Search results for: diet plan

Authors: Paula K. Novelli, Margarida M. Barros, Luciana F. Flueri

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Utilization of agricultural by-products, wheat ban and soybean bran, as substrate for solid state fermentation (SSF) was studied, aiming the achievement of different enzymes from Aspergillus sp. with distinct biological characteristics and its application and improvement on animal nutrition. Aspergillus niger and Aspergillus oryzea were studied as they showed very high yield of phytase and protease production, respectively. Phytase activity was measure using p-nitrophenilphosphate as substrate and a standard curve of p-nitrophenol, as the enzymatic activity unit was the quantity of enzyme necessary to release one μmol of p-nitrophenol. Protease activity was measure using azocasein as substrate. Activity for phytase and protease substantially increased when the different biochemical characteristics were considered in the study. Optimum pH and stability of the phytase produced by A. niger with wheat bran as substrate was between 4.0 - 5.0 and optimum temperature of activity was 37oC. Phytase fermented in soybean bran showed constant values at all pHs studied, for optimal and stability, but low production. Phytase with both substrates showed stable activity for temperatures higher than 80oC. Protease from A. niger showed very distinct behavior of optimum pH, acid for wheat bran and basic for soybean bran, respectively and optimal values of temperature and stability at 50oC. Phytase produced by A. oryzae in wheat bran had optimum pH and temperature of 9 and 37oC, respectively, but it was very unstable. On the other hand, proteases were stable at high temperatures, all pH’s studied and showed very high yield when fermented in wheat bran, however when it was fermented in soybean bran the production was very low. Subsequently the upscale production of phytase from A. niger and proteases from A. oryzae were applied as an enzyme additive in fish fed for digestibility studies. Phytases and proteases were produced with stable enzyme activity of 7,000 U.g-1 and 2,500 U.g-1, respectively. When those enzymes were applied in a plant protein based fish diet for digestibility studies, they increased protein, mineral, energy and lipids availability, showing that these new enzymes can improve animal production and performance. In conclusion, the substrate, as well as, the microorganism species can affect the biochemical character of the enzyme produced. Moreover, the production of these enzymes by SSF can be up to 90% cheaper than commercial ones produced with the same fungi species but submerged fermentation. Add to that these cheap enzymes can be easily applied as animal diet additives to improve production and performance.

Keywords: agricultural by-products, animal nutrition, enzymes production, solid state fermentation

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Authors: Nayera E. Hassan, Sahar A. El-Masry, Rokia El-Banna, Mohamed S. El Hussieny

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There are several different modalities for treatment of obesity. Common intervention methods for obesity include low-calorie diet, exercise. Also acupuncture has shown good therapeutic results in the treatment of obesity. A recent clinical observation showed that laser acupuncture could reduce body weight and body mass index in obese persons. So, the aim of this research is focused on body composition changes as related to type of intervention, before and after intentional weight loss in overweight and obesity. 76 subjects were included in the study analysis. The present study recommended that every obese female must do lipid profile and fasting blood sugar analysis before weight-loss intervention to take the decision of which method should be used.

Keywords: obesity, weight-loss, body composition, modalities

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Authors: M. Tassi, E. Dotsika, P. Karalis, A. Trantalidou, A. Mazarakis Ainian

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The Kythnos Island in Greece is of particular archaeological interest, as it has been inhabited from the 12th BC until the 7th AD. From island excavations, numerous faunal and human skeletal remains have been recovered. This work is the first attempt at the paleoenvironmental reconstruction of the island via stable isotope analysis. Specifically, we perform 13C and 18O isotope analysis in faunal bone apatite in order to investigate the climate conditions that prevailed in the area. Additionally, we conduct 13C and 15N isotope analysis in faunal bone collagen, which will constitute the baseline for the subsequent diet reconstruction of the ancient Kythnos population.

Keywords: stable isotopes analysis, bone collagen stable isotope analysis, bone apatite stable isotope analysis, paleodiet, palaeoclimate

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Authors: Marcus Lee

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The energy sector is the largest contributor of greenhouse gas emissions in Malaysia, which induces climate change. The climate change problem is therefore an energy sector problem. Tackling climate change issues successfully is contingent on actions taken in the energy sector. The researcher propounds that ‘Climate Policy Integration’ (CPI) into energy policy is a viable and insufficiently developed strategy in Malaysia that promotes the synergies between climate change and energy objectives, in order to achieve the targets found in both climate change and energy policies. In exploring this hypothesis, this paper presentation will focus on two particular aspects. Firstly, the meaning of CPI as an approach and as a concept will be explored. As an approach, CPI into energy policy means the integration of climate change objectives into the energy policy area. Its subject matter focuses on establishing the functional interrelations between climate change and energy objectives, by promoting their synergies and minimising their contradictions. However, its conceptual underpinnings are less than straightforward. Drawing from the ‘principle of integration’ found in international treaties and declarations such as the Stockholm Declaration 1972, the Rio Declaration 1992 and the United Nations Framework on Climate Change 1992 (‘UNFCCC’), this paper presentation will explore the contradictions in international standards on how the sustainable development tenets of environmental sustainability, social development and economic development are to be balanced and its relevance to CPI. Further, the researcher will consider whether authority may be derived from international treaties and declarations in order to argue for the prioritisation of environmental sustainability over the other sustainable development tenets through CPI. Secondly, this paper presentation will also explore the degree to which CPI into energy policy has been achieved and pursued in Malaysia. In particular, the strength of the conceptual framework with regard to CPI in Malaysian governance will be considered by assessing Malaysia’s National Policy on Climate Change (2009) (‘NPCC 2009’). The development (or the lack of) of CPI as an approach since the publication of the NPCC 2009 will also be assessed based on official government documents and policies that may have a climate change and/or energy agenda. Malaysia’s National Renewable Energy Policy and Action Plan (2010), draft National Energy Efficiency Action Plan (2014), Intended Nationally Determined Contributions (2015) in relation to the Paris Agreement, 11th Malaysia Plan (2015) and Biennial Update Report to the UNFCCC (2015) will be discussed. These documents will be assessed for the presence of CPI based on the language/drafting of the documents as well as the degree of subject matter regarding CPI expressed in the documents. Based on the analysis, the researcher will propose solutions on how to improve Malaysia’s climate change and energy governance. The theory of reflexive governance will be applied to CPI. The concluding remarks will be about whether CPI reflects reflexive governance by demonstrating how the governance process can be the object of shaping outcomes.

