Search results for: capacity for care
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7538

Search results for: capacity for care

1178 In-Vitro Evaluation of the Long-Term Stability of PEDOT:PSS Coated Microelectrodes for Chronic Recording and Electrical Stimulation

Authors: A. Schander, T. Tessmann, H. Stemmann, S. Strokov, A. Kreiter, W. Lang

Abstract:

For the chronic application of neural prostheses and other brain-computer interfaces, long-term stable microelectrodes for electrical stimulation are essential. In recent years many developments were done to investigate different appropriate materials for these electrodes. One of these materials is the electrical conductive polymer poly(3,4-ethylenedioxythiophene) (PEDOT), which has lower impedance and higher charge injection capacity compared to noble metals like gold and platinum. However the long-term stability of this polymer is still unclear. Thus this paper reports on the in-vitro evaluation of the long-term stability of PEDOT coated gold microelectrodes. For this purpose a highly flexible electrocorticography (ECoG) electrode array, based on the polymer polyimide, is used. This array consists of circular gold electrodes with a diameter of 560 µm (0.25 mm2). In total 25 electrodes of this array were coated simultaneously with the polymer PEDOT:PSS in a cleanroom environment using a galvanostatic electropolymerization process. After the coating the array is additionally sterilized using a steam sterilization process (121°C, 1 bar, 20.5 min) to simulate autoclaving prior to the implantation of such an electrode array. The long-term measurements were performed in phosphate-buffered saline solution (PBS, pH 7.4) at the constant body temperature of 37°C. For the in-vitro electrical stimulation a one channel bipolar current stimulator is used. The stimulation protocol consists of a bipolar current amplitude of 5 mA (cathodal phase first), a pulse duration of 100 µs per phase, a pulse pause of 50 µs and a frequency of 1 kHz. A PEDOT:PSS coated gold electrode with an area of 1 cm2 serves as the counter electrode. The electrical stimulation is performed continuously with a total amount of 86.4 million bipolar current pulses per day. The condition of the PEDOT coated electrodes is monitored in between with electrical impedance spectroscopy measurements. The results of this study demonstrate that the PEDOT coated electrodes are stable for more than 3.6 billion bipolar current pulses. Also the unstimulated electrodes show currently no degradation after the time period of 5 months. These results indicate an appropriate long-term stability of this electrode coating for chronic recording and electrical stimulation. The long-term measurements are still continuing to investigate the life limit of this electrode coating.

Keywords: chronic recording, electrical stimulation, long-term stability, microelectrodes, PEDOT

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1177 Batch and Dynamic Investigations on Magnesium Separation by Ion Exchange Adsorption: Performance and Cost Evaluation

Authors: Mohamed H. Sorour, Hayam F. Shaalan, Heba A. Hani, Eman S. Sayed

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Ion exchange adsorption has a long standing history of success for seawater softening and selective ion removal from saline sources. Strong, weak and mixed types ion exchange systems could be designed and optimized for target separation. In this paper, different types of adsorbents comprising zeolite 13X and kaolin, in addition to, poly acrylate/zeolite (AZ), poly acrylate/kaolin (AK) and stand-alone poly acrylate (A) hydrogel types were prepared via microwave (M) and ultrasonic (U) irradiation techniques. They were characterized using X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), and scanning electron microscopy (SEM). The developed adsorbents were evaluated on bench scale level and based on assessment results, a composite bed has been formulated for performance evaluation in pilot scale column investigations. Owing to the hydrogel nature of the partially crosslinked poly acrylate, the developed adsorbents manifested a swelling capacity of about 50 g/g. The pilot trials have been carried out using magnesium enriched Red Seawater to simulate Red Seawater desalination brine. Batch studies indicated varying uptake efficiencies, where Mg adsorption decreases according to the following prepared hydrogel types AU>AM>AKM>AKU>AZM>AZU, being 108, 107, 78, 69, 66 and 63 mg/g, respectively. Composite bed adsorbent tested in the up-flow mode column studies indicated good performance for Mg uptake. For an operating cycle of 12 h, the maximum uptake during the loading cycle approached 92.5-100 mg/g, which is comparable to the performance of some commercial resins. Different regenerants have been explored to maximize regeneration and minimize the quantity of regenerants including 15% NaCl, 0.1 M HCl and sodium carbonate. Best results were obtained by acidified sodium chloride solution. In conclusion, developed cation exchange adsorbents comprising clay or zeolite support indicated adequate performance for Mg recovery under saline environment. Column design operated at the up-flow mode (approaching expanded bed) is appropriate for such type of separation. Preliminary cost indicators for Mg recovery via ion exchange have been developed and analyzed.

Keywords: batch and dynamic magnesium separation, seawater, polyacrylate hydrogel, cost evaluation

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1176 Results of Three-Year Operation of 220kV Pilot Superconducting Fault Current Limiter in Moscow Power Grid

Authors: M. Moyzykh, I. Klichuk, L. Sabirov, D. Kolomentseva, E. Magommedov

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Modern city electrical grids are forced to increase their density due to the increasing number of customers and requirements for reliability and resiliency. However, progress in this direction is often limited by the capabilities of existing network equipment. New energy sources or grid connections increase the level of short-circuit currents in the adjacent network, which can exceed the maximum rating of equipment–breaking capacity of circuit breakers, thermal and dynamic current withstand qualities of disconnectors, cables, and transformers. Superconducting fault current limiter (SFCL) is a modern solution designed to deal with the increasing fault current levels in power grids. The key feature of this device is its instant (less than 2 ms) limitation of the current level due to the nature of the superconductor. In 2019 Moscow utilities installed SuperOx SFCL in the city power grid to test the capabilities of this novel technology. The SFCL became the first SFCL in the Russian energy system and is currently the most powerful SFCL in the world. Modern SFCL uses second-generation high-temperature superconductor (2G HTS). Despite its name, HTS still requires low temperatures of liquid nitrogen for operation. As a result, Moscow SFCL is built with a cryogenic system to provide cooling to the superconductor. The cryogenic system consists of three cryostats that contain a superconductor part and are filled with liquid nitrogen (three phases), three cryocoolers, one water chiller, three cryopumps, and pressure builders. All these components are controlled by an automatic control system. SFCL has been continuously operating on the city grid for over three years. During that period of operation, numerous faults occurred, including cryocooler failure, chiller failure, pump failure, and others (like a cryogenic system power outage). All these faults were eliminated without an SFCL shut down due to the specially designed cryogenic system backups and quick responses of grid operator utilities and the SuperOx crew. The paper will describe in detail the results of SFCL operation and cryogenic system maintenance and what measures were taken to solve and prevent similar faults in the future.

Keywords: superconductivity, current limiter, SFCL, HTS, utilities, cryogenics

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1175 Reconstruction of Performace-Based Budgeting in Indonesian Local Government: Application of Soft Systems Methodology in Producing Guideline for Policy Implementation

Authors: Deddi Nordiawan

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Effective public policy creation required a strong budget system, both in terms of design and implementation. Performance-based Budget is an evolutionary approach with two substantial characteristics; first, the strong integration between budgeting and planning, and second, its existence as guidance so that all activities and expenditures refer to measurable performance targets. There are four processes in the government that should be followed in order to make the budget become performance-based. These four processes consist of the preparation of a vision according to the bold aspiration, the formulation of outcome, the determination of output based on the analysis of organizational resources, and the formulation of Value Creation Map that contains a series of programs and activities. This is consistent with the concept of logic model which revealed that the budget performance should be placed within a relational framework of resources, activities, outputs, outcomes and impacts. Through the issuance of Law 17/2003 regarding State Finance, local governments in Indonesia have to implement performance-based budget. Central Government then issued Government Regulation 58/2005 which contains the detail guidelines how to prepare local governments budget. After a decade, implementation of performance budgeting in local government is still not fully meet expectations, though the guidance is completed, socialization routinely performed, and trainings have also been carried out at all levels. Accordingly, this study views the practice of performance-based budget at local governments as a problematic situation. This condition must be approached with a system approach that allows the solutions from many point of views. Based on the fact that the infrastructure of budgeting has already settled, the study then considering the situation as complexity. Therefore, the intervention needs to be done in the area of human activity system. Using Soft Systems Methodology, this research will reconstruct the process of performance-based budget at local governments is area of human activity system. Through conceptual models, this study will invite all actors (central government, local government, and the parliament) for dialogue and formulate interventions in human activity systems that systematically desirable and culturally feasible. The result will direct central government in revise the guidance to local government budgeting process as well as a reference to build the capacity building strategy.

