Search results for: John Gray
167 Toxic Metal and Radiological Risk Assessment of Soil, Water and Vegetables around a Gold Mine Turned Residential Area in Mokuro Area of Ile-Ife, Osun State Nigeria: An Implications for Human Health
Authors: Grace O. Akinlade, Danjuma D. Maza, Oluwakemi O. Olawolu, Delight O. Babalola, John A. O. Oyekunle, Joshua O. Ojo
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The Mokuro area of Ile-Ife, South West Nigeria, was well known for gold mining in the past (about twenty years ago). However, the place has since been reclaimed and converted to residential area without any environmental risk assessment of the impact of the mining tailings on the environment. Soil, water, and plant samples were collected from 4 different locations around the mine-turned-residential area. Soil samples were pulverized and sieved into finer particles, while the plant samples were dried and pulverized. All the samples were digested and analyzed for As, Pb, Cd, and Zn using atomic absorption spectroscopy (AAS). From the analysis results, the hazard index (HI) was then calculated for the metals. The soil and plant samples were air dried and pulverized, then weighed, after which the samples were packed into special and properly sealed containers to prevent radon gas leakage. After the sealing, the samples were kept for 28 days to attain secular equilibrium. The concentrations of 40K, 238U, and 232Th in the samples were measured using a cesium iodide (CsI) spectrometer and URSA software. The AAS analysis showed that As, Pb, Cd (Toxic metals), and Zn (essential trace metals) are in concentrations lower than permissible limits in plants and soil samples, while the water samples had concentrations higher than permissible limits. The calculated health indices (HI) show that HI for water is >1 and that of plants and soil is <1. Gamma spectrometry result shows high levels of activity concentrations above the recommended limits for all the soil and plant samples collected from the area. Only the water samples have activity concentrations below the recommended limit. Consequently, the absorbed dose, annual effective dose, and excess lifetime cancer risk are all above the recommended safe limit for all the samples except for water samples. In conclusion, all the samples collected from the area are either contaminated with toxic metals or they pose radiological hazards to the consumers. Further detailed study is therefore recommended in order to be able to advise the residents appropriately.Keywords: toxic metals, gamma spectrometry, Ile-Ife, radiological hazards, gold mining
Procedia PDF Downloads 57166 Artificial Neural Network Approach for Vessel Detection Using Visible Infrared Imaging Radiometer Suite Day/Night Band
Authors: Takashi Yamaguchi, Ichio Asanuma, Jong G. Park, Kenneth J. Mackin, John Mittleman
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In this paper, vessel detection using the artificial neural network is proposed in order to automatically construct the vessel detection model from the satellite imagery of day/night band (DNB) in visible infrared in the products of Imaging Radiometer Suite (VIIRS) on Suomi National Polar-orbiting Partnership (Suomi-NPP).The goal of our research is the establishment of vessel detection method using the satellite imagery of DNB in order to monitor the change of vessel activity over the wide region. The temporal vessel monitoring is very important to detect the events and understand the circumstances within the maritime environment. For the vessel locating and detection techniques, Automatic Identification System (AIS) and remote sensing using Synthetic aperture radar (SAR) imagery have been researched. However, each data has some lack of information due to uncertain operation or limitation of continuous observation. Therefore, the fusion of effective data and methods is important to monitor the maritime environment for the future. DNB is one of the effective data to detect the small vessels such as fishery ships that is difficult to observe in AIS. DNB is the satellite sensor data of VIIRS on Suomi-NPP. In contrast to SAR images, DNB images are moderate resolution and gave influence to the cloud but can observe the same regions in each day. DNB sensor can observe the lights produced from various artifact such as vehicles and buildings in the night and can detect the small vessels from the fishing light on the open water. However, the modeling of vessel detection using DNB is very difficult since complex atmosphere and lunar condition should be considered due to the strong influence of lunar reflection from cloud on DNB. Therefore, artificial neural network was applied to learn the vessel detection model. For the feature of vessel detection, Brightness Temperature at the 3.7 μm (BT3.7) was additionally used because BT3.7 can be used for the parameter of atmospheric conditions.Keywords: artificial neural network, day/night band, remote sensing, Suomi National Polar-orbiting Partnership, vessel detection, Visible Infrared Imaging Radiometer Suite
Procedia PDF Downloads 235165 Barriers and Facilitators of Physical Activity among Adults and Older Adults from Black and Minority Ethnic Groups in the UK: A Meta-Ethnographic Study
Authors: Janet Ige, Paul Pilkington, Selena Gray, Jane Powell
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Older adults from socially disadvantaged groups and Black and Minority Ethnic (BME) groups experience a higher burden of physical inactivity. Physical inactivity among BME groups is associated with the disproportionately higher level of health inequalities. People from minority ethnic groups encounter more barriers to physical activity. However, this is not often reported. There is very limited review-level evidence on the barriers and facilitators of physical activity among older adults from BME groups in the UK. This study aims to answer the following research question: what are the barriers and facilitators of physical activity participation among adults and older adults from BME background in the UK? To address this, we conducted a review of qualitative studies investigating the barriers and opportunities for physical activity among of BME adults and older adults in the UK. Method: This study is nested in an interpretive paradigm of meta-ethnography. A structured search for published literature was conducted on 6 electronic databases (MEDLINE, PsychINFO, Cumulative Index to Nursing & Allied Health Literature, Applied Social Sciences Index and Abstracts, Cochrane Database of Systematic Reviews, Allied and Complementary Medicine) from January 2007 to July 2017. Hand searching of the reference list of publications was performed in addition to a search conducted on Google Scholar to identify grey literature. Studies were eligible provided they employed any qualitative method and included participants identified as being BME, aged 50 and above, living in any community within the UK. In total, 1036 studies were identified from the structured search for literature, 718 studies were screened by titles after duplicates were removed. On applying the inclusion and exclusion criteria, a final selection of 10 studies was considered eligible for synthesis. Quality assessment was performed using the Critical Appraisal Skills Programme tool. Logic maps were used to show the relationship between factors that impact on physical activity participation among adults and older adults Result: Six key themes emerged from the data: awareness of the links between physical activity and health, interaction, and engagement with health professionals, cultural expectations and social responsibilities, appropriate environment, religious fatalism and practical challenges. Findings also showed that the barriers and facilitators of physical activity exist at the individual, community, and socio-economic, cultural and environmental level. There was a substantial gap in research among Black African groups. Findings from the review also informed the design of an ongoing survey investigating the experience and attitude of adults from Somali backgrounds towards physical activity in the UK. Conclusion: Identifying the barriers and facilitators of physical activity among BME groups is a crucial step in addressing the widening inequality gap. Findings from this study highlight the importance of engaging local BME residents in the design of exercise facilities within the community. This will ensure that cultural and social concerns are recognized and properly addressed.Keywords: BME, UK, meta-ethnographic, adults
Procedia PDF Downloads 120164 An Architecture of Ingenuity and Empowerment
Authors: Timothy Gray
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This paper will present work and discuss lessons learned during a semester-long travel study based in Southeast Asia, which was run in the Spring Semester of 2019 and again in the summer of 2023. The first travel group consisted of fifteen students, and the second group consisted of twelve students ranging from second-year to graduate level, student participants majoring in either architecture or planning. Students worked in interdisciplinary teams, each team beginning their travel study, living together in a separate small town for over a month in (relatively) remote conditions in rural Thailand. Students became intimately familiar with these towns, forged strong personal relationships, and built reservoirs of knowledge one conversation at a time. Rather than impose external ideas and solutions, students were asked to learn from and be open to lessons from the people and the place. The following design statement was used as a point of departure for their investigations: It is our shared premise that architecture exists in small villages and towns of Southeast Asia in the ingenuity of the people, that architecture exists in a shared language of making, modifying, and reusing. It is a modest but vibrant architecture, an architecture that is alive and evolving, an architecture that is small in scale, accessible, and one that emerges from the people. It is an architecture that can exist in a modified bicycle, a woven bamboo bridge, or a self-built community. Students were challenged to engage in existing conditions as design professionals, both empowering and lending coherence to the energies that already existed in the place. As one of the student teams noted in their design narrative: “During our field study, we had the unique opportunity to tour a number of informal settlements and meet and talk to residents through interpreters. We found that many of the residents work in nearby factories for dollars a day. Others find employment in self-generated informal economies such as hand carving and textiles. Despite extreme poverty, we found these places to be vibrant and full of life as people navigate these challenging conditions to live lives with purpose and dignity.” Students worked together with local community members and colleagues to develop a series of varied proposals that emerged from their interrogations of place and partnered with community members and professional colleagues in the development of these proposals. Project partners included faculty and student colleagues Yangon University, the mayor's Office, Planning Department Officials and religious leaders in Sawankhalok, Thailand, and community leaders in Natonchan, Thailand, to name a few. This paper will present a series of student community-based design projects that emerged from these conditions. The paper will also discuss this model of travel study as a way of building an architecture which uses social and cultural issues as a catalyst for design. The paper will discuss lessons relative to sustainable development that the Western students learned through their travels in Southeast Asia.Keywords: travel study, CAPasia, architecture of empowerment, modular housing