Keywords: climate policy integration, mainstreaming, policy coherence, Malaysian energy governance

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Authors: Duy Nguyen Do, Bart Julien Dewancker

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Many Soviet-style collective housing complexes (also known as KTT) were built since the 1960s in Hanoi to support the post-war population growth. Those low-rise buildings have created well-knitted, robust communities, so much to the point that in most complexes, all families in one housing block would know each other, occasionally interact and provide supports in need. To understand how the community of collective housing complexes have developed and maintained in order to adapt their advantages into modern housing designs, the study is executed on the site of Nguyen Cong Tru KTT. This is one of the oldest KTT in Hanoi, completed in 1954. The complex also has an unique characteristic that is closely related to its community: the symbiotic relationship with Hom – a flea market that has been co-developing with Nguyen Cong Tru KTT since its beginning. The research consists of three phases: the first phase is a sociological investigation with Nguyen Cong Tru KTT’s current residents and a site survey on the complex’s economic and architectural characteristics. In the second phase, the collected data is analyzed to find out people’s opinions with the KTT’s concerning their satisfaction with the current housing status, floor plan organization, community, the relationship between the KTT’s dedicated public spaces with the flea market and their usage. Simultaneously, the master plan and gathered information regarding current architectural characteristics of the complex are also inspected. On the third phase, the analyses’ results will provide information regarding the issues, positive trends and significant historical features of the complex’s architecture in order to generate suitable proposals for the redesigning project of Nguyen Cong Tru KTT, a design focused on vitalizing modern apartments’ communities.

Keywords: collective house community, collective house public space, community-focused, redesigning Nguyen Cong Tru KTT, sociological investigation

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Authors: Abdulrahman Al-Soqeer, Osamah Fahmy

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This research was aimed to investigate the possibility of using Prosopis juliflora pods as a fodder source for poultry. The study have shown that the inclusion of ground Prosopis pods in a broiler diet added some positive effects on broiler performance such as improving carcasses weight and reducing the weights of the inedible parts. The obtained results encourage repeating the experiment with an increased percentage of Prosopis supplementation in the broiler diets, using some treatments on the Prosopis pods to reduce the undesirable effects of the antinutritional factors in the pods and to increase the percentage of the essential amino acids present in the pods (lysine, methionine, arginine, histidine, isoleucine, leucine and phenylealanine) up to the limits recommended for broilers by NRC 1990.

Keywords: amino acids, arginine, broilers, lysine, methionine

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Authors: F. Fatoye, C. E. Mbada, T. Gebrye, A. O. Ogunsola, C. Fatoye, O. Oyewole

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Musculoskeletal disorders (MSDs) are a major cause of pain and disability. It is likely to become a greater economic and public health burden that is unnecessary. Thus, reliable prevalence figures are important for both clinicians and policy-makers to plan health care needs for those affected with the disease. This study estimated hospital based real-world prevalence of MSDs in Nigeria. A review of medical charts for adult patients attending Physiotherapy Outpatient Clinic at the Obafemi Awolowo University Teaching Hospitals Complex, Osun State, Nigeria between 2009 and 2018 was carried out to identify common MSDs including low back pain (LBP), cervical spondylosis (CSD), post immobilization stiffness (PIS), sprain, osteoarthritis (OA), and other conditions. Occupational class of the patients was determined using the International Labour Classification (ILO). Data were analysed using descriptive statistics of frequency and percentages. Overall, medical charts of 3,340 patients were reviewed within the span of ten years (2009 to 2018). Majority of the patients (62.8%) were in the middle class, and the remaining were in low class (25.1%) and high class (10.5%) category. An overall prevalence of 47.35% of MSD was found within the span of ten years. Of this, the prevalence of LBP, CSD, PIS, sprain, OA, and other conditions was 21.6%, 10%, 18.9%, 2%, 6.3%, and 41.3%, respectively. The highest (14.2%) and lowest (10.5%) prevalence of MSDs was recorded in the year of 2012 and 2018, respectively. The prevalence of MSDs is considerably high among Nigerian patients attending outpatient a physiotherapy clinic. The high prevalence of MSDs underscores the need for clinicians and decision makers to put in place appropriate strategies to reduce the prevalence of these conditions. In addition, they should plan and evaluate healthcare services to improve the health outcomes of patients with MSDs. Further studies are required to determine the economic burden of the condition and examine the clinical and cost-effectiveness of physiotherapy interventions for patients with MSDs.

Keywords: musculoskeletal disorders, Nigeria, prevalence, real world

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Authors: S. Paengkoum, P. Paengkoum, W. Kaewwongsa

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Twenty-four male growing goats were randomly assigned to a Randomized Complete Block Design. Dietary treatments were different level of feeding concentrate diet at 1.0, 1.5, 2.0, and 2.5% of body weight (BW). The results showed that average daily gain, microbial N supply, N retention of meat goats in the group of feeding level at 2.0% BW and 2.5% BW were significantly higher (P<0.05) than those goats fed with feeding levels of 1.0% BW and 1.5% BW. Based on this result the conclusion can be made that using 75% fermented cassava pulp by Saccharomyces cerevisiae as the main source of protein to completely replace soybean meal was beneficial to meat goats in terms of feed intake. The feeding concentrate at levels between 2.0-2.5% BW gives highest in the growth of meat goat in this experiment.

Keywords: cassava pulp, yeast, goat, nitrogen retention

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Authors: Jean Berger, Mohamed Barkaoui

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Discrete search path planning in time-constrained uncertain environment relying upon imperfect sensors is known to be hard, and current problem-solving techniques proposed so far to compute near real-time efficient path plans are mainly bounded to provide a few move solutions. A new information-theoretic –based open-loop decision model explicitly incorporating false alarm sensor readings, to solve a single agent military logistics search-and-delivery path planning problem with anticipated feedback is presented. The decision model consists in minimizing expected entropy considering anticipated possible observation outcomes over a given time horizon. The model captures uncertainty associated with observation events for all possible scenarios. Entropy represents a measure of uncertainty about the searched target location. Feedback information resulting from possible sensor observations outcomes along the projected path plan is exploited to update anticipated unit target occupancy beliefs. For the first time, a compact belief update formulation is generalized to explicitly include false positive observation events that may occur during plan execution. A novel genetic algorithm is then proposed to efficiently solve search path planning, providing near-optimal solutions for practical realistic problem instances. Given the run-time performance of the algorithm, natural extension to a closed-loop environment to progressively integrate real visit outcomes on a rolling time horizon can be easily envisioned. Computational results show the value of the approach in comparison to alternate heuristics.

