Search results for: limited capacity

Authors: Ammar Asma, Bouafia Nabiha, Dhahri Meriem, Ben Cheikh Asma, Ezzi Olfa, Chafai Rim, Njah Mansour

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Despite recent advances in treatment of the lung cancer patients, the prognosis remains poor. Information is limited regarding health related quality of life (QOL) status of advanced lung cancer patients. The purposes of this study were: to assess patient reported symptom burden, to measure their QOL, and to identify determinant factors associated with QOL. Materials/Methods: A cross sectional study of 60 patients was carried out from over the period of 03 months from February 1st to 30 April 2016. Patients were recruited in two department of health care: Pneumology department in a university hospital in Sousse and an oncology unit in a University Hospital in Kairouan. Patients with advanced stage (III and IV) of lung cancer who were hospitalized or admitted in the day hospital were recruited by convenience sampling. We used a questionnaire administrated and completed by a trained interviewer. This questionnaire is composed of three parts: demographic, clinical and therapeutic information’s, QOL measurements: based on the SF-36 questionnaire, Symptom’s burden measurement using the Lung Cancer Symptom Scale (LCSS). To assess Correlation between symptoms burden and QOL, we compared the scores of two scales two by two using the Pearson correlation. To identify factors influencing QOL in Lung cancer, a univariate statistical analysis then, a stepwise backward approach, wherein the variables with p< 0.2, were carried out to determine the association between SF-36 scores and different variables. Results: During the study period, 60 patients consented to complete symptom and quality of life questionnaires at a single point time (72% were recruited from day hospital). The majority of patients were male (88%), age ranged from 21 to 79 years with a mean of 60.5 years. Among patients, 48 (80%) were diagnosed as having non-small cell lung carcinoma (NSCLC). Approximately, 60 % (n=36) of patients were in stage IV, 25 % in stage IIIa and 15 % in stage IIIb. For symptom burden, the symptom burden index was 43.07 (Standard Deviation, 21.45). Loss of appetite and fatigue were rated as the most severe symptoms with mean scores (SD): 49.6 (25.7) and 58.2 (15.5). The average overall score of SF36 was 39.3 (SD, 15.4). The physical and emotional limitations had the lowest scores. Univariate analysis showed that factors which influence negatively QOL were: married status (p<0.03), smoking cessation after diagnosis (p<0.024), LCSS total score (p<0.001), LCSS symptom burden index (p<0.001), fatigue (p<0.001), loss of appetite (p<0.001), dyspnea (p<0.001), pain (p<0.002), and metastatic stage (p<0.01). In multivariate analysis, unemployment (p<0.014), smoking cessation after diagnosis (p<0.013), consumption of analgesic (p<0.002) and the indication of an analgesic radiotherapy (p<0.001) are revealed as independent determinants of QOL. The result of the correlation analyses between total LCSS scores and the total and individual domain SF36 scores was significant (p<0.001); the higher total LCSS score is, the poorer QOL is. Conclusion: A built in support of lung cancer patients would better control the symptoms and promote the QOL of these patients.

Keywords: quality of life, lung cancer, metastasis, symptoms burden

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Authors: Anna Makuch, Grzegorz Kokot, Konstanty Skalski, Jakub Banczorowski

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Cancellous bone is a porous composite of a hierarchical structure and anisotropic properties. The biological tissue is considered to be a viscoelastic material, but many studies based on a nanoindentation method have focused on their elasticity and microhardness. However, the response of many organic materials depends not only on the load magnitude, but also on its duration and time course. Depth Sensing Indentation (DSI) technique has been used for examination of creep in polymers, metals and composites. In the indentation tests on biological samples, the mechanical properties are most frequently determined for animal tissues (of an ox, a monkey, a pig, a rat, a mouse, a bovine). However, there are rare reports of studies of the bone viscoelastic properties on microstructural level. Various rheological models were used to describe the viscoelastic behaviours of bone, identified in the indentation process (e. g Burgers model, linear model, two-dashpot Kelvin model, Maxwell-Voigt model). The goal of the study was to determine the influence of creep effect on the mechanical properties of human cancellous bone in indentation tests. The aim of this research was also the assessment of the material properties of bone structures, having in mind the energy aspects of the curve (penetrator loading-depth) obtained in the loading/unloading cycle. There was considered how the different holding times affected the results within trabecular bone.As a result, indentation creep (CIT), hardness (HM, HIT, HV) and elasticity are obtained. Human trabecular bone samples (n=21; mean age 63±15yrs) from the femoral heads replaced during hip alloplasty were removed and drained from alcohol of 1h before the experiment. The indentation process was conducted using CSM Microhardness Tester equipped with Vickers indenter. Each sample was indented 35 times (7 times for 5 different hold times: t1=0.1s, t2=1s, t3=10s, t4=100s and t5=1000s). The indenter was advanced at a rate of 10mN/s to 500mN. There was used Oliver-Pharr method in calculation process. The increase of hold time is associated with the decrease of hardness parameters (HIT(t1)=418±34 MPa, HIT(t2)=390±50 MPa, HIT(t3)= 313±54 MPa, HIT(t4)=305±54 MPa, HIT(t5)=276±90 MPa) and elasticity (EIT(t1)=7.7±1.2 GPa, EIT(t2)=8.0±1.5 GPa, EIT(t3)=7.0±0.9 GPa, EIT(t4)=7.2±0.9 GPa, EIT(t5)=6.2±1.8 GPa) as well as with the increase of the elastic (Welastic(t1)=4.11∙10-7±4.2∙10-8Nm, Welastic(t2)= 4.12∙10-7±6.4∙10-8 Nm, Welastic(t3)=4.71∙10-7±6.0∙10-9 Nm, Welastic(t4)= 4.33∙10-7±5.5∙10-9Nm, Welastic(t5)=5.11∙10-7±7.4∙10-8Nm) and inelastic (Winelastic(t1)=1.05∙10-6±1.2∙10-7 Nm, Winelastic(t2) =1.07∙10-6±7.6∙10-8 Nm, Winelastic(t3)=1.26∙10-6±1.9∙10-7Nm, Winelastic(t4)=1.56∙10-6± 1.9∙10-7 Nm, Winelastic(t5)=1.67∙10-6±2.6∙10-7)) reaction of materials. The indentation creep increased logarithmically (R2=0.901) with increasing hold time: CIT(t1) = 0.08±0.01%, CIT(t2) = 0.7±0.1%, CIT(t3) = 3.7±0.3%, CIT(t4) = 12.2±1.5%, CIT(t5) = 13.5±3.8%. The pronounced impact of creep effect on the mechanical properties of human cancellous bone was observed in experimental studies. While the description elastic-inelastic, and thus the Oliver-Pharr method for data analysis, may apply in few limited cases, most biological tissues do not exhibit elastic-inelastic indentation responses. Viscoelastic properties of tissues may play a significant role in remodelling. The aspect is still under an analysis and numerical simulations. Acknowledgements: The presented results are part of the research project founded by National Science Centre (NCN), Poland, no.2014/15/B/ST7/03244.

Keywords: bone, creep, indentation, mechanical properties

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Authors: Waheed O. Majekodunmi

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Climate change is a real global phenomenon and an unquestionable threat to our quest for a healthy and livable planet. It is now regarded as potentially the most monumental environmental challenge people and the planet will be confronted with over the next centuries. Expectedly, climate change mitigation was one of the central themes of COP 28. Despite contributing the least to climate change, Africa is and remains the hardest hit by the negative consequences of climate change including poor growth performance. Currently, it is being hypothesized that the high level of vulnerability and exposure to climate-related disasters, low adaptive capacity against global warming and high mitigation costs of climate change across the continent could be linked to the recent abysmal economic performance of African countries, especially in oil-producing countries where greenhouse gas emissions, is potentially more prevalent. This paper examines the impact of climate change on the economic performance of selected oil-producing countries in Africa using evidence from Nigeria, Algeria and Angola. The objective of the study is to determine whether or not climate change influences the economic performance of oil-producing countries in Africa by examining the nexus between economic growth and climate-related variables. The study seeks to investigate the effect of climate change on the pace of economic growth in African oil-producing countries. To achieve the research objectives, this study utilizes a quantitative approach by using historical and current secondary data sets to determine the relationship between climate-related variables and economic growth variables in the selected countries. The study employed numbers, percentages, tables and trend graphs to explain the trends or common patterns between climate change, economic growth and determinants of economic growth: governance effectiveness, infrastructure, macroeconomic stability and regulatory efficiency. Results from the empirical analysis of data show that the trends of economic growth and climate-related variables in the selected oil-producing countries are in the opposite directions as the increasing share of renewable energy sources in total energy consumption and the reduction in greenhouse gas emissions per capita in the oil-producing countries did not translate to higher economic growth. Further findings show that annual surface temperatures in the selected countries do not share similar trends with the food imports ratio and GDP per capita annual growth rate suggesting that climate change does not impact significantly agricultural productivity and economic growth in oil-producing countries in Africa. Annual surface temperature was also found to not share a similar pattern with governance effectiveness, macroeconomic stability and regulatory efficiency reinforcing the claim that some economic growth variables are independent of climate change. The policy implication of this research is that oil-producing African countries need to focus more on improving the macroeconomic environment and streamlining governance and institutional processes to boost their economic performance before considering the adoption of climate change adaptation and mitigation strategies.

