Search results for: exploratory qualitative research study
Commenced in January 2007
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Search results for: exploratory qualitative research study

480 Relationship between Glycated Hemoglobin in Adolescents with Type 1 Diabetes Mellitus and Parental Anxiety and Depression

Authors: Evija Silina, Maris Taube, Maksims Zolovs

Abstract:

Background: Type 1 diabetes mellitus (T1D) is the most common chronic endocrine pathology in children. The management of type 1 diabetes requires a strong diet, physical activity, lifelong insulin therapy, and proper self-monitoring of blood glucose and is usually complicated and, therefore, may result in a variety of psychosocial problems for children, adolescents, and their families. Metabolic control of the disease is determined by glycated haemoglobin (HbA1c), the main criterion for diabetes compensation. A correlation was observed between anxiety and depression levels and glycaemic control in many previous studies. It is assumed that anxiety and depression symptoms negatively affect glycaemic control. Parental psychological distress was associated with higher child self-report of stress and depressive symptoms, and it had negative effects on diabetes management. Objective: The main objective of this paper is to evaluate the relationship between parental mental health conditions (depression and anxiety) and metabolic control of their adolescents with T1DM. Methods: This cross-sectional study recruited adolescents with T1D (N=251) and their parents (N=251). The respondents completed questionnaires. The 7-item Generalized Anxiety Disorder (GAD-7) scale measured anxiety level; The Patient Health Questionnaire – 9 (PHQ-9) measured depressive symptoms. Glycaemic control of patients was assessed using the last glycated haemoglobin (HbA1c) values. GLM mediation analysis was performed to determine the potential mediating effect of the parent’s mental health conditions (depression and anxiety) on the relationship between the mental health conditions (depression and anxiety) of a child on the level of glycated hemoglobin (HbA1c). To test the significance of the mediated effect (ME) for non-normally distributed data, bootstrapping procedures (10,000 bootstrapped samples) were used. Results: 502 respondents were eligible for screening to detect anxiety and depression symptoms. Mediation analysis was performed to assess the mediating role of parent GAD-7 on the linkage between a dependent variable (HbA1c) and independent variables (child GAD-7 un child PHQ-9). The results revealed that the total effect of child GAD-7 (B = 0.479, z = 4.30, p < 0.001) on HbA1c was significant but the total effect of child PHQ-9 (B = 0.166, z = 1.49, p = 0.135) was not significant. With the inclusion of the mediating variable (parent GAD-7), the impact of child GAD-7 on HbA1c was found insignificant (B = 0.113, z=0.98, p = 0.326), the impact of child PHQ-9 on HbA1c was found also insignificant (B = 0.068, z=0.74, p = 0.458). The indirect effect of child GAD-7 on HbA1c through parent GAD-7 was found significant (B = 0.366, z = 4.31, p < 0.001) and the indirect effect of child PHQ-9 on HbA1c through parent GAD-7 was found also significant (B = 0.098, z = 2.56, p = 0.010). This indicates that the relationship between a dependent variable (HbA1c) and independent variables (child GAD-7 un child PHQ-9) is fully mediated by parent GAD-7. Conclusion: The main result suggests that glycated haemoglobin in adolescents with Type 1 diabetes is related to adolescents’ mental health via parents’ anxiety. It means that parents’ anxiety plays a more significant role in the level of glycated haemoglobin in adolescents than depression and anxiety in the adolescent.

Keywords: type 1 diabetes, adolescents, parental diabetes-specific mental health conditions, glycated haemoglobin, anxiety, depression

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479 LaeA/1-Velvet Interplay in Aspergillus and Trichoderma: Regulation of Secondary Metabolites and Cellulases

Authors: Razieh Karimi Aghcheh, Christian Kubicek, Joseph Strauss, Gerhard Braus

Abstract:

Filamentous fungi are of considerable economic and social significance for human health, nutrition and in white biotechnology. These organisms are dominant producers of a range of primary metabolites such as citric acid, microbial lipids (biodiesel) and higher unsaturated fatty acids (HUFAs). In particular, they produce also important but structurally complex secondary metabolites with enormous therapeutic applications in pharmaceutical industry, for example: cephalosporin, penicillin, taxol, zeranol and ergot alkaloids. Several fungal secondary metabolites, which are significantly relevant to human health do not only include antibiotics, but also e.g. lovastatin, a well-known antihypercholesterolemic agent produced by Aspergillus. terreus, or aflatoxin, a carcinogen produced by A. flavus. In addition to their roles for human health and agriculture, some fungi are industrially and commercially important: Species of the ascomycete genus Hypocrea spp. (teleomorph of Trichoderma) have been demonstrated as efficient producer of highly active cellulolytic enzymes. This trait makes them effective in disrupting and depolymerization of lignocellulosic materials and thus applicable tools in number of biotechnological areas as diverse as clothes-washing detergent, animal feed, and pulp and fuel productions. Fungal LaeA/LAE1 (Loss of aflR Expression A) homologs their gene products act at the interphase between secondary metabolisms, cellulase production and development. Lack of the corresponding genes results in significant physiological changes including loss of secondary metabolite and lignocellulose degrading enzymes production. At the molecular level, the encoded proteins are presumably methyltransferases or demethylases which act directly or indirectly at heterochromatin and interact with velvet domain proteins. Velvet proteins bind to DNA and affect expression of secondary metabolites (SMs) genes and cellulases. The dynamic interplay between LaeA/LAE1, velvet proteins and additional interaction partners is the key for an understanding of the coordination of metabolic and morphological functions of fungi and is required for a biotechnological control of the formation of desired bioactive products. Aspergilli and Trichoderma represent different biotechnologically significant species with significant differences in the LaeA/LAE1-Velvet protein machinery and their target proteins. We, therefore, performed a comparative study of the interaction partners of this machinery and the dynamics of the various protein-protein interactions using our robust proteomic and mass spectrometry techniques. This enhances our knowledge about the fungal coordination of secondary metabolism, cellulase production and development and thereby will certainly improve recombinant fungal strain construction for the production of industrial secondary metabolite or lignocellulose hydrolytic enzymes.

Keywords: cellulases, LaeA/1, proteomics, secondary metabolites

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478 Introduction of a New and Efficient Nematicide, Abamectin by Gyah Corporation, Iran, for Root-knot Nematodes Management Planning Programs

Authors: Shiva Mardani, Mehdi Nasr-Esfahani, Majid Olia, Hamid Molahosseini, Hamed Hassanzadeh Khankahdani

Abstract:

Plant-parasitic nematodes cause serious diseases on plants and effectively reduce food production in quality and quantity worldwide, with at least 17 nematode species in the three important and major genera, including Meloidogyne, Heterodera, and Pratylenchus. Root-knot nematodes (RKN), Meloidogyne spp. with the dominant species, Meloidogynejavanica, are considered as the important plant pathogens of agricultural products globally. The hosts range can be vegetables, bedding plants, grasses, shrubs, numerous weeds, and trees, including forests. In this study, chemical management was carried out on RKN, M. javanica, to investigate the efficacy of Iranian Abamectin insecticide product [acaricide Abamectin (Vermectin® 2% EC, Gyah Corp., Iran)] verses imported normal Abamectin available in the Iran markets [acaricide Abamectin (Vermectin® 1.8% EC, Cropstar Chemical Industry Co., Ltd.)] each of which at the rate of 8 L./ha, on Tomatoes, Solanumlycopersicum L., (No. 29-41, Dutch company Siemens) as a test plant, and the controls (infested to RKN and without any chemical pesticides treatments); and (sterile soil without any RKN and chemical pesticides treatments) at the greenhouse in Isfahan, Iran. The trails were repeated thrice. The results indicated a highly significant reduction in RKN population and an increase in biomass parameters at 1% level of significance, respectively. Relatively similar results were obtained in all the three experiments conducted on tomato root-knot nematodes. The treatments of Gyah-Abamectin (51.6%) and external Abamectin (40.4%) had the highest to least effect on reducing the number of larvae in the soil compared to the infected controls, respectively. Gyah-Abamectin by 44.1% and then external one by 31.9% had the highest effect on reducing the number of larvae and eggs in the root and 31.4% and 24.1% reduction in the number of galls compared to the infected controls, respectively. Based on priority, Gyah-Abamectin (47.4 % ) and external Abamectin (31.1 %) treatments had the highest effect on reducing the number of egg- masses in the root compared to the infected controls, with no significant difference between Gyah-Abamectin and external Abamectin. The highest reproduction of larvae and egg in the root was observed in the infected controls (75.5%) and the lowest in the healthy controls (0.0%). The highest reduction in the larval and egg reproduction in the roots compared to the infected controls was observed in Gyah-Abamectin and the lowest in the external one. Based on preference, Gyah-Abamectin (37.6%) and external Abamectin (26.9%) had the highest effect on the reduction of the larvae and egg reproduction in the root compared to the infected controls, respectively. Regarding growth parameters factors, the lowest stem length was observed in external Abamectin (51.9 cm), with nosignificantly different from Gyah-Abamectin and healthy controls. The highest root fresh weight was recorded in the infected controls (19.81 gr.) and the lowest in the healthy ones (9.81 gr.); the highest root length in the healthy controls (22.4 cm), and the lowest in the infected controls and external Abamectin (12.6 and 11.9 cm), respectively. Conclusively, the results of these three tests on tomato plants revealed that Gyah-Abamectin 2% compared to external Abamectin 1.8% is competitive in the chemical management of the root nematodes of these types of products and is a suitable alternative in this regard.