Keywords: search path planning, false alarm, search-and-delivery, entropy, genetic algorithm

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Authors: Michelle Hartanto, Risheka Suthantirakumar

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Introduction Staff redeployment, increased numbers of acutely unwell patients requiring resuscitation decision-making conversations, visiting restrictions, and varying guidance regarding resuscitation for patients with COVID-19 disrupted clinicians’ management of resuscitation and escalation decision-making processes. While it was generally accepted that the COVID-19 pandemic disturbed numerous aspects of the Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) process in the United Kingdom, a process which establishes a patient’s CPR status and treatment escalation plans, the impact of the pandemic on clinicians’ attitudes towards these resuscitation and decision-making conversations was unknown. This was the first study to examine the impact of the COVID-19 pandemic on clinicians’ knowledge, skills, and attitudes towards the ReSPECT process. Methods A cross-sectional survey of clinicians at one acute teaching hospital in the UK was conducted. A questionnaire with a defined five-point Likert scale was distributed and clinicians were asked to recall their pre-pandemic views on ReSPECT and report their current views at the time of survey distribution (May 2020, end of the first COVID-19 wave in the UK). Responses were received from 171 clinicians, and self-reported views before and during the pandemic were compared. Results Clinicians reported they found managing ReSPECT conversations more challenging during the pandemic, especially when conducted over the telephone with relatives, and they experienced an increase in negative emotions before, during, and after conducting ReSPECT conversations. Our findings identified that due to the pandemic there was now a need for clinicians to receive training and support in conducting resuscitation and escalation decision-making conversations over the telephone with relatives and managing these processes.

Keywords: cardiopulmonary resuscitation, COVID-19 pandemic, DNACPR discussion, education, recommended summary plan for emergency care and treatment, resuscitation order

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Authors: Antonio Marco Miotti, Antonella Ruffatto, Giampaola Basso, Antonio Madia, Giulia Zavatta, Emanuela Salvatico, Emanuela Zilli

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A National Action Plan to fight antimicrobial resistance was launched in Italy in 2017. In order to reduce inappropriate exposure to antibiotics and infections from multi-drug resistant bacteria, it is essential to set up a structured system of surveillance and monitoring of the implementation of National Action Plan standards, including antimicrobial consumption, with a special focus on quinolones, third generation cephalosporins and carbapenems. A quantitative estimate of antibiotic consumption (defined daily dose - DDD - consumption per 100 days of hospitalization) has been provided by the Pharmaceutical Service to the Hospital of Cittadella, ULSS 6 Euganea – Health Trust (District of Padua) for the years 2019 (before the pandemic), 2020 and 2021 for all classes of antibiotics. Multidisciplinary meetings have been organized monthly by the local Antimicrobial Stewardship Group. Between 2019 and 2021, an increase in the consumption of carbapenems in the Intensive Care Unit (from 12.2 to 18.2 DDD, + 49.2%) and a decrease in Medical wards (from 5.3 to 2.6 DDD, - 50.9%) was reported; a decrease in the consumption of quinolones in Intensive Care Unit (from 17.2 to 10.8 DDD, - 37.2%), Medical wards (from 10.5 to 6.6 DDD, - 37.1%) and Surgical wards (from 10.2 to 9.3 DDD, - 8.8%) was highlighted; an increase in the consumption of third generation cephalosporins in Medical wards (from 18.1 to 22.6 DDD, + 24,1%) was reported. Finally, after an increase in the consumption of macrolides between 2020 and 2019, in 2021, a decrease was reported in the Intensive Care Unit (DDD: 8.0 in 2019, 18.0 in 2020, 6.4 in 2021) and Medical wards (DDD: 9.0 in 2019, 13.7 in 2020, 10.9 in 2021). Constant monitoring of antimicrobial consumption and timely identifying of warning situations that may need a specific intervention are the cornerstone of Antimicrobial Stewardship programs, together with analysing data on bacterial resistance rates and infections from multi-drug resistant bacteria.

Keywords: carbapenems, quinolones, antimicrobial, stewardship

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Authors: Marlene Rosa, Susana Lopes

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There are few studies that explore the potential of board games as a performance measure, despite it can be an interesting strategy in the context of frailty populations. In fact, board games are immersive strategies than can inhibit the pressure of being evaluated. This study aimed to test the ability of gamed-base strategies to assess executive function in elderly population. Sixteen old participants were included: 10 with affected executive functions (G1 – 85.30±6.00 yrs old; 10 male); 6 with executive functions with non-clinical important modifications (G2 - 76.30±5.19 yrs old; 6 male). Executive tests were assessed using the Frontal Assessment Battery (FAB), which is a quick-applicable cognitive screening test (score<12 means impairment). The board game used in this study was the TATI Hand Game, specifically for training rhythmic coordination of the upper limbs with multiple cognitive stimuli. This game features 1 table grid, 1 set of Single Game cards (to play with one hand); Double Game cards (to play simultaneously with two hands); 1 dice to plan Single Game mode; cards to plan the Double Game mode; 1 bell; 2 cups. Each participant played 3 single game cards, and the following data were collected: (i) variability in time during board game challenges (SD); (ii) number of errors; (iii) execution speed (sec). G1 demonstrated: high variability in execution time during board game challenges (G1 – 13.0s vs G2- 0.5s); a higher number of errors (1.40 vs 0.67); higher execution velocity (607.80s vs 281.83s). These results demonstrated the potential of implementing board games as a functional assessment strategy in geriatric care. Future studies might include larger samples and statistical methodologies to find cut-off values for impairment in executive functions during performance in TATI game.

