Search results for: role of mediator
913 Effect of Two Types of Shoe Insole on the Dynamics of Lower Extremities Joints in Individuals with Leg Length Discrepancy during Stance Phase of Walking
Authors: Mansour Eslami, Fereshte Habibi
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Limb length discrepancy (LLD), or anisomeric, is defined as a condition in which paired limbs are noticeably unequal. Individuals with LLD during walking use compensatory mechanisms to dynamically lengthen the short limb and shorten the long limb to minimize the displacement of the body center of mass and consequently reduce body energy expenditure. Due to the compensatory movements created, LLD greater than 1 cm increases the odds of creating lumbar problems and hip and knee osteoarthritis. Insoles are non-surgical therapies that are recommended to improve the walking pattern, pain and create greater symmetry between the two lower limbs. However, it is not yet clear what effect insoles have on the variables related to injuries during walking. The aim of the present study was to evaluate the effect of internal and external heel lift insoles on pelvic kinematic in sagittal and frontal planes and lower extremity joint moments in individuals with mild leg length discrepancy during the stance phase of walking. Biomechanical data of twenty-eight men with structural leg length discrepancy of 10-25 mm were collected while they walked under three conditions: shoes without insole (SH), with internal heel lift insoles (IHLI) in shoes, and with external heal lift insole (EHLI). The tests were performed for both short and long legs. The pelvic kinematic and joint moment were measured with a motion capture system and force plate. Five walking trials were performed for each condition. The average value of five successful trials was used for further statistical analysis. Repeated measures ANCOVA with Bonferroni post hoc test were used for between-group comparisons (p ≤ 0.05). In both internal and external heel lift insoles (IHLI, EHLI), there was a significant decrease in the peak values of lateral and anterior pelvic tilts of the long leg, hip, and knee moments of a long leg and ankle moment of short leg (p ≤ 0.05). Furthermore, significant increases in peak values of lateral and anterior pelvic tilt of short leg in IHLI and EHLI were observed as compared to Shoe (SH) condition (p ≤ 0.01). In addition, a significant difference was observed between the IHLI and EHLI conditions in peak anterior pelvic tilt of long leg and plantar flexor moment of short leg (p=0.04; p= 0.04 respectively). Our findings indicate that both IHLI and EHLI can play an important role in controlling excessive pelvic movements in the sagittal and frontal planes in individuals with mild LLD during walking. Furthermore, the EHLI may have a better effect in preventing musculoskeletal injuries compared to the IHLI.Keywords: kinematic, leg length discrepancy, shoe insole, walking
Procedia PDF Downloads 110912 Tuberculosis Outpatient Treatment in the Context of Reformation of the Health Care System
Authors: Danylo Brindak, Viktor Liashko, Olexander Chepurniy
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Despite considerable experience in implementation of the best international approaches and services within response to epidemy of multi-drug resistant tuberculosis, the results of situation analysis indicate the presence of faults in this area. In 2014, Ukraine (for the first time) was included in the world’s five countries with the highest level of drug-resistant tuberculosis. The effectiveness of its treatment constitutes only 35% in the country. In this context, the increase in allocation of funds to control the epidemic of multidrug-resistant tuberculosis does not produce perceptible positive results. During 2001-2016, only the Global Fund to fight AIDS, Tuberculosis, and Malaria allocated to Ukraine more than USD 521,3 million for programs of tuberculosis and HIV/AIDS control. However, current conditions in post-Semashko system create little motivation for rational use of resources or cost control at inpatient TB facilities. There is no motivation to reduce overdue hospitalization and to target resources to priority sectors of modern tuberculosis control, including a model of care focused on the patient. In the presence of a line-item budget at medical institutions, based on the input factors as the ratios of beds and staff, there is a passive disposal of budgetary funds by health care institutions and their employees who have no motivation to improve quality and efficiency of service provision. Outpatient treatment of tuberculosis is being implemented in Ukraine since 2011 and has many risks, namely creation of parallel systems, low consistency through dependence on funding for the project, reduced the role of the family doctor, the fragmentation of financing, etc. In terms of reforming approaches to health system financing, which began in Ukraine in late 2016, NGO Infection Control in Ukraine conducted piloting of a new, motivating method of remuneration of employees in primary health care. The innovative aspect of this funding mechanism is cost according to results of treatment. The existing method of payment on the basis of the standard per inhabitant (per capita ratio) was added with motivating costs according to results of work. The effectiveness of such treatment of TB patients at the outpatient stage is 90%, while in whole on the basis of a current system the effectiveness of treatment of newly diagnosed pulmonary TB with positive swab is around 60% in the country. Even though Ukraine has 5.24 TB beds per 10 000 citizens. Implemented pilot model of ambulatory treatment will be used for the creation of costs system according to results of activities, the integration of TB and primary health and social services and their focus on achieving results, the reduction of inpatient treatment of tuberculosis.Keywords: health care reform, multi-drug resistant tuberculosis, outpatient treatment efficiency, tuberculosis
Procedia PDF Downloads 141911 Seed Associated Microbial Communities of Holoparasitic Cistanche Species from Armenia and Portugal
Authors: K. Petrosyan, R. Piwowarczyk, K. Ruraż, S. Thijs, J. Vangronsveld, W. Kaca
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Holoparasitic plants are flowering heterotrophic angiosperms which with the help of an absorbing organ - haustorium, attach to another plant, the so-called the host. Due to the different hosts, unusual lifestyle, lack of roots, chlorophylls and photosynthesis, these plants are interesting and unique study objects for global biodiversity. The seeds germination of the parasitic plants also is unique: they germinate only in response to germination stimulants, namely strigolactones produced by the root of an appropriate host. Resistance of the seeds on different environmental conditions allow them to stay viable in the soil for more than 20 years. Among the wide range of plant protection mechanisms the endophytic communities have a specific role. In this way, they have the potential to mitigate the impacts of adverse conditions such as soil salinization. The major objective of our study was to compare the bacterial endo-microbiomes from seeds of two holoparasitic plants from Orobanchaceae family, Cistanche – C. armena (Armenia) and C. phelypaea (Portugal) – from saline habitats different in soil water status. The research aimed to perform how environmental conditions influence on the diversity of the bacterial communities of C. armena and C. phelypaea seeds. This was achieved by comparison of the endophytic microbiomes of two species and isolation of culturable bacteria. A combination of culture-dependent and molecular techniques was employed for the identification of the seed endomicrobiome (culturable and unculturable). Using the V3-V4 hypervariable region of the 16S rRNA gene, four main taxa were identified: Proteobacteria, Actinobacteria, Bacteroidetes, Firmicutes, but the relative proportion of the taxa was different in each type of seed. Generally, sixteen phyla, 323 genera and 710 bacterial species were identified, mainly Gram negative, halotolerant bacteria with an environmental origin. However, also some unclassified and unexplored taxonomic groups were found in the seeds of both plants. 16S rRNA gene sequencing analysis from both species identified the gram positive, endospore forming, halotolerant and alkaliphile Bacillus spp. which suggests that the endophytic bacteria of examined seeds possess traits that are correlated with the natural habitat of their hosts. The cultivable seed endophytes from C. armena and C. phelypaea were rather similar, notwithstanding the big distances between their growth habitats - Armenia and Portugal. Although the seed endophytic microbiomes of C. armena and C. phelypaea contain a high number of common bacterial taxa, also remarkable differences exist. We demonstrated that the environmental conditions or abiotic stresses influence on diversity of the bacterial communities of holoparasiotic seeds. To the best of our knowledge the research is the first report of endophytes from seeds of holoparasitic Cistanche armena and C. phelypaea plants.Keywords: microbiome, parasitic plant, salinity, seeds
Procedia PDF Downloads 66910 Viability Analysis of a Centralized Hydrogen Generation Plant for Use in Oil Refining Industry
Authors: C. Fúnez Guerra, B. Nieto Calderón, M. Jaén Caparrós, L. Reyes-Bozo, A. Godoy-Faúndez, E. Vyhmeister
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The global energy system is experiencing a change of scenery. Unstable energy markets, an increasing focus on climate change and its sustainable development is forcing businesses to pursue new solutions in order to ensure future economic growth. This has led to the interest in using hydrogen as an energy carrier in transportation and industrial applications. As an energy carrier, hydrogen is accessible and holds a high gravimetric energy density. Abundant in hydrocarbons, hydrogen can play an important role in the shift towards low-emission fossil value chains. By combining hydrogen production by natural gas reforming with carbon capture and storage, the overall CO2 emissions are significantly reduced. In addition, the flexibility of hydrogen as an energy storage makes it applicable as a stabilizer in the renewable energy mix. The recent development in hydrogen fuel cells is also raising the expectations for a hydrogen powered transportation sector. Hydrogen value chains exist to a large extent in the industry today. The global hydrogen consumption was approximately 50 million tonnes (7.2 EJ) in 2013, where refineries, ammonia, methanol production and metal processing were main consumers. Natural gas reforming produced 48% of this hydrogen, but without carbon capture and storage (CCS). The total emissions from the production reached 500 million tonnes of CO2, hence alternative production methods with lower emissions will be necessary in future value chains. Hydrogen from electrolysis is used for a wide range of industrial chemical reactions for many years. Possibly, the earliest use was for the production of ammonia-based fertilisers by Norsk Hydro, with a test reactor set up in Notodden, Norway, in 1927. This application also claims one of the world’s largest electrolyser installations, at Sable Chemicals in Zimbabwe. Its array of 28 electrolysers consumes 80 MW per hour, producing around 21,000 Nm3/h of hydrogen. These electrolysers can compete if cheap sources of electricity are available and natural gas for steam reforming is relatively expensive. Because electrolysis of water produces oxygen as a by-product, a system of Autothermal Reforming (ATR) utilizing this oxygen has been analyzed. Replacing the air separation unit with electrolysers produces the required amount of oxygen to the ATR as well as additional hydrogen. The aim of this paper is to evaluate the technical and economic potential of large-scale production of hydrogen for oil refining industry. Sensitivity analysis of parameters such as investment costs, plant operating hours, electricity price and sale price of hydrogen and oxygen are performed.Keywords: autothermal reforming, electrolyser, hydrogen, natural gas, steam methane reforming
