Search results for: laboratory standards
Commenced in January 2007
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Edition: International
Paper Count: 4127

Search results for: laboratory standards

347 Genetic Diversity of Cord Blood of the National Center of Blood Transfusion, Mexico (NCBT)

Authors: J. Manuel Bello-López, Julieta Rojo-Medina

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Introduction: The transplant of Umbilical Cord Blood Units (UCBU) are a therapeutic possibility for patients with oncohaematological disorders, especially in children. In Mexico, 48.5% of oncological diseases in children 1-4 years old are leukemias; whereas in patients 5-14 and 15-24 years old, lymphomas and leukemias represent the second and third cause of death in these groups respectively. Therefore it is necessary to have more registries of UCBU in order to ensure genetic diversity in the country; the above because the search for appropriate a UCBU is increasingly difficult for patients of mixed ethnicity. Objective: To estimate the genetic diversity (polymorphisms) of Human Leucocyte Antigen (HLA) Class I (A, B) and Class II (DRB1) in UCBU cryopreserved for transplant at Cord Blood Bank of the NCBT. Material and Methods: HLA typing of 533 UCBU for transplant was performed from 2003-2012 at the Histocompatibility Laboratory from the Research Department (evaluated by Los Angeles Ca. Immunogenetics Center) of the NCBT. Class I HLA-A, HLA-B and Class II HLA-DRB1 typing was performed using medium resolution Sequence-Specific Primer (SSP). In cases of an ambiguity detected by SSP; Sequence-Specific Oligonucleotide (SSO) method was carried out. A strict analysis of populations genetic parameters were done in 5 representative UCBU populations. Results: 46.5% of UCBU were collected from Mexico City, State of Mexico (30.95%), Puebla (8.06%), Morelos (6.37%) and Veracruz (3.37%). The remaining UCBU (4.75%) are represented by other states. The identified genotypes correspond to Amerindian origins (HLA-A*02, 31; HLA-B*39, 15, 48), Caucasian (HLA-A*02, 68, 01, 30, 31; HLA-B*35, 15, 40, 44, 07 y HLA-DRB1*04, 08, 07, 15, 03, 14), Oriental (HLA-A*02, 30, 01, 31; HLA-B* 35, 39, 15, 40, 44, 07,48 y HLA-DRB1*04, 07,15, 03) and African (HLA-A*30 y HLA-DRB1*03). The genetic distances obtained by Cavalli-Sforza analysis of the five states showed significant genetic differences by comparing genetic frequencies. The shortest genetic distance exists between Mexico City and the state of Puebla (0.0039) and the largest between Veracruz and Morelos (0.0084). In order to identify significant differences between this states, the ANOVA test was performed. This demonstrates that UCBU is significantly different according to their origin (P <0.05). This is shown by the divergence between arms at the Dendogram of Neighbor-Joining. Conclusions: The NCBT provides UCBU in patients with oncohaematological disorders in all the country. There is a group of patients for which not compatible UCBU can be find due to the mixed ethnic origin. For example, the population of northern Mexico is mostly Caucasian. Most of the NCBT donors are of various ethnic origins, predominantly Amerindians and Caucasians; although some ethnic minorities like Oriental, African and pure Indian ethnics are not represented. The NCBT is, therefore, establishing agreements with different states of Mexico to promote the altruistic donation of Umbilical Cord Blood in order to enrich the genetic diversity in its files.

Keywords: cord blood, genetic diversity, human leucocyte antigen, transplant

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346 The City Narrated from the Hill, Evaluation of Natural Fabric in Urban Plans: A Case Study of Santiago de Chile

Authors: Monica Sanchez

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What responsibility does urban planning have on climate changes? How does the territory give us answers of resilience? Historically, urban plans have civilized territories: waters are channeled, grounds are sealed, foreign species are incorporated, native ones are extinguished, and/or enclosed spaces are heated or cooled. Socially this facilitates coexistence, but in turn brings negative environmental consequences. The past fifty years, mankind has tried to redirect these consequences through different strategies. Research studies produced strategies designed to alleviate climate change. Exploring the nature of territories has been incorporated in urban planning to discover natures response. The case to be studied is Santiago, Chile: for its combined impacts of climate change and the significant response by this city on climate governance in the last decades. Warmer areas in Santiago are seen in the areas of high-density buildings such as the commune of Recoleta, while the coldest are characterized by the predominance of low residential densities as the commune of Providencia. These two communes are separated and complemented by an undulating body that comes from the Andes mountains called San Cristobal Hill. What if the hill were taken into account when making roads, zoning and buildings? Was it difficult to prolong in the urban plans the hill characteristics to the city solving the intersection with other natural areas? Apparently it was, because the projected-profile informs us that the planned strategies used correspond to the same operations used in the flat areas of Santiago. This research focuses on: explaining the geographic relationships between city-hill; explaining the planning process around the hill with a morphological analysis; evaluating how the hill has been considered the in the city in the plans that intended to cushion the environmental impacts and studying what is missing on the hill and city to strengthen their integration. Therefore, the research will have different scales of understanding: addressing territorial scale -understanding the vegetation, topography and hydrology; a city scale -analyzing urban plans that Santiago has dealt with the environment and city; and a local scale -studying the integration and public spaces and coverage- norms of the adjacent communes. The expected outcome is to decipher possible deficits and capabilities of the current urban plans for climate change. It is anticipated that the hill and valley is now trying to reconcile after such a long separation. Yet it seems that never will prevail all the Rules of Nature, but the Urban Rules. The plans will require pruning, irrigation, control of invasive alien species and public safety standards, but will be rejoining a dose of nature with the building environment -this will protect us better from it from the time that we feared from it and knew little about it. Today we know a little more, enough to adapt to the process. Although nature is not perceived and we ignore it, it has a remarkable ability to respond.

Keywords: resilience, climate change, urban plans, land use, hills and cities, heat islands, morphology

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345 Application of a Submerged Anaerobic Osmotic Membrane Bioreactor Hybrid System for High-Strength Wastewater Treatment and Phosphorus Recovery

Authors: Ming-Yeh Lu, Shiao-Shing Chen, Saikat Sinha Ray, Hung-Te Hsu

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Recently, anaerobic membrane bioreactors (AnMBRs) has been widely utilized, which combines anaerobic biological treatment process and membrane filtration, that can be present an attractive option for wastewater treatment and water reuse. Conventional AnMBR is having several advantages, such as improving effluent quality, compact space usage, lower sludge yield, without aeration and production of energy. However, the removal of nitrogen and phosphorus in the AnMBR permeate was negligible which become the biggest disadvantage. In recent years, forward osmosis (FO) is an emerging technology that utilizes osmotic pressure as driving force to extract clean water without additional external pressure. The pore size of FO membrane is kindly mentioned the pore size, so nitrogen or phosphorus could effectively improve removal of nitrogen or phosphorus. Anaerobic bioreactor with FO membrane (AnOMBR) can retain the concentrate organic matters and nutrients. However, phosphorus is a non-renewable resource. Due to the high rejection property of FO membrane, the high amount of phosphorus could be recovered from the combination of AnMBR and FO. In this study, development of novel submerged anaerobic osmotic membrane bioreactor integrated with periodic microfiltration (MF) extraction for simultaneous phosphorus and clean water recovery from wastewater was evaluated. A laboratory-scale AnOMBR utilizes cellulose triacetate (CTA) membranes with effective membrane area of 130 cm² was fully submerged into a 5.5 L bioreactor at 30-35℃. Active layer-facing feed stream orientation was utilized, for minimizing fouling and scaling. Additionally, a peristaltic pump was used to circulate draw solution (DS) at a cross flow velocity of 0.7 cm/s. Magnesium sulphate (MgSO₄) solution was used as DS. Microfiltration membrane periodically extracted about 1 L solution when the TDS reaches to 5 g/L to recover phosphorus and simultaneous control the salt accumulation in the bioreactor. During experiment progressed, the average water flux was achieved around 1.6 LMH. The AnOMBR process show greater than 95% removal of soluble chemical oxygen demand (sCOD), nearly 100% of total phosphorous whereas only partial removal of ammonia, and finally average methane production of 0.22 L/g sCOD was obtained. Therefore, AnOMBR system periodically utilizes MF membrane extracted for phosphorus recovery with simultaneous pH adjustment. The overall performance demonstrates that a novel submerged AnOMBR system is having potential for simultaneous wastewater treatment and resource recovery from wastewater, and hence, the new concept of this system can be used to replace for conventional AnMBR in the future.

Keywords: anaerobic treatment, forward osmosis, phosphorus recovery, membrane bioreactor

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344 The Effect of Environmental Assessment Learning in Evacuation Centers on the COVID-19 Situation

Authors: Hiromi Kawasaki, Satoko Yamasaki, Mika Iwasa, Tomoko Iki, Akiko Takaki

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In basic nursing, the conditions necessary for maintaining human health -temperature, humidity, illumination, distance from others, noise, moisture, meals, and excretion- were explained. Nursing students often think of these conditions in the context of a hospital room. In order to make students think of these conditions in terms of an environment necessary for maintaining health and preventing illness for residents, in the third year of community health nursing, students learned how to assess and improve the environment -particularly via the case of shelters in the event of a disaster. The importance of environmental management has increased in 2020 as a preventive measure against COVID-19 infection. We verified the effect of the lessons, which was decided to be conducted through distance learning. Sixty third-year nursing college students consented to participate in this study. Environmental standard knowledge for conducting environmental assessment was examined before and after class, and the percentage of correct answers was compared. The χ² test was used for the test, with a 5% significance level employed. Measures were evaluated via a report submitted by the students after class. Student descriptions were analyzed both qualitatively and descriptively with respect to expected health problems and suggestions for improvement. Students have already learned about the environment in terms of basic nursing in their second year. The correct answers for external environmental values concerning interpersonal distance, illumination, noise, and room temperature (p < 0.001) increased significantly after taking the class. Humidity was registered 83.3% before class and 93.3% after class (p = 0.077). Regarding the body, the percentage of students who answered correctly was 70% or more, both before and after the class. The students’ reports included overcrowding, high humidity/high temperature, and the number of toilets as health hazards. Health disorders to be prevented were heat stroke, infectious diseases, and economy class syndrome; improvement methods were recommended for hyperventilation, stretching, hydration, and waiting at home. After the public health nursing class, the students were able to not only propose environmental management of a hospital room but also had an understanding of the environment in terms of the lives of individuals, environmental assessment, and solutions to health problems. The response rate for basic items learned in the second year was already high before and after class, and interpersonal distance and ventilation were described by students. Students were able to use what they learned in basic nursing about the standards of the human mind and body. In the external environment, the memory of specific numerical values was ambiguous. The environment of the hospital room is controlled, and interest in numerical values may decrease. Nursing staff needs to maintain and improve human health as well as hospital rooms. With COVID-19, it was thought that students would continue to not only consider this point in reference to hospital rooms but also in regard to places where people gather. Even in distance learning, students were able to learn the important issues and lessons.

