Search results for: primary care physician
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7724

Search results for: primary care physician

1064 Efficacy and Safety of Updated Target Therapies for Treatment of Platinum-Resistant Recurrent Ovarian Cancer

Authors: John Hang Leung, Shyh-Yau Wang, Hei-Tung Yip, Fion, Ho Tsung-chin, Agnes LF Chan

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Objectives: Platinum-resistant ovarian cancer has a short overall survival of 9–12 months and limited treatment options. The combination of immunotherapy and targeted therapy appears to be a promising treatment option for patients with ovarian cancer, particularly to patients with platinum-resistant recurrent ovarian cancer (PRrOC). However, there are no direct head-to-head clinical trials comparing their efficacy and toxicity. We, therefore, used a network to directly and indirectly compare seven newer immunotherapies or targeted therapies combined with chemotherapy in platinum-resistant relapsed ovarian cancer, including antibody-drug conjugates, PD-1 (Programmed death-1) and PD-L1 (Programmed death-ligand 1), PARP (Poly ADP-ribose polymerase) inhibitors, TKIs (Tyrosine kinase inhibitors), and antiangiogenic agents. Methods: We searched PubMed (Public/Publisher MEDLINE), EMBASE (Excerpta Medica Database), and the Cochrane Library electronic databases for phase II and III trials involving PRrOC patients treated with immunotherapy or targeted therapy plus chemotherapy. The quality of included trials was assessed using the GRADE method. The primary outcomes compared were progression-free survival, the secondary outcomes were overall survival and safety. Results: Seven randomized controlled trials involving a total of 2058 PRrOC patients were included in this analysis. Bevacizumab plus chemotherapy showed statistically significant differences in PFS (Progression-free survival) but not OS (Overall survival) for all interested targets and immunotherapy regimens; however, according to the heatmap analysis, bevacizumab plus chemotherapy had a statistically significant risk of ≥grade 3 SAEs (Severe adverse effects), particularly hematological severe adverse events (neutropenia, anemia, leukopenia, and thrombocytopenia). Conclusions: Bevacizumab plus chemotherapy resulted in better PFS as compared with all interested regimens for the treatment of PRrOC. However, statistical differences in SAEs as bevacizumab plus chemotherapy is associated with a greater risk for hematological SAE.

Keywords: platinum-resistant recurrent ovarian cancer, network meta-analysis, immune checkpoint inhibitors, target therapy, antiangiogenic agents

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1063 Sukh Initiative: A Family Planning Reproductive Health Project for Squatter Settlement of Karachi, Pakistan

Authors: Arshad Hussain

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Background: Sukh Initiative is a multi-donor funded, family planning and reproductive health project, primed by Aman Healthcare Services; implemented through a consortium of local and international organizations, in a selected one million underserved peri-urban population of Karachi, Sindh; which aims at increasing modern contraceptive prevalence rate by 15 percentage point. Objective: To empower women to access contraception by increasing knowledge, improving quality of services and expanding the basket of choices; contributing to the goals of FP2020. Methods: A five years project has a multi-pronged approach with door to door services by LHWs and CHWs in an LHWs covered population and provision of quality FP/RH services both at public and private health care facilities. The project engages youth (12-16 years) both with community and at secondary schools to mentor them for responsible adulthood with life skilled base initiative. A 24/7 availability of youth and FP helpline service provides counselling, referrals in addition with a follow-up mechanism. Results: 131,810 MWRAs were reached by 191 community health workers through 29,693 of community support group meetings and 166,775 house hold visits. These MWRAs were counselled on FP related myths and misconception and referred to 216 providers trained for quality family planning services and maintaining average 64% quality scores in 43 public health and 35 private facilities in the project area. Of those referred 26% MWRAs opted modern contraception with 17.56% in LARCs and 41% PPFP as compared to baseline. Aman TeleHealth is linked with 24/7 counselling, referrals and post services follow-ups to clients, showing 14% proportion of FP call volume. Sukh has a unique role in engaging all partners on youth SRHR issues through family life education sessions, 30 higher sec. schools in Sukh area have been provided LSBE to 16,000 students (aged 15-17), and in community approximately 10, 496 girls and boys have received SRHR information. Conclusion: Through individual counselling, access to quality family planning services and involvement of stakeholders, Suk created an enabling environment to rapid increase in family planning in the project intervention area.

Keywords: family planning and reproductive health, married women with reproductive age, urban squatter, Pakistan

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1062 The Risk of Deaths from Viral Hepatitis among the Female Workers in the Beauty Service Industry

Authors: Byeongju Choi, Sanggil Lee, Kyung-Eun Lee

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Introduction: In the republic of Korea, the number of workers in the beauty industry has been increasing. Because the prevalence of hepatitis B carriers in Korea is higher than in other countries, the risk of blood-borne infection including viral hepatitis B and C, among the workers by using the sharp and contaminated instruments during procedure can be expected among beauty salon workers. However, the health care policies for the workers to prevent the blood-borne infection are not established due to the lack of evidences. Moreover, the workers in hair and nail salon were mostly employed at small businesses, where national mandatory systems or policies for workers’ health management are not applied. In this study, the risk of the viral hepatitis B and C from the job experiencing the hair and nail procedures in the mortality was assessed. Method: We conducted a retrospective review of the job histories and causes of death in the female deaths from 2006-2016. 132,744 of female deaths who had one more job experiences during their lifetime were included in this study. Job histories were assessed using the employment insurance database in Korea Employment Information Service (KEIS) and the causes of death were in death statistics produced by Statistics Korea. Case group (n= 666) who died from viral hepatitis was classified the death having record involved in ‘B15-B19’ as a cause of deaths based on Korean Standard Classification of Diseases(KCD) with the deaths from other causes, control group (n=132,078). The group of the workers in the beauty service industry were defined as the employees who had ever worked in the industry coded as ‘9611’ based on Korea Standard Industry Classification (KSIC) and others were others. Other than job histories, birth year, marital status, education level were investigated from the death statistics. Multiple logistic regression analysis were used to assess the risk of deaths from viral hepatitis in the case and control group. Result: The number of the deaths having ever job experiences at the hair and nail salon was 255. After adjusting confounders of age, marital status and education, the odds ratio(OR) for deaths from viral hepatitis was quite high in the group having experiences with working in the beauty service industry with 3.14(95% confidence interval(CI) 1.00-9.87). Other associated factors with increasing the risk of deaths from viral hepatitis were low education level(OR=1.34, 95% CI 1.04-1.73), married women (OR=1.42, 95% CI 1.02-1.97). Conclusion: The risk of deaths from viral hepatitis were high in the workers in the beauty service industry but not statistically significant, which might attributed from the small number of workers in beauty service industry. It was likely that the number of workers in beauty service industry could be underestimated due to their temporary job position. Further studies evaluating the status and the incidence of viral infection among the workers with consideration of the vertical transmission would be required.

Keywords: beauty service, viral hepatitis, blood-borne infection, viral infection

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1061 Psychotherapeutic Narratives and the Importance of Truth

Authors: Spencer Jay Knafelc

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Some mental health practitioners and theorists have suggested that we approach remedying psychological problems by centering and intervening upon patients’ narrations. Such theorists and their corresponding therapeutic approaches see persons as narrators of their lives, where the stories they tell constitute and reflect their sense-making of the world. Psychological problems, according to these approaches to therapy, are often the result of problematic narratives. The solution is the construction of more salubrious narratives through therapy. There is trouble lurking within the history of these narrative approaches. These thinkers tend to denigrate the importance of truth, insisting that narratives are not to be thought of as aiming at truth, and thus the truth of our self-narratives is not important. There are multiple motivations for the tendency to eschew truth’s importance within the tradition of narrative approaches to therapy. The most plausible and interesting motivation comes from the observation that, in general, all dominant approaches to therapy are equally effective. The theoretical commitments of each approach are quite different and are often ostensibly incompatible (psychodynamic therapists see psychological problems as resulting from unconscious conflict and repressed desires, Cognitive-Behavioral approaches see them as resulting from distorted cognitions). This strongly suggests that there must be some cases in which therapeutic efficacy does not depend on truth and that insisting that patient’s therapeutic narratives be true in all instances is a mistake. Lewis’ solution is to suggest that narratives are metaphors. Lewis’ account appreciates that there are many ways to tell a story and that many different approaches to mental health treatment can be appropriate without committing us to any contradictions, providing us with an ostensibly coherent way to treat narratives as non-literal, instead of seeing them as tools that can be more or less apt. Here, it is argued that Lewis’ metaphor approach fails. Narratives do not have the right kind of structure to be metaphors. Still, another way to understand Lewis’ view might be that self-narratives, especially when articulated in the language of any specific approach, should not be taken literally. This is an idea at the core of the narrative theorists’ tendency to eschew the importance of the ordinary understanding of truth. This very tendency will be critiqued. The view defended in this paper more accurately captures the nature of self-narratives. The truth of one’s self-narrative is important. Not only do people care about having the right conception of their abilities, who they are, and the way the world is, but self-narratives are composed of beliefs, and the nature of belief is to aim at truth. This view also allows the recognition of the importance of developing accurate representations of oneself and reality for one’s psychological well-being. It is also argued that in many cases, truth factors in as a mechanism of change over the course of therapy. Therapeutic benefit can be achieved by coming to have a better understanding of the nature of oneself and the world. Finally, the view defended here allows for the recognition of the nature of the tension between values: truth and efficacy. It is better to recognize this tension and develop strategies to navigate it as opposed to insisting that it doesn’t exist.