Procedia PDF Downloads 47163 Political Coercion from Within: Theoretical Convergence in the Strategies of Terrorist Groups, Insurgencies, and Social Movements
Authors: John Hardy
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The early twenty-first century national security environment has been characterized by political coercion. Despite an abundance of political commentary on the various forms of non-state coercion leveraged against the state, there is a lack of literature which distinguishes between the mechanisms and the mediums of coercion. Frequently non-state movements seeking to coerce the state are labelled by their tactics, not their strategies. Terrorists, insurgencies and social movements are largely defined by the ways in which they seek to influence the state, rather than by their political aims. This study examines the strategies of coercion used by non-state actors against states. This approach includes terrorist groups, insurgencies, and social movements who seek to coerce state politics. Not all non-state actors seek political coercion, so not all examples of different group types are considered. This approach also excludes political coercion by states, focusing on the non-state actor as the primary unit of analysis. The study applies a general theory of political coercion, which is defined as attempts to change the policies or action of a polity against its will, to the strategies employed by terrorist groups, insurgencies, and social movements. This distinguishes non-state actors’ strategic objectives from their actions and motives, which are variables that are often used to differentiate between types of non-state actors and the labels commonly used to describe them. It also allows for a comparative analysis of theoretical perspectives from the disciplines of terrorism, insurgency and counterinsurgency, and social movements. The study finds that there is a significant degree of overlap in the way that different disciplines conceptualize the mechanism of political coercion by non-state actors. Studies of terrorism and counterterrorism focus more on the notions of cost tolerance and collective punishment, while studies of insurgency focus on a contest of legitimacy between actors, and social movement theory tend to link political objectives, social capital, and a mechanism of influence to leverage against the state. Each discipline has a particular vernacular for the mechanism of coercion, which is often linked to the means of coercion, but they converge on three core theoretical components of compelling a polity to change its policies or actions: exceeding resistance to change, using political or violent punishments, and withholding legitimacy or consent from a government.Keywords: counter terrorism, homeland security, insurgency, political coercion, social movement theory, terrorism
Procedia PDF Downloads 174162 Implementation of Inclusive Education in DepEd-Dasmarinas: Basis for Inclusion Program Framework
Authors: Manuela S. Tolentino, John G. Nepomuceno
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The purpose of this investigation was to assess the implementation of inclusive education (IE) in 6 elementary and 5 secondary public schools in the City Schools Division of Dasmarinas. Participants in this study were 11 school heads, 73 teachers, 22 parents and 22 students (regular and with special needs) who were selected using purposive sampling. A 30-item questionnaire was used to gather data on the extent of the implementation of IE in the division while focus group discussion (FGD) was used to gather insights on what facilitate and hinder the implementation of the IE program. This study assessed the following variables: school culture and environment, inclusive education policy implementation, and curriculum design and practices. Data were analyzed using frequency count, mean and ranking. Results revealed that participants have similar assessment on the extent of the implementation of IE. School heads rated school culture and environment as highest in terms of implementation while teachers and pupils chose curriculum design and practices. On the other hand, parents felt that inclusive education policies are implemented best. School culture and environment are given high ratings. Participants perceived that the IE program in the division is making everyone feel welcome regardless of age, sex, social status, physical, mental and emotional state; students with or without disability are equally valued, and students help each. However, some aspects of the IE program implementation are given low ratings namely: partnership between staff, parents and caregivers, school’s effort to minimize discriminatory practice, and stakeholders sharing the philosophy of inclusion. As regards education policy implementation, indicators with the highest ranks were school’s effort to admit students from the locality especially students with special needs, and the implementation of the child protection policy and anti-bullying policy. The results of the FGD revealed that both school heads and teachers possessed the welcoming gesture to accommodate students with special needs. This can be linked to the increasing enrolment of SNE in the division. However, limitations of the teachers’ knowledge on handling learners, facilities and collaboration among stakeholders hinder the implementation of IE program. Based on the findings, inclusion program framework was developed for program enhancement. This will be the basis for the improvement of the program’s efficiency, the relationship between stakeholders, and formulation of solutions.Keywords: inclusion, inclusive education, framework, special education
Procedia PDF Downloads 171161 Extreme Heat and Workforce Health in Southern Nevada
Authors: Erick R. Bandala, Kebret Kebede, Nicole Johnson, Rebecca Murray, Destiny Green, John Mejia, Polioptro Martinez-Austria
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Summertemperature data from Clark County was collected and used to estimate two different heat-related indexes: the heat index (HI) and excess heat factor (EHF). These two indexes were used jointly with data of health-related deaths in Clark County to assess the effect of extreme heat on the exposed population. The trends of the heat indexes were then analyzed for the 2007-2016 decadeandthe correlation between heat wave episodes and the number of heat-related deaths in the area was estimated. The HI showed that this value has increased significantly in June, July, and August over the last ten years. The same trend was found for the EHF, which showed a clear increase in the severity and number of these events per year. The number of heat wave episodes increased from 1.4 per year during the 1980-2016 period to 1.66 per yearduring the 2007-2016 period. However, a different trend was found for heat-wave-event duration, which decreasedfrom an average of 20.4 days during the trans-decadal period (1980-2016) to 18.1 days during the most recent decade(2007-2016). The number of heat-related deaths was also found to increase from 2007 to 2016, with 2016 with the highest number of heat-related deaths. Both HI and the number of deaths showeda normal-like distribution for June, July, and August, with the peak values reached in late July and early August. The average maximum HI values better correlated with the number of deaths registered in Clark County than the EHF, probably because HI uses the maximum temperature and humidity in its estimation,whereas EHF uses the average medium temperature. However, it is worth testing the EHF of the study zone because it was reported to fit properly in the case of heat-related morbidity. For the overall period, 437 heat-related deaths were registered in Clark County, with 20% of the deaths occurring in June, 52% occurring in July, 18% occurring in August,and the remaining 10% occurring in the other months of the year. The most vulnerable subpopulation was people over 50 years old, for which 76% of the heat-related deaths were registered.Most of the cases were associated with heart disease preconditions. The second most vulnerable subpopulation was young adults (20-50), which accounted for 23% of the heat-related deaths. These deathswere associated with alcoholic/illegal drug intoxication.Keywords: heat, health, hazards, workforce
Procedia PDF Downloads 104160 Effect of Acid and Alkali Treatment on Physical and Surface Charge Properties of Clayey Soils
Authors: Nikhil John Kollannur, Dali Naidu Arnepalli
