Search results for: physical models
Commenced in January 2007
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Paper Count: 11904

Search results for: physical models

264 Multiple Plant-Based Cell Suspension as a Bio-Ink for 3D Bioprinting Applications in Food Technology

Authors: Yusuf Hesham Mohamed

Abstract:

Introduction: Three-dimensional printing technology includes multiple procedures that fabricate three-dimensional objects through consecutively layering two-dimensional cross-sections on top of each other. 3D bioprinting is a promising field of 3D printing, which fabricates tissues and organs by accurately controlling the proper arrangement of diverse biological components. 3D bioprinting uses software and prints biological materials and their supporting components layer-by-layer on a substrate or in a tissue culture plate to produce complex live tissues and organs. 3D food printing is an emerging field of 3D bioprinting in which the 3D printed products are food products that are cheap, require less effort to produce, and have more desirable traits. The Aim of the Study is the development of an affordable 3D bioprinter by altering a locally made CNC instrument with an open-source platform to suit the 3D bio-printer purposes. Later, we went through applying the prototype in several applications regarding food technology and drug testing, including the organ-On-Chip. Materials and Methods: An off-the-shelf 3D printer was modified by designing and fabricating the syringe unit, which was designed on the basis of the Milli-fluidics system. Sodium alginate and gelatin hydrogels were prepared, followed by leaf cell suspension preparation from narrow sections of Fragaria’s viable leaves. The desired 3D structure was modeled, and 3D printing preparations took place. Cell-free and cell-laden hydrogels were printed at room temperature under sterile conditions. Post printing curing process was performed. The printed structure was further studied. Results: Positive results have been achieved using the altered 3D bioprinter where a 3D hydrogel construct of two layers made of the combination of sodium alginate to gelatin (15%: 0.5%) has been printed. DLP 3D printer was used to design the syringe component with a transparent PLA-Pro resin for the creation of a microfluidics system having two channels altered to the double extruder. The hydrogel extruder’s design was based on peristaltic pumps, which utilized a stepper motor. The design and fabrication were made using DIY-3D printed parts. Hard plastic PLA was the material utilized for printing. SEM was used to carry out the porous 3D construct imaging. Multiple physical and chemical tests were performed in order to ensure that the cell line was suitable for hosting. Fragaria plant was developed by suspending Fragaria’s cells from its leaves using the 3D bioprinter. Conclusion: 3D bioprinting is considered to be an emerging scientific field that can facilitate and improve many scientific tests and studies. Thus, having a 3D bioprinter in labs is considered to be an essential requirement. 3D bioprinters are very expensive; however, the fabrication of a 3D printer into a 3D bioprinter can lower the cost of the bioprinter. The 3D bioprinter implemented made use of peristaltic pumps instead of syringe-based pumps in order to extend the ability to print multiple types of materials and cells.

Keywords: scaffold, eco on chip, 3D bioprinter, DLP printer

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263 Modification of Hyrax Expansion Screw to Be Used as an Intro-Oral Distractor for Anterior Maxillary Distraction in a Patient with Cleft Lip and Palate: A Case Report

Authors: Ananya Hazare, Ranjit Kamble

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Introduction: Patients with Cleft lip and palate (CL/P) can present with a maxillary retrution after cleft repair. Anterior Maxillary distraction osteogenesis (AMD) is a technique that provides simultaneous skeletal advancement and expansion of the soft tissues related to an anterior segment of the maxilla. This case presented is a case of AMD. The advantage of this technique is that the occlusion in the posterior segment can be maintained, and only the segment in cross bite is advanced for correction of the midfacial deficiency. The other alternative treatment is anterior movement by a Lefort 1 osteotomy. When a Lefort 1 osteotomy is compared with the Distraction osteogenesis or AMD, the disadvantages of the Le Fort 1 include a higher risk of morbidity, requirement of fixation, relapse tendency and unexpected changes in the nasal form. These complications were eliminated by AMD technique. This was followed by placement of the implant in the bone formed after AMD. Hence complete surgical, orthodontic and prosthodontics rehabilitation of the patient was done by an interdisciplinary approach. Methods: Patient presented with repaired UCL/P of the right side with midfacial retrusion. Intro-oral examination revealed a good occlusion in the posterior arch and anterior Crossbite from canine to canine. Patient's both maxillary lateral incisors were missing. The lower arch was well aligned with all teeth present. The study models when scored according to GOSLON yardstick received a score of 4. After pre-surgical orthodontic phase was completed an intraoral distractor was fabricated by modification of HYRAX expansion screw. After surgery, low subapical osteotomy cuts were placed and the distractor was fixed. The latency period of 5 days was observed after which the distraction was started. Distraction was done at a rate of 1 mm/day with a rhythm of 0.5mm in morning and 0.5mm in the evening. The total distraction of 12 mm was done. After a consolidation period, the distractor was removed, and retention by a removable partial denture was given. Radiographic examination confirmed mature bone formation in the distracted segment. Implants were placed and allowed to osseointegrate for approximately 4 months and were then loaded with abutments. Results: Total distraction done was 12mm and after relapse it was 8mm. After consolidation phase the radiographic examination revealed a B2 quality of bone according to the Misch's classification and sufficient height from the maxillary sinus. These findings were indicative for placement of implants in the distracted bone formed in premolar region. Implants were placed and after radiographic evidence of osseointegration was seen they were loaded with abutments. Thus resulting in a complete rehabilitation of a cleft patient by an interdisciplinary approach. Conclusion: Anterior maxillary distraction can be used as an alternative method instead of complete distraction osteogenesis or Lefort 1 advancement of maxilla in cases where the advancement needed is minimum. Use of HYRAX expansion screw modified as intra-oral distractor can be used in such cases, which significantly reduces the cost of treatment, as expensive distractors are not used. This technique is very useful and efficient in countries like India where the patient cannot afford expensive treatment options.

