Search results for: disability scale

Authors: Yusra Mahfooz, Saleha Mehmood

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With increase in industrialization and urbanization, water contaminating rivers through effluents laden with diverse chemicals in developing countries. The study was based on the waste water quality of the four drains (Outfall, Gulshan -e- Ravi, Hudiara, and Babu Sabu) which enter into river Ravi in Lahore, Pakistan. Different pollution parameters were analyzed including pH, DO, BOD, COD, turbidity, EC, TSS, nitrates, phosphates, sulfates and fecal coliform. Approximately all the water parameters of drains were exceeded the permissible level of wastewater standards. In calculation of pollution load, Hudiara drains showed highest pollution load in terms of COD i.e. 429.86 tons/day while in Babu Sabu drain highest pollution load was calculated in terms of BOD i.e. 162.82 tons/day (due to industrial and sewage discharge in it). Lab scale treatment (oxidation ponds) was designed in order to treat the waste water of Babu Sabu drain, through combination of different algae species i.e. chaetomorphasutoria, sirogoniumsticticum and zygnema sp. Two different sizes of ponds (horizontal and vertical), and three different concentration of algal samples (25g/3L, 50g/3L, and 75g/3L) were selected. After 6 days of treatment, 80 to 97% removal efficiency was found in the pollution parameters. It was observed that in the vertical pond, maximum reduction achieved i.e. turbidity 62.12%, EC 79.3%, BOD 86.6%, COD 79.72%, FC 100%, nitrates 89.6%, sulphates 96.9% and phosphates 85.3%. While in the horizontal pond, the maximum reduction in pollutant parameters, turbidity 69.79%, EC 83%, BOD 88.5%, COD 83.01%, FC 100%, nitrates 89.8%, sulphates 97% and phosphates 86.3% was observed. Overall treatment showed that maximum reduction was carried out in 50g algae setup in the horizontal pond due to large surface area, after 6 days of treatment. Results concluded that algae-based treatment are most energy efficient, which can improve drains water quality in cost effective manners.

Keywords: oxidation pond, ravi pollution, river water quality, wastewater treatment

Procedia PDF Downloads 295

Authors: Robin Molinier

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Industrial symbiosis (I.S) rely on two modes of cooperation that are infrastructure sharing and resource substitution to obtain economic and environmental benefits. The former consists in the intensification of use of an asset while the latter is based on the use of waste, fatal energy (and utilities) as alternatives to standard inputs. Both modes, in fact, rely on the shift from a business-as-usual functioning towards an alternative production system structure so that in a business point of view the distinction is not clear. In order to investigate the way those cooperation modes can be distinguished, we consider the stakeholders' interplay in the business model structure regarding their resources and requirements. For infrastructure sharing (following economic engineering literature) the cost function of capacity induces economies of scale so that demand pooling reduces global expanses. Grassroot investment sizing decision and the ex-post pricing strongly depends on the design optimization phase for capacity sizing whereas ex-post operational cost sharing minimizing budgets are less dependent upon production rates. Value is then mainly design driven. For resource substitution, synergies value stems from availability and is at risk regarding both supplier and user load profiles and market prices of the standard input. Baseline input purchasing cost reduction is thus more driven by the operational phase of the symbiosis and must be analyzed within the whole sourcing policy (including diversification strategies and expensive back-up replacement). Moreover, while resource substitution involves a chain of intermediate processors to match quality requirements, the infrastructure model relies on a single operator whose competencies allow to produce non-rival goods. Transaction costs appear higher in resource substitution synergies due to the high level of customization which induces asset specificity, and non-homogeneity following transaction costs economics arguments.

Keywords: business model, capacity, sourcing, synergies

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Authors: Magdalena Barbara Kaziuk, Waldemar Kosiba

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Introduction: Despite the development of technologies and improvements in the interior of dialysis stations, dialysis remains an unpleasant procedure, difficult to accept by the patients (who undergo it 2 to 3 times a week, a single treatment lasting several hours). Haemodialysis is one of the renal replacement therapies, in Poland most commonly used in patients with chronic or acute kidney failure. Purpose: An attempt was made to evaluate the quality of life in haemodialysed patients using the WHOQOL-BREF questionnaire. Material and methods: The study covered 422 patients (200 women and 222 men, aged 60.5 ± 12.9 years) undergoing dialysis at three selected stations in Poland. The patients were divided into 2 groups, depending on the duration of their dialysis treatment. The evaluation was conducted with the WHOQOL-BREF questionnaire containing 26 questions analysing 4 areas of life, as well as the perception of the quality of life and health self-assessment. A 5-point scale is used to answer them. The maximum score in each area is 20 points. The results in individual areas have a positive direction. Results: In patients undergoing dialysis for more than 3 years, a reduction in the quality of life was found in the physical area and in their environment versus a group of patients undergoing dialysis for less than 3 years, where a reduced quality of life was found in the areas of social relations and mental well-being (p < 0.05). A significant correlation (p < 0.01) between the two groups was found in self-perceived general health, while no significant differences were observed in the general perception of the quality of life (p > 0.05). Conclusions: The study confirmed that in patients undergoing dialysis for more than three years, the quality of life is especially reduced in their environment (access to and quality of healthcare, financial resources, and mental and physical safety). The assessment of the quality of life should form a part of the therapeutic process, in which the role of the patient in chronic renal care should be emphasised, reflected in the quality of services provided by dialysis stations.

Keywords: haemodialysis, perception of quality of life, quality of services provided, dialysis station

Procedia PDF Downloads 261

Authors: Nureni Amoo, Sunday Aroge, Oluranti Akintola, Hakeem Olujide, Ibrahim Alabi

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This study investigated the optimum landfill site in Osogbo so as to identify suitable solid waste dumpsite for proper waste management in the capital city. Despite an increase in alternative techniques for disposing of waste, landfilling remains the primary means of waste disposal. These changes in attitudes in many parts of the world have been supported by changes in laws and policies regarding the environment and waste disposal. Selecting the most suitable site for landfill can avoid any ecological and socio-economic effects. The increase in industrial and economic development, along with the increase of population growth in Osogbo town, generates a tremendous amount of solid waste within the region. Factors such as the scarcity of land, the lifespan of the landfill, and environmental considerations warrant that the scientific and fundamental studies are carried out in determining the suitability of a landfill site. The analysis of spatial data and consideration of regulations and accepted criteria are part of the important elements in the site selection. This paper presents a multi-criteria decision-making method using geographic information system (GIS) with the integration of the fuzzy logic multi-criteria decision making (FMCDM) technique for landfill suitability site evaluation. By using the fuzzy logic method (classification of suitable areas in the range of 0 to 1 scale), the superposing of the information layers related to drainage, soil, land use/land cover, slope, land use, and geology maps were performed in the study. Based on the result obtained in this study, five (5) potential sites are suitable for the construction of a landfill are proposed, two of which belong to the most suitable zone, and the existing waste disposal site belonged to the unsuitable zone.