Keywords: philosophy, narrative, psychotherapy, truth

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1060 Understanding the Underutilization of Electroconvulsive Therapy in Children and Adolescents

Authors: Carlos M. Goncalves, Luisa Duarte, Teresa Cartaxo

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The aim of this work was to understand the reasons behind the underutilization of electroconvulsive therapy (ECT) in the younger population and raise possible solutions. We conducted a non-systematic review of literature throughout a search on PubMed, using the terms ‘children’, ‘adolescents’ and ‘electroconvulsive’, ‘therapy’. Candidate articles written in languages other than English were excluded. Articles were selected according to title and/or abstract’s content relevance, resulting in a total of 5 articles. ECT is a recognized effective treatment in adults for several psychiatric conditions. As in adults, ECT in children and adolescents is proven most beneficial in the treatment of severe mood disorders, catatonia, and, to a lesser extent, schizophrenia. ECT in adults has also been used to treat autism’s self-injurious behaviours, Tourette’s syndrome and resistant first-episode schizophrenia disorder. Despite growing evidence on its safety and effectiveness in children and adolescents, like those found in adults, ECT remains a controversial and underused treatment in patients this age, even when it is clearly indicated. There are various possible reasons to this; limited awareness among professionals (lack of knowledge and experience among child psychiatrists), stigmatic public opinion (despite positive feedback from patients and families, there is an unfavourable and inaccurate representation in the media, contributing to a negative public opinion), legal restrictions and ethical controversies (restrictive regulations such as a minimum age for administration), lack of randomized trials (the currently available studies are retrospective, with small size samples, and most of the publications are either case reports or case series). This shows the need to raise awareness and knowledge, not only for mental health professionals, but also to the general population, through the media, regarding indications, methods and safety of ECT in order to provide reliable information to the patient and families. Large-scale longitudinal studies are also useful to further demonstrate the efficacy and safety of ECT and can aid in the formulation of algorithms and guidelines as without these changes, the availability of ECT to the younger population will remain restricted by regulations and social stigma. In conclusion, these results highlight that lack of adequate knowledge and accurate information are the most important factors behind the underutilization of ECT in younger population. Mental healthcare professionals occupy a cornerstone position; if data is given by a well-informed healthcare professional instead of the media, general population (including patients and their families) will probably regard the procedure in a more favourable way. So, the starting point should be to improve health care professional’s knowledge and experience on this choice of treatment.

Keywords: adolescents, children, electroconvulsive, therapy

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1059 The Situation of Transgender Individuals Was Worsened During Covid-19

Authors: Kajal Attri

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Introduction: Transgender people are considered third gender in India, although they still face identification issues and alienated from society. Furthermore, they face several challenges, including discrimination in employment, resources, education, and property as a result, most transgender people make a living through begging at traffic lights, trains, and buses; attending auspicious occasions such as childbirth and weddings; and engaging in sex work, which includes both home-based and street-based sex work. During COVID-19, maintaining social distance exacerbates transgender people's circumstances and prevents them from accessing health care services, sexual reassignment surgery, identity-based resources, government security, and financial stability. Nonetheless, the pandemic raised unfavorable attitudes about transgender persons, such as unsupportive family members and trouble forming emotional relationships. This study focuses on how we missed transgender people during COVID-19 to provide better facilities to cope with this situation when they are already the most vulnerable segment of the society. Methodology: The research was conducted using secondary data from published publications and grey literature obtained from four databases: Pubmed, Psychinfo, Science direct, and Google scholar. The literature included total 25 articles that met the inclusion criteria for a review. Result and Discussion: Transgender people, who are considered the most vulnerable sector of society, have already faced several obstacles as a result of the outbreak. The analysis underscores the difficulties that transgender persons faced during COVID-19, such as, They had trouble accessing the government's social security programmes during the lockdown, which provide rations and pensions since they lack the necessary identifying cards. The impact of COVID-19 leaves transgender people at heightened risk of poverty and ill health because they exist on the margins of society, those livelihood base on sex work, begging, and participation on auspicious occasions. They had a significant risk of contracting SARS-CoV2 because they lived in congested areas or did not have permanent shelter, and they were predominantly infected with HIV, cancer, and other non-communicable illnesses. The pandemic raised unfavorable attitudes about transgender persons, such as unsupportive family members and trouble forming emotional relationships. Conclusion: The study comes forward with useful suggestions based on content analysis and information to reduce the existing woes of transgenders during any pandemic like COVID-19.

Keywords: COVID-19, transgender, lockdown, transwomen, stigmatization

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1058 Ambivilance, Denial, and Adaptive Responses to Vulnerable Suspects in Police Custody: The New Limits of the Sovereign State

Authors: Faye Cosgrove, Donna Peacock

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This paper examines current state strategies for dealing with vulnerable people in police custody and identifies the underpinning discourses and practices which inform these strategies. It has previously been argued that the state has utilised contradictory and conflicting responses to the control of crime, by employing opposing strategies of denial and adaptation in order to simultaneously both display sovereignty and disclaim responsibility. This paper argues that these contradictory strategies are still being employed in contemporary criminal justice, although the focus and the purpose have now shifted. The focus is upon the ‘vulnerable’ suspect, whose social identity is as incongruous, complex and contradictory as his social environment, and the purpose is to redirect attention away from negative state practices, whilst simultaneously displaying a compassionate and benevolent countenance in order to appeal to the voting public. The findings presented here result from intensive qualitative research with police officers, with health care professionals, and with civilian volunteers who work within police custodial environments. The data has been gathered over a three-year period and includes observational and interview data which has been thematically analysed to expose the underpinning mechanisms from which the properties of the system emerge. What is revealed is evidence of contemporary state practices of denial relating to the harms of austerity and the structural relations of vulnerability, whilst simultaneously adapting through processes of ‘othering’ of the vulnerable, ‘responsibilisation’ of citizens, defining deviance down through diversionary practices, and managing success through redefining the aims of the system. The ‘vulnerable’ suspect is subject to individual pathologising, and yet the nature of risk is aggregated. ‘Vulnerable’ suspects are supported in police custody by private citizens, by multi-agency partnerships, and by for-profit organisations, while the state seeks to collate and control services, and thereby to retain a veneer of control. Late modern ambivalence to crime control and the associated contradictory practices of abjuration and adjustment have extended to state responses to vulnerable suspects. The support available in the custody environment operates to control and minimise operational and procedural risk, rather than for the welfare of the detained person, and in fact, the support available is discovered to be detrimental to the very people that it claims to benefit. The ‘vulnerable’ suspect is now subject to the bifurcated logics employed at the new limits of the sovereign state.

Keywords: custody, policing, sovereign state, vulnerability

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1057 Sympatric Calanus Species: A High Temporal Resolution of Reproductive Timing and Stage Composition

Authors: Mads Schultz, Galice Hoarau, Marvin Choquet

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Members of the genus Calanus are key species in the North Atlantic and Arctic marine ecosystems due to their vast abundance and their ability to accumulate high amounts of lipid. As a link between primary producers and higher trophic levels, the temporal presence of each Calanus species is important in a time of changing communities and northward distribution shifts. This study focused on the temporal niches of the sympatric species Calanus helgolandicus, Calanus finmarchicus, Calanus glacialis, and Calanus hyperboreus in Skjerstad fjord, a Norwegian fjord (67˚14’N, 14 ˚44’E). Three depth intervals were sampled monthly over a year, targeting copepodite stages of the genus Calanus. Species determination was carried out genetically using insertion/deletion markers. In addition, during the reproductive season (Jan-May), weekly samples of the upper 50 meters of the water column targeting nauplii and 5 depth intervals targeting copepodites were collected. Nauplii samples were sorted into two groups (NI-NIII and NIV-NVI), and species were genetically identified. Specimens from stage CIV to adults from each depth interval of copepodite sampling were photographed in order to generate a supporting timeline of visual traits, including gonad maturation stage, presence of stomach content, and total lipid content. The most abundant species were Calanus finmarchicus and Calanus glacialis, followed by Calanus hyperboreus. These species were present in the water column throughout the year, whereas Calanus helgolandicus, the least abundant species, was only present during the summer and autumn period. Each species showed distinct temporal niches, with Calanus finmarchicus occupying the upper 50 meters longer than any of the other species. Calanus hyperboreus dominates in abundance early in the spring but are outnumbered by Calanus glacialis and Calanus finmarchicus after spring bloom sets in. In Skjerstad fjord, Calanus hyperboreus is a clear capital breeder with a long period of nauplii presence before the spring bloom. Calanus glacialis and Calanus finmarchicus both utilize income breeding, with Calanus glacialis developing to the larger nauplii stages quicker than Calanus finmarchicus, but also having a shorter reproduction period. Indeed, the “traditional Arctic” species Calanus hyperboreus and Calanus glacialis appear to end their reproduction period earlier than the North Atlantic Calanus finmarchicus.