Keywords: climate change, climate vulnerability, economic growth, greenhouse gas emissions per capita, oil-producing countries, share of renewable energy in total energy consumption

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Authors: A. Chatel, I. S. Torreguitart, T. Verstraete

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The paper deals with a single point optimization of the LS89 turbine using an adjoint optimization and defining the design variables within a CAD system. The advantage of including the CAD model in the design system is that higher level constraints can be imposed on the shape, allowing the optimized model or component to be manufactured. However, CAD-based approaches restrict the design space compared to node-based approaches where every node is free to move. In order to preserve a rich design space, we develop a methodology to refine the CAD model during the optimization and to create the best parameterization to use at each time. This study presents a methodology to progressively refine the design space, which combines parametric effectiveness with a differential evolutionary algorithm in order to create an optimal parameterization. In this manuscript, we show that by doing the parameterization at the CAD level, we can impose higher level constraints on the shape, such as the axial chord length, the trailing edge radius and G2 geometric continuity between the suction side and pressure side at the leading edge. Additionally, the adjoint sensitivities are filtered out and only smooth shapes are produced during the optimization process. The use of algorithmic differentiation for the CAD kernel and grid generator allows computing the grid sensitivities to machine accuracy and avoid the limited arithmetic precision and the truncation error of finite differences. Then, the parametric effectiveness is computed to rate the ability of a set of CAD design parameters to produce the design shape change dictated by the adjoint sensitivities. During the optimization process, the design space is progressively enlarged using the knot insertion algorithm which allows introducing new control points whilst preserving the initial shape. The position of the inserted knots is generally assumed. However, this assumption can hinder the creation of better parameterizations that would allow producing more localized shape changes where the adjoint sensitivities dictate. To address this, we propose using a differential evolutionary algorithm to maximize the parametric effectiveness by optimizing the location of the inserted knots. This allows the optimizer to gradually explore larger design spaces and to use an optimal CAD-based parameterization during the course of the optimization. The method is tested on the LS89 turbine cascade and large aerodynamic improvements in the entropy generation are achieved whilst keeping the exit flow angle fixed. The trailing edge and axial chord length, which are kept fixed as manufacturing constraints. The optimization results show that the multilevel optimizations were more efficient than the single level optimization, even though they used the same number of design variables at the end of the multilevel optimizations. Furthermore, the multilevel optimization where the parameterization is created using the optimal knot positions results in a more efficient strategy to reach a better optimum than the multilevel optimization where the position of the knots is arbitrarily assumed.

Keywords: adjoint, CAD, knots, multilevel, optimization, parametric effectiveness

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Authors: Lalanthica Yogendran, Manassa Hany, Saira Pasha, Benjamin Chaucer, Simarpreet Kaur, Christopher Janusz

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Children and adolescent patients visit the Psychiatric Emergency Department (ED) for multiple reasons. Visiting the Psychiatric ED itself can be a traumatic experience that can affect an adolescents mental well-being, regardless of a history of mental illness. Despite this, limited research exists in this domain. Prospective studies have correlated adverse psychosocial determinants among adolescents to risk factors for poor well-being and unfavorable behavior outcomes. Studies have also shown that physiological stress is a contributor in the development of health problems and an increase in substance abuse in adolescents. This study aimed to retrospectively determine which psychosocial factors are associated with an increase in psychiatric ED visits. 600 charts of patients who had a psychiatric ED and inpatient admission visit from January 2014 through December 2014 were reviewed. Sociodemographics, diagnoses, ED visits and inpatient admissions were collected. Descriptive statistics, chi-square tests and independent t-test analyses were utilized to examine differences in the sample to determine which factors affected ED visits and admissions. The sample was 50% female, 35.2% self-identified black, and had a mean age of 13 years. The majority, 85%, went to public school and 17% were in special education. Attention Deficit Hyperactivity Disorder was the most common admitting diagnosis, found in 132(23%) responders. Most patients came from single parent household 305 (53%). The mean ages of patients that were sexually active, with legal issues, and reporting marijuana substance abuse were 15, 14.35, and 15 years respectively. Patients from two biological parent households had significantly fewer ED visits (1.2 vs. 1.7, p < 0.01) and admissions (0.09 vs. 0.26, p < 0.01). Among social factors, those who reported sexual, physical or emotional abuse had a significantly greater number of ED visits (2.1 vs. 1.5, p < 0.01) and admissions (0.61 vs. 0.14, p < 0.01) than those who did not. Patients that were sexually active or had legal issues or substance abuse with marijuana had a significantly greater number of admissions (0.43 vs. 0.17, p < 0.01), (0.54 vs. .18, p < 0.01) and (0.46 vs. 0.18, p < 0.01) respectively. This data supports the theory of the stability of a two parent home. Dual parenting plays a role in creating a safe space where a child can develop; this is shown by subsequent decreases in psychiatric ED visits and admissions. This may highlight the psychological protective role of a two parent household. Abuse can exacerbate existing psychiatric illness or initiate the onset of new disease. Substance abuse and legal issues result in early induction to the criminal system. Results show that this causes an increase in frequency of visits and severity of symptoms. Only marijuana, but not other illicit substances, correlated with higher incidence of psychiatric ED visits. This may speak to the psychotropic nature of tetrahydrocannabinols and their role in mental illness. This study demonstrates the array of psychosocial factors that lead to increased ED visits and admissions in children and adolescents.

Keywords: adolescent, child psychiatry, emergency department, substance abuse

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Authors: Bing Chen, Xiang Ni, Eric Li

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With the population ageing, the number of patients suffering from chronic diseases is increasing, among which stroke is a high incidence for the elderly. In addition, there is a gradual increase in the number of patients with orthopedic or neurological conditions such as spinal cord injuries, nerve injuries, and other knee injuries. These diseases are chronic, with high recurrence and complications, and normal walking is difficult for such patients. Nowadays, robotic knee exoskeletons have been developed for individuals with knee impairments. However, the currently available robotic knee exoskeletons are generally developed with heavyweight, which makes the patients uncomfortable to wear, prone to wearing fatigue, shortening the wearing time, and reducing the efficiency of exoskeletons. Some lightweight materials, such as carbon fiber and titanium alloy, have been used for the development of robotic knee exoskeletons. However, this increases the cost of the exoskeletons. This paper illustrates the design of a new ultra-light and ultra-stiff truss type of lattice structure. The lattice structures are arranged in a fan shape, which can fit well with circular arc surfaces such as circular holes, and it can be utilized in the design of rods, brackets, and other parts of a robotic knee exoskeleton to reduce the weight. The metamaterial is formed by continuous arrangement and combination of small truss structure unit cells, which changes the diameter of the pillar section, geometrical size, and relative density of each unit cell. It can be made quickly through additive manufacturing techniques such as metal 3D printing. The unit cell of the truss structure is small, and the machined parts of the robotic knee exoskeleton, such as connectors, rods, and bearing brackets, can be filled and replaced by gradient arrangement and non-uniform distribution. Under the condition of satisfying the mechanical properties of the robotic knee exoskeleton, the weight of the exoskeleton is reduced, and hence, the patient’s wearing fatigue is relaxed, and the wearing time of the exoskeleton is increased. Thus, the efficiency and wearing comfort, and safety of the exoskeleton can be improved. In this paper, a brief description of the hardware design of the prototype of the robotic knee exoskeleton is first presented. Next, the design of the ultra-light and ultra-stiff truss type of lattice structures is proposed, and the mechanical analysis of the single-cell unit is performed by establishing the theoretical model. Additionally, simulations are performed to evaluate the maximum stress-bearing capacity and compressive performance of the uniform arrangement and gradient arrangement of the cells. Finally, the static analysis is performed for the cell-filled rod and the unmodified rod, respectively, and the simulation results demonstrate the effectiveness and feasibility of the designed ultra-light and ultra-stiff truss type of lattice structures. In future studies, experiments will be conducted to further evaluate the performance of the designed lattice structures.

Keywords: additive manufacturing, lattice structures, metamaterial, robotic knee exoskeleton

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Authors: Lilian Nantume Wampande

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Group-based strategies in the delivery of HIV care have opened up new avenues not only for meaningful participation for HIV positive people but also platforms for deconstruction and reconstruction of knowledge about living with the virus. Yet the contributions of such strategies among patients who live in high risk areas are still not explored. This case study research assessed the impact of HIV support networks on sexual health outcomes of HIV positive out-of-school adolescents residing in fishing islands of Kalangala in Uganda. The study population was out-of-school adolescents living with HIV and their sexual partners (n=269), members of their households (n=80) and their health service providers (n=15). Data were collected via structured interviews, observations and focus group discussions between August 2016 and March 2017. Data was then analyzed inductively to extract key themes related to the approaches and outcomes of the groups’ activities. The study findings indicate that support groups unite HIV positive adolescents in a bid for social renegotiation to achieve change but individual constraints surpass the groups’ intentions. Some adolescents for example reported increased fear which led to failure to cope, sexual violence, self-harm and denial of status as a result of the high expectations placed on them as members of the support groups. Further investigations around this phenomenon show that HIV networks play a monotonous role as information sources for HIV positive out-of-school adolescents which limit their creativity to seek information elsewhere. Results still indicate that HIV adolescent groups recognize the complexity of long-term treatment and stay in care leading to improved immunity for the majority yet; there is still scattered evidence about how effective they are among adolescents at different phases in the disease trajectory. Nevertheless, the primary focus of developing adolescent self-efficacy and coping skills significantly address a range of disclosure difficulties and supports autonomy. Moreover, the peer techniques utilized in addition to the almost homogeneous group characteristics accelerates positive confidence, hope and belongingness. Adolescent HIV-support groups therefore have the capacity to both improve and/or worsen sexual health outcomes for a young adolescent who is out-of-school. Communication interventions that seek to increase awareness about ‘self’ should therefore be emphasized more than just fostering collective action. Such interventions should be sensitive to context and gender. In addition, facilitative support supervision done by close and trusted health care providers, most preferably Village Health Teams (who are often community elected volunteers) would help to follow-up, mentor, encourage and advise this young adolescent in matters involving sexuality and health outcomes. HIV/AIDS prevention programs have extended their efforts beyond individual focus to those that foster collective action, but programs should rekindle interpersonal level strategies to address the complexity of individual behavior.

