Search results for: local coronary artery disease
Commenced in January 2007
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Edition: International
Paper Count: 9213

Search results for: local coronary artery disease

483 Using ANN in Emergency Reconstruction Projects Post Disaster

Authors: Rasha Waheeb, Bjorn Andersen, Rafa Shakir

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Purpose The purpose of this study is to avoid delays that occur in emergency reconstruction projects especially in post disaster circumstances whether if they were natural or manmade due to their particular national and humanitarian importance. We presented a theoretical and practical concepts for projects management in the field of construction industry that deal with a range of global and local trails. This study aimed to identify the factors of effective delay in construction projects in Iraq that affect the time and the specific quality cost, and find the best solutions to address delays and solve the problem by setting parameters to restore balance in this study. 30 projects were selected in different areas of construction were selected as a sample for this study. Design/methodology/approach This study discusses the reconstruction strategies and delay in time and cost caused by different delay factors in some selected projects in Iraq (Baghdad as a case study).A case study approach was adopted, with thirty construction projects selected from the Baghdad region, of different types and sizes. Project participants from the case projects provided data about the projects through a data collection instrument distributed through a survey. Mixed approach and methods were applied in this study. Mathematical data analysis was used to construct models to predict delay in time and cost of projects before they started. The artificial neural networks analysis was selected as a mathematical approach. These models were mainly to help decision makers in construction project to find solutions to these delays before they cause any inefficiency in the project being implemented and to strike the obstacles thoroughly to develop this industry in Iraq. This approach was practiced using the data collected through survey and questionnaire data collection as information form. Findings The most important delay factors identified leading to schedule overruns were contractor failure, redesigning of designs/plans and change orders, security issues, selection of low-price bids, weather factors, and owner failures. Some of these are quite in line with findings from similar studies in other countries/regions, but some are unique to the Iraqi project sample, such as security issues and low-price bid selection. Originality/value we selected ANN’s analysis first because ANN’s was rarely used in project management , and never been used in Iraq to finding solutions for problems in construction industry. Also, this methodology can be used in complicated problems when there is no interpretation or solution for a problem. In some cases statistical analysis was conducted and in some cases the problem is not following a linear equation or there was a weak correlation, thus we suggested using the ANN’s because it is used for nonlinear problems to find the relationship between input and output data and that was really supportive.

Keywords: construction projects, delay factors, emergency reconstruction, innovation ANN, post disasters, project management

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482 Vicarious Cues in Portraying Emotion: Musicians' Self-Appraisal

Authors: W. Linthicum-Blackhorse, P. Martens

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This present study seeks to discover attitudinal commonalities and differences within a musician population relative to the communication of emotion via music. We hypothesized that instrument type, as well as age and gender, would bear significantly on musicians’ opinions. A survey was administered to 178 participants; 152 were current music majors (mean age 20.3 years, 62 female) and 26 were adult participants in a community choir (mean age 54.0 years, 12 female). The adult participants were all vocalists, while student participants represented the full range of orchestral instruments. The students were grouped by degree program, (performance, music education, or other) and instrument type (voice, brass, woodwinds, strings, percussion). The survey asked 'How important are each of the following areas to you for portraying emotion in music?' Participants were asked to rate each of 15 items on a scale of 1 (not at all important) to 10 (very important). Participants were also instructed to leave blank any item that they did not understand. The 15 items were: dynamic contrast, overall volume, phrasing, facial expression, staging (placement), pitch accuracy, tempo changes, bodily movement, your mood, your attitude, vibrato, rubato, stage/room lighting, clothing type, and clothing color. Contrary to our hypothesis, there was no overall effect of gender or age, and neither did any single response item show a significant difference due to these subject parameters. Among the student participants, however, one-way ANOVA revealed a significant effect of degree program on the rated importance of four items: dynamic contrast, tempo changes, vibrato, and rubato. Significant effects of instrument type were found in the responses to eight items: facial expression, staging, body movement, vibrato, rubato, lighting, clothing type, and clothing color. Post hoc comparisons (Tukey) show that some variation follows from obvious differences between instrument types (e.g. string players are more concerned with vibrato than everyone but woodwind players; vocalists are significantly more concerned with facial expression than everyone but string players), but other differences could point to communal mindsets toward vicarious cues within instrument type. These mindsets could be global (e.g. brass players deeming body movement significantly less important than string players, being less often featured as soloists and appearing less often at the front of the stage) or local (e.g. string players being significantly more concerned than all other groups about both clothing color and type, perhaps due to the strongly-expressed opinions of specific teachers). Future work will attempt to identify the source of these self-appraisals, whether enculturated via explicit pedagogy, or whether absorbed from individuals' observations and performance experience.

Keywords: performance, vicarious cues, communication, emotion

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481 Optimized Processing of Neural Sensory Information with Unwanted Artifacts

Authors: John Lachapelle

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Introduction: Neural stimulation is increasingly targeted toward treatment of back pain, PTSD, Parkinson’s disease, and for sensory perception. Sensory recording during stimulation is important in order to examine neural response to stimulation. Most neural amplifiers (headstages) focus on noise efficiency factor (NEF). Conversely, neural headstages need to handle artifacts from several sources including power lines, movement (EMG), and neural stimulation itself. In this work a layered approach to artifact rejection is used to reduce corruption of the neural ENG signal by 60dBv, resulting in recovery of sensory signals in rats and primates that would previously not be possible. Methods: The approach combines analog techniques to reduce and handle unwanted signal amplitudes. The methods include optimized (1) sensory electrode placement, (2) amplifier configuration, and (3) artifact blanking when necessary. The techniques together are like concentric moats protecting a castle; only the wanted neural signal can penetrate. There are two conditions in which the headstage operates: unwanted artifact < 50mV, linear operation, and artifact > 50mV, fast-settle gain reduction signal limiting (covered in more detail in a separate paper). Unwanted Signals at the headstage input: Consider: (a) EMG signals are by nature < 10mV. (b) 60 Hz power line signals may be > 50mV with poor electrode cable conditions; with careful routing much of the signal is common to both reference and active electrode and rejected in the differential amplifier with <50mV remaining. (c) An unwanted (to the neural recorder) stimulation signal is attenuated from stimulation to sensory electrode. The voltage seen at the sensory electrode can be modeled Φ_m=I_o/4πσr. For a 1 mA stimulation signal, with 1 cm spacing between electrodes, the signal is <20mV at the headstage. Headstage ASIC design: The front end ASIC design is designed to produce < 1% THD at 50mV input; 50 times higher than typical headstage ASICs, with no increase in noise floor. This requires careful balance of amplifier stages in the headstage ASIC, as well as consideration of the electrodes effect on noise. The ASIC is designed to allow extremely small signal extraction on low impedance (< 10kohm) electrodes with configuration of the headstage ASIC noise floor to < 700nV/rt-Hz. Smaller high impedance electrodes (> 100kohm) are typically located closer to neural sources and transduce higher amplitude signals (> 10uV); the ASIC low-power mode conserves power with 2uV/rt-Hz noise. Findings: The enhanced neural processing ASIC has been compared with a commercial neural recording amplifier IC. Chronically implanted primates at MGH demonstrated the presence of commercial neural amplifier saturation as a result of large environmental artifacts. The enhanced artifact suppression headstage ASIC, in the same setup, was able to recover and process the wanted neural signal separately from the suppressed unwanted artifacts. Separately, the enhanced artifact suppression headstage ASIC was able to separate sensory neural signals from unwanted artifacts in mouse-implanted peripheral intrafascicular electrodes. Conclusion: Optimizing headstage ASICs allow observation of neural signals in the presence of large artifacts that will be present in real-life implanted applications, and are targeted toward human implantation in the DARPA HAPTIX program.

Keywords: ASIC, biosensors, biomedical signal processing, biomedical sensors

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480 Strategies for Public Space Utilization

Authors: Ben Levenger

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Social life revolves around a central meeting place or gathering space. It is where the community integrates, earns social skills, and ultimately becomes part of the community. Following this premise, public spaces are one of the most important spaces that downtowns offer, providing locations for people to be witnessed, heard, and most importantly, seamlessly integrate into the downtown as part of the community. To facilitate this, these local spaces must be envisioned and designed to meet the changing needs of a downtown, offering a space and purpose for everyone. This paper will dive deep into analyzing, designing, and implementing public space design for small plazas or gathering spaces. These spaces often require a detailed level of study, followed by a broad stroke of design implementation, allowing for adaptability. This paper will highlight how to assess needs, define needed types of spaces, outline a program for spaces, detail elements of design to meet the needs, assess your new space, and plan for change. This study will provide participants with the necessary framework for conducting a grass-roots-level assessment of public space and programming, including short-term and long-term improvements. Participants will also receive assessment tools, sheets, and visual representation diagrams. Urbanism, for the sake of urbanism, is an exercise in aesthetic beauty. An economic improvement or benefit must be attained to solidify these efforts' purpose further and justify the infrastructure or construction costs. We will deep dive into case studies highlighting economic impacts to ground this work in quantitative impacts. These case studies will highlight the financial impact on an area, measuring the following metrics: rental rates (per sq meter), tax revenue generation (sales and property), foot traffic generation, increased property valuations, currency expenditure by tenure, clustered development improvements, cost/valuation benefits of increased density in housing. The economic impact results will be targeted by community size, measuring in three tiers: Sub 10,000 in population, 10,001 to 75,000 in population, and 75,000+ in population. Through this classification breakdown, the participants can gauge the impact in communities similar to their work or for which they are responsible. Finally, a detailed analysis of specific urbanism enhancements, such as plazas, on-street dining, pedestrian malls, etc., will be discussed. Metrics that document the economic impact of each enhancement will be presented, aiding in the prioritization of improvements for each community. All materials, documents, and information will be available to participants via Google Drive. They are welcome to download the data and use it for their purposes.