Keywords: calanus, depth distribution, reproduction, stage composition, temporal niches

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1056 Influence of CO₂ on the Curing of Permeable Concrete

Authors: A. M. Merino-Lechuga, A. González-Caro, D. Suescum-Morales, E. Fernández-Ledesma, J. R. Jiménez, J. M. Fernández-Rodriguez

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Since the mid-19th century, the boom in the economy and industry has grown exponentially. This has led to an increase in pollution due to rising Greenhouse Gas (GHG) emissions and the accumulation of waste, leading to an increasingly imminent future scarcity of raw materials and natural resources. Carbon dioxide (CO₂) is one of the primary greenhouse gases, accounting for up to 55% of Greenhouse Gas (GHG) emissions. The manufacturing of construction materials generates approximately 73% of CO₂ emissions, with Portland cement production contributing to 41% of this figure. Hence, there is scientific and social alarm regarding the carbon footprint of construction materials and their influence on climate change. Carbonation of concrete is a natural process whereby CO₂ from the environment penetrates the material, primarily through pores and microcracks. Once inside, carbon dioxide reacts with calcium hydroxide (Ca(OH)2) and/or CSH, yielding calcium carbonates (CaCO3) and silica gel. Consequently, construction materials act as carbon sinks. This research investigated the effect of accelerated carbonation on the physical, mechanical, and chemical properties of two types of non-structural vibrated concrete pavers (conventional and draining) made from natural aggregates and two types of recycled aggregates from construction and demolition waste (CDW). Natural aggregates were replaced by recycled aggregates using a volumetric substitution method, and the CO₂ capture capacity was calculated. Two curing environments were utilized: a carbonation chamber with 5% CO₂ and a standard climatic chamber with atmospheric CO₂ concentration. Additionally, the effect of curing times of 1, 3, 7, 14, and 28 days on concrete properties was analyzed. Accelerated carbonation in-creased the apparent dry density, reduced water-accessible porosity, improved compressive strength, and decreased setting time to achieve greater mechanical strength. The maximum CO₂ capture ratio was achieved with the use of recycled concrete aggregate (52.52 kg/t) in the draining paver. Accelerated carbonation conditions led to a 525% increase in carbon capture compared to curing under atmospheric conditions. Accelerated carbonation of cement-based products containing recycled aggregates from construction and demolition waste is a promising technology for CO₂ capture and utilization, offering a means to mitigate the effects of climate change and promote the new paradigm of circular economy.

Keywords: accelerated carbonation, CO₂ curing, CO₂ uptake and construction and demolition waste., circular economy

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1055 The Positive Impact of COVID-19 on the Level of Investments of U.S. Retail Investors: Evidence from a Quantitative Online Survey and Ordered Probit Analysis

Authors: Corina E. Niculaescu, Ivan Sangiorgi, Adrian R. Bell

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The COVID-19 pandemic has been life-changing in many aspects of people’s daily and social lives, but has it also changed attitudes towards investments? This paper explores the effect of the COVID-19 pandemic on retail investors’ levels of investments in the U.S. during the first COVID-19 wave in summer 2020. This is an unprecedented health crisis, which could lead to changes in investment behavior, including irrational behavior in retail investors. As such, this study aims to inform policymakers of what happened to investment decisions during the COVID-19 pandemic so that they can protect retail investors during extreme events like a global health crisis. The study aims to answer two research questions. First, was the level of investments affected by the COVID-19 pandemic, and if so, why? Second, how were investments affected by retail investors’ personal experience with COVID-19? The research analysis is based on primary survey data collected on the Amazon Mechanical Turk platform from a representative sample of U.S. respondents. Responses were collected between the 15th of July and 28th of August 2020 from 1,148 U.S. retail investors who hold mutual fund investments and a savings account. The research explores whether being affected by COVID-19, change in the level of savings, and risk capacity can explain the change in the level of investments by using regression analysis. The dependent variable is changed in investments measured as decrease, no change, and increase. For this reason, the methodology used is ordered probit regression models. The results show that retail investors in the U.S. increased their investments during the first wave of COVID-19, which is unexpected as investors are usually more cautious in crisis times. Moreover, the study finds that those who were affected personally by COVID-19 (e.g., tested positive) were more likely to increase their investments, which is irrational behavior and contradicts expectations. An increase in the level of savings and risk capacity was also associated with increased investments. Overall, the findings show that having personal experience with a health crisis can have an impact on one’s investment decisions as well. Those findings are important for both retail investors and policymakers, especially now that online trading platforms have made trading easily accessible to everyone. There are risks and potential irrational behaviors associated with investment decisions during times of crisis, and it is important that retail investors are aware of them before making financial decisions.

Keywords: COVID-19, financial decision-making, health crisis retail investors, survey

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1054 Ethiopia as a Tourist Destination: An Exploration of Italian Tourists’ Market Demand

Authors: Frezer Okubay Weldegebriel

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The tourism sector in Ethiopia plays a significant role in the national economy. The government is granting its pledge and readiness to develop this sector through various initiatives since to eradicate poverty and encourage economic development of the country is one of the Millennium Development plans. The tourism sector has been identified as one of the priority economic sectors by many countries, and the Government of Ethiopia has planned to make Ethiopia among the top five African destinations by 2020. Nevertheless, the international tourism demand for Ethiopia currently lags behind other African countries such as South Africa, Egypt, Morocco, Tanzania, and Kenya. Meanwhile, the number of international tourists’ arrival in Ethiopia is recently increasing even if it cannot be competitive with other African countries. Therefore, to offer demand-driven tourism products, the Ethiopian government, Tourism planners, Tour & Travel operators need to understand the important factors, which affect international tourists’ decision to visit Ethiopian destinations. This study was intended to analyze Italian Tourists Demand towards Ethiopian destination. The researcher aimed to identify the demand for Italian tourists’ preference to Ethiopian destinations comparing to the top East African countries. This study uses both qualitative and quantitative research methodology, and the data is manipulating through primary data collection method using questionnaires, interviews, and secondary data by reviewing books, journals, magazines, past researches, and websites. An active and potential Italian tourist cohort, five well-functioning tour operators based in Ethiopia for Italian tourists and professionals from Ethiopian Ministry of Tourism and Culture participated. Based on the analysis of the data collected through the questionnaire, interviews, and reviews of different materials, the study disclosed that the majority of Italian tourists have a high demand on Ethiopian Tourist destination. Historical and cultural interest, safety and security, the hospitality of the people and affordable accommodation coast are the main reason for them. However, some Italian tourists prefer to visit Kenya, Tanzania, and Uganda due to the fact that they are fascinated by adventure, safari and beaches, while Ethiopia cannot provide these attractions. Most Italian tourists have little information and practical experiences on Ethiopian tourism possibilities via a tour and travel companies. Moreover, the insufficient marketing campaign and promotion by Ethiopian Government and Ministry of Tourism could also contribute to the failure of Ethiopian tourism.

