Search results for: chronic total occlusion procedures
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11311

Search results for: chronic total occlusion procedures

661 Comparative Study on Efficacy and Clinical Outcomes in Minimally Invasive Surgery Transforaminal Interbody Fusion vs Minimally Invasive Surgery Lateral Interbody Fusion

Authors: Sundaresan Soundararajan, George Ezekiel Silvananthan, Chor Ngee Tan

Abstract:

Introduction: Transforaminal Interbody Fusion (TLIF) has been adopted for many decades now, however, XLIF, still in relative infancy, has grown to be accepted as a new Minimally Invasive Surgery (MIS) option. There is a paucity of reports directly comparing lateral approach surgery to other MIS options such as TLIF in the treatment of lumbar degenerative disc diseases. Aims/Objectives: The objective of this study was to compare the efficacy and clinical outcomes between Minimally Invasive Transforaminal Interbody Fusion (TLIF) and Minimally Invasive Lateral Interbody Fusion (XLIF) in the treatment of patients with degenerative disc disease of the lumbar spine. Methods: A single center, retrospective cohort study involving a total of 38 patients undergoing surgical intervention between 2010 and 2013 for degenerative disc disease of lumbar spine at single L4/L5 level. 18 patients were treated with MIS TLIF, and 20 patients were treated with XLIF. Results: The XLIF group showed shorter duration of surgery compared to the TLIF group (176 mins vs. 208.3 mins, P = 0.03). Length of hospital stay was also significantly shorter in XLIF group (5.9 days vs. 9 days, p = 0.03). Intraoperative blood loss was favouring XLIF as 85% patients had blood loss less than 100cc compared to 58% in the TLIF group (P = 0.03). Radiologically, disc height was significantly improved post operatively in the XLIF group compared to the TLIF group (0.56mm vs. 0.39mm, P = 0.01). Foraminal height increment was also higher in the XLIF group (0.58mm vs. 0.45mm , P = 0.06). Clinically, back pain and leg pain improved in 85% of patients in the XLIF group and 78% in the TLIF group. Post op hip flexion weakness was more common in the XLIF group (40%) than in the TLIF group (0%). However, this weakness resolved within 6 months post operatively. There was one case of dural tear and surgical site infection in the TLIF group respectively and none in the XLIF group. Visual Analog Scale (VAS) score 6 months post operatively showed comparable reduction in both groups. TLIF group had Owsterty Disability Index (ODI) improvement on 67% while XLIF group showed improvement of 70% of its patients. Conclusions: Lateral approach surgery shows comparable clinical outcomes in resolution of back pain and radiculopathy to conventional MIS techniques such as TLIF. With significantly shorter duration of surgical time, minimal blood loss and shorter hospital stay, XLIF seems to be a reasonable MIS option compared to other MIS techniques in treating degenerative lumbar disc diseases.

Keywords: extreme lateral interbody fusion, lateral approach, minimally invasive, XLIF

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660 Ecosystem Approach in Aquaculture: From Experimental Recirculating Multi-Trophic Aquaculture to Operational System in Marsh Ponds

Authors: R. Simide, T. Miard

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Integrated multi-trophic aquaculture (IMTA) is used to reduce waste from aquaculture and increase productivity by co-cultured species. In this study, we designed a recirculating multi-trophic aquaculture system which requires low energy consumption, low water renewal and easy-care. European seabass (Dicentrarchus labrax) were raised with co-cultured sea urchin (Paracentrotus lividus), deteritivorous polychaete fed on settled particulate matter, mussels (Mytilus galloprovincialis) used to extract suspended matters, macroalgae (Ulva sp.) used to uptake dissolved nutrients and gastropod (Phorcus turbinatus) used to clean the series of 4 tanks from fouling. Experiment was performed in triplicate during one month in autumn under an experimental greenhouse at the Institute Océanographique Paul Ricard (IOPR). Thanks to the absence of a physical filter, any pomp was needed to pressure water and the water flow was carried out by a single air-lift followed by gravity flow.Total suspended solids (TSS), biochemical oxygen demand (BOD5), turbidity, phytoplankton estimation and dissolved nutrients (ammonium NH₄, nitrite NO₂⁻, nitrate NO₃⁻ and phosphorus PO₄³⁻) were measured weekly while dissolved oxygen and pH were continuously recorded. Dissolved nutrients stay under the detectable threshold during the experiment. BOD5 decreased between fish and macroalgae tanks. TSS highly increased after 2 weeks and then decreased at the end of the experiment. Those results show that bioremediation can be well used for aquaculture system to keep optimum growing conditions. Fish were the only feeding species by an external product (commercial fish pellet) in the system. The others species (extractive species) were fed from waste streams from the tank above or from Ulva produced by the system for the sea urchin. In this way, between the fish aquaculture only and the addition of the extractive species, the biomass productivity increase by 5.7. In other words, the food conversion ratio dropped from 1.08 with fish only to 0.189 including all species. This experimental recirculating multi-trophic aquaculture system was efficient enough to reduce waste and increase productivity. In a second time, this technology has been reproduced at a commercial scale. The IOPR in collaboration with Les 4 Marais company run for 6 month a recirculating IMTA in 8000 m² of water allocate between 4 marsh ponds. A similar air-lift and gravity recirculating system was design and only one feeding species of shrimp (Palaemon sp.) was growth for 3 extractive species. Thanks to this joint work at the laboratory and commercial scales we will be able to challenge IMTA system and discuss about this sustainable aquaculture technology.

Keywords: bioremediation, integrated multi-trophic aquaculture (IMTA), laboratory and commercial scales, recirculating aquaculture, sustainable

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659 Analysis of Differentially Expressed Genes in Spontaneously Occurring Canine Melanoma

Authors: Simona Perga, Chiara Beltramo, Floriana Fruscione, Isabella Martini, Federica Cavallo, Federica Riccardo, Paolo Buracco, Selina Iussich, Elisabetta Razzuoli, Katia Varello, Lorella Maniscalco, Elena Bozzetta, Angelo Ferrari, Paola Modesto

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Introduction: Human and canine melanoma have common clinical, histologic characteristics making dogs a good model for comparative oncology. The identification of specific genes and a better understanding of the genetic landscape, signaling pathways, and tumor–microenvironmental interactions involved in the cancer onset and progression is essential for the development of therapeutic strategies against this tumor in both species. In the present study, the differential expression of genes in spontaneously occurring canine melanoma and in paired normal tissue was investigated by targeted RNAseq. Material and Methods: Total RNA was extracted from 17 canine malignant melanoma (CMM) samples and from five paired normal tissues stored in RNA-later. In order to capture the greater genetic variability, gene expression analysis was carried out using two panels (Qiagen): Human Immuno-Oncology (HIO) and Mouse-Immuno-Oncology (MIO) and the miSeq platform (Illumina). These kits allow the detection of the expression profile of 990 genes involved in the immune response against tumors in humans and mice. The data were analyzed through the CLCbio Genomics Workbench (Qiagen) software using the Canis lupus familiaris genome as a reference. Data analysis were carried out both comparing the biologic group (tumoral vs. healthy tissues) and comparing neoplastic tissue vs. paired healthy tissue; a Fold Change greater than two and a p-value less than 0.05 were set as the threshold to select interesting genes. Results and Discussion: Using HIO 63, down-regulated genes were detected; 13 of those were also down-regulated comparing neoplastic sample vs. paired healthy tissue. Eighteen genes were up-regulated, 14 of those were also down-regulated comparing neoplastic sample vs. paired healthy tissue. Using the MIO, 35 down regulated-genes were detected; only four of these were down-regulated, also comparing neoplastic sample vs. paired healthy tissue. Twelve genes were up-regulated in both types of analysis. Considering the two kits, the greatest variation in Fold Change was in up-regulated genes. Dogs displayed a greater genetic homology with humans than mice; moreover, the results have shown that the two kits are able to detect different genes. Most of these genes have specific cellular functions or belong to some enzymatic categories; some have already been described to be correlated to human melanoma and confirm the validity of the dog as a model for the study of molecular aspects of human melanoma.

Keywords: animal model, canine melanoma, gene expression, spontaneous tumors, targeted RNAseq

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658 Jurisdiction Conflicts in Contracts of International Maritime Transport: The Application of the Forum Selection Clause in Brazilian Courts

Authors: Renan Caseiro De Almeida, Mateus Mello Garrute

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The world walks to be ever more globalised. This trend promotes an increase on the number of transnational commercial transactions. The main modal for carriage of goods is by sea, and many countries have their economies dependent on the maritime freightage – it could be because they exercise largely this activity or because they follow the tendency of using the maritime logistic widely. Among these ones, Brazil is included. This nation counts with sixteen ports with good capacities, which receive most of the international income by sea. It is estimated that 85 per cent of the total influx of goods in Brazil is by maritime modal, leaving mere 15 per cent for the other ones. This made it necessary to develop maritime law in international and national basis, to create a standard to be applied with the intention to harmonize the transnational carriage of goods by sea. Maritime contracts are very specific and have interesting peculiarities, but in their range, little research has been made on what causes the main divergences when it comes to international contracts: the jurisdiction conflict. Likewise any other international contract, it is common for the parties to set a forum selection clause to choose the forum which will be able to judge the litigations that could rise from a maritime transport contract and, consequently, also which law should be applied to the cases. However, the forum choice in Brazil has always been somewhat polemical – not only in the maritime law sphere - for sometimes national tribunals overlook the parties’ choice and call the competence for themselves. In this sense, it is interesting to mention that the Mexico Convention of 1994 about the law applicable to international contracts did not gain strength in Brazil, nor even reached the Congress to be considered for ratification. Furthermore, it is also noteworthy that Brazil has a new Civil Procedure Code, which was put into reinforcement in 2016 bringing new legal provisions specifically about the forum selection. This represented a mark in the national legal system in this matter. Therefore, this paper intends to give an insight through Brazilian jurisprudence, making an analysis of how this issue has been treated on litigations about maritime contracts in the national tribunals, as well as the solutions found by the Brazilian legal system for the jurisdiction conflicts in those cases. To achieve the expected results, the hypothetical-deductive method will be used in combination with researches on doctrine and legislations. Also, jurisprudential research and case law study will have a special role, since the main point of this paper is to verify and study the position of the courts in Brazil in a specific matter. As a country of civil law, the Brazilian judges and tribunals are very attached to the rules displayed on codes. However, the jurisprudential understanding has been changing during the years and with the advent of the new rules about the applicable law and forum selection clause, it is noticeable that new winds are being blown.