Keywords: soft systems methodology, performance-based budgeting, Indonesia, public policy

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1174 Effect of Male and Female Early Childhood Teacher's Educational Practices on Child' Social Adaptation

Authors: Therese Besnard

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Internationally in early childhood education (ECE), the great majority of teachers are women. Some groups believe that a greater male teacher presence in ECE would be beneficial for children, specifically for boys as it could offer a positive male model. It is a common belief that children would benefit from being exposed to both male and female models. Some believe that women are naturally better suited to offer quality care to young children comparatively to men. Some authors bring forth that after equivalent training, differences in the educational practices are purely individual and do not depend on the teacher’s gender. Others believe that a greater male presence in ECE would increase the risk of pedophilia or child abuse. The few scientific studies in this area suggest that differences could exist between male and female ECE teacher, in particular when it comes to play which is the mainstay of the ECE educational program. Male teachers describe themselves as being more playful and having a greater tendency to initiate physical and turbulent play comparatively to female teachers, who describe themselves as favoring games that are calmer and focused on social interaction. Observed directly, male teachers appear more actively engaged in play with children and propose more motor play than female teachers. Furthermore children who have both male and female teachers for one year show less behavior difficulties when compared to children with only female teachers. Despite a variety of viewpoints we don’t know if the educational practices of male ECE teachers, (emotional support, classroom organization or instructional support) are different than the educational practices of female teachers and if these practices are linked with children’s adaptation. This study compares the educational practices of 37 ECE teachers (57 % male) and analyses the link with children' social adaptation (n=221). Educational practices were assessed through observational measurements with the Classroom Assessment Scoring System (CLASS) in a natural class environment. Child social adaptation was assessed with the Social Competence and Behavior Evaluation (SCBE). Observational data reveals no differences between men's and women's scale of the CLASS. Results using Multilevel models analyses suggest that the ability to propose good classroom organization and give good instructional support are linked with better child' social adaptation, and that is always true for men and women teachers. The results are discussed on the basis of their potential impact on future educational interventions.

Keywords: child social adaptation, early childhood education, educational practices, men teacher

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1173 Reasons for Lack of an Ideal Disinfectant after Dental Treatments

Authors: Ilma Robo, Saimir Heta, Rialda Xhizdari, Kers Kapaj

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Background: The ideal disinfectant for surfaces, instruments, air, skin, both in dentistry and in the fields of medicine, does not exist.This is for the sole reason that all the characteristics of the ideal disinfectant cannot be contained in one; these are the characteristics that if one of them is emphasized, it will conflict with the other. A disinfectant must be stable, not be affected by changes in the environmental conditions where it stands, which means that it should not be affected by an increase in temperature or an increase in the humidity of the environment. Both of these elements contradict the other element of the idea of an ideal disinfectant, as they disrupt the solubility ratios of the base substance of the disinfectant versus the diluent. Material and methods: The study aims to extract the constant of each disinfectant/antiseptic used during dental disinfection protocols, accompanied by the side effects of the surface of the skin or mucosa where it is applied in the role of antiseptic. In the end, attempts were made to draw conclusions about the best possible combination for disinfectants after a dental procedure, based on the data extracted from the basic literature required during the development of the pharmacology module, as a module in the formation of a dentist, against data published in the literature. Results: The sensitivity of the disinfectant to changes in the atmospheric conditions of the environment where it is kept is a known fact. The care against this element is always accompanied by the advice on the application of the specific disinfectant, in order to have the desired clinical result. The constants of disinfectants according to the classification based on the data collected and presented are for alcohols 70-120, glycols 0.2, aldehydes 30-200, phenols 15-60, acids 100, povidone iodine halogens 5-75, hypochlorous acid halogens 150, sodium hypochlorite halogens 30-35, oxidants 18-60, metals 0.2-10. The part of halogens should be singled out, where specific results were obtained according to the representatives of this class, since it is these representatives that find scope for clinical application in dentistry. Conclusions: The search for the "ideal", in the conditions where its defining criteria are also established, not only for disinfectants but also for any medication or pharmaceutical product, is an ongoing search, without any definitive results. In this mine of data in the published literature if there is something fixed, calculable, such as the specific constant for disinfectants, the search for the ideal is more concrete. During the disinfection protocols, different disinfectants are applied since the field of action is different, including water, air, aspiration devices, tools, disinfectants used in full accordance with the production indications.

Keywords: disinfectant, constant, ideal, side effects

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1172 Human Rabies Survivors in India: Epidemiological, Immunological and Virological Studies

Authors: Madhusudana S. N., Reeta Mani, Ashwini S. Satishchandra P., Netravati, Udhani V., Fiaz A., Karande S.

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Rabies is an acute encephalitis which is considered 100% fatal despite occasional reports of survivors. However, in recent times more cases of human rabies survivors are being reported. In the last 5 years, there are six laboratories confirmed human rabies survivors in India alone. All cases were children below 15 years and all contracted the disease by dog bites. All of them also had received the full or partial course of rabies vaccination and 4 out of 6 had also received rabies immunoglobulin. All cases were treated in intensive care units in hospitals at Bangalore, Mumbai, Chandigarh, Lucknow and Goa. We report here the results of immunological and virological studies conducted at our laboratory on these patients. The clinical samples that were obtained from these patients were Serum, CSF, nuchal skin biopsy and saliva. Serum and CSF samples were subjected to standard RFFIT for estimation of rabies neutralizing antibodies. Skin biopsy, CSF and saliva were processed by TaqMan real-time PCR for detection of viral RNA. CSF, saliva and skin homogenates were also processed for virus isolation by inoculation of suckling mice. The PBMCs isolated from fresh blood was subjected to ELISPOT assay to determine the type of immune response (Th1/Th2). Both CSF and serum were also investigated for selected cytokines by Luminex assay. The level of antibodies to virus G protein and N protein were determined by ELISA. All survivors had very high titers of RVNA in serum and CSF 100 fold higher than non-survivors and vaccine controls. A five-fold rise in titer could be demonstrated in 4 out of 6 patients. All survivors had a significant increase in antibodies to G protein in both CSF and serum when compared to non-survivors. There was a profound and robust Th1 response in all survivors indicating that interferon gamma could play an important factor in virus clearance. We could isolate viral RNA in only one patient four years after he had developed symptoms. The partial N gene sequencing revealed 99% homology to species I strain prevalent in India. Levels of selected cytokines in CSF and serum did not reveal any difference between survivors and non-survivors. To conclude, survival from rabies is mediated by virus-specific immune responses of the host and clearance of rabies virus from CNS may involve the participation of both Th2 and Th1 immune responses.

Keywords: rabies, rabies treatment, rabies survivors, immune reponse in rabies encephalitis

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1171 Safety Evaluation of Post-Consumer Recycled PET Materials in Chilean Industry by Overall Migration Tests

Authors: Evelyn Ilabaca, Ximena Valenzuela, Alejandra Torres, María José Galotto, Abel Guarda

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One of the biggest problems in food packaging industry, especially with the plastic materials, is the fact that these materials are usually obtained from non-renewable resources and also remain as waste after its use, causing environmental issues. This is an international concern and particular attention is given to reduction, reuse and recycling strategies for decreasing the waste from plastic packaging industry. In general, polyethylenes represent most plastic waste and recycling process of post-consumer polyethylene terephthalate (PCR-PET) has been studied. US Food and Drug Administration (FDA), European Food Safety Authority (EFSA) and Southern Common Market (MERCOSUR) have generated different legislative documents to control the use of PCR-PET in the production of plastic packaging intended direct food contact in order to ensure the capacity of recycling process to remove possible contaminants that can migrate into food. Consequently, it is necessary to demonstrate by challenge test that the recycling process is able to remove specific contaminants, obtaining a safe recycled plastic to human health. These documents establish that the concentration limit for substitute contaminants in PET is 220 ppb (ug/kg) and the specific migration limit is 10 ppb (ug/kg) for each contaminant, in addition to assure the sensorial characteristics of food are not affected. Moreover, under the Commission Regulation (EU) N°10/2011 on plastic materials and articles intended to come into contact with food, it is established that overall migration limit is 10 mg of substances per 1 dm2 of surface area of the plastic material. Thus, the aim of this work is to determine the safety of PCR-PET-containing food packaging materials in Chile by measuring their overall migration, and their comparison with the established limits at international level. This information will serve as a basis to provide a regulation to control and regulate the use of recycled plastic materials in the manufacture of plastic packaging intended to be in direct contact with food. The methodology used involves a procedure according to EN-1186:2002 with some modifications. The food simulants used were ethanol 10 % (v/v) and acetic acid 3 % (v/v) as aqueous food simulants, and ethanol 95 % (v/v) and isooctane as substitutes of fatty food simulants. In this study, preliminary results showed that Chilean food packaging plastics with different PCR-PET percentages agree with the European Legislation for food aqueous character.

