Search results for: cause specific probabilities of death

Authors: Mohsen Shati, Seyede Salehe Mortazavi, Seyed Kazem Malakouti, Hamidreza Khanke Fazlollah Ahmadi

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Taking unnecessary or excessive medication or using drugs with no indication (polypharmacy) by people of all ages, especially the elderly, is associated with increased adverse drug reactions (ADR), medical errors, hospitalization and escalating the costs. It may be facilitated or impeded by the healthcare system. In this study, we are going to describe the role of the health system in the practice of polypharmacy in Iranian elderly. In this Inductive qualitative content analysis using Graneheim and Lundman methods, purposeful sample selection until saturation has been made. Participants have been selected from doctors, pharmacists, policy-makers and the elderly. A total of 25 persons (9 men and 16 women) have participated in this study. Data analysis after incorporating codes with similar characteristics revealed 14 subcategories and six main categories of the referral system, physicians’ accessibility, health data management, drug market, laws enforcement, and social protection. Some of the conditions of the healthcare system have given rise to polypharmacy in the elderly. In the absence of a comprehensive specialty and subspecialty referral system, patients may go to any physician office so may well be confused about numerous doctors' prescriptions. Electronic records not being prepared for the patients, failure to comply with laws, lack of robust enforcement for the existing laws and close surveillance are among the contributing factors. Inadequate insurance and supportive services are also evident. Age-specific care providing has not yet been institutionalized, while, inadequate specialist workforce playing a major role. So, one may not ignore the health system as contributing factor in designing effective interventions to fix the problem.

Keywords: elderly, polypharmacy, health system, qualitative study

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Authors: Md. Zahirul Islam, Chad A. Ulven

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Fiber-reinforced polymer matrix composites have a wide range of applications in the sectors of automotive, aerospace, sports utilities, among others, due to their high specific strength, stiffness as well as reduced weight. In addition to those favorable properties, composites composed of natural fibers and bio-based resins (i.e., biocomposites) have eco-friendliness and biodegradability. However, the applications of biocomposites are limited due to the lack of knowledge about their long-term reliability under fluctuating loads. In order to explore the long-term reliability of flax fiber reinforced composites under fluctuating loads through high cycle fatigue strength (HCFS), fatigue test were conducted on unidirectional flax fiber reinforced thermoset composites at different percentage loads of ultimate tensile strength (UTS) with a loading frequency of 5 Hz. Change of temperature of the sample during cyclic loading was captured using an IR camera. Initially, the temperature increased rapidly, but after a certain time, it stabilized. A mathematical model was developed to predict the fatigue life from the data of stabilized temperature. Stabilized temperature and dissipated energy per cycle were compared with applied stress. Both showed bilinear behavior and the intersection of those curves were used to determine HCFS. HCFS for unidirectional flax fiber reinforced composites is around 45% of UTS for a loading frequency of 5Hz. Unlike fatigue life, stabilized temperature and dissipated energy-based models are convenient to define HCFS as they have little variation from sample to sample.

Keywords: energy method, fatigue, flax fiber reinforced composite, HCFS, thermographic approach

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Authors: Zain Ul Hassan, Muhammad Zain Ul Abadin, Muhammad Zubair Khan

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Unmanned aerial vehicles (UAVs) have now become of predominant importance for various operations, and an immense amount of work is going on in this specific category. The structural stability and life of these UAVs is key factor that should be considered while deploying them to different intelligent operations as their failure leads to loss of sensitive real-time data and cost. This paper presents an applied research on the development of a structural health monitoring system for a UAV designed and fabricated by deploying modular approach. Firstly, a modular UAV has been designed which allows to dismantle and to reassemble the components of the UAV without effecting the whole assembly of UAV. This novel approach makes the vehicle very sustainable and decreases its maintenance cost to a significant value by making possible to replace only the part leading to failure. Then the SHM for the designed architecture of the UAV had been specified as a combination of wings integrated with strain gauges, on-board data logger, bridge circuitry and the ground station. For the research purpose sensors have only been attached to the wings being the most load bearing part and as per analysis was done on ANSYS. On the basis of analysis of the load time spectrum obtained by the data logger during flight, fatigue life of the respective component has been predicted using fracture mechanics techniques of Rain Flow Method and Miner’s Rule. Thus allowing us to monitor the health of a specified component time to time aiding to avoid any failure.

Keywords: fracture mechanics, rain flow method, structural health monitoring system, unmanned aerial vehicle

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Authors: Ahmed F. Azmy, Amal E. Saafan, Tamer M. Essam, Magdy A. Amin, Shaban H. Ahmed

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Bacterial strains capable of degradation of malathion from the domestic sewage were isolated by an enrichment culture technique. Three bacterial strains were screened and identified as Acinetobacter baumannii (AFA), Pseudomonas aeruginosae (PS1),andPseudomonas mendocina (PS2) based on morphological, biochemical identification and 16S rRNA sequence analysis. Acinetobacter baumannii AFA was the most efficient malathion degrading bacterium, so used for further biodegradation study. AFA was able to grow in mineral salt medium (MSM) supplemented with malathion (100 mg/l) as a sole carbon source, and within 14 days, 84% of the initial dose was degraded by the isolate measured by high performance liquid chromatography. Strain AFA could also degrade other organophosphorus compounds including diazenon, chlorpyrifos and fenitrothion. The effect of different culture conditions on the degradation of malathion like inoculum density, other carbon or nitrogen sources, temperature and shaking were examined. Degradation of malathion and bacterial cell growth were accelerated when culture media were supplemented with yeast extract, glucose and citrate. The optimum conditions for malathion degradation by strain AFA were; an inoculum density of 1.5x 1012CFU/ml at 30°C with shaking. A specific polymerase chain reaction primers were designed manually using multiple sequence alignment of the corresponding carboxylesterase enzymes of Acinetobacter species. Sequencing result of amplified PCR product and phylogenetic analysis showed low degree of homology with the other carboxylesterase enzymes of Acinetobacter strains, so we suggested that this enzyme is a novel esterase enzyme. Isolated bacterial strains may have potential role for use in bioremediation of malathion contaminated.