Keywords: solanum lycopersicum, vermectin, biomass, tomato

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477 Ruta graveolens Fingerprints Obtained with Reversed-Phase Gradient Thin-Layer Chromatography with Controlled Solvent Velocity

Authors: Adrian Szczyrba, Aneta Halka-Grysinska, Tomasz Baj, Tadeusz H. Dzido

Abstract:

Since prehistory, plants were constituted as an essential source of biologically active substances in folk medicine. One of the examples of medicinal plants is Ruta graveolens L. For a long time, Ruta g. herb has been famous for its spasmolytic, diuretic, or anti-inflammatory therapeutic effects. The wide spectrum of secondary metabolites produced by Ruta g. includes flavonoids (eg. rutin, quercetin), coumarins (eg. bergapten, umbelliferone) phenolic acids (eg. rosmarinic acid, chlorogenic acid), and limonoids. Unfortunately, the presence of produced substances is highly dependent on environmental factors like temperature, humidity, or soil acidity; therefore standardization is necessary. There were many attempts of characterization of various phytochemical groups (eg. coumarins) of Ruta graveolens using the normal – phase thin-layer chromatography (TLC). However, due to the so-called general elution problem, usually, some components remained unseparated near the start or finish line. Therefore Ruta graveolens is a very good model plant. Methanol and petroleum ether extract from its aerial parts were used to demonstrate the capabilities of the new device for gradient thin-layer chromatogram development. The development of gradient thin-layer chromatograms in the reversed-phase system in conventional horizontal chambers can be disrupted by problems associated with an excessive flux of the mobile phase to the surface of the adsorbent layer. This phenomenon is most likely caused by significant differences between the surface tension of the subsequent fractions of the mobile phase. An excessive flux of the mobile phase onto the surface of the adsorbent layer distorts the flow of the mobile phase. The described effect produces unreliable, and unrepeatable results, causing blurring and deformation of the substance zones. In the prototype device, the mobile phase solution is delivered onto the surface of the adsorbent layer with controlled velocity (by moving pipette driven by 3D machine). The delivery of the solvent to the adsorbent layer is equal to or lower than that of conventional development. Therefore chromatograms can be developed with optimal linear mobile phase velocity. Furthermore, under such conditions, there is no excess of eluent solution on the surface of the adsorbent layer so the higher performance of the chromatographic system can be obtained. Directly feeding the adsorbent layer with eluent also enables to perform convenient continuous gradient elution practically without the so-called gradient delay. In the study, unique fingerprints of methanol and petroleum ether extracts of Ruta graveolens aerial parts were obtained with stepwise gradient reversed-phase thin-layer chromatography. Obtained fingerprints under different chromatographic conditions will be compared. The advantages and disadvantages of the proposed approach to chromatogram development with controlled solvent velocity will be discussed.

Keywords: fingerprints, gradient thin-layer chromatography, reversed-phase TLC, Ruta graveolens

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476 Efficient Computer-Aided Design-Based Multilevel Optimization of the LS89

Authors: A. Chatel, I. S. Torreguitart, T. Verstraete

Abstract:

The paper deals with a single point optimization of the LS89 turbine using an adjoint optimization and defining the design variables within a CAD system. The advantage of including the CAD model in the design system is that higher level constraints can be imposed on the shape, allowing the optimized model or component to be manufactured. However, CAD-based approaches restrict the design space compared to node-based approaches where every node is free to move. In order to preserve a rich design space, we develop a methodology to refine the CAD model during the optimization and to create the best parameterization to use at each time. This study presents a methodology to progressively refine the design space, which combines parametric effectiveness with a differential evolutionary algorithm in order to create an optimal parameterization. In this manuscript, we show that by doing the parameterization at the CAD level, we can impose higher level constraints on the shape, such as the axial chord length, the trailing edge radius and G2 geometric continuity between the suction side and pressure side at the leading edge. Additionally, the adjoint sensitivities are filtered out and only smooth shapes are produced during the optimization process. The use of algorithmic differentiation for the CAD kernel and grid generator allows computing the grid sensitivities to machine accuracy and avoid the limited arithmetic precision and the truncation error of finite differences. Then, the parametric effectiveness is computed to rate the ability of a set of CAD design parameters to produce the design shape change dictated by the adjoint sensitivities. During the optimization process, the design space is progressively enlarged using the knot insertion algorithm which allows introducing new control points whilst preserving the initial shape. The position of the inserted knots is generally assumed. However, this assumption can hinder the creation of better parameterizations that would allow producing more localized shape changes where the adjoint sensitivities dictate. To address this, we propose using a differential evolutionary algorithm to maximize the parametric effectiveness by optimizing the location of the inserted knots. This allows the optimizer to gradually explore larger design spaces and to use an optimal CAD-based parameterization during the course of the optimization. The method is tested on the LS89 turbine cascade and large aerodynamic improvements in the entropy generation are achieved whilst keeping the exit flow angle fixed. The trailing edge and axial chord length, which are kept fixed as manufacturing constraints. The optimization results show that the multilevel optimizations were more efficient than the single level optimization, even though they used the same number of design variables at the end of the multilevel optimizations. Furthermore, the multilevel optimization where the parameterization is created using the optimal knot positions results in a more efficient strategy to reach a better optimum than the multilevel optimization where the position of the knots is arbitrarily assumed.

Keywords: adjoint, CAD, knots, multilevel, optimization, parametric effectiveness

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475 Development of Three-Dimensional Bio-Reactor Using Magnetic Field Stimulation to Enhance PC12 Cell Axonal Extension

Authors: Eiji Nakamachi, Ryota Sakiyama, Koji Yamamoto, Yusuke Morita, Hidetoshi Sakamoto

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The regeneration of injured central nerve network caused by the cerebrovascular accidents is difficult, because of poor regeneration capability of central nerve system composed of the brain and the spinal cord. Recently, new regeneration methods such as transplant of nerve cells and supply of nerve nutritional factor were proposed and examined. However, there still remain many problems with the canceration of engrafted cells and so on and it is strongly required to establish an efficacious treating method of a central nerve system. Blackman proposed the electromagnetic stimulation method to enhance the axonal nerve extension. In this study, we try to design and fabricate a new three-dimensional (3D) bio-reactor, which can load a uniform AC magnetic field stimulation on PC12 cells in the extracellular environment for enhancement of an axonal nerve extension and 3D nerve network generation. Simultaneously, we measure the morphology of PC12 cell bodies, axons, and dendrites by the multiphoton excitation fluorescence microscope (MPM) and evaluate the effectiveness of the uniform AC magnetic stimulation to enhance the axonal nerve extension. Firstly, we designed and fabricated the uniform AC magnetic field stimulation bio-reactor. For the AC magnetic stimulation system, we used the laminated silicon steel sheets for a yoke structure of 3D chamber, which had a high magnetic permeability. Next, we adopted the pole piece structure and installed similar specification coils on both sides of the yoke. We searched an optimum pole piece structure using the magnetic field finite element (FE) analyses and the response surface methodology. We confirmed that the optimum 3D chamber structure showed a uniform magnetic flux density in the PC12 cell culture area by using FE analysis. Then, we fabricated the uniform AC magnetic field stimulation bio-reactor by adopting analytically determined specifications, such as the size of chamber and electromagnetic conditions. We confirmed that measurement results of magnetic field in the chamber showed a good agreement with FE results. Secondly, we fabricated a dish, which set inside the uniform AC magnetic field stimulation of bio-reactor. PC12 cells were disseminated with collagen gel and could be 3D cultured in the dish. The collagen gel were poured in the dish. The collagen gel, which had a disk shape of 6 mm diameter and 3mm height, was set on the membrane filter, which was located at 4 mm height from the bottom of dish. The disk was full filled with the culture medium inside the dish. Finally, we evaluated the effectiveness of the uniform AC magnetic field stimulation to enhance the nurve axonal extension. We confirmed that a 6.8 increase in the average axonal extension length of PC12 under the uniform AC magnetic field stimulation at 7 days culture in our bio-reactor, and a 24.7 increase in the maximum axonal extension length. Further, we confirmed that a 60 increase in the number of dendrites of PC12 under the uniform AC magnetic field stimulation. Finally, we confirm the availability of our uniform AC magnetic stimulation bio-reactor for the nerve axonal extension and the nerve network generation.

Keywords: nerve regeneration, axonal extension , PC12 cell, magnetic field, three-dimensional bio-reactor

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474 Determination Optimum Strike Price of FX Option Call Spread with USD/IDR Volatility and Garman–Kohlhagen Model Analysis

Authors: Bangkit Adhi Nugraha, Bambang Suripto

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On September 2016 Bank Indonesia (BI) release regulation no.18/18/PBI/2016 that permit bank clients for using the FX option call spread USD/IDR. Basically, this product is a combination between clients buy FX call option (pay premium) and sell FX call option (receive premium) to protect against currency depreciation while also capping the potential upside with cheap premium cost. BI classifies this product as a structured product. The structured product is combination at least two financial instruments, either derivative or non-derivative instruments. The call spread is the first structured product against IDR permitted by BI since 2009 as response the demand increase from Indonesia firms on FX hedging through derivative for protecting market risk their foreign currency asset or liability. The composition of hedging products on Indonesian FX market increase from 35% on 2015 to 40% on 2016, the majority on swap product (FX forward, FX swap, cross currency swap). Swap is formulated by interest rate difference of the two currency pairs. The cost of swap product is 7% for USD/IDR with one year USD/IDR volatility 13%. That cost level makes swap products seem expensive for hedging buyers. Because call spread cost (around 1.5-3%) cheaper than swap, the most Indonesian firms are using NDF FX call spread USD/IDR on offshore with outstanding amount around 10 billion USD. The cheaper cost of call spread is the main advantage for hedging buyers. The problem arises because BI regulation requires the call spread buyer doing the dynamic hedging. That means, if call spread buyer choose strike price 1 and strike price 2 and volatility USD/IDR exchange rate surpass strike price 2, then the call spread buyer must buy another call spread with strike price 1’ (strike price 1’ = strike price 2) and strike price 2’ (strike price 2’ > strike price 1‘). It could make the premium cost of call spread doubled or even more and dismiss the purpose of hedging buyer to find the cheapest hedging cost. It is very crucial for the buyer to choose best optimum strike price before entering into the transaction. To help hedging buyer find the optimum strike price and avoid expensive multiple premium cost, we observe ten years 2005-2015 historical data of USD/IDR volatility to be compared with the price movement of the call spread USD/IDR using Garman–Kohlhagen Model (as a common formula on FX option pricing). We use statistical tools to analysis data correlation, understand nature of call spread price movement over ten years, and determine factors affecting price movement. We select some range of strike price and tenor and calculate the probability of dynamic hedging to occur and how much it’s cost. We found USD/IDR currency pairs is too uncertain and make dynamic hedging riskier and more expensive. We validated this result using one year data and shown small RMS. The study result could be used to understand nature of FX call spread and determine optimum strike price for hedging plan.