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Most of the surface related phenomena in the case of fine-grained soil are attributed to their unique surface charge properties and specific surface area. The temporal variations in soil behavior, to some extent, can be credited to the changes in these properties. Among the multitude of factors that affect the charge and surface area of clay minerals, the inherent system chemistry occupies the cardinal position. The impact is more profound when the chemistry change is manifested in terms of the system pH. pH plays a significant role by modifying the edge charges of clay minerals and facilitating mineral dissolution. Hence there is a need to address the variations in physical and charge properties of fine-grained soils treated over a range of acidic as well as alkaline conditions. In the present study, three soils (two soils commercially procured and one natural soil) exhibiting distinct mineralogical compositions are subjected to different pH environment over a range of 2 to 13. The soil-solutions prepared at a definite liquid to solid ratio are adjusted to the required pH value by adding measured quantities of 0.1M HCl/0.1M NaOH. The studies are conducted over a range of interaction time, varying from 1 to 96 hours. The treated soils are then analyzed for their physical properties in terms of specific surface area and particle size characteristics. Further, modifications in surface morphology are evaluated from scanning electron microscope (SEM) imaging. Changes in the surface charge properties are assessed in terms of zeta potential measurements. Studies show significant variations in total surface area, probably because of the dissolution of clay minerals. This observation is further substantiated by the morphological analysis with SEM imaging. The zeta potential measurements on soils indicate noticeable variation upon pH treatment, which is partially ascribed to the modifications in the pH-dependant edge charges and partially due to the clay mineral dissolution. The results provide valuable insight into the role of pH in a clay-electrolyte system upon surface related phenomena such as species adsorption, fabric modification etc.Keywords: acid and alkali treatment, mineral dissolution , specific surface area, zeta potential
Procedia PDF Downloads 184159 Physico-Mechanical Properties of Wood-Plastic Composites Produced from Polyethylene Terephthalate Plastic Bottle Wastes and Sawdust of Three Tropical Hardwood Species
Authors: Amos Olajide Oluyege, Akpanobong Akpan Ekong, Emmanuel Uchechukwu Opara, Sunday Adeniyi Adedutan, Joseph Adeola Fuwape, Olawale John Olukunle
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This study was carried out to evaluate the influence of wood species and wood plastic ratio on the physical and mechanical properties of wood plastic composites (WPCs) produced from polyethylene terephthalate (PET) plastic bottle wastes and sawdust from three hardwood species, namely, Terminalia superba, Gmelina arborea, and Ceiba pentandra. The experimental WPCs were prepared from sawdust particle size classes of ≤ 0.5, 0.5 – 1.0, and 1.0 – 2.0 mm at wood/plastic ratios of 40:60, 50:50 and 60:40 (percentage by weight). The WPCs for each study variable combination were prepared in 3 replicates and laid out in a randomized complete block design (RCBD). The physical properties investigated water absorption (WA), linear expansion (LE) and thickness swelling (TS) while the mechanical properties evaluated were Modulus of Elasticity (MOE) and Modulus of Rupture (MOR). The mean values for WA, LE and TS ranged from 1.07 to 34.04, 0.11 to 1.76 and 0.11 to 4.05 %, respectively. The mean values of the three physical properties increased with decrease in wood plastic ratio. Wood plastic ratio of 40:60 at each particle size class generally resulted in the lowest values while wood plastic ratio of 60:40 had the highest values for each of the three species. For each of the physical properties, T. superba had the least mean values followed by G. arborea, while the highest values were observed C. pentandra. The mean values for MOE and MOR ranged from 458.17 to 1875.67 and 2.64 to 18.39 N/mm2, respectively. The mean values of the two mechanical properties decreased with increase in wood plastic ratio. Wood plastic ratio of 40:60 at each wood particle size class generally had the highest values while wood plastic ratio of 60:40 had the least values for each of the three species. For each of the mechanical properties, C. pentandra had the highest mean values followed by G. arborea, while the least values were observed T. superba. There were improvements in both the physical and mechanical properties due to decrease in sawdust particle size class with the particle size class of ≤ 0.5 mm giving the best result. The results of the Analysis of variance revealed significant (P < 0.05) effects of the three study variables – wood species, sawdust particle size class and wood/plastic ratio on all the physical and mechanical properties of the WPCs. It can be concluded from the results of this study that wood plastic composites from sawdust particle size ≤ 0.5 and PET plastic bottle wastes with acceptable physical and mechanical properties are better produced using 40:60 wood/plastic ratio, and that at this ratio, all the three species are suitable for the production of wood plastic composites.Keywords: polyethylene terephthalate plastic bottle wastes, wood plastic composite, physical properties, mechanical properties
Procedia PDF Downloads 201158 Nursing-Related Barriers to Children’s Pain Management at Selected Hospitals in Ghana: A Descriptive Qualitative Study
Authors: Abigail Kusi Amponsah, Evans Frimpong Kyei, John Bright Agyemang, Hanson Boakye, Joana Kyei-Dompim, Collins Kwadwo Ahoto, Evans Oduro
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Staff shortages, deficient knowledge, inappropriate attitudes, demanding workloads, analgesic shortages, and low prioritization of pain management have been identified in earlier studies as the nursing-related barriers to optimal children’s pain management. These studies have mainly been undertaken in developed countries, which have different healthcare dynamics than those in developing countries. The current study, therefore, sought to identify and understand the nursing-related barriers to children’s pain management in the Ghanaian context. A descriptive qualitative study was conducted among 28 purposively sampled nurses working in the pediatric units of five hospitals in the Ashanti region of Ghana. Over the course of three months, participants were interviewed on the barriers which prevented them from optimally managing children’s pain in practice. Recorded interviews were transcribed verbatim and deductively analysed based on a conceptual interest in pain assessment and management-related barriers. NVivo 12 plus software guided data management and analyses. The mean age of participating nurses was 30 years, with majority being females (n =24). Participants had worked in the nursing profession for an average of five years and in the pediatric care settings for an average of two years. The nursing-related barriers identified in the present study included communication difficulties in assessing and evaluating pain management interventions with children who have nonfunctional speech, insufficient training, misconceptions on the experience of pain in children, lack of assessment tools, and insufficient number of nurses to manage the workload and nurses’ inability to prescribe analgesics. The present study revealed some barriers which prevented Ghanaian nurses from optimally managing children’s pain. Nurses should be educated, empowered, and supported with the requisite material resources to effectively manage children’s pain and improve outcomes for families, healthcare systems, and the nation. Future studies should explore the facilitators and barriers from other stakeholders involved in pediatric pain managementKeywords: Nursing-Related Barriers, Children, Pain Management, Ghana
Procedia PDF Downloads 183157 Mobile Phone Text Reminders and Voice Call Follow-ups Improve Attendance for Community Retail Pharmacy Refills; Learnings from Lango Sub-region in Northern Uganda
Authors: Jonathan Ogwal, Louis H. Kamulegeya, John M. Bwanika, Davis Musinguzi
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Introduction: Community retail Pharmacy drug distribution points (CRPDDP) were implemented in the Lango sub-region as part of the Ministry of Health’s response to improving access and adherence to antiretroviral treatment (ART). Clients received their ART refills from nearby local pharmacies; as such, the need for continuous engagement through mobile phone appointment reminders and health messages. We share learnings from the implementation of mobile text reminders and voice call follow-ups among ART clients attending the CRPDDP program in northern Uganda. Methods: A retrospective data review of electronic medical records from four pharmacies allocated for CRPDDP in the Lira and Apac districts of the Lango sub-region in Northern Uganda was done from February to August 2022. The process involved collecting phone contacts of eligible clients from the health facility appointment register and uploading them onto a messaging platform customized by Rapid-pro, an open-source software. Client information, including code name, phone number, next appointment date, and the allocated pharmacy for ART refill, was collected and kept confidential. Contacts received appointment reminder messages and other messages on positive living as an ART client. Routine voice call follow-ups were done to ascertain the picking of ART from the refill pharmacy. Findings: In total, 1,354 clients were reached from the four allocated pharmacies found in urban centers. 972 clients received short message service (SMS) appointment reminders, and 382 were followed up through voice calls. The majority (75%) of the clients returned for refills on the appointed date, 20% returned within four days after the appointment date, and the remaining 5% needed follow-up where they reported that they were not in the district by the appointment date due to other engagements. Conclusion: The use of mobile text reminders and voice call follow-ups improves the attendance of community retail pharmacy refills.Keywords: antiretroviral treatment, community retail drug distribution points, mobile text reminders, voice call follow-up
Procedia PDF Downloads 99156 The Untreated Burden of Parkinson’s Disease: A Patient Perspective
Authors: John Acord, Ankita Batla, Kiran Khepar, Maude Schmidt, Charlotte Allen, Russ Bradford