Keywords: environmental assessment, evacuation center, nursing education, nursing students

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343 Jigger Flea (Tunga penetrans) Infestations and Use of Soil-Cow Dung-Ash Mixture as a Flea Control Method in Eastern Uganda

Authors: Gerald Amatre, Julius Bunny Lejju, Morgan Andama

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Despite several interventions, jigger flea infestations continue to be reported in the Busoga sub-region in Eastern Uganda. The purpose of this study was to identify factors that expose the indigenous people to jigger flea infestations and evaluate the effectiveness of any indigenous materials used in flea control by the affected communities. Flea compositions in residences were described, factors associated with flea infestation and indigenous materials used in flea control were evaluated. Field surveys were conducted in the affected communities after obtaining preliminary information on jigger infestation from the offices of the District Health Inspectors to identify the affected villages and households. Informed consent was then sought from the local authorities and household heads to conduct the study. Focus group discussions were conducted with key district informants, namely, the District Health Inspectors, District Entomologists and representatives from the District Health Office. A GPS coordinate was taken at central point at every household enrolled. Fleas were trapped inside residences using Kilonzo traps. A Kilonzo Trap comprised a shallow pan, about three centimetres deep, filled to the brim with water. The edges of the pan were smeared with Vaseline to prevent fleas from crawling out. Traps were placed in the evening and checked every morning the following day. The trapped fleas were collected in labelled vials filled with 70% aqueous ethanol and taken to the laboratory for identification. Socio-economic and environmental data were collected. The results indicate that the commonest flea trapped in the residences was the cat flea (Ctenocephalides felis) (50%), followed by Jigger flea (Tunga penetrans) (46%) and rat flea (Xenopsylla Cheopis) (4%), respectively. The average size of residences was seven squire metres with a mean of six occupants. The residences were generally untidy; with loose dusty floors and the brick walls were not plastered. The majority of the jigger affected households were headed by peasants (86.7%) and artisans (13.3%). The household heads mainly stopped at primary school level (80%) and few at secondary school level (20%). The jigger affected households were mainly headed by peasants of low socioeconomic status. The affected community members use soil-cow dung-ash mixture to smear floors of residences as the only measure to control fleas. This method was found to be ineffective in controlling the insects. The study recommends that home improvement campaigns be continued in the affected communities to improve sanitation and hygiene in residences as one of the interventions to combat flea infestations. Other cheap, available and effective means should be identified to curb jigger flea infestations.

Keywords: cow dung-soil-ash mixture, infestations, jigger flea, Tunga penetrans

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342 Techno-Economic Analysis of 1,3-Butadiene and ε-Caprolactam Production from C6 Sugars

Authors: Iris Vural Gursel, Jonathan Moncada, Ernst Worrell, Andrea Ramirez

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In order to achieve the transition from a fossil to bio-based economy, biomass needs to replace fossil resources in meeting the world’s energy and chemical needs. This calls for development of biorefinery systems allowing cost-efficient conversion of biomass to chemicals. In biorefinery systems, feedstock is converted to key intermediates called platforms which are converted to wide range of marketable products. The C6 sugars platform stands out due to its unique versatility as precursor for multiple valuable products. Among the different potential routes from C6 sugars to bio-based chemicals, 1,3-butadiene and ε-caprolactam appear to be of great interest. Butadiene is an important chemical for the production of synthetic rubbers, while caprolactam is used in production of nylon-6. In this study, ex-ante techno-economic performance of 1,3-butadiene and ε-caprolactam routes from C6 sugars were assessed. The aim is to provide insight from an early stage of development into the potential of these new technologies, and the bottlenecks and key cost-drivers. Two cases for each product line were analyzed to take into consideration the effect of possible changes on the overall performance of both butadiene and caprolactam production. Conceptual process design for the processes was developed using Aspen Plus based on currently available data from laboratory experiments. Then, operating and capital costs were estimated and an economic assessment was carried out using Net Present Value (NPV) as indicator. Finally, sensitivity analyses on processing capacity and prices was done to take into account possible variations. Results indicate that both processes perform similarly from an energy intensity point of view ranging between 34-50 MJ per kg of main product. However, in terms of processing yield (kg of product per kg of C6 sugar), caprolactam shows higher yield by a factor 1.6-3.6 compared to butadiene. For butadiene production, with the economic parameters used in this study, for both cases studied, a negative NPV (-642 and -647 M€) was attained indicating economic infeasibility. For the caprolactam production, one of the cases also showed economic infeasibility (-229 M€), but the case with the higher caprolactam yield resulted in a positive NPV (67 M€). Sensitivity analysis indicated that the economic performance of caprolactam production can be improved with the increase in capacity (higher C6 sugars intake) reflecting benefits of the economies of scale. Furthermore, humins valorization for heat and power production was considered and found to have a positive effect. Butadiene production was found sensitive to the price of feedstock C6 sugars and product butadiene. However, even at 100% variation of the two parameters, butadiene production remained economically infeasible. Overall, the caprolactam production line shows higher economic potential in comparison to that of butadiene. The results are useful in guiding experimental research and providing direction for further development of bio-based chemicals.

Keywords: bio-based chemicals, biorefinery, C6 sugars, economic analysis, process modelling

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341 Analysis of Resistance and Virulence Genes of Gram-Positive Bacteria Detected in Calf Colostrums

Authors: C. Miranda, S. Cunha, R. Soares, M. Maia, G. Igrejas, F. Silva, P. Poeta

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The worldwide inappropriate use of antibiotics has increased the emergence of antimicrobial-resistant microorganisms isolated from animals, humans, food, and the environment. To combat this complex and multifaceted problem is essential to know the prevalence in livestock animals and possible ways of transmission among animals and between these and humans. Enterococci species, in particular E. faecalis and E. faecium, are the most common nosocomial bacteria, causing infections in animals and humans. Thus, the aim of this study was to characterize resistance and virulence factors genes among two enterococci species isolated from calf colostrums in Portuguese dairy farms. The 55 enterococci isolates (44 E. faecalis and 11 E. faecium) were tested for the presence of the resistance genes for the following antibiotics: erythromicyn (ermA, ermB, and ermC), tetracycline (tetL, tetM, tetK, and tetO), quinupristin/dalfopristin (vatD and vatE) and vancomycin (vanB). Of which, 25 isolates (15 E. faecalis and 10 E. faecium) were tested until now for 8 virulence factors genes (esp, ace, gelE, agg, cpd, cylA, cylB, and cylLL). The resistance and virulence genes were performed by PCR, using specific primers and conditions. Negative and positive controls were used in all PCR assays. All enterococci isolates showed resistance to erythromicyn and tetracycline through the presence of the genes: ermB (n=29, 53%), ermC (n=10, 18%), tetL (n=49, 89%), tetM (n=39, 71%) and tetK (n=33, 60%). Only two (4%) E. faecalis isolates showed the presence of tetO gene. No resistance genes for vancomycin were found. The virulence genes detected in both species were cpd (n=17, 68%), agg (n=16, 64%), ace (n=15, 60%), esp (n=13, 52%), gelE (n=13, 52%) and cylLL (n=8, 32%). In general, each isolate showed at least three virulence genes. In three E. faecalis isolates was not found virulence genes and only E. faecalis isolates showed virulence genes for cylA (n=4, 16%) and cylB (n=6, 24%). In conclusion, these colostrum samples that were consumed by calves demonstrated the presence of antibiotic-resistant enterococci harbored virulence genes. This genotypic characterization is crucial to control the antibiotic-resistant bacteria through the implementation of restricts measures safeguarding public health. Acknowledgements: This work was funded by the R&D Project CAREBIO2 (Comparative assessment of antimicrobial resistance in environmental biofilms through proteomics - towards innovative theragnostic biomarkers), with reference NORTE-01-0145-FEDER-030101 and PTDC/SAU-INF/30101/2017, financed by the European Regional Development Fund (ERDF) through the Northern Regional Operational Program (NORTE 2020) and the Foundation for Science and Technology (FCT). This work was supported by the Associate Laboratory for Green Chemistry - LAQV which is financed by national funds from FCT/MCTES (UIDB/50006/2020 and UIDP/50006/2020).