Keywords: applicable law, forum selection clause, international business, international maritime contracts, litigation in courts

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657 Assessment of Five Photoplethysmographic Methods for Estimating Heart Rate Variability

Authors: Akshay B. Pawar, Rohit Y. Parasnis

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Heart Rate Variability (HRV) is a widely used indicator of the regulation between the autonomic nervous system (ANS) and the cardiovascular system. Besides being non-invasive, it also has the potential to predict mortality in cases involving critical injuries. The gold standard method for determining HRV is based on the analysis of RR interval time series extracted from ECG signals. However, because it is much more convenient to obtain photoplethysmogramic (PPG) signals as compared to ECG signals (which require the attachment of several electrodes to the body), many researchers have used pulse cycle intervals instead of RR intervals to estimate HRV. They have also compared this method with the gold standard technique. Though most of their observations indicate a strong correlation between the two methods, recent studies show that in healthy subjects, except for a few parameters, the pulse-based method cannot be a surrogate for the standard RR interval- based method. Moreover, the former tends to overestimate short-term variability in heart rate. This calls for improvements in or alternatives to the pulse-cycle interval method. In this study, besides the systolic peak-peak interval method (PP method) that has been studied several times, four recent PPG-based techniques, namely the first derivative peak-peak interval method (P1D method), the second derivative peak-peak interval method (P2D method), the valley-valley interval method (VV method) and the tangent-intersection interval method (TI method) were compared with the gold standard technique. ECG and PPG signals were obtained from 10 young and healthy adults (consisting of both males and females) seated in the armchair position. In order to de-noise these signals and eliminate baseline drift, they were passed through certain digital filters. After filtering, the following HRV parameters were computed from PPG using each of the five methods and also from ECG using the gold standard method: time domain parameters (SDNN, pNN50 and RMSSD), frequency domain parameters (Very low-frequency power (VLF), Low-frequency power (LF), High-frequency power (HF) and Total power or “TP”). Besides, Poincaré plots were also plotted and their SD1/SD2 ratios determined. The resulting sets of parameters were compared with those yielded by the standard method using measures of statistical correlation (correlation coefficient) as well as statistical agreement (Bland-Altman plots). From the viewpoint of correlation, our results show that the best PPG-based methods for the determination of most parameters and Poincaré plots are the P2D method (shows more than 93% correlation with the standard method) and the PP method (mean correlation: 88%) whereas the TI, VV and P1D methods perform poorly (<70% correlation in most cases). However, our evaluation of statistical agreement using Bland-Altman plots shows that none of the five techniques agrees satisfactorily well with the gold standard method as far as time-domain parameters are concerned. In conclusion, excellent statistical correlation implies that certain PPG-based methods provide a good amount of information on the pattern of heart rate variation, whereas poor statistical agreement implies that PPG cannot completely replace ECG in the determination of HRV.

Keywords: photoplethysmography, heart rate variability, correlation coefficient, Bland-Altman plot

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656 A Comparison of Three Different Modalities in Improving Oral Hygiene in Adult Orthodontic Patients: An Open-Label Randomized Controlled Trial

Authors: Umair Shoukat Ali, Rashna Hoshang Sukhia, Mubassar Fida

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Introduction: The objective of the study was to compare outcomes in terms of Bleeding index (BI), Gingival Index (GI), and Orthodontic Plaque Index (OPI) with video graphics and plaque disclosing tablets (PDT) versus verbal instructions in adult orthodontic patients undergoing fixed appliance treatment (FAT). Materials and Methods: Adult orthodontic patients have recruited from outpatient orthodontic clinics who fulfilled the inclusion criteria and were randomly allocated to three groups i.e., video, PDT, and verbal groups. We included patients undergoing FAT for six months of both genders with all teeth bonded mesial to first molars having no co-morbid conditions such as rheumatic fever and diabetes mellitus. Subjects who had gingivitis as assessed by Bleeding Index (BI), Gingival Index (GI), and Orthodontic Plaque Index (OPI) were recruited. We excluded subjects having > 2 mm of clinical attachment loss, pregnant and lactating females, any history of periodontal therapy within the last six months, and any consumption of antibiotics or anti-inflammatory drugs within the last one month. Pre- and post-interventional measurements were taken at two intervals only for BI, GI, and OPI. The primary outcome of this trial was to evaluate the mean change in the BI, GI, and OPI in the three study groups. A computer-generated randomization list was used to allocate subjects to one of the three study groups using a random permuted block sampling of 6 and 9 to randomize the samples. No blinding of the investigator or the participants was performed. Results: A total of 99 subjects were assessed for eligibility, out of which 96 participants were randomized as three of the participants declined to be part of this trial. This resulted in an equal number of participants (32) that were analyzed in all three groups. The mean change in the oral hygiene indices score was assessed, and we found no statistically significant difference among the three interventional groups. Pre- and post-interventional results showed statistically significant improvement in the oral hygiene indices for the video and PDT groups. No statistically significant difference for age, gender, and education level on oral hygiene indices were found. Simple linear regression showed that the video group produced significantly higher mean OPI change as compared to other groups. No harm was observed during the trial. Conclusions: Visual aids performed better as compared to the verbal group. Gender, age, and education level had no statistically significant impact on the oral hygiene indices. Longer follow-ups will be required to see the long-term effects of these interventions. Trial Registration: NCT04386421 Funding: Aga Khan University and Hospital (URC 183022)

Keywords: oral hygiene, orthodontic treatment, adults, randomized clinical trial

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655 Spectrum of Bacteria Causing Oral and Maxillofacial Infections and Their Antibiotic Susceptibility among Patients Attending Muhimbili National Hospital

Authors: Sima E. Rugarabamu, Mecky I. Matee, Elison N. M. Simon

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Background: In Tanzania bacteriological studies of etiological agents of oro-facial infections are very limited, and very few have investigated anaerobes. The aim of this study was to determine the spectrum of bacterial agents involved in oral and maxillofacial infections in patients attending Muhimbili National Hospital, Dar-es-salaam, Tanzania. Method: This was a hospital based descriptive cross-sectional study that was conducted in the Department of Oral and Maxillofacial Surgery of the Muhimbili National Hospital in Dar es Salaam, Tanzania from 1st January 2014 to 31st August 2014. Seventy (70) patients with various forms of oral and maxillofacial infections who were recruited for the study. The study participants were interviewed using a prepared questionnaire after getting their consent. Pus aspirate was cultured on Blood agar, Chocolate Agar, MacConkey agar and incubated aerobically at 37°C. Imported blood agar was used for anaerobic culture whereby they were incubated at 37°Cin anaerobic jars in an atmosphere of generated using commercial gas-generating kits in accordance with manufacturer’s instructions. Plates were incubated at 37°C for 24 hours (For aerobic culture and 48 hours for anaerobic cultures). Gram negative rods were identified using API 20E while all other isolates were identified by conventional biochemical tests. Antibiotic sensitivity testing for isolated aerobic and anaerobic bacteria was detected by the disk diffusion, agar dilution and E-test using routine and commercially available antibiotics used to treat oral facial infections. Results: This study comprised of 41 (58.5%) males and 29 (41.5%) females with a mean age of 32 years SD +/-15.1 and a range of 19 to 70 years. A total of 161 bacteria strains were isolated from specimens obtained from 70 patients which were an average of 2.3 isolates per patient. Of these 103 were aerobic organism and 58 were strict anaerobes. A complex mix of strict anaerobes and facultative anaerobes accounted for 87% of all infections.The most frequent aerobes isolated was streptococcus spp 70 (70%) followed by Staphylococcus spp 18 (18%). Other organisms such as Klebsiella spp 4 (4%), Proteus spp 5 (5%) and Pseudomonas spp 2 (2%) were also seen. The anaerobic group was dominated by Prevotella spp 25 (43%) followed by Peptostreptococcus spp 18 (31%); other isolates were Pseudomonas spp 2 (1%), black pigmented Pophyromonas spp 4 (5%), Fusobacterium spp 3 (3%) and Bacteroides spp 5 (8%). Majority of these organisms were sensitive to Amoxicillin (98%), Gentamycin (89%), and Ciprofloxacin (100%). A 40% resistance to metronidazole was observed in Bacteroides spp otherwise this drug and others displayed good activity against anaerobes. Conclusions: Oral and maxillofacial facial infections at Muhimbili National Hospital are mostly caused by streptococcus spp and Prevotella spp. Strict anaerobes accounted for 36% of all isolates. The profile of isolates should assist in selecting empiric therapy for infections of the oral and maxillofacial region. Inclusion of antimicrobial agents against anaerobic bacteria is highly recommended.

