Search results for: biological treatment

Authors: Moletsane Makgotso, Mogakabe Elijah, Marrengane Zinhle

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South Africa’s water resources quality is becoming more and more weakened by eutrophication, which deteriorates its usability. Thirty five percent of fresh water resources are eutrophic to hypertrophic, including grossly-enriched reservoirs that go beyond the globally-accepted definition of hypertrophy. Failing infrastructure adds to the problem of contaminated urban runoff which encompasses an important fraction of flows to inland reservoirs, particularly in the non-coastal, economic heartland of the country. Eutrophication threatens the provision of potable and irrigation water in the country because of the dependence on fresh water resources. Eutrophicated water reservoirs increase water treatment costs, leads to unsuitability for recreational purposes and health risks to human and animal livelihood due to algal proliferation. Eutrophication is caused by high concentrations of phosphorus and nitrogen in water bodies. In South Africa, Microsystis and Anabaena are widely distributed cyanobacteria, with Microcystis being the most dominant bloom-forming cyanobacterial species associated with toxin production. Two impoundments were selected, namely the Klipvoor and Leeukraal dams as they are mainly used for fishing, recreational, agricultural and to some extent, potable water purposes. The total oxidized nitrogen and total phosphorus concentration were determined as causative nutrients for eutrophication. Chlorophyll a and total microcystins, as well as the identification of cyanobacteria was conducted as indicators of cyanobacterial infestation. The orthophosphate concentration was determined by subjecting the samples to digestion and filtration followed by spectrophotometric analysis of total phosphates and dissolved phosphates using Aquakem kits. The total oxidized nitrates analysis was conducted by initially conducting filtration followed by spectrophotometric analysis. Chlorophyll a was quantified spectrophotometrically by measuring the absorbance of before and after acidification. Microcystins were detected using the Quantiplate Microcystin Kit, as well as microscopic identification of cyanobacterial species. The Klipvoor dam was found to be hypertrophic throughout the study period as the mean Chlorophyll a concentration was 269.4µg/l which exceeds the mean value for the hypertrophic state. The mean Total Phosphorus concentration was >0.130mg/l, and the total microcystin concentration was > 2.5µg/l throughout the study. The most predominant algal species were found to be the Microcystis. The Leeukraal dam was found to be mesotrophic with the potential of it becoming eutrophic as the mean concentration for chlorophyll a was 18.49 µg/l with the mean Total Phosphorus > 0.130mg/l and the Total Microcystin concentration < 0.16µg/l. The cyanobacterial species identified in Leeukraal have been classified as those that do not pose a potential risk to any impoundment. Microcystis was present throughout the sampling period and dominant during the warmer seasons. The high nutrient concentrations led to the dominance of Microcystis that resulted in high levels of microcystins rendering the impoundments, particularly Klipvoor undesirable for utilisation.

Keywords: nitrogen, phosphorus, cyanobacteria, microcystins

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Authors: Eva Masson, Andrea Kübler

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Anxiety disorders (AD) are the most prevalent psychological disorders. However, far from most affected individuals are diagnosed and receive treatment. This gap is probably due to the diagnosis criteria, relying on symptoms (according to the DSM-5 definition) with no objective biomarker. Approach-avoidance conflict tasks are one common approach to simulate such disorders in a lab setting, with most of the paradigms focusing on the relationships between behavior and neurophysiology. Approach-avoidance conflict tasks typically place participants in a situation where they have to make a decision that leads to both positive and negative outcomes, thereby sending conflicting signals that trigger the Behavioral Inhibition System (BIS). Furthermore, behavioral validation of such paradigms adds credibility to the tasks – with overt conflict behavior, it is safer to assume that the task actually induced a conflict. Some of those tasks have linked asymmetrical frontal brain activity to induced conflicts and the BIS. However, there is currently no consensus for the direction of the frontal activation. The authors present here a modified version of the T-Maze paradigm, a motivational conflict desktop task, in which behavior is recorded simultaneously to the recording of high-density EEG (HD-EEG). Methods: In this within-subject design, HD-EEG and behavior of 35 healthy participants was recorded. EEG data was collected with a 128 channels sponge-based system. The motivational conflict desktop task consisted of three blocks of repeated trials. Each block was designed to record a slightly different behavioral pattern, to increase the chances of eliciting conflict. This variety of behavioral patterns was however similar enough to allow comparison of the number of trials categorized as ‘overt conflict’ between the blocks. Results: Overt conflict behavior was exhibited in all blocks, but always for under 10% of the trials, in average, in each block. However, changing the order of the paradigms successfully introduced a ‘reset’ of the conflict process, therefore providing more trials for analysis. As for the EEG correlates, the authors expect a different pattern for trials categorized as conflict, compared to the other ones. More specifically, we expect an elevated alpha frequency power in the left frontal electrodes at around 200ms post-cueing, compared to the right one (relative higher right frontal activity), followed by an inversion around 600ms later. Conclusion: With this comprehensive approach of a psychological mechanism, new evidence would be brought to the frontal asymmetry discussion, and its relationship with the BIS. Furthermore, with the present task focusing on a very particular type of motivational approach-avoidance conflict, it would open the door to further variations of the paradigm to introduce different kinds of conflicts involved in AD. Even though its application as a potential biomarker sounds difficult, because of the individual reliability of both the task and peak frequency in the alpha range, we hope to open the discussion for task robustness for neuromodulation and neurofeedback future applications.

Keywords: anxiety, approach-avoidance conflict, behavioral inhibition system, EEG

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Authors: Sijie Chen, Xiaofang Chen, Juan Wang, Yingying Zhang, Yu Hong, Wanyu Zhuang, Xinxin Huang, Ping Ou, Longsheng Huang

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Purpose: Autistic symptom improvement can be observed in children treated with acupuncture, but the mechanism is still being explored. In the present study, we used scalp acupuncture to treat autism rat model, and then their improvement in the abnormal behaviors and specific mechanisms behind were revealed by detecting animal behaviors, analyzing the RNA sequencing of the prefrontal cortex(PFC), and observing the ultrastructure of PFC neurons under the transmission electron microscope. Methods: On gestational day 12.5, Wistar rats were given valproic acid (VPA) by intraperitoneal injection, and their offspring were considered to be reliable rat models of autism. They were randomized to VPA or VPA-acupuncture group (n=8). Offspring of Wistar pregnant rats that were simultaneously injected with saline were randomly selected as the wild-type group (WT). VPA_acupuncture group rats received acupuncture intervention at 23 days of age for 4 weeks, and the other two groups followed without intervention. After the intervention, all experimental rats underwent behavioral tests. Immediately afterward, they were euthanized by cervical dislocation, and their prefrontal cortex was isolated for RNA sequencing and transmission electron microscopy. Results: The main results are as follows: 1. Animal behavioural tests: VPA group rats showed more anxiety-like behaviour and repetitive, stereotyped behaviour than WT group rats. While VPA group rats showed less spatial exploration ability, activity level, social interaction, and social novelty preference than WT group rats. It was gratifying to observe that acupuncture indeed improved these abnormal behaviors of autism rat model. 2. RNA-sequencing: The three groups of rats differed in the expression and enrichment pathways of multiple genes related to synaptic function, neural signal transduction, and circadian rhythm regulation. Our experiments indicated that acupuncture can alleviate the major symptoms of ASD by improving these neurological abnormalities. 3. Under the transmission electron microscopy, several lysosomes and mitochondrial structural abnormalities were observed in the prefrontal neurons of VPA group rats, which were manifested as atrophy of the mitochondrial membran, blurring or disappearance of the mitochondrial cristae, and even vacuolization. Moreover, the number of synapses and synaptic vesicles was relatively small. Conversely, the mitochondrial structure of rats in the WT group and VPA_acupuncture was normal, and the number of synapses and synaptic vesicles was relatively large. Conclusion: Acupuncture effectively improved the abnormal behaviors of autism rat model and the ultrastructure of the PFC neurons, which might worked by improving their abnormal synaptic function, synaptic plasticity and promoting neuronal signal transduction.

