Search results for: contaminated sites
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2634

Search results for: contaminated sites

1554 Bacteriological Screening and Antibiotic – Heavy Metal Resistance Profile of the Bacteria Isolated from Some Amphibian and Reptile Species of the Biga Stream in Turkey

Authors: Nurcihan Hacioglu, Cigdem Gul, Murat Tosunoglu

Abstract:

In this article, the antibiogram and heavy metal resistance profile of the bacteria isolated from total 34 studied animals (Pelophylax ridibundus = 12, Mauremys rivulata = 14, Natrix natrix = 8) captured around the Biga Stream, are described. There was no database information on antibiogram and heavy metal resistance profile of bacteria from these area’s amphibians and reptiles. In this study, a total of 200 bacteria were successfully isolated from cloaca and oral samples of the aquatic amphibians and reptiles as well as from the water sample. According to Jaccard’s similarity index, the degree of similarity in the bacterial flora was quite high among the amphibian and reptile species under examination, whereas it was different from the bacterial diversity in the water sample. The most frequent isolates were A. hydrophila (31.5%), B. pseudomallei (8.5%), and C. freundii (7%). The total numbers of bacteria obtained were as follows: 45 in P. ridibundus, 45 in N. natrix 30 in M. rivulata, and 80 in the water sample. The result showed that cefmetazole was the most effective antibiotic to control the bacteria isolated in this study and that approximately 93.33% of the bacterial isolates were sensitive to this antibiotic. The Multiple Antibiotic Resistances (MAR) index indicated that P. ridibundus (0.95) > N. natrix (0.89) > M. rivulata (0.39). Furthermore, all the tested heavy metals (Pb+2, Cu+2, Cr+3, and Mn+2) inhibit the growth of the bacterial isolates at different rates. Therefore, it indicated that the water source of the animals was contaminated with both antibiotic residues and heavy metals.

Keywords: bacteriological quality, amphibian, reptile, antibiotic, heavy metal resistance

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1553 Adsorption of Congo Red on MgO Nanoparticles Prepared by Molten Salt Method

Authors: Shahbaa F. Bdewi, Bakhtyar K. Aziz, Ayad A. R. Mutar

Abstract:

Nano-materials show different surface properties due to their high surface area and active sites. This study investigates the feasibility of using nano-MgO (NMO) for removing Congo red (CR) dye from wastewater. NMO was prepared by molten salt method. Equilibrium experiments show the equilibrium was reached after 120 minutes and maximum adsorption efficiency was obtained in acidic media up to pH 6. Isotherm studies revealed the favorability of the adsorption process. The overall adsorption process was spontaneous and endothermic in nature with a maximum adsorption capacity of 1100 mg g-1 at 40°C as estimated from Langmuir isotherm. The adsorption kinetics was found to follow pseudo second-order rate equation. Relatively high activation energy (180.7 kJ mol-1) was obtained which is consistent with chemisorption mechanism for the adsorption process.

Keywords: adsorption, congo red, magnesium oxide, nanoparticles

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1552 Pakistan Nuclear Security: Threats from Non-State Actors

Authors: Jennifer Wright

Abstract:

The recent rise of powerful terrorist groups such as ISIS and Al-Qaeda brings up concerns about nuclear terrorism as well as a focus on nuclear security, specifically the physical security of nuclear weapons and fissile material storage sites in countries where powerful nonstate actors are present. Particularly because these non-state actors, who lack their own sovereign territory, cannot be ‘deterred’ in the traditional sense. In light of the current threat environment, it’s necessary to now rethink these strategies in the 21st century – a multipolar world with the presence of powerful non-state actors. As a country in the spotlight for its low ranking on the Nuclear Threat Initiative’s (NTI) Nuclear Security Index, Pakistan is a relevant example to explore the question of whether the presence of non-state actors poses a real risk to nuclear security today. It’s necessary to take a look at their nuclear security policies to determine if they’re robust enough to deal with political instability and violence in the country. After carrying out interviews with experts in May 2017 in Islamabad on nuclear security and nuclear terrorism, this paper aims to highlight findings by providing a Pakistan-centric view on the subject and give experts there a chance to counter criticism. Western media would have us fearful of nuclear security mechanisms in Pakistan after reports that areas such as cybersecurity and accounting and control of materials are weak, as well as sensitive nuclear material being transported in unmarked, unguarded vehicles. Also reported are cases where terrorist groups carried out targeted attacks against Pakistani military bases or secure sites where nuclear material is stored. One specific question asked of each interviewee in Islamabad was Do you feel the threat of nuclear terrorism calls into question the reliance on deterrence? Their responses will be elaborated on in the longer paper, but overall they demonstrate views that deterrence still serves a purpose for state-to-state security strategy, but not for a state in countering nonstate threats. If nuclear security is lax enough for these non-state actors to get their hands on either an intact nuclear weapon or enough military-grade fissile material to build a nuclear weapon, then what would stop them from launching a nuclear attack? As deterrence is a state-centric strategy, it doesn’t work to deter non-state actors from carrying out an attack on another state, as they lack their own territory, and as such, are not fearful of a reprisal attack. Deterrence will need to be addressed, and its relevance analyzed to determine its utility in the current security environment. The aim of this research is to demonstrate the real risk of nuclear terrorism by pointing to weaknesses in global nuclear security, particularly in Pakistan. The research also aims to provoke thought on the weaknesses of deterrence as a whole. Original thinking is needed as we attempt to adequately respond to the 21st century’s current threat environment.

