Search results for: quality of recovery

Authors: Ngwa Lodence Njwe

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This study investigated the response of hemodialysis patients to an established nutrition therapy guide accompanied by a 7-day menu plan administered for a month. End Stage Renal Disease (ESRD), also known as End Stage Kidney Disease (ESKD), is a non-communicable disease primarily caused by hypertension and diabetes, posing significant challenges in both developed and developing nations. Hemodialysis is a key treatment for these patients. In this experimental study, 100 hemodialysis patients from Douala General Hospital in Cameroon participated. A questionnaire was used to collect data on sociodemographic and anthropometric characteristics, health status, and dietary intake, while medical records provided biomedical data. The levels of the biochemical parameters (Phosphorus, calcium and hemoglobin) were determined before and one month after the distribution of the nutrition education guide and the use of a 7-day menu plan. The Phosphorus and Calcium levels were measured using an LTCC03 semi-automatic chemistry analyzer. Blood was collected from each patient into a test tube, allowed to clot and centrifuged. 50µl of the serum was aspirated by the analyzer for Ca and P level analysis, and results were read from the display. The hemoglobin level was measured using the URIT–12 hemoglobin Meter. The blood sample was collected by hand prick and placed in a strip, and the results were read from the screen. The means of the biochemical parameters were then computed. The most prevalent age group was 40-49 years, with males constituting 70% and females 30% of respondents. Among these patients, 80% were hypertensive, 3% had both hypertension and diabetes, 9% were hypertensive, diabetic, and obese, and 1% suffered from hypertension and heart failure. Analysis of anthropometric parameters revealed a high prevalence of underweight, overweight, and obesity, highlighting the urgent need for targeted nutrition interventions to modify cooking methods, enhance food choices, and increase dietary variety for improved quality of life. Before the nutrition therapy guide was implemented, average calcium levels were 73.05 mg/L for males and 89.44 mg/L for females; post-implementation, these values increased to 77.55 mg/L and 91.44 mg/L, respectively. Conversely, average phosphorus levels decreased from 42.05 mg/L for males and 43.55 mg/L for females to 41.05 mg/L and 39.3 mg/L, respectively, after the intervention. Additionally, average hemoglobin levels increased from 8.35 g/dL for males and 8.5 g/dL for females to 9.2 g/dL and 8.95 g/dL, respectively. The findings confirm that the nutrition therapy guide and the 7-day menu significantly impacted the biomedical parameters of hemodialysis patients, underscoring the need for ongoing nutrition education and counseling for this population.

Keywords: end stage kidney disease, nutrition therapy guide, nutritional status, anthropometric parameters, food frequency, biomedical data

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Authors: M. A. Peribanez, G. Illan, I. De Blas, A. Muniesa, I. Ruiz-Zarzuela

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Intensive aquaculture is commonly associated with increased incidence of parasites. However, in Spain, the recent intensification of cyprinid production has not led to knowledge of the parasites that develop in the aquaculture facilities, the factors that affect their development and spread and the transmission between wild and cultivated fish species. The present study focuses on the knowledge of environmental factors, as well as host dependent factors, and their possible influence as risk factors in the incidence and intensity of parasitic infections. This work was conducted in the Duero River Basin, NW Spain. A total of 114 tenches (Tinca tinca) were caught in a fish farm and 667 specimens belonging to six species of cyprinid, not tench, in five rivers. An exhaustive search and microscopic identification of protozoa on skin and gills were carried out. Physical, chemical, and biological parameters of water samples from the capture points were determined. Only two ectoprotozoa were identified, Ichthyophthirius multifiliis and Tripartiella sp. In I. multifiliis, a high intensity of infection (more than 40 parasites on the body surface and more than 80 on gills) was determined in farmed tench (14%) and in Iberian barbel (Luciobarbus bocagei) (91%) and Duero nase (Pseudochondrostoma duriense) (71%) of middle stretches of rivers. The prevalence was similar between farmed tenches and cyprinids of middle courses. Tripartiella sp. was only found in barbels (prevalence in middle stretches, 0.7%) and in farmed tenches (63%), this species resulting in a high risk factor (odds ratio, OR= 1143) in the presence of the ciliate. There were no differences between the two species relative to the intensity of parasitization. Some of the physical, chemical and microbiological water quality parameters appear to be risk factors in the presence of I. multifiliis, with maximum OR of 8. Nevertheless, in Tripartiella sp., the risk is multiplied by 720 when the pH value exceeds 8.4, if we consider the total of the data, and it is increased more than 500 times if we only consider the values recorded in the fish farm (529 by nitrates > 3 mg/l; 530 by total coliforms > 100 CFU/100 ml). However, the high prevalence and risk of infection by I. multifiliis and Tripartiella sp. in fish farms should be related to environmental factors that dependent upon sampling point rather than in direct influence of the physical-chemical and biological parameters of the water. The high pH value recorded in the fish farm (9.62 ± 0.76) is the only parameter that we consider may have a substantial direct influence. Chronic exposure to alkaline pH levels can be a chronic stress generator, predisposing to parasitization by Tripartiella sp. In conclusion, often minor changes in ecosystem conditions, both natural and man-made, can modify the host-parasite relationship, resulting in an increase in the prevalence and intensity of parasitic infections in populations of cyprinids, sometimes causing disease outbreaks.

Keywords: cyprinids, fish, parasites, protozoa, risk factors

Procedia PDF Downloads 114

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

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

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

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Authors: Reena Aggarwal, Neha Kestwal

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The Himalayan Nettle (Girardinia diversifolia) has been used for centuries as fibre and food source by Himalayan communities. Himalayan Nettle is a natural cellulosic fibre that can be handled in the same way as other cellulosic fibres. The Uttarakhand Bamboo and Fibre Development Board based in Uttarakhand, India is working extensively with the nettle fibre to explore the potential of nettle for textile production in the region. The fiber is a potential resource for rural enterprise development for some high altitude pockets of the state and traditionally the plant fibre is used for making domestic products like ropes and sacks. Himalayan Nettle is an unconventional natural fiber with functional characteristics of shrink resistance, degree of pathogen and fire resistance and can blend nicely with other fibres. Most importantly, they generate mainly organic wastes and leave residues that are 100% biodegradable. The fabrics may potentially be reused or re-manufactured and can also be used as a source of cellulose feedstock for regenerated cellulosic products. Being naturally bio- degradable, the fibre can be composted if required. Though a lot of research activities and training are directed towards fibre extraction and processing techniques in different craft clusters villagers of different clusters of Uttarkashi, Chamoli and Bageshwar of Uttarakhand like retting and Degumming process, very little is been done to analyse the crucial properties of nettle fiber like shrinkage and wash fastness. These properties are very crucial to obtain desired quality of fibre for further processing of yarn making and weaving and in developing these fibers into fine saleable products. This research therefore is focused towards various on-field experiments which were focused on shrinkage properties conducted on cotton, nettle and cotton/nettle blended yarn samples. The objective of the study was to analyze the scope of the blended fiber for developing into wearable fabrics. For the study, after conducting the initial fiber length and fineness testing, cotton and nettle fibers were mixed in 60:40 ratio and five varieties of yarns were spun in open end spinning mill having yarn count of 3s, 5s, 6s, 7s and 8s. Samples of 100% Nettle 100% cotton fibers in 8s count were also developed for the study. All the six varieties of yarns were tested with shrinkage test and results were critically analyzed as per ASTM method D2259. It was observed that 100% Nettle has a least shrinkage of 3.36% while pure cotton has shrinkage approx. 13.6%. Yarns made of 100% Cotton exhibits four times more shrinkage than 100% Nettle. The results also show that cotton and Nettle blended yarn exhibit lower shrinkage than 100% cotton yarn. It was thus concluded that as the ratio of nettle increases in the samples, the shrinkage decreases in the samples. These results are very crucial for Uttarakhand people who want to commercially exploit the abundant nettle fiber for generating sustainable employment.