Keywords: bacteria, oral and maxillofacial infections, antibiotic susceptibility, Tanzania

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654 Passive Greenhouse Systems in Poland

Authors: Magdalena Grudzińska

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Passive systems allow solar radiation to be converted into thermal energy thanks to appropriate building construction. Greenhouse systems are particularly worth attention, due to the low costs of their realization and strong architectural appeal. The paper discusses the energy effects of using passive greenhouse systems, such as glazed balconies, in an example residential building. The research was carried out for five localities in Poland, belonging to climatic zones different in terms of external air temperature and insolation: Koszalin, Poznań, Lublin, Białystok and Zakopane The analysed apartment had a floor area of approximately 74 m² Three thermal zones were distinguished in the flat - the balcony, the room adjacent to it, and the remaining space, for which various internal conditions were defined. Calculations of the energy demand were made using the dynamic simulation program, based on the control volume method. The climatic data were represented by Typical Meteorological Years, prepared on the basis of source data collected from 1971 to 2000. In each locality, the introduction of a passive greenhouse system led to a lower demand for heating in the apartment, and the shortening of the heating season. The smallest effectiveness of passive solar energy systems was noted in Białystok. Demand for heating was reduced there by 14.5% and the heating season remained the longest, due to low temperatures of external air and small sums of solar radiation intensity. In Zakopane, energy savings came to 21% and the heating season was reduced to 107 days, thanks to the greatest insolation during winter. The introduction of greenhouse systems caused an increase in cooling demand in the warmer part of the year, but total energy demand declined in each of the discussed places. However, potential energy savings are smaller if the building's annual life cycle is taken into consideration, and amount from 5.6% up to 14%. Koszalin and Zakopane are localities in which the greenhouse system allows the best energy results to be achieved. It should be emphasized that favourable conditions for introducing greenhouse systems are connected with different climatic conditions. In the seaside area (Koszalin) they result from high temperatures in the heating season and the smallest insolation in the summer period, while in the mountainous area (Zakopane) they result from high insolation in the winter and low temperatures in the summer. In the region of middle and middle-eastern Poland active systems (such as solar energy collectors or photovoltaic panels) could be more beneficial, due to high insolation during summer. It is assessed that passive systems do not eliminate the need for traditional heating in Poland. They can, however, substantially contribute to lower use of non-renewable fuels and the shortening of the heating season. The calculations showed diversification in the effectiveness of greenhouse systems resulting from climatic conditions, and allowed to identify areas which are the most suitable for the passive use of solar radiation.

Keywords: solar energy, passive greenhouse systems, glazed balconies, climatic conditions

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653 Interconnections of Circular Economy, Circularity, and Sustainability: A Systematic Review and Conceptual Framework

Authors: Anteneh Dagnachew Sewenet, Paola Pisano

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The concept of circular economy, circularity, and sustainability are interconnected and promote a more sustainable future. However, previous studies have mainly focused on each concept individually, neglecting the relationships and gaps in the existing literature. This study aims to integrate and link these concepts to expand the theoretical and practical methods of scholars and professionals in pursuit of sustainability. The aim of this systematic literature review is to comprehensively analyze and summarize the interconnections between circular economy, circularity, and sustainability. Additionally, it seeks to develop a conceptual framework that can guide practitioners and serve as a basis for future research. The review employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. A total of 78 articles were analyzed, utilizing the Scopus and Web of Science databases. The analysis involved summarizing and systematizing the conceptualizations of circularity and its relationship with the circular economy and long-term sustainability. The review provided a comprehensive overview of the interconnections between circular economy, circularity, and sustainability. Key themes, theoretical frameworks, empirical findings, and conceptual gaps in the literature were identified. Through a rigorous analysis of scholarly articles, the study highlighted the importance of integrating these concepts for a more sustainable future. This study contributes to the existing literature by integrating and linking the concepts of circular economy, circularity, and sustainability. It expands the theoretical understanding of how these concepts relate to each other and provides a conceptual framework that can guide future research in this field. The findings emphasize the need for a holistic approach in achieving sustainability goals. The data collection for this review involved identifying relevant articles from the Scopus and Web of Science databases. The selection of articles was made based on predefined inclusion and exclusion criteria. The PRISMA protocol guided the systematic analysis of the selected articles, including summarizing and systematizing their content. This study addressed the question of how circularity is conceptualized and related to both the circular economy and long-term sustainability. It aimed to identify the interconnections between these concepts and bridge the gap in the existing literature. The review provided a comprehensive analysis of the interconnections between the circular economy, circularity, and sustainability. It presented a conceptual framework that can guide practitioners in implementing circular economy strategies and serve as a basis for future research. By integrating these concepts, scholars, and professionals can enhance the theoretical and practical methods in pursuit of a more sustainable future. The findings emphasize the importance of taking a holistic approach to achieve sustainability goals and highlight conceptual gaps that can be addressed in future studies.

Keywords: circularity, circular economy, sustainability, innovation

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652 Predictability of Kiremt Rainfall Variability over the Northern Highlands of Ethiopia on Dekadal and Monthly Time Scales Using Global Sea Surface Temperature

Authors: Kibrom Hadush

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Countries like Ethiopia, whose economy is mainly rain-fed dependent agriculture, are highly vulnerable to climate variability and weather extremes. Sub-seasonal (monthly) and dekadal forecasts are hence critical for crop production and water resource management. Therefore, this paper was conducted to study the predictability and variability of Kiremt rainfall over the northern half of Ethiopia on monthly and dekadal time scales in association with global Sea Surface Temperature (SST) at different lag time. Trends in rainfall have been analyzed on annual, seasonal (Kiremt), monthly, and dekadal (June–September) time scales based on rainfall records of 36 meteorological stations distributed across four homogenous zones of the northern half of Ethiopia for the period 1992–2017. The results from the progressive Mann–Kendall trend test and the Sen’s slope method shows that there is no significant trend in the annual, Kiremt, monthly and dekadal rainfall total at most of the station's studies. Moreover, the rainfall in the study area varies spatially and temporally, and the distribution of the rainfall pattern increases from the northeast rift valley to northwest highlands. Methods of analysis include graphical correlation and multiple linear regression model are employed to investigate the association between the global SSTs and Kiremt rainfall over the homogeneous rainfall zones and to predict monthly and dekadal (June-September) rainfall using SST predictors. The results of this study show that in general, SST in the equatorial Pacific Ocean is the main source of the predictive skill of the Kiremt rainfall variability over the northern half of Ethiopia. The regional SSTs in the Atlantic and the Indian Ocean as well contribute to the Kiremt rainfall variability over the study area. Moreover, the result of the correlation analysis showed that the decline of monthly and dekadal Kiremt rainfall over most of the homogeneous zones of the study area are caused by the corresponding persistent warming of the SST in the eastern and central equatorial Pacific Ocean during the period 1992 - 2017. It is also found that the monthly and dekadal Kiremt rainfall over the northern, northwestern highlands and northeastern lowlands of Ethiopia are positively correlated with the SST in the western equatorial Pacific, eastern and tropical northern the Atlantic Ocean. Furthermore, the SSTs in the western equatorial Pacific and Indian Oceans are positively correlated to the Kiremt season rainfall in the northeastern highlands. Overall, the results showed that the prediction models using combined SSTs at various ocean regions (equatorial and tropical) performed reasonably well in the prediction (With R2 ranging from 30% to 65%) of monthly and dekadal rainfall and recommends it can be used for efficient prediction of Kiremt rainfall over the study area to aid with systematic and informed decision making within the agricultural sector.

Keywords: dekadal, Kiremt rainfall, monthly, Northern Ethiopia, sea surface temperature

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651 Correlations and Impacts Of Optimal Rearing Parameters on Nutritional Value Of Mealworm (Tenebrio Molitor)

Authors: Fabienne Vozy, Anick Lepage

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Insects are displaying high nutritional value, low greenhouse gas emissions, low land use requirements and high food conversion efficiency. They can contribute to the food chain and be one of many solutions to protein shortages. Currently, in North America, nutritional entomology is under-developed and the needs to better understand its benefits remain to convince large-scale producers and consumers (both for human and agricultural needs). As such, large-scale production of mealworms offers a promising alternative to replacing traditional sources of protein and fatty acids. To proceed orderly, it is required to collect more data on the nutritional values of insects such as, a) Evaluate the diets of insects to improve their dietary value; b) Test the breeding conditions to optimize yields; c) Evaluate the use of by-products and organic residues as sources of food. Among the featured technical parameters, relative humidity (RH) percentage and temperature, optimal substrates and hydration sources are critical elements, thus establishing potential benchmarks for to optimize conversion rates of protein and fatty acids. This research is to establish the combination of the most influential rearing parameters with local food residues, to correlate the findings with the nutritional value of the larvae harvested. 125 same-monthly old adults/replica are randomly selected in the mealworm breeding pool then placed to oviposit in growth chambers preset at 26°C and 65% RH. Adults are removed after 7 days. Larvae are harvested upon the apparition of the first nymphosis signs and batches, are analyzed for their nutritional values using wet chemistry analysis. The first samples analyses include total weight of both fresh and dried larvae, residual humidity, crude proteins (CP%), and crude fats (CF%). Further analyses are scheduled to include soluble proteins and fatty acids. Although they are consistent with previous published data, the preliminary results show no significant differences between treatments for any type of analysis. Nutritional properties of each substrate combination have yet allowed to discriminate the most effective residue recipe. Technical issues such as the particles’ size of the various substrate combinations and larvae screen compatibility are to be investigated since it induced a variable percentage of lost larvae upon harvesting. To address those methodological issues are key to develop a standardized efficient procedure. The aim is to provide producers with easily reproducible conditions, without incurring additional excessive expenditure on their part in terms of equipment and workforce.