Keywords: cleft lip and palate, distraction osteogenesis, anterior maxillary distraction, orthodontics and dentofacial orthopaedics, hyrax expansion screw modification

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262 Modelling Pest Immigration into Rape Seed Crops under Past and Future Climate Conditions

Authors: M. Eickermann, F. Ronellenfitsch, J. Junk

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Oilseed rape (Brassica napus L.) is one of the most important crops throughout Europe, but pressure due to pest insects and pathogens can reduce yield amount substantially. Therefore, the usage of pesticide applications is outstanding in this crop. In addition, climate change effects can interact with phenology of the host plant and their pests and can apply additional pressure on the yield. Next to the pollen beetle, Meligethes aeneus L., the seed-damaging pest insects, cabbage seed weevil (Ceutorhynchus obstrictus Marsham) and the brassica pod midge (Dasineura brassicae Winn.) are of main economic impact to the yield. While females of C. obstrictus are infesting oilseed rape by depositing single eggs into young pods, the females of D. brassicae are using this local damage in the pod for their own oviposition, while depositing batches of 20-30 eggs. Without a former infestation by the cabbage seed weevil, a significant yield reduction by the brassica pod midge can be denied. Based on long-term, multisided field experiments, a comprehensive data-set on pest migration to crops of B. napus has been built up in the last ten years. Five observational test sides, situated in different climatic regions in Luxembourg were controlled between February until the end of May twice a week. Pest migration was recorded by using yellow water pan-traps. Caught insects were identified in the laboratory according to species specific identification keys. By a combination of pest observations and corresponding meteorological observations, the set-up of models to predict the migration periods of the seed-damaging pests was possible. This approach is the basis for a computer-based decision support tool, to assist the farmer in identifying the appropriate time point of pesticide application. In addition, the derived algorithms of that decision support tool can be combined with climate change projections in order to assess the future potential threat caused by the seed-damaging pest species. Regional climate change effects for Luxembourg have been intensively studied in recent years. Significant changes to wetter winters and drier summers, as well as a prolongation of the vegetation period mainly caused by higher spring temperature, have also been reported. We used the COSMO-CLM model to perform a time slice experiment for Luxembourg with a spatial resolution of 1.3 km. Three ten year time slices were calculated: The reference time span (1991-2000), the near (2041-2050) and the far future (2091-2100). Our results projected a significant shift of pest migration to an earlier onset of the year. In addition, a prolongation of the possible migration period could be observed. Because D. brassiace is depending on the former oviposition activity by C. obstrictus to infest its host plant successfully, the future dependencies of both pest species will be assessed. Based on this approach the future risk potential of both seed-damaging pests is calculated and the status as pest species is characterized.

Keywords: CORDEX projections, decision support tool, Brassica napus, pests

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261 Against the Philosophical-Scientific Racial Project of Biologizing Race