Procedia PDF Downloads 204909 Determining the Distance Consumers Are Willing to Travel to a Store: A Structural Equation Model Approach
Authors: Fuseina Mahama, Lieselot Vanhaverbeke
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This research investigates the impact of patronage determinants on the distance consumers are willing to travel to patronize a tire shop. Although store patronage has been acknowledged as an important domain and has received substantial research interest, most of the studies so far conducted focus on grocery retail, leaving other categories of goods widely unexplored. In this study, we focus on car tires and provide a new perspective to the specific factors that influence tire shop patronage. An online survey of consumers’ tyre purchasing behaviour was conducted among private car owners in Belgium. A sample of 864 respondents was used in the study, with almost four out of five of them being male. 84% of the respondents had purchased a car tyre in the last 24 months and on average travelled 22.4kms to patronise a tyre shop. We tested the direct and mediated effects of store choice determinants on distance consumers are willing to travel. All hypotheses were tested using Structural Equation Modelling (SEM). Our findings show that with an increase in the consumer’s age the distance they were willing to travel to a tire shop decreased. Similarly, consumers who deemed proximity an important determinant of a tire shop our findings confirmed a negative effect on willingness to travel. On the other hand, the determinants price, personal contact and professionalism all had a positive effect on distance. This means that consumers actively sought out tire shops with these characteristics and were willing to travel longer distances in order to visit them. The indirect effects of the determinants flexible opening hours, family recommendation, dealer reputation, receiving auto service at home and availability of preferred brand on distance are mediated by dealer trust. Gender had a minimal effect on distance, with females exhibiting a stronger relation in terms of dealer trust as compared to males. Overall, we found that market relevant factors were better predictors of distance; and proximity, dealer trust and professionalism have the most profound effects on distance that consumers are willing to travel. This is related to the fact that the nature of shopping goods (among which are car tires) typically reinforces consumers to be more engaged in the shopping process, therefore factors that have to do with the store (e.g. location) and shopping process play a key role in store choice decision. These findings are very specific to shopping goods and cannot be generalized to other categories of goods. For marketers and retailers these findings can have direct implications on their location strategies. The factors found to be relevant to tire shop patronage will be used in our next study to calibrate a location model to be utilised to identify the optimum location for siting new tyre shop outlets and service centres.Keywords: dealer trust, distance to store, tire store patronage, willingness to travel
Procedia PDF Downloads 246908 Diagnostic Performance of Mean Platelet Volume in the Diagnosis of Acute Myocardial Infarction: A Meta-Analysis
Authors: Kathrina Aseanne Acapulco-Gomez, Shayne Julieane Morales, Tzar Francis Verame
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Mean platelet volume (MPV) is the most accurate measure of the size of platelets and is routinely measured by most automated hematological analyzers. Several studies have shown associations between MPV and cardiovascular risks and outcomes. Although its measurement may provide useful data, MPV remains to be a diagnostic tool that is yet to be included in routine clinical decision making. The aim of this systematic review and meta-analysis is to determine summary estimates of the diagnostic accuracy of mean platelet volume for the diagnosis of myocardial infarction among adult patients with angina and/or its equivalents in terms of sensitivity, specificity, diagnostic odds ratio, and likelihood ratios, and to determine the difference of the mean MPV values between those with MI and those in the non-MI controls. The primary search was done through search in electronic databases PubMed, Cochrane Review CENTRAL, HERDIN (Health Research and Development Information Network), Google Scholar, Philippine Journal of Pathology, and Philippine College of Physicians Philippine Journal of Internal Medicine. The reference list of original reports was also searched. Cross-sectional, cohort, and case-control articles studying the diagnostic performance of mean platelet volume in the diagnosis of acute myocardial infarction in adult patients were included in the study. Studies were included if: (1) CBC was taken upon presentation to the ER or upon admission (within 24 hours of symptom onset); (2) myocardial infarction was diagnosed with serum markers, ECG, or according to accepted guidelines by the Cardiology societies (American Heart Association (AHA), American College of Cardiology (ACC), European Society of Cardiology (ESC); and, (3) if outcomes were measured as significant difference AND/OR sensitivity and specificity. The authors independently screened for inclusion of all the identified potential studies as a result of the search. Eligible studies were appraised using well-defined criteria. Any disagreement between the reviewers was resolved through discussion and consensus. The overall mean MPV value of those with MI (9.702 fl; 95% CI 9.07 – 10.33) was higher than in those of the non-MI control group (8.85 fl; 95% CI 8.23 – 9.46). Interpretation of the calculated t-value of 2.0827 showed that there was a significant difference in the mean MPV values of those with MI and those of the non-MI controls. The summary sensitivity (Se) and specificity (Sp) for MPV were 0.66 (95% CI; 0.59 - 0.73) and 0.60 (95% CI; 0.43 – 0.75), respectively. The pooled diagnostic odds ratio (DOR) was 2.92 (95% CI; 1.90 – 4.50). The positive likelihood ratio of MPV in the diagnosis of myocardial infarction was 1.65 (95% CI; 1.20 – 22.27), and the negative likelihood ratio was 0.56 (95% CI; 0.50 – 0.64). The intended role for MPV in the diagnostic pathway of myocardial infarction would perhaps be best as a triage tool. With a DOR of 2.92, MPV values can discriminate between those who have MI and those without. For a patient with angina presenting with elevated MPV values, it is 1.65 times more likely that he has MI. Thus, it is implied that the decision to treat a patient with angina or its equivalents as a case of MI could be supported by an elevated MPV value.Keywords: mean platelet volume, MPV, myocardial infarction, angina, chest pain
Procedia PDF Downloads 74907 Implementing a Prevention Network for the Ortenaukreis
Authors: Klaus Froehlich-Gildhoff, Ullrich Boettinger, Katharina Rauh, Angela Schickler
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The Prevention Network Ortenaukreis, PNO, funded by the German Ministry of Education and Research, aims to promote physical and mental health as well as the social inclusion of 3 to 10 years old children and their families in the Ortenau district. Within a period of four years starting 11/2014 a community network will be established. One regional and five local prevention representatives are building networks with stakeholders of the prevention and health promotion field bridging the health care, educational and youth welfare system in a multidisciplinary approach. The regional prevention representative implements regularly convening prevention and health conferences. On a local level, the 5 local prevention representatives implement round tables in each area as a platform for networking. In the setting approach, educational institutions are playing a vital role when gaining access to children and their families. Thus the project will offer 18 month long organizational development processes with specially trained coaches to 25 kindergarten and 25 primary schools. The process is based on a curriculum of prevention and health promotion which is adapted to the specific needs of the institutions. Also to ensure that the entire region is reached demand oriented advanced education courses are implemented at participating day care centers, kindergartens and schools. Evaluation method: The project is accompanied by an extensive research design to evaluate the outcomes of different project components such as interview data from community prevention agents, interviews and network analysis with families at risk on their support structures, data on community network development and monitoring, as well as data from kindergarten and primary schools. The latter features a waiting-list control group evaluation in kindergarten and primary schools with a mixed methods design using questionnaires and interviews with pedagogues, teachers, parents, and children. Results: By the time of the conference pre and post test data from the kindergarten samples (treatment and control group) will be presented, as well as data from the first project phase, such as qualitative interviews with the prevention coordinators as well as mixed methods data from the community needs assessment. In supporting this project, the Federal Ministry aims to gain insight into efficient components of community prevention and health promotion networks as it is implemented and evaluated. The district will serve as a model region, so that successful components can be transferred to other regions throughout Germany. Accordingly, the transferability to other regions is of high interest in this project.Keywords: childhood research, health promotion, physical health, prevention network, psychological well-being, social inclusion
Procedia PDF Downloads 211906 Harrison’s Stolen: Addressing Aboriginal and Indigenous Islanders Human Rights
Authors: M. Shukry
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According to the United Nations Declaration of Human Rights in 1948, every human being is entitled to rights in life that should be respected by others and protected by the state and community. Such rights are inherent regardless of colour, ethnicity, gender, religion or otherwise, and it is expected that all humans alike have the right to live without discrimination of any sort. However, that has not been the case with Aborigines in Australia. Over a long period of time, the governments of the State and the Territories and the Australian Commonwealth denied the Aboriginal and Indigenous inhabitants of the Torres Strait Islands such rights. Past Australian governments set policies and laws that enabled them to forcefully remove Indigenous children from their parents, which resulted in creating lost generations living the trauma of the loss of cultural identity, alienation and even their own selfhood. Intending to reduce that population of natives and their Aboriginal culture while, on the other hand, assimilate them into mainstream society, they gave themselves the right to remove them from their families with no hope of return. That practice has led to tragic consequences due to the trauma that has affected those children, an experience that is depicted by Jane Harrison in her play Stolen. The drama is the outcome of a six-year project on lost children and which was first performed in 1997 in Melbourne. Five actors only appear on the stage, playing the role of all the different characters, whether the main protagonists or the remaining cast, present or non-present ones as voices. The play outlines the life of five children who have been taken from their parents at an early age, entailing a disastrous negative impact that differs from one to the other. Unknown to each other, what connects between them is being put in a children’s home. The purpose of this paper is to analyse the play’s text in light of the 1948 Declaration of Human Rights, using it as a lens that reflects the atrocities practiced against the Aborigines. It highlights how such practices formed an outrageous violation of those natives’ rights as human beings. Harrison’s dramatic technique in conveying the children’s experiences is through a non-linear structure, fluctuating between past and present that are linked together within each of the five characters, reflecting their suffering and pain to create an emotional link between them and the audience. Her dramatic handling of the issue by fusing tragedy with humour as well as symbolism is a successful technique in revealing the traumatic memory of those children and their present life. The play has made a difference in commencing to address the problem of the right of all children to be with their families, which renders the real meaning of having a home and an identity as people.Keywords: aboriginal, audience, Australia, children, culture, drama, home, human rights, identity, Indigenous, Jane Harrison, memory, scenic effects, setting, stage, stage directions, Stolen, trauma