Keywords: entomophagy, nutritional value, rearing parameters optimization, Tenebrio molitor

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650 Assessment of Water Pollution in the River Nile (Egypt) by Applying Blood Biomarkers in Two Excellent Model Species Oreochromis niloticus niloticus and Clarias gariepinus

Authors: Alaa G. M. Osman, Abd-El –Baset M. Abd El Reheem, Khaled Y. Abouelfadl, Usama M. Mahmoud, Mohsen A. Moustafa

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This study aimed to explore new sites of biomarker research and to establish the use of blood parameters in wild fish populations. Four hundred and twenty fish samples were collected from six sites along the whole course of the river Nile, Egypt. The mean values of erythrocytes, thrombocytes, hemoglobin concentration, hematocrit value, and mean corpuscular volume were significantly lower in the blood of Nile tilapia and African catfish collected from downstream (contaminated) compared to upstream sites. In contrast, mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration in the peripheral blood of both fish species significantly increased from upstream to downstream river Nile. The leukocytes count was significantly decreased in contaminated sites compared to upstream area. Hematological variables in the peripheral blood of Oreochromis niloticus niloticus and Clarias gariepinus exhibited significant (p<0.05) correlation with nearly all the detected chemical and physical parameters along the Nile course. In the present study, lower cellular and nuclear areas and cellular and nuclear shape factor were recorded in the erythrocytes of fish collected from downstream compared to those caught from upstream sites. This was confirmed by higher immature ratios of red cells in the blood of fish sampled from downstream river Nile. Karyorrhetic and enucleated erythrocytes were significantly correlated with physiochemical parameters in water samples collected from the same sites is being higher in the blood of fish collected from downstream sites. To see if there was any correlation between fish altered physiological fitness and environmental stress, we measured serum biochemical variables namely; total protein, cholesterol, triglycerides, calcium, chlorides, alkaline phosphatase activity (ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), uric acid activity, creatinine, and serum glucose. The level of all the selected biochemical variables in the blood of O. niloticus niloticus and C. gariepinus were recorded to be significantly higher (p<0.05) in downstream sites. According to the present results, nearly all the detected haematological and blood biochemical variables are suitable indicators of contaminant exposure in O. niloticus niloticus and C. gariepinus. Also the detected erythrocytes malformations in blood collected from Nile tilapia and African catfish were proven to be suitable for bio-monitoring aquatic pollution. The results revealed species-specific differences in sensitivities, suggesting that Nile tilapia may serve as a more sensitive test species compared to African catfish.

Keywords: biomarkers, water pollution, blood parameters, river nile, african catfish, nile tilapia

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649 Analysis Rescuers' Viewpoint about Victims Tracking in Earthquake by Using Radio Frequency Identification (RFID)

Authors: Sima Ajami, Batool Akbari

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Background: Radio frequency identification (RFID) system has been successfully applied to the areas of manufacturing, supply chain, agriculture, transportation, healthcare, and services. The RFID is already used to track and trace the victims in a disaster situation. Data can be collected in real time and be immediately available to emergency personnel and saves time by the RFID. Objectives: The aim of this study was, first, to identify stakeholders and customers for rescuing earthquake victims, second, to list key internal and external factors to use RFID to track earthquake victims, finally, to assess SWOT for rescuers' viewpoint. Materials and Methods: This study was an applied and analytical study. The study population included scholars, experts, planners, policy makers and rescuers in the "red crescent society of Isfahan province", "disaster management Isfahan province", "maintenance and operation department of Isfahan", "fire and safety services organization of Isfahan municipality", and "medical emergencies and disaster management center of Isfahan". After that, researchers held a workshop to teach participants about RFID and its usages in tracking earthquake victims. In the meanwhile of the workshop, participants identified, listed, and weighed key internal factors (strengths and weaknesses; SW) and external factors (opportunities and threats; OT) to use RFID in tracking earthquake victims. Therefore, participants put weigh strengths, weaknesses, opportunities, and threats (SWOT) and their weighted scales were calculated. Then, participants' opinions about this issue were assessed. Finally, according to the SWOT matrix, strategies to solve the weaknesses, problems, challenges, and threats through opportunities and strengths were proposed by participants. Results: The SWOT analysis showed that the total weighted score for internal and external factors were 3.91 (Internal Factor Evaluation) and 3.31 (External Factor Evaluation) respectively. Therefore, it was in a quadrant SO strategies cell in the SWOT analysis matrix and aggressive strategies were resulted. Organizations, scholars, experts, planners, policy makers and rescue workers should plan to use RFID technology in order to save more victims and manage their life. Conclusions: Researchers suppose to apply SO strategies and use a firm’s internal strength to take advantage of external opportunities. It is suggested, policy maker should plan to use the most developed technologies to save earthquake victims and deliver the easiest service to them. To do this, education, informing, and encouraging rescuers to use these technologies is essential. Originality/ Value: This study was a research paper that showed how RFID can be useful to track victims in earthquake.

Keywords: frequency identification system, strength, weakness, earthquake, victim

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648 Exploring the Gap between Coverage, Access, Utilization of Long Lasting Insecticidal Nets (LLINs) among the People of Malaria Endemic Districts in Bangladesh

Authors: Fouzia Khanam, Tridib Chowdhury, Belal Hossain, Sajedur Rahman, Mahfuzar Rahman

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Introduction: Over the last decades, the world has achieved a noticeable success in preventing malaria. Nevertheless, malaria, a vector-borne infectious disease, remains a major public health burden globally as well as in Bangladesh. To achieve the goal of eliminating malaria, BRAC, a leading organization of Bangladesh in collaboration with government, is distributing free LLIN to the 13 endemic districts of the country. The study was conducted with the aim of assessing the gap between coverage, access, and utilization of LLIN among the people of the 13 malaria endemic districts of Bangladesh. Methods: This baseline study employed a community cross-sectional design triangulated with qualitative methods to measure households’ ownership, access and use of 13 endemic districts. A multistage cluster random sampling was employed for the quantitative part and for qualitative part a purposive sampling strategy was done. Thus present analysis included 2640 households encompassing a total of 14475 populations. Data were collected using a pre-tested structured questionnaire through one on one face-to-face interview with respondents. All analyses were performed using STATA (Version 13.0). For the qualitative part participant observation, in-depth interview, focus group discussion, key informant interview and informal interview was done to gather the contextual data. Findings: According to our study, 99.8% of households possessed at least one-bed net in both study areas. 77.4% households possessed at least two LLIN and 43.2% households had access to LLIN for all the members. So the gap between coverage and access is 34%. 91.8% people in the 13 districts and 95.1% in Chittagong Hill Tracts areas reported having had slept under a bed net the night before interviewed. And despite the relatively low access, in 77.8% of households, all the members were used the LLIN the previous night. This higher utilization compared to access might be due to the increased awareness among the community people regarding LLIN uses. However, among those people with sufficient access to LLIN, 6% of them still did not use the LLIN which reflects the behavioral failure that needs to be addressed. The major reasons for not using LLIN, identified by both qualitative and quantitative findings, were insufficient access, sleeping or living outside the home, migration, perceived low efficacy of LLIN, fear of physical side effects or feeling uncomfortable. Conclusion: Given that LLIN access and use was a bit short of the targets, it conveys important messages to the malaria control program. Targeting specific population segments and groups for achieving expected LLIN coverage is very crucial. And also, addressing behavior failure by well-designed behavioral change interventions is mandatory.

Keywords: long lasting insecticide net, malaria, malaria control programme, World Health Organisation

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647 Solar Electric Propulsion: The Future of Deep Space Exploration

Authors: Abhishek Sharma, Arnab Banerjee

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The research is intended to study the solar electric propulsion (SEP) technology for planetary missions. The main benefits of using solar electric propulsion for such missions are shorter flight times, more frequent target accessibility and the use of a smaller launch vehicle than that required by a comparable chemical propulsion mission. Energized by electric power from on-board solar arrays, the electrically propelled system uses 10 times less propellant than conventional chemical propulsion system, yet the reduced fuel mass can provide vigorous power which is capable of propelling robotic and crewed missions beyond the Lower Earth Orbit (LEO). The various thrusters used in the SEP are gridded ion thrusters and the Hall Effect thrusters. The research is solely aimed to study the ion thrusters and investigate the complications related to it and what can be done to overcome the glitches. The ion thrusters are used because they are found to have a total lower propellant requirement and have substantially longer time. In the ion thrusters, the anode pushes or directs the incoming electrons from the cathode. But the anode is not maintained at a very high potential which leads to divergence. Divergence leads to the charges interacting against the surface of the thruster. Just as the charges ionize the xenon gases, they are capable of ionizing the surfaces and over time destroy the surface and hence contaminate it. Hence the lifetime of thruster gets limited. So a solution to this problem is using substances which are not easy to ionize as the surface material. Another approach can be to increase the potential of anode so that the electrons don’t deviate much or reduce the length of thruster such that the positive anode is more effective. The aim is to work on these aspects as to how constriction of the deviation of charges can be done by keeping the input power constant and hence increase the lifetime of the thruster. Predominantly ring cusp magnets are used in the ion thrusters. However, the study is also intended to observe the effect of using solenoid for producing micro-solenoidal magnetic field apart from using the ring cusp magnetic field which are used in the discharge chamber for prevention of interaction of electrons with the ionization walls. Another foremost area of interest is what are the ways by which power can be provided to the Solar Electric Propulsion Vehicle for lowering and boosting the orbit of the spacecraft and also provide substantial amount of power to the solenoid for producing stronger magnetic fields. This can be successfully achieved by using the concept of Electro-dynamic tether which will serve as a power source for powering both the vehicle and the solenoids in the ion thruster and hence eliminating the need for carrying extra propellant on the spacecraft which will reduce the weight and hence reduce the cost of space propulsion.