Authors: Anthony F. Peressini

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The concept of race has recently come prominently back into discussion in the context of medicine and medical science, along with renewed effort to biologize racial concepts. This paper argues that this renewed effort to biologize race by way of medicine and population genetics fail on their own terms, and more importantly, that the philosophical project of biologizing race ought to be recognized for what it is—a retrograde racial project—and abandoned. There is clear agreement that standard racial categories and concepts cannot be grounded in the old way of racial naturalism, which understand race as a real, interest-independent biological/metaphysical category in which its members share “physical, moral, intellectual, and cultural characteristics.” But equally clear is the very real and pervasive presence of racial concepts in individual and collective consciousness and behavior, and so it remains a pressing area in which to seek deeper understanding. Recent philosophical work has endeavored to reconcile these two observations by developing a “thin” conception of race, grounded in scientific concepts but without the moral and metaphysical content. Such “thin,” science-based analyses take the “commonsense” or “folk” sense of race as it functions in contemporary society as the starting point for their philosophic-scientific projects to biologize racial concepts. A “philosophic-scientific analysis” is a special case of the cornerstone of analytic philosophy: a conceptual analysis. That is, a rendering of a concept into the more perspicuous concepts that constitute it. Thus a philosophic-scientific account of a concept is an attempt to work out an analysis of a concept that makes use of empirical science's insights to ground, legitimate and explicate the target concept in terms of clearer concepts informed by empirical results. The focus in this paper is on three recent philosophic-scientific cases for retaining “race” that all share this general analytic schema, but that make use of “medical necessity,” population genetics, and human genetic clustering, respectively. After arguing that each of these three approaches suffers from internal difficulties, the paper considers the general analytic schema employed by such biologizations of race. While such endeavors are inevitably prefaced with the disclaimer that the theory to follow is non-essentialist and non-racialist, the case will be made that such efforts are not neutral scientific or philosophical projects but rather are what sociologists call a racial project, that is, one of many competing efforts that conjoin a representation of what race means to specific efforts to determine social and institutional arrangements of power, resources, authority, etc. Accordingly, philosophic-scientific biologizations of race, since they begin from and condition their analyses on “folk” conceptions, cannot pretend to be “prior to” other disciplinary insights, nor to transcend the social-political dynamics involved in formulating theories of race. As a result, such traditional philosophical efforts can be seen to be disciplinarily parochial and to address only a caricature of a large and important human problem—and thereby further contributing to the unfortunate isolation of philosophical thinking about race from other disciplines.

Keywords: population genetics, ontology of race, race-based medicine, racial formation theory, racial projects, racism, social construction

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260 Modeling Thermal Changes of Urban Blocks in Relation to the Landscape Structure and Configuration in Guilan Province

Authors: Roshanak Afrakhteh, Abdolrasoul Salman Mahini, Mahdi Motagh, Hamidreza Kamyab

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Urban Heat Islands (UHIs) are distinctive urban areas characterized by densely populated central cores surrounded by less densely populated peripheral lands. These areas experience elevated temperatures, primarily due to impermeable surfaces and specific land use patterns. The consequences of these temperature variations are far-reaching, impacting the environment and society negatively, leading to increased energy consumption, air pollution, and public health concerns. This paper emphasizes the need for simplified approaches to comprehend UHI temperature dynamics and explains how urban development patterns contribute to land surface temperature variation. To illustrate this relationship, the study focuses on the Guilan Plain, utilizing techniques like principal component analysis and generalized additive models. The research centered on mapping land use and land surface temperature in the low-lying area of Guilan province. Satellite data from Landsat sensors for three different time periods (2002, 2012, and 2021) were employed. Using eCognition software, a spatial unit known as a "city block" was utilized through object-based analysis. The study also applied the normalized difference vegetation index (NDVI) method to estimate land surface radiance. Predictive variables for urban land surface temperature within residential city blocks were identified categorized as intrinsic (related to the block's structure) and neighboring (related to adjacent blocks) variables. Principal Component Analysis (PCA) was used to select significant variables, and a Generalized Additive Model (GAM) approach, implemented using R's mgcv package, modeled the relationship between urban land surface temperature and predictor variables.Notable findings included variations in urban temperature across different years attributed to environmental and climatic factors. Block size, shared boundary, mother polygon area, and perimeter-to-area ratio were identified as main variables for the generalized additive regression model. This model showed non-linear relationships, with block size, shared boundary, and mother polygon area positively correlated with temperature, while the perimeter-to-area ratio displayed a negative trend. The discussion highlights the challenges of predicting urban surface temperature and the significance of block size in determining urban temperature patterns. It also underscores the importance of spatial configuration and unit structure in shaping urban temperature patterns. In conclusion, this study contributes to the growing body of research on the connection between land use patterns and urban surface temperature. Block size, along with block dispersion and aggregation, emerged as key factors influencing urban surface temperature in residential areas. The proposed methodology enhances our understanding of parameter significance in shaping urban temperature patterns across various regions, particularly in Iran.