Keywords: downtown, economic development, planning, strategic

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479 Awareness Creation of Benefits of Antitrypsin-Free Nutraceutical Biopowder for Increasing Human Serum Albumin Synthesis as Possible Adjunct for Management of MDRTB or MDRTB-HIV Patients

Authors: Vincent Oghenekevbe Olughor, Olusoji Mayowa Ige

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Except for a preexisting liver disease and malnutrition, there are no predilections for low serum albumin (SA) levels in humans. At normal reference levels (4.0-6.0g/dl) SA is a universal marker for mortality and morbidity risks assessments where depletion by 1.0g/dl increases mortality risk by 137% and morbidity by 89%.It has 40 known functions contributing significantly to the sustenance of human life. A depletion in SA to <2.2g/dl, in most clinical settings worldwide, leads to loss of oncotic pressure of blood causing clinical manifestations of bipedal Oedema, in which the patients remain conscious. SA also contributes significantly to buffering of blood to a life-sustaining pH of 7.35-7.45. A drop in blood pH to <6.9 will lead to instant coma and death, which can occur after SA continues to deplete after manifestations of bipedal Oedema. In an intervention study conducted in 2014 following the discovery that “SA is depleted during malaria fever”, a Nutraceutical formulated for use as treatment adjunct to prevent SA depletions during malaria to <2.4g/dl after Efficacy testing was found to be satisfactory. There are five known types of Malaria caused by Apicomplexan parasites, Plasmodium: the most lethal being that caused by Plasmodium falciparum causing malignant tertian malaria, in which the fever was occurring every 48 hours coincides with the dumping of malaria-toxins (Hemozoin) into blood, causing contamination: blood must remain sterile. Other Apicomplexan parasites, Toxoplasma and Cryptosporidium, are opportunistic infections of HIV. Separate studies showed SA depletions in MDRTB (multidrug resistant TB), and MDRTB-HIV patients by the same mechanism discovered with malaria and such depletions will be further complicated whenever Apicomplexan parasitic infections co-exist. Both Apicomplexan parasites and the TB parasite belong to the Obligate-group of Parasites, which are parasites that replicate only inside its host; and most of them have capacities to over-consume host nutrients during parasitaemia. In MDRTB patients the body attempts repeatedly to prevent depletions in SA to critical levels in the presence of adequate nutrients and only for a while in MDRTB-HIV patients. These groups of patients will, therefore, benefit from the already tested Nutraceutical in malaria patients. The Nutraceutical bio-Powder was formulated (to BP 1988 specification) from twelve nature-based food-grade nutrients containing all dedicated nutrients for ensuring improved synthesis of Albumin by the liver. The Nutraceutical was administered daily for 38±2days in 23 children, in a prospective phase-2 clinical trial, and its impact on body weight and core blood parameters were documented at the start and end of efficacy testing period. Sixteen children who did not experience malaria-induced depletions of SA had significant SA increase; seven children who experienced malaria-induced depletions of SA had insignificant SA decrease. The Packed Cell Volume Percentage (PCV %), a measure of the Oxygen carrying capacity of blood and the amount of nutrients the body can absorb, increased in both groups. The total serum proteins (SA+ Globulins) increased or decreased within the continuum of normal. In conclusion, MDRTB and MDRTB-HIV patients will benefit from a variant of this Nutraceutical when used as treatment adjunct.

Keywords: antitrypsin-free Nutraceutical, apicomplexan parasites, no predilections for low serum albumin, toxoplasmosis

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478 Exploring Antimicrobial Resistance in the Lung Microbial Community Using Unsupervised Machine Learning

Authors: Camilo Cerda Sarabia, Fernanda Bravo Cornejo, Diego Santibanez Oyarce, Hugo Osses Prado, Esteban Gómez Terán, Belén Diaz Diaz, Raúl Caulier-Cisterna, Jorge Vergara-Quezada, Ana Moya-Beltrán

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Antimicrobial resistance (AMR) represents a significant and rapidly escalating global health threat. Projections estimate that by 2050, AMR infections could claim up to 10 million lives annually. Respiratory infections, in particular, pose a severe risk not only to individual patients but also to the broader public health system. Despite the alarming rise in resistant respiratory infections, AMR within the lung microbiome (microbial community) remains underexplored and poorly characterized. The lungs, as a complex and dynamic microbial environment, host diverse communities of microorganisms whose interactions and resistance mechanisms are not fully understood. Unlike studies that focus on individual genomes, analyzing the entire microbiome provides a comprehensive perspective on microbial interactions, resistance gene transfer, and community dynamics, which are crucial for understanding AMR. However, this holistic approach introduces significant computational challenges and exposes the limitations of traditional analytical methods such as the difficulty of identifying the AMR. Machine learning has emerged as a powerful tool to overcome these challenges, offering the ability to analyze complex genomic data and uncover novel insights into AMR that might be overlooked by conventional approaches. This study investigates microbial resistance within the lung microbiome using unsupervised machine learning approaches to uncover resistance patterns and potential clinical associations. it downloaded and selected lung microbiome data from HumanMetagenomeDB based on metadata characteristics such as relevant clinical information, patient demographics, environmental factors, and sample collection methods. The metadata was further complemented by details on antibiotic usage, disease status, and other relevant descriptions. The sequencing data underwent stringent quality control, followed by a functional profiling focus on identifying resistance genes through specialized databases like Antibiotic Resistance Database (CARD) which contains sequences of AMR gene sequence and resistance profiles. Subsequent analyses employed unsupervised machine learning techniques to unravel the structure and diversity of resistomes in the microbial community. Some of the methods employed were clustering methods such as K-Means and Hierarchical Clustering enabled the identification of sample groups based on their resistance gene profiles. The work was implemented in python, leveraging a range of libraries such as biopython for biological sequence manipulation, NumPy for numerical operations, Scikit-learn for machine learning, Matplotlib for data visualization and Pandas for data manipulation. The findings from this study provide insights into the distribution and dynamics of antimicrobial resistance within the lung microbiome. By leveraging unsupervised machine learning, we identified novel resistance patterns and potential drivers within the microbial community.

Keywords: antibiotic resistance, microbial community, unsupervised machine learning., sequences of AMR gene

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477 Chemical Analysis of Particulate Matter (PM₂.₅) and Volatile Organic Compound Contaminants

Authors: S. Ebadzadsahraei, H. Kazemian

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The main objective of this research was to measure particulate matter (PM₂.₅) and Volatile Organic Compound (VOCs) as two classes of air pollutants, at Prince George (PG) neighborhood in warm and cold seasons. To fulfill this objective, analytical protocols were developed for accurate sampling and measurement of the targeted air pollutants. PM₂.₅ samples were analyzed for their chemical composition (i.e., toxic trace elements) in order to assess their potential source of emission. The City of Prince George, widely known as the capital of northern British Columbia (BC), Canada, has been dealing with air pollution challenges for a long time. The city has several local industries including pulp mills, a refinery, and a couple of asphalt plants that are the primary contributors of industrial VOCs. In this research project, which is the first study of this kind in this region it measures physical and chemical properties of particulate air pollutants (PM₂.₅) at the city neighborhood. Furthermore, this study quantifies the percentage of VOCs at the city air samples. One of the outcomes of this project is updated data about PM₂.₅ and VOCs inventory in the selected neighborhoods. For examining PM₂.₅ chemical composition, an elemental analysis methodology was developed to measure major trace elements including but not limited to mercury and lead. The toxicity of inhaled particulates depends on both their physical and chemical properties; thus, an understanding of aerosol properties is essential for the evaluation of such hazards, and the treatment of such respiratory and other related diseases. Mixed cellulose ester (MCE) filters were selected for this research as a suitable filter for PM₂.₅ air sampling. Chemical analyses were conducted using Inductively Coupled Plasma Mass Spectrometry (ICP-MS) for elemental analysis. VOCs measurement of the air samples was performed using a Gas Chromatography-Flame Ionization Detector (GC-FID) and Gas Chromatography-Mass Spectrometry (GC-MS) allowing for quantitative measurement of VOC molecules in sub-ppb levels. In this study, sorbent tube (Anasorb CSC, Coconut Charcoal), 6 x 70-mm size, 2 sections, 50/100 mg sorbent, 20/40 mesh was used for VOCs air sampling followed by using solvent extraction and solid-phase micro extraction (SPME) techniques to prepare samples for measuring by a GC-MS/FID instrument. Air sampling for both PM₂.₅ and VOC were conducted in summer and winter seasons for comparison. Average concentrations of PM₂.₅ are very different between wildfire and daily samples. At wildfire time average of concentration is 83.0 μg/m³ and daily samples are 23.7 μg/m³. Also, higher concentrations of iron, nickel and manganese found at all samples and mercury element is found in some samples. It is able to stay too high doses negative effects.

Keywords: air pollutants, chemical analysis, particulate matter (PM₂.₅), volatile organic compound, VOCs

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476 Coupling Strategy for Multi-Scale Simulations in Micro-Channels

Authors: Dahia Chibouti, Benoit Trouette, Eric Chenier

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With the development of micro-electro-mechanical systems (MEMS), understanding fluid flow and heat transfer at the micrometer scale is crucial. In the case where the flow characteristic length scale is narrowed to around ten times the mean free path of gas molecules, the classical fluid mechanics and energy equations are still valid in the bulk flow, but particular attention must be paid to the gas/solid interface boundary conditions. Indeed, in the vicinity of the wall, on a thickness of about the mean free path of the molecules, called the Knudsen layer, the gas molecules are no longer in local thermodynamic equilibrium. Therefore, macroscopic models based on the continuity of velocity, temperature and heat flux jump conditions must be applied at the fluid/solid interface to take this non-equilibrium into account. Although these macroscopic models are widely used, the assumptions on which they depend are not necessarily verified in realistic cases. In order to get rid of these assumptions, simulations at the molecular scale are carried out to study how molecule interaction with walls can change the fluid flow and heat transfers at the vicinity of the walls. The developed approach is based on a kind of heterogeneous multi-scale method: micro-domains overlap the continuous domain, and coupling is carried out through exchanges of information between both the molecular and the continuum approaches. In practice, molecular dynamics describes the fluid flow and heat transfers in micro-domains while the Navier-Stokes and energy equations are used at larger scales. In this framework, two kinds of micro-simulation are performed: i) in bulk, to obtain the thermo-physical properties (viscosity, conductivity, ...) as well as the equation of state of the fluid, ii) close to the walls to identify the relationships between the slip velocity and the shear stress or between the temperature jump and the normal temperature gradient. The coupling strategy relies on an implicit formulation of the quantities extracted from micro-domains. Indeed, using the results of the molecular simulations, a Bayesian regression is performed in order to build continuous laws giving both the behavior of the physical properties, the equation of state and the slip relationships, as well as their uncertainties. These latter allow to set up a learning strategy to optimize the number of micro simulations. In the present contribution, the first results regarding this coupling associated with the learning strategy are illustrated through parametric studies of convergence criteria, choice of basis functions and noise of input data. Anisothermic flows of a Lennard Jones fluid in micro-channels are finally presented.