Keywords: FX call spread USD/IDR, USD/IDR volatility statistical analysis, Garman–Kohlhagen Model on FX Option USD/IDR, Bank Indonesia Regulation no.18/18/PBI/2016

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473 Vision and Challenges of Developing VR-Based Digital Anatomy Learning Platforms and a Solution Set for 3D Model Marking

Authors: Gizem Kayar, Ramazan Bakir, M. Ilkay Koşar, Ceren U. Gencer, Alperen Ayyildiz

Abstract:

Anatomy classes are crucial for general education of medical students, whereas learning anatomy is quite challenging and requires memorization of thousands of structures. In traditional teaching methods, learning materials are still based on books, anatomy mannequins, or videos. This results in forgetting many important structures after several years. However, more interactive teaching methods like virtual reality, augmented reality, gamification, and motion sensors are becoming more popular since such methods ease the way we learn and keep the data in mind for longer terms. During our study, we designed a virtual reality based digital head anatomy platform to investigate whether a fully interactive anatomy platform is effective to learn anatomy and to understand the level of teaching and learning optimization. The Head is one of the most complicated human anatomy structures, with thousands of tiny, unique structures. This makes the head anatomy one of the most difficult parts to understand during class sessions. Therefore, we developed a fully interactive digital tool with 3D model marking, quiz structures, 2D/3D puzzle structures, and VR support so as to integrate the power of VR and gamification. The project has been developed in Unity game engine with HTC Vive Cosmos VR headset. The head anatomy 3D model has been selected with full skeletal, muscular, integumentary, head, teeth, lymph, and vein system. The biggest issue during the development was the complexity of our model and the marking of it in the 3D world system. 3D model marking requires to access to each unique structure in the counted subsystems which means hundreds of marking needs to be done. Some parts of our 3D head model were monolithic. This is why we worked on dividing such parts to subparts which is very time-consuming. In order to subdivide monolithic parts, one must use an external modeling tool. However, such tools generally come with high learning curves, and seamless division is not ensured. Second option was to integrate tiny colliders to all unique items for mouse interaction. However, outside colliders which cover inner trigger colliders cause overlapping, and these colliders repel each other. Third option is using raycasting. However, due to its own view-based nature, raycasting has some inherent problems. As the model rotate, view direction changes very frequently, and directional computations become even harder. This is why, finally, we studied on the local coordinate system. By taking the pivot point of the model into consideration (back of the nose), each sub-structure is marked with its own local coordinate with respect to the pivot. After converting the mouse position to the world position and checking its relation with the corresponding structure’s local coordinate, we were able to mark all points correctly. The advantage of this method is its applicability and accuracy for all types of monolithic anatomical structures.

Keywords: anatomy, e-learning, virtual reality, 3D model marking

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472 The Predictive Power of Successful Scientific Theories: An Explanatory Study on Their Substantive Ontologies through Theoretical Change

Authors: Damian Islas

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Debates on realism in science concern two different questions: (I) whether the unobservable entities posited by theories can be known; and (II) whether any knowledge we have of them is objective or not. Question (I) arises from the doubt that since observation is the basis of all our factual knowledge, unobservable entities cannot be known. Question (II) arises from the doubt that since scientific representations are inextricably laden with the subjective, idiosyncratic, and a priori features of human cognition and scientific practice, they cannot convey any reliable information on how their objects are in themselves. A way of understanding scientific realism (SR) is through three lines of inquiry: ontological, semantic, and epistemological. Ontologically, scientific realism asserts the existence of a world independent of human mind. Semantically, scientific realism assumes that theoretical claims about reality show truth values and, thus, should be construed literally. Epistemologically, scientific realism believes that theoretical claims offer us knowledge of the world. Nowadays, the literature on scientific realism has proceeded rather far beyond the realism versus antirealism debate. This stance represents a middle-ground position between the two according to which science can attain justified true beliefs concerning relational facts about the unobservable realm but cannot attain justified true beliefs concerning the intrinsic nature of any objects occupying that realm. That is, the structural content of scientific theories about the unobservable can be known, but facts about the intrinsic nature of the entities that figure as place-holders in those structures cannot be known. There are two possible versions of SR: Epistemological Structural Realism (ESR) and Ontic Structural Realism (OSR). On ESR, an agnostic stance is preserved with respect to the natures of unobservable entities, but the possibility of knowing the relations obtaining between those entities is affirmed. OSR includes the rather striking claim that when it comes to the unobservables theorized about within fundamental physics, relations exist, but objects do not. Focusing on ESR, questions arise concerning its ability to explain the empirical success of a theory. Empirical success certainly involves predictive success, and predictive success implies a theory’s power to make accurate predictions. But a theory’s power to make any predictions at all seems to derive precisely from its core axioms or laws concerning unobservable entities and mechanisms, and not simply the sort of structural relations often expressed in equations. The specific challenge to ESR concerns its ability to explain the explanatory and predictive power of successful theories without appealing to their substantive ontologies, which are often not preserved by their successors. The response to this challenge will depend on the various and subtle different versions of ESR and OSR stances, which show a sort of progression through eliminativist OSR to moderate OSR of gradual increase in the ontological status accorded to objects. Knowing the relations between unobserved entities is methodologically identical to assert that these relations between unobserved entities exist.

Keywords: eliminativist ontic structural realism, epistemological structuralism, moderate ontic structural realism, ontic structuralism

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471 The Artificial Intelligence Driven Social Work

Authors: Avi Shrivastava

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Our world continues to grapple with a lot of social issues. Economic growth and scientific advancements have not completely eradicated poverty, homelessness, discrimination and bias, gender inequality, health issues, mental illness, addiction, and other social issues. So, how do we improve the human condition in a world driven by advanced technology? The answer is simple: we will have to leverage technology to address some of the most important social challenges of the day. AI, or artificial intelligence, has emerged as a critical tool in the battle against issues that deprive marginalized and disadvantaged groups of the right to enjoy benefits that a society offers. Social work professionals can transform their lives by harnessing it. The lack of reliable data is one of the reasons why a lot of social work projects fail. Social work professionals continue to rely on expensive and time-consuming primary data collection methods, such as observation, surveys, questionnaires, and interviews, instead of tapping into AI-based technology to generate useful, real-time data and necessary insights. By leveraging AI’s data-mining ability, we can gain a deeper understanding of how to solve complex social problems and change lives of people. We can do the right work for the right people and at the right time. For example, AI can enable social work professionals to focus their humanitarian efforts on some of the world’s poorest regions, where there is extreme poverty. An interdisciplinary team of Stanford scientists, Marshall Burke, Stefano Ermon, David Lobell, Michael Xie, and Neal Jean, used AI to spot global poverty zones – identifying such zones is a key step in the fight against poverty. The scientists combined daytime and nighttime satellite imagery with machine learning algorithms to predict poverty in Nigeria, Uganda, Tanzania, Rwanda, and Malawi. In an article published by Stanford News, Stanford researchers use dark of night and machine learning, Ermon explained that they provided the machine-learning system, an application of AI, with the high-resolution satellite images and asked it to predict poverty in the African region. “The system essentially learned how to solve the problem by comparing those two sets of images [daytime and nighttime].” This is one example of how AI can be used by social work professionals to reach regions that need their aid the most. It can also help identify sources of inequality and conflict, which could reduce inequalities, according to Nature’s study, titled The role of artificial intelligence in achieving the Sustainable Development Goals, published in 2020. The report also notes that AI can help achieve 79 percent of the United Nation’s (UN) Sustainable Development Goals (SDG). AI is impacting our everyday lives in multiple amazing ways, yet some people do not know much about it. If someone is not familiar with this technology, they may be reluctant to use it to solve social issues. So, before we talk more about the use of AI to accomplish social work objectives, let’s put the spotlight on how AI and social work can complement each other.

Keywords: social work, artificial intelligence, AI based social work, machine learning, technology

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470 Expressing Locality in Learning English: A Study of English Textbooks for Junior High School Year VII-IX in Indonesia Context

Authors: Agnes Siwi Purwaning Tyas, Dewi Cahya Ambarwati

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This paper concerns the language learning that develops as a habit formation and a constructive process while exercising an oppressive power to construct the learners. As a locus of discussion, the investigation problematizes the transfer of English language to Indonesian students of junior high school through the use of English textbooks ‘Real Time: An Interactive English Course for Junior High School Students Year VII-IX’. English language has long performed as a global language and it is a demand upon the non-English native speakers to master the language if they desire to become internationally recognized individuals. Generally, English teachers teach the language in accordance with the nature of language learning in which they are trained and expected to teach the language within the culture of the target language. This provides a potential soft cultural penetration of a foreign ideology through language transmission. In the context of Indonesia, learning English as international language is considered dilemmatic. Most English textbooks in Indonesia incorporate cultural elements of the target language which in some extent may challenge the sensitivity towards local cultural values. On the other hand, local teachers demand more English textbooks for junior high school students which can facilitate cultural dissemination of both local and global values and promote learners’ cultural traits of both cultures to avoid misunderstanding and confusion. It also aims to support language learning as bidirectional process instead of instrument of oppression. However, sensitizing and localizing this foreign language is not sufficient to restrain its soft infiltration. In due course, domination persists making the English language as an authoritative language and positioning the locality as ‘the other’. Such critical premise has led to a discursive analysis referring to how the cultural elements of the target language are presented in the textbooks and whether the local characteristics of Indonesia are able to gradually reduce the degree of the foreign oppressive ideology. The three textbooks researched were written by non-Indonesian author edited by two Indonesia editors published by a local commercial publishing company, PT Erlangga. The analytical elaboration examines the cultural characteristics in the forms of names, terminologies, places, objects and imageries –not the linguistic aspect– of both cultural domains; English and Indonesia. Comparisons as well as categorizations were made to identify the cultural traits of each language and scrutinize the contextual analysis. In the analysis, 128 foreign elements and 27 local elements were found in textbook for grade VII, 132 foreign elements and 23 local elements were found in textbook for grade VIII, while 144 foreign elements and 35 local elements were found in grade IX textbook, demonstrating the unequal distribution of both cultures. Even though the ideal pedagogical approach of English learning moves to a different direction by the means of inserting local elements, the learners are continuously imposed to the culture of the target language and forced to internalize the concept of values under the influence of the target language which tend to marginalize their native culture.

