Search results for: single ended primary inductance converter

Authors: Louk Aourelien Andrianos, Edward Dommen, Athena Peralta

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Greed, as epitomized by overconsumption of natural resources, is at the root of ecological destruction and unsustainability of modern societies. Presently economies rely on unrestricted structural greed which fuels unlimited economic growth, overconsumption, and individualistic competitive behavior. Structural greed undermines the life support system on earth and threatens ecological integrity, social justice and peace. The World Council of Churches (WCC) has developed a program on ecological and economic justice (EEJ) with the aim to promote an economy of life where the economy is embedded in society and society in ecology. This paper aims at analyzing and assessing the economy of life (EcoLife) by offering an empirical tool to measure and monitor the root causes and effects of unsustainability resulting from human greed on global, national, institutional and individual levels. This holistic approach is based on the integrity of ecology and economy in a society founded on justice. The paper will discuss critical questions such as ‘what is an economy of life’ and ‘how to measure and control it from the effect of greed’. A model called GLIMS, which stands for Greed Lines and Indices Measurement System is used to clarify the concept of greed and help measuring the economy of life index by fuzzy logic reasoning. The inputs of the model are from statistical indicators of natural resources consumption, financial realities, economic performance, social welfare and ethical and political facts. The outputs are concrete measures of three primary indices of ecological, economic and socio-political greed (ECOL-GI, ECON-GI, SOCI-GI) and one overall multidimensional economy of life index (EcoLife-I). EcoLife measurement aims to build awareness of an economy life and to address the effects of greed in systemic and structural aspects. It is a tool for ethical diagnosis and policy making.

Keywords: greed line, sustainability indicators, fuzzy logic, eco-justice, World Council of Churches (WCC)

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Authors: J. W. Choi, S. Y. Cho, H. J. Lee, W. Z. Oh, S. J. Choi

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Ionic liquids (ILs), which is alternative to conventional organic solvent, were used for extraction of Cs ions. ILs, as useful environment friendly green solvents, have been recently applied as replacement for traditional volatile organic compounds (VOCs) in liquid/liquid extraction of heavy metal ions as well as organic and inorganic species and pollutants. Thus, Ionic liquids were used for extraction of Cs ions from the liquid radioactive waste. In most cases, Cs ions present in radioactive wastes in very low concentration, approximately less than 1ppm. Therefore, unlike established extraction system the required amount of ILs as extractant is comparatively very small. This extraction method involves cation exchange mechanism in which Cs ion transfers to the organic phase and binds to one crown ether by chelation in exchange of single ILs cation, IL_cation+, transfer to the aqueous phase. In this extraction system showed solid-liquid separation in which the Ionic liquid 1-ethyl-3-methylimidazolium bis(trifluoromethylsulfonly)imide (C2mimTf2N) and the crown ether Dicyclohexano-18-crown-6 (DCH18C6) both were used here in very little amount as solvent and as extractant, respectively. 30 mM of CsNO3 was used as simulated waste solution cesium ions. Generally, in liquid-liquid extraction, the molar ratio of CE:Cs+:ILs was 1:5~10:>100, while our applied molar ratio of CE:Cs+:ILs was 1:2:1~10. The quantity of CE and Cs ions were fixed to 0.6 and 1.2 mmol, respectively. The phenomenon of precipitation showed two kinds of separation: solid-liquid separation in the ratio of 1:2:1 and 1:2:2; solid-liquid-liquid separation (3 phase) in the ratio of 1:2:5 and 1:2:10. In the last system, 3 phases were precipitate-ionic liquids-aqueous. The precipitate was verified to consist of Cs+, DCH18C6, Tf2N- based on the cation exchange mechanism. We analyzed precipitate using scanning electron microscopy with X-ray microanalysis (SEM-EDS), an elemental analyser, Fourier transform infrared spectroscopy (FT-IR) and differential scanning calorimetry (DSC). The experimental results showed an easy extraction method and confirmed the composition of solid precipitate. We also obtained information that complex formation ratio of Cs+ to DCH18C6 is 0.88:1 regardless of C2mimTf2N quantities.

Keywords: extraction, precipitation, solid-liquid seperation, ionic liquid, precipitate

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Authors: Paolo Ragazzi, Olivier Peillon, Paul Fauris, Mathias Simon, Raul Navarro, Juan Carlos Martin, Oriol Casasayas, Laura Pacheco, Albert Perez-Bellmunt

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Introduction: The use of stretching techniques in the sports world is frequent and widely used for its many effects. One of the main benefits is the gain in flexibility, range of motion and facilitation of the sporting performance. Recently the use of Roller-Foam (RF) has spread in sports practice both at elite and recreational level for its benefits being similar to those observed in stretching. The objective of the following study is to compare the results of the Roller-Foam with the proprioceptive neuromuscular facilitation stretching (PNF) (one of the stretchings with more evidence) on the hamstring muscles. Study design: The design of the study is a single-blind, randomized controlled trial and the participants are 40 healthy volunteers. Intervention: The subjects are distributed randomly in one of the following groups; stretching (PNF) intervention group: 4 repetitions of PNF stretching (5seconds of contraction, 5 second of relaxation, 20 second stretch), Roller-Foam intervention group: 2 minutes of Roller-Foam was realized on the hamstring muscles. Main outcome measures: hamstring muscles flexibility was assessed at the beginning, during (30’’ of intervention) and the end of the session by using the Modified Sit and Reach test (MSR). Results: The baseline results data given in both groups are comparable to each other. The PNF group obtained an increase in flexibility of 3,1 cm at 30 seconds (first series) and of 5,1 cm at 2 minutes (the last of all series). The RF group obtained a 0,6 cm difference at 30 seconds and 2,4 cm after 2 minutes of application of roller foam. The results were statistically significant when comparing intragroups but not intergroups. Conclusions: Despite the fact that the use of roller foam is spreading in the sports and rehabilitation field, the results of the present study suggest that the gain of flexibility on the hamstrings is greater if PNF type stretches are used instead of RF. These results may be due to the fact that the use of roller foam intervened more in the fascial tissue, while the stretches intervene more in the myotendinous unit. Future studies are needed, increasing the sample number and diversifying the types of stretching.

Keywords: hamstring muscle, stretching, neuromuscular facilitation stretching, roller foam

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Authors: Anil Koklu, Amin Mansoorifar, Ali Beskok

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Dielectric spectroscopy (DS) is a noninvasive, label free technique for a long term real-time measurements of the impedance spectra of biological cells. DS enables characterization of cellular dielectric properties such as membrane capacitance and cytoplasmic conductivity. We have developed a lab-on-a-chip device that uses an electro-activated microwells array for loading, DS measurements, and unloading of biological cells. We utilized from dielectrophoresis (DEP) to capture target cells inside the wells and release them after DS measurement. DEP is a label-free technique that exploits differences among dielectric properties of the particles. In detail, DEP is the motion of polarizable particles suspended in an ionic solution and subjected to a spatially non-uniform external electric field. To the best of our knowledge, this is the first microfluidic chip that combines DEP and DS to analyze biological cells using electro-activated wells. Device performance is tested using two different cell lines of prostate cancer cells (RV122, PC-3). Impedance measurements were conducted at 0.2 V in the 10 kHz to 40 MHz range with 6 s time resolution. An equivalent circuit model was developed to extract the cell membrane capacitance and cell cytoplasmic conductivity from the impedance spectra. We report the time course of the variations in dielectric properties of PC-3 and RV122 cells suspended in low conductivity medium (LCB), which enhances dielectrophoretic and impedance responses, and their response to sudden pH change from a pH of 7.3 to a pH of 5.8. It is shown that microfluidic chip allowed online measurements of dielectric properties of prostate cancer cells and the assessment of the cellular level variations under external stimuli such as different buffer conductivity and pH. Based on these data, we intend to deploy the current device for single cell measurements by fabricating separately addressable N × N electrode platforms. Such a device will allow time-dependent dielectric response measurements for individual cells with the ability of selectively releasing them using negative-DEP and pressure driven flow.