Keywords: multi-scale, microfluidics, micro-channel, hybrid approach, coupling

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475 Source-Detector Trajectory Optimization for Target-Based C-Arm Cone Beam Computed Tomography

Authors: S. Hatamikia, A. Biguri, H. Furtado, G. Kronreif, J. Kettenbach, W. Birkfellner

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Nowadays, three dimensional Cone Beam CT (CBCT) has turned into a widespread clinical routine imaging modality for interventional radiology. In conventional CBCT, a circular sourcedetector trajectory is used to acquire a high number of 2D projections in order to reconstruct a 3D volume. However, the accumulated radiation dose due to the repetitive use of CBCT needed for the intraoperative procedure as well as daily pretreatment patient alignment for radiotherapy has become a concern. It is of great importance for both health care providers and patients to decrease the amount of radiation dose required for these interventional images. Thus, it is desirable to find some optimized source-detector trajectories with the reduced number of projections which could therefore lead to dose reduction. In this study we investigate some source-detector trajectories with the optimal arbitrary orientation in the way to maximize performance of the reconstructed image at particular regions of interest. To achieve this approach, we developed a box phantom consisting several small target polytetrafluoroethylene spheres at regular distances through the entire phantom. Each of these spheres serves as a target inside a particular region of interest. We use the 3D Point Spread Function (PSF) as a measure to evaluate the performance of the reconstructed image. We measured the spatial variance in terms of Full-Width-Half-Maximum (FWHM) of the local PSFs each related to a particular target. The lower value of FWHM shows the better spatial resolution of reconstruction results at the target area. One important feature of interventional radiology is that we have very well-known imaging targets as a prior knowledge of patient anatomy (e.g. preoperative CT) is usually available for interventional imaging. Therefore, we use a CT scan from the box phantom as the prior knowledge and consider that as the digital phantom in our simulations to find the optimal trajectory for a specific target. Based on the simulation phase we have the optimal trajectory which can be then applied on the device in real situation. We consider a Philips Allura FD20 Xper C-arm geometry to perform the simulations and real data acquisition. Our experimental results based on both simulation and real data show our proposed optimization scheme has the capacity to find optimized trajectories with minimal number of projections in order to localize the targets. Our results show the proposed optimized trajectories are able to localize the targets as good as a standard circular trajectory while using just 1/3 number of projections. Conclusion: We demonstrate that applying a minimal dedicated set of projections with optimized orientations is sufficient to localize targets, may minimize radiation.

Keywords: CBCT, C-arm, reconstruction, trajectory optimization

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474 Determination of 1-Deoxynojirimycin and Phytochemical Profile from Mulberry Leaves Cultivated in Indonesia

Authors: Yasinta Ratna Esti Wulandari, Vivitri Dewi Prasasty, Adrianus Rio, Cindy Geniola

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Mulberry is a plant that widely cultivated around the world, mostly for silk industry. In recent years, the study showed that the mulberry leaves have an anti-diabetic effect which mostly comes from the compound known as 1-deoxynojirimycin (DNJ). DNJ is a very potent α-glucosidase inhibitor. It will decrease the degradation rate of carbohydrates in digestive tract, leading to slower glucose absorption and reducing the post-prandial glucose level significantly. The mulberry leaves also known as the best source of DNJ. Since then, the DNJ in mulberry leaves had received a considerable attention, because of the increased number of diabetic patients and the raise of people awareness to find a more natural cure for diabetic. The DNJ content in mulberry leaves varied depend on the mulberry species, leaf’s age, and the plant’s growth environment. Few of the mulberry varieties that were cultivated in Indonesiaare Morus alba var. kanva-2, M. alba var. multicaulis, M. bombycis var. lembang, and M. cathayana. The lack of data concerning phytochemicals contained in the Indonesian mulberry leaves are restraining their use in the medicinal field. The aim of this study is to fully utilize the use of mulberry leaves cultivated in Indonesia as a medicinal herb in local, national, or global community, by determining the DNJ and other phytochemical contents in them. This study used eight leaf samples which are the young leaves and mature leaves of both Morus alba var. kanva-2, M. alba var. multicaulis, M. bombycis var. lembang, and M. cathayana. The DNJ content was analyzed using reverse phase high performance liquid chromatography (HPLC). The stationary phase was silica C18 column and the mobile phase was acetonitrile:acetic acid 0.1% 1:1 with elution rate 1 mL/min. Prior to HPLC analysis the samples were derivatized with FMOC to ensure the DNJ detectable by VWD detector at 254 nm. Results showed that the DNJ content in samples are ranging from 2.90-0.07 mg DNJ/ g leaves, with the highest content found in M. cathayana mature leaves (2.90 ± 0.57 mg DNJ/g leaves). All of the mature leaf samples also found to contain higher amount of DNJ from their respective young leaf samples. The phytochemicals in leaf samples was tested using qualitative test. Result showed that all of the eight leaf samples contain alkaloids, phenolics, flavonoids, tannins, and terpenes. The presence of this phytochemicals contribute to the therapeutic effect of mulberry leaves. The pyrolysis-gas chromatography-mass spectrometry (Py-GC-MS) analysis was also performed to the eight samples to quantitatively determine their phytochemicals content. The pyrolysis temperature was set at 400 °C, with capillary column Phase Rtx-5MS 60 × 0.25 mm ID stationary phase and helium gas mobile phase. Few of the terpenes found are known to have anticancer and antimicrobial properties. From all the results, all of four samples of mulberry leaves which are cultivated in Indonesia contain DNJ and various phytochemicals like alkaloids, phenolics, flavonoids, tannins, and terpenes which are beneficial to our health.

Keywords: Morus, 1-deoxynojirimycin, HPLC, Py-GC-MS

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473 Financial Modeling for Net Present Benefit Analysis of Electric Bus and Diesel Bus and Applications to NYC, LA, and Chicago

Authors: Jollen Dai, Truman You, Xinyun Du, Katrina Liu

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Transportation is one of the leading sources of greenhouse gas emissions (GHG). Thus, to meet the Paris Agreement 2015, all countries must adopt a different and more sustainable transportation system. From bikes to Maglev, the world is slowly shifting to sustainable transportation. To develop a utility public transit system, a sustainable web of buses must be implemented. As of now, only a handful of cities have adopted a detailed plan to implement a full fleet of e-buses by the 2030s, with Shenzhen in the lead. Every change requires a detailed plan and a focused analysis of the impacts of the change. In this report, the economic implications and financial implications have been taken into consideration to develop a well-rounded 10-year plan for New York City. We also apply the same financial model to the other cities, LA and Chicago. We picked NYC, Chicago, and LA to conduct the comparative NPB analysis since they are all big metropolitan cities and have complex transportation systems. All three cities have started an action plan to achieve a full fleet of e-bus in the decades. Plus, their energy carbon footprint and their energy price are very different, which are the key factors to the benefits of electric buses. Using TCO (Total Cost Ownership) financial analysis, we developed a model to calculate NPB (Net Present Benefit) /and compare EBS (electric buses) to DBS (diesel buses). We have considered all essential aspects in our model: initial investment, including the cost of a bus, charger, and installation, government fund (federal, state, local), labor cost, energy (electricity or diesel) cost, maintenance cost, insurance cost, health and environment benefit, and V2G (vehicle to grid) benefit. We see about $1,400,000 in benefits for a 12-year lifetime of an EBS compared to DBS provided the government fund to offset 50% of EBS purchase cost. With the government subsidy, an EBS starts to make positive cash flow in 5th year and can pay back its investment in 5 years. Please remember that in our model, we consider environmental and health benefits, and every year, $50,000 is counted as health benefits per bus. Besides health benefits, the significant benefits come from the energy cost savings and maintenance savings, which are about $600,000 and $200,000 in 12-year life cycle. Using linear regression, given certain budget limitations, we then designed an optimal three-phase process to replace all NYC electric buses in 10 years, i.e., by 2033. The linear regression process is to minimize the total cost over the years and have the lowest environmental cost. The overall benefits to replace all DBS with EBS for NYC is over $2.1 billion by the year of 2033. For LA, and Chicago, the benefits for electrification of the current bus fleet are $1.04 billion and $634 million by 2033. All NPB analyses and the algorithm to optimize the electrification phase process are implemented in Python code and can be shared.