Keywords: Himalayan nettle, sustainable, shrinkage, blending

Procedia PDF Downloads 240

Authors: Qiang Ren

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In the past 20 years, under the high standard of international investment protection, there have been numerous cases of investors ignoring the host country's measures to protect human health. Examples include investment disputes triggered by the Argentine government's measures related to human health, quality, and price of drinking water under the North American Free Trade Agreement. Examples also include Philip Morris v. Australia, in which case the Australian government announced the passing of the Plain Packing of Cigarettes Act to address the threat of smoking to public health in 2010. In order to take advantage of the investment treaty protection between Hong Kong and Australia, Philip Morris Asia acquired Philip Morris Australia in February 2011 and initiated investment arbitration under the treaty before the passage of the Act in July 2011. Philip Morris claimed the Act constitutes indirect expropriation and violation of fair and equitable treatment and claimed 4.16 billion US dollars compensation. Fortunately, the case ended at the admissibility decision stage and did not enter the substantive stage. Generally, even if the host country raises a human health defense, most arbitral tribunals will rule that the host country revoke the corresponding policy and make huge compensation in accordance with the clauses in the bilateral investment treaty to protect the rights of investors. The significant imbalance in the rights and obligations of host states and investors in international investment treaties undermines the ability of host states to act in pursuit of human health and social interests beyond economic interests. This squeeze on the nation's public policy space and disregard for the human health costs of investors' activities raises the need to include human health in investment rulemaking. The current international investment law system that emphasizes investor protection fails to fully reflect the requirements of the host country for the healthy development of human beings and even often brings negative impacts to human health. At a critical moment in the reform of the international investment law system, in order to achieve mutual enhancement of investment returns and human health development, human health should play a greater role in influencing and shaping international investment rules. International investment agreements should not be limited to investment protection tools but should also be part of national development strategies to serve sustainable development and human health. In order to meet the requirements of the new sustainable development goals of the United Nations, human health should be emphasized in the formulation of international investment rules, and efforts should be made to shape a new generation of international investment rules that meet the requirements of human health and sustainable development.

Keywords: human health, international investment law, Philip Morris v. Australia, investor protection

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Authors: Jaroslav Knapek, Kamila Vavrova, Tomas Kralik, Tereza Humesova

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The treatment and disposal of sewage sludge is one of the most important and critical problems of waste water treatment plants. Currently, 180 thousand tonnes of sludge dry matter are produced in the Czech Republic, which corresponds to approximately 17.8 kg of stabilized sludge dry matter / year per inhabitant of the Czech Republic. Due to the fact that sewage sludge contains a large amount of substances that are not beneficial for human health, the conditions for sludge management will be significantly tightened in the Czech Republic since 2023. One of the tested methods of sludge liquidation is the production of alternative fuel from sludge from sewage treatment plants and paper production. The paper presents an analysis of economic efficiency of alternative fuel production from sludge and its use for fluidized bed boiler with nominal consumption of 5 t of fuel per hour. The evaluation methodology includes the entire logistics chain from sludge extraction, through mechanical moisture reduction to about 40%, transport to the pelletizing line, moisture drying for pelleting and pelleting itself. For economic analysis of sludge pellet production, a time horizon of 10 years corresponding to the expected lifetime of the critical components of the pelletizing line is chosen. The economic analysis of pelleting projects is based on a detailed analysis of reference pelleting technologies suitable for sludge pelleting. The analysis of the economic efficiency of pellet is based on the simulation of cash flows associated with the implementation of the project over the life of the project. For the entered value of return on the invested capital, the price of the resulting product (in EUR / GJ or in EUR / t) is searched to ensure that the net present value of the project is zero over the project lifetime. The investor then realizes the return on the investment in the amount of the discount used to calculate the net present value. The calculations take place in a real business environment (taxes, tax depreciation, inflation, etc.) and the inputs work with market prices. At the same time, the opportunity cost principle is respected; waste disposal for alternative fuels includes the saved costs of waste disposal. The methodology also respects the emission allowances saved due to the displacement of coal by alternative (bio) fuel. Preliminary results of testing of pellet production from sludge show that after suitable modifications of the pelletizer it is possible to produce sufficiently high quality pellets from sludge. A mixture of sludge and paper waste has proved to be a more suitable material for pelleting. At the same time, preliminary results of the analysis of the economic efficiency of this sludge disposal method show that, despite the relatively low calorific value of the fuel produced (about 10-11 MJ / kg), this sludge disposal method is economically competitive. This work has been supported by the Czech Technology Agency within the project TN01000048 Biorefining as circulation technology.

Keywords: Alternative fuel, Economic analysis, Pelleting, Sewage sludge

Procedia PDF Downloads 135

Authors: Zuyong Chen, Jianghao Wu, Yanlai Zhang

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Flapping-wing micro aerial vehicle (FMAV) is a new type of aircraft by mimicking the flying behavior to that of small birds or insects. Comparing to the traditional fixed wing or rotor-type aircraft, FMAV only needs to control the motion of flapping wings, by changing the size and direction of lift to control the flight attitude. Therefore, its transmission system should be designed very compact. Lightweight design can effectively extend its endurance time, while engineering experience alone is difficult to simultaneously meet the requirements of FMAV for structural strength and quality. Current researches still lack the guidance of considering nonlinear factors of 3D printing material when carrying out topology optimization, especially for the tiny FMAV transmission system. The coupling of non-linear material properties and non-linear contact behaviors of FMAV transmission system is a great challenge to the reliability of the topology optimization result. In this paper, topology optimization design based on FEA solver package Altair Optistruct for the transmission system of FMAV manufactured by 3D Printing was carried out. Firstly, the isotropic constitutive behavior of the Ultraviolet (UV) Cureable Resin used to fabricate the structure of FMAV was evaluated and confirmed through tensile test. Secondly, a numerical computation model describing the mechanical behavior of FMAV transmission structure was established and verified by experiments. Then topology optimization modeling method considering non-linear factors were presented, and optimization results were verified by dynamic simulation and experiments. Finally, detail discussions of different load status and constraints were carried out to explore the leading factors affecting the optimization results. The contributions drawn from this article helpful for guiding the lightweight design of FMAV are summarizing as follow; first, a dynamic simulation modeling method used to obtain the load status is presented. Second, verification method of optimized results considering non-linear factors is introduced. Third, based on or can achieve a better weight reduction effect and improve the computational efficiency rather than taking multi-states into account. Fourth, basing on makes for improving the ability to resist bending deformation. Fifth, constraint of displacement helps to improve the structural stiffness of optimized result. Results and engineering guidance in this paper may shed lights on the structural optimization and light-weight design for future advanced FMAV.

Keywords: flapping-wing micro aerial vehicle, 3d printing, topology optimization, finite element analysis, experiment

Procedia PDF Downloads 170

Authors: Onesmus Nyaude

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The aim of the study was to investigate participants’ views on how corruption can be combated to enhance learner academic achievement. The study was undertaken on three select public secondary institutions in Zimbabwe. This study also focuses on exploring the various views of educators; parents and the learners on the role played by corruption in perpetuating the seemingly existing learner academic achievement disparities in various educational institutions. The study further interrogates and examines the nexus between the prevalence of corruption in schools and the subsequent influence on the academic achievement of learners. Corruption is considered a form of social injustice; hence in Zimbabwe, the general consensus is that it is perceived rife to the extent that it is overtaking the traditional factors that contributed to the poor academic achievement of learners. Coupled to this, have been the issue of gross abuse of power and some malpractices emanating from concealment of essential and official transactions in the conduct of business. Through proposing robust anti-corruption mechanisms, teaching and learning resources poured in schools would be put into good use. This would prevent the unlawful diversion and misappropriation of the resources in question which has always been the culture. This study is of paramount significance to curriculum planners, teachers, parents, and learners. The study was informed by the interpretive paradigm; thus qualitative research approaches were used. Both probability and non-probability sampling techniques were adopted in ‘site and participants’ selection. A representative sample of (150) participants was used. The study found that the majority of the participants perceived corruption as a social problem and a human right threat affecting the quality of teaching and learning processes in the education sector. It was established that corruption prevalence within institutions is as a result of the perpetual weakening of ethical values and other variables linked to upholding of ‘Ubuntu’ among general citizenry. It was further established that greediness and weak systems are major causes of rampant corruption within institutions of higher learning and are manifesting through abuse of power, bribery, misappropriation and embezzlement of material and financial resources. Therefore, there is great need to collectively address the problem of corruption in educational institutions and society at large. The study additionally concludes that successful combating of corruption will promote successful moral development of students as well as safeguarding their human rights entitlements. The study recommends the adoption of principles of good corporate governance within educational institutions in order to successfully curb corruption. The study further recommends the intensification of interventionist strategies and strengthening of systems in educational institutions as well as regular audits to overcome the problem associated with rampant corruption cases.

Keywords: academic achievement, combating, corruption, good corporate governance, qualitative study

Procedia PDF Downloads 243

Authors: Nguyen J. M., Lucas G., Ruan S., Digonnet H., Antonioli D.