Keywords: The demand of Italian tourists, Ethiopia economy, Ethiopia tourism destination, promoting Ethiopia tourism

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1053 Role of Yeast-Based Bioadditive on Controlling Lignin Inhibition in Anaerobic Digestion Process

Authors: Ogemdi Chinwendu Anika, Anna Strzelecka, Yadira Bajón-Fernández, Raffaella Villa

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Anaerobic digestion (AD) has been used since time in memorial to take care of organic wastes in the environment, especially for sewage and wastewater treatments. Recently, the rising demand/need to increase renewable energy from organic matter has caused the AD substrates spectrum to expand and include a wider variety of organic materials such as agricultural residues and farm manure which is annually generated at around 140 billion metric tons globally. The problem, however, is that agricultural wastes are composed of materials that are heterogeneous and too difficult to degrade -particularly lignin, that make up about 0–40% of the total lignocellulose content. This study aimed to evaluate the impact of varying concentrations of lignin on biogas yields and their subsequent response to a commercial yeast-based bioadditive in batch anaerobic digesters. The experiments were carried out in batches for a retention time of 56 days with different lignin concentrations (200 mg, 300 mg, 400 mg, 500 mg, and 600 mg) treated to different conditions to first determine the concentration of the bioadditive that was most optimal for overall process improvement and yields increase. The batch experiments were set up using 130 mL bottles with a working volume of 60mL, maintained at 38°C in an incubator shaker (150rpm). Digestate obtained from a local plant operating at mesophilic conditions was used as the starting inoculum, and commercial kraft lignin was used as feedstock. Biogas measurements were carried out using the displacement method and were corrected to standard temperature and pressure using standard gas equations. Furthermore, the modified Gompertz equation model was used to non-linearly regress the resulting data to estimate gas production potential, production rates, and the duration of lag phases as indicatives of degrees of lignin inhibition. The results showed that lignin had a strong inhibitory effect on the AD process, and the higher the lignin concentration, the more the inhibition. Also, the modelling showed that the rates of gas production were influenced by the concentrations of the lignin substrate added to the system – the higher the lignin concentrations in mg (0, 200, 300, 400, 500, and 600) the lower the respective rate of gas production in ml/gVS.day (3.3, 2.2, 2.3, 1.6, 1.3, and 1.1), although the 300 mg increased by 0.1 ml/gVS.day over that of the 200 mg. The impact of the yeast-based bioaddition on the rate of production was most significant in the 400 mg and 500 mg as the rate was improved by 0.1 ml/gVS.day and 0.2 ml/gVS.day respectively. This indicates that agricultural residues with higher lignin content may be more responsive to inhibition alleviation by yeast-based bioadditive; therefore, further study on its application to the AD of agricultural residues of high lignin content will be the next step in this research.

Keywords: anaerobic digestion, renewable energy, lignin valorisation, biogas

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1052 Influence of Variable Calcium Content on Mechanical Properties of Geopolymer Synthesized at Different Temperature and Moisture Conditions

Authors: Suraj D. Khadka, Priyantha W. Jayawickrama

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In search of a sustainable construction material, geopolymer has been investigated for past decades to evaluate its advantage over conventional products. Synthesis of geopolymer requires a source of aluminosilicate mixed with sodium hydroxide and sodium silicate at different proportions to maintain a Si/Al molar ratio of 1-3 and Na/Al molar ratio of unity. A comprehensive geopolymer study was performed with Metakaolin and Class C Fly ash as primary aluminosilicate sources. Synthesized geopolymer was analyzed for time-dependent viscosity, setting period and strength at varying initial moisture content, curing temperature and humidity. Different concentration of Ca(OH)₂ and CaSO₄.2H₂O were added to vary the amount of calcium contained in synthesized geopolymer. Influence of calcium content in unconfined compressive strength behavior of geopolymer were analyzed. Finally, Scanning Electron Microscopy-Energy Dispersive Spectroscopy (SEM-EDS) was performed to investigate the hardened product. It was observed that fly ash based geopolymer had shortened setting time and faster increase in viscosity as compared to geopolymer synthesized from metakaolin. This was primarily attributed to higher calcium content resulting in formation of calcium silicate hydrates (CSH). SEM-EDS was performed to verify the presence of CSH phases. Spectral analysis of geopolymer prepared by addition of Ca(OH)₂ and CaSO₄.2H₂O indicated higher CSH phases at higher concentration. It was observed that lower concentration of added calcium favored strength gain in geopolymer. However, at higher calcium concentration, decrease in strength was observed. Strength variation was also observed with humidity at initial curing condition. At 100% humidity, geopolymer with added calcium presented higher strength compared to samples cured at ambient humidity condition (40%). Reduction in strength in these samples at lower humidity was primarily attributed to reduction in moisture content in specimen due to the formation of CSH phases and loss of moisture through evaporation. For low calcium content geopolymers, with increase in temperature, gain in strength was observed with maximum strength observed at 200 ˚C. However, samples with higher calcium content demonstrated severe cracking resulting in low strength at elevated temperatures.

Keywords: calcium silicate hydrates, geopolymer, humidity, Scanning Electron Microscopy-Energy Dispersive Spectroscopy, unconfined compressive strength

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1051 Autonomy in Pregnancy and Childbirth: The Next Frontier of Maternal Health Rights Advocacy

Authors: Alejandra Cardenas, Ona Flores, Fabiola Gretzinger

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Since the 1990s, legal strategies for the promotion and protection of maternal health rights have achieved significant gains. Successful litigation in courts around the world have shown that these rights can be judicially enforceable. Governments and international organizations have acknowledged the importance of a human rights-based approach to maternal mortality and morbidity, and obstetric violence has been recognized as a human rights issue. Despite the progress made, maternal mortality has worsened in some regions of the world, while progress has stagnated elsewhere, and mistreatment in maternal care is reported almost universally. In this context, issues of maternal autonomy and decision-making during pregnancy, labor, and delivery as a critical barrier to access quality maternal health have been largely overlooked. Indeed, despite the principles of autonomy and informed consent in medical interventions being well-established in international and regional norms, how they are applied particularly during childbirth and pregnancy remains underdeveloped. National and global legal standards and decisions related to maternal health were reviewed and analyzed to determine how maternal autonomy and decision-making during pregnancy, labor, and delivery have been protected (or not) by international and national courts. The results of this legal research and analysis lead to the conclusion that a few standards have been set by courts regarding pregnant people’s rights to make choices during pregnancy and birth; however, most undermine the agency of pregnant people. These decisions recognize obstetric violence and gender-based discrimination, but fail to protect pregnant people’s autonomy, privacy, and their right to informed consent. As current human rights standards stand today, maternal health is the only field in medicine and law in which informed consent can be overridden, and patients can be forced to submit to treatments against their will. Unconsented treatment and loss of agency during pregnancy and childbirth can have long-term physical and mental impacts, reduce satisfaction and trust in health systems, and may deter future health-seeking behaviors. This research proposes a path forward that focuses on the pregnant person as an independent agent, relying on the doctrine of self-determination during pregnancy and childbirth, which includes access to the necessary conditions to enable autonomy and choice throughout pregnancy and childbirth as a critical step towards our approaches to reduce maternal mortality, morbidity, and mistreatment, and realize the promise of access to quality maternal health as a human right.

Keywords: autonomy in childbirth and pregnancy, choice, informed consent, jurisprudential analysis

Procedia PDF Downloads 48
1050 The Importance of Entrepreneurship for National Economy: Evaluation of Developed and Least Developed Countries

Authors: Adnan Celik

Abstract:

Entrepreneurs are people who attempt to do a business and do not hesitate to do so. They are involved in the production of economic goods and services through factors of production. They also find the financial resources necessary for production and the markets where the production will be evaluated. After all, they create economic values. The main function of the entrepreneur in contemporary societies is to realize innovations. From this point, the power of the modern entrepreneur is based on her/his capacity to innovate and transform his innovations into tangible commercial products. In this context, the concept of an entrepreneur is used to mean the person or persons who constantly innovate. Successful entrepreneurs take on the role of the locomotive in the development of their countries. They support economic development with their activities. In addition to production and marketing activities, it also has important contributions to employment. Along with the development of the country, they also try to make the income distribution more balanced. Especially developed country entrepreneurs intensely perform the following functions; “to produce new goods and services or to increase the quality and quality of known goods and services; ability to develop and apply new production methods; establishing new organizations in the industry; reach new markets; to find new sources from which raw materials and similar materials can be obtained”. Entrepreneurs who fully implement business functions are easier to achieve economic efficiency. Thus, they provide great advantages to the business and the national economy. Successful entrepreneurs are people who make money by creating economic values. These revenues are; on the one hand, it is distributed to individuals in the business as wages, premiums, or dividends; It is also used in the growth of companies. Thus, employees, managers, entrepreneurs and the whole country can benefit greatly. In the least developed countries, the guiding effect of traditional value patterns on individuals' attitudes and behaviors varies depending on the socio-economic characteristics of individuals. It is normal for an entrepreneur with a low level of education, who was brought up in a traditional structure, to behave in accordance with traditional value patterns. In fact, this is the primary problem of all countries in the development effort. The solution to this problem will be possible by giving the necessary importance to the social dimension as well as the technical dimension of development. This study mainly focuses on the importance of entrepreneurship for the national economy. This issue has been handled separately in terms of developed and least developed countries. As a result of the study, entrepreneurship suggestions were made, especially to least developed countries, with the goal of national economy and development.