Keywords: Acinetobacter baumannii, biodegradation, malathion, organophosphate pesticides

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Authors: A. O Amosu, A. M Hammed, G. W. Maneveldt, D. V. Robertson-Andersson

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In aquaculture, feed utilization is an important factor affecting growth of the target species, and thus the success of the aquaculture operation. Growth of C. gariepinus fingerlings (weight 1.60 ± 0.05 g; length 4.50 ± 0.07cm) was monitored in a closed door hatchery for a period of 21 days in an experiment consisting of 4 treatments stocked at 20 fish/10 litre tanks, fed in triplicate twice daily (08:30, 17:30) at 4% body weight with weight changes recorded every 3 days. Treatments were: 1) FeedX; 2) 35% crude protein diet + non enriched Ulva spp (11.18% crude protein) (CD + NEU); 3) 35% crude protein diet + enriched Ulva spp (11.98% crude protein)(CD +EU) and 4) control diet of 35% crude protein (CD). The production of Ulva spp. biomass was cultivated for a period of 3 months. The result shows that the fish fed macroalgal enriched diet had good growth, though no significant difference (p > 0.05) was recorded amongst the weight gain, %weight gain, specific growth rates and nitrogen metabolism of diets CD + NEU, CD + EU and CD. Significant differences (p < 0.05), were, however, found in the food conversion ratio (FCR) and gross food conversion ratio (gFCR) among the fingerlings across all the different experimental diets. The best FCRs were recorded for control diet (0.79 ± 2.39) and the Ulva enriched (1.75 ± 1.34) diets. The results suggest that the fingerlings were able to utilize Ulva supplemented with control diet better than the FeedX. We have shown that Ulva supplemented diets are good substitutes for formulated and commercial feeds, with potential to be successful fish feed in aquaculture systems.

Keywords: aquaculture, clarias gariepinus, growth, macroalgae, nutrient, ulva

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Authors: Savvas Varitis, Panagiotis Kavouras, George Vourlias, Eleni Pavlidou, Theodoros Karakostas, Philomela Komninou

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A chromium-loaded ash originating from incineration of tannery sludge under anoxic conditions was mixed with low grade soda-lime glass powder coming from commercial glass bottles. The relative weight proportions of ash over glass powder tested were 30/70, 40/60 and 50/50. The solid mixtures, formed in green state compacts, were sintered at the temperature range of 800oC up to 1200oC. The resulting products were characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM), energy dispersive X-ray spectrometry (EDXS) and micro-indentation. The above methods were employed to characterize the various phases, microstructure and hardness of the produced materials. Thermal treatment at 800oC and 1000oC produced opaque ceramic products composed of a variety of chromium-containing and chromium-free crystalline phases. Thermal treatment at 1200oC gave rise to composite products, where only chromium-containing crystalline phases were detected. Hardness results suggest that specific products are serious candidates for structural applications. Acknowledgement: This research has been co-financed by the European Union (European Social Fund – ESF) and Greek national funds through the Operational Program “Education and Lifelong Learning” of the National Strategic Reference Framework (NSRF) – Research Funding Program: THALES “WasteVal”: Reinforcement of the interdisciplinary and/or inter-institutional research and innovation.

Keywords: chromium-rich tannery residues, glass-ceramic materials, mechanical properties, microstructure

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Authors: Elizabeth Farquhar, Erich Ritter

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Studying shark's interaction with humans and their behavioral responses will have enormous implications for other fields of marine biology and oceanography. The health of sharks has direct impacts on the stability of human society with a reported 3.5 billion people depending on the ocean for food and/or livelihood. Discovering how sharks behave and interact with people, will have enormous implications for future studies, along with the development of more effective ways to reduce negative shark/human interactions. This specific study investigates the effects of contrasting ponchos worn by divers on the approach distances of Carcharhinus perezi. Data was collected over a two week period at a test site off the shore of Eleuthera Island in the Bahamas, with a depth of approximately 55 feet during mid-August. Sixty-minute dive trials were conducted and videoed from above with 5-meter radius markers on the ocean floor surrounding the two divers, kneeling back-to-back. Five poncho colors were worn by the two divers (black, navy blue, dark green, yellow and orange), rotating the color permutations randomly to test the distance a shark will approach each color. Results indicate significantly closer approach patterns when divers were wearing orange ponchos, and the combination of orange with black and blue ponchos were found to be statistically significant. These results are relevant to understanding how sharks perceive contrast and dive equipment in the marine environment, which could have the potential to prevent negative shark/human interactions.

Keywords: shark behavior, animal behavior, marine biology, conservation

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Authors: Alvaro Ramírez, Martín Muñoz-Morales, Ester López- Fernández, Javier Llanos, C. Ania

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Carbon blacks are value-added materials typically produced through the incomplete combustion or thermal decomposition of hydrocarbons. Traditionally, they have been used as catalysts in many different applications, but in the last decade, their potential in green chemistry has gained significant attention. Among them, the electrochemical production of H₂O₂ has attracted interest because of their properties as high oxidant capacity or their industrial interest as a bleaching agent. Carbon blacks are commonly used in this application in a catalytic ink that is drop-casted on supporting electrodes and acts as catalysts for the electrochemical production of H₂O₂ through oxygen reduction reaction (ORR). However, the different structural and electrochemical behaviors of each type of carbon black influence their applications. In this line, the term ‘carbon black’, has to be considered as a generic name that does not guarantee any physicochemical properties if any further description is mentioned. In fact, different specific surface area (SSA), surface functional groups, porous structure, and electro catalysts effect seem very important for electrochemical applications, and considerable differences were found during the analysis of four types of carbon blacks. Thus, the aim of this work is to evaluate the influence of SSA, porous structure, oxygen functional groups, and structural defects to differentiate among these carbon blacks (e.g. Vulcan XC72, Superior Graphite Co, Printex XE2, and Prolabo) for H₂O₂ production via ORR, using carbon paper as electrode support with improved selectivity and efficiency. Results indicate that the number and size of pores, along with surface functional groups, are key parameters that significantly affect the overall process efficiency.