Keywords: contaminants, polyethylene terephthalate, plastic food packaging, recycling

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1170 Health Seeking Manners of Road Traffic Accident Victims: A Qualitative Study

Authors: Mohammad Mahbub Alam Talukder, Shahnewaz, Hasanat-E-Rabbi, Mohammed Nazrul Islam

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Road traffic accident is a global problem which is severe in the developing countries like Bangladesh. In consequence, in developing countries road trauma has now been recognized as an increasing public health hazards and economic burning issue. And after road traffic accidents the lack of management and economic costs related with health seeking behavior have a disproportionate impact on lower income groups, thus contributing to the persistence of poverty in conjunction with disability. This cross sectional study, carried out during July 2012 to June 2013, aimed to explore health seeking decision and culture of handling the road traffic accident related victims, as taken from experiences of the poor disabled people of slum dwellers of Dhaka city. The present study has been designed based on qualitative techniques such as in-depth interview and case studies. Additionally, a survey questionnaire was used to collect the demographic characteristics of the study population (n=150) and to select participants purposely for in-depth interview (n=50) and case study (n=30). Content analysis of qualitative data was done through theme coding and matrix analysis of case study was done to use relevant verbatim. Most of the time the health seeking decision totally depended on the surrounded people of the accidental place, their knowledge, awareness and remaining facility and capacity regarding proper management of the victims. However, most of the cases the victims did not get any early treatment and it took 2-12 hours to get even the first aid because of distance, shortage of money, lack of availability of getting the aid, lack of mass awareness etc. Under the reality of discriminated and unaffordable health service provision better treatment could not turn out due to economic inability of the poor victims. To avoid the severe trauma, treatment delay must be reduced by providing first aid within very short time and to do so, mass awareness campaign is necessary for handing the victims. Moreover, necessary measures should be taken to ensure cost free health service provision to treat the chronic disabled condition of the road traffic accident related poor victims.

Keywords: accident, injury, disabled, qualitative, slum

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1169 Bionaut™: A Minimally Invasive Microsurgical Platform to Treat Non-Communicating Hydrocephalus in Dandy-Walker Malformation

Authors: Suehyun Cho, Darrell Harrington, Florent Cros, Olin Palmer, John Caputo, Michael Kardosh, Eran Oren, William Loudon, Alex Kiselyov, Michael Shpigelmacher

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The Dandy-Walker malformation (DWM) represents a clinical syndrome manifesting as a combination of posterior fossa cyst, hypoplasia of the cerebellar vermis, and obstructive hydrocephalus. Anatomic hallmarks include hypoplasia of the cerebellar vermis, enlargement of the posterior fossa, and cystic dilatation of the fourth ventricle. Current treatments of DWM, including shunting of the cerebral spinal fluid ventricular system and endoscopic third ventriculostomy (ETV), are frequently clinically insufficient, require additional surgical interventions, and carry risks of infections and neurological deficits. Bionaut Labs develops an alternative way to treat Dandy-Walker Malformation (DWM) associated with non-communicating hydrocephalus. We utilize our discreet microsurgical Bionaut™ particles that are controlled externally and remotely to perform safe, accurate, effective fenestration of the Dandy-Walker cyst, specifically in the posterior fossa of the brain, to directly normalize intracranial pressure. Bionaut™ allows for complex non-linear trajectories not feasible by any conventional surgical techniques. The microsurgical particle safely reaches targets in the lower occipital section of the brain. Bionaut™ offers a minimally invasive surgical alternative to highly involved posterior craniotomy or shunts via direct fenestration of the fourth ventricular cyst at the locus defined by the individual anatomy. Our approach offers significant advantages over the current standards of care in patients exhibiting anatomical challenge(s) as a manifestation of DWM, and therefore, is intended to replace conventional therapeutic strategies. Current progress, including platform optimization, Bionaut™ control, and real-time imaging and in vivo safety studies of the Bionauts™ in large animals, specifically the spine and the brain of ovine models, will be discussed.

Keywords: Bionaut™, cerebral spinal fluid, CSF, cyst, Dandy-Walker, fenestration, hydrocephalus, micro-robot

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1168 Innovations in the Implementation of Preventive Strategies and Measuring Their Effectiveness Towards the Prevention of Harmful Incidents to People with Mental Disabilities who Receive Home and Community Based Services

Authors: Carlos V. Gonzalez

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Background: Providers of in-home and community based services strive for the elimination of preventable harm to the people under their care as well as to the employees who support them. Traditional models of safety and protection from harm have assumed that the absence of incidents of harm is a good indicator of safe practices. However, this model creates an illusion of safety that is easily shaken by sudden and inadvertent harmful events. As an alternative, we have developed and implemented an evidence-based resilient model of safety known as C.O.P.E. (Caring, Observing, Predicting and Evaluating). Within this model, safety is not defined by the absence of harmful incidents, but by the presence of continuous monitoring, anticipation, learning, and rapid response to events that may lead to harm. Objective: The objective was to evaluate the effectiveness of the C.O.P.E. model for the reduction of harm to individuals with mental disabilities who receive home and community based services. Methods: Over the course of 2 years we counted the number of incidents of harm and near misses. We trained employees on strategies to eliminate incidents before they fully escalated. We trained employees to track different levels of patient status within a scale from 0 to 10. Additionally, we provided direct support professionals and supervisors with customized smart phone applications to track and notify the team of changes in that status every 30 minutes. Finally, the information that we collected was saved in a private computer network that analyzes and graphs the outcome of each incident. Result and conclusions: The use of the COPE model resulted in: A reduction in incidents of harm. A reduction the use of restraints and other physical interventions. An increase in Direct Support Professional’s ability to detect and respond to health problems. Improvement in employee alertness by decreasing sleeping on duty. Improvement in caring and positive interaction between Direct Support Professionals and the person who is supported. Developing a method to globally measure and assess the effectiveness of prevention from harm plans. Future applications of the COPE model for the reduction of harm to people who receive home and community based services are discussed.

Keywords: harm, patients, resilience, safety, mental illness, disability

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1167 Impact of Land Ownership on Rangeland Condition in the Gauteng Province, South Africa

Authors: N. L. Letsoalo, H. T. Pule, J. T. Tjelele, N. R. Mkhize, K. R. Mbatha

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Rangelands are major feed resource for livestock farming in South Africa, despite being subjected to different forms of degradation. These forms of degradation are as a result of inappropriate veld and livestock management practices such as excessive stocking rates. While information on judicious veld management is available, adoption of appropriate practices is still unsatisfactory and seems to depend partly on the type of land ownership of farmers. The objectives of this study were to; (I) compare rangeland condition (species richness, basal cover, veld condition score, and herbaceous biomass) among three land ownership types (leased land, communal land and private land), and (II) determine the relationships between veld condition score (%) and herbaceous biomass (kg DM/ha) production. Vegetation was assessed at fifty farms under different land use types using nearest plant technique. Grass species composition and forage value were estimated using PROC FREQ procedure of SAS 9.3. A one-way ANOVA was used to determine significant differences (P < 0.05) in species richness, basal cover, veld condition (%) large stock units, grazing capacity and herbaceous biomass production among the three grazing systems. A total of 28 grass species were identified, of which 95% and 5% were perennials and annuals, respectively. The most commonly distributed and highly palatable grass species, Digitaria eriantha had significantly higher frequency under private owned lands (32.3 %) compared to communal owned lands (12.3%). There were no significant difference on grass species richness and basal cover among land ownership types (P > 0.05). There were significant differences on veld condition score and biomass production (P < 0.05). Private lands had significantly higher (69.63%) veld condition score than leased (56.07%) and communal lands (52.55%). Biomass production was significantly higher (± S.E.) 2990.30 ± 214 kg DM/ha on private owned lands, compared to leased lands 2069.85 ± 196 kg DM/ha and communal lands 1331.04 ± 102 kg DM/ha. Biomass production was positively correlated with rangeland condition (r = 0.895; P < 0.005). These results suggest that rangeland conditions on communal and leased lands are in poor condition than those on private lands. More research efforts are needed to improve management of rangelands in communal and leased land in Gauteng province.