Keywords: entrepreneur, entrepreneurship, national economy, entrepreneurship in developed and least developed countries

Procedia PDF Downloads 132
1049 Improvement in Oral Health-Related Quality of Life of Adult Patients After Rehabilitation With Partial Dentures: A Systematic Review and Meta-Analysis

Authors: Adama NS Bah

Abstract:

Background: Loss of teeth has a negative influence on essential oral functions such as phonetics, mastication, and aesthetics. Dentists treat people with prosthodontic rehabilitation to recover essential oral functions. The oral health quality of life inventory reflects the success of prosthodontic rehabilitation. In many countries, the current conventional care delivered to replace missing teeth for adult patients involves the provision of removable partial dentures. Aim: The aim of this systematic review and meta-analysis is to gather the best available evidence to determine patients’ oral health-related quality of life improvement after treatment with partial dentures. Methods: We searched electronic databases from January 2010 to September 2019, including PubMed, ProQuest, Science Direct, Scopus and Google Scholar. In this paper, studies were included only if the average age was 30 years and above and also published in English. Two reviewers independently screened and selected all the references based on inclusion criteria using the PRISMA guideline, and assessed the quality of the included references using the Joanna Briggs Institute quality assessment tools. Data extracted were analyzed in RevMan 5.0 software, the heterogeneity between the studies was assessed using Forest plot, I2 statistics and chi-square test with a statistical P value less than 0.05 to indicate statistical significance. Random effect models were used in case of moderate or high heterogeneity. Four studies were included in the systematic review and three studies were pooled for meta-analysis. Results: Four studies included in the systematic review and three studies included in the meta-analysis with a total of 285 patients comparing the improvement in oral health-related quality of life before and after rehabilitation with partial denture, the pooled results showed a better improvement of oral health-related quality of life after treatment with partial dentures (mean difference 5.25; 95% CI [3.81, 6.68], p < 0.00001) favoring the wearing of partial dentures. In order to ascertain the reliability of the included studies for meta-analysis risk of bias was assessed and found to be low in all included studies for meta-analysis using the Cochrane collaboration tool for risk of bias assessment. Conclusion: There is high evidence that rehabilitation with partial dentures can improve the patient’s oral health-related quality of life measured with Oral Health Impact Profile 14. This review has clinical evidence value for dentists treating the expanding vulnerable adult population.

Keywords: meta-analysis, oral health impact profile, partial dentures, systematic review

Procedia PDF Downloads 99
1048 The Psychological Effects of Nature on Subjective Well-Being: An Experimental Approach

Authors: Tatjana Kochetkova

Abstract:

This paper explores the pivotal role of environmental education, specifically outdoor education, in facilitating a psychological connection to nature among young adults. This research aims to contribute to building an empirical and conceptual basis of ecopsychology by providing a picture of psyche-nature interaction. It presents the results of the four-day connection-to-nature workshop. It intends to find out the effects of the awareness of nature on subjective well-being and perception of the meaning of life. This led to finding a battery-recharging effect of nature and the influence of nature at four levels of awareness: external physical perception, internal (bodily) sensation, emotions, and existential meaning. The research on the psychological bond of humans with the natural environment, the subject of ecopsychology, is still in its infancy. However, despite several courageous and fruitful attempts, there are still no direct answers to the fundamental questions about the way in which the natural environment influences humans and the specific role of nature in the human psyche. The urge to address this question was the primary reason for the current experiment. The methodology of this study was taken from the study of Patterson, and from White and Hendee. The methodology included a series of assignments on the perception of nature (the exercises are described in the attachment). Experiences were noted in a personal diary, which we used later for analysis. There are many trustworthy claims that contact with nature has positive effects on human subjective well-being and that it is of essential psychological and spiritual value. But, there is a need for more support and theoretical explanation for this phenomenon. As a contribution to filling these gaps, this qualitative study was conducted. The aim of this study is to explore the psychological effects of short-term awareness of wilderness on one’s subjective well-being and on one’s sense of the meaning of life. This specific study is based on the more general hypothesis that there are positive relationships between the experience of wilderness and the development of the self, feelings of community, and spiritual development. It restricted the study of the psychological effects of short term stay in nature to two variables (subjective well-being and the sense of meaning of life). The study aimed at (i) testing the hypothesis that there are positive effects of the awareness of wilderness on the subjective sense of well-being and meaning in life, (ii) understanding the nature of the psychological need for wilderness. Although there is a substantial amount of data on the psychological benefits of nature, we still lack a theory that explains the findings. The present research aims to contribute to such a theory. This is an experiment aimed specifically at the effects of nature on the sense of well-being and meaning in life.

Keywords: environmental education, psychological connection to nature, subjective well-being, symbolic meaning of nature, emotional reaction to nature, meaning of life

Procedia PDF Downloads 67
1047 Resilience of the American Agriculture Sector

Authors: Dipak Subedi, Anil Giri, Christine Whitt, Tia McDonald

Abstract:

This study aims to understand the impact of the pandemic on the overall economic well-being of the agricultural sector of the United States. The two key metrics used to examine the economic well-being are the bankruptcy rate of the U.S. farm operations and the operating profit margin. One of the primary reasons for farm operations (in the U.S.) to file for bankruptcy is continuous negative profit or a significant decrease in profit. The pandemic caused significant supply and demand shocks in the domestic market. Furthermore, the ongoing trade disruptions, especially with China, also impacted the prices of agricultural commodities. The significantly reduced demand for ethanol and closure of meat processing plants affected both livestock and crop producers. This study uses data from courts to examine the bankruptcy rate over time of U.S. farm operations. Preliminary results suggest there wasn’t an increase in farm operations filing for bankruptcy in 2020. This was most likely because of record high Government payments to producers in 2020. The Federal Government made direct payments of more than $45 billion in 2020. One commonly used economic metric to measure farm profitability is the operating profit margin (OPM). Operating profit margin measures profitability as a share of the total value of production and government payments. The Economic Research Service of the United States Department of Agriculture defines a farm operation to be in a) a high-risk zone if the OPM is less than 10 percent and b) a low-risk zone if the OPM is higher than 25 percent. For this study, OPM was calculated for small, medium, and large-scale farm operations using the data from the Agriculture Resource Management Survey (OPM). Results show that except for small family farms, the share of farms in high-risk zone decreased in 2020 compared to the most recent non-pandemic year, 2019. This was most likely due to higher commodity prices at the end of 2020 and record-high government payments. Further investigation suggests a lower share of smaller farm operations receiving lower average government payments resulting in a large share (over 70 percent) being in the critical zone. This study should be of interest to multiple stakeholders, including policymakers across the globe, as it shows the resilience of the U.S. agricultural system as well as (some) impact of government payments.

Keywords: U.S. farm sector, COVID-19, operating profit margin, farm bankruptcy, ag finance, government payments to the farm sector

Procedia PDF Downloads 83
1046 Demonstrating the Efficacy of a Low-Cost Carbon Dioxide-Based Cryoablation Device in Veterinary Medicine for Translation to Third World Medical Applications

Authors: Grace C. Kuroki, Yixin Hu, Bailey Surtees, Rebecca Krimins, Nicholas J. Durr, Dara L. Kraitchman

Abstract:

The purpose of this study was to perform a Phase I veterinary clinical trial with a low-cost, carbon-dioxide-based, passive thaw cryoablation device as proof-of-principle for application in pets and translation to third-world treatment of breast cancer. This study was approved by the institutional animal care and use committee. Client-owned dogs with subcutaneous masses, primarily lipomas or mammary cancers, were recruited for the study. Inclusion was based on clinical history, lesion location, preanesthetic blood work, and fine needle aspirate or biopsy confirmation of mass. Informed consent was obtained from the owners for dogs that met inclusion criteria. Ultrasound assessment of mass extent was performed immediately prior to mass cryoablation. Dogs were placed under general anesthesia and sterilely prepared. A stab incision was created to insert a custom 4.19 OD x 55.9 mm length cryoablation probe (Kubanda Cryotherapy) into the mass. Originally designed for treating breast cancer in low resource settings, this device has demonstrated potential in effectively necrosing subcutaneous masses. A dose escalation study of increasing freeze-thaw cycles (5/4/5, 7/5/7, and 10/7/10 min) was performed to assess the size of the iceball/necrotic extent of cryoablation. Each dog was allowed to recover for ~1-2 weeks before surgical removal of the mass. A single mass was treated in seven dogs (2 mammary masses, a sarcoma, 4 lipomas, and 1 adnexal mass) with most masses exceeding 2 cm in any dimension. Mass involution was most evident in the malignant mammary and adnexal mass. Lipomas showed minimal shrinkage prior to surgical removal, but an area of necrosis was evident along the cryoablation probe path. Gross assessment indicated a clear margin of cryoablation along the cryoprobe independent of tumor type. Detailed histopathology is pending, but complete involution of large lipomas appeared to be unlikely with a 10/7/10 protocol. The low-cost, carbon dioxide-based cryotherapy device permits a minimally invasive technique that may be useful for veterinary applications but is also informative of the unlikely resolution of benign adipose breast masses that may be encountered in third world countries.