Keywords: financial modeling, total cost ownership, net present benefits, electric bus, diesel bus, NYC, LA, Chicago

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472 Qualitative Characterization of Proteins in Common and Quality Protein Maize Corn by Mass Spectrometry

Authors: Benito Minjarez, Jesse Haramati, Yury Rodriguez-Yanez, Florencio Recendiz-Hurtado, Juan-Pedro Luna-Arias, Salvador Mena-Munguia

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During the last decades, the world has experienced a rapid industrialization and an expanding economy favoring a demographic boom. As a consequence, countries around the world have focused on developing new strategies related to the production of different farm products in order to meet future demands. Consequently, different strategies have been developed seeking to improve the major food products for both humans and livestock. Corn, after wheat and rice, is the third most important crop globally and is the primary food source for both humans and livestock in many regions around the globe. In addition, maize (Zea mays) is an important source of protein accounting for up to 60% of the daily human protein supply. Generally, many of the cereal grains have proteins with relatively low nutritional value, when they are compared with proteins from meat. In the case of corn, much of the protein is found in the endosperm (75 to 85%) and is deficient in two essential amino acids, lysine, and tryptophan. This deficiency results in an imbalance of amino acids and low protein content; normal maize varieties have less than half of the recommended amino acids for human nutrition. In addition, studies have shown that this deficiency has been associated with symptoms of growth impairment, anemia, hypoproteinemia, and fatty liver. Due to the fact that most of the presently available maize varieties do not contain the quality and quantity of proteins necessary for a balanced diet, different countries have focused on the research of quality protein maize (QPM). Researchers have characterized QPM noting that these varieties may contain between 70 to 100% more residues of the amino acids essential for animal and human nutrition, lysine, and tryptophan, than common corn. Several countries in Africa, Latin America, as well as China, have incorporated QPM in their agricultural development plan. Large parts of these countries have chosen a specific QPM variety based on their local needs and climate. Reviews have described the breeding methods of maize and have revealed the lack of studies on genetic and proteomic diversity of proteins in QPM varieties, and their genetic relationships with normal maize varieties. Therefore, molecular marker identification using tools such as mass spectrometry may accelerate the selection of plants that carry the desired proteins with high lysine and tryptophan concentration. To date, QPM maize lines have played a very important role in alleviating the malnutrition, and better characterization of these lines would provide a valuable nutritional enhancement for use in the resource-poor regions of the world. Thus, the objectives of this study were to identify proteins in QPM maize in comparison with a common maize line as a control.

Keywords: corn, mass spectrometry, QPM, tryptophan

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471 Audit of Intraoperative Ventilation Strategy in Prolonged Abdominal Surgery

Authors: Prabir Patel, Eugene Ming Han Lim

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Introduction: Current literature shows that postoperative pulmonary complications following abdominal surgery may be reduced by using lower than conventional tidal volumes intraoperatively together with moderate levels of positive end expiratory pressure (PEEP). The recent studies demonstrated significant reduction demonstrated significant reduction in major complications in elective abdominal surgery through the use of lower tidal volumes (6-8 ml/kg predicted body weight), PEEP of 5 cmH20 and recruitment manoeuvres compared to higher ‘conventional’ volumes (10-12 mls/kg PBW) without lung recruitment. Our objective was to retrospectively audit current practice for patients undergoing major abdominal surgery in Sir Charles Gairdner Hospital. Methods: Patients over 18 undergoing elective general surgery lasting more than 3 hours and intubated during the duration of procedure were included in this audit. Data was collected over a 6 month period. Patients who had hepatic surgery, procedures necessitating one-lung ventilation, transplant surgery, documented history of pulmonary or intracranial hypertension were excluded. Results: 58 suitable patients were identified and notes were available for 54 patients. Key findings: Average peak airway pressure was 21cmH20 (+4), average peak airway pressure was less than 30 cmH20 in all patients, and less than 25 cmH20 in 80% of the cases. PEEP was used in 81% of the cases. Where PEEP was used, 75% used PEEP more than or equal to 5 cmH20. Average tidal volume per actual body weight was 7.1 ml/kg (+1.6). Average tidal volume per predicted body weight (PBW) was 8.8 ml/kg (+1.5). Average tidal volume was less than 10 ml/kg PBW in 90% of cases; 6-8 ml/kg PBW in 40% of the cases. There was no recorded use of recruitment manoeuvres in any cases. Conclusions: In the vast majority of patients undergoing prolonged abdominal surgery, a lung protective strategy using moderate levels of PEEP, peak airway pressures of less than 30 cmH20 and tidal volumes of less than 10 cmH20/kg PBW was utilised. A recent randomised control trial demonstrated benefit from utilising even lower volumes (6-8 mls/kg) based on findings in critical care patients, but this was compared to volumes of 10-12 ml/kg. Volumes of 6-8 ml/kg PBW were utilised in 40% of cases in this audit. Although theoretically beneficial, clinical benefit of lower volumes than what is currently practiced in this institution remains to be seen. The incidence of pulmonary complications was much lower than in the other cited studies and a larger data set would be required to investigate any benefit from lower tidal volume ventilation. The volumes used are comparable to results from published local and international data but PEEP utilisation was higher in this audit. Strategies that may potentially be implemented to ensure and maintain best practice include pre-operative recording of predicted body weight, adjustment of default ventilator settings and education/updates of current evidence.

Keywords: anaesthesia, intraoperative ventilation, PEEP, tidal volume

Procedia PDF Downloads 765
470 Exploring the Social Health and Well-Being Factors of Hydraulic Fracturing

Authors: S. Grinnell

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A PhD Research Project exploring the Social Health and Well-Being Impacts associated with Hydraulic Fracturing, with an aim to produce a Best Practice Support Guidance for those anticipating dealing with planning applications or submitting Environmental Impact Assessments (EIAs). Amid a possible global energy crisis, founded upon a number of factors, including unstable political situations, increasing world population growth, people living longer, it is perhaps inevitable that Hydraulic Fracturing (commonly referred to as ‘fracking’) will become a major player within the global long-term energy and sustainability agenda. As there is currently no best practice guidance for governing bodies the Best Practice Support Document will be targeted at a number of audiences including, consultants undertaking EIAs, Planning Officers, those commissioning EIAs Industry and interested public stakeholders. It will offer a robust, evidence-based criteria and recommendations which provide a clear narrative and consistent and shared approach to the language used along with containing an understanding of the issues identified. It is proposed that the Best Practice Support Document will also support the mitigation of health impacts identified. The Best Practice Support Document will support the newly amended Environmental Impact Assessment Directive (2011/92/EU), to be transposed into UK law by 2017. A significant amendment introduced focuses on, ‘higher level of protection to the environment and health.’ Methodology: A qualitative research methods approach is being taken with this research. It will have a number of key stages. A literature review has been undertaken and been critically reviewed and analysed. This was followed by a descriptive content analysis of a selection of international and national policies, programmes and strategies along with published Environmental Impact Assessments and associated planning guidance. In terms of data collection, a number of stakeholders were interviewed as well as a number of focus groups of local community groups potentially affected by fracking. These were determined from across the UK. A theme analysis of all the data collected and the literature review will be undertaken, using NVivo. Best Practice Supporting Document will be developed based on the outcomes of the analysis and be tested and piloted in the professional fields, before a live launch. Concluding statement: Whilst fracking is not a new concept, the technology is now driving a new force behind the use of this engineering to supply fuels. A number of countries have pledged moratoria on fracking until further investigation from the impacts on health have been explored, whilst other countries including Poland and the UK are pushing to support the use of fracking. If this should be the case, it will be important that the public’s concerns, perceptions, fears and objections regarding the wider social health and well-being impacts are considered along with the more traditional biomedical health impacts.

Keywords: fracking, hydraulic fracturing, socio-economic health, well-being

Procedia PDF Downloads 243
469 The Symbolic Power of the IMF: Looking through Argentina’s New Period of Indebtedness

Authors: German Ricci

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The research aims to analyse the symbolic power of the International Monetary Fund (IMF) in its relationship with a borrowing country, drawing upon Pierre Bourdieu’s Field Theory. This theory of power, typical of constructivist structuralism, has been minor used in international relations. Thus, selecting this perspective offers a new understanding of how the IMF's power operates and is structured. The IMF makes periodic economic reviews in which the staff evaluates the Government's performance. It also offers “last instance” loans when private external credit is not accessible. This relationship generates great expectations in financial agents because the IMF’s statements indicate the capacity of the Nation-State to meet its payment obligations (or not). Therefore, it is argued that the IMF is a legitimate actor for financial agents concerned about a government facing an economic crisis both for the effects of its immediate economic contribution through loans and the promotion of adjustment programs, helpful to guarantee the payment of the external debt. This legitimacy implies a symbolic power relationship in addition to the already known economic power relationship. Obtaining the IMF's consent implies that the government partially puts its political-economic decisions into play since the monetary policy must be agreed upon with the Fund. This has consequences at the local level. First, it implies that the debtor state must establish a daily relationship with the Fund. This everyday interaction with the Fund influences how officials and policymakers internalize the meaning of political management. On the other hand, if the Government has access to the IMF's seal of approval, the State will be again in a position to re-enter the financial market and go back into debt to face external debt. This means that private creditors increase the chances of collecting the debt and, again, grant credits. Thus, it is argued that the borrowing country submits to the relationship with the IMF in search of the latter's economic and symbolic capital. Access to this symbolic capital has objective and subjective repercussions at the national level that might tend to reproduce the relevance of the financial market and legitimizes the IMF’s intervention during economic crises. The paper has Argentina as its case study, given its historical relationship with the IMF and the relevance of the current indebtedness period, which remains largely unexplored. Argentina’s economy is characterized by recurrent financial crises, and it is the country to which the Fund has lent the most in its entire history. It surpasses more than three times the second, Egypt. In addition, Argentina is currently the country that owes the most to the Fund after receiving the largest loan ever granted by the IMF in 2018, and a new agreement in 2022. While the historical strong association with the Fund culminated in the most acute economic and social crisis in the country’s contemporary history, producing an unprecedented political and institutional crisis in 2001, Argentina still recognized the IMF as the only way out during economic crises.