Keywords: adolescent, HIV, support groups, Uganda

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Authors: Karen L. Rincon-Granados, América R. Vázquez-Olmos, Adriana-Patricia Rodríguez-Hernández, Gina Prado-Prone, Margarita Rivera, Roberto Y. Sato-Berrú

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In this work, a hybrid film based on poly-3-hydroxybutyrate (P3HB) and nickel ferrite (NiFe₂O₄) nanoparticles (NPs) was obtained by a simple and reproducible methodology in order to study its antibacterial and cytotoxic properties. The motivation for this research is the current antimicrobial resistance (RAM). This is a threat to human health and development worldwide. RAM is caused by the emergence of bacterial strains resistant to traditional antibiotics that were used as treatment. Due to this, the need to investigate new alternatives for preventing and treating bacterial infections emerges. In this sense, metal oxide NPs have aroused great interest due to their unique physicochemical properties. However, their use is limited by the nanostructured nature, commonly obtained by chemical and physical synthesis methods, as powders or colloidal dispersions. Therefore, the incorporation of nanostructured materials in polymer matrices to obtain hybrid materials that allow disinfecting and preventing the spread of bacteria on various surfaces. Accordingly, this work presents the synthesis and study of the antibacterial properties of the P3HB@NiFe₂O₄ hybrid film as a potential material to inhibit bacterial growth. The NiFe₂O₄ NPs were previously synthesized by a mechanochemical method. The P3HB and P3HB@NiFe₂O₄ films were obtained by the solvent casting method. The films were characterized by X-ray diffraction (XRD), Raman scattering, and scanning electron microscopy (SEM). The XRD pattern showed that the NiFe₂O₄ NPs were incorporated into the P3HB polymer matrix and retained their nanometric sizes. By energy dispersive X-ray spectroscopy (EDS), it was observed that the NPs are homogeneously distributed in the film. The bactericidal effect of the films obtained was evaluated in vitro using the broth surface method against two opportunistic and nosocomial pathogens, Staphylococcus aureus and Pseudomonas aeruginosa. The bacterial growth results showed that the P3HB@NiFe₂O₄ hybrid film was inhibited by 97% and 96% for S. aureus and P. aeruginosa, respectively. Surprisingly, the P3HB film inhibited both bacterial strains by around 90%. The cytotoxicity of the NiFe₂O₄ NPs, P3HB@NiFe₂O₄ hybrid film, and the P3HB film was evaluated using human skin cells, keratinocytes, and fibroblasts, finding that the NPs are biocompatible. The P3HB film and hybrids are cytotoxic, which demonstrated that although P3HB is known and reported as a biocompatible polymer, under our work conditions, P3HB was cytotoxic. Its bactericidal effect could be related to this activity. Its films are bactericidal and cytotoxic to keratinocytes and fibroblasts, the first barrier of human skin. Despite this, the hybrid film of P3HB@NiFe₂O₄ presents synergy with the bactericidal effect between P3HB and NPs, increasing bacterial inhibition. In addition, NPs decrease the cytotoxicity of P3HB to keratinocytes. The methodology used in this work was successful in producing hybrid films with antibacterial activity. However, future challenges are generated to find relationships between NPs and P3HB that allow taking advantage of their bactericidal properties and do not compromise biocompatibility.

Keywords: poly-3-hydroxybutyrate, nanoparticles, hybrid film, antibacterial

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Authors: Cameron Wilson, Megan Hanrahan, Katie Brittain, Riona McArdle, Alison Keogh, Lynn Rochester

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Background: The loss of mobility and functional dependence is a significant marker in the progression of neurodegenerative diseases such as Parkinson’s Disease (PD). Pharmacological, surgical, and therapeutic treatments are available that can help in the management and amelioration of PD symptoms; however, these only prolong more severe symptoms. Accordingly, ensuring people with PD can maintain independence and a healthy wellbeing are essential in establishing an effective treatment option for those afflicted. Existing literature reviews have examined experiences in engaging with PD treatment options and the impact of PD on independence and wellbeing. Although, the literature fails to explore the influence of treatment options on independence and wellbeing and therefore misses what people value in their treatment. This review is the first that synthesises the impact of mobility-related treatments on independence and wellbeing in people with PD and their carers, offering recommendations to clinical practice and provides a conceptual framework (in development) for future research and practice. Objectives: To explore the impact of mobility-related treatment (both pharmacological and non-pharmacological) on the independence and wellbeing of people with PD and their carers. To propose a conceptual framework to patients, carers and clinicians which captures the qualities people with PD value as part of their treatment. Methods: We performed a critical interpretive synthesis of qualitative evidence, searching six databases for reports that explored the impact of mobility-related treatments (both drug and non-pharmacological) on independence and wellbeing in Parkinson’s Disease. The types of treatments included medication (Levodopa and Amantadine), dance classes, Deep-Brain Stimulation, aquatic therapies, physical rehabilitation, balance training and foetal transplantation. Data was extracted, and quality was assessed using an adapted version of the NICE Quality Appraisal Tool Appendix H before being synthesised according to the critical interpretive synthesis framework and meta-ethnography process. Results: From 2301 records, 28 were eligible. Experiences and impact of treatment pathway on independence and wellbeing was similar across all types of treatments and are described by five inter-related themes: (i) desire to maintain independence, (ii) treatment as a social experience during and after, (iii) medication to strengthen emotional health, (iv) recognising physical capacity and (v) emphasising the personal journey of Parkinson’s treatments. Conclusion: There is a complex and inter-related experience and effect of PD treatments common across all types of treatment. The proposed conceptual framework (in development) provides patients, carers, and clinicians recommendations to personalise the delivery of PD treatment, thereby potentially improving adherence and effectiveness. This work is vital to disseminate as PD treatment transitions from subjective and clinically captured assessments to a more personalised process supplemented using wearable technology.

Keywords: parkinson's disease, medication, treatment, dance, review, healthcare, delivery, levodopa, social, emotional, psychological, personalised healthcare

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Authors: Langhit Kurar, Loren Charles

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Introduction: In light of recent BOAST 12 (August 2016) published guidance on management of ankle fractures, the project aimed to highlight key discrepancies throughout the care trajectory from admission to point of discharge at a district general hospital. Wide breadth of data covering three key domains: accident and emergency, radiology, and orthopaedic surgery were subsequently stratified and recommendations on note documentation, and outpatient follow up were made. Methods: A retrospective twelve month audit was conducted reviewing results of ankle fracture management in 37 patients. Inclusion criterion involved all patients seen at Darent Valley Hospital (DVH) emergency department with radiographic evidence of an ankle fracture. Exclusion criterion involved all patients managed solely by nursing staff or having sustained purely ligamentous injury. Medical notes, including discharge summaries and the PACS online radiographic tool were used for data extraction. Results: Cross-examination of the A & E domain revealed limited awareness of the BOAST 12 recent publication including requirements to document skin integrity and neurovascular assessment. This had direct implications as this would have changed the surgical plan for acutely compromised patients. The majority of results obtained from the radiographic domain were satisfactory with appropriate X-rays taken in over 95% of cases. However, due to time pressures within A & E, patients were often left without a post manipulation XRAY in a backslab. Poorly reduced fractures were subsequently left for a long period resulting in swollen ankles and a time-dependent lag to surgical intervention. This had knocked on implications for prolonged inpatient stay resulting in hospital-acquired co-morbidity including pressure sores. Discussion: The audit has highlighted several areas of improvement throughout the disease trajectory from review in the emergency department to follow up as an outpatient. This has prompted the creation of an algorithm to ensure patients with significant fractures presenting to the emergency department are seen promptly and treatment expedited as per recent guidance. This includes timing for X-rays taken in A & E. Re-audit has shown significant improvement in both documentation at time of presentation and appropriate follow-up strategies. Within the orthopedic domain, we are in the process of creating an ankle fracture pathway to ensure imaging and weight bearing status are made clear to the consulting clinicians in an outpatient setting. Significance/Clinical Relevance: As a result of the ankle fracture algorithm we have adapted the BOAST 12 guidance to shape an intrinsic pathway to not only improve patient management within the emergency department but also create a standardised format for follow up.

Keywords: ankle, fracture, BOAST, radiology

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Authors: Tarun Kumar Dalakoti, Debajyoti Majumder, Aditya Prasad Das, Samir Chandra Saxena

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India’s ambitious target to achieve a 50 percent share of energy from non-fossil fuels and the 500-gigawatt (GW) renewable energy capacity before the deadline of 2030, coupled with the global pursuit of sustainable development, will compel the nation to embark on a rapid clean energy transition. As a result, electricity market reforms will emerge as critical policy instruments to facilitate this transition and achieve ambitious environmental targets. This paper will present a comprehensive analysis of the various electricity market reforms to be introduced in the Indian Electricity sector to facilitate the integration of clean energy sources and will assess their impact on the overall energy landscape. The first section of this paper will delve into the policy mechanisms to be introduced by the Government of India and the Central Electricity Regulatory Commission to promote clean energy deployment. These mechanisms include extensive provisions for the integration of renewables in the Indian Electricity Grid Code, 2023. The section will also cover the projection of RE Generation as highlighted in the National Electricity Plan, 2023. It will discuss the introduction of Green Energy Market segments, the waiver of Inter-State Transmission System (ISTS) charges for inter-state sale of solar and wind power, the notification of Promoting Renewable Energy through Green Energy Open Access Rules, and the bundling of conventional generating stations with renewable energy sources. The second section will evaluate the tangible impact of these electricity market reforms. By drawing on empirical studies and real-world case examples, the paper will assess the penetration rate of renewable energy sources in India’s electricity markets, the decline of conventional fuel-based generation, and the consequent reduction in carbon emissions. Furthermore, it will explore the influence of these reforms on electricity prices, the impact on various market segments due to the introduction of green contracts, and grid stability. The paper will also discuss the operational challenges to be faced due to the surge of RE Generation sources as a result of the implementation of the above-mentioned electricity market reforms, including grid integration issues, intermittency concerns with renewable energy sources, and the need for increasing grid resilience for future high RE in generation mix scenarios. In conclusion, this paper will emphasize that electricity market reforms will be pivotal in accelerating the global transition towards clean energy systems. It will underscore the importance of a holistic approach that combines effective policy design, robust regulatory frameworks, and active participation from market actors. Through a comprehensive examination of the impact of these reforms, the paper will shed light on the significance of India’s sustained commitment to a cleaner, more sustainable energy future.