Keywords: cryoablation, cryotherapy, interventional oncology, veterinary technology

Procedia PDF Downloads 128
1045 Effectiveness Assessment of a Brazilian Larvicide on Aedes Control

Authors: Josiane N. Muller, Allan K. R. Galardo, Tatiane A. Barbosa, Evan P. Ferro, Wellington M. Dos Santos, Ana Paula S. A. Correa, Edinaldo C. Rego, Jose B. P. Lima

Abstract:

The susceptibility status of an insect population to any larvicide depends on several factors such includes genetic constitution, environmental conditions and others. The mosquito Aedes aegypti is the primary vector of three important viral diseases, Zika, Dengue, and Chikungunya. The frequent outbreaks of those diseases in different parts of Brazil demonstrate the importance of testing the susceptibility of vectors in different environments. Since the control of this mosquito leads to the control of disease, alternatives for vector control that value the different Brazilian environmental conditions are needed for effective actions. The aim of this study was to evaluate a new commercial formulation of Bacillus thuringiensis israelenses (DengueTech: Brazilian innovative technology) in the Brazilian Legal Amazon considering the climate conditions. Semi-field tests were conducted in the Institute of Scientific and Technological Research of the State of Amapa in two different environments, one in a shaded area and the other exposed to sunlight. The mosquito larvae were exposed to larvicide concentration and a control; each group was tested in three containers of 40 liters each. To assess persistence 50 third instar larvae of Aedes aegypti laboratory lineages (Rockefeller) and 50 larvae of Aedes aegypti collected in the municipality of Macapa, Brazil’s Amapa state, were added weekly and after 24 hours the mortality was assessed. In total 16 tests were performed, where 12 were done with replacement of water (1/5 of the volume, three times per week). The effectiveness of the product was determined through mortality of ≥ 80%, as recommend by the World Health Organization. The results demonstrated that high-water temperatures (26-35 °C) on the containers influenced the residual time of the product, where the maximum effect achieved was 21 days in the shaded area; and no effectiveness of 60 days was found in any of the tests, as expected according to the larvicide company. The test with and without water replacement did not present significant differences in the mortality rate. Considering the different environments and climate, these results stimulate the need to test larvicide and its effectiveness in specific environmental settings in order to identify the parameters required for better results. Thus, we see the importance of semi-field researches considering the local climate conditions for a successful control of Aedes aegypti.

Keywords: Aedes aegypti, bioassay, larvicida, vector control

Procedia PDF Downloads 120
1044 Socio-Emotional Skills of Children with Learning Disability, Their Perceived Self-Efficacy and Academic Achievement

Authors: P. Maheshwari, M. Brindavan

Abstract:

The present research aimed to study the level of socio-emotional skills and perceived self-efficacy of children with learning disability. The study further investigated the relationship between the levels of socio-emotional skills, perceived self-efficacy and academic achievement of children with learning disability. The sample comprised of 40 children with learning disability as their primary condition, belonging to middle or upper middle class, living with both the parents, residing in Mumbai. Purposive or Judgmental and snowball sampling technique was used to select the sample for the study. Proformas in the form of questionnaires were used to obtain the background information of the children with learning disability. A self-constructed Child’s Perceived Self-Efficacy Assessment Scale and Child’s Social and Emotional Skills Assessment Scale was used to measure the level of child’s perceived self-efficacy and their level of social and emotional skill respectively. Academic scores of the child were collected from the child’s parents or teachers and were converted into a percentage. The data was analyzed quantitatively using SPSS. Spearman rho or Pearson Product Moment correlation was used to ascertain the multiple relationships between child’s perceived self-efficacy, child’s social and emotional skills and child’s academic achievement. The findings revealed majority (27) of the children with learning disability perceived themselves having above average level of social and emotional skills while 13 out of 40 perceived their level of social and emotional skills at an average level. Domain wise analyses revealed that, in the domain of self- management (26) and relationship skills (22) more number of the children perceived themselves as having average or below average level of social and emotional skills indicating that they perceived themselves as having average or below average skills in regulating their emotions, thoughts, and behaviors effectively in different situations, establishing and maintaining healthy and rewarding relationships with diverse groups and individuals. With regard to perceived self-efficacy, the majority of the children with learning disability perceived themselves as having above average level of self-efficacy. Looking at the data domain wise it was found that, in the domains of self-regulated learning and emotional self-efficacy, 50% of the children perceived themselves at average or below average level, indicating that they perceived themselves as average on competencies like organizing academic activities, structuring environment to make it conducive for learning, expressing emotions in a socially acceptable manner. Further, the correlations were computed, and significant positive correlations were found between children’s social and emotional skills and academic achievement (r=.378, p < .01), and between children’s social and emotional skills and child’s perceived self-efficacy (r = .724, p < .01) and a positive significant correlation was also found between children’s perceived self-efficacy and academic achievement (r=.332, p < .05). Results of the study emphasize on planning intervention for children with learning disability focusing on improving self-management and relationship skills, self-regulated learning and emotional self-efficacy.

Keywords: learning disability, social and emotional skills, perceived self-efficacy, academic achievement

Procedia PDF Downloads 238
1043 Observational Versus Angioembolisation in Blunt Splenic Trauma: A Systematic Review

Authors: E. Gopi, E. Devaindran

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Objective: Non-operative management of blunt splenic trauma have started to overtake the traditional splenectomy in recent years across the grade of splenic injury. The two main non-operative methods are observation and angioembolisation. However, the post management convalescence in these groups are still being investigated. The study attempts to quantify the clinical indicators among the two in particular complications, mortalities, conversions to operative management and duration of inpatient stay. Methodology: A systematic search was done via PUBMED, MEDLINE, and EMBASE. A total of 639 articles identified and subsequently 68 articles were identified post duplicates, full text, and inclusion and exclusion criteria. Main exclusions were non-English articles without English translation, pure observational or angioembolisation articles of which no comparison data could be identified and articles looking into pure hemodynamically unstable patients. Results: 24 non randomized controlled trial, 5 clinical control trial and 39 retrospective studies analyzing a total of 23700 patients with blunt splenic trauma. Discrepancies in data were noted in the group who had observational management versus angioembolisation in particular as data was compared among the classes of splenic rupture, the protocol of management in different centers, availability of angiogram suite, and the study design. Further variability was also noted in the angioembolisation arm as the preference for treatment differs between distal versus proximal splenic artery involvement. Overall the cumulative mortality in both observational and angioembolisation group were similar, 2.78% and 5.97% respectively. The cause of death however is not directly attributed to the management itself but rather patient comorbidities, other associated injuries and conversions to splenectomy leading to post splenectomy complications. The cumulative morbidity among each group appears to be same approximately 12% in observational versus 15% in angioembolisation. However, the type of complications varies with the observational group having higher rates of inpatient stay and intrabdominal hematoma infection and angioembolisation group developing more splenic infarcts and bleeds. There were significant disparity in reporting the actual data on duration of inpatient stay and complications to allow a statistically significant quantitative analysis to be done, 15 articles however are currently being considered. Conclusions: Observational management appears to be much effective in managing lower grade splenic trauma (grade 1 and 2) where else angioembolisation appears to play a bigger role in intermediate grades (grade 3-4) in ensuring splenic function preservation. Care has to be taken however in the angioembolisation group in view of distal splenic infarct group compromising splenic function. The cumulated data of 15 articles are now being considered for a meta-analysis.