Keywords: board game, aging, executive function, evaluation

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Authors: Ileen Van den Berg, Reinier J. Daals, Chris E. M. Heuberger, Sven P. Hildering, Bob E. Van Maris, Carla M. Smulders, Rafael Aránguiz

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Chile is located along the subduction zone of the Nazca plate beneath the South American plate, where large earthquakes and tsunamis have taken place throughout history. The last significant earthquake (Mw 8.2) occurred in September 2015 and generated a destructive tsunami, which mainly affected the city of Coquimbo (71.33°W, 29.96°S). The inundation area consisted of a beach, damaged seawall, damaged railway, wetland and old neighborhood; therefore, local authorities started a reconstruction process immediately after the event. Moreover, a seismic gap has been identified in the same area, and another large event could take place in the near future. The present work proposed an integrated tsunami reconstruction plan for the city of Coquimbo that considered several variables such as safety, nature & recreation, neighborhood welfare, visual obstruction, infrastructure, construction process, and durability & maintenance. Possible future tsunami scenarios are simulated by means of the Non-hydrostatic Evolution of Ocean WAVEs (NEOWAVE) model with 5 nested grids and a higher grid resolution of ~10 m. Based on the score from a multi-criteria analysis, the costs of the alternatives and a preference for a multifunctional solution, the alternative that includes an elevated coastal road with floodgates to reduce tsunami overtopping and control the return flow of a tsunami was selected as the best solution. It was also observed that the wetlands are significantly restored to their former configuration; moreover, the dynamic behavior of the wetlands is stimulated. The numerical simulation showed that the new coastal protection decreases damage and the probability of loss of life by delaying tsunami arrival time. In addition, new evacuation routes and a smaller inundation zone in the city increase safety for the area.

Keywords: tsunami, Coquimbo, Chile, reconstruction, numerical simulation

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Authors: B. Sanchez, D. Zambrana-Vasquez, J. Fresner, C. Krenn, F. Morea, L. Mercatelli

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Local administrations are facing established targets on sustainable development from different disciplines at the heart of different city departments. Nevertheless, some of these targets, such as CO₂ reduction, relate to two or more disciplines, as it is the case of sustainable mobility and energy plans (SUMP & SECAP/SEAP). This opens up the possibility to efficiently cooperate among different city departments and to create and develop harmonized spatial plans by using available resources and together achieving more ambitious goals in cities. The steps of the harmonization processes developed result in the identification of areas to achieve common strategic objectives. Harmonization, in other words, helps different departments in local authorities to work together and optimize the use or resources by sharing the same vision, involving key stakeholders, and promoting common data assessment to better optimize the resources. A methodology to promote resilient city planning via the harmonization of sustainable mobility and energy plans is presented in this paper. In order to validate the proposed methodology, a representative city engaged in an innovation process in efficient spatial planning is used as a case study. The harmonization process of sustainable mobility and energy plans covers identifying matching targets between different fields, developing different spatial plans with dual benefit and common indicators guaranteeing the continuous improvement of the harmonized plans. The proposed methodology supports local administrations in consistent spatial planning, considering both energy efficiency and sustainable mobility. Thus, municipalities can use their human and economic resources efficiently. This guarantees an efficient upgrade of land use plans integrating energy and mobility aspects in order to achieve sustainability targets, as well as to improve the wellbeing of its citizens.

Keywords: integrated multi-sector planning, spatial plans harmonization, sustainable energy and climate action plan, sustainable urban mobility plan

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Authors: Ru-Yu Lien, Shih-Hsin Hung, Shu-Fen Lu, Shu-I Chin, Wen-Ju Yang, Wan Ming-Shang, Chien-Ying Wang

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Background: Upon recovery from critical condition, patients are normally transferred from the intensive care units (ICUs) to the general wards. However, transferring patients to a new environment causes stressful experiences for both patients and their families. Therefore, there is a necessity to communicate with the patients and their families to reduce psychological stress and unplanned return. Methods: This study was performed in the general ICUs from January 1, 2021, to December 31, 2021, in Taipei Veteran General Hospital. The patients who were evaluated by doctors and liaison nurses transferred to the general wards were selected as the research objects and ranked by the Critical Care Transition Program (CCTP). The plan was applied to 40 patients in a study group and usual care support for a control group of 40 patients. The psychological condition of patients was evaluated by a migration stress scale and a hospital anxiety and depression scale. In addition, the rate of return to ICU was also measured. Results: A total of 63 patients out of 80 (78.8%) experienced moderate to severe degrees of anxiety, and 42 patients (52.6%) experienced moderate to severe degrees of depression before being transferred. The difference between anxiety and depression changed more after the transfer; moreover, when a transition program was applied, it was lower than without a transition program. The return to ICU rate in the study group was lower than in the usual transition group, with an adjusted odds ratio of 0.21 (95% confidence interval: 0.05-0.888, P=0.034). Conclusion: Our study found that the transfer program could reduce the anxiety and depression of patients and the associated stress on their families during the transition from ICU. Before being transferred out of ICU, the healthcare providers need to assess the needs of patients to set the goals of the care plan and perform patient-centered decision-making with multidisciplinary support.

Keywords: ICU, critical care transition program, healthcare, transition program

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Authors: Vivian W. L. Tsang, Karen Lockhart, Samuel Spiegel, Annalee Yassi

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Background: Workers in the informal economy often incur exposure to well-documented occupational health hazards. Insufficient attention has been afforded to rigorously evaluating intervention programs to reduce the risks, especially in artisanal and small-scale gold mining (ASGM). Objectives: This systematic review, conducted as part of the World Health Organization’s Global Plan of Action for Workers’ Health, sought to assess the state of knowledge on occupational health programs and interventions for the informal artisanal and small-scale gold mining (ASGM) sector, an occupation which directly employs at least 50 million people. Methods: We used a comprehensive search strategy for four well-known databases relevant to health outcomes: PubMed, Engineering Village, OVID Medline, and Web of Science, and employed the PRISMA framework for our analysis. Findings: Ten studies met the inclusion criteria of a primary study focused on assessing the impact of interventions addressing occupational health concerns in ASGM. There were no studies evaluating or even identifying comprehensive occupational health and safety programs for this sector, although target interventions addressing specific hazards exist. Major areas of intervention –education and introduction of mercury-reducing/eliminating technology were identified, and the challenges and limitations of each intervention taken into the assessment. Even for these, however, there was a lack of standardization for measuring outcome or impact, let alone long-term health outcomes for miners and mining communities. Conclusion: There is an urgent need for research on comprehensive occupational health programs addressing the array of hazards faced by artisanal and small-scale miners.