Procedia PDF Downloads 292905 RAD-Seq Data Reveals Evidence of Local Adaptation between Upstream and Downstream Populations of Australian Glass Shrimp
Authors: Sharmeen Rahman, Daniel Schmidt, Jane Hughes
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Paratya australiensis Kemp (Decapoda: Atyidae) is a widely distributed indigenous freshwater shrimp, highly abundant in eastern Australia. This species has been considered as a model stream organism to study genetics, dispersal, biology, behaviour and evolution in Atyids. Paratya has a filter feeding and scavenging habit which plays a significant role in the formation of lotic community structure. It has been shown to reduce periphyton and sediment from hard substrates of coastal streams and hence acts as a strongly-interacting ecosystem macroconsumer. Besides, Paratya is one of the major food sources for stream dwelling fishes. Paratya australiensis is a cryptic species complex consisting of 9 highly divergent mitochondrial DNA lineages. Among them, one lineage has been observed to favour upstream sites at higher altitudes, with cooler water temperatures. This study aims to identify local adaptation in upstream and downstream populations of this lineage in three streams in the Conondale Range, North-eastern Brisbane, Queensland, Australia. Two populations (up and down stream) from each stream have been chosen to test for local adaptation, and a parallel pattern of adaptation is expected across all streams. Six populations each consisting of 24 individuals were sequenced using the Restriction Site Associated DNA-seq (RAD-seq) technique. Genetic markers (SNPs) were developed using double digest RAD sequencing (ddRAD-seq). These were used for de novo assembly of Paratya genome. De novo assembly was done using the STACKs program and produced 56, 344 loci for 47 individuals from one stream. Among these individuals, 39 individuals shared 5819 loci, and these markers are being used to test for local adaptation using Fst outlier tests (Arlequin) and Bayesian analysis (BayeScan) between up and downstream populations. Fst outlier test detected 27 loci likely to be under selection and the Bayesian analysis also detected 27 loci as under selection. Among these 27 loci, 3 loci showed evidence of selection at a significance level using BayeScan program. On the other hand, up and downstream populations are strongly diverged at neutral loci with a Fst =0.37. Similar analysis will be done with all six populations to determine if there is a parallel pattern of adaptation across all streams. Furthermore, multi-locus among population covariance analysis will be done to identify potential markers under selection as well as to compare single locus versus multi-locus approaches for detecting local adaptation. Adaptive genes identified in this study can be used for future studies to design primers and test for adaptation in related crustacean species.Keywords: Paratya australiensis, rainforest streams, selection, single nucleotide polymorphism (SNPs)
Procedia PDF Downloads 244904 The Role of Interest Groups in Foreign Policy: Assessing the Influence of the 'Pro-Jakarta Lobby' in Australia and Indonesia's Bilateral Relations
Authors: Bec Strating
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This paper examines the ways that domestic politics and pressure–generated through lobbying, public diplomacy campaigns and other tools of soft power-contributes to the formation of short-term and long-term national interests, priorities and strategies of states in their international relations. It primarily addresses the conceptual problems regarding the kinds of influence that lobby groups wield in foreign policy and how this influence might be assessed. Scholarly attention has been paid to influential foreign policy lobbies and interest groups, particularly in the areas of US foreign policy. Less attention has been paid to how lobby groups might influence the foreign policy of a middle power such as Australia. This paper examines some of the methodological complexities in developing and conducting a research project that can measure the nature and influence of lobbies on foreign affairs priorities and activities. This paper will use Australian foreign policy in the context of its historical bilateral relationship with Indonesia as a case study for considering the broader issues of domestic influences on foreign policy. Specifically, this paper will use the so-called ‘pro-Jakarta lobby’ as an example of an interest group. The term ‘pro-Jakarta lobby’ is used in media commentary and scholarship to describe an amorphous collection of individuals who have sought to influence Australian foreign policy in favour of Indonesia. The term was originally applied to a group of Indonesian experts at the Australian National University in the 1980s but expanded to include journalists, think tanks and key diplomats. The concept of the ‘pro-Jakarta lobby’ was developed largely through criticisms of Australia’s support for Indonesia’s sovereignty of East Timor and West Papua. Pro-Independence supporters were integral for creating the ‘lobby’ in their rhetoric and criticisms about the influence on Australian foreign policy. In these critical narratives, the ‘pro-Jakarta lobby’ supported a realist approach to relations with Indonesia during the years of President Suharto’s regime, which saw appeasement of Indonesia as paramount to values of democracy and human rights. The lobby was viewed as integral in embedding a form of ‘foreign policy exceptionalism’ towards Indonesia in Australian policy-making circles. However, little critical and scholarly attention has been paid to nature, aims, strategies and activities of the ‘pro-Jakarta lobby.' This paper engages with methodological issues of foreign policy analysis: what was the ‘pro-Jakarta lobby’? Why was it considered more successful than other activist groups in shaping policy? And how can its influence on Australia’s approach to Indonesia be tested in relation to other contingent factors shaping policy? In addressing these questions, this case study will assist in addressing a broader scholarly concern about the capacities of collectives or individuals in shaping and directing the foreign policies of states.Keywords: foreign policy, interests groups, Australia, Indonesia
Procedia PDF Downloads 331903 Assessment of Surface Water Quality near Landfill Sites Using a Water Pollution Index
Authors: Alejandro Cittadino, David Allende
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Landfilling of municipal solid waste is a common waste management practice in Argentina as in many parts of the world. There is extensive scientific literature on the potential negative effects of landfill leachates on the environment, so it’s necessary to be rigorous with the control and monitoring systems. Due to the specific municipal solid waste composition in Argentina, local landfill leachates contain large amounts of organic matter (biodegradable, but also refractory to biodegradation), as well as ammonia-nitrogen, small trace of some heavy metals, and inorganic salts. In order to investigate the surface water quality in the Reconquista river adjacent to the Norte III landfill, water samples both upstream and downstream the dumpsite are quarterly collected and analyzed for 43 parameters including organic matter, heavy metals, and inorganic salts, as required by the local standards. The objective of this study is to apply a water quality index that considers the leachate characteristics in order to determine the quality status of the watercourse through the landfill. The water pollution index method has been widely used in water quality assessments, particularly rivers, and it has played an increasingly important role in water resource management, since it provides a number simple enough for the public to understand, that states the overall water quality at a certain location and time. The chosen water quality index (ICA) is based on the values of six parameters: dissolved oxygen (in mg/l and percent saturation), temperature, biochemical oxygen demand (BOD5), ammonia-nitrogen and chloride (Cl-) concentration. The index 'ICA' was determined both upstream and downstream the Reconquista river, being the rating scale between 0 (very poor water quality) and 10 (excellent water quality). The monitoring results indicated that the water quality was unaffected by possible leachate runoff since the index scores upstream and downstream were ranked in the same category, although in general, most of the samples were classified as having poor water quality according to the index’s scale. The annual averaged ICA index scores (computed quarterly) were 4.9, 3.9, 4.4 and 5.0 upstream and 3.9, 5.0, 5.1 and 5.0 downstream the river during the study period between 2014 and 2017. Additionally, the water quality seemed to exhibit distinct seasonal variations, probably due to annual precipitation patterns in the study area. The ICA water quality index appears to be appropriate to evaluate landfill impacts since it accounts mainly for organic pollution and inorganic salts and the absence of heavy metals in the local leachate composition, however, the inclusion of other parameters could be more decisive in discerning the affected stream reaches from the landfill activities. A future work may consider adding to the index other parameters like total organic carbon (TOC) and total suspended solids (TSS) since they are present in the leachate in high concentrations.Keywords: landfill, leachate, surface water, water quality index
Procedia PDF Downloads 140902 The Use of Brachytherapy in the Treatment of Liver Metastases: A Systematic Review
Authors: Mateusz Bilski, Jakub Klas, Emilia Kowalczyk, Sylwia Koziej, Katarzyna Kulszo, Ludmiła Grzybowska- Szatkowska