Keywords: deterrence, non-proliferation, nuclear security, nuclear terrorism

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1551 Incidences and Factors Associated with Perioperative Cardiac Arrest in Trauma Patient Receiving Anesthesia

Authors: Visith Siriphuwanun, Yodying Punjasawadwong, Suwinai Saengyo, Kittipan Rerkasem

Abstract:

Objective: To determine incidences and factors associated with perioperative cardiac arrest in trauma patients who received anesthesia for emergency surgery. Design and setting: Retrospective cohort study in trauma patients during anesthesia for emergency surgery at a university hospital in northern Thailand country. Patients and methods: This study was permitted by the medical ethical committee, Faculty of Medicine at Maharaj Nakorn Chiang Mai Hospital, Thailand. We clarified data of 19,683 trauma patients receiving anesthesia within a decade between January 2007 to March 2016. The data analyzed patient characteristics, traumas surgery procedures, anesthesia information such as ASA physical status classification, anesthesia techniques, anesthetic drugs, location of anesthesia performed, and cardiac arrest outcomes. This study excluded the data of trauma patients who had received local anesthesia by surgeons or monitoring anesthesia care (MAC) and the patient which missing more information. The factor associated with perioperative cardiac arrest was identified with univariate analyses. Multiple regressions model for risk ratio (RR) and 95% confidence intervals (CI) were used to conduct factors correlated with perioperative cardiac arrest. The multicollinearity of all variables was examined by bivariate correlation matrix. A stepwise algorithm was chosen at a p-value less than 0.02 was selected to further multivariate analysis. A P-value of less than 0.05 was concluded as statistically significant. Measurements and results: The occurrence of perioperative cardiac arrest in trauma patients receiving anesthesia for emergency surgery was 170.04 per 10,000 cases. Factors associated with perioperative cardiac arrest in trauma patients were age being more than 65 years (RR=1.41, CI=1.02–1.96, p=0.039), ASA physical status 3 or higher (RR=4.19–21.58, p < 0.001), sites of surgery (intracranial, intrathoracic, upper intra-abdominal, and major vascular, each p < 0.001), cardiopulmonary comorbidities (RR=1.55, CI=1.10–2.17, p < 0.012), hemodynamic instability with shock prior to receiving anesthesia (RR=1.60, CI=1.21–2.11, p < 0.001) , special techniques for surgery such as cardiopulmonary bypass (CPB) and hypotensive techniques (RR=5.55, CI=2.01–15.36, p=0.001; RR=6.24, CI=2.21–17.58, p=0.001, respectively), and patients who had a history of being alcoholic (RR=5.27, CI=4.09–6.79, p < 0.001). Conclusion: Incidence of perioperative cardiac arrest in trauma patients receiving anesthesia for emergency surgery was very high and correlated with many factors, especially age of patient and cardiopulmonary comorbidities, patient having a history of alcoholic addiction, increasing ASA physical status, preoperative shock, special techniques for surgery, and sites of surgery including brain, thorax, abdomen, and major vascular region. Anesthesiologists and multidisciplinary teams in pre- and perioperative periods should remain alert for warning signs of pre-cardiac arrest and be quick to manage the high-risk group of surgical trauma patients. Furthermore, a healthcare policy should be promoted for protecting against accidents in high-risk groups of the population as well.

Keywords: perioperative cardiac arrest, trauma patients, emergency surgery, anesthesia, factors risk, incidence

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1550 Arsenic Removal from Drinking Water by Hybrid Hydrogel-Biochar Matrix: An Understanding of Process Parameters

Authors: Vibha Sinha, Sumedha Chakma

Abstract:

Arsenic (As) contamination in drinking water is a serious concern worldwide resulting in severe health maladies. To tackle this problem, several hydrogel based matrix which selectively uptake toxic metals from contaminated water has increasingly been examined as a potential practical method for metal removal. The major concern in hydrogels is low stability of matrix, resulting in poor performance. In this study, the potential of hybrid hydrogel-biochar matrix synthesized from natural plant polymers, specific for As removal was explored. Various compositional and functional group changes of the elements contained in the matrix due to the adsorption of As were identified. Moreover, to resolve the stability issue in hydrogel matrix, optimum and effective mixing of hydrogel with biochar was studied. Mixing varied proportions of matrix components at the time of digestion process was tested. Preliminary results suggest that partial premixing methods may increase the stability and reduce cost. Addition of nanoparticles and specific catalysts with different concentrations of As(III) and As(V) under batch conditions was performed to study their role in performance enhancement of the hydrogel matrix. Further, effect of process parameters, optimal uptake conditions and detailed mechanism derived from experimental studies were suitably conducted. This study provides an efficient, specific and a low-cost As removal method that offers excellent regeneration abilities which can be reused for value.

Keywords: arsenic, catalysts, hybrid hydrogel-biochar, water purification

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1549 Digitalised Welfare: Systems for Both Seeing and Working with Mess

Authors: Amelia Morris, Lizzie Coles-Kemp, Will Jones

Abstract:

This paper examines how community welfare initiatives transform how individuals use and experience an ostensibly universal welfare system. This paper argues that the digitalisation of welfare overlooks the complex reality of being unemployed or in low-wage work, and erects digital barriers to accessing welfare. Utilising analysis of ethnographic research in food banks and community groups, the paper explores the ways that Universal Credit has not abolished face-to-face support, but relocated it to unofficial sites of welfare. The apparent efficiency and simplicity of the state’s digital welfare apparatus, therefore, is produced not by reducing the ‘messiness’ of welfare, but by rendering it invisible within the digital framework. Using the analysis of the study’s data, this paper recommends three principles of service design that would render the messiness visible to the state.