Keywords: carbon blacks, oxygen reduction reaction, hydrogen peroxide, porosity, surface functional groups

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Authors: L. Correia-Sá, S. Norberto, Conceição Calhau, C. Delerue-Matos, V. F. Domingues

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Endocrine disruptor chemicals (EDCs) are synthetic compounds that even though being initially designed for a specific function are now being linked with a wide range of side effects. The list of possible EDCs is growing and includes phthalates and bisphenol A (BPA). Phthalates are one of the most widely used plasticizers to improve the extensibility, elasticity and workability of polyvinyl chloride (PVC), polyvinyl acetates, etc. Considered non-toxic and harmless additives for polymers, they were used unrestrainedly all over the world for several decades. However, recent studies have indicated that some phthalates and their metabolic products are reproductive and developmental toxicants in animals and suspected endocrine disruptors in humans. BPA (2,2-bis(4-hydroxyphenyl)propane) is a high production volume chemical mainly used in the production of polycarbonate plastics and epoxy resins. Although BPA was initially considered to be a weak environmental estrogen, nowadays it is known that this compound can stimulate several cellular responses at very low levels of concentrations. The aim of this study was to develop a method based on tandem SPE to evaluate the presence of phthalates, metabolites and BPA in human urine samples. The analyzed compounds included: dibutyl phthalate (DBP) and di-2-ethylhexyl phthalate (DEHP), BPA, mono-isobutyl phthalate (MiBP), monobutyl phthalate (MBP) and. mono-(2-ethyl-5-oxohexyl) (MEOHP). Two SPE cartridges were applied both from Phenomenex, the strata X polymeric reversed phase and the strata X A (Strong anion). Chromatographic analyses were carried out in a Thermo GC ULTRA GC-MS/MS. Good recoveries and linear calibration curves were obtained. After validation, the methodology was applied to human urine samples for phthalates, metabolites and BPA evaluation.

Keywords: Bisphenol A (BPA), gas chromatography, metabolites, phtalates, SPE, tandem mode

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Authors: Carlos Gonzales, Zaida Quiroz, Marcos Prates

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Several spatial variables collected at the same location that share a common spatial distribution can be modeled simultaneously through a multivariate geostatistical model that takes into account the correlation between these variables and the spatial autocorrelation. The main goal of this model is to perform spatial prediction of these variables in the region of study. Here we focus on a geostatistical multivariate formulation that relies on sharing common spatial random effect terms. In particular, the first response variable can be modeled by a mean that incorporates a shared random spatial effect, while the other response variables depend on this shared spatial term, in addition to specific random spatial effects. Each spatial random effect is defined through a Gaussian process with a valid covariance function, but in order to improve the computational efficiency when the data are large, each Gaussian process is approximated to a Gaussian random Markov field (GRMF), specifically to the block nearest neighbor Gaussian process (Block-NNGP). This approach involves dividing the spatial domain into several dependent blocks under certain constraints, where the cross blocks allow capturing the spatial dependence on a large scale, while each individual block captures the spatial dependence on a smaller scale. The multivariate geostatistical model belongs to the class of Latent Gaussian Models; thus, to achieve fast Bayesian inference, it is used the integrated nested Laplace approximation (INLA) method. The good performance of the proposed model is shown through simulations and applications for massive data.

Keywords: Block-NNGP, geostatistics, gaussian process, GRMF, INLA, multivariate models.

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Authors: Shivam Patel, Abdullah Y. Usmani

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Physiological flow under rest and exercise conditions in patient-specific cerebral aneurysm models is numerically investigated. A finite-volume based code with BiCGStab as the linear equation solver is used to simulate unsteady three-dimensional flow field through the incompressible Navier-Stokes equations. Flow characteristics are first established in a healthy cerebral artery for both physiological conditions. The effect of saccular aneurysm on cerebral hemodynamics is then explored through a comparative analysis of the velocity distribution, nature of flow patterns, wall pressure and wall shear stress (WSS) against the reference configuration. The efficacy of coil embolization as a potential strategy of surgical intervention is also examined by modelling coil as a homogeneous and isotropic porous medium where the extended Darcy’s law, including Forchheimer and Brinkman terms, is applicable. The Carreau-Yasuda non-Newtonian blood model is incorporated to capture the shear thinning behavior of blood. Rest and exercise conditions correspond to normotensive and hypertensive blood pressures respectively. The results indicate that the fluid impingement on the outer wall of the arterial bend leads to abnormality in the distribution of wall pressure and WSS, which is expected to be the primary cause of the localized aneurysm. Exercise correlates with elevated flow velocity, vortex strength, wall pressure and WSS inside the aneurysm sac. With the insertion of coils in the aneurysm cavity, the flow bypasses the dilatation, leading to a decline in flow velocities and WSS. Particle residence time is observed to be lower under exercise conditions, a factor favorable for arresting plaque deposition and combating atherosclerosis.

Keywords: 3D FVM, Cerebral aneurysm, hypertension, coil embolization, non-Newtonian fluid

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Authors: Mehieddine Bouatrous

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Recently bioactive ceramic materials have been applied in the biomedical field as bulk, granular, or coating materials for more than half a century. More recently, bone tissue engineering scaffolds made of highly porous bioactive ceramic, glass-ceramic, and composite materials have also been created. As a result, recent bioactive ceramic structures have a high bioactivity rate, an open pores network, and good mechanical characteristics simulating cortical bone. Cyclowollastonite frameworks are also suggested for use as a graft material. As a porogenous agent, various amounts of the polymethyl methacrylate (PMMA) powders were used in this study successfully to synthesize a highly interrelated, nanostructured porous cyclowollastonite with a large specific surface area where the morphology and porosity were investigated. Porous cyclowollastonite bioactive ceramics were synthesized with a cost-effective and eco-friendly wet chemical method. The synthesized biomaterial is bioactive according to in vitro tests and can be used for bone tissue engineering scaffolds where cyclowollastonite sintered dense discs were submerged in simulated body fluid (S.B.F.) for various periods of time (1-4 weeks), resulting in the formation of a dense and consistent layer of hydroxyapatite on the surface of the ceramics, indicating its good in vitro bioactivity. Therefore, the cyclowollastonite framework exhibits good in vitro bioactivity due to its highly interconnecting porous structure and open macropores. The results demonstrate that even after soaking for several days, the surface of cyclowollastonite ceramic can generate a dense and consistent layer of hydroxyapatite. The results showed that cyclowollastonite framework exhibits good in vitro bioactivity due to highly interconnecting porous structure and open macropores.