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Background: Liver metastases are a common complication of primary solid tumors and sig-nificantly reduce patient survival. In the era of increasing diagnosis of oligometastatic disease and oligoprogression, methods of local treatment of metastases, i.e. MDT, are becoming more important. Implementation of such treatment can be considered for liver metastases, which are a common complication of primary solid tumors and significantly reduce patient survival. To date, the mainstay of treatment for oligometastatic disease has been surgical resection, but not all patients qualify for the procedure. As an alternative to surgical resection, radiotherapy techniques have become available, including stereotactic body radiation therapy (SBRT) or high-dose interstitial brachytherapy (iBT). iBT is an invasive method that emits very high doses of radiation from the inside of the tumor to the outside. This technique provides better tumor coverage than SBRT while having little impact on surrounding healthy tissue and elim-inates some concerns involving respiratory motion. Methods: We conducted a systematic re-view of the scientific literature on the use of brachytherapy in the treatment of liver metasta-ses from 2018 - 2023 using PubMed and ResearchGate browsers according to PRISMA rules. Results: From 111 articles, 18 publications containing information on 729 patients with liver metastases were selected. iBT has been shown to provide high rates of tumor control. Among 14 patients with 54 unresectable RCC liver metastases, after iBT LTC was 92.6% during a median follow-up of 10.2 months, PFS was 3.4 months. In analysis of 167 patients after treatment with a single fractional dose of 15-25 Gy with brachytherapy at 6- and 12-month follow-up, LRFS rates of 88,4-88.7% and 70.7 - 71,5%, PFS of 78.1 and 53.8%, and OS of 92.3 - 96.7% and 76,3% - 79.6%, respectively, were achieved. No serious complications were observed in all patients. Distant intrahepatic progression occurred later in patients with unre-sectable liver metastases after brachytherapy (PFS: 19.80 months) than in HCC patients (PFS: 13.50 months). A significant difference in LRFS between CRC patients (84.1% vs. 50.6%) and other histologies (92.4% vs. 92.4%) was noted, suggesting a higher treatment dose is necessary for CRC patients. The average target dose for metastatic colorectal cancer was 40 - 60 Gy (compared to 100 - 250 Gy for HCC). To better assess sensitivity to therapy and pre-dict side effects, it has been suggested that humoral mediators be evaluated. It was also shown that baseline levels of TNF-α, MCP-1 and VEGF, as well as NGF and CX3CL corre-lated with both tumor volume and radiation-induced liver damage, one of the most serious complications of iBT, indicating their potential role as biomarkers of therapy outcome. Con-clusions: The use of brachytherapy methods in the treatment of liver metastases of various cancers appears to be an interesting and relatively safe therapeutic method alternative to sur-gery. An important challenge remains the selection of an appropriate brachytherapy method and radiation dose for the corresponding initial tumor type from which the metastasis origi-nated.Keywords: liver metastases, brachytherapy, CT-HDRBT, iBT
Procedia PDF Downloads 103901 Jurisdiction Conflicts in Contracts of International Maritime Transport: The Application of the Forum Selection Clause in Brazilian Courts
Authors: Renan Caseiro De Almeida, Mateus Mello Garrute
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The world walks to be ever more globalised. This trend promotes an increase on the number of transnational commercial transactions. The main modal for carriage of goods is by sea, and many countries have their economies dependent on the maritime freightage – it could be because they exercise largely this activity or because they follow the tendency of using the maritime logistic widely. Among these ones, Brazil is included. This nation counts with sixteen ports with good capacities, which receive most of the international income by sea. It is estimated that 85 per cent of the total influx of goods in Brazil is by maritime modal, leaving mere 15 per cent for the other ones. This made it necessary to develop maritime law in international and national basis, to create a standard to be applied with the intention to harmonize the transnational carriage of goods by sea. Maritime contracts are very specific and have interesting peculiarities, but in their range, little research has been made on what causes the main divergences when it comes to international contracts: the jurisdiction conflict. Likewise any other international contract, it is common for the parties to set a forum selection clause to choose the forum which will be able to judge the litigations that could rise from a maritime transport contract and, consequently, also which law should be applied to the cases. However, the forum choice in Brazil has always been somewhat polemical – not only in the maritime law sphere - for sometimes national tribunals overlook the parties’ choice and call the competence for themselves. In this sense, it is interesting to mention that the Mexico Convention of 1994 about the law applicable to international contracts did not gain strength in Brazil, nor even reached the Congress to be considered for ratification. Furthermore, it is also noteworthy that Brazil has a new Civil Procedure Code, which was put into reinforcement in 2016 bringing new legal provisions specifically about the forum selection. This represented a mark in the national legal system in this matter. Therefore, this paper intends to give an insight through Brazilian jurisprudence, making an analysis of how this issue has been treated on litigations about maritime contracts in the national tribunals, as well as the solutions found by the Brazilian legal system for the jurisdiction conflicts in those cases. To achieve the expected results, the hypothetical-deductive method will be used in combination with researches on doctrine and legislations. Also, jurisprudential research and case law study will have a special role, since the main point of this paper is to verify and study the position of the courts in Brazil in a specific matter. As a country of civil law, the Brazilian judges and tribunals are very attached to the rules displayed on codes. However, the jurisprudential understanding has been changing during the years and with the advent of the new rules about the applicable law and forum selection clause, it is noticeable that new winds are being blown.Keywords: applicable law, forum selection clause, international business, international maritime contracts, litigation in courts
Procedia PDF Downloads 268900 Effect of Maternal Factors and C-Peptide and Insulin Levels in Cord Blood on the Birth Weight of Newborns: A Preliminary Study from Southern Sri Lanka
Authors: M. H. A. D. de Silva, R. P. Hewawasam, M. A. G. Iresha
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Macrosomia is common in infants born to not only women diagnosed with gestational diabetes mellitus but also non-diabetic obese women. Maternal Body Mass Index (BMI) correlates with the incidence of large for gestational age infants. Obesity has reached epidemic levels in modern societies. During the past two decades, obesity in children and adolescents has risen significantly in Asian populations including Sri Lanka. There is increasing evidence to believe that infants who are born large for gestational age are more likely to be obese in childhood and adolescence and are at risk of cardiovascular and metabolic complications later in life. It is also established that Asians have lower skeletal muscle mass, low bone mineral content and excess body fat for a given BMI indicating a genetic predisposition in the occurrence of obesity. The objective of this study is to determine the effect of maternal weight, weight gain during pregnancy, c-peptide and insulin concentrations in the cord blood on the birth of appropriate for and large for gestational age infants in a tertiary care center in Southern Sri Lanka. Umbilical cord blood was collected from 90 newborns (Male 40, Female 50; gestational age 35-42 weeks) after double clamping the umbilical cord before separation of the placenta and the concentration of insulin and C-peptide were measured by ELISA technique. Anthropometric parameters of the newborn such as birth weight, length, ponderal index, occipital frontal, chest, hip and calf circumferences were measured, and characteristics of the mother were collected. The relationship between insulin, C-peptide and anthropometrics were assessed by Spearman correlation. The multiple logistic regression analysis examined influences of maternal weight, weight gain during pregnancy, C-peptide and insulin concentrations in cord blood as covariates on the birth of large for gestational age infants. A significant difference (P<0.001) was observed between the insulin levels of infants born large for gestational age (18.73 ± 0.52 µlU/ml) and appropriate for gestational age (13.08 ± 0.56 µlU/ml). Consistently, A significant decrease in concentration (41.68%, P<0.001) was observed between C-peptide levels of infants born large for gestational age and appropriate for gestational age. Cord blood insulin and C-peptide levels had a significant correlation with birth weight (r=0.35, P<0.05) of the newborn at delivery. Maternal weight and BMI which are indicators of maternal nutrition were proven to be directly correlated with birth weight and length. To our knowledge, this relationship was investigated for the first time in a Sri Lankan setting and was also evident in our results. This study confirmed the fact that insulin and C-peptide play a major role in regulating fetal growth. According to the results obtained in this study, we can suggest that the increased BMI of the mother has a direct influence on increased maternal insulin secretion, which may subsequently affect cord insulin and C-peptide levels and also birth weight of the infant.Keywords: C-peptide, insulin, large for gestational age, maternal weight
Procedia PDF Downloads 156899 Detection of Some Drugs of Abuse from Fingerprints Using Liquid Chromatography-Mass Spectrometry
Authors: Ragaa T. Darwish, Maha A. Demellawy, Haidy M. Megahed, Doreen N. Younan, Wael S. Kholeif
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The testing of drug abuse is authentic in order to affirm the misuse of drugs. Several analytical approaches have been developed for the detection of drugs of abuse in pharmaceutical and common biological samples, but few methodologies have been created to identify them from fingerprints. Liquid Chromatography-Mass Spectrometry (LC-MS) plays a major role in this field. The current study aimed at assessing the possibility of detection of some drugs of abuse (tramadol, clonazepam, and phenobarbital) from fingerprints using LC-MS in drug abusers. The aim was extended in order to assess the possibility of detection of the above-mentioned drugs in fingerprints of drug handlers till three days of handling the drugs. The study was conducted on randomly selected adult individuals who were either drug abusers seeking treatment at centers of drug dependence in Alexandria, Egypt or normal volunteers who were asked to handle the different studied drugs (drug handlers). An informed consent was obtained from all individuals. Participants were classified into 3 groups; control group that consisted of 50 normal individuals (neither abusing nor handling drugs), drug abuser group that consisted of 30 individuals who abused tramadol, clonazepam or phenobarbital (10 individuals for each drug) and drug handler group that consisted of 50 individuals who were touching either the powder of drugs of abuse: tramadol, clonazepam or phenobarbital (10 individuals for each drug) or the powder of the control substances which were of similar appearance (white powder) and that might be used in the adulteration of drugs of abuse: acetyl salicylic acid and acetaminophen (10 individuals for each drug). Samples were taken from the handler individuals for three consecutive days for the same individual. The diagnosis of drug abusers was based on the current Diagnostic and Statistical Manual of Mental disorders (DSM-V) and urine screening tests using immunoassay technique. Preliminary drug screening tests of urine samples were also done for drug handlers and the control groups to indicate the presence or absence of the studied drugs of abuse. Fingerprints of all participants were then taken on a filter paper previously soaked with methanol to be analyzed by LC-MS using SCIEX Triple Quad or QTRAP 5500 System. The concentration of drugs in each sample was calculated using the regression equations between concentration in ng/ml and peak area of each reference standard. All fingerprint samples from drug abusers showed positive results with LC-MS for the tested drugs, while all samples from the control individuals showed negative results. A significant difference was noted between the concentration of the drugs and the duration of abuse. Tramadol, clonazepam, and phenobarbital were also successfully detected from fingerprints of drug handlers till 3 days of handling the drugs. The mean concentration of the chosen drugs of abuse among the handlers group decreased when the days of samples intake increased.Keywords: drugs of abuse, fingerprints, liquid chromatography–mass spectrometry, tramadol