Keywords: IMF, fields theory, symbolic power, Argentina, Bourdieu

Procedia PDF Downloads 71
468 Willingness to Pay for Improvements of MSW Disposal: Views from Online Survey

Authors: Amornchai Challcharoenwattana, Chanathip Pharino

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Rising amount of MSW every day, maximizing material diversions from landfills via recycling is a prefer method to land dumping. Characteristic of Thai MSW is classified as 40 -60 per cent compostable wastes while potentially recyclable materials in waste streams are composed of plastics, papers, glasses, and metals. However, rate of material recovery from MSW, excluding composting or biogas generation, in Thailand is still low. Thailand’s recycling rate in 2010 was only 20.5 per cent. Central government as well as local governments in Thailand have tried to curb this problem by charging some of MSW management fees at the users. However, the fee is often too low to promote MSW minimization. The objective of this paper is to identify levels of willingness-to-pay (WTP) for MSW recycling in different social structures with expected outcome of sustainable MSW managements for different town settlements to maximize MSW recycling pertaining to each town’s potential. The method of eliciting WTP is a payment card. The questionnaire was deployed using online survey during December 2012. Responses were categorized into respondents living in Bangkok, living in other municipality areas, or outside municipality area. The responses were analysed using descriptive statistics, and multiple linear regression analysis to identify relationships and factors that could influence high or low WTP. During the survey period, there were 168 filled questionnaires from total 689 visits. However, only 96 questionnaires could be usable. Among respondents in the usable questionnaires, 36 respondents lived in within the boundary of Bangkok Metropolitan Administration while 45 respondents lived in the chartered areas that were classified as other municipality but not in BMA. Most of respondents were well-off as 75 respondents reported positive monthly cash flow (77.32%), 15 respondents reported neutral monthly cash flow (15.46%) while 7 respondent reported negative monthly cash flow (7.22%). For WTP data including WTP of 0 baht with valid responses, ranking from the highest means of WTP to the lowest WTP of respondents by geographical locations for good MSW management were Bangkok (196 baht/month), municipalities (154 baht/month), and non-urbanized towns (111 baht/month). In-depth analysis was conducted to analyse whether there are additional room for further increase of MSW management fees from the current payment that each correspondent is currently paying. The result from multiple-regression analysis suggested that the following factors could impacts the increase or decrease of WTP: incomes, age, and gender. Overall, the outcome of this study suggests that survey respondents are likely to support improvement of MSW treatments that are not solely relying on landfilling technique. Recommendations for further studies are to obtain larger sample sizes in order to improve statistical powers and to provide better accuracy of WTP study.

Keywords: MSW, willingness to pay, payment card, waste seperation

Procedia PDF Downloads 290
467 Barriers and Enablers to Climate and Health Adaptation Planning in Small Urban Areas in the Great Lakes Region

Authors: Elena Cangelosi, Wayne Beyea

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This research expands the resilience planning literature by exploring the barriers and enablers to climate and health adaptation planning for small urban, coastal Great Lakes communities. With funding from the United States Centers for Disease Control and Prevention (CDC) Climate Ready City and States Initiative, this research took place during a 3-year pilot intervention project which integrates urban planning and public health. The project used the CDC’s Building Resilience Against Climate Effects (BRACE) framework to prevent or reduce the human health impacts from climate change in Marquette County, Michigan. Using a deliberation with the analysis planning process, interviews, focus groups, and community meetings with over 25 stakeholder groups and over 100 participants identified the area’s climate-related health concerns and adaptation interventions to address those concerns. Marquette County, on the shores of Lake Superior, the largest of the Great Lakes, was selected for the project based on their existing adaptive capacity and proactive approach to climate adaptation planning. With Marquette County as the context, this study fills a gap in the adaptation literature, which currently heavily emphasizes large-urban or agriculturally-based rural areas, and largely neglects small urban areas. This research builds on the qualitative case-study, survey, and interview approach established by previous researchers on contextual barriers and enablers for adaptation planning. This research uses a case study approach, including surveys and interviews of public officials, to identify the barriers and enablers for climate and health adaptation planning for small-urban areas within a large, non-agricultural, Great Lakes county. The researchers hypothesize that the barriers and enablers will, in some cases, overlap those found in other contexts, but in many cases, will be unique to a rural setting. The study reveals that funding, staff capacity, and communication across a large, rural geography act as the main barriers, while strong networks and collaboration, interested leaders, and community interest through a strong human-land connection act as the primary enablers. Challenges unique to rural areas are revealed, including weak opportunities for grant funding, large geographical distances, communication challenges with an aging and remote population, and the out-migration of education residents. Enablers that may be unique to rural contexts include strong collaborative relationships across jurisdictions for regional work and strong connections between residents and the land. As the factors that enable and prevent climate change planning are highly contextual, understanding, and appropriately addressing the unique factors at play for small-urban communities is key for effective planning in those areas. By identifying and addressing the barriers and enablers to climate and health adaptation planning for small-urban, coastal areas, this study can help Great Lakes communities appropriately build resilience to the adverse impacts of climate change. In addition, this research expands the breadth of research and understanding of the challenges and opportunities planners confront in the face of climate change.

Keywords: climate adaptation and resilience, climate change adaptation, climate change and urban resilience, governance and urban resilience

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466 The Political Economy of the Global Climate Change Adaptation Initiatives: A Case Study on the Global Environmental Facility

Authors: Anar Koli

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After the Paris agreement in 2015, a comprehensive initiative both from the developed and developing countries towards the adaptation to climate change is emerging. The Global Environmental Facility (GEF), which is financing a global portfolio of adaptation projects and programs in over 124 countries is playing a significant role to a new financing framework that included the concept of “climate-resilient development”. However, both the adaptation and sustainable development paradigms remain continuously contested, especially the role of the multilateral institutions with their technical and financial assistance to the developing world. Focusing on the adaptation initiatives of the GEF, this study aims to understand to what extent the global multilateral institutions, particularly the GEF is contributing to the climate-resilient development. From the political ecology perspective, the argument of this study is that the global financial framework is highly politicized, and understanding the contribution of the global institutions of the global climate change needs to be related both from the response and causal perspectives. A holistic perspective, which includes the contribution of the GEF as a response to the climate change and as well the cause of global climate change, are needed to understand the broader environment- political economic relation. The study intends to make a critical analysis of the way in which the political economy structure and the environment are related along with the social and ecological implications. It does not provide a narrow description of institutional responses to climate change, rather it looks at how the global institutions are influencing the relationship of the global ecologies and economies. This study thus developed a framework combining the global governance and the political economy perspective. This framework includes environment-society relation, environment-political economy linkage, global institutions as the orchestra, and division between the North and the South. Through the analysis of the GEF as the orchestra of the global governance, this study helps to understand how GEF is coordinating the interactions between the North and the South and responding the global climate resilient development. Through the other components of the framework, the study explains how the role of the global institutions is related to the cause of the human induced global climate change. The study employs a case study based on both the quantitative and qualitative data. Along with the GEF reports and data sets, this study draws from an eclectic range of literature from a range of disciplines to explain the broader relation of the environment and political economy. Based on a case study on GEF, the study found that the GEF has positive contributions in bringing developing countries’ capacity in terms of sustainable development goal, local institutional development. However, through a critical holistic analysis, this study found that this contribution to the resilient development helps the developing countries to conform the fossil fuel based capitalist political economy. The global governance institution is contributing both to the pro market based environment society relation and, to the consequences of this relation.

Keywords: climate change adaptation, global environmental facility (GEF), political economy, the north -south relation

Procedia PDF Downloads 229
465 Viability of Permaculture Principles to Sustainable Agriculture Enterprises in Malta

Authors: Byron Baron

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Malta is a Mediterranean archipelago presenting a combination of environmental conditions which are less suitable for agriculture. This has resulted in a heavy dependence on agricultural chemicals, as well as over-extraction of groundwater, compounded by concomitant destruction of natural habitat surrounding the land areas used for agriculture. Such prolonged intensive land use has resulted in even greater degradation of Maltese soils. This study was thus designed with the goal of assessing the viability of implementing a sustainable agricultural system based on permaculture practices compared to the traditional local practices applied for intensive farming. The permaculture model was implemented over a period of two years for a number of locally-grown staple crops. The tangible targets included improved soil health, reduced water consumption, increased reliance on renewable energy, increased wild plant and insect diversity, and sustained crop yield. To achieve this in the permaculture test area, numerous practices were introduced. In line with permaculture principles land, tillage was reduced, only natural fertilisers were used, no herbicides or pesticides were used, irrigation was linked to a desalination system with sensors for monitoring soil parameters, mulching was practiced, and a photovoltaic system was installed. Furthermore, areas for wild plants were increased and controlled only by trimming, not mowing. A variety of environmental parameters were measured at regular intervals as well as crop yield (in kilos of produce) in order to quantify if any improvements in crop output and environmental conditions were obtained. The results obtained show a very slight improvement in overall soil health due to the brevity of the test period. Water consumption was reduced by over 50% with no apparent losses or ill effects on the crops. Renewable energy was sufficient to provide all electric power on-site, so apart from the initial investment costs, there were no limitations. Moreover, surrounding the commercial crops with borders of wild plants whilst only taking up less than 15% of the total land area assisted pollination, increased animal visitors, and did not give rise to any pest infestations. The conclusion from this study was that whilst results are promising, more detailed and long-term studies are required to understand the full extent of the implications brought about by such a transition, which hints towards the untapped potential of investing in the available resources on the island with the goal of improving the balance between economic prosperity and ecological sustainability.