Keywords: microfluidic, microfabrication, lab on a chip, AC electrokinetics, dielectric spectroscopy

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Authors: Yuwaratu Syafira, Wahyu K. Y. Putra, Kusharisupeni Djokosujono

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Background/Objective: Body Mass Index (BMI) serves various purposes, including measuring the prevalence of obesity in a population, and also in formulating a patient’s diet at a hospital, and can be calculated with the equation = body weight (kg)/body height (m)². However, the BMI of an individual with difficulties in carrying their weight or standing up straight can not necessarily be measured. The aim of this study was to form a prediction model for the BMI of young adult students of Public Health Faculty of University of Indonesia. Subject/Method: This study used a cross sectional design, with a total sample of 132 respondents, consisted of 58 males and 74 females aged 21- 30. The dependent variable of this study was BMI, and the independent variables consisted of sex and anthropometric measurements, which included ulna length, arm length, tibia length, knee height, mid-upper arm circumference, and calf circumference. Anthropometric information was measured and recorded in a single sitting. Simple and multiple linear regression analysis were used to create the prediction equation for BMI. Results: The male respondents had an average BMI of 24.63 kg/m² and the female respondents had an average of 22.52 kg/m². A total of 17 variables were analysed for its correlation with BMI. Bivariate analysis showed the variable with the strongest correlation with BMI was Mid-Upper Arm Circumference/√Ulna Length (MUAC/√UL) (r = 0.926 for males and r = 0.886 for females). Furthermore, MUAC alone also has a very strong correlation with BMI (r = 0,913 for males and r = 0,877 for females). Prediction models formed from either MUAC/√UL or MUAC alone both produce highly accurate predictions of BMI. However, measuring MUAC/√UL is considered inconvenient, which may cause difficulties when applied on the field. Conclusion: The prediction model considered most ideal to estimate BMI is: Male BMI (kg/m²) = 1.109(MUAC (cm)) – 9.202 and Female BMI (kg/m²) = 0.236 + 0.825(MUAC (cm)), based on its high accuracy levels and the convenience of measuring MUAC on the field.

Keywords: body mass index, mid-upper arm circumference, prediction model, ulna length

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Authors: Elsayed A. Elkhatib, Ahmed M. Mahdy, Mohamed L. Moharem, Mohamed O. Mesalem

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Mercury (Hg) is one of the most toxic and bio-accumulative heavy metal in the environment. However, cheap and effective in situ remediation technology is lacking. In this study, the effects of water treatment residuals nanoparticles (nWTR) on mobility, fractionation and speciation of mercury in an arid zone soil from Egypt were evaluated. Water treatment residual nanoparticles with high surface area (129 m 2 g-1) were prepared using Fritsch planetary mono mill. Scanning and transmission electron microscopy revealed that the nanoparticles of WTR nanoparticles are spherical in shape, and single particle sizes are in the range of 45 to 96 nm. The x-ray diffraction (XRD) results ascertained that amorphous iron, aluminum (hydr)oxides and silicon oxide dominating all nWTR, with no apparent crystalline iron–Al (hydr)oxides. Addition of nWTR, greatly increased the Hg sorption capacities of studied soils and greatly reduced the cumulative Hg released from the soils. Application of nWTR at 0.10 and 0.30 % rates reduced the released Hg from the soil by 50 and 85 % respectively. The power function and first order kinetics models well described the desorption process from soils and nWTR amended soils as evidenced by high coefficient of determination (R2) and low SE values. Application of nWTR greatly increased the association of Hg with the residual fraction. Meanwhile, application of nWTR at a rate of 0.3% greatly increased the association of Hg with the residual fraction (>93%) and significantly increased the most stable Hg species (Hg(OH)2 amor) which in turn enhanced Hg immobilization in the studied soils. Fourier transmission infrared spectroscopy analysis indicated the involvement of nWTR in the retention of Hg (II) through OH groups which suggest inner-sphere adsorption of Hg ions to surface functional groups on nWTR. These results demonstrated the feasibility of using a low-cost nWTR as best management practice to immobilize excess Hg in contaminated soils.

Keywords: release kinetics, Fourier transmission infrared spectroscopy, Hg fractionation, Hg species

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Authors: Cesar A. Nava-Gaxiola, C. Barrado

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Harmonized with SESAR (Single European Sky Research) initiatives, a new concept related with airspace structures have been introduced in Europe, the Free Route Airspace. The key of free route is based in an airspace where users may freely plan a route between a defined entry and exit waypoint, with the possibility of routing via intermediate points, the free route flights remain subject to air traffic control (ATC) for the established separations. Free route airspace does not present anymore fixed airways to airspace users, as a consequence it brings a new paradigm for managing safe separations of aircrafts inside these airspace blocks . Nowadays, several European nations have been introduced the concept, some of them in a complete or partial stage, but finally offering limited benefits to airspace users for this condition. This research evaluates the future scenario of free route implementation across Europe, considering a unique airspace block configuration with a complete upper airspace with free route. The paper is centered in investigating the benefits for airspace users, and the study of possible increments of Air Traffic Controllers task loads with a full application. In this research, fast time simulations are carrying out for discovering how much flight time and distance aircrafts can save with an overall free route establishment. In the other side, the paper explains the evolution of conflicts derivate from possible separation losses between aircrafts in this new environment. Free route conflicts can emerges in any points of the airspace, requiring a great effort for solving it, in comparison with fixed airways, where conflicts normally were found by controllers in known waypoints, and they solved using the fixed network as reference. The airspace configuration modelled in this study take into account the actual navigation waypoints structure, moving into a future scenario, where new ones waypoints are added and new traffic flow patterns appears. In this sense, this research explores the advantages and unknown difficulties that a large scale application of free route concept can carry out in the European airspace.