Keywords: electro-dynamic tether, ion thruster, lifetime of thruster, solar electric propulsion vehicle

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646 Rural Entrepreneurship as a Response to Climate Change and Resource Conservation

Authors: Omar Romero-Hernandez, Federico Castillo, Armando Sanchez, Sergio Romero, Andrea Romero, Michael Mitchell

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Environmental policies for resource conservation in rural areas include subsidies on services and social programs to cover living expenses. Government's expectation is that rural communities who benefit from social programs, such as payment for ecosystem services, are provided with an incentive to conserve natural resources and preserve natural sinks for greenhouse gases. At the same time, global climate change has affected the lives of people worldwide. The capability to adapt to global warming depends on the available resources and the standard of living, putting rural communities at a disadvantage. This paper explores whether rural entrepreneurship can represent a solution to resource conservation and global warming adaptation in rural communities. The research focuses on a sample of two coffee communities in Oaxaca, Mexico. Researchers used geospatial information contained in aerial photographs of the geographical areas of interest. Households were identified in the photos via the roofs of households and georeferenced via coordinates. From the household population, a random selection of roofs was performed and received a visit. A total of 112 surveys were completed, including questions of socio-demographics, perception to climate change and adaptation activities. The population includes two groups of study: entrepreneurs and non-entrepreneurs. Data was sorted, filtered, and validated. Analysis includes descriptive statistics for exploratory purposes and a multi-regression analysis. Outcomes from the surveys indicate that coffee farmers, who demonstrate entrepreneurship skills and hire employees, are more eager to adapt to climate change despite the extreme adverse socioeconomic conditions of the region. We show that farmers with entrepreneurial tendencies are more creative in using innovative farm practices such as the planting of shade trees, the use of live fencing, instead of wires, and watershed protection techniques, among others. This result counters the notion that small farmers are at the mercy of climate change and have no possibility of being able to adapt to a changing climate. The study also points to roadblocks that farmers face when coping with climate change. Among those roadblocks are a lack of extension services, access to credit, and reliable internet, all of which reduces access to vital information needed in today’s constantly changing world. Results indicate that, under some circumstances, funding and supporting entrepreneurship programs may provide more benefit than traditional social programs.

Keywords: entrepreneurship, global warming, rural communities, climate change adaptation

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645 Prospects of Agroforestry Products in the Emergency Situation: A Case Study of Earthquake of 2015 in Central Nepal

Authors: Raju Chhetri

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Agroforestry is one of the main sources of livelihood among the people of Nepal. In particular, this is the only one mode of livelihood among the Chepangs. The monster earthquake (7.3 MW) that hit the country on the 25th of April in 2015 and many of its aftershocks had devastating effects. As a result, not only the big structures collapsed, it incurred great losses on fabrication, collection centers, schools, markets and other necessary service centers. Although there were a large number of aftershocks after the monster earthquake, the most devastating aftershock took place on 12th May, 2015, which measured 6.3 richter scale. Consequently, it caused more destruction of houses, further calamity to the lives of people, and public life got further perdition. This study was mainly carried out to find out the food security and market situation of Agroforestry product of the Chepang community in Raksirang VDC (one of the severely affected VDCs of Makwanpur district) due to the earthquake. A total of 40 households (12 percent) were randomly selected as a sample in ward number 7 only. Questionnaires and focus groups were used to gather primary data. Additional, two Focus Group Discussions (FGD) were convened in the study area to get some descriptive information on this study. Estimated 370 hectares of land, which was full of Agroforestry plantation, ruptured by the earthquake. It caused severe damages to the households, and a serious loss of food-stock, up to 60-80 percent (maize, millet, and rice). Instead of regular cereal intake, banana (Muas Paradisca) consumption was found ‘high scale’ in the emergency period. The market price of rice (37-44 NRS/Kg) increased by 18.9 percent. Some difference in the income range before and after the earthquake was observed. Before earthquake, sale of Agroforestry, and livestock products were continuing, but after the earthquake, Agroforestry product sale is the only one means of livelihood among Chepangs. Nearly 50-60 percent Agroforestry production of banana (Mass Paradisca), citrus (Citrus Lemon), pineapple (Ananus comosus) and broom grass (Thysanolaena maxima) declined, excepting for cash income from the residual. Heavy demands of Agroforestry product mentioned above lay high farm gate prices (50-100 percent) helps surveyed the community to continue livelihood from its sale. Out of the survey samples, 30 households (75 percent) respondents migrated to safe location due to land rupture, ongoing aftershocks, and landslides. Overall food security situation in this community is acute and challenging for the days to come. Immediate and long term both response from a relief agency concerning food, shelter and safe stocking of Agroforestry product is required to keep secured livelihood in Chepang community.

Keywords: earthquake, rupture, agroforestry, livelihood, indigenous, food security

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644 Preparation of Papers - Developing a Leukemia Diagnostic System Based on Hybrid Deep Learning Architectures in Actual Clinical Environments

Authors: Skyler Kim

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An early diagnosis of leukemia has always been a challenge to doctors and hematologists. On a worldwide basis, it was reported that there were approximately 350,000 new cases in 2012, and diagnosing leukemia was time-consuming and inefficient because of an endemic shortage of flow cytometry equipment in current clinical practice. As the number of medical diagnosis tools increased and a large volume of high-quality data was produced, there was an urgent need for more advanced data analysis methods. One of these methods was the AI approach. This approach has become a major trend in recent years, and several research groups have been working on developing these diagnostic models. However, designing and implementing a leukemia diagnostic system in real clinical environments based on a deep learning approach with larger sets remains complex. Leukemia is a major hematological malignancy that results in mortality and morbidity throughout different ages. We decided to select acute lymphocytic leukemia to develop our diagnostic system since acute lymphocytic leukemia is the most common type of leukemia, accounting for 74% of all children diagnosed with leukemia. The results from this development work can be applied to all other types of leukemia. To develop our model, the Kaggle dataset was used, which consists of 15135 total images, 8491 of these are images of abnormal cells, and 5398 images are normal. In this paper, we design and implement a leukemia diagnostic system in a real clinical environment based on deep learning approaches with larger sets. The proposed diagnostic system has the function of detecting and classifying leukemia. Different from other AI approaches, we explore hybrid architectures to improve the current performance. First, we developed two independent convolutional neural network models: VGG19 and ResNet50. Then, using both VGG19 and ResNet50, we developed a hybrid deep learning architecture employing transfer learning techniques to extract features from each input image. In our approach, fusing the features from specific abstraction layers can be deemed as auxiliary features and lead to further improvement of the classification accuracy. In this approach, features extracted from the lower levels are combined into higher dimension feature maps to help improve the discriminative capability of intermediate features and also overcome the problem of network gradient vanishing or exploding. By comparing VGG19 and ResNet50 and the proposed hybrid model, we concluded that the hybrid model had a significant advantage in accuracy. The detailed results of each model’s performance and their pros and cons will be presented in the conference.

Keywords: acute lymphoblastic leukemia, hybrid model, leukemia diagnostic system, machine learning

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643 Biocompatibility of Calcium Phosphate Coatings With Different Crystallinity Deposited by Sputtering

Authors: Ekaterina S. Marchenko, Gulsharat A. Baigonakova, Kirill M. Dubovikov, Igor A. Khlusov

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NiTi alloys combine biomechanical and biochemical properties. This makes them a perfect candidate for medical applications. However, there is a serious problem with these alloys, such as the release of Ni from the matrix. Ni ions are known to be toxic to living tissues and leach from the matrix into the surrounding implant tissues due to corrosion after prolonged use. To prevent the release of Ni ions, corrosive strong coatings are usually used. Titanium nitride-based coatings are perfect corrosion inhibitors and also have good bioactive properties. However, there is an opportunity to improve the biochemical compatibility of the surface by depositing another layer. This layer can consist of elements such as calcium and phosphorus. The Ca and P ions form different calcium phosphate phases, which are present in the mineral part of human bones. We therefore believe that these elements must promote osteogenesis and osteointegration. In view of the above, the aim of this study is to investigate the effect of crystallinity on the biocompatibility of a two-layer coating deposited on NiTi substrate by sputtering. The first step of the research, apart from the NiTi polishing, is the layer-by-layer deposition of Ti-Ni-Ti by magnetron sputtering and the subsequent synthesis of this composite in an N atmosphere at 900 °C. The total thickness of the corrosion resistant layer is 150 nm. Plasma assisted RF sputtering was then used to deposit a bioactive film on the titanium nitride layer. A Ca-P powder target was used to obtain such a film. We deposited three types of Ca-P layers with different crystallinity and compared them in terms of cytotoxicity. One group of samples had no Ca-P coating and was used as a control. We obtained different crystallinity by varying the sputtering parameters such as bias voltage, plasma source current and pressure. XRD analysis showed that all coatings are calcium phosphate, but the sample obtained at maximum bias and plasma source current and minimum pressure has the most intense peaks from the coating phase. SEM and EDS showed that all three coatings have a homogeneous and dense structure without cracks and consist of calcium, phosphorus and oxygen. Cytotoxic tests carried out on three types of samples with Ca-P coatings and a control group showed that the control sample and the sample with Ca-P coating obtained at maximum bias voltage and plasma source current and minimum pressure had the lowest number of dead cells on the surface, around 11 ± 4%. Two other types of samples with Ca-P coating have 40 ± 9% and 21 ± 7% dead cells on the surface. It can therefore be concluded that these two sputtering modes have a negative effect on the corrosion resistance of the whole samples. The third sputtering mode does not affect the corrosion resistance and has the same level of cytotoxicity as the control. It can be concluded that the most suitable sputtering mode is the third with maximum bias voltage and plasma source current and minimum pressure.