Keywords: urban heat island, land surface temperature, LST modeling, GAM, Gilan province

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259 Synthesis of Smart Materials Based on Polyaniline Coated Fibers

Authors: Mihaela Beregoi, Horia Iovu, Cristina Busuioc, Alexandru Evanghelidis, Elena Matei, Monica Enculescu, Ionut Enculescu

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Nanomaterials field is very attractive for all researchers who are attempting to develop new devices with the same or improved properties than the micro-sized ones, while reducing the reagents and power consumptions. In this way, a wide range of nanomaterials were fabricated and integrated in applications for electronics, optoelectronics, solar cells, tissue reconstruction and drug delivery. Obviously, the most appealing ones are those dedicated to the medical domain. Different types of nano-sized materials, such as particles, fibers, films etc., can be synthesized by using physical, chemical or electrochemical methods. One of these techniques is electrospinning, which enable the production of fibers with nanometric dimensions by pumping a polymeric solution in a high electric field; due to the electrostatic charging and solvent evaporation, the precursor mixture is converted into nonwoven meshes with different fiber densities and mechanical properties. Moreover, polyaniline is a conducting polymer with interesting optical properties, suitable for displays and electrochromic windows. Otherwise, polyaniline is an electroactive polymer that can contract/expand by applying electric stimuli, due to the oxidation/reduction reactions which take place in the polymer chains. These two main properties can be exploited in order to synthesize smart materials that change their dimensions, exhibiting in the same time good electrochromic properties. In the context aforesaid, a poly(methyl metacrylate) solution was spun to get webs composed of fibers with diameter values between 500 nm and 1 µm. Further, the polymer meshes were covered with a gold layer in order to make them conductive and also appropriate as working electrode in an electrochemical cell. The gold shell was deposited by DC sputtering. Such metalized fibers can be transformed into smart materials by covering them with a thin layer of conductive polymer. Thus, the webs were coated with a polyaniline film by the electrochemical route, starting from and aqueous solution of aniline and sulfuric acid, where sulfuric acid acts as oxidant agent. For the polymerization of aniline, a saturated calomel electrode was employed as reference, a platinum plate as counter electrode and the gold covered webs as working electrode. Chronoamperometry was selected as deposition method for polyaniline, by modifying the deposition time. Metalized meshes with different fiber densities were used, the transmission ranging between 70 and 80 %. The morphological investigation showed that polyaniline layer has a granular structure for all deposition experiments. As well, some preliminary optical tests were done by using sulfuric acid as electrolyte, which revealed the modification of polyaniline colour from green to dark blue when applying a voltage. In conclusion, new multilayered materials were obtained by a simple approach: the merge of the electrospinning method benefits with polyaniline chemistry. This synthesis method allows the fabrication of structures with reproducible characteristics, suitable for display or tissue substituents.

Keywords: electrospinning, fibers, smart materials, polyaniline

Procedia PDF Downloads 275
258 Index and Mechanical Geotechnical Properties and Their Control on the Strength and Durability of the Cainozoic Calcarenites in KwaZulu-Natal, South Africa

Authors: Luvuno N. Jele, Warwick W. Hastie, Andrew Green

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Calcarenite is a clastic sedimentary beach rock composed of more than 50% sand sized (0.0625 – 2 mm) carbonate grains. In South Africa, these rocks occur as a narrow belt along most of the coast of KwaZulu-Natal and sporadically along the coast of the Eastern Cape. Calcarenites contain a high percentage of calcium carbonate, and due to a number of its physical and structural features, like porosity, cementing material, sedimentary structures, grain shape, and grain size; they are more prone to chemical and mechanical weathering. The objective of the research is to study the strength and compressibility characteristics of the calcarenites along the coast of KwaZulu-Natal to be able to better understand the geotechnical behaviour of these rocks, which may help to predict areas along the coast which may be potentially susceptible to failure/differential settling resulting in damage to property. A total of 148 cores were prepared and analyzed. Cores were analyzed perpendicular and parallel to bedding. Tests were carried out in accordance with the relevant codes and recommendations of the International Society for Rock Mechanics, American Standard Testing Methods, and Committee of Land and Transport Standard Specifications for Road and Bridge Works for State Road Authorities. Test carried out included: x-ray diffraction, petrography, shape preferred orientation (SPO), 3-D Tomography, rock porosity, rock permeability, ethylene glycol, slake durability, rock water absorption, Duncan swelling index, triaxial compressive strength, Brazilian tensile strength and uniaxial compression test with elastic modulus. The beach-rocks have a uniaxial compressive strength (UCS) ranging from 17,84Mpa to 287,35Mpa and exhibit three types of failure; (1) single sliding shear failure, (2) complete cone development, and (3) splitting failure. Brazilian tensile strength of the rocks ranges from 2.56 Mpa to 12,40 Ma, with those tested perpendicular to bedding showing lower tensile strength. Triaxial compressive tests indicate calcarenites have strength ranging from 86,10 Mpa to 371,85 Mpa. Common failure mode in the triaxial test is a single sliding shear failure. Porosity of the rocks varies from 1.25 % to 26.52 %. Rock tests indicate that the direction of loading, whether it be parallel to bedding or perpendicular to bedding, plays no significantrole in the strength and durability of the calcarenites. Porosity, cement type, and grain texture play major roles.UCS results indicate that saturated cores are weaker in strength compared to dry samples. Thus, water or moisture content plays a significant role in the strength and durability of the beach-rock. Loosely packed, highly porous and low magnesian-calcite bearing calcarenites show a decrease in strength compared to the densely packed, low porosity and high magnesian-calcite bearing calcarenites.