Keywords: bidirectional process, English, local culture, oppression

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469 Accuracy of Fitbit Charge 4 for Measuring Heart Rate in Parkinson’s Patients During Intense Exercise

Authors: Giulia Colonna, Jocelyn Hoye, Bart de Laat, Gelsina Stanley, Jose Key, Alaaddin Ibrahimy, Sule Tinaz, Evan D. Morris

Abstract:

Parkinson’s disease (PD) is the second most common neurodegenerative disease and affects approximately 1% of the world’s population. Increasing evidence suggests that aerobic physical exercise can be beneficial in mitigating both motor and non-motor symptoms of the disease. In a recent pilot study of the role of exercise on PD, we sought to confirm exercise intensity by monitoring heart rate (HR). For this purpose, we asked participants to wear a chest strap heart rate monitor (Polar Electro Oy, Kempele). The device sometimes proved uncomfortable. Looking forward to larger clinical trials, it would be convenient to employ a more comfortable and user friendly device. The Fitbit Charge 4 (Fitbit Inc) is a potentially comfortable, user-friendly solution since it is a wrist-worn heart rate monitor. Polar H10 has been used in large trials, and for our purposes, we treated it as the gold standard for the beat-to-beat period (R-R interval) assessment. In previous literature, it has been shown that Fitbit Charge 4 has comparable accuracy to Polar H10 in healthy subjects. It has yet to be determined if the Fitbit is as accurate as the Polar H10 in subjects with PD or in clinical populations, generally. Goal: To compare the Fitbit Charge 4 to the Polar H10 for monitoring HR in PD subjects engaging in an intensive exercise program. Methods: A total of 596 exercise sessions from 11 subjects (6 males) were collected simultaneously by both devices. Subjects with early-stage PD (Hoehn & Yahr <=2) were enrolled in a 6 months exercise training program designed for PD patients. Subjects participated in 3 one-hour exercise sessions per week. They wore both Fitbit and Polar H10 during each session. Sessions included rest, warm-up, intensive exercise, and cool-down periods. We calculated the bias in the HR via Fitbit under rest (5min) and intensive exercise (20min) by comparing the mean HR during each of the periods to the respective means measured by the Polar (HRFitbit – HRPolar). We also measured the sensitivity and specificity of Fitbit for detecting HRs that exceed the threshold for intensive exercise, defined as 70% of an individual’s theoretical maximum HR. Different types of correlation between the two devices were investigated. Results: The mean bias was 1.68 bpm at rest and 6.29 bpm during high intensity exercise, with an overestimation by Fitbit in both conditions. The mean bias of Fitbit across both rest and intensive exercise periods was 3.98 bpm. The sensitivity of the device in identifying high intensity exercise sessions was 97.14 %. The correlation between the two devices was non-linear, suggesting a saturation tendency of Fitbit to saturate at high values of HR. Conclusion: The performance of Fitbit Charge 4 is comparable to Polar H10 for assessing exercise intensity in a cohort of PD subjects. The device should be considered a reasonable replacement for the more cumbersome chest strap technology in future similar studies of clinical populations.

Keywords: fitbit, heart rate measurements, parkinson’s disease, wrist-wearable devices

Procedia PDF Downloads 73
468 Thermal Energy Storage Based on Molten Salts Containing Nano-Particles: Dispersion Stability and Thermal Conductivity Using Multi-Scale Computational Modelling

Authors: Bashar Mahmoud, Lee Mortimer, Michael Fairweather

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New methods have recently been introduced to improve the thermal property values of molten nitrate salts (a binary mixture of NaNO3:KNO3in 60:40 wt. %), by doping them with minute concentration of nanoparticles in the range of 0.5 to 1.5 wt. % to form the so-called: Nano-heat-transfer-fluid, apt for thermal energy transfer and storage applications. The present study aims to assess the stability of these nanofluids using the advanced computational modelling technique, Lagrangian particle tracking. A multi-phase solid-liquid model is used, where the motion of embedded nanoparticles in the suspended fluid is treated by an Euler-Lagrange hybrid scheme with fixed time stepping. This technique enables measurements of various multi-scale forces whose characteristic (length and timescales) are quite different. Two systems are considered, both consisting of 50 nm Al2O3 ceramic nanoparticles suspended in fluids of different density ratios. This includes both water (5 to 95 °C) and molten nitrate salt (220 to 500 °C) at various volume fractions ranging between 1% to 5%. Dynamic properties of both phases are coupled to the ambient temperature of the fluid suspension. The three-dimensional computational region consists of a 1μm cube and particles are homogeneously distributed across the domain. Periodic boundary conditions are enforced. The particle equations of motion are integrated using the fourth order Runge-Kutta algorithm with a very small time-step, Δts, set at 10-11 s. The implemented technique demonstrates the key dynamics of aggregated nanoparticles and this involves: Brownian motion, soft-sphere particle-particle collisions, and Derjaguin, Landau, Vervey, and Overbeek (DLVO) forces. These mechanisms are responsible for the predictive model of aggregation of nano-suspensions. An energy transport-based method of predicting the thermal conductivity of the nanofluids is also used to determine thermal properties of the suspension. The simulation results confirms the effectiveness of the technique. The values are in excellent agreement with the theoretical and experimental data obtained from similar studies. The predictions indicates the role of Brownian motion and DLVO force (represented by both the repulsive electric double layer and an attractive Van der Waals) and its influence in the level of nanoparticles agglomeration. As to the nano-aggregates formed that was found to play a key role in governing the thermal behavior of nanofluids at various particle concentration. The presentation will include a quantitative assessment of these forces and mechanisms, which would lead to conclusions about nanofluids, heat transfer performance and thermal characteristics and its potential application in solar thermal energy plants.

Keywords: thermal energy storage, molten salt, nano-fluids, multi-scale computational modelling

Procedia PDF Downloads 169
467 Multi-Agent System Based Distributed Voltage Control in Distribution Systems

Authors: A. Arshad, M. Lehtonen. M. Humayun

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With the increasing Distributed Generation (DG) penetration, distribution systems are advancing towards the smart grid technology for least latency in tackling voltage control problem in a distributed manner. This paper proposes a Multi-agent based distributed voltage level control. In this method a flat architecture of agents is used and agents involved in the whole controlling procedure are On Load Tap Changer Agent (OLTCA), Static VAR Compensator Agent (SVCA), and the agents associated with DGs and loads at their locations. The objectives of the proposed voltage control model are to minimize network losses and DG curtailments while maintaining voltage value within statutory limits as close as possible to the nominal. The total loss cost is the sum of network losses cost, DG curtailment costs, and voltage damage cost (which is based on penalty function implementation). The total cost is iteratively calculated for various stricter limits by plotting voltage damage cost and losses cost against varying voltage limit band. The method provides the optimal limits closer to nominal value with minimum total loss cost. In order to achieve the objective of voltage control, the whole network is divided into multiple control regions; downstream from the controlling device. The OLTCA behaves as a supervisory agent and performs all the optimizations. At first, a token is generated by OLTCA on each time step and it transfers from node to node until the node with voltage violation is detected. Upon detection of such a node, the token grants permission to Load Agent (LA) for initiation of possible remedial actions. LA will contact the respective controlling devices dependent on the vicinity of the violated node. If the violated node does not lie in the vicinity of the controller or the controlling capabilities of all the downstream control devices are at their limits then OLTC is considered as a last resort. For a realistic study, simulations are performed for a typical Finnish residential medium-voltage distribution system using Matlab ®. These simulations are executed for two cases; simple Distributed Voltage Control (DVC) and DVC with optimized loss cost (DVC + Penalty Function). A sensitivity analysis is performed based on DG penetration. The results indicate that costs of losses and DG curtailments are directly proportional to the DG penetration, while in case 2 there is a significant reduction in total loss. For lower DG penetration, losses are reduced more or less 50%, while for higher DG penetration, loss reduction is not very significant. Another observation is that the newer stricter limits calculated by cost optimization moves towards the statutory limits of ±10% of the nominal with the increasing DG penetration as for 25, 45 and 65% limits calculated are ±5, ±6.25 and 8.75% respectively. Observed results conclude that the novel voltage control algorithm proposed in case 1 is able to deal with the voltage control problem instantly but with higher losses. In contrast, case 2 make sure to reduce the network losses through proposed iterative method of loss cost optimization by OLTCA, slowly with time.

Keywords: distributed voltage control, distribution system, multi-agent systems, smart grids

Procedia PDF Downloads 288
466 Atypical Intoxication Due to Fluoxetine Abuse with Symptoms of Amnesia

Authors: Ayse Gul Bilen

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Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed antidepressants that are used clinically for the treatment of anxiety disorders, obsessive-compulsive disorder (OCD), panic disorders and eating disorders. The first SSRI, fluoxetine (sold under the brand names Prozac and Sarafem among others), had an adverse effect profile better than any other available antidepressant when it was introduced because of its selectivity for serotonin receptors. They have been considered almost free of side effects and have become widely prescribed, however questions about the safety and tolerability of SSRIs have emerged with their continued use. Most SSRI side effects are dose-related and can be attributed to serotonergic effects such as nausea. Continuous use might trigger adverse effects such as hyponatremia, tremor, nausea, weight gain, sleep disturbance and sexual dysfunction. Moderate toxicity can be safely observed in the hospital for 24 hours, and mild cases can be safely discharged (if asymptomatic) from the emergency department once cleared by Psychiatry in cases of intentional overdose and after 6 to 8 hours of observation. Although fluoxetine is relatively safe in terms of overdose, it might still be cardiotoxic and inhibit platelet secretion, aggregation, and plug formation. There have been reported clinical cases of seizures, cardiac conduction abnormalities, and even fatalities associated with fluoxetine ingestions. While the medical literature strongly suggests that most fluoxetine overdoses are benign, emergency physicians need to remain cognizant that intentional, high-dose fluoxetine ingestions may induce seizures and can even be fatal due to cardiac arrhythmia. Our case is a 35-year old female patient who was sent to ER with symptoms of confusion, amnesia and loss of orientation for time and location after being found wandering in the streets unconsciously by police forces that informed 112. Upon laboratory examination, no pathological symptom was found except sinus tachycardia in the EKG and high levels of aspartate transaminase (AST) and alanine transaminase (ALT). Diffusion MRI and computed tomography (CT) of the brain all looked normal. Upon physical and sexual examination, no signs of abuse or trauma were found. Test results for narcotics, stimulants and alcohol were negative as well. There was a presence of dysrhythmia which required admission to the intensive care unit (ICU). The patient gained back her conscience after 24 hours. It was discovered from her story afterward that she had been using fluoxetine due to post-traumatic stress disorder (PTSD) for 6 months and that she had attempted suicide after taking 3 boxes of fluoxetine due to the loss of a parent. She was then transferred to the psychiatric clinic. Our study aims to highlight the need to consider toxicologic drug use, in particular, the abuse of selective serotonin reuptake inhibitors (SSRIs), which have been widely prescribed due to presumed safety and tolerability, for diagnosis of patients applying to the emergency room (ER).

