality of care delivered to individuals with AIDD. An operational strategy promoting the widespread dissemination of information may not be the best approach to deliver quality care and optimal patient experience and patient advocacy. In addition, a more robust set of standards, with appropriate metrics, needs to be developed to assess organisational performance which will stand the test of professional and public scrutiny.

Keywords: advocacy, autism, health inequalities, intellectual developmental disabilities, quality of care

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Authors: Manuel Jose Oyson

Abstract:

The Intergovernmental Panel on Climate Change (IPCC) warned in its most recent report for the entire world “to both mitigate and adapt to climate change if it is to effectively avoid harmful climate impacts.” The IPCC observed “with high confidence” a more rapid rise in total anthropogenic greenhouse gas emissions (GHG) emissions from 2000 to 2010 than in the past three decades that “were the highest in human history”, which if left unchecked will entail a continuing process of global warming and can alter the climate system. Current efforts, however, to respond to the threat of global warming, such as the United Nations Framework Convention on Climate Change and the Kyoto Protocol, have focused on states, and fail to involve Transnational Corporations (TNCs) which are responsible for a vast amount of GHG emissions. Involving TNCs in the search for solutions to climate change is consistent with an acknowledgment by contemporary international law that there is an international role for other international persons, including TNCs, and departs from the traditional “state-centric” response to climate change. Putting the focus of GHG emissions away from states recognises that the activities of TNCs “are not bound by national borders” and that the international movement of goods meets the needs of consumers worldwide. Although there is no legally-binding instrument that covers TNC activities or legal responsibilities generally, TNCs have increasingly been made legally responsible under international law for violations of human rights, exploitation of workers and environmental damage, but not for climate change damage. Imposing on TNCs a legally-binding obligation to reduce their GHG emissions or a legal liability for climate change damage is arguably formidable and unlikely in the absence a recognisable source of obligation in international law or municipal law. Instead a recourse to “soft law” and non-legally binding instruments may be a way forward for TNCs to reduce their GHG emissions and help in addressing climate change. Positive effects have been noted by various studies to voluntary approaches. TNCs have also in recent decades voluntarily committed to “soft law” international agreements. This development reflects a growing recognition among corporations in general and TNCs in particular of their corporate social responsibility (CSR). While CSR used to be the domain of “small, offbeat companies”, it has now become part of mainstream organization. The paper argues that TNCs must voluntarily commit to reducing their GHG emissions and helping address climate change as part of their CSR. One, as a serious “global commons problem”, climate change requires international cooperation from multiple actors, including TNCs. Two, TNCs are not innocent bystanders but are responsible for a large part of GHG emissions across their vast global operations. Three, TNCs have the capability to help solve the problem of climate change. Assuming arguendo that TNCs did not strongly contribute to the problem of climate change, society would have valid expectations for them to use their capabilities, knowledge-base and advanced technologies to help address the problem. It would seem unthinkable for TNCs to do nothing while the global environment fractures.

Keywords: climate change law, corporate social responsibility, greenhouse gas emissions, transnational corporations

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Authors: Maria Krambia-Kapardis, Andreas Kapardis

Abstract:

The paper discusses regulatory and legislative measures implemented by various nations in an effort to avert another financial crisis. More specifically, to address the financial crisis, the European Commission followed the practice of other developed countries and implemented a European Economic Recovery Plan in an attempt to overhaul the regulatory and supervisory framework of the financial sector. In 2010 the Commission introduced the European Systemic Risk Board and in 2011 the European System of Financial Supervision. Some experts advocated that the type and extent of financial regulation introduced in the European crisis in the wake of the 2008 crisis has been excessive and counterproductive. In considering how different countries responded to the financial crisis, global regulators have shown a more focused commitment to combat industry misconduct and to pre-empt abusive behavior. Regulators have also increased funding and resources at their disposal; have increased regulatory fines, with an increasing trend towards action against individuals; and, finally, have focused on market abuse and market conduct issues. Financial regulation can be effected, first of all, through legislation. However, neither ex ante or ex post regulation is by itself effective in reducing systemic risk. Consequently, to avert a financial crisis, in their endeavor to achieve both economic efficiency and financial stability, governments need to balance the two approaches to financial regulation. Fiduciary duty is another means by which the behavior of actors in the financial world is constrained and, thus, regulated. Furthermore, fiduciary duties extend over and above other existing requirements set out by statute and/or common law and cover allegations of breach of fiduciary duty, negligence or fraud. Careful analysis of the etiology of the 2008 financial crisis demonstrates the great importance of corporate governance as a way of regulating boardroom behavior. In addition, the regulation of professions including accountants and auditors plays a crucial role as far as the financial management of companies is concerned. In the US, the Sarbanes-Oxley Act of 2002 established the Public Company Accounting Oversight Board in order to protect investors from financial accounting fraud. In most countries around the world, however, accounting regulation consists of a legal framework, international standards, education, and licensure. Accounting regulation is necessary because of the information asymmetry and the conflict of interest that exists between managers and users of financial information. If a holistic approach is to be taken then one cannot ignore the regulation of legislators themselves which can take the form of hard or soft legislation. The science of averting a financial crisis is yet to be perfected and this, as shown by the preceding discussion, is unlikely to be achieved in the foreseeable future as ‘disaster myopia’ may be reduced but will not be eliminated. It is easier, of course, to be wise in hindsight and regulating unreasonably risky decisions and unethical or outright criminal behavior in the financial world remains major challenges for governments, corporations, and professions alike.