Keywords: autism spectrum disorder, acupuncture, animal behavior, RNA sequencing, transmission electron microscope

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Authors: Kai-Cheng Yang, Yen-Ling Chen, Er-Chieh Cho, Kuen-Chan Lee

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Titanium dioxide nanomaterials offer superior protection for human skin against the full spectrum of ultraviolet light. However, some literature reviews indicated that it might be associated with adverse effects such as cytotoxicity or reactive oxygen species (ROS) due to their nanoscale. The surface of fullerene is covered with π electrons constituting aromatic structures, which can effectively scavenge large amount of radicals. Unfortunately, fullerenes are poor solubility in water, severe aggregation, and toxicity in biological applications when dispersed in solvent have imposed the limitations to the use of fullerenes. Carboxyfullerene acts as the scavenger of radicals for several years. Some reports indicate that carboxyfullerene not only decrease the concentration of free radicals in ambience but also prevent cells from reducing the number or apoptosis under UV irradiation. The aim of this study is to decorate fullerene –C70-carboxylic acid (C70-COOH) on the surface of titanium dioxide nanoparticles (P25) for the purpose of scavenging ROS during the irradiation. The modified material is prepared through the esterification of C70-COOH with P25 (P25/C70-COOH). The binding edge and structure are studied by using Transmission electron microscope (TEM) and Fourier transform infrared (FTIR). The diameter of P25 is about 30 nm and C70-COOH is found to be conjugated on the edge of P25 in aggregation morphology with the size of ca. 100 nm. In the next step, the FTIR was used to confirm the binding structure between P25 and C70-COOH. There are two new peaks are shown at 1427 and 1720 cm-1 for P25/C70-COOH, resulting from the C–C stretch and C=O stretch formed during esterification with dilute sulfuric acid. The IR results further confirm the chemically bonded interaction between C70-COOH and P25. In order to provide the evidence of scavenging radical ability of P25/C70-COOH, we chose pyridoxine (Vit.B6) and terephthalic acid (TA) to react with singlet oxygen and hydroxyl radicals. We utilized these chemicals to observe the radicals scavenging statement via detecting the intensity of ultraviolet adsorption or fluorescence emission. The UV spectra are measured by using different concentration of C70-COOH modified P25 with 1mM pyridoxine under UV irradiation for various duration times. The results revealed that the concentration of pyridoxine was increased when cooperating with P25/C70-COOH after three hours as compared with control (only P25). It indicates fewer radicals could be reacted with pyridoxine because of the absorption via P25/C70-COOH. The fluorescence spectra are observed by measuring P25/C70-COOH with 1mM terephthalic acid under UV irradiation for various duration times. The fluorescence intensity of TAOH was decreased in ten minutes when cooperating with P25/C70-COOH. Here, it was found that the fluorescence intensity was increased after thirty minutes, which could be attributed to the saturation of C70-COOH in the absorption of radicals. However, the results showed that the modified P25/C70-COOH could reduce the radicals in the environment. Therefore, we expect that P25/C70-COOH is a potential materials in using for antioxidant.

Keywords: titanium dioxide, fullerene, radical scavenging activity, antioxidant

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Authors: Krishmali N. Ekanayake, Brendan J. Holland, Colin J. Barrow, Rick Wood

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Globally, more than one-third of all food produced is lost or wasted, equating to 1.3 billion tonnes per year. Around 31.2 million tonnes of food waste are generated across the production, supply, and consumption chain in Australia. Generally, the food waste management processes adopt environmental-friendly and more sustainable approaches such as composting, anerobic digestion and energy implemented technologies. However, unavoidable, and non-recyclable food waste ends up as landfilling and incineration that involve many undesirable impacts and challenges on the environment. A biorefinery approach contributes to a waste-minimising circular economy by converting food and other organic biomass waste into valuable outputs, including feeds, nutrition, fertilisers, and biomaterials. As a solution, Green Eco Technologies has developed a food waste treatment process using WasteMaster system. The system uses charged oxygen and moderate temperatures to convert food waste, without bacteria, additives, or water, into a virtually odour-free, much reduced quantity of reusable residual material. In the context of a biorefinery, the WasteMaster dries and mills food waste into a form suitable for storage or downstream extraction/separation/concentration to create products. The focus of the study is to determine the nutritional composition of WasteMaster processed residue to potential develop aquafeed ingredients. The global aquafeed industry is projected to reach a high value market in future, which has shown high demand for the aquafeed products. Therefore, food waste can be utilized for aquaculture feed development by reducing landfill. This framework will lessen the requirement of raw crops cultivation for aquafeed development and reduce the aquaculture footprint. In the present study, the nutritional elements of processed residue are consistent with the input food waste type, which has shown that the WasteMaster is not affecting the expected nutritional distribution. The macronutrient retention values of protein, lipid, and nitrogen free extract (NFE) are detected >85%, >80%, and >95% respectively. The sensitive food components including omega 3 and omega 6 fatty acids, amino acids, and phenolic compounds have been found intact in each residue material. Preliminary analysis suggests a price comparability with current aquafeed ingredient cost making the economic feasibility. The results suggest high potentiality of aquafeed development as 5 to 10% of the ingredients to replace/partially substitute other less sustainable ingredients across biorefinery setting. Our aim is to improve the sustainability of aquaculture and reduce the environmental impacts of food waste.

Keywords: biorefinery, ffood waste residue, input, wasteMaster

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Authors: Sergey Nikitenko, Vladimir Klishin, Yury Malakhov, Elena Goosen

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Transition to renewable energy sources (solar, wind, bioenergy, etc.) and launching of alternative energy generation has weakened the role of coal as a source of energy. The Paris Agreement and assumption of obligations by many nations to orderly reduce CO₂ emissions by means of technological modernization and climate change adaptation has abridged coal demand yet more. This paper aims to assess current resilience of the coal industry to stress and to define prospects for coal production optimization using high technologies pursuant to global challenges and requirements of energy transition. Our research is based on the resilience concept adapted to the coal industry. It is proposed to divide the coal sector into segments depending on the prevailing value chains (VC). Four representative models of VC are identified in the coal sector. The most promising lines of upgrading VC in the coal industry include: •Elongation of VC owing to introduction of clean technologies of coal conversion and utilization; •Creation of parallel VC by means of waste management; •Branching of VC (conversion of a company’s VC into a production network). The upgrade effectiveness is governed in many ways by applicability of advanced coal processing technologies, usability of waste, expandability of production, entrance to non-rival markets and localization of new segments of VC in receiving regions. It is also important that upgrade of VC by means of formation of agile high-tech inter-industry production networks within the framework of operating surface and underground mines can reduce social, economic and ecological risks associated with closure of coal mines. Such promising route of VC upgrade is application of methanotrophic bacteria to produce protein to be used as feed-stuff in fish, poultry and cattle breeding, or in production of ferments, lipoids, sterols, antioxidants, pigments and polysaccharides. Closed mines can use recovered methane as a clean energy source. There exist methods of methane utilization from uncontrollable sources, including preliminary treatment and recovery of methane from air-and-methane mixture, or decomposition of methane to hydrogen and acetylene. Separated hydrogen is used in hydrogen fuel cells to generate power to feed the process of methane utilization and to supply external consumers. Despite the recent paradigm of carbon-free energy generation, it is possible to preserve the coal mining industry using the differentiated approach to upgrade of value chains based on flexible technologies with regard to specificity of mining companies.

Keywords: resilience, resilience concept, resilience indicator, resilience in the Russian coal industry, value chains

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Authors: Mareike Dornhoefer, Madjid Fathi

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Water supply and water quality are key problems of mankind at the moment and - due to increasing population - in the future. Management disciplines like water, environment and quality management therefore need to closely interact, to establish a high level of water quality and to guarantee water supply in all parts of the world. Groundwater remediation is one aspect in this process. From a knowledge management perspective it is only possible to solve complex ecological or environmental problems if different factors, expert knowledge of various stakeholders and formal regulations regarding water, waste or chemical management are interconnected in form of a knowledge base. In general knowledge management focuses the processes of gathering and representing existing and new knowledge in a way, which allows for inference or deduction of knowledge for e.g. a situation where a problem solution or decision support are required. A knowledge base is no sole data repository, but a key element in a knowledge based system, thus providing or allowing for inference mechanisms to deduct further knowledge from existing facts. In consequence this knowledge provides decision support. The given paper introduces an environmental knowledge system in water management. The proposed environmental knowledge system is part of a research concept called Green Knowledge Management. It applies semantic technologies or concepts such as ontology or linked open data to interconnect different data and information sources about environmental aspects, in this case, water quality, as well as background material enriching an established knowledge base. Examples for the aforementioned ecological or environmental factors threatening water quality are among others industrial pollution (e.g. leakage of chemicals), environmental changes (e.g. rise in temperature) or floods, where all kinds of waste are merged and transferred into natural water environments. Water quality is usually determined with the help of measuring different indicators (e.g. chemical or biological), which are gathered with the help of laboratory testing, continuous monitoring equipment or other measuring processes. During all of these processes data are gathered and stored in different databases. Meanwhile the knowledge base needs to be established through interconnecting data of these different data sources and enriching its semantics. Experts may add their knowledge or experiences of previous incidents or influencing factors. In consequence querying or inference mechanisms are applied for the deduction of coherence between indicators, predictive developments or environmental threats. Relevant processes or steps of action may be modeled in form of a rule based approach. Overall the environmental knowledge system supports the interconnection of information and adding semantics to create environmental knowledge about water environment, supply chain as well as quality. The proposed concept itself is a holistic approach, which links to associated disciplines like environmental and quality management. Quality indicators and quality management steps need to be considered e.g. for the process and inference layers of the environmental knowledge system, thus integrating the aforementioned management disciplines in one water management application.