Keywords: ATC conflicts, efficiency, free route airspace, SESAR

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Authors: Adepeju Simon-Oke, Olatunji Odeyemi, Mobolanle Oniya

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Urinary tract infection has become the most common bacterial infections in humans, both at the community and hospital settings; it has been reported in all age groups and in both sexes. This study was carried out in order to determine and evaluate the prevalence, current drug susceptibility pattern of the isolated organisms and identify the associated risk factors of UTIs among the pregnant women in Akure, Ondo State, Nigeria. A cross-sectional study was conducted on the urine of pregnant women, and socio-demographic information of the women was collected. A total of 300 clean midstream urine samples were collected, and a general urine microscopic examination and culture were carried out, the Microbact identification system was used to identify gram-negative bacteria. Out of the 300 urine samples cultured, 183(61.0%) yielded significant growth of urinary pathogens while 117(39.0%) yielded either insignificant growth or no growth of any urinary pathogen. Prevalence of UTI was significantly associated with the type of toilet used, symptoms of UTI, and previous history of urinary tract infection (p<0.05). Escherichia coli 58(31.7%) was the dominant pathogen isolated, and the least isolated uropathogens were Citrobacter freudii and Providencia retgerri 2(1.1%) respectively. Gram-negative bacteria showed 77.6%, 67.9%, and 61.2% susceptibility to ciprofloxacin, augmentin, and chloramphenicol, respectively. Resistance against septrin, chloramphenicol, sparfloxacin, amoxicillin, augmentin, gentamycin, pefloxacin, trivid, and streptomycin was observed in the range of 23.1 to 70.1%. Gram-positive uropathogens isolated showed high resistance to amoxicillin (68.4%) and high susceptibility to the remaining nine antibiotics in the range 65.8% to 89.5%. This study justifies that pregnant women are at high risk of UTI. Therefore screening of pregnant women during antenatal clinics should be considered very important to avoid complications. Health education with regular antenatal and personal hygiene is recommended as precautionary measures to UTI.

Keywords: pregnant women, prevalence, risk factor, UTIs

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Authors: Sheraz Gul

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The requirements for progressing a compound to clinical trials is well established and relies on the results from in-vitro and in-vivo animal tests to indicate that it is likely to be safe and efficacious when testing in humans. The typical data package required will include demonstrating compound safety, toxicity, bioavailability, pharmacodynamics (potential effects of the compound on body systems) and pharmacokinetics (how the compound is potentially absorbed, distributed, metabolised and eliminated after dosing in humans). If the desired criteria are met and the compound meets the clinical Candidate criteria and is deemed worthy of further development, a submission to regulatory bodies such as the US Food & Drug Administration for an exploratory Investigational New Drug Study can be made. The purpose of this study is to collect data to establish that the compound will not expose humans to unreasonable risks when used in limited, early-stage clinical studies in patients or normal volunteer subjects (Phase I). These studies are also designed to determine the metabolism and pharmacologic actions of the drug in humans, the side effects associated with increasing doses, and, if possible, to gain early evidence on their effectiveness. In order to reach the above goals, we have developed a pre-clinical high throughput Absorption, Distribution, Metabolism and Excretion–Toxicity (ADME–Toxicity) panel of assays to identify compounds that are likely to meet the Lead and Candidate compound acceptance criteria. This panel includes solubility studies in a range of biological fluids, cell viability studies in cancer and primary cell-lines, mitochondrial toxicity, off-target effects (across the kinase, protease, histone deacetylase, phosphodiesterase and GPCR protein families), CYP450 inhibition (5 different CYP450 enzymes), CYP450 induction, cardio-toxicity (hERG) and gene-toxicity. This panel of assays has been applied to multiple compound series developed in a number of projects delivering Lead and clinical Candidates and examples from these will be presented.

Keywords: absorption, distribution, metabolism and excretion–toxicity , drug discovery, food and drug administration , pharmacodynamics

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Authors: Jonas Sanon

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The valorization of research is becoming a transversal instrument linking different sectors (academic, public and industrial). The practice of valorization seems to impact innovation techniques within companies where, there is often the implementation of industrial conventions of training through research (CIFRE), continuous training programs for employees, collaborations and partnerships around joint research and R&D laboratories focused on the needs of companies to improve or develop more efficient innovations. Furthermore, many public initiatives to support innovation and technology transfer have been developed at the international, European and national levels, with significant budget allocations. Thus, in the context of this work, we tried to analyze the way in which research transfer structures are evaluated within the Saclay ecosystem. In fact, the University-Paris-Saclay is one of the best French universities; it is made up of 10 university components, more than 275 laboratories and is in partnership with the largest French research centers This work mainly focused on how evaluations affected research transfer structures, how evaluations were conducted, and what the managers of research transfer structures thought about assessments. Thus, with the aid of the conducted interviews, it appears that the evaluations do not have a significant impact on the qualitative aspect of research and innovation, but is rather present a directive aspect to allow the structures to benefit or not from the financial resources to develop certain research work, sometimes directed and influenced by the market, some researchers might try to accentuate their research and experimentation work on themes that are not necessarily their areas of interest, but just to comply with the calls for proposed thematic projects. The field studies also outline the primary indicators used to assess the effectiveness of valorization structures as "the number of start-ups generated, the license agreements signed, the structure's patent portfolio, and the innovations of items developed from public research.". Finally, after mapping the actors, it became clear that the ecosystem of the University of Paris-Saclay benefits from a richness allowing it to better value its research in relation to the three categories of actors it has (internal, external and transversal), united and linked by a relationship of proximity of sharing and endowed with a real opportunity to innovate openly.

Keywords: research valorization, technology transfer, innovation, evaluation, impacts and performances, innovation policy

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Authors: Joseph L. Mathew, Shourjendra N. Banerjee, R. K. Ratho, Sourabh Dutta, Vanita Suri

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Background: In India and many other developing countries, a single dose of measles vaccine is administered to infants at 9 months of age. This is based on the assumption that maternal transplacentally transferred antibodies will protect infants until that age. However, our previous data showed that most infants lose maternal anti-measles antibodies before 6 months of age, making them susceptible to measles before vaccination at 9 months. Objective: This prospective study was designed to compare susceptibility in pre-term vs term infants, at different time points. Material and Methods: Following Institutional Ethics Committee approval and a formal informed consent process, venous blood was drawn from a cohort of 45 consecutive term infants and 45 consecutive pre-term infants (both groups delivered by the vaginal route); at birth, 3 months, 6 months and 9 months (prior to measles vaccination). Serum was separated and anti-measles IgG antibody levels were measured by quantitative ELISA kits (with sensitivity and specificity > 95%). Susceptibility to measles was defined as antibody titre < 200mIU/ml. The mean antibody levels were compared between the two groups at the four time points. Results: The mean gestation of term babies was 38.5±1.2 weeks; and pre-term babies 34.7±2.8 weeks. The respective mean birth weights were 2655±215g and 1985±175g. Reliable maternal vaccination record was available in only 7 of the 90 mothers. Mean anti-measles IgG antibody (±SD) in terms babies was 3165±533 IU/ml at birth, 1074±272 IU/ml at 3 months, 314±153 IU/ml at 6 months, and 68±21 IU/ml at 9 months. The corresponding levels in pre-term babies were 2875±612 IU/ml, 948±377 IU/ml, 265±98 IU/ml, and 72±33 IU/ml at 9 months (p > 0.05 for all inter-group comparisons). The proportion of susceptible term infants at birth, 3months, 6months and 9months was 0%, 16%, 67% and 96%. The corresponding proportions in the pre-term infants were 0%, 29%, 82%, and 100% (p > 0.05 for all inter-group comparisons). Conclusion: Majority of infants are susceptible to measles before 9 months of age suggesting the need to anticipate measles vaccination, but there was no statistically significant difference between the proportion of susceptible term and pre-term infants, at any of the four-time points. A larger study is required to confirm these findings and compare sero-protection if vaccination is anticipated to be administered between 6 and 9 months.