Keywords: antimicrobial resistance, calf, colostrums, enterococci

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340 Fathers and Daughters: Their Relationship and Its Impact on Body Image and Mental Health

Authors: John Toussaint

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Objective: Our society is suffering from an epidemic of body image dissatisfaction, and related disorders appear to be increasing globally for children. There is much to indicate that children's body image and eating attitudes are being affected negatively by socio-cultural factors such as parents, peers and media. Most studies and theories, however, have focused extensively on the daughter-mother relationship. Very few studies have investigated the role of attachment to the father as an important factor in the development of girls’ and women’s attitudes towards themselves and their bodies. Recently, data have shown that the father’s parenting style, as well as the quality of the relationship with him is crucial for the understanding of the development and persistence of body image disorders. This presentation is based on samples of participants with self-defined body image dissatisfaction, and the self-reported measures of their fathers’ parental behaviours, emotional warmth, support, or protection. Attachment theory does offer support in exploring these relationships and it is used in this presentation to assist in understanding the relationship between the father and his daughter in relation to body image and mental health. Clinical implications are also offered in respect to work with body image, eating disorders and relational therapy. Methods: As awareness of the increasing frequency of body image concerns in children grows, so too does the need for a simple, valid and reliable measure of body image. The Children's Body Image Scale (CBIS) designed in Australia, depicts seven male and females figures from which children are to choose their perceived body type and ideal body type. This was compared with a range of international body mass index (BMI) reference standards. These measures together with individual one-on-one interviews were completed by 158 children aged 7-12 years. Results: A high frequency of body image dissatisfaction was indicated in the children's responses. 55% of girls and 41% of boys said they would like to be thinner, and wished for an ideal BMI figure below the 10th percentile. This is an unhealthy and unattainable level of body fatness for the majority of children when considered in relation to the reported secular trend of their increasing average body size. Thin children were generally ranked as best and perceived as kind, happy, academically skilled, and socially successful. Fat children were perceived as unintelligent, lazy, greedy, unpopular, and unable to play physical games. Conclusions: Body image ideals and fat stereotypes are well entrenched among children. There is much to indicate that children's body image and eating attitudes are being affected negatively by sociocultural factors such as parents, peers and media. Teachers and health professionals could promote intervention programs for children involving knowledge and acceptance of genetic influences on body type; the dangerous effects of weight loss dieting; the importance of physical activity and eating healthy; and scepticism and critical analysis of mass media messages.

Keywords: body image, father attachment, mental health, eating disorders

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339 Bio-Medical Equipment Technicians: Crucial Workforce to Improve Quality of Health Services in Rural Remote Hospitals in Nepal

Authors: C. M. Sapkota, B. P. Sapkota

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Background: Continuous developments in science and technology are increasing the availability of thousands of medical devices – all of which should be of good quality and used appropriately to address global health challenges. It is obvious that bio medical devices are becoming ever more indispensable in health service delivery and among the key workforce responsible for their design, development, regulation, evaluation and training in their use: biomedical technician (BMET) is the crucial. As a pivotal member of health workforce, biomedical technicians are an essential component of the quality health service delivery mechanism supporting the attainment of the Sustainable Development Goals. Methods: The study was based on cross sectional descriptive design. Indicators measuring the quality of health services were assessed in Mechi Zonal Hospital (MZH) and Sagarmatha Zonal Hospital (SZH). Indicators were calculated based on the data about hospital utilization and performance of 2018 available in Medical record section of both hospitals. MZH had employed the BMET during 2018 but SZH had no BMET in 2018.Focus Group Discussion with health workers in both hospitals was conducted to validate the hospital records. Client exit interview was conducted to assess the level of client satisfaction in both the hospitals. Results: In MZH there was round the clock availability and utilization of Radio diagnostics equipment, Laboratory equipment. Operation Theater was functional throughout the year. Bed Occupancy rate in MZH was 97% but in SZH it was only 63%.In SZH, OT was functional only 54% of the days in 2018. CT scan machine was just installed but not functional. Computerized X-Ray in SZH was functional only in 72% of the days. Level of client satisfaction was 87% in MZH but was just 43% in SZH. MZH performed all (256) the Caesarean Sections but SZH performed only 36% of 210 Caesarean Sections in 2018. In annual performance ranking of Government Hospitals, MZH was placed in 1st rank while as SZH was placed in 19th rank out of 32 referral hospitals nationwide in 2018. Conclusion: Biomedical technicians are the crucial member of the human resource for health team with the pivotal role. Trained and qualified BMET professionals are required within health-care systems in order to design, evaluate, regulate, acquire, maintain, manage and train on safe medical technologies. Applying knowledge of engineering and technology to health-care systems to ensure availability, affordability, accessibility, acceptability and utilization of the safer, higher quality, effective, appropriate and socially acceptable bio medical technology to populations for preventive, promotive, curative, rehabilitative and palliative care across all levels of the health service delivery.

Keywords: biomedical equipment technicians, BMET, human resources for health, HRH, quality health service, rural hospitals

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338 Digital Skepticism In A Legal Philosophical Approach

Authors: dr. Bendes Ákos

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Digital skepticism, a critical stance towards digital technology and its pervasive influence on society, presents significant challenges when analyzed from a legal philosophical perspective. This abstract aims to explore the intersection of digital skepticism and legal philosophy, emphasizing the implications for justice, rights, and the rule of law in the digital age. Digital skepticism arises from concerns about privacy, security, and the ethical implications of digital technology. It questions the extent to which digital advancements enhance or undermine fundamental human values. Legal philosophy, which interrogates the foundations and purposes of law, provides a framework for examining these concerns critically. One key area where digital skepticism and legal philosophy intersect is in the realm of privacy. Digital technologies, particularly data collection and surveillance mechanisms, pose substantial threats to individual privacy. Legal philosophers must grapple with questions about the limits of state power and the protection of personal autonomy. They must consider how traditional legal principles, such as the right to privacy, can be adapted or reinterpreted in light of new technological realities. Security is another critical concern. Digital skepticism highlights vulnerabilities in cybersecurity and the potential for malicious activities, such as hacking and cybercrime, to disrupt legal systems and societal order. Legal philosophy must address how laws can evolve to protect against these new forms of threats while balancing security with civil liberties. Ethics plays a central role in this discourse. Digital technologies raise ethical dilemmas, such as the development and use of artificial intelligence and machine learning algorithms that may perpetuate biases or make decisions without human oversight. Legal philosophers must evaluate the moral responsibilities of those who design and implement these technologies and consider the implications for justice and fairness. Furthermore, digital skepticism prompts a reevaluation of the concept of the rule of law. In an increasingly digital world, maintaining transparency, accountability, and fairness becomes more complex. Legal philosophers must explore how legal frameworks can ensure that digital technologies serve the public good and do not entrench power imbalances or erode democratic principles. Finally, the intersection of digital skepticism and legal philosophy has practical implications for policy-making. Legal scholars and practitioners must work collaboratively to develop regulations and guidelines that address the challenges posed by digital technology. This includes crafting laws that protect individual rights, ensure security, and promote ethical standards in technology development and deployment. In conclusion, digital skepticism provides a crucial lens for examining the impact of digital technology on law and society. A legal philosophical approach offers valuable insights into how legal systems can adapt to protect fundamental values in the digital age. By addressing privacy, security, ethics, and the rule of law, legal philosophers can help shape a future where digital advancements enhance, rather than undermine, justice and human dignity.

Keywords: legal philosophy, privacy, security, ethics, digital skepticism

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337 Features of Fossil Fuels Generation from Bazhenov Formation Source Rocks by Hydropyrolysis

Authors: Anton G. Kalmykov, Andrew Yu. Bychkov, Georgy A. Kalmykov

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Nowadays, most oil reserves in Russia and all over the world are hard to recover. That is the reason oil companies are searching for new sources for hydrocarbon production. One of the sources might be high-carbon formations with unconventional reservoirs. Bazhenov formation is a huge source rock formation located in West Siberia, which contains unconventional reservoirs on some of the areas. These reservoirs are formed by secondary processes with low predicting ratio. Only one of five wells is drilled through unconventional reservoirs, in others kerogen has low thermal maturity, and they are of low petroliferous. Therefore, there was a request for tertiary methods for in-situ cracking of kerogen and production of oil. Laboratory experiments of Bazhenov formation rock hydrous pyrolysis were used to investigate features of the oil generation process. Experiments on Bazhenov rocks with a different mineral composition (silica concentration from 15 to 90 wt.%, clays – 5-50 wt.%, carbonates – 0-30 wt.%, kerogen – 1-25 wt.%) and thermal maturity (from immature to late oil window kerogen) were performed in a retort under reservoir conditions. Rock samples of 50 g weight were placed in retort, covered with water and heated to the different temperature varied from 250 to 400°C with the durability of the experiments from several hours to one week. After the experiments, the retort was cooled to room temperature; generated hydrocarbons were extracted with hexane, then separated from the solvent and weighted. The molecular composition of this synthesized oil was then investigated via GC-MS chromatography Characteristics of rock samples after the heating was measured via the Rock-Eval method. It was found, that the amount of synthesized oil and its composition depending on the experimental conditions and composition of rocks. The highest amount of oil was produced at a temperature of 350°C after 12 hours of heating and was up to 12 wt.% of initial organic matter content in the rocks. At the higher temperatures and within longer heating time secondary cracking of generated hydrocarbons occurs, the mass of produced oil is lowering, and the composition contains more hydrocarbons that need to be recovered by catalytical processes. If the temperature is lower than 300°C, the amount of produced oil is too low for the process to be economically effective. It was also found that silica and clay minerals work as catalysts. Selection of heating conditions allows producing synthesized oil with specified composition. Kerogen investigations after heating have shown that thermal maturity increases, but the yield is only up to 35% of the maximum amount of synthetic oil. This yield is the result of gaseous hydrocarbons formation due to secondary cracking and aromatization and coaling of kerogen. Future investigations will allow the increase in the yield of synthetic oil. The results are in a good agreement with theoretical data on kerogen maturation during oil production. Evaluated trends could be tooled up for in-situ oil generation by shale rocks thermal action.