Keywords: welfare, digitalisation, food bank, Universal Credit

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1548 Offshore Wind Assessment and Analysis for South Western Mediterranean Sea

Authors: Abdallah Touaibia, Nachida Kasbadji Merzouk, Mustapha Merzouk, Ryma Belarbi

Abstract:

accuracy assessment and a better understand of the wind resource distribution are the most important tasks for decision making before installing wind energy operating systems in a given region, there where our interest come to the Algerian coastline and its Mediterranean sea area. Despite its large coastline overlooking the border of Mediterranean Sea, there is still no strategy encouraging the development of offshore wind farms in Algerian waters. The present work aims to estimate the offshore wind fields for the Algerian Mediterranean Sea based on wind data measurements ranging from 1995 to 2018 provided of 24 years of measurement by seven observation stations focusing on three coastline cities in Algeria under a different measurement time step recorded from 30 min, 60 min, and 180 min variate from one to each other, two stations in Spain, two other ones in Italy and three in the coast of Algeria from the east Annaba, at the center Algiers, and to Oran taken place at the west of it. The idea behind consists to have multiple measurement points that helping to characterize this area in terms of wind potential by the use of interpolation method of their average wind speed values between these available data to achieve the approximate values of others locations where aren’t any available measurement because of the difficulties against the implementation of masts within the deep depth water. This study is organized as follow: first, a brief description of the studied area and its climatic characteristics were done. After that, the statistical properties of the recorded data were checked by evaluating wind histograms, direction roses, and average speeds using MatLab programs. Finally, ArcGIS and MapInfo soft-wares were used to establish offshore wind maps for better understanding the wind resource distribution, as well as to identify windy sites for wind farm installation and power management. The study pointed out that Cap Carbonara is the windiest site with an average wind speed of 7.26 m/s at 10 m, inducing a power density of 902 W/m², then the site of Cap Caccia with 4.88 m/s inducing a power density of 282 W/m². The average wind speed of 4.83 m/s is occurred for the site of Oran, inducing a power density of 230 W/m². The results indicated also that the dominant wind direction where the frequencies are highest for the site of Cap Carbonara is the West with 34%, an average wind speed of 9.49 m/s, and a power density of 1722 W/m². Then comes the site of Cap Caccia, where the prevailing wind direction is the North-west, about 20% and 5.82 m/s occurring a power density of 452 W/m². The site of Oran comes in third place with the North dominant direction with 32% inducing an average wind speed of 4.59 m/s and power density of 189 W/m². It also shown that the proposed method is either crucial in understanding wind resource distribution for revealing windy sites over a large area and more effective for wind turbines micro-siting.

Keywords: wind ressources, mediterranean sea, offshore, arcGIS, mapInfo, wind maps, wind farms

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1547 Examining the Importance of the Structure Based on Grid Computing Service and Virtual Organizations

Authors: Sajjad Baghernezhad, Saeideh Baghernezhad

Abstract:

Vast changes and developments achieved in information technology field in recent decades have made the review of different issues such as organizational structures unavoidable. Applying informative technologies such as internet and also vast use of computer and related networks have led to new organizational formations with a nature completely different from the traditional, great and bureaucratic ones; some common specifications of such organizations are transfer of the affairs out of the organization, benefiting from informative and communicative networks and centered-science workers. Such communicative necessities have led to network sciences development including grid computing. First, the grid computing was only to relate some sites for short – time and use their sources simultaneously, but now it has gone beyond such idea. In this article, the grid computing technology was examined, and at the same time, virtual organization concept was discussed.

Keywords: grid computing, virtual organizations, software engineering, organization

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1546 Introduction to Buddhist Archaeology of Haryana, India

Authors: Chander Shekhar, Manoj Kumar

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The present research paper is based on the explorations and excavations of Buddhist sites of the Indian state Haryana. It is a small state in north India. Earlier it was part of greater Punjab. Haryana has a very rich ancient history right from the Stone Age. It is known as the cradle of civilization. During the Buddha period, Haryana was very prosperous. Buddha also visited this region during the travel of the northwest province of British India. In this research work, the authors describe the Buddhist trail in Haryana and the tangible heritage of Buddhism, which were built in the respect and memory of the Buddha's journey like Stupa, Monasteries, Pillar, sculptures, etc. Several stupas like Chaneti Stupa, Thanesar Stupa, Agroha stupa, Adibadri, Katrawali, Assandh Stupa, and many monasteries were come into light during the excavation and exploration in Haryana as well as a lot of Buddhist sculptures also found.

Keywords: archaeology, Buddhism, exploration, excavations, stupa

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1545 Enzymatic Remediation in Standard Crude Palm Oil for Superior Quality Oil

Authors: Haniza Ahmad, Norliza Saparin, Ahmadilfitri Md Noor, Mohd Suria Affandi Yusoff

Abstract:

Enzymatic remediation is applied in low free fatty acid (FFA) (<4%) crude palm oil (CPO) to investigate if further FFA reduction is able to take place to produce premium CPO (<1% FFA). There are four different lipase Candida Antartica brands used in this study. Samples submit to enzymatic remediation using rotary evaporator under 100mbar vacuum with rotation at 260rpm. Samples were taken at 4hours, 8hours and 24hours for analyses. FFA less than 1% was achieved after 24hours reaction with 1% enzyme and 2% glycerol. The FFA reduction was intensified with the presence of glycerol who provides more sites for fatty acid attachment. At 2% glycerol, 71-88% FFA was reduced whereas at 1% glycerol, 46-75% FFA reduced. However, partial glycerides was increased with presence of glycerol with 2% add in glycerol showed greater partial glycerides increment compared to 1% glycerol.

Keywords: enzymes, crude palm oil, free fatty acid, glycerol

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1544 Growth of New Media Advertising

Authors: Palwinder Bhatia

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As all know new media is a broad term in media studies that emerged in the latter part of the 20th century which refers to on-demand access to content any time, anywhere, on any digital device, as well as interactive user feedback, creative participation and community formation around the media content. The role of new media in advertisement is impeccable these days. It becomes the cheap and best way of advertising. Another important promise of new media is the democratization of the creation, publishing, distribution and consumption of media content. New media brings a revolution in about every field. It makes bridge between customer and companies. World make a global village with the only help of new media. Advertising helps in shaping the consumer behavior and effect on consumer psychology, sociology, social anthropology and economics. People do comments and like the particular brands on the networking sites which create mesmerism impact on the behavior of customer. Recent study did by Times of India shows that 64% of Facebook users have liked a brand on Facebook.