Keywords: agronomic measures, ecological amplification, sustainability, permaculture

Procedia PDF Downloads 97
464 A Drop of Water for the Thirsty Ground: Implementing Drip-Irrigation System as an Alternative to the Existing System to Promote Sustainable Livelihoods in the Archipelagic Dryland East Nusa Tenggara, Indonesia

Authors: F. L. Benu, I. W. Mudita, R. L. Natonis

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East Nusa Tenggara, together with part of East Java, West Nusa Tenggara, and Maluku, has been included as part of global drylands defined according to the ratio of annual precipitation (P) and annual potential evaporation (PET) and major vegetation types of grassland and savannah ecosystems. These tropical drylands are unique because, whereas drylands in other countries are mostly continental, here they are archipelagic. These archipelagic drylands are also unique in terms of being included because of more on their major vegetation types than of their P/PET ratio. Slash-and-burn cultivation and free roaming animal husbandry are two major livelihoods being widely practiced, along with alternative seasonal livelihood such as traditional fishing. Such livelihoods are vulnerable in various respects, especially because of drought, which becomes more unpredictable in the face of climate changes. To cope with such vulnerability, semi-intensive farming using drip irrigation is implemented as an appropriate technology with the goal of promoting a more sustainable alternative to the existing livelihoods. The implementation was started in 2016 with a pilot system at the university field laboratory in Kupang in which various designs of installation were tested. The modified system consisting of an uplifted water reservoir and solar-powered pump was tested in Papela, the District of Rote-Ndao, in 2017 to convince fishermen who had been involved in illegal fishing in Australia-Indonesia transboundary waters, to adopt small-scale farming as a more sustainable alternative to their existing livelihoods. The system was again tested in a larger coverage in Oesena, the District of Kupang, in 2018 to convince slash-and-burn cultivators to adopt an environmentally friendlier cultivation system. From the implementation of the modified system in both sites, the participating fishermen in Papela were able to manage the system under tight water supply to grow chili pepper, tomatoes, and watermelon and the slash-and-burn cultivators in Oesena to grow chili pepper in a more efficient water use than water use in a conventional irrigation system. The gross margin obtained from growing chili pepper, tomatoes, and watermelon in Papela and from growing chili pepper in Oesena showed that small-scale farming using drip irrigation system was a promising alternative to local people in generating cash income to support their livelihoods. However, before promoting this appropriate technology as a more sustainable alternative to the existing livelihoods elsewhere in the region, better understanding on social-related contexts of the implementation is needed.

Keywords: archipelagic drylands, drip irrigation system, East Nusa Tenggara, sustainable livelihoods

Procedia PDF Downloads 114
463 Financial Analysis of the Foreign Direct in Mexico

Authors: Juan Peña Aguilar, Lilia Villasana, Rodrigo Valencia, Alberto Pastrana, Martin Vivanco, Juan Peña C

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Each year a growing number of companies entering Mexico in search of the domestic market share. These activities, including stores, telephone long distance and local raw materials and energy, and particularly the financial sector, have managed to significantly increase its weight in the flows of FDI in Mexico , however, you should consider whether these trends FDI are positive for the Mexican economy and these activities increase Mexican exports in the medium term , and its share in GDP , gross fixed capital formation and employment. In general stresses that these activities, by far, have been unable to significantly generate linkages with the rest of the economy, a process that has not favored with competitiveness policies and activities aimed at these neutral or horizontal. Since the nineties foreign direct investment (FDI) has shown a remarkable dynamism, both internationally and in Latin America and in Mexico. Only in Mexico the first recipient of FDI in importance in Latin America during 1990-1995 and was displaced by Brazil since FDI increased from levels below 1 % of GDP during the eighties to around 3 % of GDP during the nineties. Its impact has been significant not only from a macroeconomic perspective , it has also allowed the generation of a new industrial production structure and organization, parallel to a significant modernization of a segment of the economy. The case of Mexico also is particularly interesting and relevant because the destination of FDI until 1993 had focused on the purchase of state assets during privatization process. This paper aims to present FDI flows in Mexico and analyze the different business strategies that have been touched and encouraged by the FDI. On the one hand, looking briefly discuss regulatory issues and source and recipient of FDI sectors. Furthermore, the paper presents in more detail the impacts and changes that generated the FDI contribution of FDI in the Mexican economy , besides the macroeconomic context and later legislative changes that resulted in the current regulations is examined around FDI in Mexico, including aspects of the Free Trade Agreement (NAFTA). It is worth noting that foreign investment can not only be considered from the perspective of the receiving economic units. Instead, these flows also reflect the strategic interests of transnational corporations (TNCs) and other companies seeking access to markets and increased competitiveness of their production networks and global distribution, among other reasons. Similarly it is important to note that foreign investment in its various forms is critically dependent on historical and temporal aspects. Thus, the same functionality can vary significantly depending on the specific characteristics of both receptor units as sources of FDI, including macroeconomic, institutional, industrial organization, and social aspects, among others.

Keywords: foreign direct investment (FDI), competitiveness, neoliberal regime, globalization, gross domestic product (GDP), NAFTA, macroeconomic

Procedia PDF Downloads 450
462 How Can Personal Protective Equipment Be Best Used and Reused: A Human Factors based Look at Donning and Doffing Procedures

Authors: Devin Doos, Ashley Hughes, Trang Pham, Paul Barach, Rami Ahmed

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Over 115,000 Health Care Workers (HCWs) have died from COVID-19, and millions have been infected while caring for patients. HCWs have filed thousands of safety complaints surrounding safety concerns due to Personal Protective Equipment (PPE) shortages, which included concerns around inadequate and PPE reuse. Protocols for donning and doffing PPE remain ambiguous, lacking an evidence-base, and often result in wide deviations in practice. PPE donning and doffing protocol deviations commonly result in self-contamination but have not been thoroughly addressed. No evidence-driven protocols provide guidance on protecting HCW during periods of PPE reuse. Objective: The aim of this study was to examine safety-related threats and risks to Health Care Workers (HCWs) due to the reuse of PPE among Emergency Department personnel. Method: We conducted a prospective observational study to examine the risks of reusing PPE. First, ED personnel were asked to don and doff PPE in a simulation lab. Each participant was asked to don and doff PPE five times, according to the maximum reuse recommendation set by the Centers for Disease Control and Prevention (CDC). Each participant was videorecorded; video recordings were reviewed and coded independently by at least 2 of the 3trained coders for safety behaviors and riskiness of actions. A third coder was brought in when the agreement between the 2 coders could not be reached. Agreement between coders was high (81.9%), and all disagreements (100%) were resolved via consensus. A bowtie risk assessment chart was constructed analyzing the factors that contribute to increased risks HCW are faced with due to PPE use and reuse. Agreement amongst content experts in the field of Emergency Medicine, Human Factors, and Anesthesiology was used to select aspects of health care that both contribute and mitigate risks associated with PPE reuse. Findings: Twenty-eight clinician participants completed five rounds of donning/doffing PPE, yielding 140 PPE donning/doffing sequences. Two emerging threats were associated with behaviors in donning, doffing, and re-using PPE: (i) direct exposure to contaminant, and (ii) transmission/spread of contaminant. Protective behaviors included: hand hygiene, not touching the patient-facing surface of PPE, and ensuring a proper fit and closure of all PPE materials. 100% of participants (n= 28) deviated from the CDC recommended order, and most participants (92.85%, n=26) self-contaminated at least once during reuse. Other frequent errors included failure to tie all ties on the PPE (92.85%, n=26) and failure to wash hands after a contamination event occurred (39.28%, n=11). Conclusions: There is wide variation and regular errors in how HCW don and doffPPE while including in reusing PPE that led to self-contamination. Some errors were deemed “recoverable”, such as hand washing after touching a patient-facing surface to remove the contaminant. Other errors, such as using a contaminated mask and accidentally spreading to the neck and face, can lead to compound risks that are unique to repeated PPE use. A more comprehensive understanding of the contributing threats to HCW safety and complete approach to mitigating underlying risks, including visualizing with risk management toolsmay, aid future PPE designand workflow and space solutions.

Keywords: bowtie analysis, health care, PPE reuse, risk management

Procedia PDF Downloads 90
461 Medicompills Architecture: A Mathematical Precise Tool to Reduce the Risk of Diagnosis Errors on Precise Medicine

Authors: Adriana Haulica

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Powered by Machine Learning, Precise medicine is tailored by now to use genetic and molecular profiling, with the aim of optimizing the therapeutic benefits for cohorts of patients. As the majority of Machine Language algorithms come from heuristics, the outputs have contextual validity. This is not very restrictive in the sense that medicine itself is not an exact science. Meanwhile, the progress made in Molecular Biology, Bioinformatics, Computational Biology, and Precise Medicine, correlated with the huge amount of human biology data and the increase in computational power, opens new healthcare challenges. A more accurate diagnosis is needed along with real-time treatments by processing as much as possible from the available information. The purpose of this paper is to present a deeper vision for the future of Artificial Intelligence in Precise medicine. In fact, actual Machine Learning algorithms use standard mathematical knowledge, mostly Euclidian metrics and standard computation rules. The loss of information arising from the classical methods prevents obtaining 100% evidence on the diagnosis process. To overcome these problems, we introduce MEDICOMPILLS, a new architectural concept tool of information processing in Precise medicine that delivers diagnosis and therapy advice. This tool processes poly-field digital resources: global knowledge related to biomedicine in a direct or indirect manner but also technical databases, Natural Language Processing algorithms, and strong class optimization functions. As the name suggests, the heart of this tool is a compiler. The approach is completely new, tailored for omics and clinical data. Firstly, the intrinsic biological intuition is different from the well-known “a needle in a haystack” approach usually used when Machine Learning algorithms have to process differential genomic or molecular data to find biomarkers. Also, even if the input is seized from various types of data, the working engine inside the MEDICOMPILLS does not search for patterns as an integrative tool. This approach deciphers the biological meaning of input data up to the metabolic and physiologic mechanisms, based on a compiler with grammars issued from bio-algebra-inspired mathematics. It translates input data into bio-semantic units with the help of contextual information iteratively until Bio-Logical operations can be performed on the base of the “common denominator “rule. The rigorousness of MEDICOMPILLS comes from the structure of the contextual information on functions, built to be analogous to mathematical “proofs”. The major impact of this architecture is expressed by the high accuracy of the diagnosis. Detected as a multiple conditions diagnostic, constituted by some main diseases along with unhealthy biological states, this format is highly suitable for therapy proposal and disease prevention. The use of MEDICOMPILLS architecture is highly beneficial for the healthcare industry. The expectation is to generate a strategic trend in Precise medicine, making medicine more like an exact science and reducing the considerable risk of errors in diagnostics and therapies. The tool can be used by pharmaceutical laboratories for the discovery of new cures. It will also contribute to better design of clinical trials and speed them up.