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Introduction: Deep Learning (DL) is a very powerful tool for analyzing image data. But for tabular data, it cannot compete with machine learning methods like XGBoost. The research question becomes: can tabular data be transformed into images that can be analyzed by simple CNNs (Convolutional Neuron Networks)? Will DL be the absolute tool for data classification? All current solutions consist in repositioning the variables in a 2x2 matrix using their correlation proximity. In doing so, it obtains an image whose pixels are the variables. We implement a technology, DeepNIC, that offers the possibility of obtaining an image for each variable, which can be analyzed by simple CNNs. Material and method: The 'ROP' (Regression OPtimized) model is a binary and atypical decision tree whose nodes are managed by a new artificial neuron, the Neurop. By positioning an artificial neuron in each node of the decision trees, it is possible to make an adjustment on a theoretically infinite number of variables at each node. From this new decision tree whose nodes are artificial neurons, we created the concept of a 'Random Forest of Perfect Trees' (RFPT), which disobeys Breiman's concepts by assembling very large numbers of small trees with no classification errors. From the results of the RFPT, we developed a family of 10 statistical information criteria, Nguyen Information Criterion (NICs), which evaluates in 3 dimensions the predictive quality of a variable: Performance, Complexity and Multiplicity of solution. A NIC is a probability that can be transformed into a grey level. The value of a NIC depends essentially on 2 super parameters used in Neurops. By varying these 2 super parameters, we obtain a 2x2 matrix of probabilities for each NIC. We can combine these 10 NICs with the functions AND, OR, and XOR. The total number of combinations is greater than 100,000. In total, we obtain for each variable an image of at least 1166x1167 pixels. The intensity of the pixels is proportional to the probability of the associated NIC. The color depends on the associated NIC. This image actually contains considerable information about the ability of the variable to make the prediction of Y, depending on the presence or absence of other variables. A basic CNNs model was trained for supervised classification. Results: The first results are impressive. Using the GSE22513 public data (Omic data set of markers of Taxane Sensitivity in Breast Cancer), DEEPNic outperformed other statistical methods, including XGBoost. We still need to generalize the comparison on several databases. Conclusion: The ability to transform any tabular variable into an image offers the possibility of merging image and tabular information in the same format. This opens up great perspectives in the analysis of metadata.

Keywords: tabular data, CNNs, NICs, DeepNICs, random forest of perfect trees, classification

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Authors: André Augusto Ceballos Melo

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Design to facilitate the recognition of congruent prosthetic movements, context-to-motion translations guided by image, verbal prompt, users nonverbal communication such as facial expressions, gestures, paralinguistics, scene context, and object recognition contributes to this process though it can also be applied to other tasks, such as walking, Prosthetic limbs as assistive technology through gestures, sound codes, signs, facial, body expressions, and scene context The context-to-motion model is a machine learning approach that is designed to improve the control and dexterity of prosthetic limbs. It works by using sensory input from the prosthetic limb to learn about the dynamics of the environment and then using this information to generate smooth, stable movements. This can help to improve the performance of the prosthetic limb and make it easier for the user to perform a wide range of tasks. There are several key benefits to using the context-to-motion model for prosthetic limb control. First, it can help to improve the naturalness and smoothness of prosthetic limb movements, which can make them more comfortable and easier to use for the user. Second, it can help to improve the accuracy and precision of prosthetic limb movements, which can be particularly useful for tasks that require fine motor control. Finally, the context-to-motion model can be trained using a variety of different sensory inputs, which makes it adaptable to a wide range of prosthetic limb designs and environments. Stable diffusion is a machine learning method that can be used to improve the control and stability of movements in robotic and prosthetic systems. It works by using sensory feedback to learn about the dynamics of the environment and then using this information to generate smooth, stable movements. One key aspect of stable diffusion is that it is designed to be robust to noise and uncertainty in the sensory feedback. This means that it can continue to produce stable, smooth movements even when the sensory data is noisy or unreliable. To implement stable diffusion in a robotic or prosthetic system, it is typically necessary to first collect a dataset of examples of the desired movements. This dataset can then be used to train a machine learning model to predict the appropriate control inputs for a given set of sensory observations. Once the model has been trained, it can be used to control the robotic or prosthetic system in real-time. The model receives sensory input from the system and uses it to generate control signals that drive the motors or actuators responsible for moving the system. Overall, the use of the context-to-motion model has the potential to significantly improve the dexterity and performance of prosthetic limbs, making them more useful and effective for a wide range of users Hand Gesture Body Language Influence Communication to social interaction, offering a possibility for users to maximize their quality of life, social interaction, and gesture communication.

Keywords: stable diffusion, neural interface, smart prosthetic, augmenting

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Authors: Ozlem Uguz, Ali Demirci, Hanzade Haykiri-Acma, Serdar Yaman

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Lignitic coal holds its position as Turkey’s most important indigenous energy source to generate energy in thermal power plants. Hence, efficient and environmental-friendly use of lignite in electricity generation is of great importance. Thus, clean coal technologies have been planned to mitigate emissions and provide more efficient burning in power plants. In this context, oxygen enriched combustion (oxy-combustion) is regarded as one of the clean coal technologies, which based on burning with oxygen concentrations higher than that in air. As it is known that the most of the Turkish coals are low rank with high mineral matter content, unburnt carbon trapped in ash is, unfortunately, high, and it leads significant losses in the overall efficiencies of the thermal plants. Besides, the necessity of burning huge amounts of these low calorific value lignites to get the desired amount of energy also results in the formation of large amounts of ash that is rich in unburnt carbon. Oxygen enriched combustion technology enables to increase the burning efficiency through the complete burning of almost all of the carbon content of the fuel. This also contributes to the protection of air quality and emission levels drop reasonably. The aim of this study is to investigate the unburnt carbon content and the burning reactivities of several different lignite samples under oxygen enriched conditions. For this reason, the combined effects of temperature and oxygen/nitrogen ratios in the burning atmosphere were investigated and interpreted. To do this, Turkish lignite samples from Adıyaman-Gölbaşı and Kütahya-Tunçbilek regions were characterized first by proximate and ultimate analyses and the burning profiles were derived using DTA (Differential Thermal Analysis) curves. Then, these lignites were subjected to slow burning process in a horizontal tube furnace at different temperatures (200ºC, 400ºC, 600ºC for Adıyaman-Gölbaşı lignite and 200ºC, 450ºC, 800ºC for Kütahya-Tunçbilek lignite) under atmospheres having O₂+N₂ proportions of 21%O₂+79%N₂, 30%O₂+70%N₂, 40%O₂+60%N₂, and 50%O₂+50%N₂. These burning temperatures were specified based on the burning profiles derived from the DTA curves. The residues obtained from these burning tests were also analyzed by proximate and ultimate analyses to detect the unburnt carbon content along with the unused energy potential. Reactivity of these lignites was calculated using several methodologies. Burning yield under air condition (21%O₂+79%N₂) was used a benchmark value to compare the effectiveness of oxygen enriched conditions. It was concluded that oxygen enriched combustion method enhanced the combustion efficiency and lowered the unburnt carbon content of ash. Combustion of low-rank coals under oxygen enriched conditions was found to be a promising way to improve the efficiency of the lignite-firing energy systems. However, cost-benefit analysis should be considered for a better justification of this method since the use of more oxygen brings an unignorable additional cost.

Keywords: coal, energy, oxygen enriched combustion, reactivity

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Authors: Constantinos S. Mammas, Andreas Lazaris, Adamantia S. Mamma-Graham, Georgia Kostopanagiotou, Chryssa Lemonidou, John Mantas, Eustratios Patsouris