Keywords: film, visual, culture, media, advertisement

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1543 Synthesis, Spectroscopic and Thermal Studies of Copper(I) Chlorido Complexes of Thioureas

Authors: Muhammad Mufakkar, Ghulam Hussain Bhatti, Maryem Rana

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The study of the coordination behavior of thiones is of considerable interest due to the similarity of their binding sites to those in living systems. The complexation of thiones towards Copper(I) has also received considerable attraction in view of their variable bonding modes, structural diversity and promising biological implications. Copper (I) complexes of thioureas of the general formula: CuLCl, CuL2Cl and CuL3Cl [where L= Thiourea and its N- and N, N/- mono and di alkyl and phenyl derivatives] have been prepared using Cu(I)CN in the presence of HCl. The complexes have been characterized by thermal, IR and NMR(1H and 13C) spectroscopy. An upfield shift in 13C NMR and downfield shifts in 1H NMR are consistent with the sulfur coordination to Copper(I). The disappearance of a band around 2200 cm⁻¹ in IR and a resonance around 146 ppm in 13C NMR indicates that during the course of reaction the cyanide group of the Copper(I) salt has been replaced by chloride leading to the formation of chlorido complexes.

Keywords: Thiones, complexation, spectra, TGA, thermogram, chemical shifts, deshielding, resonance

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1542 Optimisation of the Hydrometeorological-Hydrometric Network: A Case Study in Greece

Authors: E. Baltas, E. Feloni, G. Bariamis

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The operation of a network of hydrometeorological-hydrometric stations is basic infrastructure for the management of water resources, as well as, for flood protection. The assessment of water resources potential led to the necessity of adoption management practices including a multi-criteria analysis for the optimum design of the region’s station network. This research work aims at the optimisation of a new/existing network, using GIS methods. The planning of optimum network stations is based on the guidelines of international organizations such as World Meteorological Organization (WMO). The uniform spatial distribution of the stations, the drainage basin for the hydrometric stations and criteria concerning the low terrain slope, the accessibility to the stations and proximity to hydrological interest sites, were taken into consideration for its development. The abovementioned methodology has been implemented for two different areas the Florina municipality and the Argolis area in Greece, and comparison of the results has been conducted.

Keywords: GIS, hydrometeorological, hydrometric, network, optimisation

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1541 From Primer Generation to Chromosome Identification: A Primer Generation Genotyping Method for Bacterial Identification and Typing

Authors: Wisam H. Benamer, Ehab A. Elfallah, Mohamed A. Elshaari, Farag A. Elshaari

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A challenge for laboratories is to provide bacterial identification and antibiotic sensitivity results within a short time. Hence, advancement in the required technology is desirable to improve timing, accuracy and quality. Even with the current advances in methods used for both phenotypic and genotypic identification of bacteria the need is there to develop method(s) that enhance the outcome of bacteriology laboratories in accuracy and time. The hypothesis introduced here is based on the assumption that the chromosome of any bacteria contains unique sequences that can be used for its identification and typing. The outcome of a pilot study designed to test this hypothesis is reported in this manuscript. Methods: The complete chromosome sequences of several bacterial species were downloaded to use as search targets for unique sequences. Visual basic and SQL server (2014) were used to generate a complete set of 18-base long primers, a process started with reverse translation of randomly chosen 6 amino acids to limit the number of the generated primers. In addition, the software used to scan the downloaded chromosomes using the generated primers for similarities was designed, and the resulting hits were classified according to the number of similar chromosomal sequences, i.e., unique or otherwise. Results: All primers that had identical/similar sequences in the selected genome sequence(s) were classified according to the number of hits in the chromosomes search. Those that were identical to a single site on a single bacterial chromosome were referred to as unique. On the other hand, most generated primers sequences were identical to multiple sites on a single or multiple chromosomes. Following scanning, the generated primers were classified based on ability to differentiate between medically important bacterial and the initial results looks promising. Conclusion: A simple strategy that started by generating primers was introduced; the primers were used to screen bacterial genomes for match. Primer(s) that were uniquely identical to specific DNA sequence on a specific bacterial chromosome were selected. The identified unique sequence can be used in different molecular diagnostic techniques, possibly to identify bacteria. In addition, a single primer that can identify multiple sites in a single chromosome can be exploited for region or genome identification. Although genomes sequences draft of isolates of organism DNA enable high throughput primer design using alignment strategy, and this enhances diagnostic performance in comparison to traditional molecular assays. In this method the generated primers can be used to identify an organism before the draft sequence is completed. In addition, the generated primers can be used to build a bank for easy access of the primers that can be used to identify bacteria.

Keywords: bacteria chromosome, bacterial identification, sequence, primer generation

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1540 Study on the Impact of Windows Location on Occupancy Thermal Comfort by Computational Fluid Dynamics (CFD) Simulation

Authors: Farhan E Shafrin, Khandaker Shabbir Ahmed

Abstract:

Natural ventilation strategies continue to be a key alternative to costly mechanical ventilation systems, especially in healthcare facilities, due to increasing energy issues in developing countries, including Bangladesh. Besides, overcrowding and insufficient ventilation strategies remain significant causes of thermal discomfort and hospital infection in Bangladesh. With the proper location of inlet and outlet windows, uniform flow is possible in the occupancy area to achieve thermal comfort. It also determines the airflow pattern of the ward that decreases the movement of the contaminated air. This paper aims to establish a relationship between the location of the windows and the thermal comfort of the occupants in a naturally ventilated hospital ward. It defines the openings and ventilation variables that are interrelated in a way that enhances or limits the health and thermal comfort of occupants. The study conducts a full-scale experiment in one of the naturally ventilated wards in a primary health care hospital in Manikganj, Dhaka. CFD simulation is used to explore the performance of various opening positions in ventilation efficiency and thermal comfort in the study area. The results indicate that the opening located in the hospital ward has a significant impact on the thermal comfort of the occupants and the airflow pattern inside the ward. The findings can contribute to design the naturally ventilated hospital wards by identifying and predicting future solutions when it comes to relationships with the occupants' thermal comforts.