Keywords: abuse, amnesia, fluoxetine, intoxication, SSRI

Procedia PDF Downloads 180
465 Synthesis and Characterization of Fibrin/Polyethylene Glycol-Based Interpenetrating Polymer Networks for Dermal Tissue Engineering

Authors: O. Gsib, U. Peirera, C. Egles, S. A. Bencherif

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In skin regenerative medicine, one of the critical issues is to produce a three-dimensional scaffold with optimized porosity for dermal fibroblast infiltration and neovascularization, which exhibits high mechanical properties and displays sufficient wound healing characteristics. In this study, we report on the synthesis and characterization of macroporous sequential interpenetrating polymer networks (IPNs) combining skin wound healing properties of fibrin with the excellent physical properties of polyethylene glycol (PEG). Fibrin fibers serve as a provisional biologically active network to promote cell adhesion and proliferation while PEG provides the mechanical stability to maintain the entire 3D construct. After having modified both PEG and Serum Albumin (used for promoting enzymatic degradability) by adding methacrylate residues (PEGDM and SAM, respectively), Fibrin/PEGDM-SAM sequential IPNs were synthesized as follows: Macroporous sponges were first produced from PEGDM-SAM hydrogels by a freeze-drying technique and then rehydrated by adding the fibrin precursors. Environmental Scanning Electron Microscopy (ESEM) and Confocal Laser Scanning Microscopy (CLSM) were used to characterize their microstructure. Human dermal fibroblasts were cultivated during one week in the constructs and different cell culture parameters (viability, morphology, proliferation) were evaluated. Subcutaneous implantations of the scaffolds were conducted on five-week old male nude mice to investigate their biocompatibility in vivo. We successfully synthesized interconnected and macroporous Fibrin/PEGDM-SAM sequential IPNs. The viability of primary dermal fibroblasts was well maintained (above 90%) after 2 days of culture. Cells were able to adhere, spread and proliferate in the scaffolds suggesting the suitable porosity and intrinsic biologic properties of the constructs. The fibrin network adopted a spider web shape that covered partially the pores allowing easier cell infiltration into the macroporous structure. To further characterize the in vitro cell behavior, cell proliferation (EdU incorporation, MTS assay) is being studied. Preliminary histological analysis of animal studies indicated the persistence of hydrogels even after one-month post implantation and confirmed the absence of inflammation response, good biocompatibility and biointegration of our scaffolds within the surrounding tissues. These results suggest that our Fibrin/PEGDM-SAM IPNs could be considered as potential candidates for dermis regenerative medicine. Histological analysis will be completed to further assess scaffold remodeling including de novo extracellular matrix protein synthesis and early stage angiogenesis analysis. Compression measurements will be conducted to investigate the mechanical properties.

Keywords: fibrin, hydrogels for dermal reconstruction, polyethylene glycol, semi-interpenetrating polymer network

Procedia PDF Downloads 209
464 Phenotypic and Molecular Heterogeneity Linked to the Magnesium Transporter CNNM2

Authors: Reham Khalaf-Nazzal, Imad Dweikat, Paula Gimenez, Iker Oyenarte, Alfonso Martinez-Cruz, Domonik Muller

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Metal cation transport mediator (CNNM) gene family comprises 4 isoforms that are expressed in various human tissues. Structurally, CNNMs are complex proteins that contain an extracellular N-terminal domain preceding a DUF21 transmembrane domain, a ‘Bateman module’ and a C-terminal cNMP-binding domain. Mutations in CNNM2 cause familial dominant hypomagnesaemia. Growing evidence highlights the role of CNNM2 in neurodevelopment. Mutations in CNNM2 have been implicated in epilepsy, intellectual disability, schizophrenia, and others. In the present study, we aim to elucidate the function of CNNM2 in the developing brain. Thus, we present the genetic origin of symptoms in two family cohorts. In the first family, three siblings of a consanguineous Palestinian family in which parents are first cousins, and consanguinity ran over several generations, presented a varying degree of intellectual disability, cone-rod dystrophy, and autism spectrum disorder. Exome sequencing and segregation analysis revealed the presence of homozygous pathogenic mutation in the CNNM2 gene, the parents were heterozygous for that gene mutation. Magnesium blood levels were normal in the three children and their parents in several measurements. They had no symptoms of hypomagnesemia. The CNNM2 mutation in this family was found to locate in the CBS1 domain of the CNNM2 protein. The crystal structure of the mutated CNNM2 protein was not significantly different from the wild-type protein, and the binding of AMP or MgATP was not dramatically affected. This suggests that the CBS1 domain could be involved in pure neurodevelopmental functions independent of its magnesium-handling role, and this mutation could have affected a protein partner binding or other functions in this protein. In the second family, another autosomal dominant CNNM2 mutation was found to run in a large family with multiple individuals over three generations. All affected family members had hypomagnesemia and hypermagnesuria. Oral supplementation of magnesium did not increase the levels of magnesium in serum significantly. Some affected members of this family have defects in fine motor skills such as dyslexia and dyslalia. The detected mutation is located in the N-terminal part, which contains a signal peptide thought to be involved in the sorting and routing of the protein. In this project, we describe heterogenous clinical phenotypes related to CNNM2 mutations and protein functions. In the first family, and up to the authors’ knowledge, we report for the first time the involvement of CNNM2 in retinal photoreceptor development and function. In addition, we report the presence of a neurophenotype independent of magnesium status related to the CNNM2 protein mutation. Taking into account the different modes of inheritance and the different positions of the mutations within CNNM2 and its different structural and functional domains, it is likely that CNNM2 might be involved in a wide spectrum of neuropsychiatric comorbidities with considerable varying phenotypes.

Keywords: magnesium transport, autosomal recessive, autism, neurodevelopment, CBS domain

Procedia PDF Downloads 124
463 Influence of Packing Density of Layers Placed in Specific Order in Composite Nonwoven Structure for Improved Filtration Performance

Authors: Saiyed M Ishtiaque, Priyal Dixit

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Objectives: An approach is being suggested to design the filter media to maximize the filtration efficiency with minimum possible pressure drop of composite nonwoven by incorporating the layers of different packing densities induced by fibre of different deniers and punching parameters by using the concept of sequential punching technique in specific order in layered composite nonwoven structure. X-ray computed tomography technique is used to measure the packing density along the thickness of layered nonwoven structure composed by placing the layer of differently oriented fibres influenced by fibres of different deniers and punching parameters in various combinations to minimize the pressure drop at maximum possible filtration efficiency. Methodology Used: This work involves preparation of needle punched layered structure with batts 100g/m2 basis weight having fibre denier, punch density and needle penetration depth as variables to produce 300 g/m2 basis weight nonwoven composite. X-ray computed tomography technique is used to measure the packing density along the thickness of layered nonwoven structure composed by placing the layers of differently oriented fibres influenced by considered variables in various combinations. to minimize the pressure drop at maximum possible filtration efficiencyFor developing layered nonwoven fabrics, batts made of fibre of different deniers having 100g/m2 each basis weight were placed in various combinations. For second set of experiment, the composite nonwoven fabrics were prepared by using 3 denier circular cross section polyester fibre having 64 mm length on needle punched nonwoven machine by using the sequential punching technique to prepare the composite nonwoven fabrics. In this technique, three semi punched fabrics of 100 g/m2 each having either different punch densities or needle penetration depths were prepared for first phase of fabric preparation. These fabrics were later punched altogether to obtain the overall basis weight of 300 g/m2. The total punch density of the composite nonwoven fabric was kept at 200 punches/ cm2 with a needle penetration depth of 10 mm. The layered structures so formed were subcategorised into two groups- homogeneous layered structure in which all the three batts comprising the nonwoven fabric were made from same denier of fibre, punch density and needle penetration depth and were placed in different positions in respective fabric and heterogeneous layered structure in which batts were made from fibres of different deniers, punch densities and needle penetration depths and were placed in different positions. Contributions: The results concluded that reduction in pressure drop is not derived by the overall packing density of the layered nonwoven fabric rather sequencing of layers of specific packing density in layered structure decides the pressure drop. Accordingly, creation of inverse gradient of packing density in layered structure provided maximum filtration efficiency with least pressure drop. This study paves the way for the possibility of customising the composite nonwoven fabrics by the incorporation of differently oriented fibres in constituent layers induced by considered variablres for desired filtration properties.

Keywords: filtration efficiency, layered nonwoven structure, packing density, pressure drop

Procedia PDF Downloads 44
462 Monitoring and Improving Performance of Soil Aquifer Treatment System and Infiltration Basins Performance: North Gaza Emergency Sewage Treatment Plant as Case Study

Authors: Sadi Ali, Yaser Kishawi

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As part of Palestine, Gaza Strip (365 km2 and 1.8 million habitants) is considered a semi-arid zone relies solely on the Coastal Aquifer. The coastal aquifer is only source of water with only 5-10% suitable for human use. This barely cover the domestic and agricultural needs of Gaza Strip. Palestinian Water Authority Strategy is to find non-conventional water resource from treated wastewater to irrigate 1500 hectares and serves over 100,000 inhabitants. A new WWTP project is to replace the old-overloaded Biet Lahia WWTP. The project consists of three parts; phase A (pressure line & 9 infiltration basins - IBs), phase B (a new WWTP) and phase C (Recovery and Reuse Scheme – RRS – to capture the spreading plume). Currently, phase A is functioning since Apr 2009. Since Apr 2009, a monitoring plan is conducted to monitor the infiltration rate (I.R.) of the 9 basins. Nearly 23 million m3 of partially treated wastewater were infiltrated up to Jun 2014. It is important to maintain an acceptable rate to allow the basins to handle the coming quantities (currently 10,000 m3 are pumped an infiltrated daily). The methodology applied was to review and analysis the collected data including the I.R.s, the WW quality and the drying-wetting schedule of the basins. One of the main findings is the relation between the Total Suspended Solids (TSS) at BLWWTP and the I.R. at the basins. Since April 2009, the basins scored an average I.R. of about 2.5 m/day. Since then the records showed a decreasing pattern of the average rate until it reached the lower value of 0.42 m/day in Jun 2013. This was accompanied with an increase of TSS (mg/L) concentration at the source reaching above 200 mg/L. The reducing of TSS concentration directly improved the I.R. (by cleaning the WW source ponds at Biet Lahia WWTP site). This was reflected in an improvement in I.R. in last 6 months from 0.42 m/day to 0.66 m/day then to nearly 1.0 m/day as the average of the last 3 months of 2013. The wetting-drying scheme of the basins was observed (3 days wetting and 7 days drying) besides the rainfall rates. Despite the difficulty to apply this scheme accurately a control of flow to each basin was applied to improve the I.R. The drying-wetting system affected the I.R. of individual basins, thus affected the overall system rate which was recorded and assessed. Also the ploughing activities at the infiltration basins as well were recommended at certain times to retain a certain infiltration level. This breaks the confined clogging layer which prevents the infiltration. It is recommended to maintain proper quality of WW infiltrated to ensure an acceptable performance of IBs. The continual maintenance of settling ponds at BLWWTP, continual ploughing of basins and applying soil treatment techniques at the IBs will improve the I.R.s. When the new WWTP functions a high standard effluent quality (TSS 20mg, BOD 20 mg/l and TN 15 mg/l) will be infiltrated, thus will enhance I.R.s of IBs due to lower organic load.