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Objectives: Despite the availability oftreatment options, Parkinson’s disease (PD) continues to impact heavily on a patient’s quality of life (QoL), as many symptoms that bother the patient remain unexplored and untreated in clinical settings. The aims of this research were to understand the burden of PDsymptoms from a patient perspective, particularly those which are the most persistent and debilitating, and to determine if current treatments and treatment algorithms adequately focus on their resolution. Methods: A13-question, online, patient-reported survey was created based on the MDS-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS)and symptoms listed on Parkinson’s Disease Patient Advocacy Groups websites, and then validated by 10 Parkinson’s patients. In the survey, patients were asked to choose both their most common and their most bothersome symptoms, whether they had received treatment for those and, if so, had it been effective in resolving those symptoms. Results: The most bothersome symptoms reported by the 111 participants who completed the survey were sleep problems (61%), feeling tired (56%), slowness of movements (54%), and pain in some parts of the body (49%). However, while 86% of patients reported receiving dopamine or dopamine like drugs to treat their PD, far fewer reported receiving targeted therapies for additional symptoms. For example, of the patients who reported having sleep problems, only 33% received some form of treatment for this symptom. This was also true for feeling tired (30% received treatment for this symptom), slowness of movements (62% received treatment for this symptom), and pain in some parts of the body (61% received treatment for this symptom). Additionally, 65% of patients reported that the symptoms they experienced were not adequately controlled by the treatments they received, and 9% reported that their current treatments had no effect on their symptoms whatsoever. Conclusion: The survey outcomes highlight that the majority of patients involved in the study received treatment focused on their disease, however, symptom-based treatments were less well represented. Consequently, patient-reported symptoms such as sleep problems and feeling tired tended to receive more fragmented intervention than ‘classical’ PD symptoms, such as slowness of movement, even though they were reported as being amongst the most bothersome symptoms for patients. This research highlights the need to explore symptom burden from the patient’s perspective and offer Customised treatment/support for both motor and non-motor symptoms maximize patients’ quality of life.Keywords: survey, patient reported symptom burden, unmet needs, parkinson's disease
Procedia PDF Downloads 297155 Bionaut™: A Breakthrough Robotic Microdevice to Treat Non-Communicating Hydrocephalus in Both Adult and Pediatric Patients
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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Bionaut Labs, LLC is developing a minimally invasive robotic microdevice designed to treat non-communicating hydrocephalus in both adult and pediatric patients. The device utilizes biocompatible microsurgical particles (Bionaut™) that are specifically designed to safely and reliably perform accurate fenestration(s) in the 3rd ventricle, aqueduct of Sylvius, and/or trapped intraventricular cysts of the brain in order to re-establish normal cerebrospinal fluid flow dynamics and thereby balance and/or normalize intra/intercompartmental pressure. The Bionaut™ is navigated to the target via CSF or brain tissue in a minimally invasive fashion with precise control using real-time imaging. Upon reaching the pre-defined anatomical target, the external driver allows for directing the specific microsurgical action defined to achieve the surgical goal. Notable features of the proposed protocol are i) Bionaut™ access to the intraventricular target follows a clinically validated endoscopy trajectory which may not be feasible via ‘traditional’ rigid endoscopy: ii) the treatment is microsurgical, there are no foreign materials left behind post-procedure; iii) Bionaut™ is an untethered device that is navigated through the subarachnoid and intraventricular compartments of the brain, following pre-designated non-linear trajectories as determined by the safest anatomical and physiological path; iv) Overall protocol involves minimally invasive delivery and post-operational retrieval of the surgical Bionaut™. The approach is expected to be suitable to treat pediatric patients 0-12 months old as well as adult patients with obstructive hydrocephalus who fail traditional shunts or are eligible for endoscopy. 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™, cerebrospinal fluid, CSF, fenestration, hydrocephalus, micro-robot, microsurgery
Procedia PDF Downloads 170154 How Childhood Trauma Changes the Recovery Models
Authors: John Michael Weber
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The following research results spanned six months and 175 people addicted to some form of substance, from alcohol to heroin. One question was asked, and the answers were amazing and consistent. The following work is the detailed results of this writer’s answer to his own question and the 175 that followed. A constant pattern took shape throughout the bio-psycho-social assessments, these addicts had “first memories,” the memories were vivid and took place between the ages of three to six years old, to a person those first memories were traumatic. This writer’s personal search into his childhood was not to find an excuse for the way he became, but to explain the reason for becoming an addict. To treat addiction, these memories that have caused Post Traumatic Stress Disorder (PTSD), must be recognized as the catalyst that sparked a predisposition. Cognitive Behavioral Therapy (CBT), integrated with treatment specifically focused on PTSD, gives the addict a better chance at recovery sans relapse. This paper seeks to give the findings of first memories of the addicts assessed and provide the best treatment plan for such an addict, considering, the childhood trauma in congruence with treatment of the Substance Use Disorder (SUD). The question posed was concerning what their first life memory wa It is the hope of this author to take the knowledge that trauma is one of the main catalysts for addiction, will allow therapists to provide better treatment and reduce relapse from abstinence from drugs and alcohol. This research led this author to believe that if treatment of childhood trauma is not a priority, the twelve steps of Alcoholics Anonymous, specifically steps 4 and 5, will not be thoroughly addressed and odds for relapse increase. With this knowledge, parents can be educated on childhood trauma and the effect it has on their children. Parents could be mindful of the fact that the things they perceive as traumatic, do not match what a child, in the developmental years, absorbs as traumatic. It is this author’s belief that what has become the status quo in treatment facilities has not been working for a long time. It is for that reason this author believes things need to change. Relapse has been woven into the fabric of standard operating procedure and that, in this authors view, is not necessary. Childhood Trauma is not being addressed early in recovery and that creates an environment of inevitable relapse. This paper will explore how to break away from the status -quo and rethink the current “evidencebased treatments.” To begin breaking away from status-quo, this ends the Abstract, with hopes an interest has been peaked to read on.Keywords: childood, trauma, treatment, addiction, change
Procedia PDF Downloads 79153 Drivers of Global Great Power Assertiveness: Russia and Its Involvement in the Global South
Authors: Elina Vroblevska, Toms Ratfelders
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This paper examines the impact of international status-seeking aspirations on great power behavior within the international system. In particular, we seek to test the assumption advanced by the proponents of the Social Identity Theory (SIT) that the inability to achieve social mobilization through joining perceived higher-status social groups (of states) leads great powers to adopt the approach of social competition in which they aim to equal or outdo the dominant group in the area on which its claim to superior status rests. Since the dissolution of the Soviet Union, Russia has struggled to be accepted as a great power by the group of Western states that had created the dominant international system order, while the Soviet states were isolated. While the 1990s and the beginning of the 21st century can be characterized by striving to integrate into the existing order, the second decade has seen a rather sharp turn towards creating a new power center for Russia through the realization of ideas of multipolarity rivalry and uniqueness of the state itself. Increasingly, we have seen the Kremlin striving to collaborate and mobilize groups of states that fall outside of the categories of democracy, multiculturalism, and international order, the way that is perceived by the dominant group, which can be described as the West. Instead, Russia builds its own narrative where it creates an alternative understanding of these values, differentiating from the higher-status social group. The Global South, from a Russian perspective, is the group of states that can still be swayed to create an alternative power center in the international system - one where Russia can assert its status as a great power. This is based on a number of reasons, the most important being that the global north is already highly institutionalized in terms of economy (the EU) and defense (NATO), leaving no room for Russia but to integrate within the existing framework. Second, the difference in values and their interpretation - Russia has been adamant, for the last twenty years, on basing its moral code on traditional values like religion, the heterosexual family model, and moral superiority, which contradict the overall secularism of the Global North. And last, the striking difference in understanding of state governance models - with Russia becoming more autocratic over the course of the last 20 years, it has deliberately created distance between itself and democratic states, entering a “gray area” of alternative understanding of democracy which is more relatable to the global South countries. Using computational text analysis of the excerpts of Vladimir Putin’s speeches delivered from 2000-2022 regarding the areas that fall outside the immediate area of interest of Russia (the Global South), we identify 80 topics that relate to the particular component of the great power status - interest to use force globally. These topics are compared across four temporal frames that capture the periods of more and less permissible Western social boundaries. We find that there exists a negative association between such permissiveness and Putin’s emphasis on the “use of force” topics. This lends further support to the Social Identity Theory and contributes to broadening its applicability to explaining the questions related to great power assertiveness in areas outside of their primary focus regions.Keywords: Russia, Global South, great power, identity