Keywords: CFD simulation, hospital ward, natural ventilation, thermal comfort, window location

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1539 Ambivalence as Ethical Practice: Methodologies to Address Noise, Bias in Care, and Contact Evaluations

Authors: Anthony Townsend, Robyn Fasser

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While complete objectivity is a desirable scientific position from which to conduct a care and contact evaluation (CCE), it is precisely the recognition that we are inherently incapable of operating objectively that is the foundation of ethical practice and skilled assessment. Drawing upon recent research from Daniel Kahneman (2021) on the differences between noise and bias, as well as different inherent biases collectively termed “The Elephant in the Brain” by Kevin Simler and Robin Hanson (2019) from Oxford University, this presentation addresses both the various ways in which our judgments, perceptions and even procedures can be distorted and contaminated while conducting a CCE, but also considers the value of second order cybernetics and the psychodynamic concept of ‘ambivalence’ as a conceptual basis to inform our assessment methodologies to limit such errors or at least better identify them. Both a conceptual framework for ambivalence, our higher-order capacity to allow for the convergence and consideration of multiple emotional experiences and cognitive perceptions to inform our reasoning, and a practical methodology for assessment relying on data triangulation, Bayesian inference and hypothesis testing is presented as a means of promoting ethical practice for health care professionals conducting CCEs. An emphasis on widening awareness and perspective, limiting ‘splitting’, is demonstrated both in how this form of emotional processing plays out in alienating dynamics in families as well as the assessment thereof. In addressing this concept, this presentation aims to illuminate the value of ambivalence as foundational to ethical practice for assessors.

Keywords: ambivalence, forensic, psychology, noise, bias, ethics

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1538 Multi-Institutional Report on Toxicities of Concurrent Nivolumab and Radiation Therapy

Authors: Neha P. Amin, Maliha Zainib, Sean Parker, Malcolm Mattes

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Purpose/Objectives: Combination immunotherapy (IT) and radiation therapy (RT) is an actively growing field of clinical investigation due to promising findings of synergistic effects from immune-mediated mechanisms observed in preclinical studies and clinical data from case reports of abscopal effects. While there are many ongoing trials of combined IT-RT, there are still limited data on toxicity and outcome optimization regarding RT dose, fractionation, and sequencing of RT with IT. Nivolumab (NIVO), an anti-PD-1 monoclonal antibody, has been rapidly adopted in the clinic over the past 2 years, resulting in more patients being considered for concurrent RT-NIVO. Knowledge about the toxicity profile of combined RT-NIVO is important for both the patient and physician when making educated treatment decisions. The acute toxicity profile of concurrent RT-NIVO was analyzed in this study. Materials/Methods: A retrospective review of all consecutive patients who received NIVO from 1/2015 to 5/2017 at 4 separate centers within two separate institutions was performed. Those patients who completed a course of RT from 1 day prior to initial NIVO infusion through 1 month after last NIVO infusion were considered to have received concurrent therapy and included in the subsequent analysis. Descriptive statistics are reported for patient/tumor/treatment characteristics and observed acute toxicities within 3 months of RT completion. Results: Among 261 patients who received NIVO, 46 (17.6%) received concurrent RT to 67 different sites. The median f/u was 3.3 (.1-19.8) months, and 11/46 (24%) were still alive at last analysis. The most common histology, RT prescription, and treatment site included non-small cell lung cancer (23/46, 50%), 30 Gy in 10 fractions (16/67, 24%), and central thorax/abdomen (26/67, 39%), respectively. 79% (53/67) of irradiated sites were treated with 3D-conformal technique and palliative dose-fractionation. Grade 3, 4, and 5 toxicities were experienced by 11, 1, and 2 patients, respectively. However all grade 4 and 5 toxicities were outside of the irradiated area and attributed to the NIVO alone, and only 4/11 (36%) of the grade 3 toxicities were attributed to the RT-NIVO. The irradiated site in these cases included the brain [2/10 (20%)] and central thorax/abdomen [2/19 (10.5%)], including one unexpected grade 3 pancreatitides following stereotactic body RT to the left adrenal gland. Conclusions: Concurrent RT-NIVO is generally well tolerated, though with potentially increased rates of severe toxicity when irradiating the lung, abdomen, or brain. Pending more definitive data, we recommend counseling patients on the potentially increased rates of side effects from combined immunotherapy and radiotherapy to these locations. Future prospective trials assessing fractionation and sequencing of RT with IT will help inform combined therapy recommendations.

Keywords: combined immunotherapy and radiation, immunotherapy, Nivolumab, toxicity of concurrent immunotherapy and radiation

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1537 Remediation and Health: A Systematic Review of the Role of Resulting Displacement in Damaging Health and Wellbeing

Authors: Rupert G. S. Legg

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The connection between poor health outcomes and living near contaminated land has long been understood. Less examined has been the impact of remediation on residents’ health. The cleaning process undoubtedly changes the local area in which it occurs, leading to the possibility that local housing and rental prices could increase resulting in the displacement of those least able to cope. Whether or not this potential displacement resulting from remediation has a considerable impact on health remains unknown. This review aims to determine how these health effects have been approached in the health geography literature. A systematic review of health geographies literature was conducted, searching for two-word clusters: ‘health’ and ‘remediation’ (100 articles); and ‘health’, ‘displacement’ and ‘gentrification’ (43 articles). 43 articles were selected for their relevance (7 from the first cluster, 20 from the second, and 16 from those cited within the reviewed articles). Several of the reviewed cases identified that potential displacement was a contributor to stress and worry in residents living near remediation projects. Likewise, the experience of displacement in other cases beyond remediation was linked with several mental health issues. However, no remediation cases followed-up on the ultimate effects of experiencing displacement on residents’ health. A reason identified for this was a tendency for reviewed studies to adopt a contextual or compositional approach, as opposed to a relational approach, which is more concerned with dimensions of mobility and temporality. Given that remediation and displacement both involve changing mobility and temporality, focussing solely on contextual or compositional factors is problematic. This review concludes by suggesting that more thorough, relational research is conducted into the extent to which potential displacement resulting from remediation affects health.