Keywords: bio-semantic units, multiple conditions diagnosis, NLP, omics

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460 Effect of Supplementation of Hay with Noug Seed Cake (Guizotia abyssinica), Wheat Bran and Their Mixtures on Feed Utilization, Digestiblity and Live Weight Change in Farta Sheep

Authors: Fentie Bishaw Wagayie

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This study was carried out with the objective of studying the response of Farta sheep in feed intake and live weight change when fed on hay supplemented with noug seed cake (NSC), wheat bran (WB), and their mixtures. The digestibility trial of 7 days and 90 days of feeding trial was conducted using 25 intact male Farta sheep with a mean initial live weight of 16.83 ± 0.169 kg. The experimental animals were arranged randomly into five blocks based on the initial live weight, and the five treatments were assigned randomly to each animal in a block. Five dietary treatments used in the experiment comprised of grass hay fed ad libitum (T1), grass hay ad libitum + 300 g DM WB (T2), grass hay ad libitum + 300 g DM (67% WB: 33% NSC mixture) (T3), grass hay ad libitum + 300 g DM (67% NSC: 33% WB) (T4) and 300 g DM/ head/day NSC (T5). Common salt and water were offered ad libitum. The supplements were offered twice daily at 0800 and 1600 hours. The experimental sheep were kept in individual pens. Supplementation of NSC, WB, and their mixtures significantly increased (p < 0.01) the total dry matter (DM) (665.84-788 g/head/day) and (p < 0.001) crude protein (CP) intake. Unsupplemented sheep consumed significantly higher (p < 0.01) grass hay DM (540.5g/head/day) as compared to the supplemented treatments (365.8-488 g/h/d), except T2. Among supplemented sheep, T5 had significantly higher (p < 0.001) CP intake (99.98 g/head/day) than the others (85.52-90.2 g/head/day). Supplementation significantly improved (p < 0.001) the digestibility of CP (66.61-78.9%), but there was no significant effect (p > 0.05) on DM, OM, NDF, and ADF digestibility between supplemented and control treatments. Very low CP digestibility (11.55%) observed in the basal diet (grass hay) used in this study indicated that feeding sole grass hay could not provide nutrients even for the maintenance requirement of growing sheep. Significant final and daily live weight gain (p < 0.001) in the range of 70.11-82.44 g/head/day was observed in supplemented Farta sheep, but unsupplemented sheep lost weight by 9.11g/head/day. Numerically, among the supplemented treatments, sheep supplemented with a higher proportion of NSC in T4 (201 NSC + 99 g WB) gained more weight than the rest, though not statistically significant (p > 0.05). The absence of statistical difference in daily body weight gain between all supplemented sheep indicated that the supplementation of NSC, WB, and their mixtures had similar potential to provide nutrients. Generally, supplementation of NSC, WB, and their mixtures to the basal grass hay diet improved feed conversion ratio, total DM intake, CP intake, and CP digestibility, and it also improved the growth performance with a similar trend for all supplemented Farta sheep over the control group. Therefore, from a biological point of view, to attain the required level of slaughter body weight within a short period of the growing program, sheep producer can use all the supplement types depending upon their local availability, but in the order of priority, T4, T5, T3, and T2, respectively. However, based on partial budget analysis, supplementation of 300 g DM/head /day NSC (T5) could be recommended as profitable for producers with no capital limitation, whereas T4 supplementation (201 g NSC + 99 WB DM/day) is recommended when there is capital scarcity.

Keywords: weight gain, supplement, Farta sheep, hay as basal diet

Procedia PDF Downloads 63
459 In vivo Evaluation of LAB Probiotic Potential with the Zebrafish Animal Model

Authors: Iñaki Iturria, Pasquale Russo, Montserrat Nacher-Vázquez, Giuseppe Spano, Paloma López, Miguel Angel Pardo

Abstract:

Introduction: It is known that some Lactic Acid Bacteria (LAB) present an interesting probiotic effect. Probiotic bacteria stimulate host resistance to microbial pathogens and thereby aid in immune response, and modulate the host's immune responses to antigens with a potential to down-regulate hypersensitivity reactions. Therefore, probiotic therapy is valuable against intestinal infections and may be beneficial in the treatment of Inflammatory Bowel Disease (IBD). Several in vitro tests are available to evaluate the probiotic potential of a LAB strain. However, an in vivo model is required to understand the interaction between the host immune system and the bacteria. During the last few years, zebrafish (Danio rerio) has gained interest as a promising vertebrate model in this field. This organism has been extensively used to study the interaction between the host and the microbiota, as well as the host immune response under several microbial infections. In this work, we report on the use of the zebrafish model to investigate in vivo the colonizing ability and the immunomodulatory effect of probiotic LAB. Methods: Lactobacillus strains belonging to different LAB species were fluorescently tagged and used to colonize germ-free zebrafish larvae gastrointestinal tract (GIT). Some of the strains had a well-documented probiotic effect (L. acidophilus LA5); while others presented an exopolysaccharide (EPS) producing phenotype, thus allowing evaluating the influence of EPS in the colonization and immunomodulatory effect. Bacteria colonization was monitored for 72 h by direct observation in real time using fluorescent microscopy. CFU count per larva was also evaluated at different times. The immunomodulatory effect was assessed analysing the differential expression of several innate immune system genes (MyD88, NF-κB, Tlr4, Il1β and Il10) by qRT- PCR. The anti-inflammatory effect was evaluated using a chemical enterocolitis zebrafish model. The protective effect against a pathogen was also studied. To that end, a challenge test was developed using a fluorescently tagged pathogen (Vibrio anguillarum-GFP+). The progression of the infection was monitored up to 3 days using a fluorescent stereomicroscope. Mortality rates and CFU counts were also registered. Results and conclusions: Larvae exposed to EPS-producing bacteria showed a higher fluorescence and CFU count than those colonized with no-EPS phenotype LAB. In the same way, qRT-PCR results revealed an immunomodulatory effect on the host after the administration of the strains with probiotic activity. A downregulation of proinflammatory cytoquines as well as other cellular mediators of inflammation was observed. The anti-inflammatory effect was found to be particularly marked following exposure to LA% strain, as well as EPS producing strains. Furthermore, the challenge test revealed a protective effect of probiotic administration. As a matter of fact, larvae fed with probiotics showed a decrease in the mortality rate ranging from 20 to 35%. Discussion: In this work, we developed a promising model, based on the use of gnotobiotic zebrafish coupled with a bacterial fluorescent tagging in order to evaluate the probiotic potential of different LAB strains. We have successfully used this system to monitor in real time the colonization and persistence of exogenous LAB within the gut of zebrafish larvae, to evaluate their immunomodulatory effect and for in vivo competition assays. This approach could bring further insights into the complex microbial-host interactions at intestinal level.

Keywords: gnotobiotic, immune system, lactic acid bacteria, probiotics, zebrafish

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458 Implementation of Ecological and Energy-Efficient Building Concepts

Authors: Robert Wimmer, Soeren Eikemeier, Michael Berger, Anita Preisler

Abstract:

A relatively large percentage of energy and resource consumption occurs in the building sector. This concerns the production of building materials, the construction of buildings and also the energy consumption during the use phase. Therefore, the overall objective of this EU LIFE project “LIFE Cycle Habitation” (LIFE13 ENV/AT/000741) is to demonstrate innovative building concepts that significantly reduce CO₂emissions, mitigate climate change and contain a minimum of grey energy over their entire life cycle. The project is being realised with the contribution of the LIFE financial instrument of the European Union. The ultimate goal is to design and build prototypes for carbon-neutral and “LIFE cycle”-oriented residential buildings and make energy-efficient settlements the standard of tomorrow in line with the EU 2020 objectives. To this end, a resource and energy-efficient building compound is being built in Böheimkirchen, Lower Austria, which includes 6 living units and a community area as well as 2 single family houses with a total usable floor surface of approximately 740 m². Different innovative straw bale construction types (load bearing and pre-fabricated non loadbearing modules) together with a highly innovative energy-supply system, which is based on the maximum use of thermal energy for thermal energy services, are going to be implemented. Therefore only renewable resources and alternative energies are used to generate thermal as well as electrical energy. This includes the use of solar energy for space heating, hot water and household appliances like dishwasher or washing machine, but also a cooking place for the community area operated with thermal oil as heat transfer medium on a higher temperature level. Solar collectors in combination with a biomass cogeneration unit and photovoltaic panels are used to provide thermal and electric energy for the living units according to the seasonal demand. The building concepts are optimised by support of dynamic simulations. A particular focus is on the production and use of modular prefabricated components and building parts made of regionally available, highly energy-efficient, CO₂-storing renewable materials like straw bales. The building components will be produced in collaboration by local SMEs that are organised in an efficient way. The whole building process and results are monitored and prepared for knowledge transfer and dissemination including a trial living in the residential units to test and monitor the energy supply system and to involve stakeholders into evaluation and dissemination of the applied technologies and building concepts. The realised building concepts should then be used as templates for a further modular extension of the settlement in a second phase.