Keywords: grazing, herbaceous biomass, management practices, species richness

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1166 Effective Apixaban Clearance with Cytosorb Extracorporeal Hemoadsorption

Authors: Klazina T. Havinga, Hilde R. H. de Geus

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Introduction: Pre-operative coagulation management of Apixaban prescribed patients, a new oral anticoagulant (a factor Xa inhibitor), is difficult, especially when chronic kidney disease (CKD) causes drug overdose. Apixaban is not dialyzable due to its high level of protein binding. An antidote, Andexanet α, is available but expensive and has an unfavorable short half-life. We report the successful extracorporeal removal of Apixaban prior to emergency surgery with the CytoSorb® Hemoadsorption device. Methods: A 89-year-old woman with CKD, with an Apixaban prescription for atrial fibrillation, was presented at the ER with traumatic rib fractures, a flail chest, and an unstable spinal fracture (T12) for which emergency surgery was indicated. However, due to very high Apixaban levels, this surgery had to be postponed. Based on the Apixaban-specific anti-factor Xa activity (AFXaA) measurements at admission and 10 hours later, complete clearance was expected after 48 hours. In order to enhance the Apixaban removal and reduce the time to operation, and therefore reduce pulmonary complications, CRRT with CytoSorb® cartridge was initiated. Apixaban-specific anti-factor Xa activity (AFXaA) was measured frequently as a substitute for Apixaban drug concentrations, pre- and post adsorber, in order to calculate the adsorber-related clearance. Results: The admission AFXaA concentration, as a substitute for Apixaban drug levels, was 218 ng/ml, which decreased to 157 ng/ml after ten hours. Due to sustained anticoagulation effects, surgery was again postponed. However, the AFXaA levels decreased quickly to sub-therapeutic levels after CRRT (Multifiltrate Pro, Fresenius Medical Care, Blood flow 200 ml/min, Dialysate Flow 4000 ml/h, Prescribed renal dose 51 ml-kg-h) with Cytosorb® connected in series into the circuit was initiated (within 5 hours). The adsorber-related (indirect) Apixaban clearance was calculated every half hour (Cl=Qe * (AFXaA pre- AFXaA post/ AFXaA pre) with Qe=plasma flow rate calculated with Ht=0.38 and system blood flow rate 200 ml-min): 100 ml/min, 72 ml/min and 57 ml/min. Although, as expected, the adsorber-related clearance decreased quickly due to saturation of the beads, still the reduction rate achieved resulted in a very rapid decrease in AFXaA levels. Surgery was ordered and possible within 5 hours after Cytosorb initiation. Conclusion: The CytoSorb® Hemoadsorption device enabled rapid correction of Apixaban associated anticoagulation.

Keywords: Apixaban, CytoSorb, emergency surgery, Hemoadsorption

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1165 Effect of a Mixture of Phenol, O-Cresol, P-Cresol, and M-Cresol on the Nitrifying Process in a Sequencing Batch Reactor

Authors: Adriana Sosa, Susana Rincon, Chérif Ben, Diana Cabañas, Juan E. Ruiz, Alejandro Zepeda

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The complex chemical composition (mixtures of ammonium and recalcitrant compounds) of the effluents from the chemical, pharmaceutical and petrochemical industries represents a challenge in their biological treatment. This treatment involves nitrification process that can suffer an inhibition due to the presence of aromatic compounds giving as a result the decrease of the process efficiency. The inhibitory effects on nitrification in the presence of aromatic compounds have already been studied; however a few studies have considered the presence of phenolic compounds in the form of mixtures, which is the form that they are present in real context. For this reason, we realized a kinetic study on the nitrifying process in the presence of different concentrations of a mixture of phenol, o-cresol, m-cresol and p-cresol (0 - 320 mg C/L) in a sequencing batch reactor (SBR). Firstly, the nitrifying process was evaluated in absence of the phenolic mixture (control 1) in a SBR with 2 L working volume and 176 mg/L of nitrogen of microbial protein. Total oxidation of initial ammonium (efficiency; ENH4+ of 100 %) to nitrate (nitrifying yield; YNO3- of 0.95) were obtained with specific rates of ammonium consumption (qN-NH4+) and nitrate production (qN-NO3-) (of 1.11 ± 0.04 h-1 and 0.67 h-1 ± 0.11 respectively. During the phase of acclimation with 40 mg C/L of the phenolic mixture, an inhibitory effect on the nitrifying process was observed, provoking a decrease in ENH4+ and YNO3- (11 and 54 % respectively) as well as in the specific rates (89 y 46 % respectively), being the ammonia oxidizing bacteria (BAO) the most affected. However, in the next cycles without the phenolic mixture (control 2), the nitrifying consortium was able to recover its nitrifying capacity (ENH4+ = 100% and YNO3-=0.98). Afterwards the SBR was fed with 10 mg C/L of the phenolic mixture, obtaining and ENH4+ of 100%, YNO3- and qN-NH4+ 0.62 ± 0.006 and 0.13 ± 0.004 respectively, while the qN-NO3- was 0.49 ± 0.007. Moreover, with the increase of the phenolic concentrations (10-160 mg C/L) and the number of cycles the nitrifying consortium was able to oxidize the ammonia with ENH4+ of 100 % and YNO3- close to 1. However a decrease in the values of the nitrification specific rates and increase in the oxidation in phenolic compounds (70 to 94%) were observed. Finally, in the presence of 320 mg C/L, the nitrifying consortium was able to simultaneously oxidize the ammonia (ENH4+= 100%) and the phenolic mixture (p-cresol>phenol>m-cresol>o-cresol) being the o-cresol the most recalcitrant compound. In all the experiments the use of a SBR allowed a respiratory adaptation of the consortium to oxidize the phenolic mixture achieving greater adaptation of the nitrite-oxidizing bacteria (NOB) than in the ammonia-oxidizing bacteria (AOB).

Keywords: cresol, inhibition, nitrification, phenol, sequencing batch reactor

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1164 Strengthening Reinforced Concrete Beams Using Carbon Fibre Reinforced Polymer Strips

Authors: Mina Iskander, Mina Melad, Mourad Yasser, Waleed Abdel Rahim, Amr Mosa, Mohamed El Lahamy, Ezzeldin Sayed-Ahmed, Mohamed Abou-Zeid

Abstract:

Strengthening of reinforced concrete beams in flexure using externally bonded composite laminate of high tensile strength is easy and of the minimum cost compared to traditional methods such as increasing the concrete section depth or reinforcement that requires formwork and curing which affect the structure usability. One of the main limitations of this technique is debonding of the externally bonded laminate, either by end delamination or by mid-span flexural crack-induced debonding. ACI 440.2-08 suggests that using side-bonded FRP laminate in the flexural strengthening of RC beams may serve to limit the extent and width of flexural cracks. Consequently, this technique may decrease the effect of flexural cracks on initiating the mid-span debonding; i.e. delays the flexural crack-induced debonding. Furthermore, bonding the FRP strips to the side of the beam may offer an attractive, practical solution when the soffit of this beam is not accessible. This paper presents an experimental programme designed to investigate the effect of using externally bonded CFRP laminate on the sides of reinforced concrete beams and compares the results to those of bonding the CFRP laminate to the soffit of the beams. In addition, the paper discusses the effect of using end anchorage by U-wrapping the CFRP strips at their end zones with CFRP sheets for beams strengthened with soffit-bonded and side-bonded CFRP strips. Thus, ten rectangular reinforced concrete beams were tested to failure in order to study the effect of changing the location of the externally bonded laminate on the flexural capacity and ductility of the strengthened beams. Pultruded CFRP strips were bonded to the soffit of the beams or their sides to check the possibility of limiting the flexural cracking in mid-span region, which is the main reason for mid-span debonding. Pre-peg CFRP sheets were used near the support as U-wrap for the beam to act as an end-anchorage for the externally bonded strips in order to delay/prevent the end delamination. Strength gains of 38% and 43% were recorded for the soffit-bonded and the side-bonded composite strips with end U-wrapped sheets, respectively. Furthermore, beams with end sheets applied as an end anchorage showed higher ductility than those without these sheets.