Keywords: beach-rock, calcarenite, cement, compressive, failure, porosity, strength, tensile, grains

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257 Emergency Department Utilisation of Older People Presenting to Four Emergency Departments

Authors: M. Fry, L. Fitzpatrick, Julie Considine, R. Z. Shaban, Kate Curtis

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Introduction: The vast majority of older Australians lives independently and are self-managing at home, despite a growing number living with a chronic illness that requires health intervention. Evidence shows that between 50% and 80% of people presenting to the emergency department (ED) are in pain. Australian EDs manage 7.2 million attendances every year and 1.4 million of these are people aged 65 years or more. Research shows that 28% of ED patients aged 65 years or more have Cognitive impairment (CI) associated with dementia, delirium and neurological conditions. Background: Traditional ED service delivery may not be suitable for older people who present with multiple, complex and ongoing illnesses. Likewise, ED clinical staff often perceive that their role should be focused more on immediate and potential lifethreatening illness and conditions which are episodic in nature. Therefore, the needs of older people and their family/carers may not be adequately addressed in the context of an ED presentation. Aim: We aimed to explore the utilisation and characteristics of older people presenting to four metropolitan EDs. Method: The findings being presented are part of a program of research exploring pain management practices for older persons with long bone fractures. The study was conducted across four metropolitan emergency departments of older patients (65years and over) and involved a 12-month randomised medical record audit (n=255). Results: ED presentations across four ED sites in 2012 numbered 168021, with 44778 (26.6%) patients aged 65 and over. Of the 44778 patients, the average age was 79.1 years (SD 8.54). There were more females 23932 (53.5%). The majority (26925: 85.0%) of older persons self-referred to the ED and lived independently. The majority arrived by ambulance (n=18553: 41.4%) and were allocated triage category was 3 (n=19,507:43.65%) or Triage category 4 at (n=15,389: 34.43%). The top five triage symptom presentations involved pain (n=8088; 18.25%), dyspnoea (n=4735; 10.7%), falls (n=4032; 9.1%), other (n=3984; 9.0%), cardiac (n=2987; 6.7%). The top five system based diagnostic presentations involved musculoskeletal (n=8902; 20.1%), cardiac (n=6704:15.0%), respiratory (n=4933; 11.0%), neurological (n=4909; 11.0%), gastroenterology (n=4321; 9.7%). On review of one tertiary hospital database the vital signs on average at time triage: Systolic Blood Pressure 143.6mmHg. Heart Rate 83.4 beats/minute; Respiratory Rate 18.5 breaths/ minute; Oxygen saturation 97.0% and Tympanic temperature 36.7 and Blood Glucose Level 7.4mmols/litre. The majority presented with a Glasgow Coma Score of 14 or higher. On average the older person stayed in the ED 4:56 (SD 3:28minutes).The average time to be seen was 39 minutes (SD 48 minutes). The majority of older persons were admitted (n=27562: 61.5%), did not wait for treatment (n= 8879: 0.02%) discharged home (n=16256: 36.0%). Conclusion: The vast majority of older persons are living independently, although many require admission on arrival to the ED. Many arrived in pain and with musculoskeletal injuries and or conditions. New models of care need to be considered, which may better support self-management and independent living of the older person and the National Emergency Access Targets.

Keywords: chronic, older person, aged care, emergency department

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256 Rural-To-Urban Migrants' Experiences with Primary Care in Four Types of Medical Institutions in Guangzhou, China