Keywords: energy-efficiency, green architecture, renewable resources, sustainable building

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457 Brain-Derived Neurotrophic Factor and It's Precursor ProBDNF Serum Levels in Adolescents with Mood Disorders: 2-Year Follow-Up Study

Authors: M. Skibinska, A. Rajewska-Rager, M. Dmitrzak-Weglarz, N. Lepczynska, P. Sibilski, P. Kapelski, J. Pawlak, J. Twarowska-Hauser

Abstract:

Introduction: Neurotrophic factors have been implicated in neuropsychiatric disorders. Brain-Derived Neurotrophic Factor (BDNF) influences neuron differentiation in development as well as synaptic plasticity and neuron survival in adulthood. BDNF is widely studied in mood disorders and has been proposed as a biomarker for depression. BDNF is synthesized as precursor protein – proBDNF. Both forms are biologically active and exert opposite effects on neurons. Aim: The aim of the study was to examine the serum levels of BDNF and proBDNF in unipolar and bipolar young patients below 24 years old during hypo/manic, depressive episodes and in remission compared to healthy control group. Methods: In a prospective 2 years follow-up study, we investigated alterations in levels of BDNF and proBDNF in 79 patients (23 males, mean age 19.08, SD 3.3 and 56 females, mean age 18.39, SD 3.28) diagnosed with mood disorders: unipolar and bipolar disorder compared with 35 healthy control subjects (7 males, mean age 20.43, SD 4.23 and 28 females, mean age 21.25, SD 2.11). Clinical characteristics including mood, comorbidity, family history, and treatment, were evaluated during control visits and clinical symptoms were rated using the Hamilton Depression Rating Scale and Young Mania Rating Scale. Serum BDNF and proBDNF concentrations were determined by Enzyme-Linked Immunosorbent Assays (ELISA) method. Serum BDNF and proBDNF levels were analysed with covariates: sex, age, age > 18 and < 18 years old, family history of affective disorders, drug-free vs. medicated status. Normality of the data was tested using Shapiro-Wilk test. Levene’s test was used to calculate homogeneity of variance. Non-parametric Tests: Mann-Whitney U test, Kruskal-Wallis ANOVA, Friedman’s ANOVA, Wilcoxon signed rank test, Spearman correlation coefficient were applied in analyses The statistical significance level was set at p < 0.05. Results: BDNF and proBDNF serum levels did not differ between patients at baseline and controls as well as comparing patients in acute episode of depression/hypo/mania at baseline and euthymia (at month 3 or 6). Comparing BDNF and proBDNF levels between patients in euthymia and control group no differences have been found. Increased BDNF level in women compared to men at baseline (p=0.01) have been observed. BDNF level at baseline was negatively correlated with depression and mania occurence at 24 month (p=0.04). BDNF level at 12 month was negatively correlated with depression and mania occurence at 12 month (p=0.01). Correlation of BDNF level with sex have been detected (p=0.01). proBDNF levels at month 3, 6 and 12 negatively correlated with disease status (p=0.02, p=0.008, p=0.009, respectively). No other correlations of BDNF and proBDNF levels with clinical and demographical variables have been detected. Discussion: Our results did not show any differences in BDNF and proBDNF levels between depression, mania, euthymia, and controls. Imbalance in BDNF/proBDNF signalling may be involved in pathogenesis of mood disorders. Further studies on larger groups are recommended. Grant was founded by National Science Center in Poland no 2011/03/D/NZ5/06146.

Keywords: bipolar disorder, Brain-Derived Neurotrophic Factor (BDNF), proBDNF, unipolar depression

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456 The Effect of Nanocomposite on the Release of Imipenem on Bacteria Causing Infections with Implants

Authors: Mohammad Hossein Pazandeh, Monir Doudi, Sona Rostampour Yasouri

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—Results The prudent administration of antibiotics aims to avoid the side effects and the microbes' resistance to antibiotics. An approach developing methods of local administration of antibiotics is especially required for localized infections caused by bacterial colonization of medical devices or implant materials. Among the wide variety of materials used as drug delivery systems, bioactive glasses (BG) have large utilization in regenerative medicine . firstly, the production of bioactive glass/nickel oxide/tin dioxide nanocomposite using sol-gel method, and then, the controlled release of imipenem from the double metal oxide/bioactive glass nanocomposite, and finally, the investigation of the antibacterial property of the nanocomposite. against a number of implant-related infectious agents. In this study, BG/SnO2 and BG/NiO single systema with different metal oxide present and BG/NiO/SnO2 nanocomposites were synthesized by sol-gel as drug carriers for tetracycline and imepinem. These two antibiotics were widely used for osteomyelitis because of its favorable penetration and bactericidal effect on all the probable osteomyelitis pathogens. The antibacterial activity of synthesized samples were evaluated against Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa as bacteria model using disk diffusion method. The BG modification using metal oxides results to antibacterial property of samples containing metal oxide with highest efficiency for nancomposite. bioactivity of all samples was assessed by determining the surface morphology, structural and composition changes using scanning electron microscopy (SEM), FTIR and X-ray diffraction (XRD) spectroscopy, respectively, after soaking in simulated body fluid (SBF) for 28 days. The hydroxyapatite formation was clearly observed as a bioactivity measurement. Then, BG nanocomposite sample was loaded using two antibiotics, separately and their release profiles were studied. The BG nancomposite sample was shown the slow and continuous drug releasing for a period of 72 hours which is desirable for a drug delivery system. The loaded antibiotic nanocomposite sample retaining antibacterial property and showing inactivation effect against bacteria under test. The modified bioactive glass forming hydroxyapatite with controlled release drug and effective against bacterial infections can be introduced as scaffolds for bone implants after clinical trials for biomedical applications . Considering the formation of biofilm by infectious bacteria after sticking on the surfaces of implants, medical devices, etc. Also, considering the complications of traditional methods, solving the problems caused by the above-mentioned microorganisms in technical and biomedical industries was one of the necessities of this research.

Keywords: antibacterial, bioglass, drug delivery system, sol- gel

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455 Experience in Caring for a Patient with Terminal Aortic Dissection of Lung Cancer and Paralysis of the Lower Limbs after Surgery

Authors: Pei-Shan Liang

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Objective: This article explores the care experience of a terminal lung cancer patient who developed lower limb paralysis after surgery for aortic dissection. The patient, diagnosed with aortic dissection during chemotherapy for lung cancer, faced post-surgical lower limb paralysis, leading to feelings of helplessness and hopelessness as they approached death with reduced mobility. Methods: The nursing period was from July 19 to July 27, during which the author, alongside the intensive care team and palliative care specialists, conducted a comprehensive assessment through observation, direct care, conversations, physical assessments, and medical record review. Gordon's eleven functional health patterns were used for a holistic evaluation, identifying four nursing health issues: "pain related to terminal lung cancer and invasive procedures," "decreased cardiac tissue perfusion due to hemodynamic instability," "impaired physical mobility related to lower limb paralysis," and "hopelessness due to the unpredictable prognosis of terminal lung cancer." Results: The medical team initially focused on symptom relief, administering Morphine 5mg in 0.9% N/S 50ml IVD q6h for pain management and continuing chemotherapy as prescribed. Open communication was employed to address the patient's physical, psychological, and spiritual concerns. Non-pharmacological interventions, including listening, caring, companionship, opioid medication, and distraction techniques like comfortable positioning and warm foot baths, were used to alleviate pain, reducing the pain score to 3 on the numeric rating scale and easing respiratory discomfort. The palliative care team was also involved, guiding the patient and family through the "Four Paths of Life," helping the patient achieve a good end-of-life experience and the family to experience a peaceful life. This process also served to promote the concept of palliative care, enabling more patients and families to receive high-quality and dignified care. The patient was encouraged to express inner anxiety through drawing or writing, which helped reduce the hopelessness caused by psychological distress and uncertainty about the disease's prognosis, as assessed by the Hospital Anxiety and Depression Scale, reaching a level of mild anxiety but acceptable without affecting sleep. Conclusion: What left a deep impression during the care process was the need for intensive care providers to consider the patient's psychological state, not just their physical condition, when the patient's situation changes. Family support and involvement often provide the greatest solace for the patient, emphasizing the importance of comfort and dignity. This includes oral care to maintain cleanliness and comfort, frequent repositioning to alleviate pressure and discomfort, and timely removal of invasive devices and unnecessary medications to avoid unnecessary suffering. The nursing process should also address the patient's psychological needs, offering comfort and support to ensure that they can face the end of life with peace and dignity.

Keywords: intensive care, lung cancer, aortic dissection, lower limb paralysis

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454 Benefits of Using Social Media and Collaborative Online Platforms in PBL

Authors: Susanna Graziano, Lydia Krstic Ward

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The purpose of this presentation is to demonstrate the steps of using multimedia and collaborative platforms in project-based learning. The presentation will demonstrate the stages of the learning project with various components of independent and collaborative learning, where students research the topic, share information, prepare a survey, use social media (Facebook, Instagram, WhasApp) and collaborative platforms (wikispaces.com and Google docs) to collect, analyze and process data, then produce reports and logos to be displayed as a final product. At the beginning of the presentation participants will answer a questionnaire about project based learning and share their experience on using social media, real–world project work and collaborative learning. Using a PPP, the presentation will walk participants through the steps of a completed project where tertiary education students are involved in putting together a multimedia campaign for safe driving in Kuwait. The research component of the project entails taking a holistic view on the problem of the high death rate in traffic accidents. The final goal of the project is to lead students to raise public awareness about the importance of safe driving. The project steps involve using the social media and collaborative platforms for collecting data and sharing the required materials to be used in the final product – a display of written reports, slogans and videos, as well as oral presentations. The same structure can be used to organize a multimedia campaign focusing on other issues, whilst scaffolding on students’ ability to brainstorm, retrieve information, organize it and engage in collaborative/ cooperative learning whilst being immersed in content-based learning as well as in authentic tasks. More specifically, the project we carried out at Box Hill College was a real-world one and involved a multimedia Campaign for Safe Driving since reckless driving is one of the major problems in the country. The idea for the whole project started by a presentation given by a board member of the Kuwaiti Society for Traffic Safety who was invited to college and spoke about: • Driving laws in the country, • What causes car accidents, • Driving safety tips. The principal goal of this project was to let students consider problems of traffic in Kuwait from different points of view. They also had to address the number and causes of accidents, evaluate the effectiveness of the local traffic law in order to send a warning about the importance of safe driving and, finally, suggest ways of its improvement. Benefits included: • Engagement, • Autonomy, • Motivation, • Content knowledge, • Language mastery, • Enhanced critical thinking, • Increased metacognitive awareness, • Improved social skills, • Authentic experience.

Keywords: social media, online learning platforms, collaborative platforms, project based learning

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