Keywords: SAT, wastewater quality, soil remediation, North Gaza

Procedia PDF Downloads 217
461 Numerical Investigation of Thermal Energy Storage Panel Using Nanoparticle Enhanced Phase Change Material for Micro-Satellites

Authors: Jelvin Tom Sebastian, Vinod Yeldho Baby

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In space, electronic devices are constantly attacked with radiation, which causes certain parts to fail or behave in unpredictable ways. To advance the thermal controllability for microsatellites, we need a new approach and thermal control system that is smaller than that on conventional satellites and that demand no electric power. Heat exchange inside the microsatellites is not that easy as conventional satellites due to the smaller size. With slight mass gain and no electric power, accommodating heat using phase change materials (PCMs) is a strong candidate for solving micro satellites' thermal difficulty. In other words, PCMs can absorb or produce heat in the form of latent heat, changing their phase and minimalizing the temperature fluctuation around the phase change point. The main restriction for these systems is thermal conductivity weakness of common PCMs. As PCM is having low thermal conductivity, it increases the melting and solidification time, which is not suitable for specific application like electronic cooling. In order to increase the thermal conductivity nanoparticles are introduced. Adding the nanoparticles in base PCM increases the thermal conductivity. Increase in weight concentration increases the thermal conductivity. This paper numerically investigates the thermal energy storage panel with nanoparticle enhanced phase change material. Silver nanostructure have increased the thermal properties of the base PCM, eicosane. Different weight concentration (1, 2, 3.5, 5, 6.5, 8, 10%) of silver enhanced phase change material was considered. Both steady state and transient analysis was performed to compare the characteristics of nanoparticle enhanced phase material at different heat loads. Results showed that in steady state, the temperature near the front panel reduced and temperature on NePCM panel increased as the weight concentration increased. With the increase in thermal conductivity more heat was absorbed into the NePCM panel. In transient analysis, it was found that the effect of nanoparticle concentration on maximum temperature of the system was reduced as the melting point of the material reduced with increase in weight concentration. But for the heat load of maximum 20W, the model with NePCM did not attain the melting point temperature. Therefore it showed that the model with NePCM is capable of holding more heat load. In order to study the heat load capacity double the load is given, maximum of 40W was given as first half of the cycle and the other is given constant OW. Higher temperature was obtained comparing the other heat load. The panel maintained a constant temperature for a long duration according to the NePCM melting point. In both the analysis, the uniformity of temperature of the TESP was shown. Using Ag-NePCM it allows maintaining a constant peak temperature near the melting point. Therefore, by altering the weight concentration of the Ag-NePCM it is possible to create an optimum operating temperature required for the effective working of the electronics components.

Keywords: carbon-fiber-reinforced polymer, micro/nano-satellite, nanoparticle phase change material, thermal energy storage

Procedia PDF Downloads 187
460 Management of Mycotoxin Production and Fungicide Resistance by Targeting Stress Response System in Fungal Pathogens

Authors: Jong H. Kim, Kathleen L. Chan, Luisa W. Cheng

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Control of fungal pathogens, such as foodborne mycotoxin producers, is problematic as effective antimycotic agents are often very limited. Mycotoxin contamination significantly interferes with the safe production of foods or crops worldwide. Moreover, expansion of fungal resistance to commercial drugs or fungicides is a global human health concern. Therefore, there is a persistent need to enhance the efficacy of commercial antimycotic agents or to develop new intervention strategies. Disruption of the cellular antioxidant system should be an effective method for pathogen control. Such disruption can be achieved with safe, redox-active compounds. Natural phenolic derivatives are potent redox cyclers that inhibit fungal growth through destabilization of the cellular antioxidant system. The goal of this study is to identify novel, redox-active compounds that disrupt the fungal antioxidant system. The identified compounds could also function as sensitizing agents to conventional antimycotics (i.e., chemosensitization) to improve antifungal efficacy. Various benzo derivatives were tested against fungal pathogens. Gene deletion mutants of the yeast Saccharomyces cerevisiae were used as model systems for identifying molecular targets of benzo analogs. The efficacy of identified compounds as potent antifungal agents or as chemosensitizing agents to commercial drugs or fungicides was examined with methods outlined by the Clinical Laboratory Standards Institute or the European Committee on Antimicrobial Susceptibility Testing. Selected benzo derivatives possessed potent antifungal or antimycotoxigenic activity. Molecular analyses by using S. cerevisiae mutants indicated antifungal activity of benzo derivatives was through disruption of cellular antioxidant or cell wall integrity system. Certain benzo analogs screened overcame tolerance of Aspergillus signaling mutants, namely mitogen-activated protein kinase mutants, to fludioxonil fungicide. Synergistic antifungal chemosensitization greatly lowered minimum inhibitory or fungicidal concentrations of test compounds, including inhibitors of mitochondrial respiration. Of note, salicylaldehyde is a potent antimycotic volatile that has some practical application as a fumigant. Altogether, benzo derivatives targeting cellular antioxidant system of fungi (along with cell wall integrity system) effectively suppress fungal growth. Candidate compounds possess the antifungal, antimycotoxigenic or chemosensitizing capacity to augment the efficacy of commercial antifungals. Therefore, chemogenetic approaches can lead to the development of novel antifungal intervention strategies, which enhance the efficacy of established microbe intervention practices and overcome drug/fungicide resistance. Chemosensitization further reduces costs and alleviates negative side effects associated with current antifungal treatments.

Keywords: antifungals, antioxidant system, benzo derivatives, chemosensitization

Procedia PDF Downloads 229
459 Mesalazine-Induced Myopericarditis in a Professional Athlete

Authors: Tristan R. Fraser, Christopher D. Steadman, Christopher J. Boos

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Myopericarditis is an inflammation syndrome characterised by clinical diagnostic criteria for pericarditis, such as chest pain, combined with evidence of myocardial involvement, such as elevation of biomarkers of myocardial damage, e.g., troponins. It can rarely be a complication of therapeutics used for dysregulated immune-mediated diseases such as inflammatory bowel disease (IBD), for example, mesalazine. The infrequency of mesalazine-induced myopericarditis adds to the challenge in its recognition. Rapid diagnosis and the early introduction of treatment are crucial. This case report follows a 24-year-old professional footballer with a past medical history of ulcerative colitis, recently started on mesalazine for disease control. Three weeks after mesalazine was initiated, he was admitted with fever, shortness of breath, and chest pain worse whilst supine and on deep inspiration, as well as elevated venous blood cardiac troponin T level (cTnT, 288ng/L; normal: <13ng/L). Myocarditis was confirmed on initial inpatient cardiac MRI, revealing the presence of florid myocarditis with preserved left ventricular systolic function and an ejection fraction of 67%. This was a longitudinal case study following the progress of a single individual with myopericarditis over four acute hospital admissions over nine weeks, with admissions ranging from two to five days. Parameters examined included clinical signs and symptoms, serum troponin, transthoracic echocardiogram, and cardiac MRI. Serial measurements of cardiac function, including cardiac MRI and transthoracic echocardiogram, showed progressive deterioration of cardiac function whilst mesalazine was continued. Prior to cessation of mesalazine, transthoracic echocardiography revealed a small global pericardial effusion of < 1cm and worsening left ventricular systolic function with an ejection fraction of 45%. After recognition of mesalazine as a potential cause and consequent cessation of the drug, symptoms resolved, with cardiac MRI performed as an outpatient showing resolution of myocardial oedema. The patient plans to make a return to competitive sport. Patients suffering from myopericarditis are advised to refrain from competitive sport for at least six months in order to reduce the risk of cardiac remodelling and sudden cardiac death. Additional considerations must be taken in individuals for whom competitive sport is an essential component of their livelihood, such as professional athletes. Myopericarditis is an uncommon, however potentially serious medical condition with a wide variety of aetiologies, including viral, autoimmune, and drug-related causes. Management is mainly supportive and relies on prompt recognition and removal of the aetiological process. Mesalazine-induced myopericarditis is a rare condition; as such increasing awareness of mesalazine as a precipitant of myopericarditis is vital for optimising the management of these patients.

Keywords: myopericarditis, mesalazine, inflammatory bowel disease, professional athlete

Procedia PDF Downloads 113
458 Impact of Climate Change on Irrigation and Hydropower Potential: A Case of Upper Blue Nile Basin in Western Ethiopia

Authors: Elias Jemal Abdella

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The Blue Nile River is an important shared resource of Ethiopia, Sudan and also, because it is the major contributor of water to the main Nile River, Egypt. Despite the potential benefits of regional cooperation and integrated joint basin management, all three countries continue to pursue unilateral plans for development. Besides, there is great uncertainty about the likely impacts of climate change in water availability for existing as well as proposed irrigation and hydropower projects in the Blue Nile Basin. The main objective of this study is to quantitatively assess the impact of climate change on the hydrological regime of the upper Blue Nile basin, western Ethiopia. Three models were combined, a dynamic Coordinated Regional Climate Downscaling Experiment (CORDEX) regional climate model (RCM) that is used to determine climate projections for the Upper Blue Nile basin for Representative Concentration Pathways (RCPs) 4.5 and 8.5 greenhouse gas emissions scenarios for the period 2021-2050. The outputs generated from multimodel ensemble of four (4) CORDEX-RCMs (i.e., rainfall and temperature) were used as input to a Soil and Water Assessment Tool (SWAT) hydrological model which was setup, calibrated and validated with observed climate and hydrological data. The outputs from the SWAT model (i.e., projections in river flow) were used as input to a Water Evaluation and Planning (WEAP) water resources model which was used to determine the water resources implications of the changes in climate. The WEAP model was set-up to simulate three development scenarios. Current Development scenario was the existing water resource development situation, Medium-term Development scenario was planned water resource development that is expected to be commissioned (i.e. before 2025) and Long-term full Development scenario were all planned water resource development likely to be commissioned (i.e. before 2050). The projected change of mean annual temperature for period (2021 – 2050) in most of the basin are warmer than the baseline (1982 -2005) average in the range of 1 to 1.4oC, implying that an increase in evapotranspiration loss. Subbasins which already distressed from drought may endure to face even greater challenges in the future. Projected mean annual precipitation varies from subbasin to subbasin; in the Eastern, North Eastern and South western highland of the basin a likely increase of mean annual precipitation up to 7% whereas in the western lowland part of the basin mean annual precipitation projected to decrease by 3%. The water use simulation indicates that currently irrigation demand in the basin is 1.29 Bm3y-1 for 122,765 ha of irrigation area. By 2025, with new schemes being developed, irrigation demand is estimated to increase to 2.5 Bm3y-1 for 277,779 ha. By 2050, irrigation demand in the basin is estimated to increase to 3.4 Bm3y-1 for 372,779 ha. The hydropower generation simulation indicates that 98 % of hydroelectricity potential could be produced if all planned dams are constructed.