Keywords: Bazhenov formation, fossil fuels, hydropyrolysis, synthetic oil

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336 Diagnosis of Intermittent High Vibration Peaks in Industrial Gas Turbine Using Advanced Vibrations Analysis

Authors: Abubakar Rashid, Muhammad Saad, Faheem Ahmed

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This paper provides a comprehensive study pertaining to diagnosis of intermittent high vibrations on an industrial gas turbine using detailed vibrations analysis, followed by its rectification. Engro Polymer & Chemicals Limited, a Chlor-Vinyl complex located in Pakistan has a captive combined cycle power plant having two 28 MW gas turbines (make Hitachi) & one 15 MW steam turbine. In 2018, the organization faced an issue of high vibrations on one of the gas turbines. These high vibration peaks appeared intermittently on both compressor’s drive end (DE) & turbine’s non-drive end (NDE) bearing. The amplitude of high vibration peaks was between 150-170% on the DE bearing & 200-300% on the NDE bearing from baseline values. In one of these episodes, the gas turbine got tripped on “High Vibrations Trip” logic actuated at 155µm. Limited instrumentation is available on the machine, which is monitored with GE Bently Nevada 3300 system having two proximity probes installed at Turbine NDE, Compressor DE &at Generator DE & NDE bearings. Machine’s transient ramp-up & steady state data was collected using ADRE SXP & DSPI 408. Since only 01 key phasor is installed at Turbine high speed shaft, a derived drive key phasor was configured in ADRE to obtain low speed shaft rpm required for data analysis. By analyzing the Bode plots, Shaft center line plot, Polar plot & orbit plots; rubbing was evident on Turbine’s NDE along with increased bearing clearance of Turbine’s NDE radial bearing. The subject bearing was then inspected & heavy deposition of carbonized coke was found on the labyrinth seals of bearing housing with clear rubbing marks on shaft & housing covering at 20-25 degrees on the inner radius of labyrinth seals. The collected coke sample was tested in laboratory & found to be the residue of lube oil in the bearing housing. After detailed inspection & cleaning of shaft journal area & bearing housing, new radial bearing was installed. Before assembling the bearing housing, cleaning of bearing cooling & sealing air lines was also carried out as inadequate flow of cooling & sealing air can accelerate coke formation in bearing housing. The machine was then taken back online & data was collected again using ADRE SXP & DSPI 408 for health analysis. The vibrations were found in acceptable zone as per ISO standard 7919-3 while all other parameters were also within vendor defined range. As a learning from subject case, revised operating & maintenance regime has also been proposed to enhance machine’s reliability.

Keywords: ADRE, bearing, gas turbine, GE Bently Nevada, Hitachi, vibration

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335 Getting to Know ICU Nurses and Their Duties

Authors: Masih Nikgou

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ICU nurses or intensive care nurses are highly specialized and trained healthcare personnel. These nurses provide nursing care for patients with life-threatening illnesses or conditions. They provide the experience, knowledge and specialized skills that patients need to survive and recover. Intensive care nurses (ICU) are trained to make momentary decisions and act quickly when the patient's condition changes. Their primary work environment is in the hospital in intensive care units. Typically, ICU patients require a high level of care. ICU nurses work in challenging and complex fields in their nursing profession. They have the primary duty of caring for and saving patients who are fighting for their lives. Intensive care (ICU) nurses are highly trained to provide exceptional care to patients who depend on 24/7 nursing care. A patient in the ICU is often equipped with a ventilator, intubated and connected to several life support machines and medical equipment. Intensive Care Nurses (ICU) have full expertise in considering all aspects of bringing back their patients. Some of the specific responsibilities of ICU nurses include (a) Assessing and monitoring the patient's progress and identifying any sudden changes in the patient's medical condition. (b) Administration of drugs intravenously by injection or through gastric tubes. (c) Provide regular updates on patient progress to physicians, patients, and their families. (d) According to the clinical condition of the patient, perform the approved diagnostic or treatment methods. (e) In case of a health emergency, informing the relevant doctors. (f) To determine the need for emergency interventions, evaluate laboratory data and vital signs of patients. (g) Caring for patient needs during recovery in the ICU. (h) ICU nurses often provide emotional support to patients and their families. (i) Regulating and monitoring medical equipment and devices such as medical ventilators, oxygen delivery devices, transducers, and pressure lines. (j) Assessment of pain level and sedation needs of patients. (k) Maintaining patient reports and records. As the name suggests, critical care nurses work primarily in ICU health care units. ICUs are completely healthy and have proper lighting with strict adherence to health and safety from medical centers. ICU nurses usually move between the intensive care unit, the emergency department, the operating room, and other special departments of the hospital. ICU nurses usually follow a standard shift schedule that includes morning, afternoon, and night schedules. There are also other relocation programs depending on the hospital and region. Nurses who are passionate about data and managing a patient's condition and outcomes typically do well as ICU nurses. An inquisitive mind and attention to processes are equally important. ICU nurses are completely compassionate and are not afraid to advocate for their patients and family members. who are distressed.

Keywords: nursing, intensive care unit, pediatric intensive care unit, mobile intensive care unit, surgical intensive care unite

Procedia PDF Downloads 56
334 An Integrated Approach to Child Care Earthquake Preparedness through “Telemachus” Project

Authors: A. Kourou, S. Kyriakopoulos, N. Anyfanti

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A lot of children under the age of five spend their daytime hours away from their home, in a kindergarten. Caring for children is a serious subject, and their safety in case of earthquake is the first priority. Being aware of earthquakes helps to prioritize the needs and take the appropriate actions to limit the effects. Earthquakes occurring anywhere at any time require emergency planning. Earthquake planning is a cooperative effort and childcare providers have unique roles and responsibilities. Greece has high seismicity and Ionian Islands Region has the highest seismic activity of the country. The last five years Earthquake Planning and Protection Organization (EPPO), which is a national organization, has analyzed the needs and requirements of kindergartens on earthquake protection issues. In this framework it has been noticed that although the State requires child care centers to hold drills, the standards for emergency preparedness in these centers are varied, and a lot of them had not written plans for emergencies. For these reasons, EPPO supports the development of emergency planning guidance and familiarizes the day care centers’ staff being prepared for earthquakes. Furthermore, the Handbook on Day Care Earthquake Planning that has been developed by EPPO helps the providers to understand that emergency planning is essential to risk reduction. Preparedness and training should be ongoing processes, thus EPPO implements every year dozens of specific seminars on children’s disaster related needs. This research presents the results of a survey that detects the level of earthquake preparedness of kindergartens in all over the country and Ionian Islands too. A closed-form questionnaire of 20 main questions was developed for the survey in order to detect the aspects of participants concerning the earthquake preparedness actions at individual, family and day care environment level. 2668 questionnaires were gathered from March 2014 to May 2019, and analyzed by EPPO’s Department of Education. Moreover, this paper presents the EPPO’s educational activities targeted to the Ionian Islands Region that implemented in the framework of “Telemachus” Project. To provide safe environment for children to learn, and staff to work is the foremost goal of any State, community and kindergarten. This project is funded under the Priority Axis "Environmental Protection and Sustainable Development" of Operational Plan "Ionian Islands 2014-2020". It is increasingly accepted that emergency preparedness should be thought of as an ongoing process rather than a one-time activity. Creating an earthquake safe daycare environment that facilitates learning is a challenging task. Training, drills, and update of emergency plan should take place throughout the year at kindergartens to identify any gaps and to ensure the emergency procedures. EPPO will continue to work closely with regional and local authorities to actively address the needs of children and kindergartens before, during and after earthquakes.

Keywords: child care centers, education on earthquake, emergency planning, kindergartens, Ionian Islands Region of Greece

Procedia PDF Downloads 102
333 Characterization of the MOSkin Dosimeter for Accumulated Dose Assessment in Computed Tomography

Authors: Lenon M. Pereira, Helen J. Khoury, Marcos E. A. Andrade, Dean L. Cutajar, Vinicius S. M. Barros, Anatoly B. Rozenfeld

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With the increase of beam widths and the advent of multiple-slice and helical scanners, concerns related to the current dose measurement protocols and instrumentation in computed tomography (CT) have arisen. The current methodology of dose evaluation, which is based on the measurement of the integral of a single slice dose profile using a 100 mm long cylinder ionization chamber (Ca,100 and CPPMA, 100), has been shown to be inadequate for wide beams as it does not collect enough of the scatter-tails to make an accurate measurement. In addition, a long ionization chamber does not offer a good representation of the dose profile when tube current modulation is used. An alternative approach has been suggested by translating smaller detectors through the beam plane and assessing the accumulated dose trough the integral of the dose profile, which can be done for any arbitrary length in phantoms or in the air. For this purpose, a MOSFET dosimeter of small dosimetric volume was used. One of its recently designed versions is known as the MOSkin, which is developed by the Centre for Medical Radiation Physics at the University of Wollongong, and measures the radiation dose at a water equivalent depth of 0.07 mm, allowing the evaluation of skin dose when placed at the surface, or internal point doses when placed within a phantom. Thus, the aim of this research was to characterize the response of the MOSkin dosimeter for X-ray CT beams and to evaluate its application for the accumulated dose assessment. Initially, tests using an industrial x-ray unit were carried out at the Laboratory of Ionization Radiation Metrology (LMRI) of Federal University of Pernambuco, in order to investigate the sensitivity, energy dependence, angular dependence, and reproducibility of the dose response for the device for the standard radiation qualities RQT 8, RQT 9 and RQT 10. Finally, the MOSkin was used for the accumulated dose evaluation of scans using a Philips Brilliance 6 CT unit, with comparisons made between the CPPMA,100 value assessed with a pencil ionization chamber (PTW Freiburg TW 30009). Both dosimeters were placed in the center of a PMMA head phantom (diameter of 16 cm) and exposed in the axial mode with collimation of 9 mm, 250 mAs and 120 kV. The results have shown that the MOSkin response was linear with doses in the CT range and reproducible (98.52%). The sensitivity for a single MOSkin in mV/cGy was as follows: 9.208, 7.691 and 6.723 for the RQT 8, RQT 9 and RQT 10 beams qualities respectively. The energy dependence varied up to a factor of ±1.19 among those energies and angular dependence was not greater than 7.78% within the angle range from 0 to 90 degrees. The accumulated dose and the CPMMA, 100 value were 3,97 and 3,79 cGy respectively, which were statistically equivalent within the 95% confidence level. The MOSkin was shown to be a good alternative for CT dose profile measurements and more than adequate to provide accumulated dose assessments for CT procedures.