Keywords: fuzzy logic multi-criteria decision making, geographic information system, landfill, suitable site, waste disposal

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Authors: Ramona-Niculina Jurcau, Ioana-Marieta Jurcau, Dong Hun Kwak, Nicolae-Alexandru Colceriu

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Background: Stress management (SM) is a topic of great academic interest and equally a task to accomplish. In addition, it is recognized the beneficial role of unconventional therapies (UCT) in stress modulation. Aims: The aim was to evaluate medical (MS) versus non-medical students’ (NMS) opinions about academic stress management (ASM) using UCT. Methods: MS (n=103, third year males and females) and NMS (n=112, males and females, from humanities faculties, different years of study), out of their academic program, voluntarily answered to a questionnaire concerning: a) Classification of the four most important academic stress factors; b) The extent to which their daily life influences academic stress; c) The most important SM methods they know; d) Which of these methods they are applying; e) the UCT they know or about which they have heard; f) Which of these they know to have stress modulation effects; g) Which of these UCT, participants are using or would like to use for modulating stress; and if participants use UTC for their own choose or following a specialist consultation in those therapies (SCT); h) If they heard about the following UCT and what opinion they have (using visual analogue scale) about their use (following CST) for the ASM: Phytotherapy (PT), apitherapy (AT), homeopathy (H), ayurvedic medicine (AM), traditional Chinese medicine (TCM), music therapy (MT), color therapy (CT), forest therapy (FT). Results: Among the four most important academic stress factors, for MS more than for NMS, are: busy schedule, large amount of information taught; high level of performance required, reduced time for relaxing. The most important methods for SM that MS and NMS know, hierarchically are: listen to music, meeting friends, playing sport, hiking, sleep, regularly breaks, seeing positive side, faith; of which, NMS more than MS, are partially applying to themselves. UCT about which MS and less NMS have heard, are phytotherapy, apitherapy, acupuncture, reiki. Of these UTC, participants know to have stress modulation effects: some plants, bee’s products and music; they use or would like to use for ASM (the majority without SCT) certain teas, honey and music. Most of MS and only some NMS heard about PT, AT, TCM, MT and much less about H, AM, CT, TT. NMS more than MS, would use these UCT, following CST. Conclusions: 1) Academic stress is similarly reflected in MS and NMS opinions. 2) MS and NMS apply similar but very few UCT for stress modulation. 3) Information that MS and NMS have about UCT and their ASM application is reduced. 4) It is remarkable that MS and especially NMS, are open to UCT use for ASM, following an SCT.

Keywords: academic stress, stress management, stress modulation, medical students, non-medical students, unconventional therapies

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Authors: Alexander A. Tokmakov

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Cell-free protein synthesis is widely used to synthesize recombinant proteins. It allows genome-scale expression of various polypeptides under strictly controlled uniform conditions. However, only a minor fraction of all proteins can be successfully expressed in the systems of protein synthesis that are currently used. The factors determining expression success are poorly understood. At present, the vast volume of data is accumulated in cell-free expression databases. It makes possible comprehensive bioinformatics analysis and identification of multiple features associated with successful cell-free expression. Here, we describe an approach aimed at identification of multiple physicochemical and structural properties of amino acid sequences associated with protein solubility and aggregation and highlight major correlations obtained using this approach. The developed method includes: categorical assessment of the protein expression data, calculation and prediction of multiple properties of expressed amino acid sequences, correlation of the individual properties with the expression scores, and evaluation of statistical significance of the observed correlations. Using this approach, we revealed a number of statistically significant correlations between calculated and predicted features of protein sequences and their amenability to cell-free expression. It was found that some of the features, such as protein pI, hydrophobicity, presence of signal sequences, etc., are mostly related to protein solubility, whereas the others, such as protein length, number of disulfide bonds, content of secondary structure, etc., affect mainly the expression propensity. We also demonstrated that amenability of polypeptide sequences to cell-free expression correlates with the presence of multiple sites of post-translational modifications. The correlations revealed in this study provide a plethora of important insights into protein folding and rationalization of protein production. The developed bioinformatics approach can be of practical use for predicting expression success and optimizing cell-free protein synthesis.

Keywords: bioinformatics analysis, cell-free protein synthesis, expression success, optimization, recombinant proteins

Procedia PDF Downloads 416

Authors: Magdalena Bury-Kaminska, Aneta Szudy-Szczyrek, Aleksandra Nowaczynska, Olga Jankowska-Lecka, Marek Hus, Klaudia Kot

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Introduction: The aim of the research was to determine the changes in cognitive functioning in patients with plasma cell myeloma by comparing patients’ state before the treatment and during chemotherapy as well as to determine the biological factors that can be used to predict patients’ cognitive state. Methods: The patients underwent the research procedure twice: before chemotherapy and after 4-6 treatment cycles. A psychological test and measurement of the following biological variables were carried out: TNF-α (tumor necrosis factor), IL-6 (interleukin 6), IL-10 (interleukin 10), BDNF (brain-derived neurotrophic factor). The following research methods were implemented: the Montreal Cognitive Assessment (MoCA), Battery of Tests for Assessing Cognitive Functions PU1, experimental and clinical trials based on the Choynowski’s Memory Scale, Stroop Color-Word Interference Test (SCWT), depression measurement questionnaire. Results: The analysis of the research showed better cognitive functions of patients during chemotherapy in comparison to the phase before it. Moreover, neurotrophin BDNF allows to predict the level of selected cognitive functions (semantic fluency and execution control) already at the diagnosis stage. After 4-6 cycles, it is also possible to draw conclusions concerning the extent of working memory based on the level of BDNF. Cytokine TNF-α allows us to predict the level of letter fluency during anti-cancer treatment. Conclusions: It is possible to presume that BDNF has a protective influence on patients’ cognitive functions and working memory and that cytokine TNF-α co-occurs with a diminished execution control and better material grouping in terms of phonological fluency. Acknowledgment: This work was funded by the National Science Center in Poland [grant no. 2017/27/N/HS6/02057.