Keywords: flexural strengthening, externally bonded CFRP, side-bonded CFRP, CFRP laminates

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1163 The Roles of Non-Codified Traditional Medicine in a Suburban Village in Kerala, India

Authors: Sachi Matsuoka

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This study aimed at implicating a current community health in South India focusing on a Vaidya, a non-codified traditional doctor, based on long-term field works. As the prevalence of colonic diseases is increasing in all over the world, it is needed to know the potential of non-codified medicines and how they can effectively take in a part in community health. Describing the people’s treatment seeking behaviours in a suburban village which is susceptible to modernization can give us a new insight for studying Indian medicines, that is included not only non-codified but also codified traditional ones, affected by global, national and local communities. Both qualitative and quantitative data were gathered via participatory fieldworks and open-ended interviews to a Vaidya and his 97 patients and 31 individuals who lived in a community near the Vaidya’s station. It was found that the community members seldom consulted the Vaidya while a number of patients outside the village (mainly from urban nearby area) daily visited the Vaidya. Thus, the role of the Vaidya as the community’ s primary health care provider had nearly disappeared. Nonetheless, the Vaidya was deeply respected as one of the community’ s leaders by its members because of the spiritual and financial support he provided to them. The reasons for choosing the Vaidya for the patients from urban area are characterized by several social factors of the patients such as their religious belief, seriousness, occupation and medical history. Meanwhile, not only the Vaidya but also other codified traditional medicines, e.g., Ayurveda, were less popular among the community members. It sounds paradoxical given that the traditional Indian medical system has been becoming popular as an alternative medicine in societies outside of India, such as in Europe. The community members who are less educated and engaged in religious activities in daily life preferred to allopathy, the biomedicine in Indian context. It is thus concluded that roles of non-codified medicine has changed depending on its cultural and social contexts, even though its medical system is not authorized by the government. Nowadays, traditional medical effectiveness is recognized as evidenced by scientific survey and the codified medical doctors treats diseases rather than people. However, this study implicated that people’s treatment seeking behaviors are likely based on the social context in which people live their lives even though evidenced based codified medicine is provided in their community.

Keywords: medical pluralism, non-codified medicine, south india, treatment-seeking behaviours

Procedia PDF Downloads 259
1162 Performance Evaluation of On-Site Sewage Treatment System (Johkasou)

Authors: Aashutosh Garg, Ankur Rajpal, A. A. Kazmi

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The efficiency of an on-site wastewater treatment system named Johkasou was evaluated based on its pollutant removal efficiency over 10 months. This system was installed at IIT Roorkee and had a capacity of treating 7 m3/d of sewage water, sufficient for a group of 30-50 people. This system was fed with actual wastewater through an equalization tank to eliminate the fluctuations throughout the day. Methanol and ammonium chloride was added into this equalization tank to increase the Chemical Oxygen Demand (COD) and ammonia content of the influent. The outlet from Johkasou is sent to a tertiary unit consisting of a Pressure Sand Filter and an Activated Carbon Filter for further treatment. Samples were collected on alternate days from Monday to Friday and the following parameters were evaluated: Chemical Oxygen Demand (COD), Biochemical Oxygen Demand (BOD), Total Suspended Solids (TSS), and Total Nitrogen (TN). The Average removal efficiency for Chemical Oxygen Demand (COD), Biochemical Oxygen Demand (BOD), Total Suspended Solids (TSS), and Total Nitrogen (TN) was observed as 89.6, 97.7, 96, and 80% respectively. The cost of treating the wastewater comes out to be Rs 23/m3 which includes electricity, cleaning and maintenance, chemical, and desludging costs. Tests for the coliforms were also performed and it was observed that the removal efficiency for total and fecal coliforms was 100%. The sludge generation rate is approximately 20% of the BOD removal and it needed to be removed twice a year. It also showed a very good response against the hydraulic shock load. We performed vacation stress analysis on the system to evaluate the performance of the system when there is no influent for 8 consecutive days. From the result of stress analysis, we concluded that system needs a recovery time of about 48 hours to stabilize. After about 2 days, the system returns again to original conditions and all the parameters in the effluent become within the limits of National Green Tribunal (NGT) standards. We also performed another stress analysis to save the electricity in which we turned the main aeration blower off for 2 to 12 hrs a day and the results showed that we can turn the blower off for about 4-6 hrs a day and this will help in reducing the electricity costs by about 25%. It was concluded that the Johkasou system can remove a sufficient amount of all the physiochemical parameters tested to satisfy the prescribed limit set as per Indian Standard.

Keywords: on-site treatment, domestic wastewater, Johkasou, nutrient removal, pathogens removal

Procedia PDF Downloads 102
1161 The Need for Automation in the Domestic Food Processing Sector and its Impact

Authors: Shantam Gupta

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The objective of this study is to address the critical need for automation in the domestic food processing sector and study its impact. Food is the one of the most basic physiological needs essential for the survival of a living being. Some of them have the capacity to prepare their own food (like most plants) and henceforth are designated as primary food producers; those who depend on these primary food producers for food form the primary consumers’ class (herbivores). Some of the organisms relying on the primary food are the secondary food consumers (carnivores). There is a third class of consumers called tertiary food consumers/apex food consumers that feed on both the primary and secondary food consumers. Humans form an essential part of the apex predators and are generally at the top of the food chain. But still further disintegration of the food habits of the modern human i.e. Homo sapiens, reveals that humans depend on other individuals for preparing their own food. The old notion of eating raw/brute food is long gone and food processing has become very trenchant in lives of modern human. This has led to an increase in dependence on other individuals for ‘processing’ the food before it can be actually consumed by the modern human. This has led to a further shift of humans in the classification of food chain of consumers. The effects of the shifts shall be systematically investigated in this paper. The processing of food has a direct impact on the economy of the individual (consumer). Also most individuals depend on other processing individuals for the preparation of food. This dependency leads to establishment of a vital link of dependency in the food web which when altered can adversely affect the food web and can have dire consequences on the health of the individual. This study investigates the challenges arising out due to this dependency and the impact of food processing on the economy of the individual. A comparison of Industrial food processing and processing at domestic platforms (households and restaurants) has been made to provide an idea about the present scenario of automation in the food processing sector. A lot of time and energy is also consumed while processing food at home for consumption. The high frequency of consumption of meals (greater than 2 times a day) makes it even more laborious. Through the medium of this study a pressing need for development of an automatic cooking machine is proposed with a mission to reduce the inter-dependency & human effort of individuals required for the preparation of food (by automation of the food preparation process) and make them more self-reliant The impact of development of this product has also further been profoundly discussed. Assumption used: The individuals those who process food also consume the food that they produce. (They are also termed as ‘independent’ or ‘self-reliant’ modern human beings.)

Keywords: automation, food processing, impact on economy, processing individual

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1160 New Advanced Medical Software Technology Challenges and Evolution of the Regulatory Framework in Expert Software, Artificial Intelligence, and Machine Learning

Authors: Umamaheswari Shanmugam, Silvia Ronchi, Radu Vornicu

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Software, artificial intelligence, and machine learning can improve healthcare through innovative and advanced technologies that are able to use the large amount and variety of data generated during healthcare services every day. As we read the news, over 500 machine learning or other artificial intelligence medical devices have now received FDA clearance or approval, the first ones even preceding the year 2000. One of the big advantages of these new technologies is the ability to get experience and knowledge from real-world use and to continuously improve their performance. Healthcare systems and institutions can have a great benefit because the use of advanced technologies improves the same time efficiency and efficacy of healthcare. Software-defined as a medical device, is stand-alone software that is intended to be used for patients for one or more of these specific medical intended uses: - diagnosis, prevention, monitoring, prediction, prognosis, treatment or alleviation of a disease, any other health conditions, replacing or modifying any part of a physiological or pathological process–manage the received information from in vitro specimens derived from the human samples (body) and without principal main action of its principal intended use by pharmacological, immunological or metabolic definition. Software qualified as medical devices must comply with the general safety and performance requirements applicable to medical devices. These requirements are necessary to ensure high performance and quality and also to protect patients’ safety. The evolution and the continuous improvement of software used in healthcare must take into consideration the increase in regulatory requirements, which are becoming more complex in each market. The gap between these advanced technologies and the new regulations is the biggest challenge for medical device manufacturers. Regulatory requirements can be considered a market barrier, as they can delay or obstacle the device approval, but they are necessary to ensure performance, quality, and safety, and at the same time, they can be a business opportunity if the manufacturer is able to define in advance the appropriate regulatory strategy. The abstract will provide an overview of the current regulatory framework, the evolution of the international requirements, and the standards applicable to medical device software in the potential market all over the world.