Keywords: computed tomography dosimetry, MOSFET, MOSkin, semiconductor dosimetry

Procedia PDF Downloads 294
332 From Victim to Ethical Agent: Oscar Wilde's The Ballad of Reading Gaol as Post-Traumatic Writing

Authors: Mona Salah El-Din Hassanein

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Faced with a sudden, unexpected, and overwhelming event, the individual's normal cognitive processing may cease to function, trapping the psyche in "speechless terror", while images, feelings and sensations are experienced with emotional intensity. Unable to master such situation, the individual becomes a trauma victim who will be susceptible to traumatic recollections like intrusive thoughts, flashbacks, and repetitive re-living of the primal event in a way that blurs the distinction between past and present, and forecloses the future. Trauma is timeless, repetitious, and contagious; a trauma observer could fall prey to "secondary victimhood". Central to the process of healing the psychic wounds in the aftermath of trauma is verbalizing the traumatic experience (i.e., putting it into words) – an act which provides a chance for assimilation, testimony, and reevaluation. In light of this paradigm, this paper proposes a reading of Oscar Wilde's The Ballad of Reading Gaol, written shortly after his release from prison, as a post-traumatic text which traces the disruptive effects of the traumatic experience of Wilde's imprisonment for homosexual offences and the ensuing reversal of fortune he endured. Post-traumatic writing demonstrates the process of "working through" a trauma which may lead to the possibility of ethical agency in the form of a "survivor mission". This paper draws on fundamental concepts and key insights in literary trauma theory which is characterized by interdisciplinarity, combining the perspectives of different fields like critical theory, psychology, psychiatry, psychoanalysis, history, and social studies. Of particular relevance to this paper are the concepts of "vicarious traumatization" and "survivor mission", as The Ballad of Reading Gaol was written in response to Wilde's own prison trauma and the indirect traumatization he experienced as a result of witnessing the execution of a fellow prisoner whose story forms the narrative base of the poem. The Ballad displays Wilde's sense of mission which leads him to recognize the social as well as ethical implications of personal tragedy. Through a close textual analysis of The Ballad of Reading Gaol within the framework of literary trauma theory, the paper aims to: (a) demonstrate how the poem's thematic concerns, structure and rhetorical figures reflect the structure of trauma; (b) highlight Wilde's attempts to come to terms with the effects of the cataclysmic experience which transformed him into a social outcast; and (c) show how Wilde manages to transcend the victim status and assumes the role of ethical agent to voice a critique of the Victorian penal system and the standards of morality underlying the cruelties practiced against wrong doers and to solicit social action.

Keywords: ballad of reading of reading, post-traumatic writing, trauma theory, Wilde

Procedia PDF Downloads 169
331 Toxicity Evaluation of Reduced Graphene Oxide on First Larval Stages of Artemia sp.

Authors: Roberta Pecoraro

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The focus of this work was to investigate the potential toxic effect of titanium dioxide-reduced graphene oxide (TiO₂-rGO) nanocomposites on nauplii of microcrustacean Artemia sp. In order to assess the nanocomposite’s toxicity, a short-term test was performed by exposing nauplii to solutions containing TiO₂-rGO. To prepare titanium dioxide-reduced graphene oxide (TiO₂-rGO) nanocomposites, a green procedure based on solar photoreduction was proposed; it allows to obtain the photocatalysts by exploiting the photocatalytic properties of titania activated by the solar irradiation in order to avoid the high temperatures and pressures required for the standard hydrothermal synthesis. Powders of TiO₂-rGO supplied by the Department of Chemical Sciences (University of Catania) are indicated as TiO₂-rGO at 1% and TiO₂-rGO at 2%. Starting from a stock solution (1mg rGO-TiO₂/10 ml ASPM water) of each type, we tested four different concentrations (serial dilutions ranging from 10⁻¹ to 10⁻⁴ mg/ml). All the solutions have been sonicated for 12 min prior to use. Artificial seawater (called ASPM water) was prepared to guarantee the hatching of the cysts and to maintain nauplii; the durable cysts used in this study, marketed by JBL (JBL GmbH & Co. KG, Germany), were hydrated with ASPM water to obtain nauplii (instar II-III larvae). The hatching of the cysts was carried out in the laboratory by immersing them in ASPM water inside a 500 ml beaker and keeping them constantly oxygenated thanks to an aerator for the insufflation of microbubble air: after 24-48 hours, the cysts hatched, and the nauplii appeared. The nauplii in the second and third stages of development were collected one-to-one, using stereomicroscopes, and transferred into 96-well microplates where one nauplius per well was added. The wells quickly have been filled with 300 µl of each specific concentration of the solution used, and control samples were incubated only with ASPM water. Replication was performed for each concentration. Finally, the microplates were placed on an orbital shaker, and the tests were read after 24 and 48 hours from inoculating the solutions to assess the endpoint (immobility/death) for the larvae. Nauplii that appeared motionless were counted as dead, and the percentages of mortality were calculated for each treatment. The results showed a low percentage of immobilization both for TiO₂-rGO at 1% and TiO₂-rGO at 2% for all concentrations tested: for TiO₂-rGO at 1% was below 12% after 24h and below 15% after 48h; for TiO₂-rGO at 2% was below 8% after 24h and below 12% after 48h. According to other studies in the literature, the results have not shown mortality nor toxic effects on the development of larvae after exposure to rGO. Finally, it is important to highlight that the TiO₂-rGO catalysts were tested in the solar photodegradation of a toxic herbicide (2,4-Dichlorophenoxyacetic acid, 2,4-D), obtaining a high percentage of degradation; therefore, this alternative approach could be considered a good strategy to obtain performing photocatalysts.

Keywords: Nauplii, photocatalytic properties, reduced GO, short-term toxicity test, titanium dioxide

Procedia PDF Downloads 168
330 Aquatic Sediment and Honey of Apis mellifera as Bioindicators of Pesticide Residues

Authors: Luana Guerra, Silvio C. Sampaio, Vladimir Pavan Margarido, Ralpho R. Reis

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Brazil is the world's largest consumer of pesticides. The excessive use of these compounds has negative impacts on animal and human life, the environment, and food security. Bees, crucial for pollination, are exposed to pesticides during the collection of nectar and pollen, posing risks to their health and the food chain, including honey contamination. Aquatic sediments are also affected, impacting water quality and the microbiota. Therefore, the analysis of aquatic sediments and bee honey is essential to identify environmental contamination and monitor ecosystems. The aim of this study was to use samples of honey from honeybees (Apis mellifera) and aquatic sediment as bioindicators of environmental contamination by pesticides and their relationship with agricultural use in the surrounding areas. The sample collections of sediment and honey were carried out in two stages. The first stage was conducted in the Bituruna municipality region in the second half of the year 2022, and the second stage took place in the regions of Laranjeiras do Sul, Quedas do Iguaçu, and Nova Laranjeiras in the first half of the year 2023. In total, 10 collection points were selected, with 5 points in the first stage and 5 points in the second stage, where one sediment sample and one honey sample were collected for each point, totaling 20 samples. The honey and sediment samples were analyzed at the Laboratory of the Paraná Institute of Technology, with ten samples of honey and ten samples of sediment. The selected extraction method was QuEChERS, and the analysis of the components present in the sample was performed using liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). The pesticides Azoxystrobin, Epoxiconazole, Boscalid, Carbendazim, Haloxifope, Fomesafen, Fipronil, Chlorantraniliprole, Imidacloprid, and Bifenthrin were detected in the sediment samples from the study area in Laranjeiras do Sul, Paraná, with Carbendazim being the compound with the highest concentration (0.47 mg/kg). The honey samples obtained from the apiaries showed satisfactory results, as they did not show any detection or quantification of the analyzed pesticides, except for Point 9, which had the fungicide tebuconazole but with a concentration Keywords: contamination, water research, agrochemicals, beekeeping activity

Procedia PDF Downloads 23
329 A Laundry Algorithm for Colored Textiles

Authors: H. E. Budak, B. Arslan-Ilkiz, N. Cakmakci, I. Gocek, U. K. Sahin, H. Acikgoz-Tufan, M. H. Arslan

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The aim of this study is to design a novel laundry algorithm for colored textiles which have significant decoloring problem. During the experimental work, bleached knitted single jersey fabric made of 100% cotton and dyed with reactive dyestuff was utilized, since according to a conducted survey textiles made of cotton are the most demanded textile products in the textile market by the textile consumers and for coloration of textiles reactive dyestuffs are the ones that are the most commonly used in the textile industry for dyeing cotton-made products. Therefore, the fabric used in this study was selected and purchased in accordance with the survey results. The fabric samples cut out of this fabric were dyed with different dyeing parameters by using Remazol Brilliant Red 3BS dyestuff in Gyrowash machine at laboratory conditions. From the alternative reactive-dyed cotton fabric samples, the ones that have high tendency to color loss were determined and examined. Accordingly, the parameters of the dyeing process used for these fabric samples were evaluated and the dyeing process which was chosen to be used for causing high tendency to color loss for the cotton fabrics was determined in order to reveal the level of improvement in color loss during this study clearly. Afterwards, all of the untreated fabric samples cut out of the fabric purchased were dyed with the dyeing process selected. When dyeing process was completed, an experimental design was created for the laundering process by using Minitab® program considering temperature, time and mechanical action as parameters. All of the washing experiments were performed in domestic washing machine. 16 washing experiments were performed with 8 different experimental conditions and 2 repeats for each condition. After each of the washing experiments, water samples of the main wash of the laundering process were measured with UV spectrophotometer. The values obtained were compared with the calibration curve of the materials used for the dyeing process. The results of the washing experiments were statistically analyzed with Minitab® program. According to the results, the most suitable washing algorithm to be used in terms of the parameters temperature, time and mechanical action for domestic washing machines for minimizing fabric color loss was chosen. The laundry algorithm proposed in this study have the ability of minimalizing the problem of color loss of colored textiles in washing machines by eliminating the negative effects of the parameters of laundering process on color of textiles without compromising the fundamental effects of basic cleaning action being performed properly. Therefore, since fabric color loss is minimized with this washing algorithm, dyestuff residuals will definitely be lower in the grey water released from the laundering process. In addition to this, with this laundry algorithm it is possible to wash and clean other types of textile products with proper cleaning effect and minimized color loss.