Keywords: informal economy, artisanal and small-scale gold mining, occupational health, health and safety, workplace safety

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Authors: Fayez Hanna, Viet Tran

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A 20 years old lady- primigravida 6 weeks pregnant with unremarkable past history, presented to the emergency department at the Royal Hobart Hospital, Tasmania, Australia, with hyperemesis gravidarum associated with, dehydration and complicated with hematemesis and chest pain resistant. Accordingly, we conducted laboratory investigations which revealed: FBC: WBC 23.9, unremarkable U&E, LFT, lipase and her VBG showed a pH 7.4, pCo2 36.7, cK+ 3.2, cNa+ 142. The decision was made to do a chest X-ray (CXR) after explaining the risks/benefit of performing radiographic investigations during pregnancy and considering the patient's plan for the termination of the pregnancy as she was not ready for motherhood for shared decision-making and consent to look for pneumoperitoneum to suggest perforated viscus that might cause the hematemesis. However, the CXR showed pneumomediastinum but no evidence of pneumoperitoneum or pneumothorax. Consequently, a decision was made to proceed with CT oesophagography with imaging pre and post oral contrast administration to identify a potential oesophageal tear since it could not be excluded using a plain film of the CXR. The CT oesophagography could not find a leak for the administered oral contrast and thus, no oesophageal tear could be confirmed but could not exclude the Mallory-Weiss tear (lower oesophageal tear). Further, the CT oesophagography showed an extensive pneumomediastinum that could not be confirmed to be pulmonary in origin noting the presence of bilateral pulmonary interstitial emphysema and pneumothorax in the apex of the right lung that was small. The patient was admitted to the Emergency Department Inpatient Unit for monitoring, supportive therapy, and symptomatic management. Her hyperemesis was well controlled with ondansetron 8mg IV, metoclopramide 10mg IV, doxylamine 25mg PO, pyridoxine 25mg PO, esomeprazole 40mg IV and oxycodone 5mg PO was given for pain control and 2 litter of IV fluid. The patient was stabilized after 24 hours and discharged home on ondansetron 8mg every 8 hours whereas the patient had a plan for medical termination of pregnancy. Three weeks later, the patient represented with nausea and vomiting complicated by a frank hematemesis. Her observation chart showed HR 117- other vital signs were normal. Pathology showed WBC 14.3 with normal U&E and Hb. The patient was managed in the Emergency Department with the same previous regimen and was discharged home on same previous regimes. Five days later, she presented again with nausea, vomiting and hematemesis and was admitted under obstetrics and gynaecology for stabilization then discharged home with a plan for surgical termination of pregnancy after 3-days rather than the previously planned medical termination of pregnancy to avoid extension of potential oesophageal tear. The surgical termination and follow up period were uneventful. The case is considered rare as pneumomediastinum is a very rare complication of hyperemesis gravidarum where vomiting-induced barotrauma leads to a ruptured oesophagus and air leak into the mediastinum. However no rupture oesophagus in our case. Although the combination of pneumothorax and pneumomediastinum without oesophageal tear was reported only 8 times in the literature, but none of them was due to hyperemesis gravidarum.

Keywords: Pneumothorax, pneumomediastinum, hyperemesis gravidarum, pneumopericardium

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Authors: Vacharee Svamivastu

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This research investigates the application of geometrical relationship to the ancient religious assembly hall (Vihara) housing a reclining Buddha statue of Thailand's Kamphaeng Phet Historical Park. The study utilizes the archaeological and wooden roof structure remains of the Vihara as the prima facie evidence, supplemented with evidence from other active archaeological sites with architectural kinship as well as Buddhist ideology. At present, the wooden roofs of the Vihara fell prey to the elements and there remain only the base, columns and enclosing walls. Unlike typical Viharas whose floor plan are of rectangular shape, the floor plan of the Vihara housing the reclining Buddha is of square configuration of 25x25m. Further observation has revealed the utilization of large laterite boulders as the principal construction material of the assembly hall (Vihara) columns. The laterite columns are of square shape (1x1m) and various heights (H), ranging from 3.50m to 5.50m. The erection of the Vihara required a total of 36 laterite columns. The pattern of columns arrangement is of two rows of inner columns, two rows of outer columns and two rows of verandah columns. The space between pairs of the verandah columns was stacked with laterite blocks of varying sizes to form the Vihara walls with small openings for ventilation. Upon applying the geometrical relationship-grid system to the Vihara, the results reveal that the placement of the columns was deliberately and masterfully undertaken such that the center of the square-shaped Vihara is conspicuously spacious so as to accommodate the sacred reclining Buddha statue. The elegance of the Vihara demonstrates the ingenious application of geometrical relationship to transforming a space into a structure (i.e. Vihara) of architectural and religious significance.

Keywords: geometrical relationship, the religious assembly hall, Vihara, Kamphaeng Phet School of Master Builder

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Authors: Celeste E. van Rinsum, Sanne M. P. L. Gerards, Geert M. Rutten, Ien A. M. van de Goor, Stef P. J. Kremers

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Combined lifestyle interventions have shown to be effective in changing and maintaining behavioral lifestyle changes and reducing overweight and obesity. A lifestyle coach is expected to promote lifestyle changes in adults related to physical activity and diet. The present Coaching on Lifestyle (CooL) study examined participants’ physical activity level, dietary behavioral, and motivational changes immediately after the intervention and at 1.5 years after baseline. In CooL intervention a lifestyle coach coaches individuals from eighteen years and older with (a high risk of) obesity in group and individual sessions. In addition a process evaluation was conducted in order to examine the implementation process and to be able to interpret the changes within the participants. This action-oriented research has a pre-post design. Participants of the CooL intervention (N = 200) completed three questionnaires: at baseline, immediately after the intervention (on average after 44 weeks), and at 1.5 years after baseline. T-tests and linear regressions were conducted to test self-reported changes in physical activity (IPAQ), dietary behaviors, their quality of motivation for physical activity (BREQ-3) and for diet (REBS), body mass index (BMI), and quality of life (EQ-5D-3L). For the process evaluation, we used individual and group interviews, observations and document analyses to gain insight in the implementation process (e.g. the recruitment) and how the intervention was valued by the participants, lifestyle coaches, and referrers. The study is currently ongoing and therefore the results presented here are preliminary. On average, the participants that finished the intervention and those that have completed the long-term measurement improved their level of vigorous-intense physical activity, sedentary behavior, sugar-sweetened beverage consumption and BMI. Mixed results were observed in motivational regulation for physical activity and nutrition. Moreover, an improvement on the quality of life dimension anxiety/depression was found, also in the long-term. All the other constructs did not show significant change over time. The results of the process evaluation have shown that recruitment of clients was difficult. Participants evaluated the intervention positively and the lifestyle coaches have continuously adapted the structure and contents of the intervention throughout the study period, based on their experiences and feedback from research. Preliminary results indicate that the CooL-intervention may have beneficial effects on overweight and obese participants in terms of energy balance-related behaviors, weight reduction, and quality of life. Recruitment of participants and embedding the position of the lifestyle coach in traditional care structures is challenging.