Keywords: financial crisis, legislation, regulation, financial regulation

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Authors: O. Bilbao, I. Loizaga, F. A. Girot, A. Torregaray

Abstract:

The current energetical situation and the high competitiveness in industrial sectors as the automotive one have become the development of new manufacturing processes with less energy and raw material consumption a real necessity. As consequence, new forming processes related with high temperature hot forging in closed dies have emerged in the last years as new solutions to expand the possibilities of hot forging and iron casting in the automotive industry. These technologies are mid-way between hot forging and semi-solid metal processes, working at temperatures higher than the hot forging but below the solidus temperature or the semi solid range, where no liquid phase is expected. This represents an advantage comparing with semi-solid forming processes as thixoforging, by the reason that no so high temperatures need to be reached in the case of high melting point alloys as steels, reducing the manufacturing costs and the difficulties associated to semi-solid processing of them. Comparing with hot forging, this kind of technologies allow the production of parts with as forged properties and more complex and near-net shapes (thinner sidewalls), enhancing the possibility of designing lightweight components. From the process viewpoint, the forging forces are significantly decreased, and a significant reduction of the raw material, energy consumption, and the forging steps have been demonstrated. Despite the mentioned advantages, from the material behavior point of view, the expansion of these technologies has shown the necessity of developing new material flow behavior models in the process working temperature range to make the simulation or the prediction of these new forming processes feasible. Moreover, the knowledge of the material flow behavior at the working temperature range also allows the design of the new closed dies concept required. In this work, the flow behavior characterization in the mentioned temperature range of the widely used in automotive commercial components 42CrMo4 steel has been studied. For that, hot compression tests have been carried out in a thermomechanical tester in a temperature range that covers the material behavior from the hot forging until the NDT (Nil Ductility Temperature) temperature (1250 ºC, 1275 ºC, 1300 ºC, 1325 ºC, 1350ºC, and 1375 ºC). As for the strain rates, three different orders of magnitudes have been considered (0,1 s-1, 1s-1, and 10s-1). Then, results obtained from the hot compression tests have been treated in order to adapt or re-write the Spittel model, widely used in automotive commercial softwares as FORGE® that restrict the current existing models up to 1250ºC. Finally, the obtained new flow behavior model has been validated by the process simulation in a commercial automotive component and the comparison of the results of the simulation with the already made experimental tests in a laboratory cellule of the new technology. So as a conclusion of the study, a new flow behavior model for the 42CrMo4 steel in the new working temperature range and the new process simulation in its application in automotive commercial components has been achieved and will be shown.

Keywords: 42CrMo4 high temperature flow behavior, high temperature hot forging in closed dies, simulation of automotive commercial components, spittel flow behavior model

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Authors: Nebojsa Stefanovic, Sasa Milijic, Natasa Danilovic Hristic