Keywords: color loss, laundry algorithm, textiles, domestic washing process

Procedia PDF Downloads 333
328 Exploration into Bio Inspired Computing Based on Spintronic Energy Efficiency Principles and Neuromorphic Speed Pathways

Authors: Anirudh Lahiri

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Neuromorphic computing, inspired by the intricate operations of biological neural networks, offers a revolutionary approach to overcoming the limitations of traditional computing architectures. This research proposes the integration of spintronics with neuromorphic systems, aiming to enhance computational performance, scalability, and energy efficiency. Traditional computing systems, based on the Von Neumann architecture, struggle with scalability and efficiency due to the segregation of memory and processing functions. In contrast, the human brain exemplifies high efficiency and adaptability, processing vast amounts of information with minimal energy consumption. This project explores the use of spintronics, which utilizes the electron's spin rather than its charge, to create more energy-efficient computing systems. Spintronic devices, such as magnetic tunnel junctions (MTJs) manipulated through spin-transfer torque (STT) and spin-orbit torque (SOT), offer a promising pathway to reducing power consumption and enhancing the speed of data processing. The integration of these devices within a neuromorphic framework aims to replicate the efficiency and adaptability of biological systems. The research is structured into three phases: an exhaustive literature review to build a theoretical foundation, laboratory experiments to test and optimize the theoretical models, and iterative refinements based on experimental results to finalize the system. The initial phase focuses on understanding the current state of neuromorphic and spintronic technologies. The second phase involves practical experimentation with spintronic devices and the development of neuromorphic systems that mimic synaptic plasticity and other biological processes. The final phase focuses on refining the systems based on feedback from the testing phase and preparing the findings for publication. The expected contributions of this research are twofold. Firstly, it aims to significantly reduce the energy consumption of computational systems while maintaining or increasing processing speed, addressing a critical need in the field of computing. Secondly, it seeks to enhance the learning capabilities of neuromorphic systems, allowing them to adapt more dynamically to changing environmental inputs, thus better mimicking the human brain's functionality. The integration of spintronics with neuromorphic computing could revolutionize how computational systems are designed, making them more efficient, faster, and more adaptable. This research aligns with the ongoing pursuit of energy-efficient and scalable computing solutions, marking a significant step forward in the field of computational technology.

Keywords: material science, biological engineering, mechanical engineering, neuromorphic computing, spintronics, energy efficiency, computational scalability, synaptic plasticity.

Procedia PDF Downloads 13
327 A Research Review on the Presence of Pesticide Residues in Apples Carried out in Poland in the Years 1980-2015

Authors: Bartosz Piechowicz, Stanislaw Sadlo, Przemyslaw Grodzicki, Magdalena Podbielska

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Apples are popular fruits. They are eaten freshly and/or after processing. For instance Golden Delicious is an apple variety commonly used in production of foods for babies and toddlers. It is no wonder that complex analyses of the pesticide residue levels in those fruits have been carried out since eighties, and continued for the next years up to now. The results obtained were presented, usually as a teamwork, at the scientific sessions organised by the (IOR) Institute of Plant Protection-National Research Institute in Poznań and published in Scientific Works of the Institute (now Progress in Plant Protection/ Postępy w Ochronie Roślin) or Journal of Plant Protection Research, and in many non-periodical publications. These reports included studies carried out by IOR Laboratories in Poznań, Sośnicowice, Rzeszów and Bialystok. First detailed studies on the presence of pesticide residues in apple fruits by the laboratory in Rzeszów were published in 1991 in the article entitled 'The presence of pesticides in apples of late varieties from the area of south-eastern Poland in the years 1986-1989', in Annals of National Institute of Hygiene in Warsaw. These surveys gave the scientific base for business contacts between the Polish company Alima and the American company Gerber. At the beginning of XXI century, in Poland, systematic and complex studies on the deposition of pesticide residues in apples were initiated. First of all, the levels of active ingredients of plant protection products applied against storage diseases at 2-3 weeks before the harvest were determined. It is known that the above mentioned substances usually generate the highest residue levels. Also, the assessment of the fungicide residues in apples during their storage in controlled atmosphere and during their processing was carried out. Taking into account the need of actualisation the Maximum Residue Levels of pesticides, in force in Poland and in other European countries, and rationalisation of the ways of their determination, a lot of field tests on the behaviour of more important fungicides on the mature fruits just before their harvesting, were carried out. A rate of their disappearance and mathematical equation that showed the relationship between the residue level of any substance and the used dose, have been determined. The two parameters have allowed to evaluate the Maximum Residue Levels (MRLs) of pesticides, which were in force at that time, and to propose a coherent model of their determination in respect to the new substances. The obtained results were assessed in terms of the health risk for adult consumers and children, and to such determination of terms of treatment that mature apples could meet the rigorous level of 0.01 mg/kg.

Keywords: apple, disappearance, health risk, MRL, pesticide residue, research

Procedia PDF Downloads 261
326 Characterization of Alloyed Grey Cast Iron Quenched and Tempered for a Smooth Roll Application

Authors: Mohamed Habireche, Nacer E. Bacha, Mohamed Djeghdjough

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In the brick industry, smooth double roll crusher is used for medium and fine crushing of soft to medium hard material. Due to opposite inward rotation of the rolls, the feed material is nipped between the rolls and crushed by compression. They are subject to intense wear, known as three-body abrasion, due to the action of abrasive products. The production downtime affecting productivity stems from two sources: the bi-monthly rectification of the roll crushers and their replacement when they are completely worn out. Choosing the right material for the roll crushers should result in longer machine cycles, and reduced repair and maintenance costs. All roll crushers are imported from outside Algeria. This results in sometimes very long delivery times which handicap the brickyards, in particular in respecting delivery times and honored the orders made by customers. The aim of this work is to investigate the effect of alloying additions on microstructure and wear behavior of grey lamellar cast iron for smooth roll crushers in brick industry. The base gray iron was melted in an induction furnace with low frequency at a temperature of 1500 °C, in which return cast iron scrap, new cast iron ingot, and steel scrap were added to the melt to generate the desired composition. The chemical analysis of the bar samples was carried out using Emission Spectrometer Systems PV 8050 Series (Philips) except for the carbon, for which a carbon/sulphur analyser Elementrac CS-i was used. Unetched microstructure was used to evaluate the graphite flake morphology using the image comparison measurement method. At least five different fields were selected for quantitative estimation of phase constituents. The samples were observed under X100 magnification with a Zeiss Axiover T40 MAT optical microscope equipped with a digital camera. SEM microscope equipped with EDS was used to characterize the phases present in the microstructure. The hardness (750 kg load, 5mm diameter ball) was measured with a Brinell testing machine for both treated and as-solidified condition test pieces. The test bars were used for tensile strength and metallographic evaluations. Mechanical properties were evaluated using tensile specimens made as per ASTM E8 standards. Two specimens were tested for each alloy. From each rod, a test piece was made for the tensile test. The results showed that the quenched and tempered alloys had best wear resistance at 400 °C for alloyed grey cast iron (containing 0.62%Mn, 0.68%Cr, and 1.09% Cu) due to fine carbides in the tempered matrix. In quenched and tempered condition, increasing Cu content in cast irons improved its wear resistance moderately. Combined addition of Cu and Cr increases hardness and wear resistance for a quenched and tempered hypoeutectic grey cast iron.