Keywords: blunt splenic trauma, conservative, non-operative, angioembolisation

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1042 Stilbenes as Sustainable Antimicrobial Compounds to Control Vitis Vinifera Diseases

Authors: David Taillis, Oussama Becissa, Julien Gabaston, Jean-Michel Merillon, Tristan Richard, Stephanie Cluzet

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Nowadays, there is a strong pressure to reduce the phytosanitary inputs of synthetic chemistry in vineyards. It is, therefore, necessary to find viable alternatives in order to protect the vine against its major diseases. For this purpose, we suggest the use of a plant extract enriched in antimicrobial compounds. Being produced from vine trunks and roots, which are co-products of wine production, the extract produced is part of a circular economy. The antimicrobial molecules present in this plant material are polyphenols and, more particularly, stilbenes, which are derived from a common base, the resveratrol unit, and that are well known vine phytoalexins. The stilbenoids were extracted from trunks and roots (30/70, w/w) by a double extraction with ethyl acetate followed by enrichment by liquid-liquid extraction. The produced extract was characterized by UHPLC-MS, then its antimicrobial activities were tested on Plasmopara viticola and Botrytis cinerea in the laboratory and/or in greenhouse and in vineyard. The major compounds were purified, and their antimicrobial activity was evaluated on B. cinerea. Moreover, after its spraying, the effect of the stilbene extract on the plant defence status was evaluated by analysis of defence gene expression. UHPLC-MS analysis revealed that the extract contains 50% stilbenes with resveratrol, ε-viniferin and r-viniferin as major compounds. The extract showed antimicrobial activities on P. viticola with IC₅₀ and IC₁₀₀ respectively of 90 and 300 mg/L in the laboratory. In addition, it inhibited 40% of downy mildew development in greenhouse. However, probably because of the sensitivity of stilbenes to the environment, such as UV degradation, no activity has been observed in vineyard towards P. viticola development. For B. cinerea, the extract IC50 was 123 mg/L, with resveratrol and ε-viniferin being the most active stilbenes (IC₅₀ of 88 and 142 mg/L, respectively). The analysis of the expression of defence genes revealed that the extract can induce the expression of some defence genes 24, 48, and 72 hours after treatment, meaning that the extract has a defence-stimulating effect at least for the first three days after treatment. In conclusion, we produced a plant extract enriched in stilbenes with antimicrobial properties against two major grapevine pathogenic agents P. viticola and B. cinerea. In addition, we showed that this extract displayed eliciting activity of plant defences. This extract can therefore represent, after formulation development, a viable eco-friendly alternative for vineyard protection. Subsequently, the effect of the stilbenoid extract on primary metabolism will be evaluated by quantitative NMR.

Keywords: antimicrobial, bioprotection, grapevine, Plasmopara viticola, stilbene

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1041 Pooled Analysis of Three School-Based Obesity Interventions in a Metropolitan Area of Brazil

Authors: Rosely Sichieri, Bruna K. Hassan, Michele Sgambato, Barbara S. N. Souza, Rosangela A. Pereira, Edna M. Yokoo, Diana B. Cunha

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Obesity is increasing at a fast rate in low and middle-income countries where few school-based obesity interventions have been conducted. Results of obesity prevention studies are still inconclusive mainly due to underestimation of sample size in cluster-randomized trials and overestimation of changes in body mass index (BMI). The pooled analysis in the present study overcomes these design problems by analyzing 4,448 students (mean age 11.7 years) from three randomized behavioral school-based interventions, conducted in public schools of the metropolitan area of Rio de Janeiro, Brazil. The three studies focused on encouraging students to change their drinking and eating habits over one school year, with monthly 1-h sessions in the classroom. Folders explaining the intervention program and suggesting the participation of the family, such as reducing the purchase of sodas were sent home. Classroom activities were delivered by research assistants in the first two interventions and by the regular teachers in the third one, except for culinary class aimed at developing cooking skills to increase healthy eating choices. The first intervention was conducted in 2005 with 1,140 fourth graders from 22 public schools; the second, with 644 fifth graders from 20 public schools in 2010; and the last one, with 2,743 fifth and sixth graders from 18 public schools in 2016. The result was a non-significant change in BMI after one school year of positive changes in dietary behaviors associated with obesity. Pooled intention-to-treat analysis using linear mixed models was used for the overall and subgroup analysis by BMI status, sex, and race. The estimated mean BMI changes were from 18.93 to 19.22 in the control group and from 18.89 to 19.19 in the intervention group; with a p-value of change over time of 0.94. Control and intervention groups were balanced at baseline. Subgroup analyses were statistically and clinically non-significant, except for the non-overweight/obese group with a 0.05 reduction of BMI comparing the intervention with control. In conclusion, this large pooled analysis showed a very small effect on BMI only in the normal weight students. The results are in line with many of the school-based initiatives that have been promising in relation to modifying behaviors associated with obesity but of no impact on excessive weight gain. Changes in BMI may require great changes in energy balance that are hard to achieve in primary prevention at school level.

Keywords: adolescents, obesity prevention, randomized controlled trials, school-based study

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1040 Repurposing Dairy Manure Solids as a Non- Polluting Fertilizer and the Effects on Nutrient Recovery in Tomatoes (Solanum Lycopersicum)

Authors: Devon Simpson

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Recycled Manure Solids (RMS), attained via centrifugation from Canadian dairy farms, were synthesized into a non-polluting fertilizer by bonding micronutrients (Fe, Zn, and Mn) to cellulose fibers and then assessed for the effectiveness of nutrient recovery in tomatoes. Manure management technology is critical for improving the sustainability of agroecosystems and has the capacity to offer a truly circular economy. The ability to add value to manure byproducts offers an opportunity for economic benefits while generating tenable solutions to livestock waste. The dairy industry is under increasing pressure from new environmental protections such as government restrictions on manure applications, limitations on herd size as well as increased product demand from a growing population. Current systems use RMS as bedding, so there is a lack of data pertaining to RMS use as a fertilizer. This is because of nutrient distribution, where most nutrients are retained in the liquid effluent of the solid-liquid separation. A literature review on the physical and chemical properties of dairy manure further revealed more data for raw manure than centrifuged solids. This research offers an innovative perspective and a new avenue of exploration in the use of RMS. Manure solids in this study were obtained directly from dairy farms in Salmon Arm and Abbotsford, British Columbia, and underwent physical, chemical, and biological characterizations pre- and post-synthesis processing. Samples were sent to A&L labs Canada for analysis. Once characterized and bonded to micronutrients, the effect of synthesized RMS on nutrient recovery in tomatoes was studied in a greenhouse environment. The agricultural research package ‘agricolae’ for R was used for experimental design and data analysis. The growth trials consisted of a randomized complete block design (RCBD) that allowed for analysis of variance (ANOVA). The primary outcome was to measure nutrient uptake, and this was done using an Inductively Coupled Plasma Mass Spectrometer (IC-PMS) to analyze the micronutrient content of both the tissue and fruit of the tomatoes. It was found that treatments containing bonded dairy manure solids had an increased micronutrient concentration. Treatments with bonded dairy manure solids also saw an increase in yield, and a brix analysis showed higher sugar content than the untreated control and a grower standard.

Keywords: aoecosystems, dairy manure, micronutrient fertilizer, manure management, nutrient recovery, nutrient recycling, recycled manure solids, regenerative agricugrlture, sustainable farming

Procedia PDF Downloads 182
1039 Surface Elevation Dynamics Assessment Using Digital Elevation Models, Light Detection and Ranging, GPS and Geospatial Information Science Analysis: Ecosystem Modelling Approach

Authors: Ali K. M. Al-Nasrawi, Uday A. Al-Hamdany, Sarah M. Hamylton, Brian G. Jones, Yasir M. Alyazichi

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Surface elevation dynamics have always responded to disturbance regimes. Creating Digital Elevation Models (DEMs) to detect surface dynamics has led to the development of several methods, devices and data clouds. DEMs can provide accurate and quick results with cost efficiency, in comparison to the inherited geomatics survey techniques. Nowadays, remote sensing datasets have become a primary source to create DEMs, including LiDAR point clouds with GIS analytic tools. However, these data need to be tested for error detection and correction. This paper evaluates various DEMs from different data sources over time for Apple Orchard Island, a coastal site in southeastern Australia, in order to detect surface dynamics. Subsequently, 30 chosen locations were examined in the field to test the error of the DEMs surface detection using high resolution global positioning systems (GPSs). Results show significant surface elevation changes on Apple Orchard Island. Accretion occurred on most of the island while surface elevation loss due to erosion is limited to the northern and southern parts. Concurrently, the projected differential correction and validation method aimed to identify errors in the dataset. The resultant DEMs demonstrated a small error ratio (≤ 3%) from the gathered datasets when compared with the fieldwork survey using RTK-GPS. As modern modelling approaches need to become more effective and accurate, applying several tools to create different DEMs on a multi-temporal scale would allow easy predictions in time-cost-frames with more comprehensive coverage and greater accuracy. With a DEM technique for the eco-geomorphic context, such insights about the ecosystem dynamic detection, at such a coastal intertidal system, would be valuable to assess the accuracy of the predicted eco-geomorphic risk for the conservation management sustainability. Demonstrating this framework to evaluate the historical and current anthropogenic and environmental stressors on coastal surface elevation dynamism could be profitably applied worldwide.