Keywords: water quality, environmental knowledge system, green knowledge management, semantic technologies, quality management

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Authors: M. Soleimani, D. Cree, C. Chafe, L. Bates

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The accidental release of petroleum products into the environment could have harmful consequences to our ecosystem. Different techniques such as mechanical separation, membrane filtration, incineration, treatment processes using enzymes and dispersants, bioremediation, and sorption process using sorbents have been applied for oil spill remediation. Most of the techniques investigated are too costly or do not have high enough efficiency. This study was conducted to determine the sorption performance of hemp byproducts (cellulosic materials) in terms of sorption capacity and kinetics for hydrophobic and hydrophilic fluids. In this study, heavy oil, light oil, diesel fuel, and water/water vapor were used as sorbate fluids. Hemp stalk in different forms, including loose material (hammer milled (HM) and shredded (Sh) with low bulk densities) and densified forms (pellet form (P) and crumbled pellets (CP)) with high bulk densities, were used as sorbents. The sorption/retention tests were conducted according to ASTM 726 standard. For a quick-purpose application of the sorbents, the sorption tests were conducted for 15 min, and for an ideal sorption capacity of the materials, the tests were carried out for 24 h. During the test, the sorbent material was exposed to the fluid by immersion, followed by filtration through a stainless-steel wire screen. Water vapor adsorption was carried out in a controlled environment chamber with the capability of controlling relative humidity (RH) and temperature. To determine the kinetics of sorption for each fluid and sorbent, the retention capacity also was determined intervalley for up to 24 h. To analyze the kinetics of sorption, pseudo-first-order, pseudo-second order and intraparticle diffusion models were employed with the objective of minimal deviation of the experimental results from the models. The results indicated that HM and Sh materials had the highest sorption capacity for the hydrophobic fluids with approximately 6 times compared to P and CP materials. For example, average retention values of heavy oil on HM and Sh was 560% and 470% of the mass of the sorbents, respectively. Whereas, the retention of heavy oil on P and CP was up to 85% of the mass of the sorbents. This lower sorption capacity for P and CP can be due to the less exposed surface area of these materials and compacted voids or capillary tubes in the structures. For water uptake application, HM and Sh resulted in at least 40% higher sorption capacity compared to those obtained for P and CP. On average, the performance of sorbate uptake from high to low was as follows: water, heavy oil, light oil, diesel fuel. The kinetic analysis indicated that the second-pseudo order model can describe the sorption process of the oil and diesel better than other models. However, the kinetics of water absorption was better described by the pseudo-first-order model. Acetylation of HM materials could improve its oil and diesel sorption to some extent. Water vapor adsorption of hemp fiber was a function of temperature and RH, and among the models studied, the modified Oswin model was the best model in describing this phenomenon.

Keywords: environment, fiber, petroleum, sorption

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Authors: Magdalena Wilk-Kozubek, Magdalena Rowińska, Krzysztof Rola, Joanna Cybińska

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Leuco dye-based thermochromic systems are classified as intelligent materials because they exhibit thermally induced color changes. Thanks to this feature, they are mainly used as temperature sensors in many industrial sectors. For example, placing a thermochromic material on a chemical reactor may warn about exceeding the maximum permitted temperature for a chemical process. Usually two components, a color former and a developer are needed to produce a system with irreversible color change. The color former is an electron donating (proton accepting) compound such as fluoran leuco dye. The developer is an electron accepting (proton donating) compound such as organic carboxylic acid. When the developer melts, the color former - developer complex is created and the termochromic system becomes colored. Typically, the melting point of the applied developer determines the temperature at which the color change occurs. When the lactone ring of the color former is closed, then the dye is in its colorless state. The ring opening, induced by the addition of a proton, causes the dye to turn into its colored state. Since the color former and the developer are often solid, they can be incorporated into polymer films to facilitate their practical use in industry. The objective of this research was to fabricate a leuco dye-based termochromic system that will irreversibly change color after reaching the temperature of 100°C. For this purpose, benzofluoran leuco dye (as color former) and phenoxyacetic acid (as developer with a melting point of 100°C) were introduced into the polymer films during the drop casting process. The film preparation process was optimized in order to obtain thin films with appropriate properties such as transparency, flexibility and homogeneity. Among the optimized factors were the concentration of benzofluoran leuco dye and phenoxyacetic acid, the type, average molecular weight and concentration of the polymer, and the type and concentration of the surfactant. The selected films, containing benzofluoran leuco dye and phenoxyacetic acid, were combined by mild heat treatment. Structural characterization of single and combined films was carried out by FTIR spectroscopy, morphological analysis was performed by optical microscopy and SEM, phase transitions were examined by DSC, color changes were investigated by digital photography and UV-Vis spectroscopy, while emission changes were studied by photoluminescence spectroscopy. The resulting thermochromic system is colorless at room temperature, but after reaching 100°C the developer melts and it turns irreversibly pink. Therefore, it could be used as an additional sensor to warn against boiling of water in power plants using water cooling. Currently used electronic temperature indicators are prone to faults and unwanted third-party actions. The sensor constructed in this work is transparent, thanks to which it can be unnoticed by an outsider and constitute a reliable reference for the person responsible for the apparatus.

Keywords: color developer, leuco dye, thin film, thermochromism

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Authors: Huang Wei-Yi

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Objective: This article explores the intensive care nursing experience of a terminal lung cancer patient who received palliative care after tracheal intubation. The patient was nearing death, and the family experienced sadness and grief as they faced the patient’s deteriorating condition and impending death. Methods: The patient was diagnosed with lung cancer in 2018 and received chemotherapy and radiation therapy with regular outpatient follow-ups. Due to brain metastasis and recent poor pain control and treatment outcomes, the patient was admitted to the intensive care unit (ICU), where the tracheal tube was removed, and palliative care was initiated. During the care period, a holistic assessment was conducted, addressing the physical, psychological, social, and spiritual aspects of care. Medical records were reviewed, interviews and family meetings were held, and a comprehensive assessment was carried out by the critical care team in collaboration with the palliative care team. The primary nursing issues identified included pain, ineffective breathing patterns, fear of death, and altered tissue perfusion. Results: Throughout the care process, the palliative care nurse, along with the family, utilized listening, caring, companionship, pain management, essential oil massage, distraction, and comfortable positioning to alleviate the patient’s pain and breathing difficulties. The use of Morphine 6mg in 0.9% N/S 50ml IV drip q6h reduced the FLACC pain score from 6 to 3. The patient’s respiratory rate improved from 28 breaths/min to 18-22 breaths/min, and sleep duration increased from 4 to 7 uninterrupted hours. The holistic palliative care approach, coupled with the involvement of the palliative care team, facilitated expressions of gratitude, apologies, and love between the patient and family. Visiting hours were extended, and with the nurse’s assistance, these moments were recorded and shared with the patient’s consent, providing cherished memories for the family. The patient’s end-of-life experience was thus improved, and the family was able to find peace. This case also served to promote the concept of palliative care, ensuring that more patients and families receive high-quality nursing care. Conclusion: When caring for terminal patients, collaboration with the palliative care team, including social workers, clergy, psychologists, and nutritionists, is essential. Involving the family in decision-making and providing opportunities for closeness and expressions of gratitude improve personalized care and enhance the patient's quality of life. Upon transferring to the ward, the patient’s hemodynamic stability was maintained, including SBP 110-130 mmHg, respiratory rate 20-22 breaths/min, and pain score <3. The patient was later discharged and transitioned to home hospice care for ongoing support.

Keywords: intensive care, lung cancer, palliative care, ICU

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Authors: Tiziana Pepe, Gerardo Manfreda, Adriana Ianieri, Aniello Anastasio

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The sustainable exploitation of marine biological resources is among the most important objectives of the EU's Common Fisheries Policy (CFP). Currently, Europe imports about 65% of its fish products, indicating that domestic production does not meet consumer demand. Despite the availability of numerous commercially significant fish species, European consumption is concentrated on a limited number of products (e.g., sea bass, sea bream, shrimp). Many native species, present in large quantities in the Mediterranean Sea, are little known to consumers and are therefore considered ‘fishing by-products’. All the data presented so far indicate a significant waste of local resources and the overexploitation of a few fish stocks. It is therefore necessary to develop strategies that guide the market towards sustainable conversion. The objective of this work was to valorize underutilized fish species of the Mediterranean Sea through a multidisciplinary approach. To this end, three fish species were sampled: Atlantic Horse Mackerel (Trachurus trachurus), Bogue (Boops boops), and Common Dolphinfish (Coryphaena hippurus). Nutritional properties (water %, fats, proteins, ashes, salts), physical/chemical properties (TVB-N, histamine, pH), and rheological properties (color, texture, viscosity) were analyzed. The analyses were conducted on both fillets and processing by-products. Additionally, mitochondrial DNA (mtDNA) was extracted from the muscle of each species. The mtDNA was then sequenced using the Illumina NGS technique. The analysis of nutritional properties classified the fillets of the sampled species as lean or semi-fat, as they had a fat content of less than 3%, while the by-products showed a higher lipid content (2.7-5%). The protein percentage for all fillets was 22-23%, while for processing by-products, the protein concentration was 18-19% for all species. Rheological analyses showed an increase in viscosity in saline solution in all species, indicating their potential suitability for industrial processing. High-quality and quantity complete mtDNA was extracted from all analyzed species. The complete mitochondrial genome sequences were successfully obtained and annotated. The results of this study suggest that all analyzed species are suitable for both human consumption and feed production. The sequencing of the complete mtDNA and its availability in international databases will be useful for accurate phylogenetic analysis and proper species identification, even in prepared and processed products. Underutilized fish species represent an important economic resource. Encouraging their consumption could limit the phenomenon of overfishing, protecting marine biodiversity. Furthermore, the valorization of these species will increase national fish production, supporting the local economy, cultural, and gastronomic tradition, and optimizing the exploitation of Mediterranean resources in accordance with the CFP.