Keywords: renewables, Indian electricity grid code, national electricity plan, green energy market

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Authors: Katherine Dropiewski, Michael Yakimov, Vadim Tokranov, Allan Minns, Pavel Murat, Serge Oktyabrsky

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InAs Quantum Dots (QDs) in a GaAs matrix is a well-documented luminescent material with high light yield, as well as thermal and ionizing radiation tolerance due to quantum confinement. These benefits can be leveraged for high-efficiency, room temperature scintillation detectors. The proposed scintillator is composed of InAs QDs acting as luminescence centers in a GaAs stopping medium, which also acts as a waveguide. This system has appealing potential properties, including high light yield (~240,000 photons/MeV) and fast capture of photoelectrons (2-5ps), orders of magnitude better than currently used inorganic scintillators, such as LYSO or BaF2. The high refractive index of the GaAs matrix (n=3.4) ensures light emitted by the QDs is waveguided, which can be collected by an integrated photodiode (PD). Scintillation structures were grown using Molecular Beam Epitaxy (MBE) and consist of thick GaAs waveguiding layers with embedded sheets of modulation p-type doped InAs QDs. An AlAs sacrificial layer is grown between the waveguide and the GaAs substrate for epitaxial lift-off to separate the scintillator film and transfer it to a low-index substrate for waveguiding measurements. One consideration when using a low-density material like GaAs (~5.32 g/cm³) as a stopping medium is the matrix thickness in the dimension of radiation collection. Therefore, luminescence properties of very thick (4-20 microns) waveguides with up to 100 QD layers were studied. The optimization of the medium included QD shape, density, doping, and AlGaAs barriers at the waveguide surfaces to prevent non-radiative recombination. To characterize the efficiency of QD luminescence, low temperature photoluminescence (PL) (77-450 K) was measured and fitted using a kinetic model. The PL intensity degrades by only 40% at RT, with an activation energy for electron escape from QDs to the barrier of ~60 meV. Attenuation within the waveguide (WG) is a limiting factor for the lateral size of a scintillation detector, so PL spectroscopy in the waveguiding configuration was studied. Spectra were measured while the laser (630 nm) excitation point was scanned away from the collecting fiber coupled to the edge of the WG. The QD ground state PL peak at 1.04 eV (1190 nm) was inhomogeneously broadened with FWHM of 28 meV (33 nm) and showed a distinct red-shift due to self-absorption in the QDs. Attenuation stabilized after traveling over 1 mm through the WG, at about 3 cm⁻¹. Finally, a scintillator sample was used to test detection and evaluate timing characteristics using 5.5 MeV alpha particles. With a 2D waveguide and a small area of integrated PD, the collected charge averaged 8.4 x10⁴ electrons, corresponding to a collection efficiency of about 7%. The scintillation response had 80 ps noise-limited time resolution and a QD decay time of 0.6 ns. The data confirms unique properties of this scintillation detector which can be potentially much faster than any currently used inorganic scintillator.

Keywords: GaAs, InAs, molecular beam epitaxy, quantum dots, III-V semiconductor

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Authors: Kanchan Mondal, Adam Sims, Madhav Soti, Jitendra Gautam, David Carron

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Fischer-Tropsch (FT) synthesis is a complex series of heterogeneous reactions between CO and H2 molecules (present in the syngas) on the surface of an active catalyst (Co, Fe, Ru, Ni, etc.) to produce gaseous, liquid, and waxy hydrocarbons. This product is composed of paraffins, olefins, and oxygenated compounds. The key challenge in applying the Fischer-Tropsch process to produce transportation fuels is to make the capital and production costs economically feasible relative to the comparative cost of existing petroleum resources. To meet this challenge, it is imperative to enhance the CO conversion while maximizing carbon selectivity towards the desired liquid hydrocarbon ranges (i.e. reduction in CH4 and CO2 selectivities) at high throughputs. At the same time, it is equally essential to increase the catalyst robustness and longevity without sacrificing catalyst activity. This paper focuses on process development to achieve the above. The paper describes the influence of operating parameters on Fischer Tropsch synthesis (FTS) from coal derived syngas in supercritical carbon dioxide (ScCO2). In addition, the unreacted gas and solvent recycle was incorporated and the effect of unreacted feed recycle was evaluated. It was expected that with the recycle, the feed rate can be increased. The increase in conversion and liquid selectivity accompanied by the production of narrower carbon number distribution in the product suggest that higher flow rates can and should be used when incorporating exit gas recycle. It was observed that this process was capable of enhancing the hydrocarbon selectivity (nearly 98 % CO conversion), reducing improving the carbon efficiency from 17 % to 51 % in a once through process and further converting 16 % CO2 to liquid with integrated recycle of the product gas stream and increasing the life of the catalyst. Catalyst robustness enhancement has been attributed to the absorption of heat of reaction by the compressed CO2 which reduced the formation of hotspots and the dissolution of waxes by the CO2 solvent which reduced the blinding of active sites. In addition, the recycling the product gas stream reduced the reactor footprint to one-fourth of the once through size and product fractionation utilizing the solvent effects of supercritical CO2 were realized. In addition to the negative CO2 selectivities, methane production was also inhibited and was limited to less than 1.5%. The effect of the process conditions on the life of the catalysts will also be presented. Fe based catalysts are known to have a high proclivity for producing CO2 during FTS. The data of the product spectrum and selectivity on Co and Fe-Co based catalysts as well as those obtained from commercial sources will also be presented. The measurable decision criteria were the increase in CO conversion at H2:CO ratio of 1:1 (as commonly found in coal gasification product stream) in supercritical phase as compared to gas phase reaction, decrease in CO2 and CH4 selectivity, overall liquid product distribution, and finally an increase in the life of the catalysts.

Keywords: carbon efficiency, Fischer Tropsch synthesis, low GHG, pressure tunable fractionation

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Authors: M. N. Nwodo, Y. P. Cheng, N. H. Minh

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In the process of recovering oil in weak sandstone formations, the strength of sandstones around the wellbore is weakened due to the increase of effective stress/load from the completion activities around the cavity. The weakened and de-bonded sandstone may be eroded away by the produced fluid, which is termed sand production. It is one of the major trending subjects in the petroleum industry because of its significant negative impacts, as well as some observed positive impacts. For efficient sand management therefore, there has been need for a reliable study tool to understand the mechanism of sanding. One method of studying sand production is the use of the widely recognized Discrete Element Method (DEM), Particle Flow Code (PFC3D) which represents sands as granular individual elements bonded together at contact points. However, there is limited knowledge of the particle-scale behavior of the weak sandstone, and the parameters that affect sanding. This paper aims to investigate the reliability of using PFC3D and a simple Darcy flow in understanding the sand production behavior of a weak sandstone. An isotropic tri-axial test on a weak oil sandstone sample was first simulated at a confining stress of 1MPa to calibrate and validate the parallel bond models of PFC3D using a 10m height and 10m diameter solid cylindrical model. The effect of the confining stress on the number of bonds failure was studied using this cylindrical model. With the calibrated data and sample material properties obtained from the tri-axial test, simulations without and with fluid flow were carried out to check on the effect of Darcy flow on bonds failure using the same model geometry. The fluid flow network comprised of every four particles connected with tetrahedral flow pipes with a central pore or flow domain. Parametric studies included the effects of confining stress, and fluid pressure; as well as validating flow rate – permeability relationship to verify Darcy’s fluid flow law. The effect of model size scaling on sanding was also investigated using 4m height, 2m diameter model. The parallel bond model successfully calibrated the sample’s strength of 4.4MPa, showing a sharp peak strength before strain-softening, similar to the behavior of real cemented sandstones. There seems to be an exponential increasing relationship for the bigger model, but a curvilinear shape for the smaller model. The presence of the Darcy flow induced tensile forces and increased the number of broken bonds. For the parametric studies, flow rate has a linear relationship with permeability at constant pressure head. The higher the fluid flow pressure, the higher the number of broken bonds/sanding. The DEM PFC3D is a promising tool to studying the micromechanical behavior of cemented sandstones.

Keywords: discrete element method, fluid flow, parametric study, sand production/bonds failure

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Authors: S. A. Abeykoon

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This study explores the empowerment potential of the mobile phone, the widely penetrated and greatly affordable communication technology in Sri Lanka, for female heads of households in Trincomalee District, Sri Lanka-an area recovering from the effects of a 30-year civil war and the 2004 Boxing Day Tsunami. It also investigates how the use of mobile phones by these women is shaped and appropriated by the gendered power relations and inequalities in their respective communities and by their socio-economic factors and demographic characteristics. This qualitative study is based on the epistemology of constructionism; interpretivist, functionalist and critical theory approaches; and the process of action research. The data collection was conducted from September 2014 to November 2014 in two Divisional Secretaries of the Trincomalee District, Sri Lanka. A total of 30 semi-structured depth interviews and six focus groups with the female heads of households of Sinhalese, Tamil and Muslim ethnicities were conducted using purposive, representative and snowball sampling methods. The Grounded theory method was used to analyze transcribed interviews, focus group discussions and field notes that were coded and categorized in accordance with the research questions and the theoretical framework of the study. The findings of the study indicated that the mobile phone has mainly enabled the participants to balance their income earning activities and family responsibilities and has been useful in maintaining their family and social relationships, occupational duties and in making decisions. Thus, it provided them a higher level of security, safety, reassurance and self-confidence in carrying out their daily activities. They also practiced innovative strategies for the effective and efficient use of their mobile expenses. Although participants whose husbands or relatives have migrated were more tended to use smart phones, mobile literacy level of the majority of the participants was at a lower level limited to making and receiving calls and using SMS (Short Message Service) services. However, their interaction with the mobile phone was significantly shaped by the gendered power relations and their multiple identities based on their ethnicity, religion, class, education, profession and age. Almost all the participants were precautious of giving their mobile numbers to and have been harassed with ‘nuisance calls’ from men. For many, ownership and use of their mobile phone was shaped and influenced by their children and migrated husbands. Although these practices limit their use of the technology, there were many instances that they challenged these gendered harassments. While man-made and natural destructions have disempowered and victimized the women in the Sri Lankan society, they have also liberated women making them stronger and transforming their agency and traditional gender roles. Therefore, their present position in society is reflected in their mobile phone use as they assist such women to be more self-reliant and liberated, yet making them disempowered at some time.