Keywords: artificial intelligence, machine learning, SaMD, regulatory, clinical evaluation, classification, international requirements, MDR, 510k, PMA, IMDRF, cyber security, health care systems.

Procedia PDF Downloads 76
1159 Nutrition Program Planning Based on Local Resources in Urban Fringe Areas of a Developing Country

Authors: Oktia Woro Kasmini Handayani, Bambang Budi Raharjo, Efa Nugroho, Bertakalswa Hermawati

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Obesity prevalence and severe malnutrition in Indonesia has increased from 2007 to 2013. The utilization of local resources in nutritional program planning can be used to program efficiency and to reach the goal. The aim of this research is to plan a nutrition program based on local resources for urban fringe areas in a developing country. This research used a qualitative approach, with a focus on local resources including social capital, social system, cultural system. The study was conducted in Mijen, Central Java, as one of the urban fringe areas in Indonesia. Purposive and snowball sampling techniques are used to determine participants. A total of 16 participants took part in the study. Observation, interviews, focus group discussion, SWOT analysis, brainstorming and Miles and Huberman models were used to analyze the data. We have identified several local resources, such as the contributions from nutrition cadres, social organizations, social financial resources, as well as the cultural system and social system. The outstanding contribution of nutrition cadres is the participation and creativity to improve nutritional status. In addition, social organizations, like the role of the integrated health center for children (Pos Pelayanan Terpadu), can be engaged in the nutrition program planning. This center is supported by House of Nutrition to assist in nutrition program planning, and provide social support to families, neighbors and communities as social capitals. The study also reported that cultural systems that show appreciation for well-nourished children are a better way to improve the problem of balanced nutrition. Social systems such as teamwork and mutual cooperation can also be a potential resource to support nutritional programs and overcome associated problems. The impact of development in urban areas such as the introduction of more green areas which improve the perceived status of local people, as well as new health services facilitated by people and companies, can also be resources to support nutrition programs. Local resources in urban fringe areas can be used in the planning of nutrition programs. The expansion of partnership with all stakeholders, empowering the community through optimizing the roles of nutrition care centers for children as our recommendation with regard to nutrition program planning.

Keywords: developing country, local resources, nutrition program, urban fringe

Procedia PDF Downloads 239
1158 Experimental Study of Nucleate Pool Boiling Heat Transfer Characteristics on Laser-Processed Copper Surfaces of Different Patterns

Authors: Luvindran Sugumaran, Mohd Nashrul Mohd Zubir, Kazi Md Salim Newaz, Tuan Zaharinie Tuan Zahari, Suazlan Mt Aznam, Aiman Mohd Halil

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With the fast growth of integrated circuits and the trend towards making electronic devices smaller, the heat dissipation load of electronic devices has continued to go over the limit. The high heat flux element would not only harm the operation and lifetime of the equipment but would also impede the performance upgrade brought about by the iteration of technological updates, which would have a direct negative impact on the economic and production cost benefits of rising industries. Hence, in high-tech industries like radar, information and communication, electromagnetic power, and aerospace, the development and implementation of effective heat dissipation technologies were urgently required. Pool boiling is favored over other cooling methods because of its capacity to dissipate a high heat flux at a low wall superheat without the usage of mechanical components. Enhancing the pool boiling performance by increasing the heat transfer coefficient via surface modification techniques has received a lot of attention. There are several surface modification methods feasible today, but the stability and durability of surface modification are the greatest priority. Thus, laser machining is an interesting choice for surface modification due to its low production cost, high scalability, and repeatability. In this study, different patterns of laser-processed copper surfaces are fabricated to investigate the nucleate pool boiling heat transfer performance of distilled water. The investigation showed that there is a significant enhancement in the pool boiling heat transfer performance of the laser-processed surface compared to the reference surface due to the notable increase in nucleation frequency and nucleation site density. It was discovered that the heat transfer coefficients increased when both the surface area ratio and the ratio of peak-to-valley height of the microstructure were raised. It is believed that the development of microstructures on the surface as a result of laser processing is the primary factor in the enhancement of heat transfer performance.

Keywords: heat transfer coefficient, laser processing, micro structured surface, pool boiling

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1157 Process Performance and Nitrogen Removal Kinetics in Anammox Hybrid Reactor

Authors: Swati Tomar, Sunil Kumar Gupta

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Anammox is a promising and cost effective alternative to conventional treatment systems that facilitates direct oxidation of ammonium nitrogen under anaerobic conditions with nitrite as an electron acceptor without addition of any external carbon sources. The present study investigates the process kinetics of laboratory scale anammox hybrid reactor (AHR) which combines the dual advantages of attached and suspended growth. The performance & behaviour of AHR was studied under varying hydraulic retention time (HRTs) and nitrogen loading rate (NLRs). The experimental unit consisted of 4 numbers of 5L capacity anammox hybrid reactor inoculated with mixed seed culture containing anoxic and activated sludge. Pseudo steady state (PSS) ammonium and nitrite removal efficiencies of 90.6% and 95.6%, respectively, were achieved during acclimation phase. After establishment of PSS, the performance of AHR was monitored at seven different HRTs of 3.0, 2.5, 2.0, 1.5, 1.0, 0.5 and 0.25 d with increasing NLR from 0.4 to 4.8 kg N/m3d. The results showed that with increase in NLR and decrease in HRT (3.0 to 0.25 d), AHR registered appreciable decline in nitrogen removal efficiency from 92.9% to 67.4 %, respectively. The HRT of 2.0 d was considered optimal to achieve substantial nitrogen removal of 89%, because on further decrease in HRT below 1.5 days, remarkable decline in the values of nitrogen removal efficiency were observed. Analysis of data indicated that attached growth system contributes an additional 15.4 % ammonium removal and reduced the sludge washout rate (additional 29% reduction). This enhanced performance may be attributed to 25% increase in sludge retention time due to the attached growth media. Three kinetic models, namely, first order, Monod and Modified Stover-Kincannon model were applied to assess the substrate removal kinetics of nitrogen removal in AHR. Validation of the models were carried out by comparing experimental set of data with the predicted values obtained from the respective models. For substrate removal kinetics, model validation revealed that Modified Stover-Kincannon is most precise (R2=0.943) and can be suitably applied to predict the kinetics of nitrogen removal in AHR. Lawrence and McCarty model described the kinetics of bacterial growth. The predicted value of yield coefficient and decay constant were in line with the experimentally observed values.

Keywords: anammox, kinetics, modelling, nitrogen removal, sludge wash out rate, AHR

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1156 Rhizospheric Oxygen Release of Hydroponically Grown Wetland Macrophytes as Passive Source for Cathodic Reduction in Microbial Fuel Cell

Authors: Chabungbam Niranjit Khuman, Makarand Madhao Ghangrekar, Arunabha Mitra

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The cost of aeration is one of the limiting factors in the upscaling of microbial fuel cells (MFC) for field-scale applications. Wetland macrophytes have the ability to release oxygen into the water to maintain aerobic conditions in their root zone. In this experiment, the efficacy of rhizospheric oxygen release of wetland macrophytes as a source of oxygen in the cathodic chamber of MFC was conducted. The experiment was conducted in an MFC consisting of a three-liter anodic chamber made of ceramic cylinder and a 27 L cathodic chamber. Untreated carbon felts were used as electrodes (i.e., anode and cathode) and connected to an external load of 100 Ω using stainless steel wire. Wetland macrophytes (Canna indica) were grown in the cathodic chamber of the MFC in a hydroponic fashion using a styrofoam sheet (termed as macrophytes assisted-microbial fuel cell, M-MFC). The catholyte (i.e., water) in the M-MFC had negligible contact with atmospheric air due to the styrofoam sheet used for maintaining the hydroponic condition. There was no mixing of the catholyte in the M-MFC. Sucrose based synthetic wastewater having chemical oxygen demand (COD) of 3000 mg/L was fed into the anodic chamber of the MFC in fed-batch mode with a liquid retention time of four days. The C. indica thrived well throughout the duration of the experiment without much care. The average dissolved oxygen (DO) concentration and pH value in the M-MFC were 3.25 mg/L and 7.07, respectively, in the catholyte. Since the catholyte was not in contact with air, the DO in the catholyte might be considered as solely liberated from the rhizospheric oxygen release of C. indica. The maximum COD removal efficiency of M-MFC observed during the experiment was 76.9%. The inadequacy of terminal electron acceptor in the cathodic chamber in M-MFC might have hampered the electron transfer, which in turn, led to slower specific microbial activity, thereby resulting in lower COD removal efficiency than the traditional MFC with aerated catholyte. The average operating voltage (OV) and open-circuit voltage (OCV) of 294 mV and 594 mV, respectively, were observed in M-MFC. The maximum power density observed during polarization was 381 mW/m³, and the maximum sustainable power density observed during the experiment was 397 mW/m³ in M-MFC. The maximum normalized energy recovery and coulombic efficiency of 38.09 Wh/m³ and 1.27%, respectively, were observed. Therefore, it was evidenced that rhizospheric oxygen release of wetland macrophytes (C. indica) was capable of sustaining the cathodic reaction in MFC for field-scale applications.