Keywords: contamination, displacement, health geography, remediation

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1536 A Review on Agricultural Landscapes as a Habitat of Rodents

Authors: Nadeem Munawar, Tariq Mahmood, Paula Rivadeneira, Ali Akhter

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In this paper, we review on rodent species which are common inhabitants of agricultural landscapes where they are an important prey source for a wide variety of avian, reptilian, and mammalian predators. Agricultural fields are surrounded by fallow land, which provide suitable sites for shelter and breeding for rodents, while shrubs, grasses, annual weeds and forbs may provide supplementary food. The assemblage of rodent’s fauna in the cropland habitats including cropped fields, meadows and adjacent field structures like hedgerows, woodland and field margins fluctuates seasonally. The mature agricultural crops provides good source of food and shelter to the rodents and these factors along with favorable climatic factors/season facilitate breeding activities of these rodent species. Changes in vegetation height and vegetative cover affect two important aspects of a rodent’s life: food and shelter. In addition, during non-crop period vegetation can be important for building nests above or below ground and it provides thermal protection for rodents from heat and cold. The review revealed that rodents form a very diverse group of mammals, ranging from tiny pigmy mice to big capybaras, from arboreal flying squirrels to subterranean mole rats, from opportunistic omnivores (e.g. Norway rats) to specialist feeders (e.g. the North African fat sand rats that feed on a single family of plants only). It is therefore no surprise that some species thrive well under the conditions that are found in agricultural fields. The review on the population dynamics of the rodent species indicated that they are agricultural pests probably due to the heterogeneous landscape and to the high rotativity of vegetable crop cultivation. They also cause damage to various crops, directly and indirectly, by gnawing, spoilage, contamination and hoarding activities, besides this behavior they have also significance importance in agricultural habitat. The burrowing activities of rodents alter the soil properties around their burrows which improve its aeration, infiltration, increase the water holding capacity and thus encourage plant growth. These properties are beneficial for the soil because they affect absorption of phosphorus, absorption zinc, copper, other nutrients and the uptake of water and thus rodents are known as indicator species in agricultural fields. Our review suggests that wide crop field’s borders, particularly those contiguous to various cropland fields, should be understood as priority sites for nesting, feeding, and cover for the rodent’s fauna. The goal of this review paper is to provide a comprehensive synthesis of understanding regarding rodent habitat and biodiversity in agricultural landscapes.

Keywords: agricultural landscapes, food, indicator species, shelter

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1535 Lead and Cadmium Residue Determination in Spices Available in Tripoli City Markets (Libya)

Authors: Mohamed Ziyaina, Ahlam Rajab, Khadija Alkhweldi, Wafia Algami, Omer Al. Toumi, Barbara Rasco1

Abstract:

In recent years, there has been a growing interest in monitoring heavy metal contamination in food products. Spices can improve the taste of food and can also be a source of many bioactive compounds but can unfortunately, also be contaminated with dangerous materials, potentially heavy metals. This study was conducted to investigate lead (Pb) and cadmium (Cd) contamination in selected spices commonly consumed in Libya including Capsicum frutescens (chili pepper) Piper nigrum, (black pepper), Curcuma longa (turmeric), and mixed spices (HRARAT) which consist of a combination of: Alpinia officinarum, Zingiber officinale and Cinnamomum zeylanicum. Spices were analyzed by atomic absorption spectroscopy after digestion with nitric acid/hydrogen peroxide. The highest level of lead (Pb) was found in Curcuma longa and Capsicum frutescens in wholesale markets (1.05 ± 0.01 mg/kg, 0.96 ± 0.06 mg/kg). Cadmium (Cd) levels exceeded FAO/WHO permissible limit. Curcuma longa and Piper nigrum sold in retail markets had a high concentration of Cd (0.36 ± 0.09, 0.35 ± 0.07 mg/kg, respectively) followed by (0.32 ± 0.04 mg/kg) for Capsicum frutescens. Mixed spices purchased from wholesale markets also had high levels of Cd (0.31 ± 0.08 mg/kg). Curcuma longa and Capsicum frutescens may pose a food safety risk due to high levels of lead and cadmium. Cadmium levels exceeded FAO/WHO recommendations (0.2 ppm) for Piper nigrum, Curcuma longa, and mixed spices (HRARAT).

Keywords: heavy metals, lead, cadmium determination, spice

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1534 Monitoring and Evaluation of the Water Quality of Taal Lake, Talisay, Batangas, Philippines

Authors: Felipe B. Martinez, Imelda C. Galera

Abstract:

This paper presents an update on the physico-chemical properties of the Taal Lake for local government officials and representatives of non-government organizations by monitoring and evaluating a total of nine (9) water quality parameters. The study further shows that the Taal Lakes surface temperature, pH, total dissolved solids, total suspended solids, color, and dissolved oxygen content conform to the standards set by the Department of Environment and Natural resources (DENR); while phosphate, chlorine, and 5-Day 20°C BOD are below the standard. Likewise, the T-test result shows no significant difference in the overall average of the two sites at the Taal Lake (P > 0.05). Based on the data, the Lake is safe for primary contact recreation such as bathing, swimming and skin diving, and can be used for aqua culture purposes.

Keywords: cool dry season, hot dry season, rainy season, Taal Lake, water quality

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1533 Procedure for Recommendation of Archival Documents

Authors: Marlon J. Remedios, Maria T. Morell, Jesse D. Cano

Abstract:

Diffusion and accessibility of historical collections is one of the main objectives of the institutions that aim to safeguard archival documents (General Archives). Several countries have Web applications that try to make accessible and public the large number of documents that they guard. Each of these sites has a set of features in order to facilitate access, navigability, and search for information. Different sources of information include Recommender Systems as a way of customizing content. This paper aims at describing a process for the production of archival documents relevant to the user. To comply with this, the characteristics ruling archival description, elements and main techniques that establishes the design of Recommender Systems, a set of rules to follow, and how these rules operate and the way in which take advantage of the domain knowledge are discussed. Finally, relevant issues are discussed in the design of the proposed tests and the results obtained are shown.