Keywords: porous, bioactive, biomaterials, S.B.F, cyclowollastonite, biodegradability

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Authors: Patrick Strefford, Michael Davies, Masahiko Iguchi

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The Sustainable Development Goals (SDGs) were adopted in 2015 to end poverty, protect the planet, and ensure prosperity for all. Sustainable tourism is firmly positioned in these Goals, since tourism has significant potential to contribute to inclusive and sustainable economic growth, as well as to promote sustainable use of natural capital. Recognizing this, the new quasi-democratic government of Myanmar has embraced Sustainable Tourism as a core component of its economic reforms and opening up of the country. However, it is also highly likely that the Democrats within the government also support Sustainable Tourism as a potential contributor to the democratization of the country. This paper outlines how the government of Myanmar has understood the concept of Sustainable Tourism, and how it intends to implement and facilitate Sustainable Tourism. This paper, therefore, focuses primarily on the institutional frameworks that have been put in place, a specific one being the Inlay Lake Destination Management Plan, which is one of the four priority destinations identified by the government. The plan aims to improve local infrastructure, manage the local environment and develop local human resources. Importantly, the Plan also includes the establishment of a Destination Management Organization (DMO) to implement and manage Inlay Lake as a Sustainable Tourism destination. This research aims to investigate, for example, the equality in both input to the DMO and benefits accrued to the various stakeholders. How such equality can be ensured and how this can be reliably quantified will be crucial to ultimately evaluating the success of any such plans to implement Sustainable Tourism in Myanmar in the coming years. However, this research paper concludes that while the establishment of the DMO is a positive development, there are considerable institutional, economic and cultural factors that severely limit the ability of the DMO to function as an agent of sustainable tourism implementation.

Keywords: sustainable tourism, myanmar, country in transition, destination management organizations

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Authors: Muhammad Siddique, Volodymyr Lugovskyy

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This paper explores how nations might mitigate the unfavorable impacts of oil price volatility on economic growth by switching to renewable energy sources. The impacts of uncertain factor prices on economic activity are examined by looking at the Realized Volatility (RV) of oil prices rather than the more traditional method of looking at oil price shocks. The United States of America (USA), China (C), India (I), United Kingdom (UK), Germany (G), Malaysia (M), and Pakistan (P) are all included to round out the traditional literature's examination of selected nations, which focuses on oil-importing and exporting economies. Granger Causality Tests (GCT), Impulse Response Functions (IRF), and Variance Decompositions (VD) demonstrate that in a Vector Auto-Regressive (VAR) scenario, the negative impacts of oil price volatility extend beyond what can be explained by oil price shocks alone for all of the nations in the sample. Different nations have different levels of vulnerability to changes in oil prices and other factors that may play a role in a sectoral composition and the energy mix. The conventional method, which only takes into account whether a country is a net oil importer or exporter, is inadequate. The potential economic advantages of initiatives to decouple the macroeconomy from volatile commodities markets are shown through simulations of volatility shocks in alternative energy mixes (with greater proportions of renewables). It is determined that in developing countries like Pakistan, increasing the use of renewable energy sources might lessen an economy's sensitivity to changes in oil prices; nonetheless, a country-specific study is required to identify particular policy actions. In sum, the research provides an innovative justification for mitigating economic growth's dependence on stable oil prices in our sample countries.

Keywords: oil price volatility, renewable energy, economic growth, developed and developing economies

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Authors: Gwendy Darras, Mattias Desmet

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Previous research showed that psychological distress has a negative impact on the disease course of viral infections. For COVID-19, the same association was observed in small samples of specific segments of the population (e.g. health care workers). The present study presents a more refined analysis of this association, measuring a broader spectrum of psychological distress in a large sample (n=3084) of the general Flemish population. Several types of psychological distress (state, trait and health anxiety, depression, intra-, and interpersonal stress) are registered throughout three periods: one year before the contamination, one week before the contamination, and during the contamination. In doing so, validated scales such as DASS-21, IIP-32, and FCV-19S are used. Furthermore, the course of COVID-19 is registered in several ways: number of symptoms, number of days sick leave due to COVID-19, and number of days the symptoms have lasted. Also, different control variables such as vaccination status, medical and psychological history are taken into account. Statistical analysis shows that all types of psychological distress are positively correlated with the severity of the COVID-19 disease course. Anxiety during the contamination shows the strongest correlation, but psychological distress one year before the onset of COVID-19 was still significantly associated with the worsening of the disease course. As the assessment of the latter type of distress happened before the onset of the COVID-19 disease course, retrospective bias resulting in artificial associations between self-reported stress and COVID-19 severity is unlikely to have impacted the observations. In view of possible future pandemics, it is important to focus on general stress and anxiety reduction in the general population as soon as possible. It is also advisable to minimize the use of stress-inducing messages to encourage the population to adhere to the measures issued during a pandemic.

Keywords: anxiety, COVID-19, depression, psychoneuroimmunology, psychological distress, stress

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Authors: Mai. M. Toughan, Ahmed A. A. Sallam, Ashraf O. Abd El-Latif

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Termites are eusocial insects that are found on all continents except Antarctica. Termites have serious destructive impact, damaging local huts and crops of poor subsistence. The annual cost of termite damage and its control is determined in the billions globally. In Egypt, most of these damages are due to the subterranean termite species especially the sand termite, P. hypostoma. Pyrethroids became the primary weapon for subterranean termite control, after the use of chlorpyrifos as a soil termiticide was banned. Despite the important role of pyrethroids in termite control, its extensive use in pest control led to the eventual rise of insecticide resistance which may make many of the pyrethroids ineffective. The ability to diagnose the precise mechanism of pyrethroid resistance in any insect species would be the key component of its management at specified location for a specific population. In the present study, detailed toxicological and biochemical studies was conducted on the mechanism of pyrethroid resistance in P. hypostoma. The susceptibility of field populations of P. hypostoma against deltamethrin, α-cypermethrin and ƛ-cyhalothrin was evaluated. The obtained results revealed that the workers of P. hypostoma have developed high resistance level against the tested pyrethroids. Studies carried out through estimation of detoxification enzyme activity indicated that enhanced esterase and cytochrome P450 activities were probably important mechanisms for pyrethroid resistance in field populations. Elevated esterase activity and also additional esterase isozyme were observed in the pyrethroid-resistant populations compared to the susceptible populations. Strong positive correlation between cytochrome P450 activity and pyrethroid resistance was also reported. |Deltamethrin could be recommended as a resistance-breaking pyrethroid that is active against resistant populations of P. hypostoma.