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The process to build a better safety culture, methods of error analysis, and preventive measures, starts with an understanding of the effects when human factors engineering refer to remote microscopic diagnosis in surgery and specially in organ transplantation for the evaluation of the grafts. Α high percentage of solid organs arrive at the recipient hospitals and are considered as injured or improper for transplantation in the UK. Digital microscopy adds information on a microscopic level about the grafts (G) in Organ Transplant (OT), and may lead to a change in their management. Such a method will reduce the possibility that a diseased G will arrive at the recipient hospital for implantation. Aim: The aim of this study is to analyze the ergonomics of digital microscopy (DM) based on virtual slides, on telemedicine systems (TS) for tele-pathological evaluation (TPE) of the grafts (G) in organ transplantation (OT). Material and Methods: By experimental simulation, the ergonomics of DM for microscopic TPE of renal graft (RG), liver graft (LG) and pancreatic graft (PG) tissues is analyzed. In fact, this corresponded to the ergonomics of digital microscopy for TPE in OT by applying virtual slide (VS) system for graft tissue image capture, for remote diagnoses of possible microscopic inflammatory and/or neoplastic lesions. Experimentation included the development of an OTE-TS similar experimental telemedicine system (Exp.-TS) for simulating the integrated VS based microscopic TPE of RG, LG and PG Simulation of DM on TS based TPE performed by 2 specialists on a total of 238 human renal graft (RG), 172 liver graft (LG) and 108 pancreatic graft (PG) tissues digital microscopic images for inflammatory and neoplastic lesions on four electronic spaces of the four used TS. Results: Statistical analysis of specialist‘s answers about the ability to accurately diagnose the diseased RG, LG and PG tissues on the electronic space among four TS (A,B,C,D) showed that DM on TS for TPE in OT is elaborated perfectly on the ES of a desktop, followed by the ES of the applied Exp.-TS. Tablet and mobile-phone ES seem significantly risky for the application of DM in OT (p<.001). Conclusion: To make the largest reduction in errors and adverse events referring to the quality of the grafts, it will take application of human factors engineering to procurement, design, audit, and awareness-raising activities. Consequently, it will take an investment in new training, people, and other changes to management activities for DM in OT. The simulating VS based TPE with DM of RG, LG and PG tissues after retrieval, seem feasible and reliable and dependable on the size of the electronic space of the applied TS, for remote prevention of diseased grafts from being retrieved and/or sent to the recipient hospital and for post-grafting and pre-transplant planning.

Keywords: digital microscopy, organ transplantation, tele-pathology, virtual slides

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Authors: Paritosh Goel

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The conservation of historic buildings and historic Centre’s over recent years has become fully encompassed in the planning of built-up areas and their management following climate changes. The approach of the world of restoration, in the Indian context on integrated urban regeneration and its strategic potential for a smarter, more sustainable and socially inclusive urban development introduces, for urban transformations in general (historical centers and otherwise), the theme of sustainability. From this viewpoint, it envisages, as a primary objective, a real “green, ecological or environmental” requalification of the city through interventions within the main categories of sustainability: mobility, energy efficiency, use of sources of renewable energy, urban metabolism (waste, water, territory, etc.) and natural environment. With this the concept of a “resilient city” is also introduced, which can adapt through progressive transformations to situations of change which may not be predictable, behavior that the historical city has always been able to express. Urban planning on the other hand, has increasingly focused on analyses oriented towards the taxonomic description of social/economic and perceptive parameters. It is connected with human behavior, mobility and the characterization of the consumption of resources, in terms of quantity even before quality to inform the city design process, which for ancient fabrics, and mainly affects the public space also in its social dimension. An exact definition of the term “smart city” is still essentially elusive, since we can attribute three dimensions to the term: a) That of a virtual city, evolved based on digital networks and web networks b) That of a physical construction determined by urban planning based on infrastructural innovation, which in the case of historic Centre’s implies regeneration that stimulates and sometimes changes the existing fabric; c) That of a political and social/economic project guided by a dynamic process that provides new behavior and requirements of the city communities that orients the future planning of cities also through participation in their management. This paper is a preliminary research into the connections between these three dimensions applied to the specific case of the fabric of ancient cities with the aim of obtaining a scientific theory and methodology to apply to the regeneration of Indian historical Centre’s. The Smart city scheme if contextualize with heritage of the city it can be an initiative which intends to provide a transdisciplinary approach between various research networks (natural sciences, socio-economics sciences and humanities, technological disciplines, digital infrastructures) which are united in order to improve the design, livability and understanding of urban environment and high historical/cultural performance levels.

Keywords: historical cities regeneration, sustainable restoration, urban planning, smart cities, cultural heritage development strategies

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Authors: Neha Gupta, Sonika Verma, Seema Puri, Nikhil Tandon, Narendra K. Arora

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The concurrent increasing prevalence of underweight and overweight/obesity among children with changing lifestyle and the rapid transitioning society has necessitated the need for a unifying/multi-level approach to understand the determinants of the problem. The present community-based cross-sectional research study was conducted to assess the associations between lifestyle behavior and food environment of the child at household, neighborhood, and school with the BMI of children (6-12 year old) (n=612) residing in three rural clusters of Palwal district, Haryana. The study used innovative and robust methods for assessing the lifestyle and various components of food environment in the study. The three rural clusters selected for the study were located at three different locations according to their access to highways in the SOMAARTH surveillance site. These clusters were significantly different from each other in terms of their socio-demographic and socio-economic profile, living conditions, environmental hygiene, health seeking behavior and retail density. Despite of being different, the quality of living conditions and environmental hygiene was poor across three clusters. The children had higher intakes of dietary energy and sugars; one-fifth share of the energy being derived from unhealthy foods, engagement in high levels of physical activity and significantly different food environment at home, neighborhood and school level. However, despite having a high energy intake, 22.5% of the recruited children were thin/severe thin, and 3% were overweight/obese as per their BMI-for-age categories. The analysis was done using multi-variate logistic regression at three-tier hierarchy including individual, household and community level. The factors significantly explained the variability in governing the risk of getting thin/severe thin among children in rural area (p-value: 0.0001; Adjusted R2: 0.156) included age (>10years) (OR: 2.1; 95% CI: 1.0-4.4), the interaction between minority category and poor SES of the household (OR: 4.4; 95% CI: 1.6-12.1), availability of sweets (OR: 0.9; 95% CI: 0.8-0.99) and cereals (OR: 0.9; 95% CI: 0.8-1.0) in the household and poor street condition (proxy indicator of the hygiene and cleanliness in the neighborhood) (OR: 0.3; 95% CI: 0.1-1.1). The homogeneity of other factors at neighborhood and school level food environment diluted the heterogeneity in the lifestyles and home environment of the recruited children and their households. However, it is evident that when various individual factors interplay at multiple levels amplifies the risk of undernutrition in a rural community. Conclusion: These rural areas in Haryana are undergoing developmental, economic and societal transition. In correspondence, no improvements in the nutritional status of children have happened. Easy access to the unhealthy foods has become a paradox.

Keywords: transition, food environment, lifestyle, undernutrition, overnutrition

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Authors: Urvi Panwar, Kanchan Mishra, Kanjaksha Ghosh, ShankerLal Kothari

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Background: Day-by-day the increasing prevalence of neurodegenerative diseases have become a global issue to manage them by medical sciences. The adult neural stem cells are rare and require an invasive and painful procedure to obtain it from central nervous system. Mesenchymal stem cell (MSCs) therapies have shown remarkable application in treatment of various cell injuries and cell loss. MSCs can be derived from various sources like adult tissues, human bone marrow, umbilical cord blood and cord tissue. MSCs have similar proliferation and differentiation capability, but the human umbilical cord-derived mesenchymal stem cells (hUCMSCs) are proved to be more beneficial with respect to cell procurement, differentiation to other cells, preservation, and transplantation. Material and method: Human umbilical cord is easily obtainable and non-controversial comparative to bone marrow and other adult tissues. The umbilical cord can be collected after delivery of baby, and its tissue can be cultured using explant culture method. Cell culture medium such as DMEMF12+10% FBS and DMEMF12+Neural growth factors (bFGF, human noggin, B27) with antibiotics (Streptomycin/Gentamycin) were used to culture and differentiate mesenchymal stem cells into neural cells, respectively. The characterisations of MSCs were done with Flow Cytometer for surface markers CD90, CD73 and CD105 and colony forming unit assay. The differentiated various neural cells will be characterised by fluorescence markers for neurons, astrocytes, and oligodendrocytes; quantitative PCR for genes Nestin and NeuroD1 and Western blotting technique for gap43 protein. Result and discussion: The high quality and number of MSCs were isolated from human umbilical cord via explant culture method. The obtained MSCs were differentiated into neural cells like neurons, astrocytes and oligodendrocytes. The differentiated neural cells can be used to treat neural injuries and neural cell loss by delivering cells by non-invasive administration via cerebrospinal fluid (CSF) or blood. Moreover, the MSCs can also be directly delivered to different injured sites where they differentiate into neural cells. Therefore, human umbilical cord is demonstrated to be an inexpensive and easily available source for MSCs. Moreover, the hUCMSCs can be a potential source for neural cell therapies and neural cell regeneration for neural cell injuries and neural cell loss. This new way of research will be helpful to treat and manage neural cell damages and neurodegenerative diseases like Alzheimer and Parkinson. Still the study has a long way to go but it is a promising approach for many neural disorders for which at present no satisfactory management is available.