Procedia PDF Downloads 107898 Effect of High Dose of Black Tea Extract on Physiological Parameters of Mother and Pups in Experimental Albino Rats
Authors: Avijit Dey, Antony Gomes, Subir Chandra Dasgupta
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Tea (Camellia sinensis) is the most popular beverages in the world and is ranked second after the water. Tea has been considered as a health promoting beverage since ancient times due to its health-promoting activity. Recently, immunomodulatory, anti-arthritic, antioxidant, anticancer and cardioprotective activity of tea has been established. Very few studies have demonstrated the effect of high dose of black tea on health. The aim of the present study was to evaluate the role of low & high dose of Black Tea Extract (BTE) on the different physiological parameters of mother and pups during prenatal and postnatal developmental period in the experimental rodent. BTE was orally administered in LD (50mg BTE/kg/day) and HD (100mg BTE/kg/day) except control groups of rats (n=6/group) throughout the prenatal (day 0-21) and postnatal (day 21-42) periods. During prenatal period (0, 7th, 14th, 20th days) body weight, urinary calcium, magnesium, urea and creatinine was measured. In postnatal period physical (0, 10th, 21th days) parameters of pups like body weight, cranial length, cranial diameter, neck width, tail length, craniosacral length of pups were analyzed. Liver and lungs from pups and kidney spleen, etc. from mothers were collected on day 42 for histopathological studies. The comparative urine strip and morphology of RBC was also analyzed by SEM from mothers of different groups on day 42. The level of cytokines like IL-1alpha, IL-1beta, IL-6, IL-10, TNF-alpha were analysed by enzyme-linked immunosorbent assay (ELISA) on day 0, day 20 and day 42. The body weight of LD and HD mothers were also significantly (P<0.05) less than control mothers at 20th day of pregnancy and there was also significant changes in urinary calcium, urea, creatinine. The bio morphometric analysis of pups showed significant alteration (P<0.05) in HD groups relative to control. Some histological alterations were also observed in pups and mothers. Comparative urine strip analysis and morphology of RBC showed significant changes in treated groups. LD and HD treated mothers showed an increase in proinflammatory cytokines like IL-1beta, TNF-alpha and decrease in anti-inflammatory cytokine-like IL-10 on day 20 compared to PC mothers. This study clearly indicated that high dose of BTE possesses detrimental effect on pregnant mother and the pup. Further studies are in progress to elucidate the molecular mechanism of actions. This project work has been sponsored by National Tea Research Foundation vide Project Sanction No.: 17 (305)/2013/4423 dated 11th March, 2014. All experimental protocols described in the study were approved by animal ethics committee.Keywords: black tea extract, pregnancy, prenatal and postnatal development, inflammation
Procedia PDF Downloads 267897 Mitochondrial DNA Defect and Mitochondrial Dysfunction in Diabetic Nephropathy: The Role of Hyperglycemia-Induced Reactive Oxygen Species
Authors: Ghada Al-Kafaji, Mohamed Sabry
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Mitochondria are the site of cellular respiration and produce energy in the form of adenosine triphosphate (ATP) via oxidative phosphorylation. They are the major source of intracellular reactive oxygen species (ROS) and are also direct target to ROS attack. Oxidative stress and ROS-mediated disruptions of mitochondrial function are major components involved in the pathogenicity of diabetic complications. In this work, the changes in mitochondrial DNA (mtDNA) copy number, biogenesis, gene expression of mtDNA-encoded subunits of electron transport chain (ETC) complexes, and mitochondrial function in response to hyperglycemia-induced ROS and the effect of direct inhibition of ROS on mitochondria were investigated in an in vitro model of diabetic nephropathy using human renal mesangial cells. The cells were exposed to normoglycemic and hyperglycemic conditions in the presence and absence of Mn(III)tetrakis(4-benzoic acid) porphyrin chloride (MnTBAP) or catalase for 1, 4 and 7 days. ROS production was assessed by the confocal microscope and flow cytometry. mtDNA copy number and PGC-1a, NRF-1, and TFAM, as well as ND2, CYTB, COI, and ATPase 6 transcripts, were all analyzed by real-time PCR. PGC-1a, NRF-1, and TFAM, as well as ND2, CYTB, COI, and ATPase 6 proteins, were analyzed by Western blotting. Mitochondrial function was determined by assessing mitochondrial membrane potential and adenosine triphosphate (ATP) levels. Hyperglycemia-induced a significant increase in the production of mitochondrial superoxide and hydrogen peroxide at day 1 (P < 0.05), and this increase remained significantly elevated at days 4 and 7 (P < 0.05). The copy number of mtDNA and expression of PGC-1a, NRF-1, and TFAM as well as ND2, CYTB, CO1 and ATPase 6 increased after one day of hyperglycemia (P < 0.05), with a significant reduction in all those parameters at 4 and 7 days (P < 0.05). The mitochondrial membrane potential decreased progressively at 1 to 7 days of hyperglycemia with the parallel progressive reduction in ATP levels over time (P < 0.05). MnTBAP and catalase treatment of cells cultured under hyperglycemic conditions attenuated ROS production reversed renal mitochondrial oxidative stress and improved mtDNA, mitochondrial biogenesis, and function. These results show that hyperglycemia-induced ROS caused an early increase in mtDNA copy number, mitochondrial biogenesis and mtDNA-encoded gene expression of the ETC subunits in human mesangial cells as a compensatory response to the decline in mitochondrial function, which precede the mtDNA defect and mitochondrial dysfunction with a progressive oxidative response. Protection from ROS-mediated damage to renal mitochondria induced by hyperglycemia may be a novel therapeutic approach for the prevention/treatment of DN.Keywords: diabetic nephropathy, hyperglycemia, reactive oxygen species, oxidative stress, mtDNA, mitochondrial dysfunction, manganese superoxide dismutase, catalase
Procedia PDF Downloads 240896 Gender Specific Differences in Clinical Outcomes of Knee Osteoarthritis Treated with Micro-Fragmented Adipose Tissue
Authors: Tiffanie-Marie Borg, Yasmin Zeinolabediny, Nima Heidari, Ali Noorani, Mark Slevin, Angel Cullen, Stefano Olgiati, Alberto Zerbi, Alessandro Danovi, Adrian Wilson
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Knee Osteoarthritis (OA) is a critical cause of disability globally. In recent years, there has been growing interest in non-invasive treatments, such as intra-articular injection of micro-fragmented fat (MFAT), showing great potential in treating OA. Mesenchymal stem cells (MSCs), originating from pericytes of micro-vessels in MFAT, can differentiate into mesenchymal lineage cells such as cartilage, osteocytes, adipocytes, and osteoblasts. Secretion of growth factor and cytokines from MSCs have the capability to inhibit T cell growth, reduced pain and inflammation, and create a micro-environment that through paracrine signaling, can promote joint repair and cartilage regeneration. Here we have shown, for the first time, data supporting the hypothesis that women respond better in terms of improvements in pain and function to MFAT injection compared to men. Historically, women have been underrepresented in studies, and studies with both sexes regularly fail to analyse the results by sex. To mitigate this bias and quantify it, we describe a technique using reproducible statistical analysis and replicable results with Open Access statistical software R to calculate the magnitude of this difference. Genetic, hormonal, environmental, and age factors play a role in our observed difference between the sexes. This observational, intention-to-treat study included the complete sample of 456 patients who agreed to be scored for pain (visual analogue scale (VAS)) and function (Oxford knee score (OKS)) at baseline regardless of subsequent changes to adherence or status during follow-up. We report that a significantly larger number of women responded to treatment than men: [90% vs. 60% change in VAS scores with 87% vs. 65% change in OKS scores, respectively]. Women overall had a stronger positive response to treatment with reduced pain and improved mobility and function. Pre-injection, our cohort of women were in more pain with worse joint function which is quite common to see in orthopaedics. However, during the 2-year follow-up, they consistently maintained a lower incidence of discomfort with superior joint function. This data clearly identifies a clear need for further studies to identify the cell and molecular biological and other basis for these differences and be able to utilize this information for stratification in order to improve outcome for both women and men.Keywords: gender differences, micro-fragmented adipose tissue, knee osteoarthritis, stem cells
Procedia PDF Downloads 179895 The Use of Social Stories and Digital Technology as Interventions for Autistic Children; A State-Of-The-Art Review and Qualitative Data Analysis
Authors: S. Hussain, C. Grieco, M. Brosnan
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Background and Aims: Autism is a complex neurobehavioural disorder, characterised by impairments in the development of language and communication skills. The study involved a state-of-art systematic review, in addition to qualitative data analysis, to establish the evidence for social stories as an intervention strategy for autistic children. An up-to-date review of the use of digital technologies in the delivery of interventions to autistic children was also carried out; to propose the efficacy of digital technologies and the use of social stories to improve intervention outcomes for autistic children. Methods: Two student researchers reviewed a range of randomised control trials and observational studies. The aim of the review was to establish if there was adequate evidence to justify recommending social stories to autistic patients. Students devised their own search strategies to be used across a range of search engines, including Ovid-Medline, Google Scholar and PubMed. Students then critically appraised the generated literature. Additionally, qualitative data obtained from a comprehensive online questionnaire on social stories was also thematically analysed. The thematic analysis was carried out independently by each researcher, using a ‘bottom-up’ approach, meaning contributors read and analysed responses to questions and devised semantic themes from reading the responses to a given question. The researchers then placed each response into a semantic theme or sub-theme. The students then joined to discuss the merging of their theme headings. The Inter-rater reliability (IRR) was calculated before and after theme headings were merged, giving IRR for pre- and post-discussion. Lastly, the thematic analysis was assessed by a third researcher, who is a professor of psychology and the director for the ‘Centre for Applied Autism Research’ at the University of Bath. Results: A review of the literature, as well as thematic analysis of qualitative data found supporting evidence for social story use. The thematic analysis uncovered some interesting themes from the questionnaire responses, relating to the reasons why social stories were used and the factors influencing their effectiveness in each case. However, overall, the evidence for digital technologies interventions was limited, and the literature could not prove a causal link between better intervention outcomes for autistic children and the use of technologies. However, they did offer valid proposed theories for the suitability of digital technologies for autistic children. Conclusions: Overall, the review concluded that there was adequate evidence to justify advising the use of social stories with autistic children. The role of digital technologies is clearly a fast-emerging field and appears to be a promising method of intervention for autistic children; however, it should not yet be considered an evidence-based approach. The students, using this research, developed ideas on social story interventions which aim to help autistic children.Keywords: autistic children, digital technologies, intervention, social stories