Keywords: measles, preterm, susceptibility, term infant

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Authors: Surendra Mund

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At the beginning, the physical entity force was defined mathematically by Sir Isaac Newton in his Principia Mathematica as F ⃗=(dp ⃗)/dt in form of his second law of motion. Newton also defines his Universal law of Gravitational force exist in same outstanding book, but at the end of 20th century and beginning of 21st century, we have tried a lot to specify and unify four or five Fundamental forces or Interaction exist in universe, but we failed every time. Usually, Gravity creates problems in this unification every single time, but in my previous papers and presentations, I defined and derived Field and force equations for Gravitational like Interactions for each and every kind of central systems. This force is named as Variational Force by me, and this force is generated by variation in the scalar field density around the body. In this particular paper, at first, I am specifying which type of Interactions are Fundamental in Universal sense (or in all type of central systems or bodies predicted by my N-time Inflationary Model of Universe) and then unify them in Universal framework (defined and derived by me as Universal Mechanics in a separate paper) as well. This will also be valid in Universal dynamical sense which includes inflations and deflations of universe, central system relativity, Universal relativity, ϕ-ψ transformation and transformation of spin, physical perception principle, Generalized Fundamental Dynamical Law and many other important Generalized Principles of Generalized Quantum Mechanics (GQM) and Central System Theory (CST). So, In this article, at first, I am Generalizing some Fundamental Principles, and then Unifying Variational Forces (General form of Gravitation like Interactions) and Flow Generated Force (General form of EM like Interactions), and then Unify all Fundamental Forces by specifying Weak and Strong Interactions in form of more basic terms - Variational, Flow Generated and Transformational Interactions.

Keywords: Central System Force, Disturbance Force, Flow Generated Forces, Generalized Nuclear Force, Generalized Weak Interactions, Generalized EM-Like Interactions, Imbalance Force, Spin Generated Forces, Transformation Generated Force, Unified Force, Universal Mechanics, Uniform And Non-Uniform Variational Interactions, Variational Interactions

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Authors: Tim Giesen, Raphael Adamietz, Pablo Mayer, Philipp Stiefel, Patrick Alle, Dirk Schlenker

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The competitiveness and success of new electrical energy storages such as battery cells are significantly dependent on a short time-to-market. Producers who decide to supply new battery cells to the market need to be easily adaptable in manufacturing with respect to the early customers’ needs in terms of cell size, materials, delivery time and quantity. In the initial state, the required output rates do not yet allow the producers to have a fully automated manufacturing line nor to supply handmade battery cells. Yet there was no solution for manufacturing battery cells in low to medium volumes in a reproducible way. Thus, in terms of cell format and output quantity, a concept for the flexible assembly of battery cells was developed by the Fraunhofer-Institute for Manufacturing Engineering and Automation. Based on clustered processes, the modular system platform can be modified, enlarged or retrofitted in a short time frame according to the ordered product. The paper shows the analysis of the production steps from a conventional battery cell assembly line. Process solutions were found by using I/O-analysis, functional structures, and morphological boxes. The identified elementary functions were subsequently clustered by functional coherences for automation solutions and thus the single process cluster was generated. The result presented in this paper enables to manufacture different cell products on the same production system using seven process clusters. The paper shows the solution for a batch-wise flexible battery cell production using advanced process control. Further, the performed tests and benefits by using the process clusters as cyber-physical systems for an integrated production and value chain are discussed. The solution lowers the hurdles for SMEs to launch innovative cell products on the global market.

Keywords: automation, battery production, carrier, advanced process control, cyber-physical system

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Authors: Sanja Jovanovic, Aleksandar Simic, Ognjan Skrobic, Dragan Masulovic, Aleksandra Djuric-Stefanovic

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Introduction: Achalasia is an idiopathic primary esophageal motility disorder characterized by esophageal peristalsis and impaired swallow-induced relaxation of the lower esophageal sphincter (LES). It is a rare disease that affects both genders with an incidence of 1/100.000 and a prevalence rate of 10/100,000 per year. Objective: Laparoscopic Heller myotomy (LHM) represents a therapy of choice for patients with achalasia, providing excellent outcomes. The aim of this study was to evaluate the significance of computed tomography (CT) in analyzing achalasia subtypes and timed barium esophagogram (TBE) in evaluation of LHM success, as a part of standardized diagnostic protocol. Method: Fifty-one patients with achalasia, confirmed by manometric studies, in addition to standardized diagnostic methods, underwent CT and TBE. CT was done with multiplanar reconstruction, measuring the wall thickness above the esophago-gastric junction in the axial plane. TBE was performed preoperatively and two days postoperatively swallowing low-density barium sulfate, and plane upright frontal films were performed 1, 2 and 5 minutes after the ingestion. In all patients, LHM was done, and pre and postoperative height and weight of the barium column were compared. Results: According to CT findings we divided patients into 3 subtypes of achalasia according to wall thickness: < 4mm as subtype one, between 4 - 9mm as II, and > 10 mm as subtype 3. Correlation of manometric results, as a reference values, and CT findings indicated CT sensitivity of 90% and specificity of 70 % in establishing subtypes of achalasia. The preoperative values of TBE at 1, 2 and 5 minutes were: median barium column height 17.4 ± 7.4, 15.9 ± 6.2 and 13.9 ± 6.2 cm; median column width 5 ± 1.5, 4.7 ± 1.6 and 4.5 ± 1.8 cm respectively. LHM significantly reduced these values (height 7 ± 4.6, 5.8 ± 4.2, 3.7 ± 3.4 cm; width 2.9 ± 1.3, 2.6 ± 1.3 and 2.4 ± 1.4 cm), indicating the quantitative estimates of emptying as excellent (p value < 0.01). Conclusion: CT has high sensitivity and specificity in evaluation of achalasia subtypes, and can be introduced as an additional method for standardized evaluation of these patients. The quantitative assessment of TBE based on measurements of the barium column is an accurate and beneficial method, which adequately estimates esophageal emptying success of LHM.

Keywords: achalasia, computed tomography, esophagography, myotomy

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Authors: Christopher S. Perez, Kendal C. Boyd

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global suicide rates have decreased in recent decades, rates in the United States have increased by 35.2 percent since 1999.American Indians and Alaska Natives (AI/AN) have the highest rates of suicide in the U.S., with approximately 22 suicides per 100,000 people as of 2019. AI/AN have experienced significant historical trauma resulting in disproportionate rates of substance abuse and mental disorders. This literature review aimed to identify the demographic and clinical risk and protective factors for American Indians and Alaska Natives and provide an overview of suicidality in this population. The literature reflected varying definitions of suicidality depending on region, with some AI/AN tribesconceptualizing suicide through a spiritual framework, while others defined suicide in the biomedical sense. Furthermore, AI/AN adults and adolescents experienced higher rates of suicidal ideation when compared to other racial groups. Religious preference, sexual orientation, prior suicidal behavior, psychiatric admission, history of abuse, substance abuse, family history of mental illness, family history of substance abuse, family history of suicidal behaviors, domestic violence, and trauma were discussed as factors related to suicidality. Recommendations included increasing access to and utilization of mental health and medical services, culturally adapting suicide prevention programs to AI/AN communities, increasing support for LGBTQ+ AI/AN, providing opportunities that reinforce ethnic identity, and post-hospitalization follow-up care. The following databases were utilized to obtain peer-reviewed articles for this literature review: Complementary Index, Academic Search Premier, Science Direct, PsycInfo, Social Sciences Citation Index, PsycArticles, PubMed, EbscoHost, and PsycBooks. Articles that examined Native populations outside of the United States did not cite a primary source and/or were published before 1990 were excluded.