Keywords: chemobrain, cognitive impairment, non−central nervous system cancers, hematologic diseases

Procedia PDF Downloads 151

Authors: Beata Bilska, Marzena Tomaszewska, Danuta Kolozyn-Krajewska

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Food loss and food waste are a global problem of the modern economy. The research undertaken aimed to analyze how food is handled in catering establishments when it comes to food waste and to demonstrate the main ways of management with foods/dishes not served to consumers. A survey study was conducted from January to June 2019. The selection of catering establishments participating in the study was deliberate. The study included establishments located only in Mazowieckie Voivodeship (Poland). Forty-two completed questionnaires were collected. In some questions, answers were based on a 5-point scale of 1 to 5 (from "always" / "every day" to "never"). The survey also included closed questions with a suggested cafeteria of answers. The respondents stated that in their workplaces, dishes served cold and hot ready meals are discarded every day or almost every day (23.7% and 20.5% of answers respectively). A procedure most frequently used for dealing with dishes not served to consumers on a given day is their storage at a cool temperature until the following day. In the research, 1/5 of respondents admitted that consumers "always" or "usually" leave uneaten meals on their plates, and over 41% "sometimes" do so. It was found additionally that food not used in the foodservice sector is most often thrown into a public container for rubbish. Most often thrown into the public container (with communal trash) were: expired products (80.0%), plate waste (80.0%) and inedible products (fruit and vegetable peels, eggshells) (77.5%). Most frequently into the container dedicated only to food waste were thrown out used deep-frying oil (62.5%). 10% of respondents indicated that inedible products in their workplaces are allocated for animal feeds. Food waste in the foodservice sector remains an insufficiently studied issue, as owners of these objects are often unwilling to disclose data about the subject. Incorrect ways of management with foods not served to consumers were observed. There is a need to develop educational activities for employees and management in the context of food waste management in the foodservice sector.

Keywords: food waste, inedible products, plate waste, used deep-frying oil

Procedia PDF Downloads 125

Authors: Warjito, Kevin Geraldo, Budiarso, Muhammad Mizan, Rafi Adhi Pranata, Farhan Rizqi Syahnakri

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According to data from 2021, the number of households in Indonesia that have access to on-grid electricity is claimed to have reached 99.28%, which means that around 0.7% of Indonesia's population (1.95 million people) still have no proper access to electricity and 38.1% of it comes from remote areas in Nusa Tenggara Timur. Remote areas are classified as areas with a small population of 30 to 60 families, have limited infrastructure, have scarce access to electricity and clean water, have a relatively weak economy, are behind in access to technological innovation, and earn a living mostly as farmers or fishermen. These people still need electricity but can’t afford the high cost of electricity from national on-grid sources. To overcome this, it is proposed that a hydroelectric power plant driven by a pico-hydro turbine with an undershot water wheel will be a suitable pico-hydro turbine technology because of the design, materials and installation of the turbine that is believed to be easier (i.e., operational and maintenance) and cheaper (i.e., investment and operating costs) than any other type. The comparative study of the angle of the undershot water wheel blades will be discussed comprehensively. This study will look into the best variation of curved blades on an undershot water wheel that produces maximum hydraulic efficiency. In this study, the blade angles were varied by 180 ̊, 160 ̊, and 140 ̊. Two methods of analysis will be used, which are analytical and numerical methods. The analytical method will be based on calculations of the amount of torque and rotational speed of the turbine, which is used to obtain the input and output power of the turbine. Whereas the numerical method will use the ANSYS application to simulate the flow during the collision with the designed turbine blades. It can be concluded, based on the analytical and numerical methods, that the best angle for the blade is 140 ̊, with an efficiency of 43.52% for the analytical method and 37.15% for the numerical method.

Keywords: pico hydro, undershot waterwheel, blade angle, computational fluid dynamics

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Authors: Hamidreza Hoshyarmanesh, Sanju Lama, Garnette R. Sutherland

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In tele-operative robotic surgery, an ideal haptic device should be equipped with an intuitive and smooth end-effector to cover the surgeon’s hand/wrist degrees of freedom (DOF) and translate the hand joint motions to the end-effector of the remote manipulator with low effort and high level of comfort. This research introduces the design and development of a microsurgery-specific end-effector, a gimbal mechanism possessing 4 passive and 1 active DOFs, equipped with a bipolar forceps and haptic feedback. The robust gimbal structure is comprised of three light-weight links/joint, pitch, yaw, and roll, each consisting of low-friction support and a 2-channel accurate optical position sensor. The third link, which provides the tool roll, was specifically designed to grip the tool prongs and accommodate a low mass geared actuator together with a miniaturized capstan-rope mechanism. The actuator is able to generate delicate torques, using a threaded cylindrical capstan, to emulate the sense of pinch/coagulation during conventional microsurgery. While the tool left prong is fixed to the rolling link, the right prong bears a miniaturized drum sector with a large diameter to expand the force scale and resolution. The drum transmits the actuator output torque to the right prong and generates haptic force feedback at the tool level. The tool is also equipped with a hall-effect sensor and magnet bar installed vis-à-vis on the inner side of the two prongs to measure the tooltip distance and provide an analogue signal to the control system. We believe that such a haptic end-effector could significantly increase the accuracy of telerobotic surgery and help avoid high forces that are known to cause bleeding/injury.

Keywords: end-effector, force generation, haptic interface, robotic surgery, surgical tool, tele-operation

Procedia PDF Downloads 117

Authors: Doaa Hamdi, Ahmed Hashem

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The present study aims at integrating the ASTER data and Landsat 8 data to discriminate and map alteration and/or mineralization zones in addition to delineating different lithological units of Humr Akarim Granites area. The study area is located at 24º9' to 24º13' N and 34º1' to 34º2'45"E., covering a total exposed surface area of about 17 km². The area is characterized by rugged topography with low to moderate relief. Geologic fieldwork and petrographic investigations revealed that the basement complex of the study area is composed of metasediments, mafic dikes, older granitoids, and alkali-feldspar granites. Petrographic investigations revealed that the secondary minerals in the study area are mainly represented by chlorite, epidote, clay minerals and iron oxides. These minerals have specific spectral signatures in the region of visible near-infrared and short-wave infrared (0.4 to 2.5 µm). So that the ASTER imagery processing was concentrated on VNIR-SWIR spectrometric data in order to achieve the purposes of this study (geologic mapping of hydrothermal alteration zones and delineate possible radioactive potentialities). Mapping of hydrothermal alterations zones in addition to discriminating the lithological units in the study area are achieved through the utilization of some different image processing, including color band composites (CBC) and data transformation techniques such as band ratios (BR), band ratio codes (BRCs), principal component analysis(PCA), Crosta Technique and minimum noise fraction (MNF). The field verification and petrographic investigation confirm the results of ASTER imagery and Landsat 8 data, proposing a geological map (scale 1:50000).