Procedia PDF Downloads 110894 Accounting for Downtime Effects in Resilience-Based Highway Network Restoration Scheduling
Authors: Zhenyu Zhang, Hsi-Hsien Wei
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Highway networks play a vital role in post-disaster recovery for disaster-damaged areas. Damaged bridges in such networks can disrupt the recovery activities by impeding the transportation of people, cargo, and reconstruction resources. Therefore, rapid restoration of damaged bridges is of paramount importance to long-term disaster recovery. In the post-disaster recovery phase, the key to restoration scheduling for a highway network is prioritization of bridge-repair tasks. Resilience is widely used as a measure of the ability to recover with which a network can return to its pre-disaster level of functionality. In practice, highways will be temporarily blocked during the downtime of bridge restoration, leading to the decrease of highway-network functionality. The failure to take downtime effects into account can lead to overestimation of network resilience. Additionally, post-disaster recovery of highway networks is generally divided into emergency bridge repair (EBR) in the response phase and long-term bridge repair (LBR) in the recovery phase, and both of EBR and LBR are different in terms of restoration objectives, restoration duration, budget, etc. Distinguish these two phases are important to precisely quantify highway network resilience and generate suitable restoration schedules for highway networks in the recovery phase. To address the above issues, this study proposes a novel resilience quantification method for the optimization of long-term bridge repair schedules (LBRS) taking into account the impact of EBR activities and restoration downtime on a highway network’s functionality. A time-dependent integer program with recursive functions is formulated for optimally scheduling LBR activities. Moreover, since uncertainty always exists in the LBRS problem, this paper extends the optimization model from the deterministic case to the stochastic case. A hybrid genetic algorithm that integrates a heuristic approach into a traditional genetic algorithm to accelerate the evolution process is developed. The proposed methods are tested using data from the 2008 Wenchuan earthquake, based on a regional highway network in Sichuan, China, consisting of 168 highway bridges on 36 highways connecting 25 cities/towns. The results show that, in this case, neglecting the bridge restoration downtime can lead to approximately 15% overestimation of highway network resilience. Moreover, accounting for the impact of EBR on network functionality can help to generate a more specific and reasonable LBRS. The theoretical and practical values are as follows. First, the proposed network recovery curve contributes to comprehensive quantification of highway network resilience by accounting for the impact of both restoration downtime and EBR activities on the recovery curves. Moreover, this study can improve the highway network resilience from the organizational dimension by providing bridge managers with optimal LBR strategies.Keywords: disaster management, highway network, long-term bridge repair schedule, resilience, restoration downtime
Procedia PDF Downloads 138893 Mealtime Talk as a Context of Learning: A Multiple Case Study of Australian Chinese Parents' Interaction with Their Preschool Aged Children at Dinner Table
Authors: Jiangbo Hu, Frances Hoyte, Haiquan Huang
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Research identifies that mealtime talk can be a significant learning context that provides children with rich experiences to foster their language and cognitive development. Middle-classed parents create an extended learning discourse for their children through sophisticated vocabulary, narrative and explanation genres at dinner table. However, mealtime opportunities vary with some parents having little interaction with their children and some parents focusing on directive of children’s behaviors. This study investigated five Chinese families’ parent-child interaction during mealtime that was rarely reported in the literature. The five families differ in terms of their living styles. Three families are from professional background where both mothers the fathers work in Australian companies and both of them present at dinner time. The other two families own business. The mothers are housemakers and the fathers are always absent at dinner time due to their busy business life. Employing case study method, the five Chinese families’ parent-child interactions at dinner table were recorded using a video camera. More than 3000 clauses were analyzed with the framework of 'systems of clause complexing' from systemic functional linguistic theory. The finding shows that mothers played a critical role in the interaction with their children by initiating most conversations. The three mothers from professional background tended to use more language in extending and expanding pattern that is beneficial for children’s language development and high level of thinking (e.g., logical thinking). The two house making mothers’ language focused more on the directive of their children’s social manners and dietary behaviors. The fathers though seemed to be less active, contributing to the richness of the conversation through their occasional props such as asking open questions or initiating a new topic. In general, the families from professional background were more advantaged in providing learning opportunities for their children at dinner table than the families running business were. The home experiences of Chinese children is an important topic in research due to the rapidly increasing number of Chinese children in Australia and other English speaking countries. Such research assist educators in the education of Chinese children with more awareness of Chinese children experiences at home that could be very unlike the settings in English schools. This study contributes to the research in this area through the analysis of language in parent-child interaction during mealtime, which is very different from previous research that mainly investigated Chinese families through survey and interview. The finding of different manners in language use between the professional families and business families has implication for the understanding of the variation of Chinese children’s home experiences that is influenced not only by parents’ socioeconomic status but their lifestyles.Keywords: Chinese children, Chinese parents, mealtime talk, parent-child interaction
Procedia PDF Downloads 227892 Development of the Food Market of the Republic of Kazakhstan in the Field of Milk Processing
Authors: Gulmira Zhakupova, Tamara Tultabayeva, Aknur Muldasheva, Assem Sagandyk
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The development of technology and production of products with increased biological value based on the use of natural food raw materials are important tasks in the policy of the food market of the Republic of Kazakhstan. For Kazakhstan, livestock farming, in particular sheep farming, is the most ancient and developed industry and way of life. The history of the Kazakh people is largely connected with this type of agricultural production, with established traditions using dairy products from sheep's milk. Therefore, the development of new technologies from sheep’s milk remains relevant. In addition, one of the most promising areas for the development of food technology for therapeutic and prophylactic purposes is sheep milk products as a source of protein, immunoglobulins, minerals, vitamins, and other biologically active compounds. This article presents the results of research on the study of milk processing technology. The objective of the study is to study the possibilities of processing sheep milk and its role in human nutrition, as well as the results of research to improve the technology of sheep milk products. The studies were carried out on the basis of sanitary and hygienic requirements for dairy products in accordance with the following test methods. To perform microbiological analysis, we used the method for identifying Salmonella bacteria (Horizontal method for identifying, counting, and serotyping Salmonella) in a certain mass or volume of product. Nutritional value is a complex of properties of food products that meet human physiological needs for energy and basic nutrients. The protein mass fraction was determined by the Kjeldahl method. This method is based on the mineralization of a milk sample with concentrated sulfuric acid in the presence of an oxidizing agent, an inert salt - potassium sulfate, and a catalyst - copper sulfate. In this case, the amino groups of the protein are converted into ammonium sulfate dissolved in sulfuric acid. The vitamin composition was determined by HPLC. To determine the content of mineral substances in the studied samples, the method of atomic absorption spectrophotometry was used. The study identified the technological parameters of sheep milk products and determined the prospects for researching sheep milk products. Microbiological studies were used to determine the safety of the study product. According to the results of the microbiological analysis, no deviations from the norm were identified. This means high safety of the products under study. In terms of nutritional value, the resulting products are high in protein. Data on the positive content of amino acids were also obtained. The results obtained will be used in the food industry and will serve as recommendations for manufacturers.Keywords: dairy, milk processing, nutrition, colostrum
Procedia PDF Downloads 42891 Post Covid-19 Scenario and Contemporary International Security Challenges
Authors: Rubina Waseem