Authors: Jiazhi Zeng, Leiyu Shi, Xia Zou, Wen Chen, Li Ling

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Background: China is facing the unprecedented challenge of rapidly increasing rural-to-urban migration. Due to the household registration system, migrants are in a vulnerable state when they attempt to access to primary care services. A strong primary care system can reduce health inequities and mitigate socioeconomic disparities in healthcare utilization. Literature indicated that migrants were more reliant on the primary care system than local residents. Although the Chinese government has attached great importance to creating an efficient health system, primary care services are still underutilized. The referral system between primary care institutions and hospitals has not yet been completely established in China. The general populations often go directly to hospitals instead of primary care institutions for their primary care. Primary care institutions generally consist of community health centers (CHCs) and community health stations (CHSs) in urban areas, and township health centers (THCs) and rural health stations (THSs) in rural areas. In addition, primary care services are also provided by the outpatient department of municipal hospitals and tertiary hospitals. A better understanding of migrants’ experiences with primary care in the above-mentioned medical institutions is critical for improving the performance of primary care institutions and providing indications of the attributes that require further attention. The purpose of this pioneering study is to explore rural-to-urban migrants’ experiences in primary care, compare their primary care experiences in four types of medical institutions in Guangzhou, China, and suggest implications for targeted interventions to improve primary care for the migrants. Methods: This was a cross-sectional study conducted with 736 rural-to-urban migrants in Guangzhou, China, in 2014. A multistage sampling method was employed. A validated Chinese version of Primary Care Assessment Tool - Adult Short Version (PCAT-AS) was used to collect information on migrants’ primary care experiences. The PCAT-AS consists of 10 domains. Analysis of covariance was conducted for comparison on PCAT domain scores and total scores among migrants accessing four types of medical institutions. Multiple linear regression models were used to explore factors associated with PCAT total scores. Results: After controlling for socio-demographic characteristics, migrant characteristics, health status and health insurance status, migrants accessing primary care in tertiary hospitals had the highest PCAT total scores when compared with those accessing primary care THCs/ RHSs (25.49 vs. 24.18, P=0.007) and CHCs/ CHSs(25.49 vs. 24.24, P=0.006). There was no statistical significant difference for PCAT total scores between migrants accessing primary care in CHCs/CHSs and those in municipal hospitals (24.24 vs. 25.02, P=0.436). Factors positively associated with higher PCAT total scores also included insurance covering parts of healthcare payment (P < 0.001). Conclusions: This study highlights the need for improvement in primary care provided by primary care institutions for rural-to-urban migrants. Migrants receiving primary care from THCs, RHSs, CHSs and CHSs reported worse primary care experiences than those receiving primary care from tertiary hospitals. Relevant policies related to medical insurance should be implemented for providing affordable healthcare services for migrants accessing primary care. Further research exploring the specific reasons for poorer PCAT scores of primary care institutions users will be needed.

Keywords: China, PCAT, primary care, rural-to-urban migrants

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255 Longitudinal Examination of Depressive Symptoms among U.S. Parents who Gave Birth During the COVID-19 Pandemic

Authors: Amy Claridge, Tishra Beeson

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Background: Maternal depression is a serious health concern impacting between 10-16% of birthing persons. It is associated with difficulty in emotional interaction and the formation of attachment bonds between parent and infant. Longitudinally, maternal depression can have severe, lasting impacts on both parent and child, increasing the risk for mental, social, and physical health issues. Rates of prenatal depression have been higher among individuals who were pregnant during the first year of the COVID-19 pandemic. Pregnant persons are considered a high-risk group for poor clinical outcomes from COVID-19 infection and may also have faced or continue to face additional stressors such as financial burdens, loss of income or employment, and the benefits accompanying employment, especially among those in the United States (U.S.). It is less clear whether individuals who gave birth during the pandemic continue to experience high levels of depressive symptoms or whether symptoms have been reduced as a pandemic response has shifted. The current study examined longitudinal reports of depressive symptoms among individuals in the U.S. who gave birth between March 2020 and September 2021. Methods: This mixed-method study involved surveys and interviews with birthing persons (18-45 years old) in their third trimester of pregnancy and at 8 weeks postpartum. Participants also completed a follow-up survey at 12-18 months postpartum. Participants were recruited using convenience methods via an online survey. Survey participants included 242 U.S. women who self-reported depressive symptoms (10-item Edinburgh Postnatal Depression Scale) at each data collection wave. A subset of 23 women participated in semi-structured prenatal and 8-week postpartum qualitative interviews. Follow-up interviews are currently underway and will be integrated into the presentation. Preliminary Results: Prenatal depressive symptoms were significantly positively correlated to 8-week and 12-18-month postpartum depressive symptoms. Participants who reported clinical levels of depression prenatally were 3.29 times (SE = .32, p < .001) more likely to report clinical levels of depression at 18 months postpartum. Those who reported clinical depression at 8-weeks postpartum were 6.52 times (SE = .41, p < .001) more likely to report clinical levels of depression at 18 months postpartum. Participants who gave birth earlier in the pandemic reported significantly higher prenatal (t(103) = 2.84, p < .01) and 8-week postpartum depressive symptoms (t(126) = 3.31, p < .001). Data from qualitative interviews contextualize the findings. Participants reported negative emotions during pregnancy, including sadness, grief, and anxiety. They attributed this in part to their experiences of pregnancy during the pandemic and uncertainty related to the birth experience and postpartum period. Postpartum interviews revealed some stressors specific to childbirth during the COVID-19 pandemic; however, most women reflected on positive experiences of birth and postpartum. Conclusions: Taken together, findings reveal a pattern of persistent depressive symptoms among U.S. parents who gave birth during the pandemic. Depressive symptoms are of significant concern for the health of parents and children, and the findings of this study suggest a need for continued mental health intervention for parents who gave birth during the pandemic. Policy and practice implications will be discussed.