Keywords: remote sensing, petrography, mineralization, alteration detection

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Authors: Maria Ghorbanian, Mohammad Ghahramani, Mahmood Abolghasemi

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Universities and institutions of higher education in Iran, like other higher education institutions in the world, have a heavy mission and task to educate students based on the needs of the country. Taking on such a serious responsibility requires having a good governance system for planning, formulating executive plans, evaluating, and finally modifying them in accordance with the current conditions and challenges ahead. In this regard, the present study was conducted with the aim of identifying the components of good governance in the Iranian higher education system by survey method and with a quantitative approach. In order to collect data, a researcher-made questionnaire was used, which includes two parts: personal and professional characteristics (5 questions) and the three components of good governance in the Iranian higher education system, including good management and leadership (8 items), continuous evaluation and effective (university performance, finance, and university appointments) (8 items) and civic responsibility and sustainable development (7 items). These variables were measured and coded in the form of a five-level Likert scale from "Very Low = 1" to "Very High = 5". First, the validity and reliability of the research model were examined. In order to calculate the reliability of the questionnaire, two methods of Cronbach's alpha and combined reliability were used. Fornell-Larker interaction and criterion were also used to determine the degree of diagnostic validity. The statistical population of this study included all faculty members of public universities in Tehran (N = 4429). The sample size was estimated to be 340 using the Cochran's formula. These numbers were studied using a randomized method with a proportional assignment. The data were analyzed by the structural equation method with the least-squares approach. The results showed that the component of civil responsibility and sustainable development with a factor load of 0.827 is the most important element of good governance.

Keywords: good governance, higher education, sustainable, development

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Authors: Adefarati Oloruntoba, Yongmin Zhang, Hongliang Xiao

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An annular fluidized bed (AFB) is gaining extensive application in the process industry due to its efficient gas-solids contacting. But a direct evaluation of its reaction performance is still lacking. In this paper, comparative 3D Euler–Lagrange multiphase-particle-in-cell (MP-PIC) computations are performed to assess the reaction performance of AFB relative to a bubbling fluidized bed (BFB) in an FCC regeneration process. By using the energy-minimization multi-scale (EMMS) drag model with a suitable heterogeneity index, the MP-PIC simulation predicts the typical fountain region in AFB and solids holdup of BFB, which is consistent with an experiment. Coke combustion rate, flue gas and temperature profile are utilized as the performance indicators, while related bed hydrodynamics are explored to account for the different performance under varying superficial gas velocities (0.5 m/s, 0.6 m/s, and 0.7 m/s). Simulation results indicate that the burning rates of coke and its species are relatively the same in both beds, albeit marginal increase in BFB. Similarly, the shape and evolution time of flue gas (CO, CO₂, H₂O and O₂) curves are indistinguishable but match the coke combustion rates. However, AFB has high proclivity to high temperature-gradient as higher gas and solids temperatures are predicted in the freeboard. Moreover, for both beds, the effect of superficial gas velocity is only conspicuous on the temperature but negligible on combustion efficiency and effluent gas emissions due to constant gas volumetric flow rate and bed loading criteria. Cross-flow of solids from the annulus to the spout region as well as the high primary gas in the AFB directly assume the underlying mechanisms for its unique gas-solids hydrodynamics (pressure, solids holdup, velocity, mass flux) and local spatial homogeneity, which in turn influence the reactor performance. Overall, the study portrays AFB as a cheap alternative reactor to BFB for catalyst regeneration.

Keywords: annular fluidized bed, bubbling fluidized bed, coke combustion, flue gas, fountaining, CFD, MP-PIC, hydrodynamics, FCC regeneration

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Authors: Sidra Pervez, Afsheen Aman, Shah Ali Ul Qader

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The importance of attaining an optimum performance of an enzyme is often a question of devising an effective method for its immobilization. Cross-linked enzyme aggregate (CLEAs) is a new approach for immobilization of enzymes using carrier free strategy. This method is exquisitely simple (involving precipitation of the enzyme from aqueous buffer followed by cross-linking of the resulting physical aggregates of enzyme molecules) and amenable to rapid optimization. Among many industrial enzymes, amyloglucosidase is an important amylolytic enzyme that hydrolyzes alpha (1→4) and alpha (1→6) glycosidic bonds in starch molecule and produce glucose as a sole end product. Glucose liberated by amyloglucosidase can be used for the production of ethanol and glucose syrups. Besides this amyloglucosidase can be widely used in various food and pharmaceuticals industries. For production of amyloglucosidase on commercial scale, filamentous fungi of genera Aspergillus are mostly used because they secrete large amount of enzymes extracellularly. The current investigation was based on isolation and identification of filamentous fungi from genus Aspergillus for the production of amyloglucosidase in submerged fermentation and optimization of cultivation parameters for starch saccharification. Natural isolates were identified as Aspergillus niger KIBGE-IB36, Aspergillus fumigatus KIBGE-IB33, Aspergillus flavus KIBGE-IB34 and Aspergillus terreus KIBGE-IB35 on taxonomical basis and 18S rDNA analysis and their sequence were submitted to GenBank. Among them, Aspergillus fumigatus KIBGE-IB33 was selected on the basis of maximum enzyme production. After optimization of fermentation conditions enzyme was immobilized on CLEA. Different parameters were optimized for maximum immobilization of amyloglucosidase. Data of enzyme stability (thermal and Storage) and reusability suggested the applicability of immobilized amyloglucosidase for continuous saccharification of starch in industrial processes.

Keywords: aspergillus, immobilization, industrial processes, starch saccharification

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Authors: Abdoullah Nyassi, Golam Sarwar, Sarra Baldeh, Mamadou S. K. Jallow, Bai Lamin Dondeh, Isaac Osei, Grant A. Mackenzie

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A randomized controlled trial is the "gold standard" for evaluating the efficacy of an intervention. Large-scale, cluster-randomized trials are expensive and difficult to conduct, though. To guarantee the validity and generalizability of findings, high-quality, dependable, and accurate data management systems are necessary. Robust data management systems are crucial for optimizing and validating the quality, accuracy, and dependability of trial data. Regarding the difficulties of data gathering in clinical trials in low-resource areas, there is a scarcity of literature on this subject, which may raise concerns. Effective data management systems and implementation goals should be part of trial procedures. Publicizing the creative clinical data management techniques used in clinical trials should boost public confidence in the study's conclusions and encourage further replication. In the ongoing pneumococcal vaccine schedule study in rural Gambia, this report details the development and deployment of multi-data management systems and methodologies. We implemented six different data management, synchronization, and reporting systems using Microsoft Access, RedCap, SQL, Visual Basic, Ruby, and ASP.NET. Additionally, data synchronization tools were developed to integrate data from these systems into the central server for reporting systems. Clinician, lab, and field data validation systems and methodologies are the main topics of this report. Our process development efforts across all domains were driven by the complexity of research project data collected in real-time data, online reporting, data synchronization, and ways for cleaning and verifying data. Consequently, we effectively used multi-data management systems, demonstrating the value of creative approaches in enhancing the consistency, accuracy, and reporting of trial data in a poor resource setting.