Procedia PDF Downloads 54152 Understanding Hydrodynamic in Lake Victoria Basin in a Catchment Scale: A Literature Review
Authors: Seema Paul, John Mango Magero, Prosun Bhattacharya, Zahra Kalantari, Steve W. Lyon
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The purpose of this review paper is to develop an understanding of lake hydrodynamics and the potential climate impact on the Lake Victoria (LV) catchment scale. This paper briefly discusses the main problems of lake hydrodynamics and its’ solutions that are related to quality assessment and climate effect. An empirical methodology in modeling and mapping have considered for understanding lake hydrodynamic and visualizing the long-term observational daily, monthly, and yearly mean dataset results by using geographical information system (GIS) and Comsol techniques. Data were obtained for the whole lake and five different meteorological stations, and several geoprocessing tools with spatial analysis are considered to produce results. The linear regression analyses were developed to build climate scenarios and a linear trend on lake rainfall data for a long period. A potential evapotranspiration rate has been described by the MODIS and the Thornthwaite method. The rainfall effect on lake water level observed by Partial Differential Equations (PDE), and water quality has manifested by a few nutrients parameters. The study revealed monthly and yearly rainfall varies with monthly and yearly maximum and minimum temperatures, and the rainfall is high during cool years and the temperature is high associated with below and average rainfall patterns. Rising temperatures are likely to accelerate evapotranspiration rates and more evapotranspiration is likely to lead to more rainfall, drought is more correlated with temperature and cloud is more correlated with rainfall. There is a trend in lake rainfall and long-time rainfall on the lake water surface has affected the lake level. The onshore and offshore have been concentrated by initial literature nutrients data. The study recommended that further studies should consider fully lake bathymetry development with flow analysis and its’ water balance, hydro-meteorological processes, solute transport, wind hydrodynamics, pollution and eutrophication these are crucial for lake water quality, climate impact assessment, and water sustainability.Keywords: climograph, climate scenarios, evapotranspiration, linear trend flow, rainfall event on LV, concentration
Procedia PDF Downloads 99151 Solar Photovoltaic Foundation Design
Authors: Daniel John Avutia
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Solar Photovoltaic (PV) development is reliant on the sunlight hours available in a particular region to generate electricity. A potential area is assessed through its inherent solar radiation intensity measured in watts per square meter. Solar energy development involves the feasibility, design, construction, operation and maintenance of the relevant infrastructure, but this paper will focus on the design and construction aspects. Africa and Australasia have the longest sunlight hours per day and the highest solar radiation per square meter, 7 sunlight hours/day and 5 kWh/day respectively. Solar PV support configurations consist of fixed-tilt support and tracker system structures, the differentiation being that the latter was introduced to improve the power generation efficiency of the former due to the sun tracking movement capabilities. The installation of Solar PV foundations involves rammed piles, drilling/grout piles and shallow raft reinforced concrete structures. This paper presents a case study of 2 solar PV projects in Africa and Australia, discussing the foundation design consideration and associated construction cost implications of the selected foundations systems. Solar PV foundations represent up to one fifth of the civil works costs in a project. Therefore, the selection of the most structurally sound and feasible foundation for the prevailing ground conditions is critical towards solar PV development. The design wind speed measured by anemometers govern the pile embedment depth for rammed and drill/grout foundation systems. The lateral pile deflection and vertical pull out resistance of piles increase proportionally with the embedment depth for uniform pile geometry and geology. The pile driving rate may also be used to anticipate the lateral resistance and skin friction restraining the pile. Rammed pile foundations are the most structurally suitable due to the pile skin friction and ease of installation in various geological conditions. The competitiveness of solar PV projects within the renewable energy mix is governed by lowering capital expenditure, improving power generation efficiency and power storage technological advances. The power generation reliability and efficiency are areas for further research within the renewable energy niche.Keywords: design, foundations, piles, solar
Procedia PDF Downloads 192150 Neuro-Fuzzy Approach to Improve Reliability in Auxiliary Power Supply System for Nuclear Power Plant
Authors: John K. Avor, Choong-Koo Chang
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The transfer of electrical loads at power generation stations from Standby Auxiliary Transformer (SAT) to Unit Auxiliary Transformer (UAT) and vice versa is through a fast bus transfer scheme. Fast bus transfer is a time-critical application where the transfer process depends on various parameters, thus transfer schemes apply advance algorithms to ensure power supply reliability and continuity. In a nuclear power generation station, supply continuity is essential, especially for critical class 1E electrical loads. Bus transfers must, therefore, be executed accurately within 4 to 10 cycles in order to achieve safety system requirements. However, the main problem is that there are instances where transfer schemes scrambled due to inaccurate interpretation of key parameters; and consequently, have failed to transfer several critical loads from UAT to the SAT during main generator trip event. Although several techniques have been adopted to develop robust transfer schemes, a combination of Artificial Neural Network and Fuzzy Systems (Neuro-Fuzzy) has not been extensively used. In this paper, we apply the concept of Neuro-Fuzzy to determine plant operating mode and dynamic prediction of the appropriate bus transfer algorithm to be selected based on the first cycle of voltage information. The performance of Sequential Fast Transfer and Residual Bus Transfer schemes was evaluated through simulation and integration of the Neuro-Fuzzy system. The objective for adopting Neuro-Fuzzy approach in the bus transfer scheme is to utilize the signal validation capabilities of artificial neural network, specifically the back-propagation algorithm which is very accurate in learning completely new systems. This research presents a combined effect of artificial neural network and fuzzy systems to accurately interpret key bus transfer parameters such as magnitude of the residual voltage, decay time, and the associated phase angle of the residual voltage in order to determine the possibility of high speed bus transfer for a particular bus and the corresponding transfer algorithm. This demonstrates potential for general applicability to improve reliability of the auxiliary power distribution system. The performance of the scheme is implemented on APR1400 nuclear power plant auxiliary system.Keywords: auxiliary power system, bus transfer scheme, fuzzy logic, neural networks, reliability
Procedia PDF Downloads 171149 Destigmatising Generalised Anxiety Disorder: The Differential Effects of Causal Explanations on Stigma
Authors: John McDowall, Lucy Lightfoot
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Stigma constitutes a significant barrier to the recovery and social integration of individuals affected by mental illness. Although there is some debate in the literature regarding the definition and utility of stigma as a concept, it is widely accepted that it comprises three components: stereotypical beliefs, prejudicial reactions, and discrimination. Stereotypical beliefs describe the cognitive knowledge-based component of stigma, referring to beliefs (often negative) about members of a group that is based on cultural and societal norms (e.g. ‘People with anxiety are just weak’). Prejudice refers to the affective/evaluative component of stigma and describes the endorsement of negative stereotypes and the resulting negative emotional reactions (e.g. ‘People with anxiety are just weak, and they frustrate me’). Discrimination refers to the behavioural component of stigma, which is arguably the most problematic, as it exerts a direct effect on the stigmatized person and may lead people to behave in a hostile or avoidant way towards them (i.e. refusal to hire them). Research exploring anti-stigma initiatives focus primarily on an educational approach, with the view that accurate information will replace misconceptions and decrease stigma. Many approaches take a biogenetic stance, emphasising brain and biochemical deficits - the idea being that ‘mental illness is an illness like any other.' While this approach tends to effectively reduce blame, it has also demonstrated negative effects such as increasing prognostic pessimism, the desire for social distance and perceptions of stereotypes. In the present study 144 participants were split into three groups and read one of three vignettes presenting causal explanations for Generalised Anxiety Disorder (GAD): One explanation emphasized biogenetic factors as being important in the etiology of GAD, another emphasised psychosocial factors (e.g. aversive life events, poverty, etc.), and a third stressed the adaptive features of the disorder from an evolutionary viewpoint. A variety of measures tapping the various components of stigma were administered following the vignettes. No difference in stigma measures as a function of causal explanation was found. People who had contact with mental illness in the past were significantly less stigmatising across a wide range of measures, but this did not interact with the type of causal explanation.Keywords: generalised anxiety disorder, discrimination, prejudice, stigma