Keywords: casting, cast iron, microstructure, heat treating

Procedia PDF Downloads 92
325 Efficiency of Different Types of Addition onto the Hydration Kinetics of Portland Cement

Authors: Marine Regnier, Pascal Bost, Matthieu Horgnies

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Some of the problems to be solved for the concrete industry are linked to the use of low-reactivity cement, the hardening of concrete under cold-weather and the manufacture of pre-casted concrete without costly heating step. The development of these applications needs to accelerate the hydration kinetics, in order to decrease the setting time and to obtain significant compressive strengths as soon as possible. The mechanisms enhancing the hydration kinetics of alite or Portland cement (e.g. the creation of nucleation sites) were already studied in literature (e.g. by using distinct additions such as titanium dioxide nanoparticles, calcium carbonate fillers, water-soluble polymers, C-S-H, etc.). However, the goal of this study was to establish a clear ranking of the efficiency of several types of additions by using a robust and reproducible methodology based on isothermal calorimetry (performed at 20°C). The cement was a CEM I 52.5N PM-ES (Blaine fineness of 455 m²/kg). To ensure the reproducibility of the experiments and avoid any decrease of the reactivity before use, the cement was stored in waterproof and sealed bags to avoid any contact with moisture and carbon dioxide. The experiments were performed on Portland cement pastes by using a water-to-cement ratio of 0.45, and incorporating different compounds (industrially available or laboratory-synthesized) that were selected according to their main composition and their specific surface area (SSA, calculated using the Brunauer-Emmett-Teller (BET) model and nitrogen adsorption isotherms performed at 77K). The intrinsic effects of (i) dry powders (e.g. fumed silica, activated charcoal, nano-precipitates of calcium carbonate, afwillite germs, nanoparticles of iron and iron oxides , etc.), and (ii) aqueous solutions (e.g. containing calcium chloride, hydrated Portland cement or Master X-SEED 100, etc.) were investigated. The influence of the amount of addition, calculated relatively to the dry extract of each addition compared to cement (and by conserving the same water-to-cement ratio) was also studied. The results demonstrated that the X-SEED®, the hydrated calcium nitrate, the calcium chloride (and, at a minor level, a solution of hydrated Portland cement) were able to accelerate the hydration kinetics of Portland cement, even at low concentration (e.g. 1%wt. of dry extract compared to cement). By using higher rates of additions, the fumed silica, the precipitated calcium carbonate and the titanium dioxide can also accelerate the hydration. In the case of the nano-precipitates of calcium carbonate, a correlation was established between the SSA and the accelerating effect. On the contrary, the nanoparticles of iron or iron oxides, the activated charcoal and the dried crystallised hydrates did not show any accelerating effect. Future experiments will be scheduled to establish the ranking of these additions, in terms of accelerating effect, by using low-reactivity cements and other water to cement ratios.

Keywords: acceleration, hydration kinetics, isothermal calorimetry, Portland cement

Procedia PDF Downloads 241
324 Pregnancy Outcomes in Women With History of COVID-19 in Alexandria, Egypt

Authors: Nermeen Elbeltagy, Helmy abd Elsatar, Sara Hassan, Mohamed Darwish

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Introduction: with the inial appearance in Wuhan, China, in December 2019, the coronavirus disease-related respiratory infection (COVID-19) has rapidly spread among people all over the world. The WHO considered it a pandemic in March 2020. The severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV) outbreaks have proved that pregnant females as well as their fetuses are exposed to adverse outcomes, including high rates of intensive care unit (ICU) admission and case fatality. Physiological changes occurring during pregnancy such as the increased transverse diameter of the thoracic cage as well as the elevation of the diaphragm can expose the mother to severe infections because of her decreased tolerance for hypoxia. Furthermore, vasodilation and changes in lung capacity can cause mucosal edema and an increase in upper respiratory tract secretions. In addition, the increased susceptibility to infection is enhanced by changes in cellmediated immunity. Aim of the work: to study the effect of COVID-19 on pregnant females admitted to El-Shatby Maternity University Hospital regarding maternal antepartum, intrapartum and postpartum adverse effects on the mothers and their neonates. Method: A retrospective cohort study was done between October 2020 and October 2022. Maternal characteristics and associated health conditions of COVID-19 positive parents were investigated. Also, the severity of their conditions and me of infection (first or second or third trimester)were explored. Cases were diagnosed based on presence of symptoms suggestive of COVID-19, laboratory tests (other than PCR) and radiological findings.all cases were confirmed by positive PCR test results. Results: The most common adverse maternal outcomes were pre-term labor (11.6%) followed by premature rupture of membranes (5.7%), post-partum hemorrhage (5.4%), preeclampsia (5.0%) and placental abrupon (4.3%). One sixth of the neonates of the studied paents were admied to NICUs and 6.5% of them had respiratory distress with no neonatal deaths. The majority of neonates (85.4%) had a birth weight of 2500- 4000g (normal range). Most of the neonates (77.9%) had an APGAR score of equal or more than 7 in 5 minutes. Conclusion: the most common comorbidity that might increase the incidence of COVID-19 before pregnancy were diabetes, cardiac disorders/ chronic hypertension and chronic obstructive lung diseases (non-asthma). During pregnancy, anemia followed by gestational diabetes and pre-eclampsia/gestational hypertension were the most prevalent comorbidity. So, severity of infection can be reduced by good antenatal care.

Keywords: COVID-19, pregnancy outcome, complicated pregnancy., COVID in Egypt

Procedia PDF Downloads 57
323 Small and Medium-Sized Enterprises, Flash Flooding and Organisational Resilience Capacity: Qualitative Findings on Implications of the Catastrophic 2017 Flash Flood Event in Mandra, Greece

Authors: Antonis Skouloudis, Georgios Deligiannakis, Panagiotis Vouros, Konstantinos Evangelinos, Loannis Nikolaou

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On November 15th, 2017, a catastrophic flash flood devastated the city of Mandra in Central Greece, resulting in 24 fatalities and extensive damages to the built environment and infrastructure. It was Greece's deadliest and most destructive flood event for the past 40 years. In this paper, we examine the consequences of this event too small and medium-sized enterprises (SMEs) operating in Mandra during the flood event, which were affected by the floodwaters to varying extents. In this context, we conducted semi-structured interviews with business owners-managers of 45 SMEs located in flood inundated areas and are still active nowadays, based on an interview guide that spanned 27 topics. The topics pertained to the disaster experience of the business and business owners-managers, knowledge and attitudes towards climate change and extreme weather, aspects of disaster preparedness and related assistance needs. Our findings reveal that the vast majority of the affected businesses experienced heavy damages in equipment and infrastructure or total destruction, which resulted in business interruption from several weeks up to several months. Assistance from relatives or friends helped for the damage repairs and business recovery, while state compensations were deemed insufficient compared to the extent of the damages. Most interviewees pinpoint flooding as one of the most critical risks, and many connect it with the climate crisis. However, they are either not willing or unable to apply property-level prevention measures in their businesses due to cost considerations or complex and cumbersome bureaucratic processes. In all cases, the business owners are fully aware of the flood hazard implications, and since the recovery from the event, they have engaged in basic mitigation measures and contingency plans in case of future flood events. Such plans include insurance contracts whenever possible (as the vast majority of the affected SMEs were uninsured at the time of the 2017 event) as well as simple relocations of critical equipment within their property. The study offers fruitful insights on latent drivers and barriers of SMEs' resilience capacity to flash flooding. In this respect, findings such as ours, highlighting tensions that underpin behavioral responses and experiences, can feed into a) bottom-up approaches for devising actionable and practical guidelines, manuals and/or standards on business preparedness to flooding, and, ultimately, b) policy-making for an enabling environment towards a flood-resilient SME sector.

Keywords: flash flood, small and medium-sized enterprises, organizational resilience capacity, disaster preparedness, qualitative study

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322 Health and Disease, Sickness and Well Being: Depictions in the Vinaya Pitaka and Jataka Narratives

Authors: Abhimanyu Kumar

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The relationship between religion and medicine is much evident in the context of Buddhism. This paper is an attempt to look at the processes of social and cultural evolution of scientific creativity in the field of medicine and institutionalization of medical practices. The objective of the paper is to understand the Buddhist responses towards health as understood from the Vinaya Piṭaka and the Jātaka. This work is a result of the analysis of two important Buddhist texts: the Vinaya Piṭaka and the Jātaka. Broadly the Vinaya Piṭaka is concerned with the growth of Buddhist monasticism. The Vinaya Piṭaka is considered one of the most important sacred texts of the Buddhists, and contains rules for monastic life. These rules deal with such aspects as formal meetings of the saṃgha (monastery), expiation, confession, training, and legal questions. The Jātaka stories, on the other hand, are in the form of folk narratives, and provide a major source of medical consultation for all classes. These texts help us to ascertain the ‘proficiency and perceptions’ of the prevailing medical traditions. The Jātakas are a collection of 547 stories about the past lives of the Buddha, who is represented in anthropomorphic and animal form. The Jātaka connects itself between existing cognitive environments related to ethics and Buddhist didacticism. These stories are a reflection of the connection between the past and contemporary times (in the sense of time of creation of the story) as well. This is visible through the narrative strategy of the text, where every story is sub-divided into the story of the past and story of the present, and there is a significant identification element or connection that established at the end of each story. The minimal presence of philosophical content and the adoption of a narrative strategy make it possible for more of everyday life. This study gives me an opportunity to raise questions about how far were the body and mind closely interrelated in the Buddhist perceptions, and also did the society act like a laboratory for the Buddhists to practice healing activities? How far did religious responses to afflictions, be they leprosy or plague or anger, influence medical care; what impact did medical practitioners, religious authorities and the regulation of medical activity and practice have on healing the body and the mind; and, how has the healing environment been viewed. This paper is working with the idea that medical science in early India was not only for the curative purpose of diseases, but it fulfilled a greater cause of promoting, maintaining and restoring human health. In this regard, studying these texts gives an insight regarding religious responses to epidemics, from leprosy to plague, as well as to behavioral disorder such as anger. In other words, it deals with the idea about healing the body and healing the soul from a religious perspective.