Keywords: data management, data collection, data cleaning, cluster-randomized trial

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Authors: Cleto J. Sauer Jr., Rita C. Sauer, Chaider G. Andrade, Dóris F. Rabelo

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Some patients with COVID-19 disease and difficult airway characteristics undergo to endotracheal intubation (ETI) procedure. The tracheal introducer, known as the bougie guide, can aid ETI in patients with difficult airway pattern. Realistic simulation (RS) is a methodology utilized for healthcare professionals training. To improve skills in using the bougie guide of physicians from Recôncavo da Bahia region in Brazil, during COVID-19 outbreak, RS training was carried out. Simulated scenario included the Nasco Lifeform realistic simulator for ETI and a bougie guide introducer. Training was a capacitation program organized by the Health Department of Bahia State. Objective: To report effects in participants´ self-confidence perception for using bougie guide after a RS based training. Methods: Descriptive study, secondary data extracted from questionnaires. Priority workplace and previous knowledge about bougie were reported on a preparticipation formulary. Participants also completed pre- and post-training qualitative self-assessment (10-point Likert scale) regarding to self-confidence in using bougie guide. Distribution analysis for qualitative data was performed with Wilcoxon Signed Rank Test, and self-confidence increase analysis in frequency contingency tables with Fisher's exact test. Results: From May to June 2020 a total of 36 physicians participated of training, 25 (69%) from primary care setting, 32 (89%) with no previous knowledge about the bougie guide utilization. For those who had previous knowledge about bougie pre-training self-confidence median was 6,5, and 2 for participants who had not. In overall there was an increase in self-confidence median for bougie utilization. Median (variation) before and after training was 2.5 (1-7) vs. 8 (4-10) (p <0.0001). Among those who had no previous knowledge about bougie (n = 32) an increase in self-confidence greater than 3 points for bougie utilization was reported by 31 vs. 1 participants (p = 0.71). Conclusions: Most of participants had no previous knowledge about using the bougie guide. RS training contributed to self-confidence increase for using bougie for ETI procedure. RS methodology can contribute for training in using the bougie guide for ETI procedure during COVID-19 outbreak.

Keywords: bougie, confidence, COVID-19, endotracheal intubation, realistic simulation

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Authors: Muhammad Tayyab Afzal, Muhammad Arslan, Mirza Muhammad Waqar

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One of the key components of the water cycle is evapotranspiration (ET), which represents water consumption by vegetated and non-vegetated surfaces. Conventional techniques for measurements of ET are point based and representative of the local scale only. Satellite remote sensing data with large area coverage and high temporal frequency provide representative measurements of several relevant biophysical parameters required for estimation of ET at regional scales. The objective is of this research is to exploit satellite data in order to estimate evapotranspiration. This study uses Surface Energy Balance System (SEBS) model to calculate daily actual evapotranspiration (ETa) in Larkana District, Sindh Pakistan using Landsat TM data for clouds-free days. As there is no flux tower in the study area for direct measurement of latent heat flux or evapotranspiration and sensible heat flux, therefore, the model estimated values of ET were compared with reference evapotranspiration (ETo) computed by FAO-56 Penman Monteith Method using meteorological data. For a country like Pakistan, agriculture by irrigation in the river basins is the largest user of fresh water. For the better assessment and management of irrigation water requirement, the estimation of consumptive use of water for agriculture is very important because it is the main consumer of water. ET is yet an essential issue of water imbalance due to major loss of irrigation water and precipitation on cropland. As large amount of irrigated water is lost through ET, therefore its accurate estimation can be helpful for efficient management of irrigation water. Results of this study can be used to analyse surface conditions, i.e. temperature, energy budgets and relevant characteristics. Through this information we can monitor vegetation health and suitable agricultural conditions and can take controlling steps to increase agriculture production.

Keywords: SEBS, remote sensing, evapotranspiration, ETa

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Authors: Christopher B. Obida, George A. Blackburn, James D. Whyatt, Kirk T. Semple

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In many regions of the world, especially in developing countries, river network data are outdated or completely absent, yet such information is critical for supporting important functions such as flood mitigation efforts, land use and transportation planning, and the management of water resources. In this study, a method was developed for delineating river networks using Sentinel 1 imagery. Unsupervised classification was applied to multi-temporal Sentinel 1 data to discriminate water bodies from other land covers then the outputs were combined to generate a single persistent water bodies product. A thinning algorithm was then used to delineate river centre lines, which were converted into vector features and built into a topologically structured geometric network. The complex river system of the Niger Delta was used to compare the performance of the Sentinel-based method against alternative freely available water body products from United States Geological Survey, European Space Agency and OpenStreetMap and a river network derived from a Shuttle Rader Topography Mission Digital Elevation Model. From both raster-based and vector-based accuracy assessments, it was found that the Sentinel-based river network products were superior to the comparator data sets by a substantial margin. The geometric river network that was constructed permitted a flow routing analysis which is important for a variety of environmental management and planning applications. The extracted network will potentially be applied for modelling dispersion of hydrocarbon pollutants in Ogoniland, a part of the Niger Delta. The approach developed in this study holds considerable potential for generating up to date, detailed river network data for the many countries where such data are deficient.