Keywords: Blue Nile River, climate change, hydropower, SWAT, WEAP

Procedia PDF Downloads 324
457 Budget Impact Analysis of a Stratified Treatment Cascade for Hepatitis C Direct Acting Antiviral Treatment in an Asian Middle-Income Country through the Use of Compulsory and Voluntary Licensing Options

Authors: Amirah Azzeri, Fatiha H. Shabaruddin, Scott A. McDonald, Rosmawati Mohamed, Maznah Dahlui

Abstract:

Objective: A scaled-up treatment cascade with direct-acting antiviral (DAA) therapy is necessary to achieve global WHO targets for hepatitis C virus (HCV) elimination in Malaysia. Recently, limited access to Sofosbuvir/Daclatasvir (SOF/DAC) is available through compulsory licensing, with future access to Sofosbuvir/Velpatasvir (SOF/VEL) expected through voluntary licensing due to recent agreements. SOF/VEL has superior clinical outcomes, particularly for cirrhotic stages, but has higher drug acquisition costs compared to SOF/DAC. It has been proposed that a stratified treatment cascade might be the most cost-efficient approach for Malaysia whereby all HCV patients are treated with SOF/DAC except for patients with cirrhosis who are treated with SOF/VEL. This study aimed to conduct a five-year budget impact analysis from the provider perspective of the proposed stratified treatment cascade for HCV treatment in Malaysia. Method: A disease progression model that was developed based on model-predicted HCV epidemiology data in Malaysia was used for the analysis, where all HCV patients in scenario A were treated with SOF/DAC for all disease stages while in scenario B, SOF/DAC was used only for non-cirrhotic patients and SOF/VEL was used for the cirrhotic patients. The model projections estimated the annual numbers of patients in care and the numbers of patients to be initiated on DAA treatment nationally. Healthcare costs associated with DAA therapy and disease stage monitoring was included to estimate the downstream cost implications. For scenario B, the estimated treatment uptake of SOF/VEL for cirrhotic patients were 25%, 50%, 75%, 100% and 100% for 2018, 2019, 2020, 2021 and 2022 respectively. Healthcare costs were estimated based on standard clinical pathways for DAA treatment described in recent guidelines. All costs were reported in US dollars (conversion rate US$1=RM4.09, the price year 2018). Scenario analysis was conducted for 5% and 10% reduction of SOF/VEL acquisition cost anticipated from the competitive market pricing of generic DAA in Malaysia. Results: The stratified treatment cascade with SOF/VEL in Scenario B was found to be cost-saving compared to Scenario A. A substantial portion of the cost reduction was due to the costs associated with DAA therapy which resulted in USD 40 thousand (year 1) to USD 443 thousand (year 5) savings annually, with cumulative savings of USD 1.1 million after 5 years. Cost reductions for disease stage monitoring were seen in year three onwards which resulted in cumulative savings of USD 1.1 thousand. Scenario analysis estimated cumulative savings of USD 1.24 to USD 1.35 million when the acquisition cost of SOF/VEL was reduced. Conclusion: A stratified treatment cascade with SOF/VEL was expected to be cost-saving and can results in a budget impact reduction in overall healthcare expenditure in Malaysia compared to treatment with SOF/DAC. The better clinical efficacy with SOF/VEL is expected to halt patients’ HCV disease progression and may reduce downstream costs of treating advanced disease stages. The findings of this analysis may be useful to inform healthcare policies for HCV treatment in Malaysia.

Keywords: Malaysia, direct acting antiviral, compulsory licensing, voluntary licensing

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456 Effects of Exposure to a Language on Perception of Non-Native Phonologically Contrastive Duration

Authors: Chuyu Huang, Itsuki Minemi, Kuanlin Chen, Yuki Hirose

Abstract:

It remains unclear how language speakers are able to perceive phonological contrasts that do not exist on their own. This experiment uses the vowel-length distinction in Japanese, which is phonologically contrastive and co-occurs with tonal change in some cases. For speakers whose first language does not distinguish vowel length, contrastive duration is usually misperceived, e.g., Mandarin speakers. Two alternative hypotheses for how Mandarin speakers would perceive a phonological contrast that does not exist in their language make different predictions. The stress parameter model does not have a clear prediction about the impact of tonal type. Mandarin speakers will likely be not able to perceive vowel length as well as Japanese native speakers do, but the performance might not correlate to tonal type because the prosody of their language is distinctive, which requires users to encode lexical prosody and notice subtle differences in word prosody. By contrast, cue-based phonetic models predict that Mandarin speakers may rely on pitch differences, a secondary cue, to perceive vowel length. Two groups of Mandarin speakers, including naive non-Japanese speakers and beginner learners, were recruited to participate in an AX discrimination task involving two Japanese sound stimuli that contain a phonologically contrastive environment. Participants were asked to indicate whether the two stimuli containing a vowel-length contrast (e.g., maapero vs. mapero) sound the same. The experiment was bifactorial. The first factor contrasted three syllabic positions (syllable position; initial/medial/final), as it would be likely to affect the perceptual difficulty, as seen in previous studies, and the second factor contrasted two pitch types (accent type): one with accentual change that could be distinguished with the lexical tones in Mandarin (the different condition), with the other group having no tonal distinction but only differing in vowel length (the same condition). The overall results showed that a significant main effect of accent type by applying a linear mixed-effects model (β = 1.48, SE = 0.35, p < 0.05), which implies that Mandarin speakers tend to more successfully recognize vowel-length differences when the long vowel counterpart takes on a tone that exists in Mandarin. The interaction between the accent type and the syllabic position is also significant (β = 2.30, SE = 0.91, p < 0.05), showing that vowel lengths in the different conditions are more difficult to recognize in the word-final case relative to the initial condition. The second statistical model, which compares naive speakers to beginners, was conducted with logistic regression to test the effects of the participant group. A significant difference was found between the two groups (β = 1.06, 95% CI = [0.36, 2.03], p < 0.05). This study shows that: (1) Mandarin speakers are likely to use pitch cues to perceive vowel length in a non-native language, which is consistent with the cue-based approaches; (2) an exposure effect was observed: the beginner group achieved a higher accuracy for long vowel perception, which implied the exposure effect despite the short period of language learning experience.

Keywords: cue-based perception, exposure effect, prosodic perception, vowel duration

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455 Antioxidant Activity of Some Important Indigenous Plant Foods of the North Eastern Region of India

Authors: L. Bidyalakshmi, R. Ananthan, T. Longvah

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Antioxidants are substances that can prevent or delay oxidative damage of lipids, proteins and nucleic acids by reactive oxygen species. These help in lowering incidence of degenerative diseases such as cancer, arthritis, atherosclerosis, heart disease, inflammation, brain dysfunction and acceleration of the ageing process. The north eastern part of India falls among the global hotspots of biodiversity. Over the years, the local communities in the region have developed ingenious uses of many wild plants within their environment as food sources. Many of these less familiar foods form an integral part of the diet of these communities, and some are traditionally valued for its therapeutic effects. So the study was carried to estimate the antioxidant activity of some of these indigenous foods. Twenty-eight indigenous plant foods were studied for their antioxidant activity. Antioxidant activities were determined by using DPPH (2, 2-diphenyl-1-picrylhydrazyl) assay, FRAP (Ferric Reducing Antioxidant Power) assay and SOSA (Super Oxide Scavenging Assay). Out of the twenty-eight plant foods, there were thirteen leafy vegetables, four fruits, five roots and tubers, four spices and two mushrooms. Water extract and methanol extract of the samples were used for the analysis. The leafy vegetable samples exhibited antioxidant capacity with IC50 ranging from 8-1414 mg/ml for lipid extract and 34-37878 mg/ml for aqueous extract in DPPH assay. Total FRAP value ranging from 58-1005 mmol FeSO4 Eq/100g of the sample, which is comparatively higher than the antioxidant capacity of some commonly consumed leafy vegetables. In SOSA, water extract of leafy vegetables show a range of 0.05-193.68 µmol ascorbic acid equivalent/g of the samples. While the methanol extract of the samples show 0.20-21.94 µmol Trolox equivalent/g of the samples. Polygonum barbatum, Wendlandia glabrata and Polygonum posumbu have higher antioxidant activity among the leafy vegetables analysed. Among the fruits, Rhus hookerii showed the highest antioxidant activities in both FRAP and SOSA methods while Spondias magnifera exhibited higher antioxidant activity in DPPH method. Alocasia cucullata exhibited higher antioxidant activity in DPPH and FRAP assays while Alpinia galanga showed higher antioxidant activity in SOSA assay when compared to the other samples of roots and tubers. Elsholtzia communis showed high antioxidant activity in all the three parameters among the spices. For the mushrooms, Pleurotus ostreatus exhibited higher antioxidant activity than Auricularia delicate in DPPH and SOSA. The samples analysed exhibited antioxidant activity at varying levels and some exhibited higher antioxidant activity than the commonly consumed foods. So consumption of these less familiar foods may play a role in preventing human disease in which free radicals are involved. Further studies on these food samples on phytonutrients and its contribution to the antioxidant activities are required.