Keywords: maternal mental health, perinatal depression, postpartum depression, covid-19 pandemic

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254 Sustainable Strategies for Managing Rural Tourism in Abyaneh Village, Isfahan

Authors: Hoda Manafian, Stephen Holland

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Problem statement: Rural areas in Iran are one of the most popular tourism destinations. Abyaneh Village is one of them with a long history behind it (more than 1500 years) which is a national heritage site and also is nominated as a world heritage site in UNESCO tentative list from 2007. There is a considerable foundation of religious-cultural heritage and also agricultural history and activities. However, this heritage site suffers from mass tourism which is beyond its social and physical carrying capacity, since the annual number of tourists exceed 500,000. While there are four adjacent villages around Abyaneh which can benefit from advantages of tourism. Local managers also can at the same time prorate the tourists’ flux of Abyaneh on those other villages especially in high-season. The other villages have some cultural and natural tourism attractions as well. Goal: The main goal of this study is to identify a feasible development strategy according to the current strengths, weaknesses, opportunities and threats of rural tourism in this area (Abyaneh Village and four adjacent villages). This development strategy can lead to sustainable management of these destinations. Method: To this end, we used SWOT analysis as a well-established tool for conducting a situational analysis to define a sustainable development strategy. The procedures included following steps: 1) Extracting variables of SWOT chart based on interviewing tourism experts (n=13), local elites (n=17) and personal observations of researcher. 2) Ranking the extracted variables from 1-5 by 13 tourism experts in Isfahan Cultural Heritage, Handcrafts and Tourism Organization (ICHTO). 3) Assigning weights to the ranked variables using Expert Choice Software and the method of Analytical Hierarchical Process (AHP). 4) Defining the Total Weighted Score (TWS) for each part of SWOT chart. 5) Identifying the strategic position according to the TWS 6) Selecting the best development strategy based on the defined position using the Strategic Position and Action Evaluation (SPACE) matrix. 7) Assessing the Probability of Strategic Success (PSS) for the preferred strategy using relevant formulas. 8) Defining two feasible alternatives for sustainable development. Results and recommendations: Cultural heritage attractions were first-ranked variable in strength chart and also lack of sufficient amenities for one-day tourists (catering, restrooms, parking, and accommodation) was firs-ranked weakness. The strategic position was in ST (Strength-Threat) quadrant which is a maxi-mini position. According this position we would suggest ‘Competitive Strategy’ as a development strategy which means relying on strengths in order to neutralization threats. The result of Probability of Strategic Success assessment which was 0.6 shows that this strategy could be successful. The preferred approach for competitive strategy could be rebranding the market of tourism in this area. Rebranding the market can be achieved by two main alternatives which are based on the current strengths and threats: 1) Defining a ‘Heritage Corridor’ from first adjacent village to Abyaneh as a final destination. 2) Focus on ‘educational tourism’ versus mass tourism and also green tourism by developing agritourism in that corridor.

Keywords: Abyaneh village, rural tourism, SWOT analysis, sustainable strategies

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253 Evaluation of Toxicity of Cerium Oxide on Zebrafish Developmental Stages