Keywords: archival document, recommender system, procedure, information management

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1532 Aerosol Characterization in a Coastal Urban Area in Rimini, Italy

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

Abstract:

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

Keywords: aerosol, biomass burning, seacoast, urban area

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1531 Peak Constituent Fluxes from Small Arctic Rivers Generated by Late Summer Episodic Precipitation Events

Authors: Shawn G. Gallaher, Lilli E. Hirth

Abstract:

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

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

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1530 Investigating Perception of Iranian Organizations on Internet of Things Solutions and Applications

Authors: Changiz Valmohammadi

Abstract:

The main purpose of this study is to explore the perception of Iranian experts and executive managers of sample organizations on the benefits and barriers of Internet of Things (IoT) solutions implementation. Based on the review of the related literature and web sites, benefits and barriers of successful implementation to IoT solutions were identified. Through a self-administered questionnaire which was collected from 67 Iranian organizations the ranking and importance of benefits and barriers of IoT solutions implementation were determined based on the perception of the experts of the surveyed organizations. Analysis of data and the obtained results revealed that “improved customer experience” and “Supply chain optimization and responsiveness” are the most important benefits that the survey organizations expect to reap as a result of IoT solutions implementation. Also,” Integration challenges" and “cannot find right suppliers” were ranked as the most challenging barriers to IoT solutions implementation.

Keywords: internet of things (IoT), exploratory study, benefits, barriers, Iran

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1529 Density Functional Theory Study of the Surface Interactions between Sodium Carbonate Aerosols and Fission Products

Authors: Ankita Jadon, Sidi Souvi, Nathalie Girault, Denis Petitprez

Abstract:

The interaction of fission products (FP) with sodium carbonate (Na₂CO₃) aerosols is of a high safety concern because of their potential role in the radiological source term mitigation by FP trapping. In a sodium-cooled fast nuclear reactor (SFR) experiencing a severe accident, sodium (Na) aerosols can be formed after the ejection of the liquid Na coolant inside the containment. The surface interactions between these aerosols and different FP species have been investigated using ab-initio, density functional theory (DFT) calculations using Vienna ab-initio simulation package (VASP). In addition, an improved thermodynamic model has been proposed to treat DFT-VASP calculated energies to extrapolate them to temperatures and pressures of interest in our study. A combined experimental and theoretical chemistry study has been carried out to have both atomistic and macroscopic understanding of the chemical processes; the theoretical chemistry part of this approach is presented in this paper. The Perdew, Burke, and Ernzerhof functional were applied in combination with Grimme’s van der Waals correction to compute exchange-correlational energy at 0 K. Seven different surface cleavages were studied of Ƴ-Na₂CO₃ phase (stable at 603.15 K), it was found that for defect-free surfaces, the (001) facet is the most stable. Furthermore, calculations were performed to study surface defects and reconstructions on the ideal surface. All the studied surface defects were found to be less stable than the ideal surface. More than one adsorbate-ligand configurations were found to be stable confirming that FP vapors could be trapped on various adsorption sites. The calculated adsorption energies (Eads, eV) for the three most stable adsorption sites for I₂ are -1.33, -1.088, and -1.085. Moreover, the adsorption of the first molecule of I₂ changes the surface in a way which would favor stronger adsorption of a second molecule of I2 (Eads, eV = -1.261). For HI adsorption, the most favored reactions have the following Eads (eV) -1.982, -1.790, -1.683 implying that HI would be more reactive than I₂. In addition to FP species, adsorption of H₂O was also studied as the hydrated surface can have different reactivity than the bare surface. One thermodynamically favored site for H₂O adsorption was found with an Eads, eV of -0.754. Finally, the calculations of hydrated surfaces of Na₂CO₃ show that a layer of water adsorbed on the surface significantly reduces its affinity for iodine (Eads, eV = -1.066). According to the thermodynamic model built, the required partial pressure at 373 K to have adsorption of the first layer of iodine is 4.57×10⁻⁴ bar. The second layer will be adsorbed at partial pressures higher than 8.56×10⁻⁶ bar; a layer of water on the surface will increase these pressure almost ten folds to 3.71×10⁻³ bar. The surface interacts with elemental Cs with an Eads (eV) of -1.60, while interacts even strongly with CsI with an Eads (eV) of -2.39. More results on the interactions between Na₂CO₃ (001) and cesium-based FP will also be presented in this paper.

Keywords: iodine uptake, sodium carbonate surface, sodium-cooled fast nuclear reactor, DFT calculations, fission products

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1528 Information Technology and Communications in Management of the Imperial Citadel of Thang Long-A World Heritage Site

Authors: Ngo the Bach

Abstract:

Information technology and communications are growing strongly and penetrated almost the entire Vietnamese economy and society. The article presents an overview of information technology and application communications in the management the Central Sector of the Imperial Citadel of Thang Long (Hanoi, Vietnam) - A World Heritage Site. The author also points out the opportunities and challenges of the information technology and communications in the sectors of culture and heritage; the use of information technology as an effective tool to develop mass and interactive communications. The article emphasizes on the advantage of information technology and communications in supporting effectively the management reform with respect to the Imperial Citadel of Thang Long in particular and the management of world heritage sites in Vietnam in general.