Keywords: mobile phone, gender power relations, empowerment, female heads of households

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Authors: Celine Shi Ying Lee, Jong Jian Lee

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Background: Infectious keratitis is one of the leading causes of blindness worldwide. Prompt treatment with effective medication will control the infection early, preventing corneal scarring and visual loss. fluoroquinolones ophthalmic medication is used because of its broad-spectrum properties, potency, good intraocular penetration, and low toxicity. The study aims to evaluate the treatment outcome of corneal ulcers using Levofloxacin 1.5% ophthalmic solution (LVFX) with adjuvant oral ciprofloxacin when indicated and apply this treatment strategy in primary health care as first-line treatment. Methods: Patients with infective corneal ulcer treated in an eye center were recruited. Inclusion criteria includes Corneal infection consistent with bacterial keratitis, single or multiple small corneal ulcers. Treatment regime: LVFX hourly for the first 2 days, 2 hourly from the 3rd day, and 3 hourly on the 5th day of review. Adjuvant oral ciprofloxacin 500mg BD was administered for 5 days if there were multiple corneal ulcers or when the location of the cornea ulcer was central or paracentral. Results: 47 subjects were recruited. There were 16 (34%) males and 31 (66%) females. 40 subjects (85%) were contact lens (CL) related to corneal ulcer, and 7 subjects (15%) were non-contact lens related. 42 subjects (89%) presented with one ulcer, of which 20 of them (48%) needed adjuvant therapy. 5 subjects presented with 2 or 3 ulcers, of which 3 needed adjuvant therapy. A total of 23 subjects (49%) was given adjuvant therapy (oral ciprofloxacin 500mg BD for 5 days).21 of them (91%) were CL related. All subjects recovered fully, and the average duration of treatment was 3.7 days, with 49% of the subjects resolved on the 3rd day, 38% on the 5thday of and 13% on the 7thday. All subjects showed symptoms of relief of pain, light-sensitivity, and redness on the 3rd day with full visual recovery post-treatment. No adverse drug reactions were recorded. Conclusion: Our treatment regime demonstrated good clinical outcome as first-line treatment for corneal ulcers. A corneal ulcer is a common eye condition in Singapore, mainly due to CL wear. Pseudomonas aeruginosa is the most frequent and potentially sight-threatening pathogen involved in CL related corneal ulcer. Coagulase-negative Staphylococci, Staphylococcus aureus, and Streptococcus Pneumoniae were seen in non-CL users. All these bacteria exhibit good sensitivity rates to ciprofloxacin and levofloxacin. It is therefore logical in our study to use LVFX Eyedrops and adjuvant ciprofloxacin oral antibiotics when indicated as first line treatment for most corneal ulcers. Our study of patients, both CL related and non-CL related, have shown good clinical response and full recovery using the above treatment strategy. There was also a full restoration of visual acuity in all the patients. Eye-trained primary Healthcare practitioners can consider adopting this treatment strategy as first line treatment in patients with corneal ulcers. This is relevant during the COVID pandemic, where hospitals are overwhelmed with patients and in regions with limited access to specialist eye care. This strategy would enable early treatment with better clinical outcome.

Keywords: corneal ulcer, levofloxacin hydrate, treatment strategy, ciprofloxacin

Procedia PDF Downloads 154

Authors: Debarpita Pande

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On 22nd May 2013 Chinese Premier Li Keqiang on his visit to Pakistan tabled a proposal for connecting Kashgar in China’s Xinjiang Uygur Autonomous Region with the south-western Pakistani seaport of Gwadar via the China Pakistan Economic Corridor (hereinafter referred to as CPEC). The project, popularly termed as 'One Belt One Road' will encompass within it a connectivity component including a 3000-kilometre road, railways and oil pipeline from Kashgar to Gwadar port along with an international airport and a deep sea port. Superficially, this may look like a 'game changer' for Pakistan and other countries of South Asia but this article by doctrinal method of research will unearth some serious flaws in it, which may change the entire economic system of this region heavily affecting the socio-economic conditions of South Asia, further complicating the complete geopolitical situation of the region disturbing the world economic stability. The paper besets with a logical analyzation of the socio-economic issues arising out of this project with an emphasis on its impact on the Pakistani and Indian economy due to Chinese dominance, serious tension in international relations, security issues, arms race, political and provincial concerns. The research paper further aims to study the impact of huge burden of loan given by China towards this project where Pakistan already suffers from persistent debts in the face of declining foreign currency reserves along with that the sovereignty of Pakistan will also be at stake as the entire economy of the country will be held hostage by China. The author compares this situation with the fallout from projects in Sri Lanka, Tajikistan, and several countries of Africa, all of which are now facing huge debt risks brought by Chinese investments. The entire economic balance will be muddled by the increment in Pakistan’s demand of raw materials resulting to the import of the same from China, which will lead to exorbitant price-hike and limited availability. CPEC will also create Chinese dominance over the international movement of goods that will take place between the Atlantic and the Pacific oceans and hence jeopardising the entire economic balance of South Asia along with Middle Eastern countries like Dubai. Moreover, the paper also analyses the impact of CPEC in the context of international unrest and arms race between Pakistan and India as well as India and China due to border disputes and Chinese surveillance. The paper also examines the global change in economic dynamics in international trade that CPEC will create in the light of U.S.-China relationship. The article thus reflects the grave consequences of CPEC on the international economy, security and bilateral relations, which surpasses the positive impacts of it. The author lastly suggests for more transparency and proper diplomatic planning in the execution of this mega project, which can be a cause of economic complexity in international trade in near future.

Keywords: China, CPEC, international trade, Pakistan

Procedia PDF Downloads 154

Authors: A. Rahim Baharudin, Nor Arinee binti Mat Saaud, Muhammad Afiq Azman, Farah Adiba A. Sani

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Objectives: This paper shares the case study on the engineering analysis, data analysis, and real-time data comparison for qualifying the stand wires' minimum breaking load and safe working load upon loadout operation for a new project and, at the same time, eliminate the risk due to discrepancies and unalignment of COMPANY Technical Standards to Industry Standards and Practices. This paper demonstrates “Lean Construction” for COMPANY’s Project by sustaining fit-for-purpose Technical Requirements of Loadout Strand Wire Factor of Safety (F.S). The case study utilizes historical engineering data from a few loadout operations by skidding methods from different projects. It is also demonstrating and qualifying the skidding wires' minimum breaking load and safe working load used for loadout operation for substructure and other facilities for the future. Methods: Engineering analysis and comparison of data were taken as referred to the international standard and internal COMPANY standard requirements. Data was taken from nine (9) previous projects for both topsides and jacket facilities executed at the several local fabrication yards where load out was conducted by three (3) different service providers with emphasis on four (4) basic elements: i) Industry Standards for Loadout Engineering and Operation Reference: COMPANY internal standard was referred to superseded documents of DNV-OS-H201 and DNV/GL 0013/ND. DNV/GL 0013/ND and DNVGL-ST-N001 do not mention any requirements of Strand Wire F.S of 4.0 for Skidding / Pulling Operations. ii) Reference to past Loadout Engineering and Execution Package: Reference was made to projects delivered by three (3) major offshore facilities operators. Strand Wire F.S observed ranges from 2.0 MBL (Min) to 2.5 MBL (Max). No Loadout Operation using the requirements of 4.0 MBL was sighted from the reference. iii) Strand Jack Equipment Manufacturer Datasheet Reference: Referring to Strand Jack Equipment Manufactured Datasheet by different loadout service providers, it is shown that the Designed F.S for the equipment is also ranging between 2.0 ~ 2.5. Eight (8) Strand Jack Datasheet Model was referred to, ranging from 15 Mt to 850 Mt Capacity; however, there are NO observations of designed F.S 4.0 sighted. iv) Site Monitoring on Actual Loadout Data and Parameter: Max Load on Strand Wire was captured during 2nd Breakout, which is during Static Condition of 12.9 MT / Strand Wire (67.9% Utilization). Max Load on Strand Wire for Dynamic Conditions during Step 8 and Step 12 is 9.4 Mt / Strand Wire (49.5% Utilization). Conclusion: This analysis and study demonstrated the adequacy of strand wires supplied by the service provider were technically sufficient in terms of strength, and via engineering analysis conducted, the minimum breaking load and safe working load utilized and calculated for the projects were satisfied and operated safely for the projects. It is recommended from this study that COMPANY’s technical requirements are to be revised for future projects’ utilization.

Keywords: construction, load out, minimum breaking load, safe working load, strand jacking, skidding

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Authors: Stephen Kyakulumbye, Vivian Kobusingye

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Generally, World over, COVID-19 has had adverse effects on all sectors but with more debilitating effects on the education sector. After reactive lockdowns, education institutions that could continue teaching and learning had to go a distance mediated by digital technological tools. In Uganda, the Ministry of Education thereby issued COVID-19 Online Distance E-learning (ODeL) emergent guidelines. Despite such guidelines, academic institutions in Uganda and similar developing contexts with academically constrained resource environments were caught off-guard and ill-prepared to transform from face-to-face learning to online distance learning mode. Most academic institutions that migrated spontaneously did so with no deliberate tools, systems, strategies, or software to cause active, meaningful, and engaging learning for students. By experience, most of these academic institutions shifted to Zoom and WhatsApp and instead conducted online teaching in real-time than blended synchronous and asynchronous tools. This paper provides students’ experiences while blending synchronous and asynchronous content-creating and learning tools within a technological resource-constrained environment to navigate in such a challenging Uganda context. These conceptual case-based findings, using experience from Uganda Christian University (UCU), point at the design of learning activities with two certain characteristics, the enhancement of synchronous learning technologies with asynchronous ones to mitigate the challenge of system breakdown, passive learning to active learning, and enhances the types of presence (social, cognitive and facilitatory). The paper, both empirical and experiential in nature, uses online experiences from third-year students in Bachelor of Business Administration student lectured using asynchronous text, audio, and video created with Open Broadcaster Studio software and compressed with Handbrake, all open-source software to mitigate disk space and bandwidth usage challenges. The synchronous online engagements with students were a blend of zoom or BigBlueButton, to ensure that students had an alternative just in case one failed due to excessive real-time traffic. Generally, students report that compared to their previous face-to-face lectures, the pre-recorded lectures via Youtube provided them an opportunity to reflect on content in a self-paced manner, which later on enabled them to engage actively during the live zoom and/or BigBlueButton real-time discussions and presentations. The major recommendation is that lecturers and teachers in a resource-constrained environment with limited digital resources like the internet and digital devices should harness this approach to offer students access to learning content in a self-paced manner and thereby enabling reflective active learning through reflective and high-order thinking.