Keywords: alaska native, american indian, protective factors, risk factors, suicidality, suicide

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Authors: Barry D. Kyle, Jessica Boyd, Robin Pickersgill, Nicole Squires, Cynthia Balion

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Background-Aim: Fentanyl is a highly-potent synthetic μ-opioid receptor agonist used for exceptional pain management. Its main metabolite, norfentanyl, is typically present in urine at significantly high concentrations (i.e. ~20%) representing an effective targeting molecule for immunoassay detection. Here, we evaluated the NCS^TM One Step Fentanyl Test Device© and the BTNX Rapid Response^TM Single Drug Test Strip© point of care (POC) test strips targeting norfentanyl (20 ng/ml) and fentanyl (100 ng/ml) molecules for potential risperidone interference. Methods: POC tests calibrated against norfentanyl (20 ng/ml) used [immunochromatographic] lateral flow devices to provide qualitative results within five minutes of urine sample contact. Results were recorded as negative if lines appeared in the test and control regions according to manufacturer’s instructions. Positive results were recorded if no line appeared in the test region (i.e., control line only visible). Pooled patient urine (n=20), that screened negative for drugs of abuse (using NCS One Step Multi-Line Screen) and fentanyl (using BTNX Rapid Response Strip) was used for spiking studies. Urine was spiked with risperidone alone and with combinations of fentanyl, norfentanyl and/or risperidone to evaluate cross-reactivity in each test device. Results: A positive screen result was obtained when 8,000 ng/mL of risperidone was spiked into drug free urine using the NCS test device. Positive screen results were also obtained in spiked urine samples containing fentanyl and norfentanyl combinations below the cut-off concentrations when 4000 ng/mL risperidone was present using the NCS testing device. There were no screen positive test results using the BTNX test strip with up to 8,000 ng/mL alone or in combination with concentrations of fentanyl and norfentanyl below the cut-off. Both devices screened positive when either fentanyl or norfentanyl exceeded the cut-off threshold in the absence and presence of risperidone. Conclusion: We report that urine samples containing risperidone may give a false positive result using the NCS One Step Fentanyl Test Device.

Keywords: fentanyl, interferences, point of care test, Risperidone

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Authors: Zuhal Mohammed, Khalid Siddig, Harald Grethe

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Vocational training (VT) has been identified as a potential engine for achieving economic and social development, particularly in developing countries, while during the last two decades it is deemed as an essential determinant of human capital accumulation. Furthermore, it has a crucial role in reducing inequality, wage gaps and unemployment and in promoting skill decomposition. Government plays an important role in the human capital formulation by providing finance for education. In some countries, a large portion of the public educational investment is devoted to academic education (primary, secondary and tertiary). This is reflected in disproportionately increasing investment in various education sectors other than vocational education and VT. Nevertheless, the finance of VT system is not likely to increase or even remain at its existing level. This paper conducts an in-depth analysis to quantify the impacts of various options for expanding the public expenditure on education as well as vocational training in the Sudan. The study uses a recursive dynamic CGE modelling framework that accommodates VT and allows depicting the impact of various policies targeting the vocational training system with special focus on the agricultural sector. This allows for depicting the potential effects of various resource allocation policies not only among education versus non-education sectors, but also between the various types of education and training. Moreover, the study assesses the role of VT system in the economy through its influence on workers’ skill improvement and their movement across sectors. The results show that an increase in the public educational investment will lead to decrease the supply of low and high educated workers as results of increasing the school participation of the students in the short run. While in the medium to long run, this measure guides to increase the productivity of the labour and thus the growth rate of the gross domestic product (GDP). Therefore, the findings of the study provide Sudanese policymakers with needed information to help to adopt measures to reduce unemployment, enhance workers’ skill and ultimately improve livelihoods.

Keywords: vocational training, recursive dynamic CGE, skill level, labour market, economic growth, Sudan

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Authors: Jaeyoung Kim, Heeju Lee, Huijin Jung, Heesoo Pyo, Seungki Kim, Joonseok Lee

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Avian influenza viruses (AIV) are the primary cause of highly contagious respiratory diseases caused by type A influenza viruses of the Orthomyxoviridae family. AIV are categorized on the basis of types of surface glycoproteins such as hemagglutinin and neuraminidase. Certain H5 and H7 subtypes of AIV have evolved to the high pathogenic avian influenza (HPAI) virus, which has caused considerable economic loss to the poultry industry and led to severe public health crisis. Several commercial kits have been developed for on-site detection of AIV. However, the sensitivity of these methods is too low to detect low virus concentrations in clinical samples and opaque stool samples. Here, we introduced a background-free near-infrared (NIR)-to-NIR upconversion nanoparticle-based lateral flow immunoassay (NNLFA) platform to yield a sensor that detects AIV within 20 minutes. Ca²⁺ ion in the shell was used to enhance the NIR-to-NIR upconversion photoluminescence (PL) emission as a heterogeneous dopant without inducing significant changes in the morphology and size of the UCNPs. In a mixture of opaque stool samples and gold nanoparticles (GNPs), which are components of commercial AIV LFA, the background signal of the stool samples mask the absorption peak of GNPs. However, UCNPs dispersed in the stool samples still show strong emission centered at 800 nm when excited at 980 nm, which enables the NNLFA platform to detect 10-times lower viral load than a commercial GNP-based AIV LFA. The detection limit of NNLFA for low pathogenic avian influenza (LPAI) H5N2 and HPAI H5N6 viruses was 10² EID₅₀/mL and 10³.⁵ EID₅₀/mL, respectively. Moreover, when opaque brown-colored samples were used as the target analytes, strong NIR emission signal from the test line in NNLFA confirmed the presence of AIV, whereas commercial AIV LFA detected AIV with difficulty. Therefore, we propose that this rapid and background-free NNLFA platform has the potential of detecting AIV in the field, which could effectively prevent the spread of these viruses at an early stage.

Keywords: avian influenza viruses, lateral flow immunoassay on-site detection, upconversion nanoparticles

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Authors: James Patrick A. Diaz, Raul E. Ramboyong

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Background: Hypertensive response during maximal exercise test provides important information on the level of blood pressure control and evaluation of treatment. Method: A single center retrospective descriptive study was conducted among 117 young (aged 20 to 40) and middle age (aged 40 to 65) hypertensive patients, who underwent treadmill stress test. Currently on maintenance frontline medication either monotherapy (Angiotensin-converting enzyme inhibitor/Angiotensin receptor blocker [ACEi/ARB], Calcium channel blocker [CCB], Diuretic - Hydrochlorthiazide [HCTZ]) or combination therapy (ARB+CCB, ARB+HCTZ), who attained a maximal exercise on treadmill stress test (TMST) with hypertensive response (systolic blood pressure: male >210 mm Hg, female >190 mm Hg, diastolic blood pressure >100 mmHg, or increase of >10 mm Hg at any time during the test), on Bruce and Modified Bruce protocol. Exaggerated blood pressure response during exercise (systolic [SBP] and diastolic [DBP]), peak exercise blood pressure (SBP and DBP), recovery period (SBP and DBP) and test for ischemia and their antihypertensive medication/s were investigated. Analysis of variance and chi-square test were used for statistical analysis. Results: Hypertensive responses on maximal exercise test were seen mostly among female population (P < 0.000) and middle age (P < 0.000) patients. Exaggerated diastolic blood pressure responses were significantly lower in patients who were taking CCB (P < 0.004). A longer recovery period that showed a delayed decline in SBP was observed in patients taking ARB+HCTZ (P < 0.036). There were no significant differences in the level of exaggerated systolic blood pressure response and during peak exercise (both systolic and diastolic) in patients using either monotherapy or combination antihypertensives. Conclusion: Calcium channel blockers provided lower exaggerated diastolic BP response during maximal exercise test in hypertensive middle age patients. Patients on combination therapy using ARB+HCTZ exhibited a longer recovery period of systolic blood pressure.