Keywords: mtDNA, nutritional analysis, sustainable fisheries, underutilized fish species

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Authors: Tatiana L. Avalos-Rendon, Elias A. Pasten Chelala, Carlos J. Mendoza EScobedo, Ignacio A. Figueroa, Victor H. Lara, Luis M. Palacios-Romero

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The cement industry is facing cost increments in energy supply, requirements for reduction of CO₂, and insufficient supply of raw materials of good quality. According to all these environmental issues, cement industry must change its consumption patterns and reduce CO₂ emissions to the atmosphere. This can be achieved by generating environmental consciousness, which encourages the use of industrial by-products and/or recycling for the production of cement, as well as alternate, environment-friendly methods of synthesis which reduce CO₂. Calcination is the conventional method for the obtainment of Portland cement clinker. This method consists of grinding and mixing of raw materials (limestone, clay, etc.) in an adequate dosage. Resulting mix has a clinkerization temperature of 1450 °C so that the formation of the main component occur: alite (Ca₃SiO₅, C₃S). Considering that the energy required to produce C₃S is 1810 kJ kg -1, calcination method for the obtainment of clinker represents two major disadvantages: long thermal treatment and elevated temperatures of synthesis, both of which cause high emissions of carbon dioxide (CO₂) to the atmosphere. Belite Portland clinker is characterized by having a low content of calcium oxide (CaO), causing the presence of alite to diminish and favoring the formation of belite (β-Ca₂SiO₄, C₂S), so production of clinker requires a reduced energy consumption (1350 kJ kg-1), releasing less CO₂ to the atmosphere. Conventionally, β-Ca₂SiO₄ is synthetized by the calcination of calcium carbonate (CaCO₃) and silicon dioxide (SiO₂) through the reaction in solid state at temperatures greater than 1300 °C. Resulting belite shows low hydraulic reactivity. Therefore, this study concerns a new simple modified combustion method for the synthesis of two belite cements at low temperatures (1000 °C). Silica fume, as subproduct of metallurgic industry and commercial natural zeolite were utilized as raw materials. These are considered low-cost materials and were utilized with no additional purification process. Belite cements properties were characterized by XRD, SEM, EDS and BET techniques. Hydration capacity of belite cements was calculated while the mechanical strength was determined in ordinary Portland cement specimens (PC) with a 10% partial replacement of the belite cements obtained. Results showed belite cements presented relatively high surface áreas, at early ages mechanical strengths similar to those of alite cement and comparable to strengths of belite cements obtained by different synthesis methods. Cements obtained in this work present good hydraulic reactivity properties.

Keywords: belite, silica fume, zeolite, hydraulic reactivity

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Authors: B. S. Muddukrishna, Karthik Aithal, Aravind Pai

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Introduction: Preparation of binary cocrystals of Etraverine (ETR) by using Tartaric Acid (TAR) as a conformer was the main focus of this study. Etravirine is a Class IV drug, as per the BCS classification system. Methods: Cocrystals were prepared by slow evaporation technique. A mixture of total 500mg of ETR: TAR was weighed in molar ratios of 1:1 (371.72mg of ETR and 128.27mg of TAR). Saturated solution of Etravirine was prepared in Acetone: Methanol (50:50) mixture in which tartaric acid is dissolved by sonication and then this solution was stirred using a magnetic stirrer until the solvent got evaporated. Shimadzu FTIR – 8300 system was used to acquire the FTIR spectra of the cocrystals prepared. Shimadzu thermal analyzer was used to achieve DSC measurements. X-ray diffractometer was used to obtain the X-ray powder diffraction pattern. Shake flask method was used to determine the equilibrium dynamic solubility of pure, physical mixture and cocrystals of ETR. USP buffer (pH 6.8) containing 1% of Tween 80 was used as the medium. The pure, physical mixture and the optimized cocrystal of ETR were accurately weighed sufficient to maintain the sink condition and were filled in hard gelatine capsules (size 4). Electrolab-Tablet Dissolution tester using basket apparatus at a rotational speed of 50 rpm and USP phosphate buffer (900 mL, pH = 6.8, 37 ˚C) + 1% Tween80 as a media, was used to carry out dissolution. Shimadzu LC-10 series chromatographic system was used to perform the analysis with PDA detector. An Hypersil BDS C18 (150mm ×4.6 mm ×5 µm) column was used for separation with mobile phase comprising of a mixture of ace¬tonitrile and phosphate buffer 20mM, pH 3.2 in the ratio 60:40 v/v. The flow rate was 1.0mL/min and column temperature was set to 30°C. The detection was carried out at 304 nm for ETR. Results and discussions: The cocrystals were subjected to various solid state characterization and the results confirmed the formation of cocrystals. The C=O stretching vibration (1741cm-1) in tartaric acid was disappeared in the cocrystal and the peak broadening of primary amine indicates hydrogen bond formation. The difference in the melting point of cocrystals when compared to pure Etravirine (265 °C) indicates interaction between the drug and the coformer which proves that first ordered transformation i.e. melting endotherm has disappeared. The difference in 2θ values of pure drug and cocrystals indicates the interaction between the drug and the coformer. Dynamic solubility and dissolution studies were also conducted by shake flask method and USP apparatus one respectively and 3.6 fold increase in the dynamic solubility were observed and in-vitro dissolution study shows four fold increase in the solubility for the ETR: TAR (1:1) cocrystals. The ETR: TAR (1:1) cocrystals shows improved solubility and dissolution as compared to the pure drug which was clearly showed by solid state characterization and dissolution studies.

Keywords: dynamic solubility, Etraverine, in vitro dissolution, slurry method

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Authors: Giovana Vesentini, Fernanda Piculo, Gabriela Marini, Debora Damasceno, Angelica Barbosa, Selma Martheus, Marilza Rudge

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Problem statement: Skeletal muscle is highly adaptable, muscle fiber composition and size can respond to a variety of stimuli, such physiologic, as pregnancy, and metabolic abnormalities, as Diabetes mellitus. This study aimed to analyze the effects of pregnancy-associated diabetes on the rectus abdominis muscle (RA), and to compare this changes in rats and women. Methods: Female Wistar rats were maintained under controlled conditions and distributed in Pregnant (P) and Long-term mild pregnant diabetic (LTMd) (n=3 r/group). Diabetes in rats was induced by streptozotocin (100mg/Kg, sc) on the first day of life, for a hyperglycemic state between 120-300 mg/dL in adult life. Female rats were mated overnight, at day 21 of pregnancy were anesthetized, and killed for the harvesting of maternal RA. Pregnant women who attended the Diabetes Prenatal Care Clinic of Botucatu Medical School were distributed in Pregnant non-diabetic (Pnd) and Gestational Diabetic (GDM) (n=3 w/group). The diagnosis of GDM was established according to ADA’s criteria (2016). The harvesting of RA was during the cesarean section. Transversal cross-sections of the RA of both women and rats were analyzed by transmission electron microscopy. All procedures were approved by the Ethics Committee on Animal Experiments of the Botucatu Medical School (Protocol Number 1003/2013) and by the Botucatu Medical School Ethical Committee for Human Research in Medical Sciences (CAAE: 41570815.0.0000.5411). Results: The photomicrographs of the RA of rats revealed disorganized Z lines, thinning sarcomeres, and a usual quantity of intermyofibrillar mitochondria in the P group. The LTMd group showed swollen sarcoplasmic reticulum, dilated T tubes and areas with sarcomere disruption. The ultrastructural analysis of Pnd non-diabetic women in the RA showed well-organized myofibrils forming intact sarcomeres, organized Z lines and a normal distribution of intermyofibrillar mitochondria. The GDM group revealed increase in intermyofibrillar mitochondria, areas with sarcomere disruption and increased lipid droplets. Conclusion: Pregnancy and diabetes induce adaptations in the ultrastructure of the rectus abdominis muscle for both women and rats, changing the architectural design of these tissues. However, in rats these changes are more severe maybe because, besides the high blood glucose levels, the quadrupedal animal may suffer an excessive mechanical tension during pregnancy by gravity. Probably, these findings may suggest that these alterations are a risk factor that contributes to the development of muscle dysfunction in women with GDM and may motivate treatment strategies in these patients.