Keywords: synchronous learning, asynchronous learning, active learning, reflective learning, resource-constrained environment

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Authors: Q. R. Cheah, Y. F. Tan

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In modern times, the push for a low carbon footprint entails achieving carbon neutrality as a goal for future generations. One possible step towards carbon footprint reduction is the use of more durable materials with longer lifespans, for example, silicone data cableswhich show at least double the lifespan of similar plastic products. By having greater durability and longer lifespans, silicone data cables can reduce the amount of trash produced as compared to plastics. Furthermore, silicone products don’t produce micro contamination harmful to the ocean. Every year the electronics industry produces an estimated 5 billion data cables for USB type C and lightning data cables for tablets and mobile phone devices. Material usage for outer jacketing is 6 to 12 grams per meter. Tests show that the product lifespan of a silicone data cable over plastic can be doubled due to greater durability. This can save at least 40,000 tonnes of material a year just on the outer jacketing of the data cable. The facility in this study specialises in compounding of liquid silicone rubber (LSR) material for the extrusion process in jacketing for the silicone data cable. This study analyses the carbon emissions from the facility, which is presently capable of producing more than 1,000 tonnes of LSR annually. This study uses guidelines from the World Business Council for Sustainable Development (WBCSD) and World Resources Institute (WRI) to define the boundaries of the scope. The scope of emissions is defined as 1. Emissions from operations owned or controlled by the reporting company, 2. Emissions from the generation of purchased or acquired energy such as electricity, steam, heating, or cooling consumed by the reporting company, and 3. All other indirect emissions occurring in the value chain of the reporting company, including both upstream and downstream emissions. As the study is limited to the compounding facility, the system boundaries definition according to GHG protocol is cradle-to-gate instead of cradle-to-grave exercises. Malaysia’s present electricity generation scenario was also used, where natural gas and coal constitute the bulk of emissions. Calculations show the LSR produced for the silicone data cable with high fire retardant capability has scope 1 emissions of 0.82kg CO2/kg, scope 2 emissions of 0.87kg CO2/kg, and scope 3 emissions of 2.76kg CO2/kg, with a total product carbon footprint of 4.45kg CO2/kg. This total product carbon footprint (Cradle-to-gate) is comparable to the industry and to plastic materials per tonne of material. Although per tonne emission is comparable to plastic material, due to greater durability and longer lifespan, there can be significantly reduced use of LSR material. Suggestions to reduce the calculated product carbon footprint in the scope of emissions involve 1. Incorporating the recycling of factory silicone waste into operations, 2. Using green renewable energy for external electricity sources and 3. Sourcing eco-friendly raw materials with low GHG emissions.

Keywords: carbon footprint, liquid silicone rubber, silicone data cable, Malaysia facility

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Authors: Ana Paula S. Horodenski, Priscila Pelegrini, Salli Baggenstoss

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The brewing industry with artisanal concepts seeks to serve a specific market, with diversified production that has been gaining ground in the national environment, also in the Amazon region. This growth is due to the more demanding consumer, with a diversified taste that wants to try new types of beer, enjoying products with new aromas, flavors, as a differential of what is so widely spread through the big industrial brands. Thus, through qualitative research methods, the study aimed to investigate how is the process of managing the production of a craft brewery in a city in the northern State of Mato Grosso (BRAZIL), providing knowledge of production processes and strategies in the industry. With the efficient use of resources, it is possible to obtain the necessary quality and provide better performance and differentiation of the company, besides analyzing the best management model. The research is descriptive with a qualitative approach through a case study. For the data collection, a semi-structured interview was elaborated, composed of the areas: microbrewery characterization, artisan beer production process, and the company supply chain management. Also, production processes were observed during technical visits. With the study, it was verified that the artisan brewery researched develops preventive maintenance strategies with the inputs, machines, and equipment, so that the quality of the product and the production process are achieved. It was observed that the distance from the supplying centers makes the management of processes and the supply chain be carried out with a longer planning time so that the delivery of the final product is satisfactory. The production process of the brewery is composed of machines and equipment that allows the control and quality of the product, which the manager states that for the productive capacity of the industry and its consumer market, the available equipment meets the demand. This study also contributes to highlight one of the challenges for the development of small breweries in front of the market giants, that is, the legislation, which fits the microbreweries as producers of alcoholic beverages. This makes the micro and small business segment to be taxed as a major, who has advantages in purchasing large batches of raw materials and tax incentives because they are large employers and tax pickers. It was possible to observe that the supply chain management system relies on spreadsheets and notes that are done manually, which could be simplified with a computer program to streamline procedures and reduce risks and failures of the manual process. In relation to the control of waste and effluents affected by the industry is outsourced and meets the needs. Finally, the results showed that the industry uses preventive maintenance as a productive strategy, which allows better conditions for the production and quality of artisanal beer. The quality is directly related to the satisfaction of the final consumer, being prized and performed throughout the production process, with the selection of better inputs, the effectiveness of the production processes and the relationship with the commercial partners.

Keywords: artisanal brewery, production management, production processes, supply chain

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Authors: Jung-Il Suh, Hong-Gun Park, Jae-Eun Oh

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Recently, the use of long-span precast concrete (PC) construction has increased in modular construction such as storage buildings and parking facilities. When applying long span PC member, reducing weight of long span PC member should be conducted considering lifting capacity of crane and self-weight of PC member and use of structural lightweight concrete made by lightweight aggregate (LWA) can be considered. In the process of lightweight concrete production, segregation and bleeding could occur due to difference of specific gravity between cement (3.3) and lightweight aggregate (1.2~1.8) and reducing weight of binder is needed to prevent the segregation between binder and aggregate. Also, lightweight precast concrete made by cementitious materials such as fly ash and ground granulated blast furnace (GGBFS) which is lower than specific gravity of cement as a substitute for cement has been studied. When only using fly ash for cementless binder alkali-activation of fly ash is most important chemical process in which the original fly ash is dissolved by a strong alkaline medium in steam curing with high-temperature condition. Because curing condition is similar with environment of precast member production, additional process is not needed. Na-based chloride generally used as a strong alkali activator has a practical problem such as high pH toxicity and high manufacturing cost. Instead of Na-based alkali activator calcium hydroxide [Ca(OH)2] and sodium hydroxide [Na2CO3] might be used because it has a lower pH and less expensive than Na-based alkali activator. This study explored the influences on Ca(OH)2-Na2CO3-activated fly ash system in its microstructural aspects and strength and permeability using powder X-ray analysis (XRD), thermogravimetry (TGA), mercury intrusion porosimetry (MIP). On the basis of microstructural analysis, the conclusions are made as follows. Increase of Ca(OH)2/FA wt.% did not affect improvement of compressive strength. Also, Ca(OH)2/FA wt.% and Na2CO3/FA wt.% had little effect on specific gravity of saturated surface dry (SSD) and absolute dry (AD) condition to calculate water absorption. Especially, the binder is appropriate for structural lightweight concrete because specific gravity of the hardened paste has no difference with that of lightweight aggregate. The XRD and TGA/DTG results did not present considerable difference for the types and quantities of hydration products depending on w/b ratio, Ca(OH)2 wt.%, and Na2CO3 wt.%. In the case of higher molar quantity of Ca(OH)2 to Na2CO3, XRD peak indicated unreacted Ca(OH)2 while DTG peak was not presented because of small quantity. Thus, presence of unreacted Ca(OH)2 is too small quantity to effect on mechanical performance. As a result of MIP, the porosity volume related to capillary pore depends on the w/b ratio. In the same condition of w/b ratio, quantities of Ca(OH)2 and Na2CO3 have more influence on pore size distribution rather than total porosity. While average pore size decreased as Na2CO3/FA w.t% increased, the average pore size increased over 20 nm as Ca(OH)2/FA wt.% increased which has inverse proportional relationship between pore size and mechanical properties such as compressive strength and water permeability.

Keywords: Ca(OH)2, compressive strength, microstructure, fly ash, Na2CO3, water absorption

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Authors: Nadezhda F. Mikahailova, Margarita E. Fattakhova, Mirgarita A. Mironova, Ekaterina V. Vyacheslavova, Vladimir A. Mikahailov

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Stigma is a significant obstacle to the successful adaptation of deaf students to the conditions of an educational institution, especially for those who study in inclusion. The aim of the study was to identify the spheres of life which are the most significant for developing of the stigma of deaf students; to assess the influence of factors associated with deafness on the degree of their self-stigmatization (time and degree of hearing loss, type of education - inclusion / differentiation) and to find out who is more prone to stigma - which characteristics of personality, identity, mental health and coping are specific for those deaf who demonstrates stigmatizing attitudes. The study involved 154 deaf and hard-of-hearing students (85 male and 69 female) aged from 18 to 45 years - 28 students of the Herzen State Pedagogical University (St. Petersburg), who study in inclusion, 108 students of the National Research Technological University and 18 students of the Aviation Technical College (Kazan) - students in groups with a sign language interpreter. We used the following methods: modified questionnaire 'Self-assessment and coping strategies' (Jambor & Elliot, 2005), Scale of self-esteem (Rosenberg et al, 1995), 'Big-Five' (Costa&McCrae, 1997), TRF (Becker, 1989), WCQ (Lazarus & Folkman, 1988), self-stigma scale (Mikhailov, 2008). The severity of self-stigmatization of deaf and hard of hearing students was determined by the degree of deafness and the time they live with hearing loss, learning conditions, the type of self-identification (acculturation), personality traits, and the specifics of coping behavior. Persons with congenital hearing loss more often noted a benevolent and sympathetic attitude towards them on the part of the hearers and less often, due to deafness, limited themselves to visiting public places than late deaf people, which indicates 'get rid of' the experience of their defect and normalization of the state. Students studying in conditions of inclusion more often noted the dismissive attitude of society towards deaf people. Individuals with mild to moderate hearing loss were more likely to fear marriage and childbearing because of their deafness than students with profound hearing loss. Those who considered themselves disabled (49% of all respondents) were more inclined to cope with seeking social support and less used 'distancing' coping. Those who believed that their quality of life and social opportunities were most influenced by the attitude of society towards the deaf (39%) were distinguished by a less pronounced sense of self-worth, a desire for autonomy, and frequent usage of 'avoidance' coping strategies. 36.4% of the respondents noted that there have been situations in their lives when people learned that they are deaf, began to treat them worse. These respondents had predominantly deaf acculturation, but more often, they used 'bicultural skills,' specific coping for the deaf, and had a lower level of extraversion and emotional stability. 31.2% of the respondents tried to hide from others that they have hearing problems. They considered themselves to be in a culture of hearing, used coping strategies 'bicultural skills,' and had lower levels of extraversion, cooperation, and emotional stability. Acknowledgment: Supported by the RFBR № 19-013-0040