Keywords: antioxidant activity, DPPH, FRAP, SOSA

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454 Mesenchymal Stem Cells on Fibrin Assemblies with Growth Factors

Authors: Elena Filova, Ondrej Kaplan, Marie Markova, Helena Dragounova, Roman Matejka, Eduard Brynda, Lucie Bacakova

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Decellularized vessels have been evaluated as small-diameter vascular prostheses. Reseeding autologous cells onto decellularized tissue prior implantation should prolong prostheses function and make them living tissues. Suitable cell types for reseeding are both endothelial cells and bone marrow-derived stem cells, with a capacity for differentiation into smooth muscle cells upon mechanical loading. Endothelial cells assure antithrombogenicity of the vessels and MSCs produce growth factors and, after their differentiation into smooth muscle cells, they are contractile and produce extracellular matrix proteins as well. Fibrin is a natural scaffold, which allows direct cell adhesion based on integrin receptors. It can be prepared autologous. Fibrin can be modified with bound growth factors, such as basic fibroblast growth factor (FGF-2) and vascular endothelial growth factor (VEGF). These modifications in turn make the scaffold more attractive for cells ingrowth into the biological scaffold. The aim of the study was to prepare thin surface-attached fibrin assemblies with bound FGF-2 and VEGF, and to evaluate growth and differentiation of bone marrow-derived mesenchymal stem cells on the fibrin (Fb) assemblies. Following thin surface-attached fibrin assemblies were prepared: Fb, Fb+VEGF, Fb+FGF2, Fb+heparin, Fb+heparin+VEGF, Fb+heparin+FGF2, Fb+heparin+FGF2+VEGF. Cell culture poly-styrene and glass coverslips were used as controls. Human MSCs (passage 3) were seeded at the density of 8800 cells/1.5 mL alpha-MEM medium with 2.5% FS and 200 U/mL aprotinin per well of a 24-well cell culture. The cells have been cultured on the samples for 6 days. Cell densities on day 1, 3, and 6 were analyzed after staining with LIVE/DEAD cytotoxicity/viability assay kit. The differentiation of MSCs is being analyzed using qPCR. On day 1, the highest density of MSCs was observed on Fb+VEGF and Fb+FGF2. On days 3 and 6, there were similar densities on all samples. On day 1, cell morphology was polygonal and spread on all sample. On day 3 and 6, MSCs growing on Fb assemblies with FGF2 became apparently elongated. The evaluation of expression of genes for von Willebrand factor and CD31 (endothelial cells), for alpha-actin (smooth muscle cells), and for alkaline phosphatase (osteoblasts) is in progress. We prepared fibrin assemblies with bound VEGF and FGF-2 that supported attachment and growth of mesenchymal stem cells. The layers are promising for improving the ingrowth of MSCs into the biological scaffold. Supported by the Technology Agency of the Czech Republic TA04011345, and Ministry of Health NT11270-4/2010, and BIOCEV – Biotechnology and Biomedicine Centre of the Academy of Sciences and Charles University” project (CZ.1.05/1.1.00/02.0109), funded by the European Regional Development Fund for their financial supports.

Keywords: fibrin assemblies, FGF-2, mesenchymal stem cells, VEGF

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453 The Ethics of Physical Restraints in Geriatric Care

Authors: Bei Shan Lin, Chun Mei Lu, Ya Ping Chen, Li Chen Lu

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This study explores the ethical issues concerning the use of physical restraint in geriatric care. Physical restraint use in a medical care setting is seen as a controversial form of treatment that has occurred over decades. There is no doubt that people nowadays are living longer than previous generations. The ageing process is inevitable. Common disease such as impaired comprehension, memory loss, and trouble expressing one’s self contribute to the difficulty that these older patients have in adapting to medical institution. For these reasons, physical restraint is often used in reducing the risk of falling, managing wandering behaviour, preventing agitation, and promoting patient compliance in geriatric care. It can mean that physical restraints are considered as a common practice that is used in the care of older patients. It is most commonly used for three specific purposes, including procedural restraint, restraint to prevent falls, and behavioural restraints. Although there have been well documented instances of morbidity and mortality recognised as being potential risks associated with physical restraint use, it continues to be permitted and used in healthcare, often in the name of safety. However, there is insufficient evidence supporting the effectiveness of physical restraint use reducing injuries from falls and controlling challenging behaviour in geriatric care settings. There is barely any empirical evidence of either a scientific basis or clinical trials have evaluated the improvement in patient safety following physical restraint. In difficult clinical situations, guidelines and practical suggestions for Healthcare professionals to comply requirements can help those making appropriate decisions and to facilitate better judgement regarding physical restraint use. The following recommendations are given for physical restraint use in long-term care settings: an interdisciplinary team approach to assess, evaluate, and treat underlying diseases to determine if treatment can ease issues precipitating physical restraint use; a clearly stated purpose of treatment plan should be made after weighing up the risk of physical restraint use against the risk of without physical restraint use; a care plan for physical restraint has to include individualised treatment planning, informed consent, identification and remedial action to avoid negative consequences, regular assessment and modification, reduction and removal of risks; patients and their families must have the opportunity to consider and give voluntary informed consent prior to physical restraint utilisation; patients, family members, and Healthcare professionals should be educated on use and adverse consequences of physical restraints in order to make raise awareness of potential risks and to take appropriate steps to prevent unnecessary harm; after physical restraint removal, Healthcare professionals should discuss with patients and family members about their experience, feelings, and any anxieties regarding the treatment. Physical restraint should always be considered a last resort as deprive patient’s freedom, control, and individuality. Healthcare professionals should emphasise on providing individualized care, interdisciplinary decision-making process, and creative and collaborative alternatives to promote older patient’s rights, dignity and overall well-being as much as possible.

Keywords: ethics healthcare, geriatric care, healthcare, physical restraint

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452 Treatment of Wastewater by Constructed Wetland Eco-Technology: Plant Species Alters the Performance and the Enrichment of Bacteria Ries Alters the Performance and the Enrichment of Bacteria

Authors: Kraiem Khadija, Hamadi Kallali, Naceur Jedidi

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Constructed wetland systems are eco-technology recognized as environmentally friendly and emerging innovative solutions remediation as these systems are cost-effective and sustainable wastewater treatment systems. The performance of these biological system is affected by various factors such as plant, substrate, wastewater type, hydraulic loading rate, hydraulic retention time, water depth, and operation mood. The objective of this study was to to assess the alters of plant species on pollutants reduction and enrichment of anammox and nitrifing denitrifing bacteria in a modified vertical flow (VFCW) constructed wetland. This tests were carried out using three modified vertical constructed wetlands with a surface of 0.23 m² and depth 80 cm. It was a saturated vertical constructed wetland at the bottom. The saturation zone is maintained by the siphon structure at the outlet. The VFCW (₁) system was unplanted, VFCW (₂) planted with Typha angustofolia, and VFCW(₃) planted with Phragmites australis. The experimental units were fed with domestic wastewater and were operated by batch mode during 8 months at an average hydraulic loading rate around 20 cm day− 1. The operation cycle was two days feeding and five days rest. Results indicated that plants presence improved the removal efficiency; the removal rates of organic matter (85.1–90.9%; COD and 81.8–88.9%; BOD5), nitrogen (54.2–73%; NTK and 66–77%; NH4 -N) were higher by 10.7–30.1% compared to the unplanted vertical constructed wetland. On the other hand, the plant species had no significant effect on removal efficiency of COD, The removal of COD was similar in VFCW (₂) and VFCW (₃) (p > 0.05), attaining average removal efficiencies of 88.7% and 85.2%, respectively. Whereas it had a significant effect on NTK removal (p > 0.05), with an average removal rate of 72% versus 51% for VFCW (₂) and VFCW (₃), respectively. Among the three sets of vertical flow constructed wetlands, the VFCW(₂) removed the highest percent of total streptococcus, fecal streptococcus total coliforms, fecal coliforms, E. coli as 59, 62, 52, 63, and 58%, respectively. The presence and the plant species alters the community composition and abundance of the bacteria. The abundance of bacteria in the planted wetland was much higher than that in the unplanted one. VFCW(₃) had the highest relative abundance of nitrifying bacteria such as Nitrosospira (18%), Nitrosospira (12%), and Nitrobacter (8%). Whereas the vertical constructed wetland planted with typha had larger number of denitrifying species, with relative abundances of Aeromonas (13%), Paracoccus (11%), Thauera (7%), and Thiobacillus (6%). However, the abundance of nitrifying bacteria was very lower in this system than VFCW(₂). Interestingly, the presence of Thypha angustofolia species favored the enrichment of anammox bacteria compared to unplanted system and system planted with phragmites australis. The results showed that the middle layer had the most accumulation of anammox bacteria, which the anaerobic condition is better and the root system is moderate. Vegetation has several characteristics that make it an essential component of wetlands, but its exact effects are complex and debated.

Keywords: wastawater, constructed wetland, anammox, removal

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451 The Efficiency Analysis in the Health Sector: Marmara Region

Authors: Hale Kirer Silva Lecuna, Beyza Aydin

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Health is one of the main components of human capital and sustainable development, and it is very important for economic growth. Health economics, which is an indisputable part of the science of economics, has five stages in general. These are health and development, financing of health services, economic regulation in the health, allocation of resources and efficiency of health services. A well-developed and efficient health sector plays a major role by increasing the level of development of countries. The most crucial pillars of the health sector are the hospitals that are divided into public and private. The main purpose of the hospitals is to provide more efficient services. Therefore the aim is to meet patients’ satisfaction by increasing the service quality. Health-related studies in Turkey date back to the Ottoman and Seljuk Empires. In the near past, Turkey applied 'Health Sector Transformation Programs' under different titles between 2003 and 2010. Our aim in this paper is to measure how effective these transformation programs are for the health sector, to see how much they can increase the efficiency of hospitals over the years, to see the return of investments, to make comments and suggestions on the results, and to provide a new reference for the literature. Within this framework, the public and private hospitals in Balıkesir, Bilecik, Bursa, Çanakkale, Edirne, Istanbul, Kirklareli, Kocaeli, Sakarya, Tekirdağ, Yalova will be examined by using Data Envelopment Analysis (DEA) for the years between 2000 and 2019. DEA is a linear programming-based technique, which gives relatively good results in multivariate studies. DEA basically estimates an efficiency frontier and make a comparison. Constant returns to scale and variable returns to scale are two most commonly used DEA methods. Both models are divided into two as input and output-oriented. To analyze the data, the number of personnel, number of specialist physicians, number of practitioners, number of beds, number of examinations will be used as input variables; and the number of surgeries, in-patient ratio, and crude mortality rate as output variables. 11 hospitals belonging to the Marmara region were included in the study. It is seen that these hospitals worked effectively only in 7 provinces (Balıkesir, Bilecik, Bursa, Edirne, İstanbul, Kırklareli, Yalova) for the year 2001 when no transformation program was implemented. After the transformation program was implemented, for example, in 2014 and 2016, 10 hospitals (Balıkesir, Bilecik, Bursa, Çanakkale, Edirne, İstanbul, Kocaeli, Kırklareli, Tekirdağ, Yalova) were found to be effective. In 2015, ineffective results were observed for Sakarya, Tekirdağ and Yalova. However, since these values are closer to 1 after the transformation program, we can say that the transformation program has positive effects. For Sakarya alone, no effective results have been achieved in any year. When we look at the results in general, it shows that the transformation program has a positive effect on the effectiveness of hospitals.

Keywords: data envelopment analysis, efficiency, health sector, Marmara region

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