Keywords: bone marrow, cell therapy, explant culture method, flow cytometer, human umbilical cord, mesenchymal stem cells, neurodegenerative diseases, neuroprotective, regeneration

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Authors: Madhura Bapat, Uma Krishnan

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Exploring the redefinition of masculinity through the experiences of male Indian classical dancers, this qualitative research focuses on their perceived quality of life, psychosocial challenges, and coping strategies. This study aims to explore the mental health nuances of male Indian classical dancers through an in-depth understanding of their lived experiences with dance. The benefits and personal journeys of dancers, particularly in Indian classical forms, reveal insights into culture, gender, and societal expectations. Men in Indian classical dance frequently encounter stigma due to prevailing gender norms in the arts and society. Acknowledgment of these experiences is key to understanding issues of identity, mental wellness, and communal acceptance of male Indian classical dancers in the Indian dance scenario. This study follows an interpretive phenomenological approach to follow the lived experiences of male Indian classical dancers. Male Indian classical dancers were selected using criterion-based sampling. The participants are male, fluent in English and pursue Indian classical dance styles professionally, like Kathak, Bharatanatyam, Chhau, etc. Six participants were recruited for personal, semi-structured, in-depth interviews. A focus group discussion with four participants was conducted to explore the stigma surrounding their roles. The data were analyzed using interpretive phenomenological analysis (IPA), revealing superordinate themes of (1) identity fragmentation and negotiation in gendered social contexts; (2) gendered constraints and artistic expression; (3) psychosocial distress and mental health challenges; (4) coping mechanisms and resilience; and (5) stigmatization and social integration dynamics. Male Indian classical dancers grapple with identity formation, navigating a paradox of self-perception, artistic identity, and societal expectation. They reported experiencing emasculation, compromising artistic expression, and struggling with gender norms and gendered training constraints. They have faced name-calling, bullying, taunting, slandering, and discrimination. These experiences have led to psychological challenges and distress. However, the paradox continues as male dancers use adaptive coping strategies despite the adversities that intertwine self-perception, societal pressures, and their passion for dance. This research sheds light on the intersection of gender, mental health, and art. These findings provide a strong foundation for making changes in the dance community for acceptance of male dancers, policy making for better job opportunities for male dancers and mental health services to be provided to help them deal with distress. The study offers valuable insights into how male classical dancers navigate stigma and mental health challenges in gendered social contexts, contributing to a deeper understanding of identity formation in the arts.

Keywords: gendered experiences, Indian classical dance, male dancers, mental health, stigma

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Authors: Julio Jesus Salazar, Manuel Andres Jesus De Lama

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There are very few models that serve to analyze the use of water in the socio-economic process. On the supply side, the joint use of groundwater has been considered in addition to the simple limits on the availability of surface water. In addition, we have worked on waterlogging and the effects on water quality (mainly salinity). In this paper, a 'complex' water economy is examined; one in which demands grow differentially not only within but also between sectors, and one in which there are limited opportunities to increase consumptive use. In particular, high-value growth, the growth of the production of irrigated crops of high value within the basins of the case study, together with the rapidly growing urban areas, provides a rich context to examine the general problem of water management at the basin level. At the same time, the long-term aridity of nature has made the eco-environment in the basins located on the coast of Peru very vulnerable, and the exploitation and immediate use of water resources have further deteriorated the situation. The presented methodology is the optimization with embedded simulation. The wide basin simulation of flow and water balances and crop growth are embedded with the optimization of water allocation, reservoir operation, and irrigation scheduling. The modeling framework is developed from a network of river basins that includes multiple nodes of origin (reservoirs, aquifers, water courses, etc.) and multiple demand sites along the river, including places of consumptive use for agricultural, municipal and industrial, and uses of running water on the coast of Peru. The economic benefits associated with water use are evaluated for different demand management instruments, including water rights, based on the production and benefit functions of water use in the urban agricultural and industrial sectors. This work represents a new effort to analyze the use of water at the regional level and to evaluate the modernization of the integrated management of water resources and socio-economic territorial development in Peru. It will also allow the establishment of policies to improve the process of implementation of the integrated management and development of water resources. The input-output analysis is essential to present a theory about the production process, which is based on a particular type of production function. Also, this work presents the Computable General Equilibrium (CGE) version of the economic model for water resource policy analysis, which was specifically designed for analyzing large-scale water management. As to the platform for CGE simulation, GEMPACK, a flexible system for solving CGE models, is used for formulating and solving CGE model through the percentage-change approach. GEMPACK automates the process of translating the model specification into a model solution program.

Keywords: water economy, simulation, modeling, integration

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Authors: Sophie-Bo Heinkel, Andrea Rechenburg, Thomas Kistemann

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The current status of wellbeing and life satisfaction of subsistence farmers in a wetland in Uganda and the contributing role of place attachment has been assessed. The aim of this study is to shed light on environmental factors supporting wellbeing in a wetland setting. Furthermore, it has been assessed, how the emotional bonding to the wetland as ‘place’ influences the peoples’ wellbeing and life satisfaction. The results shed light on the human-environment-relationship. A survey was carried out in three communities in urban and rural areas in a wetland basin in Uganda. A sample (n=235) provided information about the attachment to the wetland, the participants’ relation to the place of their residence and their emotional wellbeing. The Wellbeing Index (WHO-5) was assessed as well as the Perceived Stress Scale (PSS-10) and Rosenberg’s Self-Esteem scale (RSE). Furthermore, the Satisfaction With Life Scale (SWLS) was applied as well as the Place Attachment Inventory (PAI), which consists of the two intertwined dimensions of place identity and place dependence. Beside this, binary indicators as ‘feeling save’ and ‘feeling comfortable’ and ‘enjoying to live at the place of residence’ have been assessed. A bivariate correlation analysis revealed a high interconnectivity between all metric scales. Especially, the subscale ‘place identity’ showed significances with all other scales. A cluster analysis revealed three groups, which differed in the perception of place-related indicators and their attachment to the wetland as well as the status of wellbeing. First, a cluster whose majority is dissatisfied with their lives, but mainly had a good status of emotional well-being. This group does not feel attached to the wetland and lives in a town. Comparably less persons of this group feel safe and comfortable at their place of residence. In the second cluster, persons feel highly attached to the wetland and identify with it. This group was characterized by the high number of persons preferring their current place of residence and do not consider moving. All persons feel well and satisfied with their lives. The third group of persons is mainly living in rural areas and feels highly attached to the wetland. They are satisfied with their lives, but only a small minority is in a good emotional state of wellbeing. The emotional attachment to a place influences life satisfaction and, indirectly, the emotional wellbeing. In the present study it could be shown that subsistence farmers are attached to the wetland, as it is the source of their livelihood. While those living in areas with a good infrastructure are less dependent on the wetland and, therefore, less attached to. This feeling also was mirrored in the perception of a place as being safe and comfortable. The identification with a place is crucial for the feeling of being at “home”. Subsistence farmers feel attached to the ecosystem, but they also might be exposed to environmental and social stressors influencing their short-term emotional wellbeing. The provision of place identity is an ecosystem service provided by wetlands, which supports the status of wellbeing in human beings.

Keywords: mental health, positive environments, quality of life, wellbeing

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Authors: Thao Nguyen, Maximiliano Hyon, Sany Rajagukguk, Anna Melkonyan