Keywords: acculturation, coping, deafness, stigmatization

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Authors: Guo Bingkun

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With the rapid development of China's social economy and the continuous improvement of urbanization level, people's living standards have undergone tremendous changes, and more and more people are gathering in cities. The demand for urban residents' housing has been greatly released in the past decade. The demand for housing and related construction land required for urban development has brought huge pressure to urban operations, and land prices have also risen rapidly in the short term. On the other hand, from the comparison of the eastern and western regions of China, there are also great differences in urban socioeconomics and land prices in the eastern, central and western regions. Although judging from the current overall market development, after more than ten years of housing market reform and development, the quality of housing and land use efficiency in Chinese cities have been greatly improved. However, the current contradiction between land demand for urban socio-economic development and land supply, especially the contradiction between land supply and demand for urban residential land, has not been effectively alleviated. Since land is closely linked to all aspects of society, changes in land prices will be affected by many complex factors. Therefore, this paper studies the factors that may affect urban residential land prices and compares them among eastern, central and western cities, and finds the main factors that determine the level of urban residential land prices. This paper provides guidance for urban managers in formulating land policies and alleviating land supply and demand. It provides distinct ideas for improving urban planning and improving urban planning and promotes the improvement of urban management level. The research in this paper focuses on residential land prices. Generally, the indicators for measuring land prices mainly include benchmark land prices, land price level values, parcel land prices, etc. However, considering the requirements of research data continuity and representativeness, this paper chooses to use residential land price level values. Reflects the status of urban residential land prices. First of all, based on the existing research at home and abroad, the paper considers the two aspects of land supply and demand and, based on basic theoretical analysis, determines some factors that may affect urban housing, such as urban expansion, taxation, land reserves, population, and land benefits. Factors of land price and correspondingly selected certain representative indicators. Secondly, using conventional econometric analysis methods, we established a model of factors affecting urban residential land prices, quantitatively analyzed the relationship and intensity of influencing factors and residential land prices, and compared the differences in the impact of urban residential land prices between the eastern, central and western regions. Compare similarities. Research results show that the main factors affecting China's urban residential land prices are urban expansion, land use efficiency, taxation, population size, and residents' consumption. Then, the main reason for the difference in residential land prices between the eastern, central and western regions is the differences in urban expansion patterns, industrial structures, urban carrying capacity and real estate development investment.

Keywords: urban housing, urban planning, housing prices, comparative study

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Authors: Yuvraj Singh Dangi, Brajesh Kumar Tiwari, Ashok Kumar Jain, Kamta Prasad Namdeo

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The potential use of liposomes as drug carriers by i.v. injection is limited by their low stability in blood stream. Firstly, phospholipid exchange and transfer to lipoproteins, mainly HDL destabilizes and disintegrates liposomes with subsequent loss of content. To avoid the pain associated with injection and to obtain better patient compliance studies concerning various dosage forms, have been developed. Conventional liposomes (unilamellar and multilamellar) have certain drawbacks like low entrapment efficiency, stability and release of drug after single breach in external membrane, have led to the new type of liposomal systems. The challenge has been successfully met in the form of Double Liposomes (DL). DL is a recently developed type of liposome, consisting of smaller liposomes enveloped in lipid bilayers. The outer lipid layer of DL can protect inner liposomes against various enzymes, therefore DL was thought to be more effective than ordinary liposomes. This concept was also supported by in vitro release characteristics i.e. DL formation inhibited the release of drugs encapsulated in inner liposomes. DL consists of several small liposomes encapsulated in large liposomes, i.e., multivesicular vesicles (MVV), therefore, DL should be discriminated from ordinary classification of multilamellar vesicles (MLV), large unilamellar vesicles (LUV), small unilamellar vesicles (SUV). However, for these liposomes, the volume of inner phase is small and loading volume of water-soluble drugs is low. In the present study, the potential of phosphatidylethanolamine (PE) lipid anchored double liposomes (DL) to incorporate two drugs in a single system is exploited as a tool to augment the H. pylori eradication rate. Preparation of DL involves two steps, first formation of primary (inner) liposomes by thin film hydration method containing one drug, then addition of suspension of inner liposomes on thin film of lipid containing the other drug. The success of formation of DL was characterized by optical and transmission electron microscopy. Quantitation of DL-bacterial interaction was evaluated in terms of percent growth inhibition (%GI) on reference strain of H. pylori ATCC 26695. To confirm specific binding efficacy of DL to H. pylori PE surface receptor we performed an agglutination assay. Agglutination in DL treated H. pylori suspension suggested selectivity of DL towards the PE surface receptor of H. pylori. Monotherapy is generally not recommended for treatment of a H. pylori infection due to the danger of development of resistance and unacceptably low eradication rates. Therefore, combination therapy with amoxicillin trihydrate (AMOX) as anti-H. pylori agent and ranitidine bismuth citrate (RBC) as antisecretory agent were selected for the study with an expectation that this dual-drug delivery approach will exert acceptable anti-H. pylori activity.

Keywords: Helicobacter pylorI, amoxicillin trihydrate, Ranitidine Bismuth citrate, phosphatidylethanolamine, multi vesicular systems

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Authors: Chen Jin

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This topic seeks to re-examine the New Women Incident in 1935 Shanghai from the perspective of the influence of leftist cinematic aesthetics on public discourse in 1930s Shanghai. Accordingly, an original means of interpreting the death of Ruan Lingyu will be provided. On 8th March 1935, Ruan Lingyu, the queen of Chinese silent film, committed suicide through overdosing on sleeping tablets. Her last words, ‘gossip is fearful thing’, interlinks her destiny with the protagonist she played in the film The New Women (Cai Chusheng, 1935). The coincidence was constantly questioned by the masses following her suicide, constituting the enduring question: ‘who killed Ruan Lingyu?’ Responding to this query, previous scholars primarily analyze the characters played by women -particularly new women as part of the leftist movement or public discourse of 1930s Shanghai- as a means of approaching the truth. Nevertheless, alongside her status as a public celebrity, Ruan Lingyu also plays as a screen image of mechanical reproduction. The overlap between her screen image and personal destiny attracts limited academic focus in terms of the effect and implications of leftist aesthetics of reality in relation to her death, which itself has provided impetus to this research. With the reconfiguration of early Chinese film theory in the 1980s, early discourses on the relationship between cinematic reality and consciousness proposed by Hou Yao and Gu Kenfu in the 1920s are integrated into the category of Chinese film ontology, which constitutes a transcultural contrast with the Euro-American ontology that advocates the representation of reality. The discussion of Hou and Gu overlaps cinematic reality with effect, which emphasizes the empathy of cinema that is directly reflected in the leftist aesthetics of the 1930s. As the main purpose of leftist cinema is to encourage revolution through depicting social reality truly, Ruan Lingyu became renowned for her natural and realistic acting proficiency, playing leading roles in several esteemed leftist films. The realistic reproduction and natural acting skill together constitute the empathy of leftist films, which establishes a dialogue with the virtuous female image within the 1930s public discourse. On this basis, this research considers Chinese cinematic ontology and affect theory as the theoretical foundation for investigating the relationship between the screen image of Ruan Lingyu reproduced by the leftist film The New Women and the female image in the 1930s public discourse. Through contextualizing Ruan Lingyu’s death within the Chinese leftist movement, the essay indicates that the empathy embodied within leftist cinematic reality limits viewers’ cognition of the actress, who project their sentiments for the perfect screen image on to Ruan Lingyu’s image in reality. Essentially, Ruan Lingyu is imprisoned in her own perfect replication. Consequently, this article states that alongside leftist anti-female consciousness, the leftist aesthetics of reality restricts women in a passive position within public discourse, which ultimately plays a role in facilitating the death of Ruan Lingyu.