Keywords: Sentinel 1, image processing, river delineation, large scale mapping, data comparison, geometric network

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Authors: Firoozeh Ghazanfari, Kourosh Amraei, Parisa Poorabadi

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Mild cognitive impairment is one of the neurocognitive disorders that go beyond age-related decline in cognitive functions, but in fact, it is not so severe which affects daily activities. This study aimed to investigate and compare the effectiveness of treatment with cranial electrical stimulation, brain training and their double combination on the language and verbal fluency of the elderly with mild cognitive impairment. This is a single-subject method with comparative intervention designs. Four patients with a definitive diagnosis of mild cognitive impairment by a psychiatrist were selected via purposive and convenience sampling method. Addenbrooke's Cognitive Examination Scale (2017) was used to assess language and verbal fluency. Two groups were formed with different order of cranial electrical stimulation treatment, brain training by pencil and paper method and their double combination, and two patients were randomly replaced in each group. The arrangement of the first group included cranial electrical stimulation, brain training, double combination and the second group included double combination, cranial electrical stimulation and brain training, respectively. Treatment plan included: A1, B, A2, C, A3, D, A4, where electrical stimulation treatment was given in ten 30-minutes sessions (5 mA and frequency of 0.5-500 Hz) and brain training in ten 30-minutes sessions. Each baseline lasted four weeks. Patients in first group who first received cranial electrical stimulation treatment showed a higher percentage of improvement in the language and verbal fluency subscale of Addenbrooke's Cognitive Examination in comparison to patients of the second group. Based on the results, it seems that cranial electrical stimulation with its effect on neurotransmitters and brain blood flow, especially in the brain stem, may prepare the brain at the neurochemical and molecular level for a better effectiveness of brain training at the behavioral level, and the selective treatment of electrical stimulation solitude in the first place may be more effective than combining it with paper-pencil brain training.

Keywords: cranial electrical stimulation, treatment, brain training, verbal fluency, cognitive impairment

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Authors: Pratima Kumari, Sukha Ranjan Samadder

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This research aims to contribute to the sustainable production of graphene materials by exploring the extraction of graphite from spent primary and secondary batteries. The increasing demand for graphene materials, a versatile and high-performance material, necessitates environmentally friendly methods for its synthesis. The process involves a well-planned methodology, beginning with the gathering and categorization of batteries, followed by the disassembly and careful removal of graphite from anode structures. The use of environmentally friendly solvents and mechanical techniques ensures an efficient and eco-friendly extraction of graphite. Advanced approaches such as the modified Hummers' method and chemical reduction process are utilized for the synthesis of graphene materials, with a focus on optimizing parameters. Various analytical techniques such as Fourier-transform infrared spectroscopy, X-ray diffraction, scanning electron microscopy, thermogravimetric analysis, and Raman spectroscopy were employed to validate the quality and structure of the produced graphene materials. The major findings of this study reveal the successful implementation of the methodology, leading to the production of high-quality graphene materials suitable for advanced material applications. Thorough characterization using various advanced techniques validates the structural integrity and purity of the graphene. The economic viability of the process is demonstrated through a comprehensive economic analysis, highlighting the potential for large-scale production. This research contributes to the field of sustainable production of graphene materials by offering a systematic methodology that efficiently transforms spent batteries into valuable graphene resources. Furthermore, the findings not only showcase the potential for upcycling electronic waste but also address the pressing need for environmentally conscious processes in advanced material synthesis.

Keywords: spent primary batteries, spent secondary batteries, graphite extraction, advanced material synthesis, circular economy approach

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Authors: Pinna Beatrice., Laini Alex, Negro Giovanni, Burgazzi Gemma, Viaroli Pierluigi, Vezza Paolo

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Habitat models rarely consider macroinvertebrates as ecological targets in rivers. Available approaches mainly focus on single macroinvertebrate species, not addressing the ecological needs and functionality of the entire community. This research aimed to provide an approach to model the habitat of the macroinvertebrate community. The approach is based on the recently developed Flow-T index, together with a Random Forest (RF) regression, which is employed to apply the Flow-T index at the meso-habitat scale. Using different datasets gathered from both field data collection and 2D hydrodynamic simulations, the model has been calibrated in the Trebbia river (2019 campaign), and then validated in the Trebbia, Taro, and Enza rivers (2020 campaign). The three rivers are characterized by a braiding morphology, gravel riverbeds, and summer low flows. The RF model selected 12 mesohabitat descriptors as important for the macroinvertebrate community. These descriptors belong to different frequency classes of water depth, flow velocity, substrate grain size, and connectivity to the main river channel. The cross-validation R² coefficient (R²𝒸ᵥ) of the training dataset is 0.71 for the Trebbia River (2019), whereas the R² coefficient for the validation datasets (Trebbia, Taro, and Enza Rivers 2020) is 0.63. The agreement between the simulated results and the experimental data shows sufficient accuracy and reliability. The outcomes of the study reveal that the model can identify the ecological response of the macroinvertebrate community to possible flow regime alterations and to possible river morphological modifications. Lastly, the proposed approach allows extending the MesoHABSIM methodology, widely used for the fish habitat assessment, to a different ecological target community. Further applications of the approach can be related to flow design in both perennial and non-perennial rivers, including river reaches in which fish fauna is absent.

Keywords: ecological flows, macroinvertebrate community, mesohabitat, river habitat modeling

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Authors: Teguh R. Hakim, Frenny F. F. Kairupan, Alberta M. Mantiri

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The face of the coastal city is generally the same as other cities face showing the dualistic, traditional and modern, rural and urbanity, planned and unplanned, slum and high quality. Manado city is located on the northern coastal areas of the island of Sulawesi, Indonesia. Manado city is located on the northern coastal areas of the island of Sulawesi, Indonesia. Urban environmental problems ever occurred in this city, which is the impact of dualistic urban. Overcrowding, inadequate infrastructure, and limited human resources become the main cause of untidiness the coastal settlements in Malalayang. This has an impact on the activities of social, economic, public health level in the environment of coastal City of Manado, Malalayang. This is becoming a serious problem which must be tackled jointly by the government, private parties, and the community. Community-based settlement environment setup, into one solution to realize the city's coastal settlements livable. As for this research aims to analyze the involvement of local communities in arrangements of the settlement. The participatory approach of the model used in this study. Its application is mainly at macro and meso-scale (region, city, and environment) or community architecture. Model participatory approach leads more operational research approach to find a solution/answer to the problems of settlement. The participatory approach is a model for research that involves researchers and society as an object at the same time the subject of research, which in the process in addition to researching also developed other forms of participation in the design and build together. The expected results of this study were able to provide education to the community about environmental and set up a livable settlement for the sake of improving the quality of life. The study also becomes inputs to the government in applying the pattern of development that will be implemented in the future.