Procedia PDF Downloads 286148 Environmental Effect of Empty Nest Households in Germany: An Empirical Approach
Authors: Dominik Kowitzke
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Housing constructions have direct and indirect environmental impacts especially caused by soil sealing and gray energy consumption related to the use of construction materials. Accordingly, the German government introduced regulations limiting additional annual soil sealing. At the same time, in many regions like metropolitan areas the demand for further housing is high and of current concern in the media and politics. It is argued that meeting this demand by making better use of the existing housing supply is more sustainable than the construction of new housing units. In this context, targeting the phenomenon of so-called over the housing of empty nest households seems worthwhile to investigate for its potential to free living space and thus, reduce the need for new housing constructions and related environmental harm. Over housing occurs if no space adjustment takes place in household lifecycle stages when children move out from home and the space formerly created for the offspring is from then on under-utilized. Although in some cases the housing space consumption might actually meet households’ equilibrium preferences, frequently space-wise adjustments to the living situation doesn’t take place due to transaction or information costs, habit formation, or government intervention leading to increasing costs of relocations like real estate transfer taxes or tenant protection laws keeping tenure rents below the market price. Moreover, many detached houses are not long-term designed in a way that freed up space could be rent out. Findings of this research based on socio-economic survey data, indeed, show a significant difference between the living space of empty nest and a comparison group of households which never had children. The approach used to estimate the average difference in living space is a linear regression model regressing the response variable living space on a two-dimensional categorical variable distinguishing the two groups of household types and further controls. This difference is assumed to be the under-utilized space and is extrapolated to the total amount of empty nests in the population. Supporting this result, it is found that households that move, despite market frictions impairing the relocation, after children left their home tend to decrease the living space. In the next step, only for areas with tight housing markets in Germany and high construction activity, the total under-utilized space in empty nests is estimated. Under the assumption of full substitutability of housing space in empty nests and space in new dwellings in these locations, it is argued that in a perfect market with empty nest households consuming their equilibrium demand quantity of housing space, dwelling constructions in the amount of the excess consumption of living space could be saved. This, on the other hand, would prevent environmental harm quantified in carbon dioxide equivalence units related to average constructions of detached or multi-family houses. This study would thus provide information on the amount of under-utilized space inside dwellings which is missing in public data and further estimates the external effect of over housing in environmental terms.Keywords: empty nests, environment, Germany, households, over housing
Procedia PDF Downloads 171147 Algae Biofertilizers Promote Sustainable Food Production and Nutrient Efficiency: An Integrated Empirical-Modeling Study
Authors: Zeenat Rupawalla, Nicole Robinson, Susanne Schmidt, Sijie Li, Selina Carruthers, Elodie Buisset, John Roles, Ben Hankamer, Juliane Wolf
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Agriculture has radically changed the global biogeochemical cycle of nitrogen (N). Fossil fuel-enabled synthetic N-fertiliser is a foundation of modern agriculture but applied to soil crops only use about half of it. To address N-pollution from cropping and the large carbon and energy footprint of N-fertiliser synthesis, new technologies delivering enhanced energy efficiency, decarbonisation, and a circular nutrient economy are needed. We characterised algae fertiliser (AF) as an alternative to synthetic N-fertiliser (SF) using empirical and modelling approaches. We cultivated microalgae in nutrient solution and modelled up-scaled production in nutrient-rich wastewater. Over four weeks, AF released 63.5% of N as ammonium and nitrate, and 25% of phosphorous (P) as phosphate to the growth substrate, while SF released 100% N and 20% P. To maximise crop N-use and minimise N-leaching, we explored AF and SF dose-response-curves with spinach in glasshouse conditions. AF-grown spinach produced 36% less biomass than SF-grown plants due to AF’s slower and linear N-release, while SF resulted in 5-times higher N-leaching loss than AF. Optimised blends of AF and SF boosted crop yield and minimised N-loss due to greater synchrony of N-release and crop uptake. Additional benefits of AF included greener leaves, lower leaf nitrate concentration, and higher microbial diversity and water holding capacity in the growth substrate. Life-cycle-analysis showed that replacing the most effective SF dosage with AF lowered the carbon footprint of fertiliser production from 2.02 g CO₂ (C-producing) to -4.62 g CO₂ (C-sequestering), with a further 12% reduction when AF is produced on wastewater. Embodied energy was lowest for AF-SF blends and could be reduced by 32% when cultivating algae on wastewater. We conclude that (i) microalgae offer a sustainable alternative to synthetic N-fertiliser in spinach production and potentially other crop systems, and (ii) microalgae biofertilisers support the circular nutrient economy and several sustainable development goals.Keywords: bioeconomy, decarbonisation, energy footprint, microalgae
Procedia PDF Downloads 137146 The Strategies and Mediating Processes of Learning the Inflectional Morphology in English: A Case Study for Taiwanese English Learners
Authors: Hsiu-Ling Hsu, En-Minh (John) Lan
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Pronunciation has received more and more language researchers’ and teachers’ attention because it is important for effective or even successful communication. How to consistently and correctly orally produce verbal morphology, such as English regular past tense inflection, has been a big challenge and troublesome for FL learners. The research aims to explore EFL (English as a foreign language) learners’ developmental trajectory of the inflectional morphology, that is, what mediating processes and strategies EFL learners use, to attain native-like prosodic structure of inflectional morphemes (e.g., –ed and –s suffixes) by comparing the differences among EFL learners at different English levels. This research adopted a self-repair analysis and Prosodic Transfer Hypothesis with three developmental stages as a theoretical framework. To answer the research questions, we conducted two experiments, grammatical tense test written production (Experiment 1) and read-aloud oral production (Experiment 2), and recruited 30 participants who were divided into three groups, low-, middle-, and advanced EFL learners. Experiment 1 was conducted to ensure that participants had learned the knowledge of forming the English regular past tense rules and Experiment 2 was carried out to compare the data across FL English learner groups at different English levels. The EFL learners’ self-repair data showed at least four interesting findings. First, low achievers were more sensitive to the plural suffix -s than the past tense suffix -ed. Middle achievers exhibited a greater responsiveness to the past tense suffix, while high achievers demonstrated equal sensitivity to both suffixes. Additionally, two strategies used by EFL English learners to produce verbs and nouns with inflectional morphemes were to delete internal syllable and to divide a four-syllable verb (e.g., ‘graduated’) into two prosodic structures (e.g., ‘gradu’ and ‘ated’ or ‘gradua’ and ‘ted’). Third, true vowel epenthesis was found only in the low EFL achievers. Moreover fortition (native-like sound) was observed in the low and middle EFL achievers. These findings and self-repair data disclosed mediating processes between the developmental stages and provided insight on how Taiwan EFL learners attained the adjunction prosodic structures of inflectional Morphemes in English.Keywords: inflectional morphology, prosodic structure, developmental trajectory, strategies and mediating processes, English as a foreign language
Procedia PDF Downloads 69145 The Efficacy of Albendazole against Soil-Transmitted Helminths and the Impact of Mass Drug Administration of Albendazole and Ivermectin on Health Status
Authors: Mike Yaw Osei-Atweneboana, John Asiedu Larbi, Edward Jenner Tettevi