Keywords: cinematic reality, leftist aesthetics, Ruan Lingyu, The New Women

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Authors: Amirah Azzeri, Fatiha H. Shabaruddin, Scott A. McDonald, Rosmawati Mohamed, Maznah Dahlui

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Objective: A scaled-up treatment cascade with direct-acting antiviral (DAA) therapy is necessary to achieve global WHO targets for hepatitis C virus (HCV) elimination in Malaysia. Recently, limited access to Sofosbuvir/Daclatasvir (SOF/DAC) is available through compulsory licensing, with future access to Sofosbuvir/Velpatasvir (SOF/VEL) expected through voluntary licensing due to recent agreements. SOF/VEL has superior clinical outcomes, particularly for cirrhotic stages, but has higher drug acquisition costs compared to SOF/DAC. It has been proposed that a stratified treatment cascade might be the most cost-efficient approach for Malaysia whereby all HCV patients are treated with SOF/DAC except for patients with cirrhosis who are treated with SOF/VEL. This study aimed to conduct a five-year budget impact analysis from the provider perspective of the proposed stratified treatment cascade for HCV treatment in Malaysia. Method: A disease progression model that was developed based on model-predicted HCV epidemiology data in Malaysia was used for the analysis, where all HCV patients in scenario A were treated with SOF/DAC for all disease stages while in scenario B, SOF/DAC was used only for non-cirrhotic patients and SOF/VEL was used for the cirrhotic patients. The model projections estimated the annual numbers of patients in care and the numbers of patients to be initiated on DAA treatment nationally. Healthcare costs associated with DAA therapy and disease stage monitoring was included to estimate the downstream cost implications. For scenario B, the estimated treatment uptake of SOF/VEL for cirrhotic patients were 25%, 50%, 75%, 100% and 100% for 2018, 2019, 2020, 2021 and 2022 respectively. Healthcare costs were estimated based on standard clinical pathways for DAA treatment described in recent guidelines. All costs were reported in US dollars (conversion rate US$1=RM4.09, the price year 2018). Scenario analysis was conducted for 5% and 10% reduction of SOF/VEL acquisition cost anticipated from the competitive market pricing of generic DAA in Malaysia. Results: The stratified treatment cascade with SOF/VEL in Scenario B was found to be cost-saving compared to Scenario A. A substantial portion of the cost reduction was due to the costs associated with DAA therapy which resulted in USD 40 thousand (year 1) to USD 443 thousand (year 5) savings annually, with cumulative savings of USD 1.1 million after 5 years. Cost reductions for disease stage monitoring were seen in year three onwards which resulted in cumulative savings of USD 1.1 thousand. Scenario analysis estimated cumulative savings of USD 1.24 to USD 1.35 million when the acquisition cost of SOF/VEL was reduced. Conclusion: A stratified treatment cascade with SOF/VEL was expected to be cost-saving and can results in a budget impact reduction in overall healthcare expenditure in Malaysia compared to treatment with SOF/DAC. The better clinical efficacy with SOF/VEL is expected to halt patients’ HCV disease progression and may reduce downstream costs of treating advanced disease stages. The findings of this analysis may be useful to inform healthcare policies for HCV treatment in Malaysia.

Keywords: Malaysia, direct acting antiviral, compulsory licensing, voluntary licensing

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Authors: Owen Cegielski, Kristi Maida, Danny Morales, Sylvia L. Mendez

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This study explores the challenges and threats US secondary educators experience in incorporating culturally relevant education (CRE) practices in their classrooms. CRE is a social justice pedagogical practice used to connect student’s cultural references to academic skills and content, to promote critical reflection, to facilitate cultural competence, and to critique discourses of power and oppression. Empirical evidence on CRE demonstrates positive student educational outcomes in terms of achievement, engagement, and motivation. Additionally, due to the direct focus on uplifting diverse cultures through the curriculum, students experience greater feelings of belonging, increased interest in the subject matter, and stronger racial/ethnic identities. When these teaching practices are in place, educators develop deeper relationships with their students and appreciate the multitude of gifts they (and their families) bring to the classroom environment. Yet, educators regularly report being unprepared to incorporate CRE in their daily teaching practice and identify substantive gaps in their knowledge and skills in this area. Often, they were not exposed to CRE in their educator preparation program, nor do they receive adequate support through school- or district-wide professional development programming. Through a descriptive phenomenological research design, 20 interviews were conducted with a diverse set of secondary school educators to explore the challenges and threats they experience in incorporating CRE practices in their classrooms. The guiding research question for this study is: What are the challenges and threats US secondary educators face when seeking to incorporate CRE practices in their classrooms? Interviews were grounded by the theory of challenge and threat states, which highlights the ways in which challenges and threats are appraised and how resources factor into emotional valence and perception, as well as the potential to meet the task at hand. Descriptive phenomenological data analysis strategies were utilized to develop an essential structure of the educators’ views of challenges and threats in regard to incorporating CRE practices in their secondary classrooms. The attitude of the phenomenological reduction method was adopted, and the data were analyzed through five steps: sense of the whole, meaning units, transformation, structure, and essential structure. The essential structure that emerged was while secondary educators display genuine interest in learning how to successfully incorporate CRE practices, they perceive it to be a challenge (and not a threat) due to lack of exposure which diminishes educator capacity, comfort, and confidence in employing CRE practices. These findings reveal the value of attending to emotional valence and perception of CRE in promoting this social justice pedagogical practice. Findings also reveal the importance of appropriately resourcing educators with CRE support to ensure they develop and utilize this practice.

Keywords: culturally relevant education, descriptive phenomenology, social justice practice, US secondary education

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Authors: Fangfang Wang, Tianjing Wang, Leyi Fu, Feng Yun, Ningning Xie, Jue Zhou, Fan Qu

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Background: Ferroptosis, a recently discovered form of programmed cell death characterized by iron-dependent lipid peroxidation, may be linked to polycystic ovary syndrome (PCOS). Diseases marked by iron overload have been correlated with ferroptosis. Coincidently, investigations have revealed anomalies in iron metabolism among women with PCOS; however, there were inconsistencies in the evidence. Objective and Rationale: This review aimed to comprehensively explore the potential relationship between ferroptosis and PCOS by investigating the differences in iron metabolism among women with PCOS in comparison to a control group. Additionally, a narrative synthesis was provided on the past research status regarding the association between PCOS and ferroptosis. Methods: A systematic search of the literature was performed using PubMed, Embase, Web of Science from inception up to December 2022. Search terms relating to assisted PCOS, ferroptosis, and iron metabolism were used. PRISMA guidance was followed. RevMan 5.4 was utilized for conducting the meta-analysis, wherein the investigated outcomes included iron status (ferritin, iron, transferrin saturation) and a systemic iron-regulatory hormone (hepcidin). A narrative synthesis was performed to explore the correlation between PCOS and ferroptosis. Results: In the meta-analysis comprising a total of 16 studies, significant differences in serum ferritin levels between the PCOS group and the control group were observed (15 studies, standardized mean difference (SMD): 0.41, 95% CI: 0.22 to 0.59, P<0.01). This indicates elevated serum ferritin levels in PCOS patients compared to women without PCOS. The transferrin saturation in PCOS patients was significantly higher than that in the control group (3 studies, mean difference (MD): 4.39, 95% CI: 1.67 to 7.11, P<0.01). Regarding serum iron (6 studies, SMD: 0.05, 95% CI: -0.24 to 0.33, P=0.75) and serum hepcidin (4 studies, SMD: -0.44, 95% CI: -1.41 to 0.52, P=0.37), no statistically significant differences were observed between the PCOS group and the control group. Other studies have found that ferroptosis is involved in the occurrence and development of PCOS, offering valuable insights for guiding potential treatment measures and prognosis evaluation of PCOS. In addition, ferroptosis is involved in the miscarriage of PCOS-like rats; thus, controlling ferroptosis might improve pregnancy outcomes in PCOS. Conclusions: The observation of a significant elevation in serum ferritin and transferrin saturation levels in women with PCOS may suggest an underlying disturbance in iron metabolism, potentially inducing the activation of ferroptosis. Further research is imperative to elucidate the underlying pathophysiology, providing insights for potential preventive measures and therapeutic strategies. Limitation: There are some limitations as follows: First, due to limited extractable information, we excluded purely abstract publications and non-English publications. Second, the majority of original articles were case-control studies, making it difficult to determine the causal relationship between iron metabolism abnormalities and the onset of PCOS. Third, there is substantial heterogeneity in the definition of PCOS.

Keywords: polycystic ovary syndrome, ferroptosis, iron metabolism, systematic review and meta-analysis

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Authors: Abdelkhalek Bouchikhi, Elyes Benmokhtar, Sebastien Saletzki

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The aeronautical field is experiencing issues with RF spectrum congestion due to the constant increase in the number of flights, aircrafts and telecom systems on board. In addition, these systems are bulky in size, weight and energy consumption. The cognitive radio helps particularly solving the spectrum congestion issue by its capacity to detect idle frequency channels then, allowing an opportunistic exploitation of the RF spectrum. The present work aims to propose a new use case for aeronautical spectrum sharing and to study the performances of three different detection techniques: energy detector, matched filter and cyclostationary detector within the aeronautical use case. The spectrum in the proposed cognitive radio is allocated dynamically where each cognitive radio follows a cognitive cycle. The spectrum sensing is a crucial step. The goal of the sensing is gathering data about the surrounding environment. Cognitive radio can use different sensors: antennas, cameras, accelerometer, thermometer, etc. In IEEE 802.22 standard, for example, a primary user (PU) has always the priority to communicate. When a frequency channel witch used by the primary user is idle, the secondary user (SU) is allowed to transmit in this channel. The Distance Measuring Equipment (DME) is composed of a UHF transmitter/receiver (interrogator) in the aircraft and a UHF receiver/transmitter on the ground. While the future cognitive radio will be used jointly to alleviate the spectrum congestion issue in the aeronautical field. LDACS, for example, is a good candidate; it provides two isolated data-links: ground-to-air and air-to-ground data-links. The first contribution of the present work is a strategy allowing sharing the L-band. The adopted spectrum sharing strategy is as follow: the DME will play the role of PU which is the licensed user and the LDACS1 systems will be the SUs. The SUs could use the L-band channels opportunely as long as they do not causing harmful interference signals which affect the QoS of the DME system. Although the spectrum sensing is a key step, it helps detecting holes by determining whether the primary signal is present or not in a given frequency channel. A missing detection on primary user presence creates interference between PU and SU and will affect seriously the QoS of the legacy radio. In this study, first brief definitions, concepts and the state of the art of cognitive radio will be presented. Then, a study of three communication channel detection algorithms in a cognitive radio context is carried out. The study is made from the point of view of functions, material requirements and signal detection capability in the aeronautical field. Then, we presented a modeling of the detection problem by three different methods (energy, adapted filter, and cyclostationary) as well as an algorithmic description of these detectors is done. Then, we study and compare the performance of the algorithms. Simulations were carried out using MATLAB software. We analyzed the results based on ROCs curves for SNR between -10dB and 20dB. The three detectors have been tested with a synthetics and real world signals.

Keywords: aeronautic, communication, navigation, surveillance systems, cognitive radio, spectrum sensing, software defined radio

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