Keywords: antihypertensive, exercise test, hypertension, hyperytensive response

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Authors: Glenda Wrenn, Juliet Muzere, Meldra Hall, Allyson Belton, Kisha Holden, Chanita Hughes-Halbert, Martha Kent, Bekh Bradley

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Understanding the help seeking decision making process and experiences of health disparity populations with posttraumatic stress disorder (PTSD) is central to development of trauma-informed, culturally centered, and patient focused services. Yet, little is known about the decision making process among adult Black women who are non-treatment seekers as they are, by definition, not engaged in services. Methods: Audiotaped interviews were conducted with 30 African American adult women with clinically significant PTSD symptoms who were engaged in primary care, but not in treatment for PTSD despite symptom burden. A qualitative interview guide was used to elucidate key themes. Independent coding of themes mapped to theory and identification of emergent themes were conducted using qualitative methods. An existing quantitative dataset was analyzed to contextualize responses and provide a descriptive summary of the sample. Results: Emergent themes revealed that active mental avoidance, the intermittent nature of distress, ambivalence, and self-identified resilience as undermining to help seeking decisions. Participants were stuck within the help-seeking phase of ‘recognition’ of illness and retained a sense of “it is my decision” despite endorsing significant social and environmental negative influencers. Participants distinguished ‘help acceptance’ from ‘help seeking’ with greater willingness to accept help and importance placed on being of help to others. Conclusions: Elucidation of the decision-making process from the perspective of non-treatment seekers has implications for outreach and treatment within models of integrated and specialty systems care. The salience of responses to trauma symptoms and stagnation in the help seeking recognition phase are findings relevant to integrated care service design and community engagement.

Keywords: culture, help-seeking, integrated care, PTSD

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Authors: Zeiler M., Stadler D., Schmaderer C.

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Over the years of dialysis treatment, most patients experience significant weight loss. The primary emphasis in earlier research was the underlying mechanism of protein energy wasting and the subsequent malnutrition inflammation syndrome. In the interest to provide an effective and rapid solution for the patients, the aim of this study is identifying individual influences of their assumed reduced dietary intake, such as nausea, appetite loss and taste changes, and to determine whether the patients adhere to their nutrition guidelines. A prospective, controlled study with 38 end-stage renal disease patients was performed using a questionnaire to reflect their diet within the last 12 months. Thereby, the daily intake for the most important macro-and micronutrients was calculated to be compared with the individual KDQOI-guideline value, as well as controls matched in age and gender. The majority of the study population did not report symptoms commonly associated with dialysis, such as nausea or inappetence, and denied any change in dietary behavior since receiving renal replacement therapy. The patients’ daily intake of energy (3080kcal ± 1266) and protein (89,9g [53,4-142,0]) did not differ significantly from the controls (energy intake: 3233kcal ± 1046, p=0,597; protein intake: 103,7g [90,1-125,5], p=0,120). The average difference to the individual calculated KDQOI-guideline was +176,0kcal ± 1156 (p=0,357) for energy intake and -1,75g ± 45,9 (p=0,491) for protein intake. However, there was an observed imbalance in the distribution of macronutrients, with a preference for fats over proteins. The patients’ daily intake of sodium (5,4g [ 2,95-10,1]) was higher than in the controls (4,1g [2,04-5,99], p= 0,058) whereas both values for potassium (3,7g ± 1,84) and phosphorous (1,79g ± 0,91) went significantly below the controls’ values (potassium intake: 4,89g ± 1,74, p=0,014; phosphorous intake: 2,04g ± 0,64, p=0,038). Thus, the values exceeded the calculated KDQOI-recommendation by + 3,3g [0,63-7,90] (p<0,001) for sodium, +1,49g ± 1,84 (p<0,001) for potassium and +0,89g ± 0,91 (p<0,001) for phosphorous. Contrary to the assumption, the patients did not under-eat. Nevertheless, their diets did not align with the recommended values. These findings highlight the need for intervention and education among patients and that regular dietary monitoring could prevent unhealthy nutrition habits. The elaboration of individual references instead of standardized guidelines could increase the compliance to the advised diet so that interdisciplinary comorbidities do not develop or worsen.

Keywords: compliance, dialysis, end-stage renal disease, KDQOI, malnutrition, nutrition guidelines, questionnaire, salt intake

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Authors: Atousa Khodadadyan, Gabe Mythen, Hirbod Assa, Beverley Bishop

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Risk assessment and the knowledge provided through this process is a crucial part of any decision-making process in the management of risks and uncertainties. Failure in assessment of risks can cause inadequacy in the entire process of risk management, which in turn can lead to failure in achieving organisational objectives as well as having significant damaging consequences on populations affected by the potential risks being assessed. The choice of tools and techniques in risk assessment can influence the degree and scope of decision-making and subsequently the risk response strategy. There are various available qualitative and quantitative tools and techniques that are deployed within the broad process of risk assessment. The sheer diversity of tools and techniques available to practitioners makes it difficult for organisations to consistently employ the most appropriate methods. This tools and techniques adaptation is rendered more difficult in public risk regulation organisations due to the sensitive and complex nature of their activities. This is particularly the case in areas relating to the environment, food, and human health and safety, when organisational goals are tied up with societal, political and individuals’ goals at national and international levels. Hence, recognising, analysing and evaluating different decision support tools and techniques employed in assessing risks in public risk management organisations was considered. This research is part of a mixed method study which aimed to examine the perception of risk assessment and the extent to which organisations practise risk assessment’ tools and techniques. The study adopted a semi-structured questionnaire with qualitative and quantitative data analysis to include a range of public risk regulation organisations from the UK, Germany, France, Belgium and the Netherlands. The results indicated the public risk management organisations mainly use diverse tools and techniques in the risk assessment process. The primary hazard analysis; brainstorming; hazard analysis and critical control points were described as the most practiced risk identification techniques. Within qualitative and quantitative risk analysis, the participants named the expert judgement, risk probability and impact assessment, sensitivity analysis and data gathering and representation as the most practised techniques.