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Background: The lymphatic filariasis (LF) control programme has been on-going in Ghana since 2000. This community-wide approach involves the use of ivermectin (IVM) and albendazole (ALB). Soil-transmitted helminth (STH) infections control is augmented within this programme; however, in areas where LF is not prevalent, albendazole alone is administered to school children. The purpose of this study was therefore, to determine the efficacy of albendazole against soils transmitted helminths and the impact of mass drug administration of albendazole and ivermectin on the health status of children of school going age and pregnant women. Material/Methods: This was a twelve months longitudinal study. A total of 412 subjects including school children (between the ages of 2-17 years) and pregnant women were randomly selected from four endemic communities in Kpandai district of the Northern region. Coprological assessment for parasites was based on the Kato–Katz technique in both dry and rainy seasons at baseline, 21 days and 3 months post-treatment. Single-dose albendazole treatment was administered to all patients at baseline. Preserved samples are currently under molecular studies to identify possible single nucleotide polymorphism (SNP) within the beta tubulin gene which is associated with benzimidazole resistance. Results: Of all the parasites found (hookworm, Trichuris trichiura, Hymenolepis nana, and Taenia sp.); hookworm was the most prevalent. In the dry season, the overall STHs prevalence at pre-treatment was 29%, while 9% and 13% prevalence was recorded at 21 days, and three months after treatment respectively. However, in the rainy season, the overall STHs prevalence was 8%, while 4% and 12% was recorded at 21 days and three months respectively after ALB treatment. In general, ALB treatment resulted in an overall hookworm egg count reduction rate of 89% in the dry season and 93% in the rainy season, while the T. trichiura egg count reduction rate was 100% in both seasons. Conclusions: STH infections still remains a significant public health burden in Ghana. Hookworm infection seems to respond poorly or sub-optimally to ALB, raising concerns of possible emergence of resistance which may lead to a major setback for the control and elimination of STH infections, especially hookworm infections.Keywords: hookworm, sub-optimal response, albendazole, trichuriasis, soil-transmitted helminths
Procedia PDF Downloads 290144 Effects of Renin Angiotensin Pathway Inhibition on Efficacy of Anti-PD-1/PD-L1 Treatment in Metastatic Cancer
Authors: Philip Friedlander, John Rutledge, Jason Suh
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Inhibition of programmed death-1 (PD-1) or its ligand PD-L1 confers therapeutic efficacy in a wide range of solid tumor malignancies. Primary or acquired resistance can develop through activation of immunosuppressive immune cells such as tumor-associated macrophages. The renin angiotensin system (RAS) systemically regulates fluid and sodium hemodynamics, but components are expressed on and regulate the activity of immune cells, particularly of myeloid lineage. We hypothesized that inhibition of RAS would improve the efficacy of PD-1/PD-L-1 treatment. A retrospective analysis was performed through a chart review of patients with solid metastatic malignancies treated with a PD-1/PD-L1 inhibitor between 1/2013 and 6/2019 at Valley Hospital, a community hospital in New Jersey, USA. Efficacy was determined by medical oncologist documentation of clinical benefit in visit notes and by the duration of time on immunotherapy treatment. The primary endpoint was the determination of efficacy differences in patients treated with an inhibitor of RAS ( ace inhibitor, ACEi, or angiotensin blocker, ARB) compared to patients not treated with these inhibitors. To control for broader antihypertensive effects, efficacy as a function of treatment with beta blockers was assessed. 173 patients treated with PD-1/PD-L-1 inhibitors were identified of whom 52 were also treated with an ACEi or ARB. Chi-square testing revealed a statistically significant relationship between being on an ACEi or ARB and efficacy to PD-1/PD-L-1 therapy (p=0.001). No statistically significant relationship was seen between patients taking or not taking beta blocker antihypertensives (p= 0.33). Kaplan-Meier analysis showed statistically significant improvement in the duration of therapy favoring patients concomitantly treated with ACEi or ARB compared to patients not exposed to antihypertensives and to those treated with beta blockers. Logistic regression analysis revealed that age, gender, and cancer type did not have significant effects on the odds of experiencing clinical benefit (p=0.74, p=0.75, and p=0.81, respectively). We conclude that retrospective analysis of the treatment of patients with solid metastatic tumors with anti-PD-1/PD-L1 in a community setting demonstrates greater clinical benefit in the context of concomitant ACEi or ARB inhibition, irrespective of gender or age. This data supports the development of prospective assessment through randomized clinical trials.Keywords: angiotensin, cancer, immunotherapy, PD-1, efficacy
Procedia PDF Downloads 76143 Strategies for Drought Adpatation and Mitigation via Wastewater Management
Authors: Simrat Kaur, Fatema Diwan, Brad Reddersen
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The unsustainable and injudicious use of natural renewable resources beyond the self-replenishment limits of our planet has proved catastrophic. Most of the Earth’s resources, including land, water, minerals, and biodiversity, have been overexploited. Owing to this, there is a steep rise in the global events of natural calamities of contrasting nature, such as torrential rains, storms, heat waves, rising sea levels, and megadroughts. These are all interconnected through common elements, namely oceanic currents and land’s the green cover. The deforestation fueled by the ‘economic elites’ or the global players have already cleared massive forests and ecological biomes in every region of the globe, including the Amazon. These were the natural carbon sinks prevailing and performing CO2 sequestration for millions of years. The forest biomes have been turned into mono cultivation farms to produce feedstock crops such as soybean, maize, and sugarcane; which are one of the biggest green house gas emitters. Such unsustainable agriculture practices only provide feedstock for livestock and food processing industries with huge carbon and water footprints. These are two main factors that have ‘cause and effect’ relationships in the context of climate change. In contrast to organic and sustainable farming, the mono-cultivation practices to produce food, fuel, and feedstock using chemicals devoid of the soil of its fertility, abstract surface, and ground waters beyond the limits of replenishment, emit green house gases, and destroy biodiversity. There are numerous cases across the planet where due to overuse; the levels of surface water reservoir such as the Lake Mead in Southwestern USA and ground water such as in Punjab, India, have deeply shrunk. Unlike the rain fed food production system on which the poor communities of the world relies; the blue water (surface and ground water) dependent mono-cropping for industrial and processed food create water deficit which put the burden on the domestic users. Excessive abstraction of both surface and ground waters for high water demanding feedstock (soybean, maize, sugarcane), cereal crops (wheat, rice), and cash crops (cotton) have a dual and synergistic impact on the global green house gas emissions and prevalence of megadroughts. Both these factors have elevated global temperatures, which caused cascading events such as soil water deficits, flash fires, and unprecedented burning of the woods, creating megafires in multiple continents, namely USA, South America, Europe, and Australia. Therefore, it is imperative to reduce the green and blue water footprints of agriculture and industrial sectors through recycling of black and gray waters. This paper explores various opportunities for successful implementation of wastewater management for drought preparedness in high risk communities.Keywords: wastewater, drought, biodiversity, water footprint, nutrient recovery, algae
Procedia PDF Downloads 100142 Modeling the Downstream Impacts of River Regulation on the Grand Lake Meadows Complex using Delft3D FM Suite
Authors: Jaime Leavitt, Katy Haralampides
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Numerical modelling has been used to investigate the long-term impact of a large dam on downstream wetland areas, specifically in terms of changing sediment dynamics in the system. The Mactaquac Generating Station (MQGS) is a 672MW run-of-the-river hydroelectric facility, commissioned in 1968 on the mainstem of the Wolastoq|Saint John River in New Brunswick, Canada. New Brunswick Power owns and operates the dam and has been working closely with the Canadian Rivers Institute at UNB Fredericton on a multi-year, multi-disciplinary project investigating the impact the dam has on its surrounding environment. With focus on the downstream river, this research discusses the initialization, set-up, calibration, and preliminary results of a 2-D hydrodynamic model using the Delft3d Flexible Mesh Suite (successor of the Delft3d 4 Suite). The flexible mesh allows the model grid to be structured in the main channel and unstructured in the floodplains and other downstream regions with complex geometry. The combination of grid types improves computational time and output. As the movement of water governs the movement of sediment, the calibrated and validated hydrodynamic model was applied to sediment transport simulations, particularly of the fine suspended sediments. Several provincially significant Protected Natural Areas and federally significant National Wildlife Areas are located 60km downstream of the MQGS. These broad, low-lying floodplains and wetlands are known as the Grand Lake Meadows Complex (GLM Complex). There is added pressure to investigate the impacts of river regulation on these protected regions that rely heavily on natural river processes like sediment transport and flooding. It is hypothesized that the fine suspended sediment would naturally travel to the floodplains for nutrient deposition and replenishment, particularly during the freshet and large storms. The purpose of this research is to investigate the impacts of river regulation on downstream environments and use the model as a tool for informed decision making to protect and maintain biologically productive wetlands and floodplains.Keywords: hydrodynamic modelling, national wildlife area, protected natural area, sediment transport.