Keywords: calcium phosphate coating, cytotoxicity, NiTi alloy, two-layer coating

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642 Missed Opportunities for Immunization of under Five Children in Calabar South County Cros River State, Nigeria, the Way Forward

Authors: Celestine Odigwe, Epoke Lincoln, Rhoda-Dara Ephraim

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Background; Immunization against the childhood killer diseases is the cardinal strategy for the prevention of these diseases all over the world in under five children, these diseases include; Tuberculosis, Measles, Polio, Tetanus, Diphthria, Pertusis, Yellow Fever, Hepatitis B, Haemophilus Influenza type B. 6.9 million children die before their fifth birthday , 80% of the worlds death in children under 5 years occur in 25 countries most in Africa and Asia and 2 million children can be saved each year with routine immunization Therefore failure to achieve total immunization coverage puts several children at risk. Aim; The aim of the study was to ascertain the prevalence, Investigate the various reasons and causes why several under five children in a suburb of calabar municipal county fail to get the required immunizations as at and when due and possibly the consequences, so that efforts can be re-directed towards the solution of the problems so identified. Methods; the study was a community based cross sectional study. The respondents were the mothers/guardians of the sampled children who were all aged 0-59 months. To be eligible for recruitment into the study, the parent or guardian was required to give an informed consent, reside within the Calabar South County with his/her children aged 0-59 months. We calculated our sample size using the Leslie-Kish formula and we used a two-staged sampling method, first to ballot for the wards to be involved and then to select four of the most populated ones in the wards chosen. Data collection was by interviewer administered structured questionnaire (Appendix I), Data collected was entered and analyzed using Statistical Package for the Social Sciences (SPSS) Version 20. Percentages were calculated and represented using charts and tables Results; The number of children sampled was 159. We found that 150 were fully immunized and 9 were not, the prevalence of missed opportunity was 32% from the study. The reasons for missed opportunities were varied, ranging from false contraindications, logistical problems resulting in very poor access roads to health facilities and poor organization of health centers together with negative health worker attitudes. Some of the consequences of these missed opportunities were increased susceptibility to vaccine preventable diseases, resurgence of the above diseases and increased morbidity and mortality of children aged less than 5 years. Conclusion; We found that ignorance on the part of both parents/guardians and health care staff together with infrastructural inadequacies in the county such as- roads, poor electric power supply for storage of vaccines were hugely responsible for most missed opportunities for immunization. The details of these and suggestions for improvement and the way forward are discussed.

Keywords: missed opportunity, immunization, under five, Calabar south

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641 Processing, Nutritional Assessment and Sensory Evaluation of Bakery Products Prepared from Orange Fleshed Sweet Potatoes (OFSP) and Wheat Composite Flours

Authors: Hategekimana Jean Paul, Irakoze Josiane, Ishimweyizerwe Valentin, Iradukunda Dieudonne, Uwanyirigira Jeannette

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Orange fleshed sweet potatoes (OFSP) are highly grown and are available plenty in rural and urban local markets and its contribution in reduction of food insecurity in Rwanda is considerable. But the postharvest loss of this commodity is a critical challenge due to its high perishability. Several research activities have been conducted on how fresh food commodities can be transformed into extended shelf life food products for prevention of post-harvest losses. However, such activity was not yet well studied in Rwanda. The aim of the present study was the processing of backed products from (OFSP)combined with wheat composite flour and assess the nutritional content and consumer acceptability of new developed products. The perishability of OFSP and their related lack during off season can be eradicated by producing cake, doughnut and bread with OFSP puree or flour. The processing for doughnut and bread were made by making OFSP puree and other ingredients then a dough was made followed by frying and baking while for cake OFSP was dried through solar dryer to have a flour together with wheat flour and other ingredients to make dough cake and baking. For each product, one control and three experimental samples, (three products in three different ratios (30,40 and50%) of OFSP and the remaining percentage of wheat flour) were prepared. All samples including the control were analyzed for the consumer acceptability (sensory attributes). Most preferred samples (One sample for each product with its control sample and for each OFSP variety) were analyzed for nutritional composition along with control sample. The Cake from Terimbere variety and Bread from Gihingumukungu supplemented with 50% OFSP flour or Puree respectively were most acceptable except Doughnut from Vita variety which was highly accepted at 50% of OFSP supplementation. The moisture, ash, protein, fat, fiber, Total carbohydrate, Vitamin C, reducing sugar and minerals (Sodium, Potassium and Phosphorus.) content was different among products. Cake was rich in fibers (14.71%), protein (6.590%), and vitamin c(19.988mg/100g) compared to other samples while bread found to be rich in reducing sugar with 12.71mg/100g compared to cake and doughnut. Also doughnut was found to be rich in fat content with 6.89% compared to other samples. For sensory analysis, doughnut was highly accepted in ratio of 60:40 compared to other products while cake was least accepted at ratio of 50:50. The Proximate composition and minerals content of all the OFSP products were significantly higher as compared to the control samples.

Keywords: post-harvest loss, OFSP products, wheat flour, sensory evaluation, proximate composition

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640 Educational Institutional Approach for Livelihood Improvement and Sustainable Development

Authors: William Kerua

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The PNG University of Technology (Unitech) has mandatory access to teaching, research and extension education. Given such function, the Agriculture Department has established the ‘South Pacific Institute of Sustainable Agriculture and Rural Development (SPISARD)’ in 2004. SPISARD is established as a vehicle to improve farming systems practiced in selected villages by undertaking pluralistic extension method through ‘Educational Institutional Approach’. Unlike other models, SPISARD’s educational institutional approach stresses on improving the whole farming systems practiced in a holistic manner and has a two-fold focus. The first is to understand the farming communities and improve the productivity of the farming systems in a sustainable way to increase income, improve nutrition and food security as well as livelihood enhancement trainings. The second is to enrich the Department’s curriculum through teaching, research, extension and getting inputs from farming community. SPISARD has established number of model villages in various provinces in Papua New Guinea (PNG) and with many positive outcome and success stories. Adaption of ‘educational institutional approach’ thus binds research, extension and training into one package with the use of students and academic staff through model village establishment in delivering development and extension to communities. This centre (SPISARD) coordinates the activities of the model village programs and linkages. The key to the development of the farming systems is establishing and coordinating linkages, collaboration, and developing partnerships both within and external institutions, organizations and agencies. SPISARD has a six-point step strategy for the development of sustainable agriculture and rural development. These steps are (i) establish contact and identify model villages, (ii) development of model village resource centres for research and trainings, (iii) conduct baseline surveys to identify problems/needs of model villages, (iv) development of solution strategies, (v) implementation and (vi) evaluation of impact of solution programs. SPISARD envisages that the farming systems practiced being improved if the villages can be made the centre of SPISARD activities. Therefore, SPISARD has developed a model village approach to channel rural development. The model village when established become the conduit points where teaching, training, research, and technology transfer takes place. This approach is again different and unique to the existing ones, in that, the development process take place in the farmers’ environment with immediate ‘real time’ feedback mechanisms based on the farmers’ perspective and satisfaction. So far, we have developed 14 model villages and have conducted 75 trainings in 21 different areas/topics in 8 provinces to a total of 2,832 participants of both sex. The aim of these trainings is to directly participate with farmers in the pursuit to improving their farming systems to increase productivity, income and to secure food security and nutrition, thus to improve their livelihood.