Keywords: hydroponic, microbial fuel cell, rhizospheric oxygen release, wetland macrophytes

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1155 Comparison of Cardiovascular and Metabolic Responses Following In-Water and On-Land Jump in Postmenopausal Women

Authors: Kuei-Yu Chien, Nai-Wen Kan, Wan-Chun Wu, Guo-Dong Ma, Shu-Chen Chen

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Purpose: The purpose of this study was to investigate the responses of systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), rating of perceived exertion (RPE) and lactate following continued high-intensity interval exercise in water and on land. The results of studies can be an exercise program design reference for health care and fitness professionals. Method: A total of 20 volunteer postmenopausal women was included in this study. The inclusion criteria were: duration of menopause > 1 year; and sedentary lifestyle, defined as engaging in moderate-intensity exercise less than three times per week, or less than 20 minutes per day. Participants need to visit experimental place three times. The first time visiting, body composition was performed and participant filled out the questionnaire. Participants were assigned randomly to the exercise environment (water or land) in second and third time visiting. Water exercise testing was under water of trochanter level. In continuing jump testing, each movement consisted 10-second maximum volunteer jump for two sets. 50% heart rate reserve dynamic resting (walking or running) for one minute was within each set. SBP, DBP, HR, RPE of whole body/thigh (RPEW/RPET) and lactate were performed at pre and post testing. HR, RPEW, and RPET were monitored after 1, 2, and 10 min of exercise testing. SBP and DBP were performed after 10 and 30 min of exercise testing. Results: The responses of SBP and DBP after exercise testing in water were higher than those on land. Lactate levels after exercise testing in water were lower than those on land. The responses of RPET were lower than those on land post exercise 1 and 2 minutes. The heart rate recovery in water was faster than those on land at post exercise 5 minutes. Conclusion: This study showed water interval jump exercise induces higher cardiovascular responses with lower RPE responses and lactate levels than on-land jumps exercise in postmenopausal women. Fatigue is one of the major reasons to obstruct exercise behavior. Jump exercise could enhance cardiorespiratory fitness, the lower-extremity power, strength, and bone mass. There are several health benefits to the middle to older adults. This study showed that water interval jumping could be more relaxed and not tried to reach the same land-based cardiorespiratory exercise intensity.

Keywords: interval exercise, power, recovery, fatigue

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1154 The Millennium Development Goals and Algerian Economic Policy: Some Evidences

Authors: Abdelkader Guendouz, Fatima Zohra Adel

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Even if both the economic and the human development are an axial pillar in its global policy, Algerian government seems to be more and more engaged in the international context aiming to reach of the so called millennium development goals, and this since its beginning. By looking closely at the Algerian economic policy, it is easy to mention the existence of several programs in which both economic and social realisations including among others, poverty reduction, enhancement of education level and conditions, woman statute and gender equity amelioration targets. The efforts of Algerian government in the field of these targets had been acheminated through three main plans, which are: -PSRE (Plan de Soutien à la Relance Economique), for the period of 2001 to 2004, initiated with about 7 billion US dollar, had been focused on three objectives, namely, poverty reduction, job creation and regional equilibrium with rural areas revitalization. -PCSC (le Programme complémentaire de soutien à la croissance économique), for the period of 2005 to 2009, with a starting funding of 114 billion US dollar. This program aims to develop public services and supporting public investments, especially in which concerns social infrastructures. Now, and at the end of the maturity of the MDGs agenda, an important question is to be asked: what are the main realizations regarding these MDGs? In order to answer this question, the present paper tries to examine the Algerian economic policy (but also the social one) by considering the MDGs challenges, for the period from 2000 to 2010, but also until 2015. This examination is focused on three main targets, namely poverty, education, and health. Firstly, statistical assessment for the Algerian economic and social situation shows that almost all MDGs had been reached during the period of 2000 to 2009 and it continues to maintain and improve them. This observation can be endorsed by invoking some achievements. Starting by the reduction of poverty, the proportion of population living with less than 1 US dollar per a day passed from 8.0 % in 2000 to 0.5 % in 2009, and 0.3 % in 2015. For education sphere, the enrolment ratio of six-year child, which is the most significant index for school attendance, is about 98 % for 2009 against 93 % in 1999, and only 43 % in 1966. Concluding with health care and relevant services; the Algerian government has accomplished big steps in providing easy access to this sector for the population. Moreover, the percentage of assisted accouchement had been raised from 91.2 % in 2000 to 97.2 % in 2009.

Keywords: Algerian economic policy, MDGs, poverty, education, health

Procedia PDF Downloads 239
1153 Variability of the Arbuscular Mycorrhizal Fungi Communities Associated with Wild Agraz Plants (Vaccinium meridionale Swartz) in the Colombian Andes

Authors: Gabriel Roveda-Hoyos, Margarita Ramirez-Gomez, Adrian Perez, Diana Paola Serralde

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The objective of this study was to determine the variability of arbuscular mycorrhizal fungi (HFMA) communities associated with wild agraz plants (Vaccinium meridionale Swartz) in the Colombian Andes. This species is one of the most promising fruits within the genus Vaccinium because of the high content of anthocyanins and antioxidants in its fruits, and like other species of the Ericaceae family, it depends on the association with HFM for its development in the natural environment. In this study, the presence of mycorrhizae in wild communities of V. meridionale was evaluated, and their relationship with the edaphic and climatic conditions of the study area was analyzed. Sampling was conducted in the rural area of the municipalities of Raquira, and Chiquinquira, Chia, and Tabio in the departments of Cundinamarca and Boyaca, Colombia. Seven sites were selected, and in each site, 5 plants were randomly selected, root and soil samples were taken from each plant in the rhizosphere zone for the quantification of colonization and the presence of spores. The samples were collected on different soils, taxonomic orders Entisols, Inceptisols, and Alfisols, located at altitudes between 2,600 and 3,000 above sea level in the Eastern Cordillera of Colombia. The physicochemical characteristics of the soil were compared with the density of spores and the percentage of presence of mycorrhizae in the roots and variables with the morphometric and physiological characteristics of the plants. Four types of mutual associations were found: arbuscular mycorrhizae, ectendomycorrhiza, ericoid mycorrhizae, and endophytic septate fungi. The main results obtained show a predominance of spores of the genera Glomus and Acaulsopora, in most of the soils analyzed. The spore density of Glomeromycete fungi in the soil varied considerably between the different sites; it was higher ( > 50 spores/g of dry soil) in soil samples with lower bulk density and higher content of organic matter; in these soils a higher cation exchange capacity was found, as well as of nitrogen, calcium, magnesium, manganese and zinc concentration. It can be concluded that Vaccinium meridionale is able to establish in a natural way, association with HFMA.

Keywords: Ericaceae, Arbuscular mycorrhizae, Andes, soils, Glomus sp.

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1152 Understanding the Coping Experience of Mothers with Childhood Trauma Histories: A Qualitative Study

Authors: Chan Yan Nok

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The present study is a qualitative study based on the coping experiences of six Hong Kong Chinese mothers who had childhood trauma from their first-person perspective. Expanding the perspective beyond the dominant discourse of “inter-generation transmission of trauma”, this study explores the experiences and meanings of child trauma embedded in their narratives through the process of thematic analysis and narrative analysis. The interviewees painted a nuanced picture of their process of coping and trauma resolution. First, acknowledgement; second, feel safe and start to tell the story of trauma; third, feel the feelings and expression of emotions; fourth, clarifying and coping with the impacts of trauma; fifth, integration and transformation; and sixth, using their new understanding of experience to have a better life. It was seen that there was no “end” within the process of trauma resolution. Instead, this is an ongoing process with positive healing trajectory. Analysis of the stories of the mothers revealed recurrent themes around continuous self-reflective awareness in the process of trauma coping. Rather than being necessarily negative and detrimental, childhood trauma could highlight the meanings of being a mother and reveal opportunities for continuous personal growth and self-enhancement. Utilizing the sense of inadequacy as a core driver in the trauma recovery process while developing a heightened awareness of the unfinished business embedded in their “automatic pattern” of behaviors, emotions, and thoughts can help these mothers become more flexible to formulate new methods in facing future predicaments. Future social work and parent education practices should help mothers deal with unresolved trauma, make sense of their impacts of childhood trauma and discover the growth embedded in the past traumatic experience. They should be facilitated in “acknowledging the reality of the trauma”, including understanding their complicated emotions arising from the traumatic experiences and voicing their struggles. In addition, helping these mothers to be aware of short-term and long-term trauma impacts (i.e., secondary responses to the trauma) and explore their effective coping strategies in “overcoming secondary responses to the trauma” are crucial for their future positive adjustment and transformation. Through affirming their coping abilities and lessons learnt from past experiences, mothers can reduce feelings of shame and powerlessness and enhance their parental capacity.