Procedia PDF Downloads 6141 Improving Access and Quality of Patient Information Resources for Orthognathic Treatment: A Quality Improvement Project
Authors: Evelyn Marie Richmond, Andrew McBride, Chris Johnston, John Marley
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Background: Good quality patient information resources for orthognathic treatment help to reinforce information delivered during the initial consultation and help patients make informed decisions about their care. The Consultant Orthodontists and a Dental Core Trainee noted limited patient engagement with the British Orthodontic Society (BOS) 'Your Jaw Surgery' online resources and that the existing BOS patient information leaflet (PIL) could be customised and developed to meet local requirements. Aim: The quality improvement project (QIP) aimed to improve patients' understanding of orthognathic treatment by ensuring at least 90% of patients had read the new in-house patient information leaflet (PIL) and a minimum of 50% of patients had accessed the British Orthodontic Society (BOS) 'Your Jaw Surgery' online resources before attending the joint orthognathic multidisciplinary clinic by June 2023. Methods: The QIP was undertaken in the orthodontic department of the School of Dentistry, Belfast. Data was collected prospectively during a 6-month period from January 2023 to June 2023 over 3 Plan, Do, Study, Act (PDSA) cycles. Suitable patients were identified at consultant orthodontic new patient clinics. Following initial consultation for orthognathic treatment, patients were contacted to complete a patient questionnaire. Design: The change ideas were a poster with a QR code directing patients to the BOS 'Your Jaw Surgery' website in consultation areas and a new in-house PIL with a QR code directing patients to the BOS 'Your Jaw Surgery' website. Results: In PDSA cycle 1, 86.7% of patients were verbally directed to the BOS 'Your Jaw Surgery' website, and 53.3% accessed the online resources after their initial consultation. Although 100% of patients reported reading the existing PIL, only 64.3% felt it discussed the risks of orthognathic treatment in sufficient detail. By PDSA cycle 3, 100% of patients reported being directed to the BOS 'Your Jaw Surgery' website, however, only 58.3% engaged with the website. 100% of patients who read the new PIL felt that it discussed the risks of orthognathic treatment in sufficient detail. Conclusion: The slight improvement in access to the BOS 'Your Jaw Surgery' website shows that patients do not necessarily choose to access information online despite its availability. The uptake of the new PIL was greater than reported patient engagement with the BOS 'Your Jaw Surgery' website, which indicates patients still value written information despite the availability of online resources.Keywords: orthognathic surgery, patient information resources, quality improvement project, risks
Procedia PDF Downloads 60140 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
Procedia PDF Downloads 221139 Advanced Magnetic Field Mapping Utilizing Vertically Integrated Deployment Platforms
Authors: John E. Foley, Martin Miele, Raul Fonda, Jon Jacobson
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This paper presents development and implementation of new and innovative data collection and analysis methodologies based on deployment of total field magnetometer arrays. Our research has focused on the development of a vertically-integrated suite of platforms all utilizing common data acquisition, data processing and analysis tools. These survey platforms include low-altitude helicopters and ground-based vehicles, including robots, for terrestrial mapping applications. For marine settings the sensor arrays are deployed from either a hydrodynamic bottom-following wing towed from a surface vessel or from a towed floating platform for shallow-water settings. Additionally, sensor arrays are deployed from tethered remotely operated vehicles (ROVs) for underwater settings where high maneuverability is required. While the primary application of these systems is the detection and mapping of unexploded ordnance (UXO), these system are also used for various infrastructure mapping and geologic investigations. For each application, success is driven by the integration of magnetometer arrays, accurate geo-positioning, system noise mitigation, and stable deployment of the system in appropriate proximity of expected targets or features. Each of the systems collects geo-registered data compatible with a web-enabled data management system providing immediate access of data and meta-data for remote processing, analysis and delivery of results. This approach allows highly sophisticated magnetic processing methods, including classification based on dipole modeling and remanent magnetization, to be efficiently applied to many projects. This paper also briefly describes the initial development of magnetometer-based detection systems deployed from low-altitude helicopter platforms and the subsequent successful transition of this technology to the marine environment. Additionally, we present examples from a range of terrestrial and marine settings as well as ongoing research efforts related to sensor miniaturization for unmanned aerial vehicle (UAV) magnetic field mapping applications.Keywords: dipole modeling, magnetometer mapping systems, sub-surface infrastructure mapping, unexploded ordnance detection
Procedia PDF Downloads 464138 Euthanasia as a Case of Judicial Entrepreneurship in India: Analyzing the Role of the Supreme Court in the Policy Process of Euthanasia
Authors: Aishwarya Pothula
Abstract:
Euthanasia in India is a politically dormant policy issue in the sense that discussions around it are sporadic in nature (usually with developments in specific cases) and it stays as a dominant issue in the public domain for a fleeting period. In other words, it is a non-political issue that has been unable to successfully get on the policy agenda. This paper studies how the Supreme Court of India (SC) plays a role in euthanasia’s policy making. In 2011, the SC independently put a law in place that legalized passive euthanasia through its judgement in the Aruna Shanbaug v. Union of India case. According to this, it is no longer illegal to withhold/withdraw a patient’s medical treatment in certain cases. This judgement, therefore, is the empirical focus of this paper. The paper essentially employs two techniques of discourse analysis to study the SC’s system of argumentation. The two methods, Text Analysis using Gasper’s Analysis Table and Frame Analysis – are complemented by two discourse techniques called metaphor analysis and lexical analysis. The framework within which the analysis is conducted lies in 1) the judicial process of India, i.e. the SC procedures and the Constitutional rules and provisions, and 2) John W. Kingdon’s theory of policy windows and policy entrepreneurs. The results of this paper are three-fold: first, the SC dismiss the petitioner’s request for passive euthanasia on inadequate and weak grounds, thereby setting no precedent for the historic law they put in place. In other words, they leave the decision open for the Parliament to act upon. Hence the judgement, as opposed to arguments by many, is by no means an instance of judicial activism/overreach. Second, they define euthanasia in a way that resonates with existing broader societal themes. They combine this with a remarkable use of authoritative and protective tones/stances to settle at an intermediate position that balances the possible opposition to their role in the process and what they (perhaps) perceive to be an optimal solution. Third, they soften up the policy community (including the public) to the idea of passive euthanasia leading it towards a Parliamentarian legislation. They achieve this by shaping prevalent principles, provisions and worldviews through an astute use of the legal instruments at their disposal. This paper refers to this unconventional role of the SC as ‘judicial entrepreneurship’ which is also the first scholarly contribution towards research on euthanasia as a policy issue in India.Keywords: argumentation analysis, Aruna Ramachandra Shanbaug, discourse analysis, euthanasia, judicial entrepreneurship, policy-making process, supreme court of India
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