Keywords: development, educational institutional approach, livelihood improvement, sustainable agriculture

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639 Immunoprotective Role of Baker's Yeast (Saccharomyces cerevisiae) against Experimentally Induced Aflatoxicosis in Broiler Chicks

Authors: Zain Ul Abadeen, Muhammad Zargham Khan, Muhammad Kashif Saleemi, Ahrar Khan, Ijaz Javed Hassan, Aisha Khatoon, Qasim Altaf

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Aflatoxins are secondary metabolites produced by toxigenic fungi, and there are four types of aflatoxins include AFB1, AFB2, AFG1 and AFG2. Aflatoxin B1 (AFB1) is considered as most toxic form. It is mainly responsible for the contamination of poultry feed and produces a condition called aflatoxicosis leads to immunosuppression in poultry birds. Saccharomyces cerevisiae is a single cell microorganism and acts as a source of growth factors, minerals and amino acids which improve the immunity and digestibility in poultry birds as probiotics. Saccharomyces cerevisiae is well recognized to cause the biological degradation of mycotoxins (toxin binder) because its cell wall contains β-glucans and mannans which specifically bind with aflatoxins and reduce their absorption or transfer them to some non-toxic compounds. The present study was designed to investigate the immunosuppressive effects of aflatoxins in broiler chicks and the reduction of severity of these effects by the use of Baker’s Yeast (Saccharomyces cerevisiae). One-day-old broiler chicks were procured from local hatchery and were divided into various groups (A-I). These groups were treated with different levels of AFB1 @ 400 µg/kg and 600 µg/kg along with different levels of Baker’s Yeast (Saccharomyces cerevisiae) 0.1% and 0.5 % in the feed. The total duration of the experiment was six weeks and different immunological parameters including the cellular immune response by injecting PHA-P (Phytohemagglutinin-P) in the skin of the birds, phagocytic function of mononuclear cells by Carbon clearance assay from blood samples and humoral immune response against intravenously injected sheep RBCs from the serum samples were determined. The birds from each group were slaughtered at the end of the experiment to determine the presence of gross lesions in the immune organs and these tissues were fixed in 10% neutral buffered formalin for histological investigations. The results showed that AFB1 intoxicated groups had reduced body weight gain, feed intake, organs weight and immunological responses compared to the control and Baker’s Yeast (Saccharomyces cerevisiae) treated groups. Different gross and histological degenerative changes were recorded in the immune organs of AFB1 intoxicated groups compared to control and Baker’s Yeast (Saccharomyces cerevisiae) treated groups. The present study concluded that Baker’s Yeast (Saccharomyces cerevisiae) addition in the feed helps to ameliorate the immunotoxigenic effects produced by AFB1 in broiler chicks.

Keywords: aflatoxins, body weight gain, feed intake, immunological response, toxigenic effect

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638 The Effect of the Construction Contract System by Simulating the Comparative Costs of Capital to the Financial Feasibility of the Construction of Toll Bali Mandara

Authors: Mas Pertiwi I. G. AG Istri, Sri Kristinayanti Wayan, Oka Aryawan I. Gede Made

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Ability of government to meet the needs of infrastructure investment constrained by the size of the budget commitments for other sectors. Another barrier is the complexity of the process of land acquisition. Public Private Partnership can help bridge the investment gap by including the amount of funding from the private sector, shifted the responsibility of financing, construction of the asset, and the operation and post-project design and care to them. In principle, a construction project implementation always requires the investor as a party to provide resources in the form of funding which it must be contained in a successor agreement in the form of a contract. In general, construction contracts consist of contracts which passed in Indonesia and contract International. One source of funding used in the implementation of construction projects comes from funding that comes from the collaboration between the government and the private sector, for example with the system: BLT (Build Lease Transfer), BOT (Build Operate Transfer), BTO (Build Transfer Operate) and BOO (Build Operate Own). And form of payment under a construction contract can be distinguished several ways: monthly payment, payments based on progress and payment after completed projects (Turn Key). One of the tools used to analyze the feasibility of the investment is to use financial models. The financial model describes the relationship between different variables and assumptions used. From a financial model will be known how the cash flow structure of the project, which includes revenues, expenses, liabilities to creditors and the payment of taxes to the government. Net cash flow generated from the project will be used as a basis for analyzing the feasibility of investment source of project financing Public Private Partnership could come from equity or debt. The proportion of funding according to its source is a comparison of a number of investment funds originating from each source of financing for a total investment cost during the construction period by selected the contract system and several alternative financing percentage ratio determined according to sources will generate cash flow structure that is different. Of the various possibilities for the structure of the cash flow generated will be analyzed by software is to test T Paired to compared the contract system used by various alternatives comparison of financing to determine the effect of the contract system and the comparison of such financing for the feasibility of investment toll road construction project for the economic life of 20 (twenty) years. In this use case studies of toll road contruction project Bali Mandara. And in this analysis only covered two systems contracts, namely Build Operate Transfer and Turn Key. Based on the results obtained by analysis of the variable investment feasibility of the NPV, BCR and IRR between the contract system Build Operate Transfer and contract system Turn Key on the interest rate of 9%, 12% and 15%.

Keywords: contract system, financing, internal rate of return, net present value

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637 Aerosol Characterization in a Coastal Urban Area in Rimini, Italy

Authors: Dimitri Bacco, Arianna Trentini, Fabiana Scotto, Flavio Rovere, Daniele Foscoli, Cinzia Para, Paolo Veronesi, Silvia Sandrini, Claudia Zigola, Michela Comandini, Marilena Montalti, Marco Zamagni, Vanes Poluzzi

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The Po Valley, in the north of Italy, is one of the most polluted areas in Europe. The air quality of the area is linked not only to anthropic activities but also to its geographical characteristics and stagnant weather conditions with frequent inversions, especially in the cold season. Even the coastal areas present high values of particulate matter (PM10 and PM2.5) because the area closed between the Adriatic Sea and the Apennines does not favor the dispersion of air pollutants. The aim of the present work was to identify the main sources of particulate matter in Rimini, a tourist city in northern Italy. Two sampling campaigns were carried out in 2018, one in winter (60 days) and one in summer (30 days), in 4 sites: an urban background, a city hotspot, a suburban background, and a rural background. The samples are characterized by the concentration of the ionic composition of the particulates and of the main a hydro-sugars, in particular levoglucosan, a marker of the biomass burning, because one of the most important anthropogenic sources in the area, both in the winter and surprisingly even in the summer, is the biomass burning. Furthermore, three sampling points were chosen in order to maximize the contribution of a specific biomass source: a point in a residential area (domestic cooking and domestic heating), a point in the agricultural area (weed fires), and a point in the tourist area (restaurant cooking). In these sites, the analyzes were enriched with the quantification of the carbonaceous component (organic and elemental carbon) and with measurement of the particle number concentration and aerosol size distribution (6 - 600 nm). The results showed a very significant impact of the combustion of biomass due to domestic heating in the winter period, even though many intense peaks were found attributable to episodic wood fires. In the summer season, however, an appreciable signal was measured linked to the combustion of biomass, although much less intense than in winter, attributable to domestic cooking activities. Further interesting results were the verification of the total absence of sea salt's contribution in the particulate with the lower diameter (PM2.5), and while in the PM10, the contribution becomes appreciable only in particular wind conditions (high wind from north, north-east). Finally, it is interesting to note that in a small town, like Rimini, in summer, the traffic source seems to be even more relevant than that measured in a much larger city (Bologna) due to tourism.

Keywords: aerosol, biomass burning, seacoast, urban area

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636 Acoustic Energy Harvesting Using Polyvinylidene Fluoride (PVDF) and PVDF-ZnO Piezoelectric Polymer

Authors: S. M. Giripunje, Mohit Kumar

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Acoustic energy that exists in our everyday life and environment have been overlooked as a green energy that can be extracted, generated, and consumed without any significant negative impact to the environment. The harvested energy can be used to enable new technology like wireless sensor networks. Technological developments in the realization of truly autonomous MEMS devices and energy storage systems have made acoustic energy harvesting (AEH) an increasingly viable technology. AEH is the process of converting high and continuous acoustic waves from the environment into electrical energy by using an acoustic transducer or resonator. AEH is not popular as other types of energy harvesting methods since sound waves have lower energy density and such energy can only be harvested in very noisy environment. However, the energy requirements for certain applications are also correspondingly low and also there is a necessity to observe the noise to reduce noise pollution. So the ability to reclaim acoustic energy and store it in a usable electrical form enables a novel means of supplying power to relatively low power devices. A quarter-wavelength straight-tube acoustic resonator as an acoustic energy harvester is introduced with polyvinylidene fluoride (PVDF) and PVDF doped with ZnO nanoparticles, piezoelectric cantilever beams placed inside the resonator. When the resonator is excited by an incident acoustic wave at its first acoustic eigen frequency, an amplified acoustic resonant standing wave is developed inside the resonator. The acoustic pressure gradient of the amplified standing wave then drives the vibration motion of the PVDF piezoelectric beams, generating electricity due to the direct piezoelectric effect. In order to maximize the amount of the harvested energy, each PVDF and PVDF-ZnO piezoelectric beam has been designed to have the same structural eigen frequency as the acoustic eigen frequency of the resonator. With a single PVDF beam placed inside the resonator, the harvested voltage and power become the maximum near the resonator tube open inlet where the largest acoustic pressure gradient vibrates the PVDF beam. As the beam is moved to the resonator tube closed end, the voltage and power gradually decrease due to the decreased acoustic pressure gradient. Multiple piezoelectric beams PVDF and PVDF-ZnO have been placed inside the resonator with two different configurations: the aligned and zigzag configurations. With the zigzag configuration which has the more open path for acoustic air particle motions, the significant increases in the harvested voltage and power have been observed. Due to the interruption of acoustic air particle motion caused by the beams, it is found that placing PVDF beams near the closed tube end is not beneficial. The total output voltage of the piezoelectric beams increases linearly as the incident sound pressure increases. This study therefore reveals that the proposed technique used to harvest sound wave energy has great potential of converting free energy into useful energy.