Keywords: Psammotermes hypostoma, pyrethroid resistance, esterase, cytochrome P450

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Authors: Eun Hui Bae, Sang Yeob Lim, Bongseong Kim, Tae Ryom Oh, Su Hyun Song, Sang Heon Suh, Hong Sang Choi, Eun Mi Yang, Chang Seong Kim, Seong Kwon Ma, Kyung-Do Han, Soo Wan Kim

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Background: Recent hypertension guidelines have recommended lower blood pressure (BP) targets in high-risk patients. However, there are no specific guidelines based on age or systolic and diastolic blood pressure (SBP and DBP, respectively). We aimed to assess the effects of age-related BP on the development of end-stage renal disease (ESRD) in patients with diabetes. Methods: A total of 2,563,870 patients with DM aged >20 years were selected from the Korean National Health Screening Program from 2009 to 2012 and followed up until the end of 2019. Participants were categorized into age and BP groups, and the hazard ratios (HRs) for ESRD were calculated. Results: During a median follow-up of 7.15 years, the incidence rates of ESRD increased with increasing SBP and DBP. The HR for ESRD was the highest in patients younger than 40 years of age with DBP ≥ 100 mmHg. The effect of SBP and DBP on ESRD development was attenuated with age (interaction p-value was <0.0001 for age and SBP and 0.0022 for age and DBP). The subgroup analysis for sex, anti-hypertension medication, and history of chronic kidney disease (CKD) showed higher HRs for ESRD among males younger than 40 years, not taking anti-hypertension medications and CKD compared to those among females older than 40 years, anti-hypertension medication and non-CKD groups. Conclusions: Higher SBP and DBP increase the risk of developing ESRD in patients with diabetes, and in particular, younger individuals face greater risk. Therefore, intensive BP management is warranted in younger patients to prevent ESRD.

Keywords: hypertension, young adult, end-stage renal disease, diabetes mellitus, chronic kidney disease, blood pressure

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Authors: Maryam Hamlehdar, Guillermo A. Narsilio

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To enhance the feasibility of utilising geothermal hot sedimentary aquifers (HSAs) for clean hydrogen production, one approach is the implementation of solar-integrated geothermal energy systems. This detailed modelling study conducts a thermo-economic assessment of an advanced Organic Rankine Cycle (ORC)-based hydrogen production system that uses low-temperature geothermal reservoirs, with a specific focus on hot sedimentary aquifers (HSAs) over a 30-year period. In the proposed hybrid system, solar-thermal energy is used to raise the water temperature extracted from the geothermal production well. This temperature increase leads to a higher steam output, powering the turbine and subsequently enhancing the electricity output for running the electrolyser. Thermodynamic modeling of a parabolic trough solar (PTS) collector is developed and integrated with modeling for a geothermal-based configuration. This configuration includes a closed regenerator cycle (CRC), proton exchange membrane (PEM) electrolyser, and thermoelectric generator (TEG). Following this, the study investigates the impact of solar energy use on the temperature enhancement of the geothermal reservoir. It assesses the resulting consequences on the lifecycle performance of the hydrogen production system in comparison with a standalone geothermal system. The results indicate that, with the appropriate solar collector area, a combined solar-geothermal hydrogen production system outperforms a standalone geothermal system in both cost and rate of production. These findings underscore a solar-assisted geothermal hybrid system holds the potential to generate lower-cost hydrogen with enhanced efficiency, thereby boosting the appeal of numerous low to medium-temperature geothermal sources for hydrogen production.

Keywords: clean hydrogen production, integrated solar-geothermal, low-temperature geothermal energy, numerical modelling

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Authors: Raviteja Chintala

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Water shortage in many areas of the world have predominantly increased the demand for efficient methods involved in the production of drinking water, So purification of water invoking cost effective and efficient methods is a challenging field of research. In this regard, Reverse osmosis membrane desalination of both seawater and inland brackish water is currently being deployed in various locations around the world. In the present work an attempt is made to integrate these existing technologies with novel method, Wherein carbon nanotubes at the lab scale are prepared which further replace activated carbon tubes being used traditionally. This has proven to enhance the efficiency of the water filter, Effectively neutralising most of the organic impurities. Furthermore, This ensures the reduction in TDS. Carbon nanotubes have wide range in scope of applications such as composite reinforcements, Field emitters, Sensors, Energy storage and energy conversion devices and catalysts support phases, Because of their unusual mechanical, Electrical, Thermal and structural properties. In particular, The large specific surface area, as well as the high chemical and thermal stability, Makes carbon nanotube an attractive adsorbent in waste water treatment. Carbon nanotubes are effective in eliminating these harmful media from water as an adsorbent. In this work, Candle soot method has been incorporated for the preparation of carbon nanotubes and mixed with activated charcoal in different compositions. The effect of composition change is monitored by using TDS measuring meter. As the composition of Nano carbon increases, The TDS of the water gradually decreases. In order to enhance the life time for carbon filter, Nano tubes are provided with larger surface area.