Keywords: information technology, communications, management, culture, heritage

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1527 The Invisibility of Production: A Comparative Study of the Marker of Modern Urban-Centric Economic Development

Authors: Arpita Banerjee

Abstract:

We now live in a world where half of the human population is city dwellers. The migration of people from rural to urban areas is rising continuously. But, the promise of a greater wage and better quality of life cannot keep up with the pace of migration. The rate of urbanization is much higher in developing countries. The UN predicts that 95 percent of this urban expansion will take place in the developing world in the next few decades. The population in the urban settlements of the developing nations is soaring, and megacities like Mumbai, Dhaka, Jakarta, Karachi, Manila, Shanghai, Rio de Janeiro, Lima, and Kinshasa are crammed with people, a majority of whom are migrants. Rural-urban migration has taken a new shape with the rising number of smaller cities. Apart from the increase in non-agricultural economic activities, growing demand for resources and energy, an increase in wastes and pollution, and a greater ecological footprint, there is another significant characteristic of the current wave of urbanization. This paper analyses that important marker of urbanization. It is the invisibility of production sites. The growing urban space ensures that the producers, the production sites, or the process stay beyond urban visibility. In cities and towns, living is majorly about earning money in either the informal service and small scale manufacturing sectors (a major part of which is food preparation), or the formal service sector. In the cases of both the informal service and small scale manufacturing or the formal service sector, commodity creation cannot be seen. The urban space happens to be the marketplace, where nature and its services, along with the non-urban labour, cannot be seen unless it is sold in the market. Hence, the consumers are now increasingly becoming disengaged from the producers. This paper compares the rate of increase in the size of and employment in the informal sector and/or that of the formal sector of some selected urban areas of India. Also, a comparison over the years of the aforementioned characteristics is presented in this paper, in order to find out how the anonymity of the producers to the urban consumers have grown as urbanization has risen. This paper also analyses the change in the transport cost of goods into the cities and towns of India and supports that claim made here that the invisibility of production is a crucial marker of modern-day urban-centric economic development. Such urbanization has an important ecological impact. The invisibility of the production site saves the urban consumer society from dealing with the ethical and ecological aspects of the production process. Once the real sector production is driven out of the cities and towns, the invisible ethical and ecological impacts of the growing urban consumption frees the consumers from associating themselves with any responsibility towards those impacts.

Keywords: ecological impact of urbanization, informal sector, invisibility of production, urbanization

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1526 Fat-Tail Test of Regulatory DNA Sequences

Authors: Jian-Jun Shu

Abstract:

The statistical properties of CRMs are explored by estimating similar-word set occurrence distribution. It is observed that CRMs tend to have a fat-tail distribution for similar-word set occurrence. Thus, the fat-tail test with two fatness coefficients is proposed to distinguish CRMs from non-CRMs, especially from exons. For the first fatness coefficient, the separation accuracy between CRMs and exons is increased as compared with the existing content-based CRM prediction method – fluffy-tail test. For the second fatness coefficient, the computing time is reduced as compared with fluffy-tail test, making it very suitable for long sequences and large data-base analysis in the post-genome time. Moreover, these indexes may be used to predict the CRMs which have not yet been observed experimentally. This can serve as a valuable filtering process for experiment.

Keywords: statistical approach, transcription factor binding sites, cis-regulatory modules, DNA sequences

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1525 An Integrated HCV Testing Model as a Method to Improve Identification and Linkage to Care in a Network of Community Health Centers in Philadelphia, PA

Authors: Catelyn Coyle, Helena Kwakwa

Abstract:

Objective: As novel and better tolerated therapies become available, effective HCV testing and care models become increasingly necessary to not only identify individuals with active infection but also link them to HCV providers for medical evaluation and treatment. Our aim is to describe an effective HCV testing and linkage to care model piloted in a network of five community health centers located in Philadelphia, PA. Methods: In October 2012, National Nursing Centers Consortium piloted a routine opt-out HCV testing model in a network of community health centers, one of which treats HCV, HIV, and co-infected patients. Key aspects of the model were medical assistant initiated testing, the use of laboratory-based reflex test technology, and electronic medical record modifications to prompt, track, report and facilitate payment of test costs. Universal testing on all adult patients was implemented at health centers serving patients at high-risk for HCV. The other sites integrated high-risk based testing, where patients meeting one or more of the CDC testing recommendation risk factors or had a history of homelessness were eligible for HCV testing. Mid-course adjustments included the integration of dual HIV testing, development of a linkage to care coordinator position to facilitate the transition of HIV and/or HCV-positive patients from primary to specialist care, and the transition to universal HCV testing across all testing sites. Results: From October 2012 to June 2015, the health centers performed 7,730 HCV tests and identified 886 (11.5%) patients with a positive HCV-antibody test. Of those with positive HCV-antibody tests, 838 (94.6%) had an HCV-RNA confirmatory test and 590 (70.4%) progressed to current HCV infection (overall prevalence=7.6%); 524 (88.8%) received their RNA-positive test result; 429 (72.7%) were referred to an HCV care specialist and 271 (45.9%) were seen by the HCV care specialist. The best linkage to care results were seen at the test and treat the site, where of the 333 patients were current HCV infection, 175 (52.6%) were seen by an HCV care specialist. Of the patients with active HCV infection, 349 (59.2%) were unaware of their HCV-positive status at the time of diagnosis. Since the integration of dual HCV/HIV testing in September 2013, 9,506 HIV tests were performed, 85 (0.9%) patients had positive HIV tests, 81 (95.3%) received their confirmed HIV test result and 77 (90.6%) were linked to HIV care. Dual HCV/HIV testing increased the number of HCV tests performed by 362 between the 9 months preceding dual testing and first 9 months after dual testing integration, representing a 23.7% increment. Conclusion: Our HCV testing model shows that integrated routine testing and linkage to care is feasible and improved detection and linkage to care in a primary care setting. We found that prevalence of current HCV infection was higher than that seen in locally in Philadelphia and nationwide. Intensive linkage services can increase the number of patients who successfully navigate the HCV treatment cascade. The linkage to care coordinator position is an important position that acts as a trusted intermediary for patients being linked to care.

Keywords: HCV, routine testing, linkage to care, community health centers

Procedia PDF Downloads 357