Keywords: combined lifestyle intervention, effect evaluation, lifestyle coaching, process evaluation, overweight, the Netherlands

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Authors: Saúl Rivero, Estefanya Marín, Katherine Bolaño, Elena Urán, Juan Yepes, Andrés Cossio

Abstract:

Medellín is the Colombian city with the best public transport systems in the country, which is made up of two metro lines, five metrocables, two BRT-type bus lines, and a tram. But despite the above, the Aburrá Valley, the area in which the city is located, has about 3000 km of roads, which for the existing population of 3.2 million inhabitants, gives an indicator of 900 meters of road per 1000 inhabitants, which is lower than the country's average, which is approximately 3900 meters. In addition, given that in Medellín, there is approximately one vehicle for every three inhabitants, the problems of congestion and environmental pollution have worsened over the years. In this sense, due to the limitations of physical space, the low public investment in road infrastructure, it is necessary to opt for mobility alternatives according to the above. Among the options for the city, there is what is known as micromobility. Micromobility is understood to be those small and light means of transport that are used for short distances, that use electrical energy, such as skateboards and bicycles. Taking into account the above, in this work, the current state and future of micromobility in the city of Medellín were analyzed, carrying out a prospective analysis, supported by a PEST analysis, but also of the crossed impact matrices; of influence and dependence; and the technique of the actor's game. The analysis was carried out for two future scenarios: one normal and one optimistic. Result of the analysis, it was determined that micromobility as an alternative social practice to mobility in the city of Medellín has favorable conditions since the local government has adopted strategies such as the Metropolitan Bicycle Master Plan of Valle de Aburrá and the plan " Bicycle paths in the city: more public spaces for life,” where a projection of 400 kilometers of bicycle paths was estimated by the year 2030, as for that same year it is expected that 10% of all trips in the region will be in bike mode. The total trip indicator is an achievable goal, while that of the number of kilometers of bike paths would be close to being met.

Keywords: electric vehicles, micromobilty, public transport, sustainable transport

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Authors: L. Strauta, S. Muižniece-Brasava

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Even though legumes possess high nutritional value and have a rather high protein content for plant origin products, they are underutilized mostly due to their lengthy cooking time. To increase the presence of legume-based products in human diet, new extruded products were made of cow peas (Vigna unguiculata (L.) Walp.). But as it is known, adding different moisture content to flour before extrusion can change the physical properties of the extruded product. Experiments were carried out to estimate the optimal moisture content for cow pea extrusion. After extrusion, the pH level had dropped from 6.7 to 6.5 and the lowest hardness rate was observed in the samples with additional 9 g 100g^-1 of moisture - 28±4N, but the volume mass of the samples with additional 9 g100g^-1 of water was 263±3 g L^-1; all samples were approximately 7±1mm long.

Keywords: cow pea, extrusion–cooking, moisture, size

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Authors: Ahmad Zamzam

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With the development of the economy in recent years, Saudi Arabia has been maintaining high economic growth. Therefore, its energy consumption has increased dramatically. This economic growth reflected on the expansion of high-rise tower's construction. Jeddah coastal strip (cornice) has many high-rise buildings planned to start next few years. These projects required a massive amount of electricity that was not planned to be supplied by the old infrastructure. This research studies the effect of the building envelope on its thermal performance. It follows a parametric simulation methodology using Ecotect software to analyze the effect of the building envelope design on its cooling energy load for an office high-rise building in Jeddah, Saudi Arabia, which includes building geometrical form, massing treatments, orientation and glazing type effect. The research describes an integrated passive design approach to reduce the cooling requirement for high-rise building through an improved building envelope design. The research used Ecotect to make four simulation studies; the first simulation compares the thermal performance of five high-rise buildings, presenting the basic shape of the plan. All the buildings have the same plan area and same floor height. The goal of this simulation is to find out the best shape for the thermal performance. The second simulation studies the effect of orientation on the thermal performance by rotating the same building model to find out the best and the worst angle for the building thermal performance. The third simulation studies the effect of the massing treatment on the total cooling load. It compared five models with different massing treatment, but with the same total built up area. The last simulation studied the effect of the glazing type by comparing the total cooling load of the same building using five different glass type and also studies the feasibility of using these glass types by studying the glass cost effect. The results indicate that using the circle shape as building plan could reduce the thermal cooling load by 40%. Also, using shading devices could reduce the cooling loads by 5%. The study states that using any of the massing grooving, recess or any treatment that could increase the outer exposed surface is not preferred and will decrease the building thermal performance. Also, the result shows that the best direction for glazing and openings from thermal performance viewpoint in Jeddah is the North direction while the worst direction is the East one. The best direction angle for openings - regarding the thermal performance in Jeddah- is 15 deg West and the worst is 250 deg West (110 deg East). Regarding the glass type effect, comparing to the double glass with air fill type as a reference case, the double glass with Air-Low-E will save 14% from the required amount of the thermal cooling load annually. Argon fill and triple glass will save 16% and 17% from the total thermal cooling load respectively, but for the glass cost purpose, using the Argon fill and triple glass is not feasible.