Keywords: acoustic energy, acoustic resonator, energy harvester, eigenfrequency, polyvinylidene fluoride (PVDF)

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635 Peak Constituent Fluxes from Small Arctic Rivers Generated by Late Summer Episodic Precipitation Events

Authors: Shawn G. Gallaher, Lilli E. Hirth

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As permafrost thaws with the continued warming of the Alaskan North Slope, a progressively thicker active thaw layer is evidently releasing previously sequestered nutrients, metals, and particulate matter exposed to fluvial transport. In this study, we estimate material fluxes on the North Slope of Alaska during the 2019-2022 melt seasons. The watershed of the Alaskan North Slope can be categorized into three regions: mountains, tundra, and coastal plain. Precipitation and discharge data were collected from repeat visits to 14 sample sites for biogeochemical surface water samples, 7 point discharge measurements, 3 project deployed meteorology stations, and 2 U. S. Geological Survey (USGS) continuous discharge observation sites. The timing, intensity, and spatial distribution of precipitation determine the material flux composition in the Sagavanirktok and surrounding bodies of water, with geogenic constituents (e.g., dissolved inorganic carbon (DIC)) expected from mountain flushed events and biogenic constituents (e.g., dissolved organic compound (DOC)) expected from transitional tundra precipitation events. Project goals include connecting late summer precipitation events to peak discharge to determine the responses of the watershed to localized atmospheric forcing. Field study measurements showed widespread precipitation in August 2019, generating an increase in total suspended solids, dissolved organic carbon, and iron fluxes from the tundra, shifting the main-stem mountain river biogeochemistry toward tundra source characteristics typically only observed during the spring floods. Intuitively, a large-scale precipitation event (as defined by this study as exceeding 12.5 mm of precipitation on a single observation day) would dilute a body of water; however, in this study, concentrations increased with higher discharge responses on several occasions. These large-scale precipitation events continue to produce peak constituent fluxes as the thaw layer increases in depth and late summer precipitation increases, evidenced by 6 large-scale events in July 2022 alone. This increase in late summer events is in sharp contrast to the 3 or fewer large events in July in each of the last 10 years. Changes in precipitation intensity, timing, and location have introduced late summer peak constituent flux events previously confined to the spring freshet.

Keywords: Alaska North Slope, arctic rivers, material flux, precipitation

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634 Study of the Kinetics of Formation of Carboxylic Acids Using Ion Chromatography during Oxidation Induced by Rancimat of the Oleic Acid, Linoleic Acid, Linolenic Acid, and Biodiesel

Authors: Patrícia T. Souza, Marina Ansolin, Eduardo A. C. Batista, Antonio J. A. Meirelles, Matthieu Tubino

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Lipid oxidation is a major cause of the deterioration of the quality of the biodiesel, because the waste generated damages the engines. Among the main undesirable effects are the increase of viscosity and acidity, leading to the formation of insoluble gums and sediments which cause the blockage of fuel filters. The auto-oxidation is defined as the spontaneous reaction of atmospheric oxygen with lipids. Unsaturated fatty acids are usually the components affected by such reactions. They are present as free fatty acids, fatty esters and glycerides. To determine the oxidative stability of biodiesels, through the induction period, IP, the Rancimat method is used, which allows continuous monitoring of the induced oxidation process of the samples. During the oxidation of the lipids, volatile organic acids are produced as byproducts, in addition, other byproducts, including alcohols and carbonyl compounds, may be further oxidized to carboxylic acids. By the methodology developed in this work using ion chromatography, IC, analyzing the water contained in the conductimetric vessel, were quantified organic anions of carboxylic acids in samples subjected to oxidation induced by Rancimat. The optimized chromatographic conditions were: eluent water:acetone (80:20 v/v) with 0.5 mM sulfuric acid; flow rate 0.4 mL min-1; injection volume 20 µL; eluent suppressor 20 mM LiCl; analytical curve from 1 to 400 ppm. The samples studied were methyl biodiesel from soybean oil and unsaturated fatty acids standards: oleic, linoleic and linolenic. The induced oxidation kinetics curves were constructed by analyzing the water contained in the conductimetric vessels which were removed, each one, from the Rancimat apparatus at prefixed intervals of time. About 3 g of sample were used under the conditions of 110 °C and air flow rate of 10 L h-1. The water of each conductimetric Rancimat measuring vessel, where the volatile compounds were collected, was filtered through a 0.45 µm filter and analyzed by IC. Through the kinetic data of the formation of the organic anions of carboxylic acids, the formation rates of the same were calculated. The observed order of the rates of formation of the anions was: formate >>> acetate > hexanoate > valerate for the oleic acid; formate > hexanoate > acetate > valerate for the linoleic acid; formate >>> valerate > acetate > propionate > butyrate for the linolenic acid. It is possible to suppose that propionate and butyrate are obtained mainly from linolenic acid and that hexanoate is originated from oleic and linoleic acid. For the methyl biodiesel the order of formation of anions was: formate >>> acetate > valerate > hexanoate > propionate. According to the total rate of formation these anions produced during the induced degradation of the fatty acids can be assigned the order of reactivity: linolenic acid > linoleic acid >>> oleic acid.

Keywords: anions of carboxylic acids, biodiesel, ion chromatography, oxidation

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633 Application of Industrial Ecology to the INSPIRA Zone: Territory Planification and New Activities

Authors: Mary Hanhoun, Jilla Bamarni, Anne-Sophie Bougard

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INSPIR’ECO is a 18-month research and innovation project that aims to specify and develop a tool to offer new services for industrials and territorial planners/managers based on Industrial Ecology Principles. This project is carried out on the territory of Salaise Sablons and the services are designed to be deployed on other territories. Salaise-Sablons area is located in the limit of 5 departments on a major European economic axis multimodal traffic (river, rail and road). The perimeter of 330 ha includes 90 hectares occupied by 20 companies, with a total of 900 jobs, and represents a significant potential basin of development. The project involves five multi-disciplinary partners (Syndicat Mixte INSPIRA, ENGIE, IDEEL, IDEAs Laboratory and TREDI). INSPIR’ECO project is based on the principles that local stakeholders need services to pool, share their activities/equipment/purchases/materials. These services aims to : 1. initiate and promote exchanges between existing companies and 2. identify synergies between pre-existing industries and future companies that could be implemented in INSPIRA. These eco-industrial synergies can be related to: the recovery / exchange of industrial flows (industrial wastewater, waste, by-products, etc.); the pooling of business services (collective waste management, stormwater collection and reuse, transport, etc.); the sharing of equipments (boiler, steam production, wastewater treatment unit, etc.) or resources (splitting jobs cost, etc.); and the creation of new activities (interface activities necessary for by-product recovery, development of products or services from a newly identified resource, etc.). These services are based on IT tool used by the interested local stakeholders that intends to allow local stakeholders to take decisions. Thus, this IT tool: - include an economic and environmental assessment of each implantation or pooling/sharing scenarios for existing or further industries; - is meant for industrial and territorial manager/planners - is designed to be used for each new industrial project. - The specification of the IT tool is made through an agile process all along INSPIR’ECO project fed with: - Users expectations thanks to workshop sessions where mock-up interfaces are displayed; - Data availability based on local and industrial data inventory. These input allow to specify the tool not only with technical and methodological constraints (notably the ones from economic and environmental assessments) but also with data availability and users expectations. A feedback on innovative resource management initiatives in port areas has been realized in the beginning of the project to feed the designing services step.

Keywords: development opportunities, INSPIR’ECO, INSPIRA, industrial ecology, planification, synergy identification

Procedia PDF Downloads 145
632 Validation of Global Ratings in Clinical Performance Assessment

Authors: S. J. Yune, S. Y. Lee, S. J. Im, B. S. Kam, S. Y. Baek

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This study aimed to determine the reliability of clinical performance assessments, having been emphasized by ability-based education, and professors overall assessment methods. We addressed the following problems: First, we try to find out whether there is a difference in what we consider to be the main variables affecting the clinical performance test according to the evaluator’s working period and the number of evaluation experience. Second, we examined the relationship among the global rating score (G), analytic global rating score (Gc), and the sum of the analytical checklists (C). What are the main factors affecting clinical performance assessments in relation to the numbers of times the evaluator had administered evaluations and the length of their working period service? What is the relationship between overall assessment score and analytic checklist score? How does analytic global rating with 6 components in OSCE and 4 components in sub-domains (Gc) CPX: aseptic practice, precision, systemic approach, proficiency, successfulness, and attitude overall assessment score and task-specific analytic checklist score sum (C) affect the professor’s overall global rating assessment score (G)? We studied 75 professors who attended a 2016 Bugyeoung Consortium clinical skills performances test evaluating third and fourth year medical students at the Pusan National University Medical school in South Korea (39 prof. in OSCE, 36 prof. in CPX; all consented to participate in our study). Each evaluator used 3 forms; a task-specific analytic checklist, subsequent analytic global rating scale with sub-6 domains, and overall global scale. After the evaluation, the professors responded to the questionnaire on the important factors of clinical performance assessment. The data were analyzed by frequency analysis, correlation analysis, and hierarchical regression analysis using SPSS 21.0. Their understanding of overall assessment was analyzed by dividing the subjects into groups based on experiences. As a result, they considered ‘precision’ most important in overall OSCE assessment, and ‘precise accuracy physical examination’, ‘systemic approaches to taking patient history’, and ‘diagnostic skill capability’ in overall CPX assessment. For OSCE, there was no clear difference of opinion about the main factors, but there was for CPX. Analytic global rating scale score, overall rating scale score, and analytic checklist score had meaningful mutual correlations. According to the regression analysis results, task-specific checklist score sum had the greatest effect on overall global rating. professors regarded task-specific analytic checklist total score sum as best reflecting overall OSCE test score, followed by aseptic practice, precision, systemic approach, proficiency, successfulness, and attitude on a subsequent analytic global rating scale. For CPX, subsequent analytic global rating scale score, overall global rating scale score, and task-specific checklist score had meaningful mutual correlations. These findings support explanations for validity of professors’ global rating in clinical performance assessment.

Keywords: global rating, clinical performance assessment, medical education, analytic checklist

Procedia PDF Downloads 219