Keywords: DEMs, eco-geomorphic-dynamic processes, geospatial Information Science, remote sensing, surface elevation changes,

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1038 Finite Element Analysis of the Drive Shaft and Jacking Frame Interaction in Micro-Tunneling Method: Case Study of Tehran Sewerage

Authors: B. Mohammadi, A. Riazati, P. Soltan Sanjari, S. Azimbeik

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The ever-increasing development of civic demands on one hand; and the urban constrains for newly establish of infrastructures, on the other hand, perforce the engineering committees to apply non-conflicting methods in order to optimize the results. One of these optimized procedures to establish the main sewerage networks is the pipe jacking and micro-tunneling method. The raw information and researches are based on the experiments of the slurry micro-tunneling project of the Tehran main sewerage network that it has executed by the KAYSON co. The 4985 meters route of the mentioned project that is located nearby the Azadi square and the most vital arteries of Tehran is faced to 45% physical progress nowadays. The boring machine is made by the Herrenknecht and the diameter of the using concrete-polymer pipes are 1600 and 1800 millimeters. Placing and excavating several shafts on the ground and direct Tunnel boring between the axes of issued shafts is one of the requirements of the micro-tunneling. Considering the stream of the ground located shafts should care the hydraulic circumstances, civic conditions, site geography, traffic cautions and etc. The profile length has to convert to many shortened segment lines so the generated angle between the segments will be based in the manhole centers. Each segment line between two continues drive and receive the shaft, displays the jack location, driving angle and the path straight, thus, the diversity of issued angle causes the variety of jack positioning in the shaft. The jacking frame fixing conditions and it's associated dynamic load direction produces various patterns of Stress and Strain distribution and creating fatigues in the shaft wall and the soil surrounded the shaft. This pattern diversification makes the shaft wall transformed, unbalanced subsidence and alteration in the pipe jacking Stress Contour. This research is based on experiments of the Tehran's west sewerage plan and the numerical analysis the interaction of the soil around the shaft, shaft walls and the Jacking frame direction and finally, the suitable or unsuitable location of the pipe jacking shaft will be determined.

Keywords: underground structure, micro-tunneling, fatigue analysis, dynamic-soil–structure interaction, underground water, finite element analysis

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1037 Cultural Heritage Resources for Tourism, Two Countries – Two Approaches: A Comparative Analysis of Cultural Tourism Products in Turkey and Austria

Authors: Irfan Arikan, George Christian Steckenbauer

Abstract:

Turkey and Austria are examples for highly developed tourism destinations, where tourism providers use cultural heritage and regional natural resources to develop modern tourism products in order to be successful on increasingly competitive international tourism markets. The use and exploitation of these resources follow on the one hand international standards of tourism marketing (as ‘sustainability’). Therefore, we find highly comparable internationalized products in these destinations (like hotel products, museums, spas etc.). On the other hand, development standards and processes strongly depend on local, regional and national cultures, which influence the way how people work, cooperate, think and create. Thus, cultural factors also influence the attitude towards cultural heritage and natural resources and the way, how these resources are used for the creation of tourism products. This leads to differences in the development of tourism products on several levels: 1. In the selection of cultural heritage and natural resources for the product development process 2. In the processes, how tourism products are created 3. In the way, how providers and marketing organisations work with tourism products based on cultural heritage or natural resources. Aim of this paper is to discover differences in these dimensions by analysing and comparing examples of tourism products in Turkey and Austria, both countries with a highly developed, high professional tourism industry and rich experience of stakeholders in tourism industry in the field of product development and marketing. The cases are selected from the following fields: + Cultural tourism / heritage tourism + City tourism + Industrial heritage tourism + Nature and outdoor tourism + Health tourism The cases are analysed based on available secondary data (as several cases are scientifically described) and expert interviews with local and regional stakeholders of tourism industry and tourism experts. The available primary and secondary data will be analysed and displayed in a comparative structure that allows to derive answers to the above stated research question. The result of the project therefore will be a more precise picture about the influence of cultural differences on the use and exploitation of resources in the field of tourism that allows developing recommendations for tourism industry, which must be taken into consideration to assure cultural and natural resources are treated in a sustainable and responsible way. The authors will edit these culture-cross recommendations in form of a ‘check-list’ that can be used as a ‘guideline’ for tourism professionals in the field of product development and marketing and therefore connects theoretical research to the field of practical application and closes the gap between academic research and the field of tourism practice.

Keywords: cultural heritage, natural resources, Austria, Turkey

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1036 Assessment of the Efficacy of Routine Medical Tests in Screening Medical Radiation Staff in Shiraz University of Medical Sciences Educational Centers

Authors: Z. Razi, S. M. J. Mortazavi, N. Shokrpour, Z. Shayan, F. Amiri

Abstract:

Long-term exposure to low doses of ionizing radiation occurs in radiation health care workplaces. Although doses in health professions are generally very low, there are still matters of concern. The radiation safety program promotes occupational radiation safety through accurate and reliable monitoring of radiation workers in order to effectively manage radiation protection. To achieve this goal, it has become mandatory to implement health examination periodically. As a result, based on the hematological alterations, working populations with a common occupational radiation history are screened. This paper calls into question the effectiveness of blood component analysis as a screening program which is mandatory for medical radiation workers in some countries. This study details the distribution and trends of changes in blood components, including white blood cells (WBCs), red blood cells (RBCs) and platelets as well as received cumulative doses from occupational radiation exposure. This study was conducted among 199 participants and 100 control subjects at the medical imaging departments at the central hospital of Shiraz University of Medical Sciences during the years 2006–2010. Descriptive and analytical statistics, considering the P-value<0.05 as statistically significance was used for data analysis. The results of this study show that there is no significant difference between the radiation workers and controls regarding WBCs and platelet count during 4 years. Also, we have found no statistically significant difference between the two groups with respect to RBCs. Besides, no statistically significant difference was observed with respect to RBCs with regards to gender, which has been analyzed separately because of the lower reference range for normal RBCs levels in women compared to men and. Moreover, the findings confirm that in a separate evaluation between WBCs count and the personnel’s working experience and their annual exposure dose, results showed no linear correlation between the three variables. Since the hematological findings were within the range of control levels, it can be concluded that the radiation dosage (which was not more than 7.58 mSv in this study) had been too small to stimulate any quantifiable change in medical radiation worker’s blood count. Thus, use of more accurate method for screening program based on the working profile of the radiation workers and their accumulated dose is suggested. In addition, complexity of radiation-induced functions and the influence of various factors on blood count alteration should be taken into account.

Keywords: blood cell count, mandatory testing, occupational exposure, radiation

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1035 Friction and Wear Characteristics of Diamond Nanoparticles Mixed with Copper Oxide in Poly Alpha Olefin

Authors: Ankush Raina, Ankush Anand

Abstract:

Plyometric training is a form of specialised strength training that uses fast muscular contractions to improve power and speed in sports conditioning by coaches and athletes. Despite its useful role in sports conditioning programme, the information about plyometric training on the athletes cardiovascular health especially Electrocardiogram (ECG) has not been established in the literature. The purpose of the study was to determine the effects of lower and upper body plyometric training on ECG of athletes. The study was guided by three null hypotheses. Quasi–experimental research design was adopted for the study. Seventy-two university male athletes constituted the population of the study. Thirty male athletes aged 18 to 24 years volunteered to participate in the study, but only twenty-three completed the study. The volunteered athletes were apparently healthy, physically active and free of any lower and upper extremity bone injuries for past one year and they had no medical or orthopedic injuries that may affect their participation in the study. Ten subjects were purposively assigned to one of the three groups: lower body plyometric training (LBPT), upper body plyometric training (UBPT), and control (C). Training consisted of six plyometric exercises: lower (ankle hops, squat jumps, tuck jumps) and upper body plyometric training (push-ups, medicine ball-chest throws and side throws) with moderate intensity. The general data were collated and analysed using Statistical Package for Social Science (SPSS version 22.0). The research questions were answered using mean and standard deviation, while paired samples t-test was also used to test for the hypotheses. The results revealed that athletes who were trained using LBPT had reduced ECG parameters better than those in the control group. The results also revealed that athletes who were trained using both LBPT and UBPT indicated lack of significant differences following ten weeks plyometric training than those in the control group in the ECG parameters except in Q wave, R wave and S wave (QRS) complex. Based on the findings of the study, it was recommended among others that coaches should include both LBPT and UBPT as part of athletes’ overall training programme from primary to tertiary institution to optimise performance as well as reduce the risk of cardiovascular diseases and promotes good healthy lifestyle.

Keywords: boundary lubrication, copper oxide, friction, nano diamond

Procedia PDF Downloads 117