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The research focuses on the major crises and major effects, largely unforeseen, to counter international security concerns. At the close of 2019, the Covid-19 pandemic broke out in the city of Wuhan in Hubei province, China. The coronavirus was initially seen as an inchoate danger, aimed at striking people randomly. Owing to the extraordinary transmissibility of the virus and the highly knitted nature of the international political world, the Covid-19 soon became a formidable global challenge. The once hustling and bustling avenues, city centers, and market places became deserted. Lockdown, self-isolation, hygiene and safety, social-distancing, and job losses became a new norm. The national economies gradually plunged into crisis. The pandemic has so far caused over 33 million cases and one million deaths. The virus continues to devastate social life, as there is yet no therapeutic available. While the world was preoccupied addressing the human and social toll, the pandemic has exacerbated despair, mistrust, and friction in international relations, diplomacy, and strategy. The research will discuss how the coronavirus has accelerated the trends of transition in the postwar security order constructed by the United States. China, Russia, European Union, and other lesser regional players are now increasingly changing their security orientations to undermine the United States standing and authority in world politics. The systemic level analyses will be adopted as a methodology to broaden the lens of the study, and the research will analyze the prevalent global power distribution, whether vulnerable or exposed. The trends of parochial nationalism and isolationism are increasingly replacing multilateralism and collectivism. Yet worse, military posturing is assuming a greater role in international interactions. Taken together, the pandemic has worsened the prospects of international peace and stability by mounting equal pressure across the channels of international relations, diplomacy, and strategy. It is yet unclear which country or collectivity will face the real brunt. Despite this jaded and pessimistic view, the lingering pandemic has the potential to reinforce cooperation, multilateralism, and collectivism in the realm of international politics. There is a renewed momentum for global efforts against the pandemic. States and societies are coming closer to act as a whole. Equally important, the world leaders are feeling tempted to revisit the traditional conception of national security. In this regard, they are exploring the possibility of according preference to non-traditional security issues. In essence, the research concludes that Covid-19 has put the international political system under a great trial.Keywords: covid-19, global challenges, international politics, international security
Procedia PDF Downloads 157890 Evaluation of Monoterpenes Induction in Ugni molinae Ecotypes Subjected to a Red Grape Caterpillar (Lepidoptera: Arctiidae) Herbivory
Authors: Manuel Chacon-Fuentes, Leonardo Bardehle, Marcelo Lizama, Claudio Reyes, Andres Quiroz
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The insect-plant interaction is a complex process in which the plant is able to release chemical signaling that modifies the behavior of insects. Insect herbivory can trigger mechanisms that allow the increase in the production of secondary metabolites that allow coping against the herbivores. Monoterpenes are a kind of secondary metabolites involved in direct defense acting as repellents of herbivorous or even in indirect defense acting as attractants for insect predators. In addition, an increase of the monoterpenes concentration is an effect commonly associated with the herbivory. Hence, plants subjected to damage by herbivory increase the monoterpenes production in comparison to plants without herbivory. In this framework, co-evolutionary aspects play a fundamental role in the adaptation of the herbivorous to their host and in the counter-adaptive strategies of the plants to avoid the herbivorous. In this context, Ugni molinae 'murtilla' is a native shrub from Chile characterized by its antioxidant activity mainly related to the phenolic compounds presents in its fruits. The larval stage of the red grape caterpillar Chilesia rudis Butler (Lepidoptera: Arctiidae) has been reported as an important defoliator of U. molinae. This insect is native from Chile and probably has been involved in a co-evolutionary process with murtilla. Therefore, we hypothesized that herbivory by the red grape caterpillar increases the emission of monoterpenes in Ugni molinae. Ecotypes 19-1 and 22-1 of murtilla were established and maintained at 25° C in the Laboratorio de Química Ecológica at Universidad de La Frontera. Red grape caterpillars of ⁓40 mm were collected near to Temuco (Chile) from grasses, and they were deprived of food for 24 h before performing the assays. Ten caterpillars were placed on the foliage of the ecotypes 19-1 and 22-1 and allowed to feed during 48 h. After this time, caterpillars were removed from the ecotypes and monoterpenes were collected. A glass chamber was used to enclose the ecotypes and a Porapak-Q column was used to trap the monoterpenes. After 24 h of capturing, columns were desorbed with hexane. Then, samples were injected in a gas chromatograph coupled to mass spectrometer and monoterpenes were determined according to the NIST library. All the experiments were performed in triplicate. Results showed that α-pinene, β-phellandrene, limonene, and 1,8 cineole were the main monoterpenes released by murtilla ecotypes. For the ecotype 19-1, the abundance of α-pinene was significantly higher in plants subjected to herbivory (100%) in relation to control plants (54.58%). Moreover, β-phellandrene and 1,8 cineole were observed only in control plants. For ecotype 22-1, there was no significant difference in monoterpenes abundance. In conclusion, the results suggest a trade-off of β-phellandrene and 1,8 cineole in response to herbivory damage by red grape caterpillar generating an increase in α-pinene abundance.Keywords: Chilesia rudis, gas chromatography, monoterpenes, Ugni molinae
Procedia PDF Downloads 146889 Extra Skin Removal Surgery and Its Effects: A Comprehensive Review
Authors: Rebin Mzhda Mohammed, Hoshmand Ali Hama Agha
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Excess skin, often consequential to substantial weight loss or the aging process, introduces physical discomfort, obstructs daily activities, and undermines an individual's self-esteem. As these challenges become increasingly prevalent, the need to explore viable solutions grows in significance. Extra skin removal surgery, colloquially known as body contouring surgery, has emerged as a compelling intervention to ameliorate the physical and psychological burdens of excess skin. This study undertakes a comprehensive review to illuminate the intricacies of extra skin removal surgery, encompassing its diverse procedures, associated risks, benefits, and psychological implications on patients. The methodological approach adopted involves a systematic and exhaustive review of pertinent scholarly literature sourced from reputable databases, including PubMed, Google Scholar, and specialized cosmetic surgery journals. Articles are meticulously curated based on their relevance, credibility, and recency. Subsequently, data from these sources are synthesized and categorized, facilitating a comprehensive understanding of the subject matter. Qualitative analysis serves to unravel the nuanced psychological effects, while quantitative data, where available, are harnessed to underpin the study's conclusions. In terms of major findings, the research underscores the manifold advantages of extra skin removal surgery. Patients experience a notable improvement in physical comfort, amplified mobility, enhanced self-confidence, and a newfound ability to don clothing comfortably. Nonetheless, the benefits are juxtaposed with potential risks, encompassing infection, scarring, hematoma, delayed healing, and the challenge of achieving symmetry. A salient discovery is the profound psychological impact of the surgery, as patients consistently report elevated body image satisfaction, heightened self-esteem, and a substantial enhancement in overall quality of life. In summation, this research accentuates the pivotal role of extra skin removal surgery in ameliorating the intricate interplay of physical and psychological difficulties posed by excess skin. By elucidating the diverse procedures, associated risks, and psychological outcomes, the study contributes to a comprehensive and informed comprehension of the surgery's multifaceted effects. Therefore, individuals contemplating this transformative surgical option are equipped with comprehensive insights, ultimately fostering informed decision-making, guided by the expertise of medical professionals.Keywords: extra skin removal surgery, body contouring, abdominoplasty, brachioplasty, thigh lift, body lift, benefits, risks, psychological effects
Procedia PDF Downloads 61888 Extracting an Experimental Relation between SMD, Mass Flow Rate, Velocity and Pressure in Swirl Fuel Atomizers
Authors: Mohammad Hassan Ziraksaz
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Fuel atomizers are used in a wide range of IC engines, turbojets and a variety of liquid propellant rocket engines. As the fuel spray fully develops its characters approach their ultimate amounts. Fuel spray characters such as SMD, injection pressure, mass flow rate, droplet velocity and spray cone angle play important roles to atomize the liquid fuel to finely atomized fuel droplets and finally form the fine fuel spray. Well performed, fully developed, fine spray without any defections, brings the idea of finding an experimental relation between the main effective spray characters. Extracting an experimental relation between SMD and other fuel spray physical characters in swirl fuel atomizers is the main scope of this experimental work. Droplet velocity, fuel mass flow rate, SMD and spray cone angle are the parameters which are measured. A set of twelve reverse engineering atomizers without any spray defections and a set of eight original atomizers as referenced well-performed spray are contributed in this work. More than 350 tests, mostly repeated, were performed. This work shows that although spray cone angle plays a very effective role in spray formation, after formation, it smoothly approaches to an almost constant amount while the other characters are changed to create fine droplets. Therefore, the work to find the relation between the characters is focused on SMD, droplet velocity, fuel mass flow rate, and injection pressure. The process of fuel spray formation begins in 5 Psig injection pressures, where a tiny fuel onion attaches to the injector tip and ended in 250 Psig injection pressure, were fully developed fine fuel spray forms. Injection pressure is gradually increased to observe how the spray forms. In each step, all parameters are measured and recorded carefully to provide a data bank. Various diagrams have been drawn to study the behavior of the parameters in more detail. Experiments and graphs show that the power equation can best show changes in parameters. The SMD experimental relation with pressure P, fuel mass flow rate Q ̇ and droplet velocity V extracted individually in pairs. Therefore, the proportional relation of SMD with other parameters is founded. Now it is time to find an experimental relation including all the parameters. Using obtained proportional relation, replacing the parameters with experimentally measured ones and drawing the graphs of experimental SMD versus proportion SMD (〖SMD〗_P), a correctional equation and consequently the final experimental equation is obtained. This experimental equation is specified to use for swirl fuel atomizers and the use of this experimental equation in different conditions shows about 3% error, which is expected to achieve lower error and consequently higher accuracy by increasing the number of experiments and increasing the accuracy of data collection.Keywords: droplet velocity, experimental relation, mass flow rate, SMD, swirl fuel atomizer
Procedia PDF Downloads 154887 Analyzing Social Media Discourses of Domestic Violence in Promoting Awareness and Support Seeking: An Exploratory Study
Authors: Sudha Subramani, Hua Wang