Keywords: arrangements the coastal environment, community participation, urban environmental problems, livable settlement

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Authors: Rachida Benabbou, Sang Hun Park, Hee Chung Lee

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The world’s population is increasing with unprecedented speed, leading to fast growing urbanization pace. Cities since the Industrial revolution had evolved to fit the growing demand on infrastructure, roads, transportation, and housing. Through this evolution, cities had grown into grey, polluted, and vehicle-oriented urban areas with a significant lack of green spaces. Consequently, we ended up with low quality of life for citizens. Therefore, many cities, nowadays, are revising the way we think urbanism and try to grow into more livable and citizen-friendly, by creating change from the inside out. Thus, cities are trying to bring back nature in its crowded grey centers and regenerate many urban areas as green public spaces not only as a way to give new breath to the city, but also as a way to create change either in the environmental, social and economic levels. The city of Seoul is one of the fast growing global cities. Its population is over 12 million and it is expected to continue to grow to a point where the quality of life may seriously deteriorate. As most green areas in Seoul are located in the suburbs in form of mountains, the city’s urban areas suffer from lack of accessible green spaces in a walking distance. Understanding the gravity and consequences of this issue, Seoul city is undergoing major changes. Many of its projects are oriented to be green public spaces where citizens can enjoy the public life in healthy outdoors. The aim of this paper is to explore the results of urban conversions into green public spaces. Starting with different locations, nature, size, and scale, these conversions can lead to significant change in the surrounding areas, thus can be used as an efficient tool of regeneration for urban areas. Through a comparative analysis of three different types of urban conversions projects in the city of Seoul, we try to show the positive urban influence of the outcomes, in order to encourage cities to use green spaces as a strategic tool for urban regeneration and redevelopment.

Keywords: urban conversion, green public space, change, urban regeneration

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Authors: Cristina-Corina Bențea, Teodora-Mihaela Iconomescu, Laurențiu-Gabriel Talaghir, Claudiu Mereuță, Anamaria Berdilă

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The study aims to examine the relationships between motor abilities, self-evaluation of athletic competence, and demographic characteristics in a sample of late-childhood participants. Defined as physical elements that enable the movements, motor skills are classified according to movement precision as gross and fine motor skills. Across their development, children enhance their ability to coordinate the limbs to produce different actions. In educational settings, they perform various instructional activities that involve the improvement of their athletic prowess and are taught how to strengthen their gross and fine motor abilities. Also, in relation to their activities, children tend to evaluate themselves differently across the various domains of their life. Starting from childhood, athletic competence is one of the area-specific evaluations of competence that refers to one’s ability to do well at sports, including outdoor games. Method: The sample consisted of fifty-eight primary school children, thirty girls, and twenty-eight boys, with ages between 8-10 years. The Bruininks-Oseretsky test of motor proficiency was used to assess both gross and fine motor skills in eight specific areas (fine motor precision, fine motor integration, manual dexterity, bilateral coordination, balance, running speed and agility, upper-limb coordination, strength). Athletic competence self-perceived was assessed with one of the six subscales of the Self-Perception Profile for Children. Results: Were examined both the relationships between each motor skills scale and subscales and between motor skills and general self-perceived athletic competence. Results indicated correlations between the athletic competence and four motor skills subscales depending on the gender and age of the children. The findings of the study were discussed related to the possibility to improve children's physical proficiency in educational settings according to the level of self-perceived athletic competence.

Keywords: gross motor skills, fine motor skills, athletic competence, self-evaluation, children, education

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Authors: Rameh Chauhan

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Tunnel construction in Himalayan rock is a challenging task due to fragile nature of the strata. Tunnel excavation carried out from lower Himalayas to high Himalayas in different metamorphic rock. Therefore application of engineering geology plays a vital role during various stage of the tunneling projects. Engineering geology is defined as application of geology to construction of civil structures through engineering practice. It is applied to the design, construction and performance aspects of engineering structure on the surface or sub-surface like dam, underground and surface power house, cut slopes, tunnels and underground storage cavern for nuclear material. But this paper emphasized mostly on underground structures like big caverns of Power house, desilting chambers, and tunnels of various sizes. Construction of these structures in the fragile rock conditions of Himalayan geology from Western Himalayas to Eastern Himalayas necessitated the application of the engineering geology on the micro-scale base for the stability, performance, and longevity of the civil structures. Number of hydropower projects have been constructed, some of them are under construction and under investigation stage. These projects are located in various parts of Himalayas under various seismic-tectonic zones. Tunneling works are involved in these projects. This paper represents the various engineering geological practices adopted in investigation and construction stage of various projects based on experiences gained during past construction histories in Himalayan geology of young mountains in very fragile geological conditions. Highlighting and sharing of use of these techniques on various platforms will definitely enhance the knowledge for carrying out the construction of various projects for the development of society. Construction of the tunnels, surface, and sub-surface caverns, dams, highway, metro, highway tunnels are all based on engineering geological parameters in combinations with other engineering considerations.

Keywords: cavern-power house, desilting chambers and tunnels, seismic-tectonic-zones, earthquake-prone zones based on intensities

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Authors: Lotsmart Fonjong

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The livelihood of rural communities in the West African state of Cameroon, which is largely dictated by natural forces (rainfall, temperatures, and soil), is today threatened by climate change and armed conflict. This paper investigates the extent to which rural communities are aware of climate change, how their perceptions of changes across different agro-ecological zones have impacted farming practices, output, and lifestyles, on the one hand, and the extent to which local armed conflicts are confounding their efforts and adaptation abilities. The paper is based on a survey conducted among small farmers in selected localities within the forest and savanna ecological zones of the conflict-ridden Northwest and Southwest Cameroon. Attention is paid to farmers’ gender, scale, and type of farming. Farmers’ perception of/and response to climate change are analysed alongside local rainfall and temperature data and mobilization for climate justice. Findings highlight the fact that farmers’ perception generally corroborates local climatic data. Climatic instability has negatively affected farmers’ output, food prices, standards of living, and food security. However, the vulnerability of the population varies across ecological zones, gender, and crop types. While these factors also account for differences in local response and adaptation to climate change, ongoing armed conflicts in these regions have further complicated opportunities for climate-driven agricultural innovations, inputs, and exchange of information among farmers. This situation underlines how poor communities, as victims, are forced into many complex problems outsider their making. It is therefore important to mainstream farmers’ perceptions and differences into policy strategies that consider both climate change and Anglophone conflict as national security concerns foe sustainable development in Cameroon.