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Introduction: Type 2 Diabetes is a well-established risk factor for severe SARS-CoV-2 infection. Uncontrolled hyperglycemia in patients with established or newly diagnosed diabetes is associated with poor outcomes, including increased mortality and hospital length of stay. Objectives: Our study aims to compare three different glycemic management strategies and their association with clinical outcomes in patients hospitalized for moderate to severe SARS-CoV-2 infection. Identifying optimal glycemic management strategies will improve the quality of patient care and improve their outcomes. Method: This is a retrospective observational study on patients hospitalized at Adventist Health White Memorial with severe SARS-CoV-2 infection from 11/1/2020 to 02/28/2021. The following inclusion criteria were used: positive SARS-CoV-2 PCR test, age >18 yrs old, diabetes or random glucose >200 mg/dL on admission, oxygen requirement >4L/min, and treatment with glucocorticoids. Our exclusion criteria included: ICU admission within 24 hours, discharge within five days, death within five days, and pregnancy. The patients were divided into three glycemic management groups: Group 1, managed solely by the Primary Team, Group 2, by Pharmacy; and Group 3, by Endocrinologist. Primary outcomes were average glucose on Day 5, change in glucose between Days 3 and 5, and average insulin dose on Day 5 among groups. Secondary outcomes would be upgraded to ICU, inpatient mortality, and hospital length of stay. For statistics, we used IBM® SPSS, version 28, 2022. Results: Most studied patients were Hispanic, older than 60, and obese (BMI >30). It was the first CV-19 surge with the Delta variant in an unvaccinated population. Mortality was markedly high (> 40%) with longer LOS (> 13 days) and a high ICU transfer rate (18%). Most patients had markedly elevated inflammatory markers (CRP, Ferritin, and D-Dimer). These, in combination with glucocorticoids, resulted in severe hyperglycemia that was difficult to control. Average glucose on Day 5 was not significantly different between groups primary vs. pharmacy vs. endocrine (220.5 ± 63.4 vs. 240.9 ± 71.1 vs. 208.6 ± 61.7 ; P = 0.105). Change in glucose from days 3 to 5 was not significantly different between groups but trended towards favoring the endocrinologist group (-26.6±73.6 vs. 3.8±69.5 vs. -32.2±84.1; P= 0.052). TDD insulin was not significantly different between groups but trended towards higher TDD for the endocrinologist group (34.6 ± 26.1 vs. 35.2 ± 26.4 vs. 50.5 ± 50.9; P=0.054). The endocrinologist group used significantly more preprandial insulin compared to other groups (91.7% vs. 39.1% vs. 65.9% ; P < 0.001). The pharmacy used more basal insulin than other groups (95.1% vs. 79.5% vs. 79.2; P = 0.047). There were no differences among groups in the clinical outcomes: LOS, ICU upgrade, or mortality. Multivariate regression analysis controlled for age, sex, BMI, HbA1c level, renal function, liver function, CRP, d-dimer, and ferritin showed no difference in outcomes among groups. Conclusion: Given high-risk factors in our population, despite efforts from the glycemic management teams, it’s unsurprising no differences in clinical outcomes in mortality and length of stay.

Keywords: glycemic management, strategies, hospitalized, SARS-CoV-2, outcomes

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Authors: Eman Hegazy, Stefan Anderberg, Joakim Krook

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Urban water infrastructure is crucial for efficient and reliable water supply in growing cities. With the growth of cities, the need for maintenance and renewal of these systems increases but often goes unfulfilled due to a variety of reasons, such as limited funding, political priorities, or lack of public awareness. Neglecting the renewal needs of these systems can lead to frequent malfunctions and reduced quality and reliability of water supply, as well as increased costs and health and environmental hazards. It is important for cities to prioritize investment in water infrastructure and develop long-term plans to address renewal needs. Drawing general conclusions about the rate of renewal of urban water infrastructure systems at an international or national level can be challenging due to the influence of local management decisions. In many countries, the responsibility for water infrastructure management lies with the municipal authorities, who are responsible for making decisions about the allocation of resources for repair, maintenance, and renewal. These decisions can vary widely based on factors such as local finances, political priorities, and public perception of the importance of water infrastructure. As a result, it is difficult to make generalizations about the rate of renewal across different countries or regions. In Sweden, the situation is not different, and the information from Svenskt Vatten indicates that the rate of renewal varies across municipalities and can be insufficient, leading to a buildup of maintenance and renewal needs. This study aims to examine the adequacy of the rate of renewal of urban water infrastructure in Linköping case city in Sweden. Using a case study framework, the study will assess the current status of the urban water system and the need for renewal. The study will also consider the role of factors such as proper identification processes, limited funding, competing for political priorities, and local management decisions in contributing to insufficient renewal. The study investigates the following questions: (1) What is the current status of water and sewerage networks in terms of length, age distribution, and material composition, estimated total water leakage in the network per year, damages, leaks, and outages occur per year, both overall and by district? (2) What are the main causes of these damages, leaks, and interruptions, and how are they related to lack of maintenance and renewal? (3) What is the current status of renewal work for the water and sewerage networks, including the renewal rate and changes over time, recent renewal material composition, and the budget allocation for renewal and emergency repairs? (4) What factors influence the need for renewal and what conditions should be considered in the assessment? The findings of the study provide insights into the challenges facing urban water infrastructure and identify strategies for improving the rate of renewal to ensure a reliable and sustainable water supply.

Keywords: case study, infrastructure, management, renewal need, Sweden

Procedia PDF Downloads 104

Authors: F. O’Dowd, G. Murphy, M. Roche, E. Shudell, F. Keane, M. O’Kane

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Intoduction: Apremilast (Otezla®) is an oral phosphodiesterase-4 (PDE4) inhibitor indicated for treatment of adult patients with moderate to severe plaque psoriasis who have contraindications to have failed or intolerant of standard systemic therapy and/or phototherapy; and adult patients with active psoriatic arthritis. Apremilast influences intracellular regulation of inflammatory mediators. Two randomized, placebo-controlled trials evaluating apremilast in 1426 patients with moderate to severe plague psoriasis (ESTEEM 1 and 2) demonstrated that the commonest adverse reactions (AE’s) leading to discontinuation were nausea (1.6%), diarrhoea (1.0%), and headaches (0.8%). The overall proportion of subjects discontinuing due to adverse reactions was 6.1%. At week 16 these trials demonstrated significant more apremilast-treated patients (33.1%) achieved the primary end point PASI-75 than placebo (5.3%). We began prescribing apremilast in July 2015. Aim: To evaluate efficacy and tolerability of apremilast in an Irish teaching hospital psoriasis population. Methods: A proforma documenting clinical evaluation parameters, prior treatment experience and AE’s; was completed prospectively on all patients commenced on apremilast since July 2015 – July 2017. Data was collected at week 0,6,12,24,36 and week 52 with 20/71 patients having passed week 52. Efficacy was assessed using Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI). AE’s documented included GI effects, infections, changes in weight and mood. Retrospective chart review and telephone review was utilised for missing data. Results: A total of 71 adult subjects (38 male, 33 female; age range 23-57), with moderate to severe psoriasis, were evaluated. Prior treatment: 37/71 (52%) were systemic/biologic/phototherapy naïve; 14/71 (20%) has prior phototherapy alone;20/71 (28%) had previous systemic/biologic exposure; 12/71 (17%) had both psoriasis and psoriatic arthritis. PASI responses: mean baseline PASI was 10.1 and DLQI was 15.Week 6: N=71, n=15 (21%) achieved PASI 75. Week 12: N= 48, n=6 (13%) achieved a PASI 100%; n=16 (34.5%) achieved a PASI 75. Week 24: N=40, n=10 (25%) achieved a PASI 100; n=15 (37.5%) achieved a PASI 75. Week 52: N= 20, n=4 (20%) achieved a PASI 100; n= 16 (80%) achieved a PASI 75. (N= number of pts having passed the time point indicated, n= number of pts (out of N) achieving PASI or DLQI responses at that time). DLQI responses: week 24: N= 40, n=30 (75%) achieved a DLQI score of 0; n=5 (12.5%) achieved a DLQI score of 1; n=1 (2.5%) achieved a DLQI score of 10 (due to lack of efficacy). Adverse Events: The proportion of patients that discontinued treatment due to AE’s was n=7 (9.8%). One patient experienced nausea alleviated by dose reduction; another developed significant dysgeusia for certain foods, both continued therapy. Two patients lost 2-3 kg. Conclusion: Initial Irish patient experience of Apremilast appears comparable to that observed in trials with good efficacy and tolerability.

Keywords: Apremilast, introduction, Ireland, clinical audit

Procedia PDF Downloads 149

Authors: A. Marais

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A challenging aspect of teaching cello to novice adult learners is finding adequate lesson material and applying relevant teaching methodologies. It could play a crucial role in adult learners' decision to commence or stop taking music lessons. This study contributes to the theory and practises of continuing education. This study is important to lifelong learning, especially with the focus on adult teaching and learning and the difficulties concerning these themes. The research problem identified for this study is we are not aware of adults' life stories; thus, cello lesson material is not always relevant for adult's specific needs for motivation and goals for starting cello lessons. In my experience, an adult does not necessarily want to play children songs when they learn a new instrument. They want material and lessons fitted to adult learners. Adults also learn differently from younger beginners. Adults ask questions such as how and why, while children more readily accept what is being taught. This research creates awareness of adults' musical needs and learning methods. If every adult shares their own story for commencing and continuing with cello lessons, material should be created, revised, or adapted for more individually appropriate lessons. A number of studies show that adults taking music lessons experience a decrease in feelings of loneliness and isolation. It gives adults a sense of wellbeing and can help improve immune systems. The purpose of this research study will be to discover the life stories of adult amateur cellists. At this stage in the research, the life stories of amateur cellists can generally be defined as personal reflections of their motivations for and experiences of commencing and continuing with individual lessons. The findings of this study will contribute to the development of cello lesson material for adult beginners based on their stories. This research could also encourage adults to commence with music lessons and could, in that way, contribute to their quality of life. Music learners become aware of deep spiritual, emotional, and social values incorporated or experienced through musical learning. This will be a qualitative study with a narrative approach making use of oral history. The chosen method will encapsulate the stories of amateur individual adults starting and continuing with cello lessons. The narrative method entails experiences as expressed in lived and told stories of individuals. Oral history is used as part of the narrative method and entails gathering of personal reflections of events and their cause and effects from an individual or several individuals. These findings from this study will contribute to adult amateur cellists' motivations to continue with music lessons and inspire others to commence. The inspiring life stories of the amateur cellists would provide insight into finding and creating new cello lesson material and enhance existing teaching methodologies for adult amateur cellists.