Keywords: TDS (Total Dissolved Solids), carbon nanotubes, water, candle soot

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Authors: C. M. Williams, R. English, P. King, I. M. Brown

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Introduction: Pseudoangiomatous Stromal Hyperplasia (PASH) is a benign fibrous proliferation of breast stroma affecting predominantly premenopausal women with no significant increased risk of breast cancer. Informal recommendations for management have continued to evolve over recent years from surgical excision to observation, although there are no specific national guidelines. This study assesses the safety of a non-surgical approach to PASH management by review of cases at a single centre. Methods: Retrospective case series review (January 2011 – August 2016) was conducted on consecutive PASH cases. Diagnostic classification (clinical, radiological and histological), management outcomes, and breast cancer incidence were recorded. Results: 43 patients were followed up for median of 25 months (3-64) with 75% symptomatic at presentation. 12% of cases (n=5) had a radiological score (BIRADS MMG or US) ≥ 4 of which 3 were confirmed malignant. One further malignancy was detected and proven radiologically occult and contralateral. No patients were diagnosed with a malignancy during follow-up. Treatment evolved from 67% surgical in 2011 to 33% in 2016. Conclusions: The management of PASH has transitioned in line with other published experience. The preliminary findings suggest this appears safe with no evidence of missed malignancies; however, longer follow up is required to confirm long-term safety. Recommendations: PASH with suspicious radiological findings ( ≥ U4/R4) warrants multidisciplinary discussion for excision. In the absence of histological or radiological suspicion of malignancy, PASH can be safely managed without surgery.

Keywords: benign breast disease, conservative management, malignancy, pseudoangiomatous stromal hyperplasia, surgical excision

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Authors: Skander Ben Mami

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Despite its particular patterns and historical importance, the remote region of the Pamir Hindu Kush still lacks public recognition, as well as scientific substance, because of the abundance of classical state-centred geopolitical studies, the resilience of (inter)national narratives, and the political utility of the concepts of 'Central Asia' and 'South Asia'. However, this specific region of about 100 million inhabitants and located at the criss-cross of four geopolitical areas (Indian, Iranian, Chinese and Russian) over a territory of half a million square kilometres features a string of patterns that set it apart from the neighbouring areas of the Fergana, the Gansu and Punjab. Moreover, the Pamir Hindu Kush undergoes a series of parallel social and economic transformations that deserve scrutiny for their strong effect on the people’s lifestyle, particularly in three major urban centres (Aksu in China, Bukhara in Uzbekistan and Islamabad in Pakistan) and their immediate rural surroundings. While the involvement of various public and private stakeholders (States, NGOs, civil movements, private firms…) has undeniably resulted in positive elements (economic growth, connectivity, higher school attendance), it has in the same time generated a collection of negative effects (radicalizing, inequalities, pollution, territorial divide) that need to be addressed to strengthen regional and international security. This paper underscores the region’s strategical importance as the major hotbed and engine of insecurity and violence in Asia, notably in the context of Afghanistan’s enduring violence. It introduces the inner structures of the region, the different sources of violence as well as the governments’ responses to address it.

Keywords: geography, security, terrorism, urbanisation

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Authors: Singh Deepeshwar, Suhas Vinchurkar

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Similar to neuroimaging findings through functional magnetic resonance imaging (fMRI) assessing regional cerebral blood oxygenation, the functional near infrared spectroscopy (fNIRS) has also been used to assess hemodynamic responses in the imaged region of the brain. The present study assessed hemodynamic responses in terms of changes in oxygenation (HbO), deoxygenation (HbR) and total hemoglobin (THb) on the prefrontal cortex (PFC), bilaterally, using fNIRS in 10 participants who performed three voluntary regulated breathing (pranayama) practices viz. (i) Left nostril breathing (LNB), (ii) Right nostril breathing (RNB); and (iii) Alternating nostril breathing (ANB) and compared with normal breathing as baseline (BS). For this, we used 64 channel NIRS system covering left and the right prefrontal cortex. The normal breathing kept as baseline (BS) measures as regressors in the investigation of hemodynamic responses when compared with LNB, RNB and ANB. In the results, we found greater oxygenation in contralateral side i.e., higher activation on the left prefrontal cortex (lPFC) during RNB, and right prefrontal cortex (rPFC) during LNB, whereas ANB showed greater deoxygenation responses on both sides of PFC. Interestingly, LNB showed increased oxygenation on ipsilateral side i.e., lPFC but not during RNB. This suggests that voluntary regulated breathing produced an immediate effect not only on contralateral but ipsilateral sides of the brain as well. In conclusion, breathing practices are tightly coupled to cerebral rhythms of alternating cerebral hemispheric activity during particular nostril breathing. These results of the specific nostril breathing do not support previous findings of contralateral hemispheric improvement while left or right nostril breathing only.

Keywords: hemodynamic responses, brain, pranayama, voluntary regulated breathing practices, prefrontal cortex

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Authors: Kateryna Zharan, Jan C. Bongaerts

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Mining operations are energy intensive, and the share of energy costs in total costs is often quoted in the range of 40 %. Saving on energy costs is, therefore, a key element of any mine operator. With the improving reliability and security of renewable energy (RE) sources, and requirements to reduce carbon dioxide emissions, perspectives for using RE in mining operations emerge. These aspects are stimulating the mining companies to search for ways to substitute fossil energy with RE. Hereby, the main purpose of this study is to present the survey research assessment in matter of finding out the key issues related to the integration of RE into mining activities, based on the mining and renewable energy experts’ opinion. The purpose of the paper is to present the outcomes of a survey conducted among mining and renewable energy experts about the feasibility of RE in mining operations. The survey research has been developed taking into consideration the following categories: first of all, the mining and renewable energy experts were chosen based on the specific criteria. Secondly, they were offered a questionnaire to gather their knowledge and opinions on incentives for mining operators to turn to RE, barriers and challenges to be expected, environmental effects, appropriate business models and the overall impact of RE on mining operations. The outcomes of the survey allow for the identification of factors which favor and disfavor decision-making on the use of RE in mining operations. It concludes with a set of recommendations for further study. One of them relates to a deeper analysis of benefits for mining operators when using RE, and another one suggests that appropriate business models considering economic and environmental issues need to be studied and developed. The results of the paper will be used for developing a hybrid optimized model which might be adopted at mines according to their operation processes as well as economic and environmental perspectives.