Keywords: adaptation policies, climate change, conflict, small farmers, cameroon

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Authors: Amna Ali Al-Saadi, Riken Homma, Kazuhisa Iki

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Despite the fact that many places have successes in achieving some aspects of sustainable urban development, there are no scientific facts to convince decision makers. Also, each of them was developed to fulfill the need of specific city only. Therefore, objective method to generate the solutions from a successful case is the aim of this research. The questions were: how to learn the lesson from each case study; how to distinguish the potential criteria and negative one; snd how to quantify their effects in the future development. Walkability has been selected as a goal. This is because it has been found as a solution to achieve healthy life style as well as social, environmental and economic sustainability. Moreover, it has complication as every aspect of sustainable development. This research is stand on quantitative- comparative methodology in order to assess pedestrian oriented development. Three analyzed area (AAs) were selected. One site is located in Oman in which hypotheses as motorized oriented development, while two sites are in Japan where the development is pedestrian friendly. The study used Multi- criteria evaluation method (MCEM). Initially, MCEM stands on analytic hierarchy process (AHP). The later was structured into main goal (walkability), objectives (functions and layout) and attributes (the urban form criteria). Secondly, the GIS were used to evaluate the attributes in multi-criteria maps. Since each criterion has different scale of measurement, all results were standardized by z-score and used to measure the co-relations among criteria. As results, different scenario was generated from each AA. MCEM (AHP-OWA)-GIS measured the walkability score and determined the priority of criteria development in the non-walker friendly environment. The comparison criteria for z-score presented a measurable distinguished orientation of development. This result has been used to prove that Oman is motorized environment while Japan is walkable. Also, it defined the powerful criteria and week criteria regardless to the AA. This result has been used to generalize the priority for walkable development. In conclusion, the method was found successful in generate scientific base for policy decisions.

Keywords: walkability, policy decisions, sustainable development, GIS

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Authors: A. Čelan, M. Ćosić, D. Rušić, N. Kuzmanić

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Conducting crystallization in an agitated vessel requires a proper selection of mixing parameters that would result in a production of crystals of specific properties. In dual impeller systems, which are characterized by a more complex hydrodynamics due to the possible fluid flow interactions, revealing a clear link between mixing parameters and crystallization kinetics is still an open issue. The aim of this work is to establish this connection by investigating how fluid flow patterns, generated by two impellers mounted on the same shaft, reflect on metastable zone width of borax decahydrate, one of the most important parameters of the crystallization process. Investigation was carried out in a 15-dm³ bench scale batch cooling crystallizer with an aspect ratio (H/T) equal to 1.3. For this reason, two radial straight blade turbines (4-SBT) were used for agitation. Experiments were conducted at different impeller spacings at the state of complete suspension. During the process of an unseeded batch cooling crystallization, solution temperature and supersaturation were continuously monitored what enabled a determination of the metastable zone width. Hydrodynamic conditions in the vessel achieved at different impeller spacings investigated were analyzed in detail. This was done firstly by measuring the mixing time required to attain the desired level of homogeneity. Secondly, fluid flow patterns generated in a described dual impeller system were both photographed and simulated by VisiMix Turbulent software. Also, a comparison of these two visualization methods was performed. Experimentally obtained results showed that metastable zone width is definitely affected by the hydrodynamics in the crystallizer. This means that this crystallization parameter can be controlled not only by adjusting the saturation temperature or cooling rate, as is usually done, but also by choosing a suitable impeller spacing that will result in a formation of crystals of wanted size distribution.

Keywords: dual impeller crystallizer, fluid flow pattern, metastable zone width, mixing time, radial impeller

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Authors: Xiangjun Li, Huaiyuan Tian, Wujie Zhang, Dianhua Liu

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Polyoxymethylene dimethyl ethers (PODE_n) as clean diesel additive can improve the combustion efficiency and quality of diesel fuel and alleviate the problem of atmospheric pollution. Considering synthetic routes, PODE production from methanol and formaldehyde is regarded as the most economical and promising synthetic route. However, methanol used for synthesizing PODE can produce water, which causes the loss of active center of catalyst and hydrolysis of PODE_n in the production process. Macroporous strong acidic cation exchange resin catalyst was prepared, which has comparative advantages over other common solid acid catalysts in terms of stability and catalytic efficiency for synthesizing PODE. Catalytic reactions were carried out under 353 K, 1 MPa and 3mL·g_cat^-1·h^-1 in a fixed bed reactor. Methanol conversion and PODE_3-6 selectivity reached 49.91% and 23.43%, respectively. Catalyst lifetime evaluation showed that resin catalyst retained its catalytic activity for 20 days without significant changes and catalytic activity of completely deactivated resin catalyst can basically return to previous level by simple acid regeneration. The acid exchange capacities of original and deactivated catalyst were 2.5191 and 0.0979 mmol·g^-1, respectively, while regenerated catalyst reached 2.0430 mmol·g^-1, indicating that the main reason for resin catalyst deactivation is that Brønsted acid sites of original resin catalyst were temporarily replaced by non-hydrogen ion cations. A separation process consisting of extraction and distillation for PODE_3-6 product was designed for separation of water and unreacted formaldehyde from reactive mixture and purification of PODE_3-6, respectively. The concentration of PODE_3-6 in final product can reach up to 97%. These results indicate that the scale-up production of PODE_3-6 from methanol and formaldehyde solution is feasible.

Keywords: inactivation, polyoxymethylene dimethyl ethers, separation process, sulfonic cation exchange resin

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Authors: Mitra Assadi, Md. Faan

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Background: Autism Spectrum Disorder (ASD) in a common neurodevelopmental disorder with limited pharmacological interventions. Transcranial Magnetic Stimulation (rTMS) has produced promising results in ASD, although there is no consensus regarding optimal targets or stimulation paradigms. A prevailing theory in ASD attributes the core deficits to dysfunction of the mirror neurons located in the inferior parietal lobule (IPL) and inferior frontal gyrus (IFG). Methods: Thus far, 11 subjects with ASD, 10 boys and 1 girl with the mean age of 13.36 years have completed the study by receiving 10 session of high frequency rTMS to the IPL. The subjects were randomized to receive stimulation on the left or right IPL and sham stimulation to the opposite side. The outcome measures included the Social Responsiveness Scale – Second Edition (SRS-2) and Delis-Kaplan Executive Function System (D-KEFS) Verbal Fluency task. Results: None of the 11 subjects experienced any adverse effects. The rTMS did not produce any improvement in verbal fluency, nor there was any statistically significant difference between the right versus left sided stimulation. Analysis of social awareness on SRS-2 (SRS-AWR) indicated a close to significant effect of the treatment with a small to medium effect size. After removing a single subject with Level 3 ASD, we demonstrated a close to significant improvement on SRS-AWR with a large effect size. The analysis of the data 3-month post TMS demonstrated return of the SRS-AWR values to baseline. Conclusion: This preliminary analysis of the 11 subjects who have completed our study thus far shows a favorable response to high frequency rTMS stimulation of the mirror neurons/IPL on social awareness. While the decay of the response noted during the 3-month follow-up may be considered a limitation of rTMS, the presence of the improvement, especially the effect size despite the small sample size, is indicative of the efficacy of this technique.

Keywords: rTMS, autism, scoial cognition, mirror neurons

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