Keywords: adult, amateur, cello, education, learning, music, stories

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Authors: Oluwafunmibi Omotayo Fasanya, Augustine Kena Adjei

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Background and Aims: This meta-analysis aimed to evaluate the effect of vitamin D supplementation on key metabolic and cardiovascular parameters, such as glycated hemoglobin (HbA1C), fasting blood sugar (FBS), low-density lipoprotein (LDL), high-density lipoprotein (HDL), systolic blood pressure (SBP), and total vitamin D levels in patients with Type 2 diabetes mellitus (T2DM). Methods: A systematic search was performed across databases, including PubMed, Scopus, Embase, Web of Science, Cochrane Library, and ClinicalTrials.gov, from January 1990 to January 2024. A total of 4,177 relevant studies were initially identified. Using an unsupervised K-means clustering algorithm, publications were grouped based on common text features. Maximum entropy classification was then applied to filter studies that matched a pre-identified training set of 139 potentially relevant articles. These selected studies were manually screened for relevance. A parallel manual selection of all initially searched studies was conducted for validation. The final inclusion of studies was based on full-text evaluation, quality assessment, and meta-regression models using random effects. Sensitivity analysis and publication bias assessments were also performed to ensure robustness. Results: The unsupervised K-means clustering algorithm grouped the patients based on their responses to vitamin D supplementation, using key biomarkers such as HbA1C, FBS, LDL, HDL, SBP, and total vitamin D levels. Two primary clusters emerged: one representing patients who experienced significant improvements in these markers and another showing minimal or no change. Patients in the cluster associated with significant improvement exhibited lower HbA1C, FBS, and LDL levels after vitamin D supplementation, while HDL and total vitamin D levels increased. The analysis showed that vitamin D supplementation was particularly effective in reducing HbA1C, FBS, and LDL within this cluster. Furthermore, BMI, weight gain, and disease duration were identified as factors that influenced cluster assignment, with patients having lower BMI and shorter disease duration being more likely to belong to the improvement cluster. Conclusion: The findings of this machine learning-assisted meta-analysis confirm that vitamin D supplementation can significantly improve glycemic control and reduce the risk of cardiovascular complications in T2DM patients. The use of automated screening techniques streamlined the process, ensuring the comprehensive evaluation of a large body of evidence while maintaining the validity of traditional manual review processes.

Keywords: HbA1C, T2DM, SBP, FBS

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Authors: Dariusz M. Trzmielak, William Bradley Zehner, Elin Oftedal, Ilona Lipka-Matusiak

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The use of new technologies should create new value for all stakeholders in the healthcare system. The article focuses on demonstrating that technologies or products typically enable new functionality, a higher standard of service, or a higher level of knowledge and competence for clinicians. It also highlights the key benefits that can be achieved through the use of artificial intelligence, such as relieving clinicians of many tasks and enabling the expansion and greater specialisation of healthcare services. The comparative analysis allowed the authors to create a classification of new technologies in e-health according to health needs and benefits for patients, doctors, and healthcare systems, i.e., the main stakeholders in the implementation of new technologies and products in healthcare. The added value of the development of new technologies in healthcare is diagnosed. The work is both theoretical and practical in nature. The primary research methods are bibliographic analysis and analysis of research data and market potential of new solutions for healthcare organisations. The bibliographic analysis is complemented by the author's case studies of implemented technologies, mostly based on artificial intelligence or telemedicine. In the past, patients were often passive recipients, the end point of the service delivery system, rather than stakeholders in the system. One of the dangers of powerful new technologies is that patients may become even more marginalised. Healthcare will be provided and delivered in an increasingly administrative, programmed way. The doctor may also become a robot, carrying out programmed activities - using 'non-human services'. An alternative approach is to put the patient at the centre, using technologies, products, and services that allow them to design and control technologies based on their own needs. An important contribution to the discussion is to open up the different dimensions of the user (carer and patient) and to make them aware of healthcare units implementing new technologies. The authors of this article outline the importance of three types of patients in the successful implementation of new medical solutions. The impact of implemented technologies is analysed based on: 1) "Informed users", who are able to use the technology based on a better understanding of it; 2) "Engaged users" who play an active role in the broader healthcare system as a result of the technology; 3) "Innovative users" who bring their own ideas to the table based on a deeper understanding of healthcare issues. The authors' research hypothesis is that the distinction between informed, engaged, and innovative users has an impact on the perceived and actual quality of healthcare services. The analysis is based on case studies of new solutions implemented in different medical centres. In addition, based on the observations of the Polish author, who is a manager at the largest medical research institute in Poland, with analytical input from American and Norwegian partners, the added value of the implementations for patients, clinicians, and the healthcare system will be demonstrated.

Keywords: innovation, management, medicine, e-health, artificial intelligence

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Authors: Ali Mohammed Ali Lmbash

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The global refugee crisis points to the vital need for sustainable and resistant solutions to different kinds of problems for displaced persons all over the world. Among the myriads of sustainable concerns, however, there are diverse considerations including energy consumption, waste management, water access, and resiliency of structures. Our research aims to develop distinct ideas for sustainable architecture given the exigent problems in disaster-threatened areas starting with the Hatay Refugee camp in Turkey where the majority of the camp dwellers are Syrian refugees. Commencing community-based participatory research which focuses on the socio-environmental issues of displaced populations, this study will apply two approaches with a specific focus on the Hatay region. The initial experiment uses Richter's predictive model and simulations to forecast earthquake outcomes in refugee campers. The result could be useful in implementing architectural design tactics that enhance structural reliability and ensure the security and safety of shelters through earthquakes. In the second experiment a model is generated which helps us in predicting the quality of the existing water sources and since we understand how greatly water is vital for the well-being of humans, we do it. This research aims to enable camp administrators to employ forward-looking practices while managing water resources and thus minimizing health risks as well as building resilience of the refugees in the Hatay area. On the other side, this research assesses other sustainability problems of Hatay Refugee Camp as well. As energy consumption becomes the major issue, housing developers are required to consider energy-efficient designs as well as feasible integration of renewable energy technologies to minimize the environmental impact and improve the long-term sustainability of housing projects. Waste management is given special attention in this case by imposing recycling initiatives and waste reduction measures to reduce the pace of environmental degradation in the camp's land area. As well, study gives an insight into the social and economic reality of the camp, investigating the contribution of initiatives such as urban agriculture or vocational training to the enhancement of livelihood and community empowerment. In a similar fashion, this study combines the latest research with practical experience in order to contribute to the continuing discussion on sustainable architecture during disaster relief, providing recommendations and info that can be adapted on every scale worldwide. Through collaborative efforts and a dedicated sustainability approach, we can jointly get to the root of the cause and work towards a far more robust and equitable society.

Keywords: smart architecture, Hatay Camp, sustainability, machine learning.