Keywords: carbon dioxide emissions, mining industry, photovoltaic, renewable energy, survey research, wind generation

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Authors: Demiraw Bikila, Tadesse Lejisa, Yosef Tolcha, Chala Bashea, Mehari Meles Tigist Getahun Genet Ashebir, Wossene Habtu, Feyissa Challa, Ousman Mohammed, Melkitu Kassaw, Adisu Kebede, Letebrhan G. Egzeabher, Endalkachew Befekadu, Mistire Wolde, Aster Tsegaye

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Background: Even though several factors affect reference intervals (RIs), the company-derived values are currently in use in many laboratories worldwide. However, little or no data is available regarding serum protein RIs, mainly in resource-limited setting countries like Ethiopia. Objective: To establish a reference interval for serum protein electrophoresis of apparently healthy adults in Addis Ababa, Ethiopia. Method: A cross-sectional study was conducted on a total of 297 apparently healthy adults from April-October 2019 in four selected sub-cities (Akaki, Kirkos, Arada, Yeka) of Addis Ababa, Ethiopia. Laboratory analysis of collected samples was performed using Capillarys 2 Flex Piercing analyzer, while statistical analysis was done using SPSS version 23 and med-cal software. Mann-Whitney test was used to check Partitions. Non-parametric method of reference range establishment was performed as per CLSI guideline EP28A3C. Result: The established RIs were: Albumin 53.83-64.59%, 52.24-63.55%; Alpha-1 globulin 3.04-5.40%, 3.44-5.60%; Alpha-2 globulin 8.0-12.67%, 8.44-12.87%; and Beta-1 globulin 5.01-7.38%, 5.14-7.86%. Moreover, Albumin to globulin ratio was 1.16-1.8, 1.09-1.74 for males and females, respectively. The combined RIs for Beta-2 globulin and Gamma globulin were 2.54-4.90% and 12.40-21.66%, respectively. Conclusion: The established reference interval for serum protein fractions revealed gender-specific differences except for Beta-2 globulin and Gamma globulin.

Keywords: serum protein electrophoresis, reference interval, Addis Ababa, Ethiopia

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Authors: Daniela Rimnacova, Maryna Vorokhta, Martina Svabova

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CO₂ adsorption capacity of several materials - waste (power fly ash, slag, carbonized sewage sludge), rocks (Czech Silurian shale, black coal), and carbon (synthesized carbon, activated carbon as a reference material) - were measured on dry samples using a unique hand-made manometric sorption apparatus at a temperature of 45 °C and pressures of up to 7 MPa. The main aim was finding utilization of the waste materials and rocks for removal of the air or water pollutants caused by anthropogenic activities, as well as for the carbon dioxide storage. The equilibrium amount of the adsorbate depends on temperature, gas saturation pressure, porosity, surface area and volume of pores, and last but not least, on the composition of the adsorbents. Given experimental conditions can simulate in-situ situations in the rock bed and can be achieved just by a high-pressure apparatus. The CO₂ excess adsorption capacities ranged from 0.018 mmol/g (ash) to 13.55 mmol/g (synthesized carbon). The synthetized carbon had the highest adsorption capacity among all studied materials as well as the highest price. This material is usually used for the adsorption of specific pollutants. The excess adsorption capacity of activated carbon was 9.19 mmol/g. It is used for water and air cleaning. Ash can be used for chemisorption onto ash particle surfaces or capture of special pollutants. Shale is a potential material for enhanced gas recovery or CO₂ sequestration in-situ. Slag is a potential material for capture of gases with a possibility of the underground gas storage after the adsorption process. The carbonized sewage sludge is quite a good adsorbent for the removal and capture of pollutants, as well as shales or black coal which show an interesting relationship between the price and adsorption capacity.

Keywords: adsorption, CO₂, high pressure, porous materials

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Authors: Silvano Salvador, Maryam Zarrinderakht, Alan Martin

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Open pits, which are the result of mining, are filled by water over time until the water reaches the elevation of the local water table and generates mine pit lakes. There are several specific regulations about the water quality of pit lakes, and mining operations should keep the quality of groundwater above pre-defined standards. Therefore, an accurate, acceptable numerical model predicting pit lakes’ water balance and water quality is needed in advance of mine excavation. We carry on analyzing and developing the model introduced by Crusius, Dunbar, et al. (2002) for pit lakes. This model, called “PitMod”, simulates the physical and geochemical evolution of pit lakes over time scales ranging from a few months up to a century or more. Here, a lake is approximated as one-dimensional, horizontally averaged vertical layers. PitMod calculates the time-dependent vertical distribution of physical and geochemical pit lake properties, like temperature, salinity, conductivity, pH, trace metals, and dissolved oxygen, within each model layer. This model considers the effect of pit morphology, climate data, multiple surface and subsurface (groundwater) inflows/outflows, precipitation/evaporation, surface ice formation/melting, vertical mixing due to surface wind stress, convection, background turbulence and equilibrium geochemistry using PHREEQC and linking that to the geochemical reactions. PitMod, which is used and validated in over 50 mines projects since 2002, incorporates physical processes like those found in other lake models such as DYRESM (Imerito 2007). However, unlike DYRESM PitMod also includes geochemical processes, pit wall runoff, and other effects. In addition, PitMod is actively under development and can be customized as required for a particular site.

Keywords: pit lakes, mining, modeling, hydrology

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Authors: Annamária Käferné Rácz, Bence Jáger, Balázs Kövesdi, László Dunai

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Due to the numerous advantages of steel corrugated web girders, its application field is growing for bridges as well as for buildings. The global stability behavior of such girders is significantly larger than those of conventional I-girders with flat web, thus the application of the structural steel material can be significantly reduced. Design codes and specifications do not provide clear and complete rules or recommendations for the determination of the lateral torsional buckling (LTB) resistance of corrugated web girders. Therefore, the authors made a thorough investigation regarding the LTB resistance of the corrugated web girders. Finite element (FE) simulations have been performed to develop new design formulas for the determination of the LTB resistance of trapezoidally corrugated web girders. FE model is developed considering geometrical and material nonlinear analysis using equivalent geometric imperfections (GMNI analysis). The equivalent geometric imperfections involve the initial geometric imperfections and residual stresses coming from rolling, welding and flame cutting. Imperfection sensitivity analysis was performed to determine the necessary magnitudes regarding only the first eigenmodes shape imperfections. By the help of the validated FE model, an extended parametric study is carried out to investigate the LTB resistance for different trapezoidal corrugation profiles. First, the critical moment of a specific girder was calculated by FE model. The critical moments from the FE calculations are compared to the previous analytical calculation proposals. Then, nonlinear analysis was carried out to determine the ultimate resistance. Due to the numerical investigations, new proposals are developed for the determination of the LTB resistance of trapezoidally corrugated web girders through a modification factor on the design method related to the conventional flat web girders.