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Domestic Violence (DV) against women is now recognized to be a serious and widespread problem worldwide. There is a growing concern that violence against women has a global public health impact, as well as a violation of human rights. From the existing statistical surveys, it is revealed that there exists a strong relationship between DV and health issues of women like bruising, lacerations, depression, anxiety, flashbacks, sleep disturbances, hyper-arousal, emotional distress, sexually transmitted diseases and so on. This social problem is still considered as behind the closed doors issue and stigmatized topic. Women conceal their sufferings from family and friends, as they experience a lack of trust in others, feelings of shame and embarrassment among the society. Hence, women survivors of DV experience some barriers in seeking the support of specialized services such as health care access, crisis support, and legal guidance. Fortunately, with the popularity of social media like Facebook and Twitter, people share their opinions and emotional feelings to seek the social and emotional support, for sympathetic encouragement, to show compassion and empathy among the public. Considering the DV, social media plays a predominant role in creating the awareness and promoting the support services to the public, as we live in the golden era of social media. The various professional people like the public health researchers, clinicians, psychologists, social workers, national family health organizations, lawyers, and victims or their family and friends share the unprecedentedly valuable information (personal opinions and experiences) in a single platform to improve the social welfare of the community. Though each tweet or post contains a less informational value, the consolidation of millions of messages can generate actionable knowledge and provide valuable insights about the public opinion in general. Hence, this paper reports on an exploratory analysis of the effectiveness of social media for unobtrusive assessment of attitudes and awareness towards DV. In this paper, mixed methods such as qualitative analysis and text mining approaches are used to understand the social media disclosures of DV through the lenses of opinion sharing, anonymity, and support seeking. The results of this study could be helpful to avoid the cost of wide scale surveys, while still maintaining appropriate research conditions is to leverage the abundance of data publicly available on the web. Also, this analysis with data enrichment and consolidation would be useful in assisting advocacy and national family health organizations to provide information about resources and support, raise awareness and counter common stigmatizing attitudes about DV.Keywords: domestic violence, social media, social stigma and support, women health
Procedia PDF Downloads 276886 Research on the Updating Strategy of Public Space in Small Towns in Zhejiang Province under the Background of New-Style Urbanization
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Small towns are the most basic administrative institutions in our country, which are connected with cities and rural areas. Small towns play an important role in promoting local urban and rural economic development, providing the main public services and maintaining social stability in social governance. With the vigorous development of small towns and the transformation of industrial structure, the changes of social structure, spatial structure, and lifestyle are lagging behind, causing that the spatial form and landscape style do not belong to both cities and rural areas, and seriously affecting the quality of people’s life space and environment. The rural economy in Zhejiang Province has started, the society and the population are also developing in relative stability. In September 2016, Zhejiang Province set out the 'Technical Guidelines for Comprehensive Environmental Remediation of Small Towns in Zhejiang Province,' so as to comprehensively implement the small town comprehensive environmental remediation with the main content of strengthening the plan and design leading, regulating environmental sanitation, urban order and town appearance. In November 2016, Huzhou City started the comprehensive environmental improvement of small towns, strived to use three years to significantly improve the 115 small towns, as well as to create a number of high quality, distinctive and beautiful towns with features of 'clean and livable, rational layout, industrial development, poetry and painting style'. This paper takes Meixi Town, Zhangwu Town and Sanchuan Village in Huzhou City as the empirical cases, analyzes the small town public space by applying the relative theory of actor-network and space syntax. This paper also analyzes the spatial composition in actor and social structure elements, as well as explores the relationship of actor’s spatial practice and public open space by combining with actor-network theory. This paper introduces the relevant theories and methods of spatial syntax, carries out research analysis and design planning analysis of small town spaces from the perspective of quantitative analysis. And then, this paper proposes the effective updating strategy for the existing problems in public space. Through the planning and design in the building level, the dissonant factors produced by various spatial combination of factors and between landscape design and urban texture during small town development will be solved, inhabitant quality of life will be promoted, and town development vitality will be increased.Keywords: small towns, urbanization, public space, updating
Procedia PDF Downloads 221885 Research Insights into Making the Premises Spiritually Pure
Authors: Jayant Athavale, Rendy Ekarantio, Sean Clarke
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The Maharshi University of Spirituality was founded on the base of 30 years of spiritual research. It specializes in conducting research on how the subtle-world and spiritual-vibrations affect the lives of people. One such area of research is how to create spiritually positive vibrations in the premises. By using aura and energy scanners along with the sixth sense, the spiritual research team has identified 3 aspects that are instrumental in enhancing or reducing the spiritual positivity of any premises. Firstly, the characteristics of the land should be considered holistically, that is, from a physical, psychological and spiritual point of view. While procedures for the physical assessment of land are well documented, due to ignorance and disbelief, the spiritual aspects are not considered. For example, if the land was previously a graveyard site, it can have highly detrimental effects on the residents within the premises at the spiritual level. This can further manifest as physical and psychological problems that are faced by the residents. Secondly, the manner of construction and the purpose/use of the building affects the subtle-vibrations in the premises. The manner of construction includes gross aspects such as the materials used, kind of architecture, etc. It also includes the subtle aspects provided in detail in the ancient science of Vastu Shastra and Feng Shui. For example, having the front door of the premises facing the south direction can negatively affect the premises because the southern direction is prone to distressing vibrations. The purpose and use of the premises also plays an important role in determining the type of subtle-vibrations that will be predominantly found within its area. Thirdly, the actions, thoughts, value systems and attitudes of the residents play an important part in determining whether the subtle-vibrations will be positive or negative. Residents with many personality defects emit negative vibrations. If some of the residents are affected with negative energies and are not doing any spiritual practice to overcome it, then it can have a harmful spiritual effect on the rest of the residents and the premises. If these three aspects are appropriately considered and attended to, then the premises will generate higher levels of spiritually positive vibrations. Both living and non-living objects within the premises imbibe this positivity and therefore, it holistically enhances the overall well-being of its residents. The positivity experienced in the premises of the Spiritual Research Centre of the Maharshi University of Spirituality, is a testimony to the success of this research. Due to regular and intense spiritual practice carried out by 10 Saints and over 500 seekers residing in its premises, the positivity in the environment can be felt by people when they enter its premises and even from a distance, and can easily be picked up by aura and energy scanners. Extraordinary and fascinating phenomena are observed and experienced in its premises as both living and non-living objects emit spiritually positive vibrations. This also protects the residents from negative vibrations. Examples of such phenomena and their positive impact are discussed in the paper.Keywords: negative energies, positive vibrations on the premises, resident’s spiritual practice, science of the premises
Procedia PDF Downloads 140884 Goal-Setting in a Peer Leader HIV Prevention Intervention to Improve Preexposure Prophylaxis Access among Black Men Who Have Sex with Men
Authors: Tim J. Walsh, Lindsay E. Young, John A. Schneider
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Background: The disproportionate rate of HIV infection among Black men who have sex with men (BMSM) in the United States suggest the importance of Preexposure Prophylaxis (PrEP) interventions for this population. As such, there is an urgent need for innovative outreach strategies that extend beyond the traditional patient-provider relationship to reach at-risk populations. Training members of the BMSM community as peer change agents (PCAs) is one such strategy. An important piece of this training is goal-setting. Goal-setting not only encourages PCAs to define the parameters of the intervention according to their lived experience, it also helps them plan courses of action. Therefore, the aims of this mixed methods study are: (1) Characterize the goals that BMSM set at the end of their PrEP training and (2) Assess the relationship between goal types and PCA engagement. Methods: Between March 2016 and July 2016, preliminary data were collected from 68 BMSM, ages 18-33, in Chicago as part of an ongoing PrEP intervention. Once enrolled, PCAs participate in a half-day training in which they learn about PrEP, practice initiating conversations about PrEP, and identify strategies for supporting at-risk peers through the PrEP adoption process. Training culminates with a goal-setting exercise, whereby participants establish a goal related to their role as a PCA. Goals were coded for features that either emerged from the data itself or existed in extant goal-setting literature. The main outcomes were (1) number of PrEP conversations PCAs self-report during booster conversations two weeks following the intervention and (2) number of peers PCAs recruit into the study that completed the PrEP workshop. Results: PCA goals (N=68) were characterized in terms of four features: Specificity, target population, personalization, and purpose defined. To date, PCAs report a collective 52 PrEP conversations. 56, 25, and 6% of PrEP conversations occurred with friends, family, and sexual partners, respectively. PCAs with specific goals had more PrEP conversations with at-risk peers compared to those with vague goals (58% vs. 42%); PCAs with personalized goals had more PrEP conversations compared to those with de-personalized goals (60% vs. 53%); and PCAs with goals that defined a purpose had more PrEP conversations compared to those who did not define a purpose (75% vs. 52%). 100% of PCAs with goals that defined a purpose recruited peers into the study compared to 45 percent of PCAs with goals that did not define a purpose. Conclusion: Our preliminary analysis demonstrates that BMSM are motivated to set and work toward a diverse set of goals to support peers in PrEP adoption. PCAs with goals involving a clearly defined purpose had more PrEP conversations and greater peer recruitment than those with goals lacking a defined purpose. This may indicate that PCAs who define their purpose at the outset of their participation will be more engaged in the study than those who do not. Goal-setting may be considered as a component of future HIV prevention interventions to advance intervention goals and as an indicator of PCAs understanding of the intervention.Keywords: HIV prevention, MSM, peer change agent, preexposure prophylaxis
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