Keywords: food for health, folk narratives, human body, materia medica, social sickness

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321 Learning the Most Common Causes of Major Industrial Accidents and Apply Best Practices to Prevent Such Accidents

Authors: Rajender Dahiya

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Investigation outcomes of major process incidents have been consistent for decades and validate that the causes and consequences are often identical. The debate remains as we continue to experience similar process incidents even with enormous development of new tools, technologies, industry standards, codes, regulations, and learning processes? The objective of this paper is to investigate the most common causes of major industrial incidents and reveal industry challenges and best practices to prevent such incidents. The author, in his current role, performs audits and inspections of a variety of high-hazard industries in North America, including petroleum refineries, chemicals, petrochemicals, manufacturing, etc. In this paper, he shares real life scenarios, examples, and case studies from high hazards operating facilities including key challenges and best practices. This case study will provide a clear understanding of the importance of near miss incident investigation. The incident was a Safe operating limit excursion. The case describes the deficiencies in management programs, the competency of employees, and the culture of the corporation that includes hazard identification and risk assessment, maintaining the integrity of safety-critical equipment, operating discipline, learning from process safety near misses, process safety competency, process safety culture, audits, and performance measurement. Failure to identify the hazards and manage the risks of highly hazardous materials and processes is one of the primary root-causes of an incident, and failure to learn from past incidents is the leading cause of the recurrence of incidents. Several investigations of major incidents discovered that each showed several warning signs before occurring, and most importantly, all were preventable. The author will discuss why preventable incidents were not prevented and review the mutual causes of learning failures from past major incidents. The leading causes of past incidents are summarized below. Management failure to identify the hazard and/or mitigate the risk of hazardous processes or materials. This process starts early in the project stage and continues throughout the life cycle of the facility. For example, a poorly done hazard study such as HAZID, PHA, or LOPA is one of the leading causes of the failure. If this step is performed correctly, then the next potential cause is. Management failure to maintain the integrity of safety critical systems and equipment. In most of the incidents, mechanical integrity of the critical equipment was not maintained, safety barriers were either bypassed, disabled, or not maintained. The third major cause is Management failure to learn and/or apply learning from the past incidents. There were several precursors before those incidents. These precursors were either ignored altogether or not taken seriously. This paper will conclude by sharing how a well-implemented operating management system, good process safety culture, and competent leaders and staff contributed to managing the risks to prevent major incidents.

Keywords: incident investigation, risk management, loss prevention, process safety, accident prevention

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320 Application of Industrial Ecology to the INSPIRA Zone: Territory Planification and New Activities

Authors: Mary Hanhoun, Jilla Bamarni, Anne-Sophie Bougard

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INSPIR’ECO is a 18-month research and innovation project that aims to specify and develop a tool to offer new services for industrials and territorial planners/managers based on Industrial Ecology Principles. This project is carried out on the territory of Salaise Sablons and the services are designed to be deployed on other territories. Salaise-Sablons area is located in the limit of 5 departments on a major European economic axis multimodal traffic (river, rail and road). The perimeter of 330 ha includes 90 hectares occupied by 20 companies, with a total of 900 jobs, and represents a significant potential basin of development. The project involves five multi-disciplinary partners (Syndicat Mixte INSPIRA, ENGIE, IDEEL, IDEAs Laboratory and TREDI). INSPIR’ECO project is based on the principles that local stakeholders need services to pool, share their activities/equipment/purchases/materials. These services aims to : 1. initiate and promote exchanges between existing companies and 2. identify synergies between pre-existing industries and future companies that could be implemented in INSPIRA. These eco-industrial synergies can be related to: the recovery / exchange of industrial flows (industrial wastewater, waste, by-products, etc.); the pooling of business services (collective waste management, stormwater collection and reuse, transport, etc.); the sharing of equipments (boiler, steam production, wastewater treatment unit, etc.) or resources (splitting jobs cost, etc.); and the creation of new activities (interface activities necessary for by-product recovery, development of products or services from a newly identified resource, etc.). These services are based on IT tool used by the interested local stakeholders that intends to allow local stakeholders to take decisions. Thus, this IT tool: - include an economic and environmental assessment of each implantation or pooling/sharing scenarios for existing or further industries; - is meant for industrial and territorial manager/planners - is designed to be used for each new industrial project. - The specification of the IT tool is made through an agile process all along INSPIR’ECO project fed with: - Users expectations thanks to workshop sessions where mock-up interfaces are displayed; - Data availability based on local and industrial data inventory. These input allow to specify the tool not only with technical and methodological constraints (notably the ones from economic and environmental assessments) but also with data availability and users expectations. A feedback on innovative resource management initiatives in port areas has been realized in the beginning of the project to feed the designing services step.

Keywords: development opportunities, INSPIR’ECO, INSPIRA, industrial ecology, planification, synergy identification

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319 Development and Preliminary Testing of the Dutch Version of the Program for the Education and Enrichment of Relational Skills

Authors: Sakinah Idris, Gabrine Jagersma, Bjorn Jaime Van Pelt, Kirstin Greaves-Lord

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Background: The PEERS (Program for the Education and Enrichment of Relational Skills) intervention can be considered a well-established, evidence-based intervention in the USA. However, testing the efficacy of cultural adaptations of PEERS is still ongoing. More and more, the involvement of all stakeholders in the development and evaluation of interventions is acknowledged as crucial for the longer term implementation of interventions across settings. Therefore, in the current project, teens with ASD (Autism Spectrum Disorder), their neurotypical peers, parents, teachers, as well as clinicians were involved in the development and evaluation of the Dutch version of PEERS. Objectives: The current presentation covers (1) the formative phase and (2) the preliminary adaptation test phase of the cultural adaptation of evidence-based interventions. In the formative phase, we aim to describe the process of adaptation of the PEERS program to the Dutch culture and care system. In the preliminary adaptation phase, we will present results from the preliminary adaptation test among 32 adolescents with ASD. Methods: In phase 1, a group discussion on common vocabulary was conducted among 70 teenagers (and their teachers) from special and regular education aged 12-18 years old. This inventory concerned 14 key constructs from PEERS, e.g., areas of interests, locations for making friends, common peer groups and crowds inside and outside of school, activities with friends, commonly used ways for electronic communication, ways for handling disagreements, and common teasing comebacks. Also, 15 clinicians were involved in the translation and cultural adaptation process. The translation and cultural adaptation process were guided by the research team, and who included input and feedback from all stakeholders through an iterative feedback incorporation procedure. In phase 2, The parent-reported Social Responsiveness Scale (SRS), the Test of Adolescent Social Skills Knowledge (TASSK), and the Quality of Socialization Questionnaire (QSQ) were assessed pre- and post-intervention to evaluate potential treatment outcome. Results: The most striking cultural adaptation - reflecting the standpoints of all stakeholders - concerned the strategies for handling rumors and gossip, which were suggested to be taught using a similar approach as the teasing comebacks, more in line with ‘down-to-earth’ Dutch standards. The preliminary testing of this adapted version indicated that the adolescents with ASD significantly improved their social knowledge (TASSK; t₃₁ = -10.9, p < .01), social experience (QSQ-Parent; t₃₁ = -4.2, p < .01 and QSQ-Adolescent; t₃₂ = -3.8, p < .01), and in parent-reported social responsiveness (SRS; t₃₃ = 3.9, p < .01). In addition, subjective evaluations of teens with ASD, their parents and clinicians were positive. Conclusions: In order to further scrutinize the effectiveness of the Dutch version of the PEERS intervention, we recommended performing a larger scale randomized control trial (RCT) design, for which we provide several methodological considerations.

Keywords: cultural adaptation, PEERS, preliminary testing, translation

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318 An Integrated HCV Testing Model as a Method to Improve Identification and Linkage to Care in a Network of Community Health Centers in Philadelphia, PA

Authors: Catelyn Coyle, Helena Kwakwa

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Objective: As novel and better tolerated therapies become available, effective HCV testing and care models become increasingly necessary to not only identify individuals with active infection but also link them to HCV providers for medical evaluation and treatment. Our aim is to describe an effective HCV testing and linkage to care model piloted in a network of five community health centers located in Philadelphia, PA. Methods: In October 2012, National Nursing Centers Consortium piloted a routine opt-out HCV testing model in a network of community health centers, one of which treats HCV, HIV, and co-infected patients. Key aspects of the model were medical assistant initiated testing, the use of laboratory-based reflex test technology, and electronic medical record modifications to prompt, track, report and facilitate payment of test costs. Universal testing on all adult patients was implemented at health centers serving patients at high-risk for HCV. The other sites integrated high-risk based testing, where patients meeting one or more of the CDC testing recommendation risk factors or had a history of homelessness were eligible for HCV testing. Mid-course adjustments included the integration of dual HIV testing, development of a linkage to care coordinator position to facilitate the transition of HIV and/or HCV-positive patients from primary to specialist care, and the transition to universal HCV testing across all testing sites. Results: From October 2012 to June 2015, the health centers performed 7,730 HCV tests and identified 886 (11.5%) patients with a positive HCV-antibody test. Of those with positive HCV-antibody tests, 838 (94.6%) had an HCV-RNA confirmatory test and 590 (70.4%) progressed to current HCV infection (overall prevalence=7.6%); 524 (88.8%) received their RNA-positive test result; 429 (72.7%) were referred to an HCV care specialist and 271 (45.9%) were seen by the HCV care specialist. The best linkage to care results were seen at the test and treat the site, where of the 333 patients were current HCV infection, 175 (52.6%) were seen by an HCV care specialist. Of the patients with active HCV infection, 349 (59.2%) were unaware of their HCV-positive status at the time of diagnosis. Since the integration of dual HCV/HIV testing in September 2013, 9,506 HIV tests were performed, 85 (0.9%) patients had positive HIV tests, 81 (95.3%) received their confirmed HIV test result and 77 (90.6%) were linked to HIV care. Dual HCV/HIV testing increased the number of HCV tests performed by 362 between the 9 months preceding dual testing and first 9 months after dual testing integration, representing a 23.7% increment. Conclusion: Our HCV testing model shows that integrated routine testing and linkage to care is feasible and improved detection and linkage to care in a primary care setting. We found that prevalence of current HCV infection was higher than that seen in locally in Philadelphia and nationwide. Intensive linkage services can increase the number of patients who successfully navigate the HCV treatment cascade. The linkage to care coordinator position is an important position that acts as a trusted intermediary for patients being linked to care.

Keywords: HCV, routine testing, linkage to care, community health centers

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