Keywords: decision-making, public risk management organisations, risk assessment, tools and techniques

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Authors: Hira Lal Gope, Hidekazu Fukai

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The aim of this study is to develop a system which can identify and sort peaberries automatically at low cost for coffee producers in developing countries. In this paper, the focus is on the classification of peaberries and normal coffee beans using image processing and machine learning techniques. The peaberry is not bad and not a normal bean. The peaberry is born in an only single seed, relatively round seed from a coffee cherry instead of the usual flat-sided pair of beans. It has another value and flavor. To make the taste of the coffee better, it is necessary to separate the peaberry and normal bean before green coffee beans roasting. Otherwise, the taste of total beans will be mixed, and it will be bad. In roaster procedure time, all the beans shape, size, and weight must be unique; otherwise, the larger bean will take more time for roasting inside. The peaberry has a different size and different shape even though they have the same weight as normal beans. The peaberry roasts slower than other normal beans. Therefore, neither technique provides a good option to select the peaberries. Defect beans, e.g., sour, broken, black, and fade bean, are easy to check and pick up manually by hand. On the other hand, the peaberry pick up is very difficult even for trained specialists because the shape and color of the peaberry are similar to normal beans. In this study, we use image processing and machine learning techniques to discriminate the normal and peaberry bean as a part of the sorting system. As the first step, we applied Deep Convolutional Neural Networks (CNN) and Support Vector Machine (SVM) as machine learning techniques to discriminate the peaberry and normal bean. As a result, better performance was obtained with CNN than with SVM for the discrimination of the peaberry. The trained artificial neural network with high performance CPU and GPU in this work will be simply installed into the inexpensive and low in calculation Raspberry Pi system. We assume that this system will be used in under developed countries. The study evaluates and compares the feasibility of the methods in terms of accuracy of classification and processing speed.

Keywords: convolutional neural networks, coffee bean, peaberry, sorting, support vector machine

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Authors: S. Probine

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The visual arts have been proven to be a central means through which young children can communicate their ideas, reflect on experience, and construct new knowledge. Despite this, perceptions of, and the degree to which the visual arts are valued within education, vary widely within political, educational, community and family contexts. These differing perceptions informed my doctoral research project, which explored the contextual factors that affect how young children come to value and use the visual arts in their lives and learning. The qualitative methodology of narrative inquiry with inclusion of arts-based methods was most appropriate for this inquiry. Using a sociocultural framework, the stories collected were analysed through the sociocultural theories of Lev Vygotsky as well as the work of Urie Bronfenbrenner, together with postmodern theories about identity formation. The use of arts-based methods such as teacher’s reflective art journals and the collection of images by child participants and their parent/caregivers allowed the research participants to have a significant role in the research. Three early childhood settings at which the visual arts were deeply valued as a meaning-making device in children’s learning, were purposively selected to be involved in the research. At each setting, the study found a unique and complex web of influences and interconnections, which shaped how children utilised the visual arts to mediate their thinking. Although the teachers' practices at all three centres were influenced by sociocultural theories, each settings' interpretations of these theories were unique and resulted in innovative interpretations of the role of the teacher in supporting visual arts learning. These practices had a significant impact on children’s experiences of the visual arts. For many of the children involved in this study, visual art was the primary means through which they learned. The children in this study used visual art to represent their experiences, relationships, to explore working theories, their interests (including those related to popular culture), to make sense of their own and other cultures, and to enrich their imaginative play. This research demonstrates that teachers have fundamental roles in fostering and disseminating the importance of the visual arts within their educational communities.

Keywords: arts-based methods, early childhood education, teacher's visual arts pedagogies, visual arts

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Authors: E. Gouya Bozorg

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The issue of ranking of sports teams, in particular soccer teams is of primary importance in the professional sports. However, it is still based on classical statistics and models outside of area of mathematics. Rigorous mathematics and then statistics despite the expectation held of them have not been able to effectively engage in the issue of ranking. It is something that requires serious pathology. The purpose of this study is to change the approach to get closer to mathematics proper for using in the ranking. We recommend using theoretical mathematics as a good option because it can hermeneutically obtain the theoretical concepts and criteria needful for the ranking from everyday language of a League. We have proposed a framework that puts the issue of ranking into a new space that we have applied in soccer as a case study. This is an experimental and theoretical study on the issue of ranking in a professional soccer league based on theoretical mathematics, followed by theoretical statistics. First, we showed the theoretical definition of constant number Є = 1.33 or ‘golden number’ of a soccer league. Then, we have defined the ‘efficiency of a team’ by this number and formula of μ = (Pts / (k.Є)) – 1, in which Pts is a point obtained by a team in k number of games played. Moreover, K.Є index has been used to show the theoretical median line in the league table and to compare top teams and bottom teams. Theoretical coefficient of σ= 1 / (1+ (Ptx / Ptxn)) has also been defined that in every match between the teams x, xn, with respect to the ability of a team and the points of both of them Ptx, Ptxn, and it gives a performance point resulting in a special ranking for the League. And it has been useful particularly in evaluating the performance of weaker teams. The current theory has been examined for the statistical data of 4 major European Leagues during the period of 1998-2014. Results of this study showed that the issue of ranking is dependent on appropriate theoretical indicators of a League. These indicators allowed us to find different forms of ranking of teams in a league including the ‘special table’ of a league. Furthermore, on this basis the issue of a record of team has been revised and amended. In addition, the theory of ranking can be used to compare and classify the different leagues and tournaments. Experimental results obtained from archival statistics of major professional leagues in the world in the past two decades have confirmed the theory. This topic introduces a new theory for ranking of a soccer league. Moreover, this theory can be used to compare different leagues and tournaments.

Keywords: efficiency of a team, ranking, special table, theoretical mathematic

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Authors: Abu Yousuf, Maksudur Rahman Khan, Ahasanul Karim, Amirul Islam, Minhaj Uddin Monir, Sharmin Sultana, Domenico Pirozzi

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Traditional biodiesel feedstock like edible oils or plant oils, animal fats and cooking waste oil have been replaced by microbial oil in recent research of biodiesel synthesis. The well-known community of microbial oil producers includes microalgae, oleaginous yeast and seaweeds. Conventional transesterification of microbial oil to produce biodiesel is lethargic, energy consuming, cost-ineffective and environmentally unhealthy. This process follows several steps such as microbial biomass drying, cell disruption, oil extraction, solvent recovery, oil separation and transesterification. Therefore, direct transesterification of biodiesel synthesis has been studying for last few years. It combines all the steps in a single reactor and it eliminates the steps of biomass drying, oil extraction and separation from solvent. Apparently, it seems to be cost-effective and faster process but number of difficulties need to be solved to make it large scale applicable. The main challenges are microbial cell disruption in bulk volume and make faster the esterification reaction, because water contents of the medium sluggish the reaction rate. Several methods have been proposed but none of them is up to the level to implement in large scale. It is still a great challenge to extract maximum lipid from microbial cells (yeast, fungi, algae) investing minimum energy. Electroporation technique results a significant increase in cell conductivity and permeability caused due to the application of an external electric field. Electroporation is required to alter the size and structure of the cells to increase their porosity as well as to disrupt the microbial cell walls within few seconds to leak out the intracellular lipid to the solution. Therefore, incorporation of electroporation techniques contributed in direct transesterification of microbial lipids by increasing the efficiency of biodiesel production rate.