Keywords: passive cooling, reduce thermal load, Jeddah, building shape, energy

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Authors: Delphine Mukaneza, Lin Qiao, Wang Pengxin, Li Yan, Chen Yingyi

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Human activities on land use make the land-cover gradually change or transit. In this study, we examined the use of Landsat TM data to detect the land use change of Kigali between 1987 and 2009 using remote sensing techniques and analysis of data using ENVI and ArcGIS, a GIS software. Six different categories of land use were distinguished: bare soil, built up land, wetland, water, vegetation, and others. With remote sensing techniques, we analyzed land use data in 1987, 1999 and 2009, changed areas were found and a dynamic situation of land use in Kigali city was found during the 22 years studied. According to relevant Landsat data, the research focused on land use change in accordance with the role of remote sensing in the process of urbanization. The result of the work has shown the rapid increase of built up land between 1987 and 1999 and a big decrease of vegetation caused by the rebuild of the city after the 1994 genocide, while in the period of 1999 to 2009 there was a reduction in built up land and vegetation, after the authority of Kigali city established, a Master Plan where all constructions which were not in the range of the master Plan were destroyed. Rwanda's capital, Kigali City, through the expansion of the urban area, it is increasing the internal employment rate and attracts business investors and the service sector to improve their economy, which will increase the population growth and provide a better life. The overall planning of the city of Kigali considers the environment, land use, infrastructure, cultural and socio-economic factors, the economic development and population forecast, urban development, and constraints specification. To achieve the above purpose, the Government has set for the overall planning of city Kigali, different stages of the detailed description of the design, strategy and action plan that would guide Kigali planners and members of the public in the future to have more detailed regional plans and practical measures. Thus, land use change is significantly the performance of Kigali active human area, which plays an important role for the country to take certain decisions. Another area to take into account is the natural situation of Kigali city. Agriculture in the region does not occupy a dominant position, and with the population growth and socio-economic development, the construction area will gradually rise and speed up the process of urbanization. Thus, as a developing country, Rwanda's population continues to grow and there is low rate of utilization of land, where urbanization remains low. As mentioned earlier, the 1994 genocide massacres, population growth and urbanization processes, have been the factors driving the dramatic changes in land use. The focus on further research would be on analysis of Rwanda’s natural resources, social and economic factors that could be, the driving force of land use change.

Keywords: land use change, urbanization, Kigali City, Landsat

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Authors: Tarnai Tena, Strinić Dean

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Chronic non-communicable diseases are today the leading cause of mortality, morbidity and mortality disability at the world level and in Croatia. Among them are the most represented precisely cardiovascular diseases (CVD), so today we are talking about their global card epidemic. From 2018 to 2021, cardiovascular diseases are the leading cause of death for both women and men in the Dubrovnik- Neretva County. With regard to the COVID-19 pandemic, which has taken over, without forgetting how much these patients are additionally affected, we are still talking about the primary cause of sickness and death in the population of this county and region. In this record, we present collected data processed according to gender and disease classification. We also bring a kind of overview because, for years, we have been following how the population of one of the origins of the Mediterranean diet has been struggling with cardiovascular diseases.

Keywords: cardiovascular disease, burden, COVID-19, epidemiology, ishemic heart disease, cardiovascular medicine

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Authors: Padmaja R. Jonnalagadda

Abstract:

Dietary exposure assessment of fifteen pesticide residues was done in Andhra Pradesh. Twelve commonly consumed foods including water, which were representative of the diet, were collected, processed as table ready and analysed for the presence of various Organochlorines, organophosphates and synthetic pyrethroids. All the samples were contaminated with one or more of the 15 pesticide residues and all of them were within the MRLs. DDT and its isomers, Chlorpyriphos and Cypermethrin were frequently detected in many of the food samples. The mean concentration of the pesticide residues ranged from 0.02 μg kg-1 to 5.1 μg kg-1 (fresh weight) in the analysed foods. When exposure assessments was carried out for different age, sex and physiological groups it was found that the estimates of daily dietary intakes of the analysed pesticide residues in the present study are much lower than the violative levels in all age groups that were computed.

Keywords: table ready foods, pesticide residues, dietary intake, physiological groups, risk

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Authors: Abraham Finkelman

Abstract:

Computerized Surgical Guides have been proven to be a predictable way to perform dental implants, with a relatively high accuracy in comparison to a treatment plan. When using the CSG Bone supported, it allows us to make the necessary changes of the hard tissue prior to the implant placement and after the implant placement. The CSG gives us an accurate position for the drilling, and during the implant placement it allows us to alter the vertical position of the implant altering the final position of the abutment and avoiding any risk of any damage to the adjacent anatomical structures. Any Changes required to the bone level can be done prior to the fixation of the CSG using a reduction guide, which incur extra surgical fees and the need of a second surgical guide. Any changes of the bone level after the implant placement are at the risk of damaging the implant neck surface. The technique consists of a universal system that allows us to remove the excess bone around the implant sockets prior to the implant placement which then enables us to place the implant in the vertical position with accuracy as planned with the CSG. The systems consist of a hollow pin of different sizes and diameters. Depending on the implant system that we are using. Length sizes are from 6mm-16mm and a diameter of 2.6mm-4.8mm. Upon the completion of the drilling, the pin is then inserted into the implant socket-using the insertion tool. Once the insertion tool has unscrewed the pin, we can continue with the bone reduction. The bone reduction can be done using conventional methods upon the removal of all the excess bone around the pin. The insertion tool is then screwed into the pin and the pin is then removed. We now, have the new bone level at the crest of the implant socket which is our mark for the vertical position of the implant. In some cases, when we are locating the implant very close to anatomical structures, any form of deviation to the vertical position of the implant during the surgery, can cause damage to such anatomical structures, creating irreversible damages such as paresthesia or dysesthesia of the mandibular nerve. If we are planning for immediate loading and we have done our temporary restauration in base of our computerized plan, deviation in the vertical position of the implant will affect the position of the abutment, affecting the accuracy of the temporary prosthesis, extending the working time till we adapt the prosthesis to the new position.