Keywords: gestational diabetes, muscle dysfunction, pregnancy, rectus abdominis

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Authors: Meirav Eshkol, Miri Blaufeld, Rinat Basal

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Aim: The working environment in rural clinics is often isolated and distant from major health centers. In these circumstances, rural health care faces numerous challenges. The hope is that, in the immediate future and in the medium and long range, the rural nursing staff will realize their full professional and personal potential to their own satisfaction and to the health and welfare of their patients. Background: Rural nurses work mostly alone or with very few colleagues, and have the authority to make professional decisions, a fact which often requires them to make critical decisions in pressure situations. In addition, the expectations set for these nurses are extremely high, a fact which requires them to be extremely skilled and to fulfill their professional potential. They are required to provide high-quality and comprehensive care to the individual, the family, and the community and to maintain close interaction with the community. Work in a rural setting requires the flexibility to perform multiple tasks in an isolated setting, often far removed from major health centers. In order to maintain professional satisfaction for the rural nurse, expanded direction and training are required in professional know-how, and in the development of new and existing skills, toward the goal of treating a diverse population and to obtain a comprehensive view of the components of a diagnosis for treatment and to develop an understanding appropriate to the presented reality. Objective: To provide knowledge and to expand and develop professional skills in the prevention and advancement of health in the care of a diverse patient population. The development of strategies and skills for work under pressure alone instills expertise in performing multiple tasks in diverse disciplines. To reduce feelings of stress and burnout. Methodology: This course is the first and one of a kind in Clalit - the biggest health organisation in Israel. Observing and identifying the needs of the nurses in the field relating to the development of professional and personal skills defining goals and objectives, and determining the content of a course designed for rural nurses and kibbutz nurses who are not Clalit employees. Results: 43 nurses participated and 30 answered the feedback questionnaire. The rating of their experience was 4.33 (on a scale of 1-5, with 5 being the highest ranking). 92% indicated the importance of meeting with additional nurses to teach their colleagues. 83% of the nurses indicated an increased sense of organizational belonging. 60% indicated that the course helped to reduce feelings of stress and burnout in becoming a better rural nurse. 80% indicated that the course helped them establish intra-organizational professional cooperation and initiating processes. Conclusion: The course is an instrument which aids in increasing the feeling of organizational belonging, reducing feelings of stress and burnout, creation of relationships and cooperation both within and outside of the organization, increased the realization of the potential of the village nurse.

Keywords: rural nurse, alone, burnout, multiple tasks

Procedia PDF Downloads 63

Authors: Angela Cristina Da F. De Oliveira, Salma E. Asmar, Norbert P. Battlori, Yaz Vera, Uriel R. Valencia, Tâmara Duarte Borges, Antoni D. Bueno, Leandro Batista Costa

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As homeothermic animals, pigs manifest maximum performance when kept at comfortable temperature levels, represented by a limit where thermoregulatory processes are minimal (18 - 20°C). In a stress situation where it will have a higher energy demand for thermal maintenance, the energy contribution to the productive functions will be reduced, generating health imbalances, drop in productive rates and welfare problems. The hypothesis of this project is that 5% starch replacement per 5% sunflower oil (SO), in growing and finishing pig’s diet (Iberic x Duroc), is effective as a nutritional strategy to reduce the negative impacts of thermal stress on performance and animal welfare. Seventy-two crossbred males (51± 6,29 kg body weight- BW) were housed according to the initial BW, in climate-controlled rooms, in collective pens, and exposed to heat stress conditions (30 - 32°C; 35% to 50% humidity). The experiment lasted 90 days, and it was carried out in a randomized block design, in a 2 x 2 factorial, composed of two diets (starch or sunflower oil (with or without) and two feed intake management (ad libitum and restriction). The treatments studied were: 1) control diet (5% starch x 0% SO) with ad libitum intake (n = 18); 2) SO diet (replacement of 5% of starch per 5% SO) with ad libitum intake (n = 18); 3) control diet with restriction feed intake (n = 18); or 4) SO diet with restriction feed intake (n = 18). Feed was provided in two phases, 50–100 Kg BW for growing and 100-140 Kg BW for finishing period, respectively. Hematological, biochemical and growth performance parameters were evaluated on all animals at the beginning of the environmental treatment, on the transition of feed (growing to finishing) and in the final of experiment. After the experimental period, when animals reached a live weight of 130-140 kg, they were slaughtered by carbon dioxide (CO2) stunning. Data have shown for the growing phase no statistical interaction between diet (control x SO) and management feed intake (ad libitum x restriction) on animal performance. At finishing phase, pigs fed with SO diet with restriction feed intake had the same average daily gain (ADG) compared with pigs in control diet with ad libitum feed intake. Furthermore, animals fed with the same diet (SO), presented a better feed gain (p < 0,05) due to feed intake reduce (p < 0,05) when compared with control group. To hematological and biochemical parameters, animals under heat stress had an increase in hematocrit, corpuscular volume, urea concentration, creatinine, calcium, alanine aminotransferase and aspartate aminotransferase (p < 0,05) when compared with the beginning of experiment. These parameters were efficient to characterize the heat stress, although the experimental treatments were not able to reduce the hematological and biochemical stress indicators. In addition, the inclusion of SO on pig diets improve feed gain in pigs at finishing phase, even with restriction feed intake.

Keywords: hematological, performance, pigs, welfare

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Authors: Evans V. Mauda, Stefan H. Foord, Thinandavha C. Munyai

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The greatest threat to biodiversity is a loss of habitat through landscape fragmentation and attrition. Land use changes are therefore among the most immediate drivers of species diversity. Urbanization and agriculture are the main drivers of habitat loss and transformation in the Savanna biomes of South Africa. Agricultural expansion and the intensification in particular, take place at the expense of biodiversity and will probably be the primary driver of biodiversity loss in this century. Arthropods show measurable behavioural responses to changing land mosaics at the smallest scale and heterogeneous environments are therefore predicted to support more complex and diverse biological assemblages. Ants are premier soil turners, channelers of energy and dominate insect fauna, while spiders are a mega-diverse group that can regulate other invertebrate populations. This study aims to quantify the response of these two taxa in a rural-urban mosaic of a rapidly developing communal area. The study took place in and around two villages in the north-eastern corner of South Africa. Two replicates for each of the dominant land use categories, viz. urban settlements, dryland cultivation and cattle rangelands, were set out in each of the villages and sampled during the dry and wet seasons for a total of 2 villages × 3 land use categories × 2 seasons = 24 assemblages. Local scale variables measured included vertical and horizontal habitat structure as well as structural and chemical composition of the soil. Ant richness was not affected by land use but local scale variables such as vertical vegetation structure (+) and leaf litter cover (+), although vegetation complexity at lower levels was negatively associated with ant richness. However, ant richness was largely shaped by regional and temporal processes invoking the importance of dispersal and historical processes. Spider species richness was mostly affected by land use and local conditions highlighting their landscape elements. Spider richness did not vary much between villages and across seasons and seems to be less dependent on context or history. There was a considerable amount of variation in spider richness that was not explained and this could be related to factors which were not measured in this study such as temperature and competition. For both ant and spider assemblages the constrained ordination explained 18 % of variation in these taxa. Three environmental variables (leaf litter cover, active carbon and rock cover) were important in explaining ant assemblage structure, while two (sand and leaf litter cover) were important for spider assemblage structure. This study highlights the importance of disturbance (land use activities) and leaf litter with the associated effects on ant and spider assemblages across the study area.

Keywords: ants, assemblages, biosphere, diversity, land use, spiders, urbanization

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Authors: Giada Feletti, Daniela Tedesco, Paolo Trucco

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The present study aims to develop a dashboard of Key Performance Indicators (KPI) to enhance information and predictive capabilities in Emergency Medical Services (EMS) systems, supporting both operational and strategic decisions of different actors. The employed research methodology consists of the first phase of revision of the technical-scientific literature concerning the indicators currently used for the performance measurement of EMS systems. From this literature analysis, it emerged that current studies focus on two distinct perspectives: the ambulance service, a fundamental component of pre-hospital health treatment, and the patient care in the Emergency Department (ED). The perspective proposed by this study is to consider an integrated view of the ambulance service process and the ED process, both essential to ensure high quality of care and patient safety. Thus, the proposal focuses on the entire healthcare service process and, as such, allows considering the interconnection between the two EMS processes, the pre-hospital and hospital ones, connected by the assignment of the patient to a specific ED. In this way, it is possible to optimize the entire patient management. Therefore, attention is paid to the dependency of decisions that in current EMS management models tend to be neglected or underestimated. In particular, the integration of the two processes enables the evaluation of the advantage of an ED selection decision having visibility on EDs’ saturation status and therefore considering the distance, the available resources and the expected waiting times. Starting from a critical review of the KPIs proposed in the extant literature, the design of the dashboard was carried out: the high number of analyzed KPIs was reduced by eliminating the ones firstly not in line with the aim of the study and then the ones supporting a similar functionality. The KPIs finally selected were tested on a realistic dataset, which draws us to exclude additional indicators due to the unavailability of data required for their computation. The final dashboard, which was discussed and validated by experts in the field, includes a variety of KPIs able to support operational and planning decisions, early warning, and citizens’ awareness of EDs accessibility in real-time. By associating each KPI to the EMS phase it refers to, it was also possible to design a well-balanced dashboard covering both efficiency and effective performance of the entire EMS process. Indeed, just the initial phases related to the interconnection between ambulance service and patient’s care are covered by traditional KPIs compared to the subsequent phases taking place in the hospital ED. This could be taken into consideration for the potential future development of the dashboard. Moreover, the research could proceed by building a multi-layer dashboard composed of the first level with a minimal set of KPIs to measure the basic performance of the EMS system at an aggregate level and further levels with KPIs that can bring additional and more detailed information.