Keywords: biodiesel, electroporation, microbial lipids, transesterification

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Authors: Tebeu Pierre Marie

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Introduction: WHO defines community participation as a process in which the local population, take responsibility in planning for their health, participates in the strategy’s development for implementation and accessibility to physical, moral and social well-being. For the purpose of dealing with health, the community participation is made through the organization called health Centre committee leader (HCCL/COSA) for Integrated health Center and District hospital committee leaser (HDCL/COGES) for District Hospital. Little is known about the effective participation of the community in health related activities in Ignié-Ngabé-Mayama health district. Objective: This study aimed at assessing the involvement of community in the health system running at the Ignié-Ngabé-Mayama health district. Methods: This was a qualitative cross-sectional study conducted in the Ignié-Ngabé-Mayama health district from 15 December 2020 to 30 April 2021. The study population consisted of 10 HCCL and one District hospital committee leaser (DHCL). Data were collected using a pretested questionnaire and validated by the investigating team. The variables of interest were; effective existence of HCCL/DHCL, their involvement HCCL/DHCL in health related activities, their financing management, planning of activities and leadership. Results: A total of 11 participants were interviewed, including 10 HCCL and 1 DHCL. The Sex-Ratio was 9/11; with primary level 6/11 and were mostly farmers 6/11. Analyzing the involvement of the HDCL/DHCL in health promotion and preventive activities; this was effective only for two of them (2/11). Analyzing the barriers for their involvement, the leaders reported the lack of financial support by the state, lack NGO support. Additionally, they reported to have been very active when there was Performance Based Founding Project in the District. Conclusion: Only two of the (HDCL/HCCL) out of 11 were really functioning. Reported barriers to their running were: lack of state/NGOs support and ending of PBF Project. There is a need to organize a tripartite forum including stats, NGOs and Community for boosting the community participation in health related activities in Ignié-Ngabé-Mayama health district.

Keywords: health district committee, health Centre committee, community participation, Brazzaville, Congo

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Authors: Irfan Anjum Manarvi, Zahid Ali kaimkhani

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Predicting location of the fracture in human bones has been a keen area of research for the past few decades. A variety of tests for hardness, deformation, and strain field measurement have been conducted in the past; but considered insufficient due to various limitations. Researchers, therefore, have proposed further studies due to inaccuracies in measurement methods, testing machines, and experimental errors. Advancement and availability of hardware, measuring instrumentation, and testing machines can now provide remedies to these limitations. The human foot is a critical part of the body exposed to various forces throughout its life. A number of products are developed for using it for protection and care, which many times do not provide sufficient protection and may itself become a source of stress due to non-consideration of the delicacy of bones in the feet. A continuous strain or overloading on feet may occur resulting to discomfort and even fracture. Mechanical properties of Tarsals, Metatarsals, and phalanges are, therefore, the primary area of consideration for all such design applications. Hardness is one of the mechanical properties which are considered very important to establish the mechanical resistance behavior of a material against applied loads. Past researchers have worked in the areas of investigating mechanical properties of these bones. However, their results were based on a limited number of experiments and taking average values of hardness due to either limitation of samples or testing instruments. Therefore, they proposed further studies in this area. The present research has been carried out to develop a hardness map of the human foot by measuring micro hardness at various locations of these bones. Results are compiled in the form of distance from a reference point on a bone and the hardness values for each surface. The number of test results is far more than previous studies and are spread over a typical bone to give a complete hardness map of these bones. These results could also be used to establish other properties such as stress and strain distribution in the bones. Also, industrial engineers could use it for design and development of various accessories for human feet health care and comfort and further research in the same areas.

Keywords: tarsals, metatarsals, phalanges, hardness testing, biomechanics of human foot

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Authors: Esabelle Lo Yan Yam, Pheak Chhoun, Sovannary Tuot, Emily Lancsar, Siyan Yi

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Persons living with HIV (PLHIV) need lifelong antiretroviral treatment (ART) to keep their viral load suppressed to an undetectable level, maintain a healthy immune system, and reduce the risk of transmitting HIV to others. However, many factors affect PLHIV's adherence to ART, including access to antiretrovirals (ARV), stigma, lack of social support, and the burden of seeking lifelong care. Community-based care has been shown to be instrumental in the experience of PLHIV in many countries, including Cambodia. In this study based in Cambodia, a community-based ART delivery (CAD) intervention involving community action workers (CAWs) who are PLHIVs was introduced. These workers collect pre-packaged ARVs from the ART clinics and dispense them to PLHIVs in the communities. The quasi-experimental study involved approximately 2000 stable PLHIV in the intervention arm and another 2000 PLHIV in the control arm (receiving usual care). A cost-effectiveness analysis is currently conducted to complement the clinical effectiveness of the CAD intervention on the care continuum and treatment outcomes for stable PLHIV, as well as the operational effectiveness in increasing the efficiency of the ART clinics and the health system. The analysis will consider health system and societal perspectives based on primary outcomes, including retention in care, viral load suppression, and adherence to ART. Additionally, a consultation with the National Centre for HIV/AIDS, Dermatology, and STD under the Cambodia Ministry of Health will be done to discuss the conduct of a budget impact analysis that can quantify the financial impact on the government's budget when adopting the CAD intervention at the provincial and national levels. The budget impact analysis will take into consideration various scaling-up scenarios for the interventions in the country. The research will assess the cost-effectiveness of the CAD intervention to support national stakeholders in Cambodia to make an informed decision on the adoption and scaling up of the intervention in Cambodia. The results are currently being analyzed and will be available at the time of the conference.

Keywords: Cambodia, community intervention, economic evaluation, global health, HIV/AIDs, implementation research

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Authors: Siti Hazar Sitorus, Marini Kristina Situmeang, Mukhammad Fatkhullah, Arfan Fadli

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This study aims to examine how the Batak tribe in the Village Lumban Sitorus Parmaksian District, Toba Samosir (Tobasa) interpret the culture of drinking Tuak as a social interaction. This research uses qualitative method with case study approach. Through this approach, the researchers obtained primary data by looking at and observing the social interaction that occurs when the activity of drinking tuak takes place on the daily life of the Batak Toba community in the village of Lumban Sitorus. The technique of data collecting is done by observation and in-depth interview. This study focuses on Batak Toba community, especially men who daily drink tuak. The results obtained from this study is Batak Toba society has a habit of drinking Tuak (a type of alcoholic beverage derived from water sapphire juice that is fermented). In Batak Toba society, tuak is not only considered as an alcoholic drink which is usually drunk in the afternoon at lapotuak (tuak shop), but tuak is also understood as a drink of honor in a traditional party at Toba Batak society. On the other hand, the activity of drinking of tuak was also considered as a medium or a means of connecting the formation of a sense of solidarity among the people of LumbanSitorous Village. In its existence, drinking tuak is defined as a mean that can facilitate the establishment to open communication with fellow members of Batak Toba community, such as at leisure, birth party, death or as medicine. Specifically, tuak in a special sense in Batak Toba society is also a symbol of intimacy, gratitude, and respect which is manifested in the activity of daily drinking tuak. In Indonesia, if we refer to the Criminal Code in articles 300 and 536 it is clear that whoever intentionally sells and consumes intoxicating / alcoholic drinks will be subject to a maximum jail term of one year. It became interesting then when looking at Indonesia as a country that has a diversity of cultures in which the law implies the prohibition of alcoholic / intoxicating beverages. However, the existence of drinking of tuak as a drink that categorized intoxicating in Batak Toba society still continues to.

Keywords: tradition of drinking tuak, meaning of tuak, Batak society, cultural studies

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