Keywords: bone reduction, computer aided navigation, dental implant placement, surgical guides

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Authors: Rasouli Divkalaee Zeinab, Kalteh Safa, Roudbari Aliakbar

Abstract:

Introduction: Medical waste can lead to the generation and transmission of many infectious and contagious diseases due to the presence of pathogenic agents, thereby necessitating the need for special management to collect, decontaminate, and finally dispose of such products. This study aimed to design a centralized health care (medical) waste management program for the cities of Semnan, Mahdishahr, and Shahmirzad. Methods: This descriptive-analytical study was conducted for six months in the cities of Semnan, Mahdishahr, and Shahmirzad. In this study, the quantitative and qualitative characteristics of the generated wastes were determined by taking samples from all medical waste production centers. Then, the equipment, devices, and machines required for separate collection of the waste from the production centers and for their subsequent decontamination were estimated. Next, the investment costs, current costs, and working capital required for collection, decontamination, and final disposal of the wastes were determined. Finally, the payment for proper waste management of each category of medical waste-producing centers was determined. Results: 1021 kilograms of medical waste are produced daily in the cities of Semnan, Mahdishahr, and Shahmirzad. It was estimated that a 1000-liter autoclave, a machine for collecting medical waste, four 60-liter bins, four 120-liter bins, and four 1200-liter bins were required for implementing the study plan. Also, the estimated total annual medical waste management costs for Semnan City were determined (23,283,903,720 Iranian Rials). Conclusion: The study results showed that establishing a proper management system for medical wastes generated in the three studied cities will cost between 334,280 and 1,253,715 Iranian Rials in fees for the medical centers. The findings of this study provided comprehensive data regarding medical wastes from the generation point to the landfill site, which is vital for the government and the private sector.

Keywords: clinics, decontamination, management, medical waste

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Authors: Anderson S. Fonseca, Italo F. S. Da Silva, Robert D. A. Santos, Mayara G. Da Silva, Pedro H. C. Vieira, Antonio M. S. Sobrinho, Victor H. B. Lemos, Petterson S. Diniz, Anselmo C. Paiva, Eliana M. G. Monteiro

Abstract:

In Brazil, the National Electric Energy Agency (ANEEL) establishes that electrical energy companies are responsible for measuring and billing their customers. Among these regulations, it’s defined that a company must bill your customers within 27-33 days. If a relocation or a change of period is required, the consumer must be notified in writing, in advance of a billing period. To make it easier to organize a workday’s measurements, these companies create a reading plan. These plans consist of grouping customers into reading groups, which are visited by an employee responsible for measuring consumption and billing. The creation process of a plan efficiently and optimally is a capacitated clustering problem with constraints related to homogeneity and compactness, that is, the employee’s working load and the geographical position of the consuming unit. This process is a work done manually by several experts who have experience in the geographic formation of the region, which takes a large number of days to complete the final planning, and because it’s human activity, there is no guarantee of finding the best optimization for planning. In this paper, the GBKMeans method presents a technique based on K-Means and genetic algorithms for creating a capacitated cluster that respects the constraints established in an efficient and balanced manner, that minimizes the cost of relocating consumer units and the time required for final planning creation. The results obtained by the presented method are compared with the current planning of a real city, showing an improvement of 54.71% in the standard deviation of working load and 11.97% in the compactness of the groups.

Keywords: capacitated clustering, k-means, genetic algorithm, districting problems

Procedia PDF Downloads 198

Authors: M. Iqbal Hossain, Azharul Islam Khan, S. M. Rafiqul Islam, Tahmeed Ahmed

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Objective: Moderate acute malnutrition (MAM) is a major cause of morbidity and mortality in under-5 children of low-income countries. Approximately 14.6% of all under-5 mortality worldwide is attributed to MAM with >3 times increased risk of death compared to well-nourished peers. Prevalence of MAM among under-5 children in Bangladesh is ~12% (~1.7 million). Providing a diet containing adequate nutrients is the mainstay of treatment of children with MAM. It is now possible to process fish into fish peptides with longer shelf-life without refrigerator, known as ‘Fish Surimi peptide’ and this could be an attractive alternative to supply fish protein in the diet of children in low-income countries like Bangladesh. We conducted this study to assess the acceptability of Fish Surimi peptide given with various foods/meals in 2-5 years old children with MAM. Design/methods: Fish Surimi peptide is broken down from white fish meat using plant-derived enzyme and the ingredient is just fish meat consisted of 20 different kinds of amino acids including nine essential amino acids. In a convenience sample of 34 children we completed the study ward of Dhaka Hospital of icddr,b in Bangladesh during November 2014 through February 2015. For each child the study was for two consecutive days: i.e. direct observation of food intake of two lunches and two suppers. In a randomly and blinded manner and cross over design an individual child received Fish Surimi peptide (5g at lunch and 5g at supper) mixed meal [e.g. 30g rice and 30g dahl (thick lentil soup) or 60g of a vegetables-lentil-rice mixed local dish known as khichuri in one day and the same meal on other day without any Fish Surimi peptide. We observed the completeness and eagerness of eating and any possible side effect (e.g. allergy, vomiting, diarrhea etc.) over these two days. Results: The mean±SD age of the enrolled children was 38.4±9.4 months, weight 11.22±1.41 kg, height 91.0±6.3 cm, and WHZ was -2.13±0.76. Their mean±SD total feeding time (minutes) for lunch was 25.4±13.6 vs. 20.6±11.1 (p=0.130) and supper was 22.3±9.7 vs. 19.7±11.2 (p=0.297), and total amount (g) of food eaten in lunch and supper was found similar 116.1±7.0 vs. 117.7±8.0 (p=3.01) in A (Fish Surimi) and B group respectively. Score in Hedonic scale by mother on test of food given to children at lunch or supper was 3.9±0.2 vs. 4.0±0.2 (p=0.317) and on overall acceptance (including the texture, smell, and appearance) of food at lunch or supper was 3.9±0.2 vs. 4.0±0.2 (p=0.317) for A and B group respectively. No adverse event was observed in any food group during the study period. Conclusions: Fish Surimi peptide may be a cost effective supplementary food, which should be tested by appropriately designed randomized community level intervention trial both in wasted children and stunted children.

Keywords: protein-energy malnutrition, moderate acute malnutrition, weight-for-height z-score, mid upper arm circumference, acceptability, fish surimi peptide, under-5 children

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Authors: Raquel Zydeck, Karina Azzolin, Luis Kosteski, Alisson Milani

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This work presents numerical models in plane deformations (2D), using the Discrete Element Method formedbybars (LDEM) andtheFiniteElementMethod (FEM), in structuralmasonrywallswith horizontal chasesof 20%, 30%, and 50% deep, located in the central part and 1/3 oftheupperpartofthewall, withcenteredandeccentricloading. Differentcombinationsofboundaryconditionsandinteractionsbetweenthemethodswerestudied.

Keywords: chases in structural masonry walls, discrete element method formed by bars, finite element method, numerical models, boundary condition

Procedia PDF Downloads 168