Keywords: dashboard, decision support, emergency medical services, key performance indicators

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Authors: Soma Kanta Baral

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Background: Since 1981, when the first AIDS case was reported, worldwide, more than 34 million people have been infected with HIV. Almost 95 percent of the people infected with HIV live in developing countries. As HBV & HIV share similar routes of transmission by sexual intercourse or drug use by parenteral injection, co-infection is common. Because of the limited access to healthcare & HIV treatment in developing countries, HIV-infected individuals are present late for care. Enumeration of CD4+ T cell count at the time of diagnosis has been useful to initiate the therapy in HIV infected individuals. The baseline CD4+ T cell count shows high immunological variability among patients. Methods: This prospective study was done in the serology section of the Department of Microbiology over a period of one year from august 2012 to July 2013. A total of 13037 individuals subjected for HIV test were included in the study comprising of 4982 males & 8055 females. Blood sample was collected by vein puncture aseptically with standard operational procedure in clean & dry test-tube. All blood samples were screened for HIV as described by WHO algorithm by Immuno-chromatography rapid kits. Further confirmation was done by biokit ELISA method as per the manufacturer’s guidelines. After informed consent, HIV positive individuals were screened for HBsAg by Immuno-chromatography rapid kits (Hepacard). Further confirmation was done by biokit ELISA method as per the manufacturer’s guidelines. EDTA blood samples were collected from the HIV sero-positive individuals for baseline CD4+ T count. Then, CD4+ T cells count was determined by using FACS Calibur Flow Cytometer (BD). Results: Among 13037 individuals screened for HIV, 104 (0.8%) were found to be infected comprising of 69(66.34%) males & 35 (33.65%) females. The study showed that the high infection was noted in housewives (28.7%), active age group (30.76%), rural area (56.7%) & in heterosexual route (80.9%) of transmission. Out of total HIV infected individuals, distribution of HBV co-infection was found to be 6(5.7%). All co- infected individuals were married, male, above the age of 25 years & heterosexual route of transmission. Baseline CD4+ T cell count of HIV infected patient was found higher (mean CD4+ T cell count; 283cells/cu.mm) than HBV co-infected patients (mean CD4+ T cell count; 91 cells/cu.mm). Majority (77.2%) of HIV infected & all co-infected individuals were presented in our center late (CD4+ T cell count;< 350/cu. mm) for diagnosis and care. Majority of co- infected 4 (80%) were late presented with advanced AIDS stage (CD4+ count; <200/cu.mm). Conclusions: The study showed a high percentage of HIV sero-positive & co- infected individuals. Baseline CD4+ T cell count of majority of HIV infected individuals was found to be low. Hence, more sustained and vigorous awareness campaigns & counseling still need to be done in order to promote early diagnosis and management.

Keywords: HIV/AIDS, HBsAg, co-infection, CD4+

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Authors: Henry Venter, Murali Thyloth, Alceu Casseb

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Historically, mental and substance use disorders were not a global health priority. Since the 1993 World Development Report, the importance of the contribution of mental health and substance abuse on the relative global burden associated with disease morbidity has been recognized with 300 million people worldwide suffering from depression alone. This led to an international effort to improve the mental health of populations around the world. Despite these efforts some countries remain at the top of the list of countries with the highest rate of mental illness. Important research questions were asked: Would there be commonalities regarding mental health between these countries; would there be common factors leading to the high prevalence of mental illness; and how prepared are these countries with mental health delivery? Findings from this research can aid organizations and institutions preparing mental health service providers to focus training and preparation to address specific needs revealed by the study. Methods: Researchers decided to compare three distinctly different countries at the top of the list of countries with the highest rate of mental illness, the USA, India and Brazil, situated on three different continents with different economies and lifestyles. Data were collected using archival research methodology, reviewing records and findings of international and national health and mental health studies to subtract and compare data and findings. Results: The findings indicated that India is the most depressed country in the world, followed by the USA (and China) with Brazil in Latin America with the greatest number of depressed individuals. By 2020 roughly 20% of India, acountry of over one billion citizens, will suffer from some form of mental illnees, yet there are less than 4,000 experts available. In the USA 164.8 million people were substance abusers and an estimate of 47.6 million adults, 18 or older, had any mental illness in 2018. That means that about one in five adults in the USA experiences some form of mental illness each year, but only 41% of those affected received mental health care or services in the past year. Brazil has the greatest number of depressed individuals, in Latin America. Adults living in Sao Paulo megacity has prevalence of mental disorders at greater levels than similar surveys conducted in other areas of the world with more than one million adults with serious impairment levels. Discussion: The results show that, despite the vast socioeconomic differences between the three countries, there are correlations regarding mental health prevalence and difficulty to provide adequate services including a lack of awareness of how serious mental illness is, stigma for seeking mental illness, with comorbidity a common phenomenon, and a lack of partnership between different levels of service providers, which weakens mental health service delivery. The findings also indicate that mental health training institutions have a monumental task to prepare personnel to address the future mental health needs in each of the countries compared, which will constitute the next phase of the research.

Keywords: mental health epidemiology, mental health disorder, mental health prevalence, mental health treatment

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Authors: Ahmed Tawfik

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Oxidation of 1,4 dioxane produces metabolites by-products involving glycolaldehyde and acids that have geno- and cytotoxicity impact on microbial degradation. Thereby, the incorporation of algae with bacteria in the treatment system would eliminate and overcome the accumulation of metabolites that are utilized as a carbon source for the build-up of biomass. Therefore, the aim of the present study is to assess the potential of algae/bacteria-based membrane bioreactor (AB-MBR) for biodegradation of 1,4 dioxane-rich wastewater at a high imposed loading rate. Three identical reactors, i.e., AB-MBR1, AB-MBR2, and AB-MBR3, were operated in parallel at 1,4 dioxane loading rates of 641.7, 320.9, and 160.4 mg/L. d., and HRTs of 6.0, 12 and 24 h. respectively. The AB-MBR1 achieved 1,4 dioxane removal rate of 263.7 mg/L.d., where the residual value in the treated effluent amounted to 94.4±22.9 mg/L. Reducing the 1,4 dioxane loading rate (LR) to 320.9 mg/L.d in the AB-MBR2 maximized the removal rate efficiency of 265.9 mg/L.d., with a removal efficiency of 82.8±3.2%. The minimum value of 1,4 dioxane of 17.3±1.8 mg/L in the treated effluent of AB-MBR3 was obtained at an HRT of 24.0 h and loading rate of 160.4 mg/L.d. The mechanism of 1,4 dioxane degradation in AB-MBR was a combination of volatilization (8.03±0.6%), UV oxidation (14.1±0.9%), microbial biodegradation (49.1±3.9%) and absorption/uptake and assimilation by algae (28.8±2.%). Further, the Thioclava, Afipia, and Mycobacterium genera oxidized and produced the required enzymes for hydrolysis and cleavage of the dioxane ring into 2-hydroxy-1,4 dioxane. Moreover, the fungi, i.e., Basidiomycota and Cryptomycota, played a big role in the degradation of the 1,4 dioxane into 2-hydroxy-1,4 dioxane. Xanthobacter and Mesorhizobium were involved in the metabolism process by secreting alcohol dehydrogenase (ADH), aldehyde dehydrogenase (ALDH), and glycolate oxidase. Bacteria and fungi produced dehydrogenase (DH) for the transformation of 2-hydroxy-1,4 dioxane into 2-hydroxy-ethoxyacetaldehyde. The latter is converted into Ethylene glycol by Aldehyde hydrogenase (ALDH). Ethylene glycol is oxidized into acids using Alcohol hydrogenase (ADH). The Diatomea, Chlorophyta, and Streptophyta utilize the metabolites for biomass assimilation and produce the required oxygen for further oxidation of the dioxane and its metabolites by-products of bacteria and fungi. The major portion of metabolites (ethylene glycol, glycolic acid, and oxalic acid were removed due to uptake and absorption by algae (43±4.3%), followed by adsorption (18.4±0.9%). The volatilization and UV oxidation contribution for the degradation of metabolites were 8.7±0.7% and 12.3±0.8%, respectively. The capabilities of genera Defluviimonas, Thioclava, Luteolibacter, and Afipia. The genera of Defluviimonas, Thioclava, Luteolibacter, and Mycobacterium were grown under a high 1,4 dioxane LR of 641.7 mg/L.d. The Chlorophyta (4.1-43.6%), Streptophyta (2.5-21.7%), and Diatomea (0.8-1.4%) phyla were dominant for degradation of 1,4 dioxane. The results of this study strongly demonstrated that the bioremediation and bioaugmentation process can safely remove 1,4 dioxane from industrial wastewater while minimizing environmental concerns and reducing economic costs.