Keywords: childhood trauma, coping, mothers, self-awareness, self-reflection, trauma resolution

Procedia PDF Downloads 139
1151 The Effectiveness of Blended Learning in Pre-Registration Nurse Education: A Mixed Methods Systematic Review and Met Analysis

Authors: Albert Amagyei, Julia Carroll, Amanda R. Amorim Adegboye, Laura Strumidlo, Rosie Kneafsey

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Introduction: Classroom-based learning has persisted as the mainstream model of pre-registration nurse education. This model is often rigid, teacher-centered, and unable to support active learning and the practical learning needs of nursing students. Health Education England (HEE), a public body of the Department of Health and Social Care, hypothesises that blended learning (BL) programmes may address health system and nursing profession challenges, such as nursing shortages and lack of digital expertise, by exploring opportunities for providing predominantly online, remote-access study which may increase nursing student recruitment, offering alternate pathways to nursing other than the traditional classroom route. This study will provide evidence for blended learning strategies adopted in nursing education as well as examine nursing student learning experiences concerning the challenges and opportunities related to using blended learning within nursing education. Objective: This review will explore the challenges and opportunities of BL within pre-registration nurse education from the student's perspective. Methods: The search was completed within five databases. Eligible studies were appraised independently by four reviewers. The JBI-convergent segregated approach for mixed methods review was used to assess and synthesize the data. The study’s protocol has been registered with the International Register of Systematic Reviews with registration number// PROSPERO (CRD42023423532). Results: Twenty-seven (27) studies (21 quantitative and 6 qualitative) were included in the review. The study confirmed that BL positively impacts nursing students' learning outcomes, as demonstrated by the findings of the meta-analysis and meta-synthesis. Conclusion: The review compared BL to traditional learning, simulation, laboratory, and online learning on nursing students’ learning and programme outcomes as well as learning behaviour and experience. The results show that BL could effectively improve nursing students’ knowledge, academic achievement, critical skills, and clinical performance as well as enhance learner satisfaction and programme retention. The review findings outline that students’ background characteristics, BL design, and format significantly impact the success of the BL nursing programme.

Keywords: nursing student, blended learning, pre-registration nurse education, online learning

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1150 Antigen Stasis can Predispose Primary Ciliary Dyskinesia (PCD) Patients to Asthma

Authors: Nadzeya Marozkina, Joe Zein, Benjamin Gaston

Abstract:

Introduction: We have observed that many patients with Primary Ciliary Dyskinesia (PCD) benefit from asthma medications. In healthy airways, the ciliary function is normal. Antigens and irritants are rapidly cleared, and NO enters the gas phase normally to be exhaled. In the PCD airways, however, antigens, such as Dermatophagoides, are not as well cleared. This defect leads to oxidative stress, marked by increased DUOX1 expression and decreased superoxide dismutase [SOD] activity (manuscript under revision). H₂O₂, in high concentrations in the PCD airway, injures the airway. NO is oxidized rather than being exhaled, forming cytotoxic peroxynitrous acid. Thus, antigen stasis on PCD airway epithelium leads to airway injury and may predispose PCD patients to asthma. Indeed, recent population genetics suggest that PCD genes may be associated with asthma. We therefore hypothesized that PCD patients would be predisposed to having asthma. Methods. We analyzed our database of 18 million individual electronic medical records (EMRs) in the Indiana Network for Patient Care research database (INPCR). There is not an ICD10 code for PCD itself; code Q34.8 is most commonly used clinically. To validate analysis of this code, we queried patients who had an ICD10 code for both bronchiectasis and situs inversus totalis in INPCR. We also studied a validation cohort using the IBM Explorys® database (over 80 million individuals). Analyses were adjusted for age, sex and race using a 1 PCD: 3 controls matching method in INPCR and multivariable logistic regression in the IBM Explorys® database. Results. The prevalence of asthma ICD10 codes in subjects with a code Q34.8 was 67% vs 19% in controls (P < 0.0001) (Regenstrief Institute). Similarly, in IBM*Explorys, the OR [95% CI] for having asthma if a patient also had ICD10 code 34.8, relative to controls, was =4.04 [3.99; 4.09]. For situs inversus alone the OR [95% CI] was 4.42 [4.14; 4.71]; and bronchiectasis alone the OR [95% CI] =10.68 (10.56; 10.79). For both bronchiectasis and situs inversus together, the OR [95% CI] =28.80 (23.17; 35.81). Conclusions: PCD causes antigen stasis in the human airway (under review), likely predisposing to asthma in addition to oxidative and nitrosative stress and to airway injury. Here, we show that, by several different population-based metrics, and using two large databases, patients with PCD appear to have between a three- and 28-fold increased risk of having asthma. These data suggest that additional studies should be undertaken to understand the role of ciliary dysfunction in the pathogenesis and genetics of asthma. Decreased antigen clearance caused by ciliary dysfunction may be a risk factor for asthma development.

Keywords: antigen, PCD, asthma, nitric oxide

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1149 Differences in Guilt, Shame, Self-Anger, and Suicide Cognitions Based on Recent Suicide Ideation and Lifetime Suicide Attempt History

Authors: E. H. Szeto, E. Ammendola, J. V. Tabares, A. Starkey, J. Hay, J. G. McClung, C. J. Bryan

Abstract:

Introduction: Suicide is a leading cause of death globally, which accounts for more deaths annually than war, acquired immunodeficiency syndrome, homicides, and car accidents, while an estimated 140 million individuals have significant suicide ideation (SI) each year in the United States. Typical risk factors such as hopelessness, depression, and psychiatric disorders can predict suicide ideation but cannot distinguish between those who ideate from those who attempt suicide (SA). The Fluid Vulnerability Theory of suicide posits that a person’s activation of the suicidal mode is predicated on one’s predisposition, triggers, baseline/acute risk, and protective factors. The current study compares self-conscious cognitive-affective states (including guilt, shame, anger towards the self, and suicidal beliefs) among patients based on the endorsement of recent SI (i.e., past two weeks; acute risk) and lifetime SA (i.e., baseline risk). Method: A total of 2,722 individuals in an outpatient primary care setting were included in this cross-sectional, observational study; data for 2,584 were valid and retained for analysis. The Differential Emotions Scale measuring guilt, shame, and self-anger and the Suicide Cognitions Scale measuring suicide cognitions were administered. Results: A total of 2,222 individuals reported no recent SI or lifetime SA (Group 1), 161 reported recent SI only (Group 2), 145 reported lifetime SA only (Group 3), 56 reported both recent SI and lifetime SA (Group 4). The Kruskal-Wallis test showed that guilt, shame, self-anger, and suicide cognitions were the highest for Group 4 (both recent SI and lifetime SA), followed by Group 2 (recent SI-only), then Group 3 (lifetime SA-only), and lastly, Group 1 (no recent SI or lifetime SA). Conclusion: The results on recent SI-only versus lifetime SA-only contribute to the literature on the Fluid Vulnerability Theory of suicide by capturing SI and SA in two different time periods, which signify the acute risks and chronic baseline risks of the suicidal mode, respectively. It is also shown that: (a) people with a lifetime SA reported more severe symptoms than those without, (b) people with recent SI reported more severe symptoms than those without, and (c) people with both recent SI and lifetime SA were the most severely distressed. Future studies may replicate the findings here with other pertinent risk factors such as thwarted belongingness, perceived burdensomeness, and acquired capability, the last of which is consistently linked to attempting among ideators.

Keywords: suicide, guilt, shame, self-anger, suicide cognitions, suicide ideation, suicide attempt

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