Keywords: corrugated web, lateral torsional buckling, critical moment, FE modeling

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Authors: Roy. H. A. Lindelauf

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Cyberattacks are complex processes consisting of multiple interwoven tasks conducted by a set of agents. Interdictions and defenses against such attacks often rely on cyber kill chain (CKC) models. A CKC is a framework that tries to capture the actions taken by a cyber attacker. There exists a growing body of literature on CKCs. Most of this work either a) describes the CKC with respect to one or more specific cyberattacks or b) discusses the tools and technologies used by the attacker at each stage of the CKC. Defenders, facing scarce resources, have to decide where to allocate their resources given the CKC and partial knowledge on the tools and techniques attackers use. In this presentation CKCs are analyzed through the lens of covert projects, i.e., interrelated tasks that have to be conducted by agents (human and/or computer) with the aim of going undetected. Various aspects of covert project models have been studied abundantly in the operations research and game theory domain, think of resource-limited interdiction actions that maximally delay completion times of a weapons project for instance. This presentation has investigated both cooperative and non-cooperative game theoretic covert project models and elucidated their relation to CKC modelling. To view a CKC as a covert project each step in the CKC is broken down into tasks and there are players of which each one is capable of executing a subset of the tasks. Additionally, task inter-dependencies are represented by a schedule. Using multi-glove cooperative games it is shown how a defender can optimize the allocation of his scarce resources (what, where and how to monitor) against an attacker scheduling a CKC. This study presents and compares several cooperative game theoretic solution concepts as metrics for assigning resources to the monitoring of agents.

Keywords: cyber defense, cyber kill chain, game theory, information warfare techniques

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Authors: Christine Maleesha Withanachchi, Eithne Heffernan, Derek Hoare

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Background: Social isolation (SI} is a major consequence of hearing loss (HL}. Isolation can lead to serious health problems (e.g., dementia and depression). Hearing Aids (HA) is the primary intervention for HL. However, these are less effective in social situations. Interventions are needed for SI in adults with hearing loss (AHL). Objectives: Investigated the relationship between HL and SI. Explored the views of AHL and hearing healthcare professionals (HHP) towards interventions for isolation. Methods: Individual and group semi-structured interviews were conducted. Interviews were conducted at the Nottingham Institute of Health Research (NIHR) Biomedical Research Centre (BRC). Six AHL and seven HHP were recruited via maximum variation sampling. The interview transcripts were analyzed using inductive thematic analysis. Results: Social impacts of HL: Most participants described that HL hurt them. This was in the form of social withdrawal, strain on relationships, and identity loss. Downstream effects of HL: Most audiologists acknowledged that isolation from HL could lead to depression. HL can also lead to exhaustion and unemployment. Impact of stigma: There are negative connotations around HL and HA (e.g. old age) and there is difficulty talking about isolation. The complexity of SI: There can be difficulty separating SI due to HL from SI due to other contributing factors (e.g. comorbidities). Potential intervention for isolation: Participants were unfamiliar with interventions for isolation and few, if any, were targeted for AHL specifically. Most participants thought an intervention should be patient-centered and run by an AHL in the community. Opinions differed regarding whether it should hear specific or generic. Implementation of intervention: Challenges to the implementation of an intervention for SI exist due to the sensitivity of the subject. Conclusions: This study demonstrated that SI is a major consequence of HL and uncovered novel findings related to its interventions. Uptake of interventions offered to AHL to reduce loneliness and social isolation is expected to be better if led by AHL in the community as opposed to HHP led interventions in the hospital or clinic settings.

Keywords: adults with hearing loss, hearing aids, interventions, social isolation

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Authors: Surabhi Agrawal Kohli, Sunita Gupta, Esha Khanuja, Parul Garg, P. Gupta

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Background: Adenomyosis is a common gynaecological condition that affects the menstruating women. Uterine enlargement, dysmenorrhoea, and menorrhagia are regarded as the cardinal clinical symptoms of adenomyosis. Classically it was thought, compared with ultrasonography, when adenomyosis is suspected, MRI enables more accurate diagnosis of the disease. Materials and Methods: 172 subjects were enrolled after an informed consent that had complaints of HMB, dyspareunia, dysmenorrhea, and chronic pelvic pain. Detailed history of the enrolled subjects was taken, followed by a clinical examination. These patients were then subjected to TVS where myometrial echo texture, presence of myometrial cysts, blurring of endomyometrial junction was noted. MRI was followed which noted the presence of junctional zone thickness and myometrial cysts. After hysterectomy, histopathological diagnosis was obtained. Results: 78 participants were analysed. The mean age was 44.2 years. 43.5% had parity of 4 or more. heavy menstrual bleeding (HMB) was present in 97.8% and dysmenorrhea in 93.48 % of HPE positive patient. Transvaginal sonography (TVS) and MRI had a sensitivity of 89.13% and 80.43%, specificity of 90.62% and 84.37%, positive likelihood ratio of 9.51 and 5.15, negative likelihood ratio of 0.12 and 0.23, positive predictive value of 93.18% and 88.1%, negative predictive value of 85.29% and 75% and a diagnostic accuracy of 89.74% and 82.5%. Comparison of sensitivity (p=0.289) and specificity (p=0.625) showed no statistically significant difference between TVS and MRI. Conclusion: Prevalence of 30.23%. HMB with dysmenorrhoea and chronic pelvic pain helps in diagnosis. TVS (Endomyometrial junction blurring) is both sensitive and specific in diagnosing adenomyosis without need for additional diagnostic tool. Both TVS and MRI are equally efficient, however because of certain additional advantages of TVS over MRI, it may be used as the first choice of imaging. MRI may be used additionally in difficult cases as well as in patients with existing co-pathologies.

Keywords: adenomyosis, heavy menstrual bleeding, MRI, TVS

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