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Spatial plan of the special purpose area constitutes a basic tool in the planning of infrastructure corridor of a highway. The aim of the plan is to define the planning basis and provision of spatial conditions for the construction and operation of the highway, as well as for developing other infrastructure systems in the corridor. This paper presents a methodology and approach to the preparation of the Spatial Plan for the special purpose area for the infrastructure corridor of the highway E-80, Section Niš-Merdare in Serbia. The applied methodological approach is based on the combined application of the integrative and participatory method in the decision-making process on the sustainable development of the highway corridor. It was found that, for the planning and management of the infrastructure corridor, a key problem is coordination of spatial and urban planning, strategic environmental assessment and sectoral traffic planning and designing. Through the development of the plan, special attention is focused on increasing the accessibility of the local and regional surrounding, reducing the adverse impacts on the development of settlements and the economy, protection of natural resources, natural and cultural heritage, and the development of other infrastructure systems in the corridor of the highway. As a result of the applied methodology, this paper analyzes the basic features such as coverage, the concept, protected zones, service facilities and objects, the rules of development and construction, etc. Special emphasis is placed to methodology and results of the Strategic Environmental Assessment of the Spatial Plan, and to the importance of protection measures, with the special significance of air and noise protection measures. For evaluation in the Strategic Environmental Assessment, a multicriteria expert evaluation (semi-quantitative method) of planned solutions was used in relation to the set of goals and relevant indicators, based on the basic set of indicators of sustainable development. Evaluation of planned solutions encompassed the significance and size, spatial conditions and probability of the impact of planned solutions on the environment, and the defined goals of strategic assessment. The framework of the implementation of the Spatial Plan is presented, which is determined for the simultaneous elaboration of planning solutions at two levels: the strategic level of the spatial plan and detailed urban plan level. It is also analyzed the relationship of the Spatial Plan to other applicable planning documents for the planning area. The effects of this methodological approach relate to enabling integrated planning of the sustainable development of the infrastructure corridor of the highway and its surrounding area, through coordination of spatial, urban and sectoral traffic planning and design, as well as the participation of all key actors in the adoption and implementation of planned decisions. By the conclusions of the paper, it is pointed to the direction for further research, particularly in terms of harmonizing methodology of planning documentation and preparation of technical-design documentation.

Keywords: corridor, environment, highway, impact, methodology, spatial plan, urban

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Authors: Mustafa Cam, Nedim Ongun, Ufuk Kutluana

Abstract:

Introduction: Restless LegsSyndrome (RLS) is a common, under-recognized disorder disrupts sleep and diminishes quality of life (1). The most common conditions highly associated with RLS include renalfailure, iron and folic acid deficiency, peripheral neuropathy, pregnancy, celiacdisease, Crohn’sdiseaseandrarelymalignancy (2).Despite a clear relation between low peripheral iron and increased prevalence and severity of RLS, the prevalence and clinical significance of RLS in iron-deficientanemic populations is unknown (2). We report here a case of RLS due to iron deficiency in the setting of neuroendocrinetumor. Report of Case: A 35 year-old man was referred to our clinic with general weakness, weight loss (10 kg in 2 months)and 2-month history of uncomfortable sensations in his legs with urge to move, partially relieved by movement. The symptoms were presented very day, worsening in the evening; the discomfort forced the patient to getup and walk around at night. RLS was severe, with a score of 22 at the International RLS ratingscale. The patient had no past medical history. The patient underwent a complete set of blood analyses and the following ab normal values were found (normal limitswithinbrackets): hemoglobin 9.9 g/dl (14-18), MCV 70 fL (80-94), ferritin 3,5 ng/mL (13-150). Brain and spinemagnetic resonance imaging was normal. The patient consultated with gastroenterology clinic and gastointestinal systemendoscopy was performed for theetiology of the iron deficiency anemia. After the gastricbiopsy, results allowed us to reach the diagnosis of neuroen docrine tumor and the patient referred to oncology clinic. Discussion: The first important consideration from this case report is that the patient was referred to our clinic because of his severe RLS symptoms dramatically reducing his quality of life. However, our clinical study clearly demonstrated that RLS was not the primary disease. Considering the information available for this patient, we believe that the most likely possibility is that RLS was secondary to iron deficiency, a very well-known and established cause of RLS in theliterature (3,4). Neuroendocrine tumors (NETs) are rare epithelial neoplasms with neuroendocrine differentiation that most commonly originate in the lungs and gastrointestinal tract (5). NETs vary widely in their clinical presentation; symptoms are often nonspecific and can be mistaken for those of other more common conditions (6). 50% of patients with reported disease stage have either regional or distant metastases at diagnosis (7). Accurate and earlier NET diagnosis is the first step in shortening the time to optimal care and improved outcomes for patients (8). The most important message from this case report is that RLS symptoms can sometimes be thesign of a life-threatening condition. Conclusion: Careful and complete collection of clinical and laboratory data should be carried out in RLS patients. Inparticular, if RLS onset coincides with weight loss and iron deficieny anemia, gastricendos copy should be performed. It is known about that malignancy is a rare etiology in RLS patients and to our knowledge; it is the first case with neuro endocrine tumor presenting with RLS.

Keywords: neurology, neuroendocrine tumor, restless legs syndrome, sleep

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