Keywords: wastewater, membrane bioreactor, bacterial community, algal community

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Authors: Nikolai A. Khlebnikov, Vladimir N. Krasilnikov, Evgenii V. Polyakov, Anastasia A. Maltceva

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Carbon materials with advanced surfaces are widely used both in modern industry and in environmental protection. The physical-chemical nature of these materials is determined by the morphology of primary atomic and molecular carbon structures, which are the basis for synthesizing the following materials: zero-dimensional (fullerenes), one-dimensional (fiber, tubes), two-dimensional (graphene) carbon nanostructures, three-dimensional (multi-layer graphene, graphite, foams) with unique physical-chemical and functional properties. Experience shows that the microscopic morphological level is the basis for the creation of the next mesoscopic morphological level. The dependence of the morphology on the chemical way and process prehistory (crystallization, colloids formation, liquid crystal state and other) is the peculiarity of the last called level. These factors determine the consumer properties of carbon materials, such as specific surface area, porosity, chemical resistance in corrosive environments, catalytic and adsorption activities. Based on the developed ideology of thin precursor synthesis, the authors discuss one of the approaches of the porosity control of carbon-containing materials with a given aggregates morphology. The low-temperature thermolysis of precursors in a gas environment of a given composition is the basis of the above-mentioned idea. The processes of carbothermic precursor synthesis of two different compounds: tungsten carbide WC:nC and zinc oxide ZnO:nC containing an impurity phase in the form of free carbon were selected as subjects of the research. In the first case, the transition metal (tungsten) forming carbides was the object of the synthesis. In the second case, there was selected zinc that does not form carbides. The synthesis of both kinds of transition metals compounds was conducted by the method of precursor carbothermic synthesis from the organic solution. ZnO:nC composites were obtained by thermolysis of succinate Zn(OO(CH2)2OO), formate glycolate Zn(HCOO)(OCH2CH2O)1/2, glycerolate Zn(OCH2CHOCH2OH), and tartrate Zn(OOCCH(OH)CH(OH)COO). WC:nC composite was synthesized from ammonium paratungstate and glycerol. In all cases, carbon structures that are specific for diamond- like carbon forms appeared on the surface of WC and ZnO particles after the heat treatment. Tungsten carbide and zinc oxide were removed from the composites by selective chemical dissolution preserving the amorphous carbon phase. This work presents the results of investigating WC:nC and ZnO:nC composites and carbon nanopowders with tubular, tape, plate and onion morphologies of aggregates that are separated by chemical dissolution of WC and ZnO from the composites by the following methods: SEM, TEM, XPA, Raman spectroscopy, and BET. The connection between the carbon morphology under the conditions of synthesis and chemical nature of the precursor and the possibility of regulation of the morphology with the specific surface area up to 1700-2000 m2/g of carbon-structured materials are discussed.

Keywords: carbon morphology, composite materials, precursor synthesis, tungsten carbide, zinc oxide

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Authors: Anna Slupik, Anna Mosiolek, Sebastian Wojtowicz, Dariusz Bialoszewski

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Introduction: Whole-body vibration (WBV) uses high frequency mechanical stimuli generated by a vibration plate and transmitted through bone, muscle and connective tissues to the whole body. Research has shown that long-term vibration-plate training improves neuromuscular facilitation, especially in afferent neural pathways, responsible for the conduction of vibration and proprioceptive stimuli, muscle function, balance and proprioception. Some researchers suggest that the vibration stimulus briefly inhibits the conduction of afferent signals from proprioceptors and can interfere with the maintenance of body balance. The aim of this study was to evaluate the influence of a single set of exercises associated with whole-body vibration on the joint position sense and body balance. Material and methods: The study enrolled 55 people aged 19-24 years. These individuals were randomly divided into a test group (30 persons) and a control group (25 persons). Both groups performed the same set of exercises on a vibration plate. The following vibration parameters: frequency of 20Hz and amplitude of 3mm, were used in the test group. The control group performed exercises on the vibration plate while it was off. All participants were instructed to perform six dynamic exercises lasting 30 seconds each with a 60-second period of rest between them. The exercises involved large muscle groups of the trunk, pelvis and lower limbs. Measurements were carried out before and immediately after exercise. Joint position sense (JPS) was measured in the knee joint for the starting position at 45° in an open kinematic chain. JPS error was measured using a digital inclinometer. Balance was assessed in a standing position with both feet on the ground with the eyes open and closed (each test lasting 30 sec). Balance was assessed using Matscan with FootMat 7.0 SAM software. The surface of the ellipse of confidence and front-back as well as right-left swing were measured to assess balance. Statistical analysis was performed using Statistica 10.0 PL software. Results: There were no significant differences between the groups, both before and after the exercise (p> 0.05). JPS did not change in both the test (10.7° vs. 8.4°) and control groups (9.0° vs. 8.4°). No significant differences were shown in any of the test parameters during balance tests with the eyes open or closed in both the test and control groups (p> 0.05). Conclusions. 1. Deterioration in proprioception or balance was not observed immediately after the vibration stimulus. This suggests that vibration-induced blockage of proprioceptive stimuli conduction can have only a short-lasting effect that occurs only as long as a vibration stimulus is present. 2. Short-term use of vibration in treatment does not impair proprioception and seems to be safe for patients with proprioceptive impairment. 3. These results need to be supplemented with an assessment of proprioception during the application of vibration stimuli. Additionally, the impact of vibration parameters used in the exercises should be evaluated.

Keywords: balance, joint position sense, proprioception, whole body vibration

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Authors: Josef Uher, Jana Boháčová, Richard Kadeřábek

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In this paper, we present a multi-robot imaging and irradiation research platform referred to as Irradion, with full capabilities of portable arbitrary path computed tomography (CT). Irradion is an imaging and irradiation unit entirely based on robotic arms for research on cancer treatment with ion beams on small animals (mice or rats). The platform comprises two subsystems that combine several imaging modalities, such as 2D X-ray imaging, CT, and particle tracking, with precise positioning of a small animal for imaging and irradiation. Computed Tomography: The CT subsystem of the Irradion platform is equipped with two 6-joint robotic arms that position a photon counting detector and an X-ray tube independently and freely around the scanned specimen and allow image acquisition utilizing computed tomography. Irradiation measures nearly all conventional 2D and 3D trajectories of X-ray imaging with precisely calibrated and repeatable geometrical accuracy leading to a spatial resolution of up to 50 µm. In addition, the photon counting detectors allow X-ray photon energy discrimination, which can suppress scattered radiation, thus improving image contrast. It can also measure absorption spectra and recognize different materials (tissue) types. X-ray video recording and real-time imaging options can be applied for studies of dynamic processes, including in vivo specimens. Moreover, Irradion opens the door to exploring new 2D and 3D X-ray imaging approaches. We demonstrate in this publication various novel scan trajectories and their benefits. Proton Imaging and Particle Tracking: The Irradion platform allows combining several imaging modules with any required number of robots. The proton tracking module comprises another two robots, each holding particle tracking detectors with position, energy, and time-sensitive sensors Timepix3. Timepix3 detectors can track particles entering and exiting the specimen and allow accurate guiding of photon/ion beams for irradiation. In addition, quantifying the energy losses before and after the specimen brings essential information for precise irradiation planning and verification. Work on the small animal research platform Irradion involved advanced software and hardware development that will offer researchers a novel way to investigate new approaches in (i) radiotherapy, (ii) spectral CT, (iii) arbitrary path CT, (iv) particle tracking. The robotic platform for imaging and radiation research developed for the project is an entirely new product on the market. Preclinical research systems with precision robotic irradiation with photon/ion beams combined with multimodality high-resolution imaging do not exist currently. The researched technology can potentially cause a significant leap forward compared to the current, first-generation primary devices.

Keywords: arbitrary path CT, robotic CT, modular, multi-robot, small animal imaging

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Authors: Fentie Bishaw Wagayie

Abstract:

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

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

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Authors: Cheryl Forchuk, Sandra Fisman, Steve Cordes, Dan Catunto, Katherine Krakowski, Melissa Jeffrey, John D’Oria

Abstract:

The discharge of youth aged 16-25 from hospital into homelessness is a prevalent issue despite research indicating social, safety, health and economic detriments on both the individual and community. Lack of stable housing for youth discharged into homelessness results in long-term consequences, including exacerbation of health problems and costly health care service use and hospital readmission. People experiencing homelessness are four times more likely to be readmitted within one month of discharge and hospitals must spend $2,559 more per client. Finding safe housing for these individuals is imperative to their recovery and transition back to the community. People discharged from hospital to homelessness experience challenges, including poor health outcomes and increased hospital readmissions. Youth are the fastest-growing subgroup of people experiencing homelessness in Canada. The needs of youth are unique and include supports related to education, employment opportunities, and age-related service barriers. This study aims to identify the needs of youth at risk of homelessness by evaluating the efficacy of the “Preventing Discharge to No Fixed Address – Youth” (NFA-Y) program, which aims to prevent youth from being discharged from hospital into homelessness. The program connects youth aged 16-25 who are inpatients at London Health Sciences Centre and St. Joseph’s Health Care London to housing and financial support. Supports are offered through collaboration with community partners: Youth Opportunities Unlimited, Canadian Mental Health Association Elgin Middlesex, City of London Coordinated Access, Ontario Works, and Salvation Army’s Housing Stability Bank. This study was reviewed and approved by Western University’s Research Ethics Board. A series of interviews are being conducted with approximately ninety-three youth participants at three time points: baseline (pre-discharge), six, and twelve months post-discharge. Focus groups with participants, health care providers, and community partners are being conducted at three-time points. In addition, administrative data from service providers will be collected and analyzed. Since homelessness has a detrimental effect on recovery, client and community safety, and healthcare expenditure, locating safe housing for psychiatric patients has had a positive impact on treatment, rehabilitation, and the system as a whole. If successful, the findings of this project will offer safe policy alternatives for the prevention of homelessness for at-risk youth, help set them up for success in their future years, and mitigate the rise of the homeless youth population in Canada.