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Authors: Leigh G. Hayden, Susan E. Shepley, Cristina Passarelli, William Tingo

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Introduction: Sensory interventions are popular therapeutic and recreational approaches for people living with all stages of dementia. However, it is unknown which sensory interventions are used to achieve which outcomes across all subtypes of dementia. Methods: To address this gap, we conducted a scoping review of sensory interventions for people living with dementia. We conducted a search of the literature for any article published in English from 1 January 1990 to 1 June 2019, on any sensory or multisensory intervention targeted to people living with any kind of dementia, which reported on patient health outcomes. We did not include complex interventions where only a small aspect was related to sensory stimulation. We searched the databases Medline, CINHAL, and Psych Articles using our institutional discovery layer. We conducted all screening in duplicate to reduce Type 1 and Type 2 errors. The data from all included papers were extracted by one team member, and audited by another, to ensure consistency of extraction and completeness of data. Results: Our initial search captured 7654 articles, and the removal of duplicates (n=5329), those that didn’t pass title and abstract screening (n=1840) and those that didn’t pass full-text screening (n=281) resulted in 174 articles included. The countries with the highest publication in this area were the United States (n=59), the United Kingdom (n=26) and Australia (n=15). The most common type of interventions were music therapy (n=36), multisensory rooms (n=27) and multisensory therapies (n=25). Seven articles were published in the 1990’s, 55 in the 2000’s, and the remainder since 2010 (n=112). Discussion: Multisensory rooms have been present in the literature since the early 1990’s. However, more recently, nature/garden therapy, art therapy, and light therapy have emerged since 2008 in the literature, an indication of the increasingly diverse scholarship in the area. The least popular type of intervention is a traditional food intervention. Taste as a sensory intervention is generally avoided for safety reasons, however it shows potential for increasing quality of life. Agitation, behavior, and mood are common outcomes for all sensory interventions. However, light therapy commonly targets sleep. The majority (n=110) of studies have very small sample sizes (n=20 or less), an indicator of the lack of robust data in the field. Additional small-scale studies of the known sensory interventions will likely do little to advance the field. However, there is a need for multi-armed studies which directly compare sensory interventions, and more studies which investigate the use of layering sensory interventions (for example, adding an aromatherapy component to a lighting intervention). In addition, large scale studies which enroll people at early stages of dementia will help us better understand the potential of sensory and multisensory interventions to slow the progression of the disease.

Keywords: sensory interventions, dementia, scoping review

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Authors: Juliane Spaak

Abstract:

A life-cycle assessment was performed, looking at seven retrofit projects in New Zealand using LCAQuickV3.5. The study found that retrofits save up to 80% of embodied carbon emissions for the structural elements compared to a new building. In other words, it is only a 20% carbon investment to transform and extend a building’s life. In addition, the systems were evaluated by looking at environmental impacts over the design life of these buildings and resilience using FEMA P58 and PACT software. With the increasing interest in Zero Carbon targets, significant changes in the building and construction sector are required. Emissions for buildings arise from both embodied carbon and operations. Based on the significant advancements in building energy technology, the focus is moving more toward embodied carbon, a large portion of which is associated with the structure. Since older buildings make up most of the real estate stock of our cities around the world, their reuse through structural retrofit and wider refurbishment plays an important role in extending the life of a building’s embodied carbon. New Zealand’s building owners and engineers have learned a lot about seismic issues following a decade of significant earthquakes. Recent earthquakes have brought to light the necessity to move away from constructing code-minimum structures that are designed for life safety but are frequently ‘disposable’ after a moderate earthquake event, especially in relation to a structure’s ability to minimize damage. This means weaker buildings sit as ‘carbon liabilities’, with considerably more carbon likely to be expended remediating damage after a shake. Renovating and retrofitting older assets plays a big part in reducing the carbon profile of the buildings sector, as breathing new life into a building’s structure is vastly more sustainable than the highest quality ‘green’ new builds, which are inherently more carbon-intensive. The demolition of viable older buildings (often including heritage buildings) is increasingly at odds with society’s desire for a lower carbon economy. Bringing seismic resilience and carbon best practice together in decision-making can open the door to commercially attractive outcomes, with retrofits that include structural and sustainability upgrades transforming the asset’s revenue generation. Across the global real estate market, tenants are increasingly demanding the buildings they occupy be resilient and aligned with their own climate targets. The relationship between seismic performance and ‘sustainable design’ has yet to fully mature, yet in a wider context is of profound consequence. A whole-of-life carbon perspective on a building means designing for the likely natural hazards within the asset’s expected lifespan, be that earthquake, storms, damage, bushfires, fires, and so on, ¬with financial mitigation (e.g., insurance) part, but not all, of the picture.

Keywords: retrofit, sustainability, earthquake, reuse, carbon, resilient

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Authors: Geday Elias, Montaigne Etienne, Padilla Martine, Tollossa Degefa

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Smallholder farmers’ participation in agricultural value chain identified as a pathway to get out of poverty trap in Ethiopia. The smallholder dairy activities have a huge potential in poverty reduction through enhancing income, achieving food and nutritional security in the country. However, much less is known about the effects of smallholder’s participation in milk value chain on household food security and nutrition. This paper therefore, aims at evaluating the effects of smallholders’ participation in milk value chain on household food security taking in to account the four pillars of food security measurements (availability, access, utilization and stability). Using a semi-structured interview, a cross sectional farm household data collected from a randomly selected sample of 333 households (170 in Amhara and 163 in Oromia regions).Binary logit and propensity score matching( PSM) models are employed to examine the mechanisms through which smallholder’s participation in the milk value chain affects household food security where crop production, per capita calorie intakes, diet diversity score, and food insecurity access scale are used to measure food availability, access, utilization and stability respectively. Our findings reveal from 333 households, only 34.5% of smallholder farmers are participated in the milk value chain. Limited access to inputs and services, limited access to inputs markets and high transaction costs are key constraints for smallholders’ limited access to the milk value chain. To estimate the true average participation effects of milk value chain for participated households, the outcome variables (food security) of farm households who participated in milk value chain are compared with the outcome variables if the farm households had not participated. The PSM analysis reveals smallholder’s participation in milk value chain has a significant positive effect on household income, food security and nutrition. Smallholder farmers who are participated in milk chain are better by 15 quintals crops production and 73 percent of per capita calorie intakes in food availability and access respectively than smallholder farmers who are not participated in the market. Similarly, the participated households are better in dietary quality by 112 percents than non-participated households. Finally, smallholders’ who are participated in milk value chain are better in reducing household vulnerability to food insecurity by an average of 130 percent than non participated households. The results also shows income earned from milk value chain participation contributed to reduce capital’s constraints of the participated households’ by higher farm income and total household income by 5164 ETB and 14265 ETB respectively. This study therefore, confirms the potential role of smallholders’ participation in food value chain to get out of poverty trap through improving rural household income, food security and nutrition. Therefore, identified the determinants of smallholder participation in milk value chain and the participation effects on food security in the study areas are worth considering as a positive knock for policymakers and development agents to tackle the poverty trap in the study area in particular and in the country in general.

Keywords: effects, food security and nutrition, milk, participation, smallholders, value chain

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Authors: Moletsane Makgotso, Mogakabe Elijah, Marrengane Zinhle

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

Keywords: nitrogen, phosphorus, cyanobacteria, microcystins

Procedia PDF Downloads 287

Authors: Mairaj Salim, Asma Zaheer

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Oman has accomplished as much or more than its fellow Gulf monarchies, despite starting from scratch considerably later, having less oil income to utilize, dealing with a larger and more rugged geography, and resolving a bitter civil war along the way. Of course, Oman's progress in the past 30-plus years has not been without problems and missteps, but the balance is squarely on the positive side of the ledger. Oil has been the driving force of the Omani economy since Oman began commercial production in 1967. The oil industry supports the country’s high standard of living and is primarily responsible for its modern and expansive infrastructure, including electrical utilities, telephone services, roads, public education and medical services. In addition to extensive oil reserves, Oman also has substantial natural gas reserves, which are expected to play a leading role in the Omani economy in the Twenty-first Century. To reduce the country’s dependence on oil revenues, the government is restructuring the economy by directing investment to non-oil activities. Since the 21st century IT has changed the performing tasks. To manage the affairs for the benefits of organizations and economy, the Omani government has adopted E-Business technologies for the development. E-Business is important because it allows • Transformation of old economy relationships (vertical/linear relationships) to new economy relationships characterized by end-to-end relationship management solutions (integrated or extended relationships) • Facilitation and organization of networks, small firms depend on ‘partner’ firms for supplies and product distribution to meet customer demands • SMEs to outsource back-end process or cost centers enabling the SME to focus on their core competence • ICT to connect, manage and integrate processes internally and externally • SMEs to join networks and enter new markets, through shortened supply chains to increase market share, customers and suppliers • SMEs to take up the benefits of e-business to reduce costs, increase customer satisfaction, improve client referral and attract quality partners • New business models of collaboration for SMEs to increase their skill base • SMEs to enter virtual trading arena and increase their market reach A national strategy for the advancement of information and communication technology (ICT) has been worked out, mainly to introduce e-government, e-commerce, and a digital society. An information technology complex KOM (Knowledge Oasis Muscat) had been established, consisting of section for information technology, incubator services, a shopping center of technology software and hardware, ICT colleges, E-Government services and other relevant services. So, all these efforts play a vital role in the development of Oman economy.

Keywords: ICT, ITA, CRM, SCM, ERP, KOM, SMEs, e-commerce and e-business

Procedia PDF Downloads 251