Keywords: youth homelessness, no-fixed address, mental health, homelessness prevention, hospital discharge

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Authors: Aarthi Mariappan, Janani Selvaraj, P. B. Harathi, M. Prashanthi Devi

Abstract:

Anthropogenic modification of the urban environment has largely increased in the recent years in order to sustain the growing human population. Intense industrial activity, permanent and high traffic on the roads, a developed subterranean infrastructure network, land use patterns are just some specific characteristics. Every day, the urban environment is polluted by more or less toxic emissions, organic or metals wastes discharged from specific activities such as industrial, commercial, municipal. When these eventually deposit into the soil, the physical and chemical properties of the surrounding soil is changed, transforming it into a human exposure indicator. Metals are non-degradable and occur cumulative in soil due to regular deposits are a result of permanent human activity. Due to this, metals are a contaminant factor for soil when persistent over a long period of time and a possible danger for inhabitant’s health on prolonged exposure. Metals accumulated in contaminated soil may be transferred to humans directly, by inhaling the dust raised from top soil, or by ingesting, or by dermal contact and indirectly, through plants and animals grown on contaminated soil and used for food. Some metals, like Cu, Mn, Zn, are beneficial for human’s health and represent a danger only if their concentration is above permissible levels, but other metals, like Pb, As, Cd, Hg, are toxic even at trace level causing gastrointestinal and lung cancers. In urban areas, metals can be emitted from a wide variety of sources like industrial, residential, commercial activities. Our study interrogates the spatial distribution of heavy metals in soil in relation to their permissible levels and their association with the health risk to the urban population in Coimbatore, India. Coimbatore region is a high cancer risk zone and case records of gastro intestinal and respiratory cancer patients were collected from hospitals and geocoded in ArcGIS10.1. The data of patients pertaining to the urban limits were retained and checked for their diseases history based on their diagnosis and treatment. A disease map of cancer was prepared to show the disease distribution. It has been observed that in our study area Cr, Pb, As, Fe and Mg exceeded their permissible levels in the soil. Using spatial overlay analysis a relationship between environmental exposure to these potentially toxic elements in soil and cancer distribution in Coimbatore district was established to show areas of cancer risk. Through this, our study throws light on the impact of prolonged exposure to soil contamination in soil in the urban zones, thereby exploring the possibility to detect cancer risk zones and to create awareness among the exposed groups on cancer risk.

Keywords: soil contamination, cancer risk, spatial analysis, India

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Authors: Amar Ghelani

Abstract:

People with auditory verbal hallucinations (AVH) who seek support from mental health services commonly report feeling unheard and invalidated in their interactions with social workers and psychiatric professionals. Current mental health training and clinical approaches have proven to be inadequate in addressing the complex nature of voice hearing. Childhood trauma is a key factor in the development of AVH and can render people more vulnerable to hearing both supportive and/or disturbing voices. Lived experiences of racism, poverty, and immigration are also associated with development of what is broadly classified as psychosis. Despite evidence affirming the influence of environmental factors on voice hearing, the Western biomedical system typically conceptualizes this experience as a symptom of genetically-based mental illnesses which requires diagnosis and treatment. Overemphasis on psychiatric medications, referrals, and directive approaches to people’s problems has shifted clinical interventions away from assessing and addressing problems directly related to AVH. The Maastricht approach offers voice hearers and mental health workers an alternative and respectful starting point for understanding and coping with voices. The approach was developed by voice hearers in partnership with mental health professionals and entails an innovative method to assess and create meaning from voice hearing and related life stressors. The objectives of the approach are to help people who hear voices: (1) understand the problems and/or people the voices may represent in their history, and (2) cope with distress and find solutions to related problems. The Maastricht approach has also been found to help voice hearers integrate emotional conflicts, reduce avoidance or fear associated with AVH, improve therapeutic relationships, and increase a sense of control over internal experiences. The proposed oral presentation will be guided by a recovery-oriented theoretical framework which suggests healing from psychological wounds occurs through social connections and community support systems. The presentation will start with a brainstorming exercise to identify participants pre-existing knowledge of the subject matter. This will lead into a literature review on the relations between trauma, intersectionality, and AVH. An overview of the Maastricht approach and review of research related to its therapeutic risks and benefits will follow. Participants will learn trauma-informed coping skills and questions which can help voice hearers make meaning from their experiences. The presentation will conclude with a review of resources and learning opportunities where participants can expand their knowledge of the Hearing Voices Movement and Maastricht approach.

Keywords: Maastricht interview, recovery, therapeutic assessment, voice hearing

Procedia PDF Downloads 105

Authors: Fei Wang, Jie Meng, Qingxiang Meng

Abstract:

China is rich in straw and by-product resources, whose utilization has always been a hot topic. The objective of this study was to investigate the effect of feeding soybean straw and wine distiller’s grain as a replacement for corn stover on performance of beef cattle. Sixty Simmental×local crossbred bulls averaging 12 months old and 335.7 ± 39.1 kg of body weight (BW) were randomly assigned into four groups (15 animals per group) and allocated to a diet with 40% maize stover (MSD), a diet with 40% wrapping package maize silage (PMSD), a diet with 12% soybean straw plus 28% maize stover (SSD) and a diet with 12% wine distiller’s grain plus 28% maize stover (WDD). Bulls were fed ad libitum an TMR consisting of 36.0% maize, 12.5% of DDGS, 5.0% of cottonseed meal, 4.0% of soybean meal and 40.0% of by-product as described above. Treatment period lasted for 22 weeks, consisting of 1 week of dietary adaptation. The results showed that dry matter intake (DMI) was significantly higher (P < 0.01) for PMSD group than MSD and SSD groups during 0-7 week and 8-14week, and PMSD and WDD groups had higher (P < 0.05) DMI values than MSD and SSD groups during the whole period. Average daily gain (ADG) values were 1.56, 1.72, 1.68 and 1.58 kg for MSD, PMSD, SSD and WDD groups respectively, although the differences were not significant (P > 0.05). The value of blood sugar concentration was significantly higher (P < 0.01) for MSD group than WDD group, and the blood urea nitrogen concentration of SSD group was lower (P < 0.05) than MSD and WDD groups. No significant difference (P > 0.05) of serum total cholesterol, triglycerides or total protein content was observed among the different groups. Ten bulls with similar body weight were selected at the end of feeding trial and slaughtered for measurement of slaughtering performance, carcass quality and meat chemical composition. SSD group had significantly lower (P < 0.05) shear force value and cooking loss than MSD and PMSD groups. The pH values of MSD and SSD groups were lower (P < 0.05) than PMSD and WDD groups. WDD group had a higher fat color brightness (L*) value than PMSD and SSD groups. There were no significant differences in dressing percentage, meat percentage, top grade meat weight, ribeye area, marbling score, meat color and meat chemical compositions among different dietary treatments. Based on these results, the packed maize stover silage showed a potential of improving the average daily gain and feed intake of beef cattle. Soybean straw had a significant effect on improving the tenderness and reducing cooking loss of beef. In general, soybean straw and packed maize stover silage would be beneficial to nitrogen deposition and showed a potential to substitute maize stover in beef cattle diets.

Keywords: beef cattle, by-products, carcass quality, growth performance

Procedia PDF Downloads 509

Authors: Robert L. Fine, Zhiyong Yang, Christy Spivey, Bonnie Boardman, Maureen Courtney

Abstract:

Importance: Barriers to traditional advance care planning (ACP) and advance directive (AD) creation have limited the promise of ACP/AD for individuals and families, the healthcare team, and society. Reengineering ACP by using a web-based, consumer-driven process has recently been suggested. We report early experience with such a process. Objective: Begin to analyze the potential of the creation and use of ACP/ADs as generated by a consumer-friendly, digital process by 1) assessing the likelihood that consumers would create ACP/ADs without structured intervention by medical or legal professionals, and 2) analyzing the responses to determine if the plans can help doctors better understand a person’s goals, preferences, and priorities for their medical treatments and the naming of healthcare agents. Design: The authors chose 900 users of MyDirectives.com, a digital ACP/AD tool, solely based on their state of residence in order to achieve proportional representation of all 50 states by population size and then reviewed their responses, summarizing these through descriptive statistics including treatment preferences, demographics, and revision of preferences. Setting: General United States population. Participants: The 900 participants had an average age of 50.8 years (SD = 16.6); 84.3% of the men and 91% of the women were in self-reported good health when signing their ADs. Main measures: Preferences regarding the use of life-sustaining treatments, where to spend final days, consulting a supportive and palliative care team, attempted cardiopulmonary resuscitation (CPR), autopsy, and organ and tissue donation. Results: Nearly 85% of respondents prefer cessation of life-sustaining treatments during their final days whenever those may be, 76% prefer to spend their final days at home or in a hospice facility, and 94% wanted their future doctors to consult a supportive and palliative care team. 70% would accept attempted CPR in certain limited circumstances. Most respondents would want an autopsy under certain conditions, and 62% would like to donate their organs. Conclusions and relevance: Analysis of early experience with an all-digital web-based ACP/AD platform demonstrates that individuals from a wide range of ages and conditions can engage in an interrogatory process about values, goals, preferences, and priorities for their medical treatments by developing advance directives and easily make changes to the AD created. Online creation, storage, and retrieval of advance directives has the potential to remove barriers to ACP/AD and, thus, to further improve patient-centered end-of-life care.

Keywords: Advance Care Plan, Advance Decisions, Advance Directives, Consumer; Digital, End of Life Care, Goals, Living Wills, Prefences, Universal Advance Directive, Statements

Procedia PDF Downloads 320