Authors: Roberta Pecoraro, Elena Maria Scalisi

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Engineered Nanoparticles (ENPs) and Nanomaterials (ENMs) concern an active research area and a sector in full expansion. They have physical-chemical characteristics and small size that improve their performance compared to common materials. Due to the increase in their production and their subsequent release into the environment, new strategies are emerging to assess risk of nanomaterials. NPs can be released into the environment through aquatic systems by human activities and exert toxicity on living organisms. We evaluated the potential toxic effect of cerium oxide (CeO2) nanoparticles because it’s used in different fields due to its peculiar properties. In order to assess nanoparticles toxicity, Fish Embryo Toxicity (FET) test was performed. Powders of CeO2 NPs supplied by the CNR-IMM of Catania are indicated as CeO2 type 1 (as-prepared) and CeO2 type 2 (modified), while CeO2 type 3 (commercial) is supplied by Sigma-Aldrich. Starting from a stock solution (0.001g/10 ml dilution water) of each type of CeO2 NPs, the other concentration solutions were obtained adding 1 ml of the stock solution to 9 ml of dilution water, leading to three different solutions of concentration (10-4, 10-5, 10-6 g/ml). All the solutions have been sonicated to avoid natural tendency of NPs to aggregate and sediment. FET test was performed according to the OECD guidelines for testing chemicals using our internal protocol procedure. A number of eight selected fertilized eggs were placed in each becher filled with 5 ml of each concentration of the three types of CeO2 NPs; control samples were incubated only with dilution water. Replication was performed for each concentration. During the exposure period, we observed four endpoints (embryo coagulation, lack of formation of somites, failure to lift the yolk bag, no heartbeat) by a stereomicroscope every 24 hours. Immunohistochemical analysis on treated larvae was performed to evaluate the expression of metallothioneins (MTs), Heat Shock Proteins 70 (HSP70) and 7-ethoxyresorufin-O-diethylase (EROD). Our results have not shown evident alterations on embryonic development because all embryos completed the development and the hatching of the eggs, started around the 48th hour after exposure, took place within the last observation at 72 hours. A good reactivity, both in the embryos and in the newly hatched larvae, was found. The presence of heartbeat has also been observed in embryos with reduced mobility confirming their viability. A higher expression of EROD biomarker was observed in the larvae exposed to the three types of CeO2, showing a clear difference with the control. A weak positivity was found for MTs biomarker in treated larvae as well as in the control. HSP70 are expressed homogeneously in all the type of nanoparticles tested but not too much greater than control. Our results are in agreement with other studies in the literature, in which the exposure of Danio rerio larvae to other metal oxide nanoparticles does not show adverse effects on survival and hatching time. Further studies are necessary to clarify the role of these NPs and also to solve conflicting opinions.

Keywords: Danio rerio, endpoints, fish embryo toxicity test, metallic nanoparticles

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252 Ectopic Osteoinduction of Porous Composite Scaffolds Reinforced with Graphene Oxide and Hydroxyapatite Gradient Density

Authors: G. M. Vlasceanu, H. Iovu, E. Vasile, M. Ionita

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Herein, the synthesis and characterization of chitosan-gelatin highly porous scaffold reinforced with graphene oxide, and hydroxyapatite (HAp), crosslinked with genipin was targeted. In tissue engineering, chitosan and gelatin are two of the most robust biopolymers with wide applicability due to intrinsic biocompatibility, biodegradability, low antigenicity properties, affordability, and ease of processing. HAp, per its exceptional activity in tuning cell-matrix interactions, is acknowledged for its capability of sustaining cellular proliferation by promoting bone-like native micro-media for cell adjustment. Genipin is regarded as a top class cross-linker, while graphene oxide (GO) is viewed as one of the most performant and versatile fillers. The composites with natural bone HAp/biopolymer ratio were obtained by cascading sonochemical treatments, followed by uncomplicated casting methods and by freeze-drying. Their structure was characterized by Fourier Transform Infrared Spectroscopy and X-ray Diffraction, while overall morphology was investigated by Scanning Electron Microscopy (SEM) and micro-Computer Tomography (µ-CT). Ensuing that, in vitro enzyme degradation was performed to detect the most promising compositions for the development of in vivo assays. Suitable GO dispersion was ascertained within the biopolymer mix as nanolayers specific signals lack in both FTIR and XRD spectra, and the specific spectral features of the polymers persisted with GO load enhancement. Overall, correlations between the GO induced material structuration, crystallinity variations, and chemical interaction of the compounds can be correlated with the physical features and bioactivity of each composite formulation. Moreover, the HAp distribution within follows an auspicious density gradient tuned for hybrid osseous/cartilage matter architectures, which were mirrored in the mice model tests. Hence, the synthesis route of a natural polymer blend/hydroxyapatite-graphene oxide composite material is anticipated to emerge as influential formulation in bone tissue engineering. Acknowledgement: This work was supported by the project 'Work-based learning systems using entrepreneurship grants for doctoral and post-doctoral students' (Sisteme de invatare bazate pe munca prin burse antreprenor pentru doctoranzi si postdoctoranzi) - SIMBA, SMIS code 124705 and by a grant of the National Authority for Scientific Research and Innovation, Operational Program Competitiveness Axis 1 - Section E, Program co-financed from European Regional Development Fund 'Investments for your future' under the project number 154/25.11.2016, P_37_221/2015. The nano-CT experiments were possible due to European Regional Development Fund through Competitiveness Operational Program 2014-2020, Priority axis 1, ID P_36_611, MySMIS code 107066, INOVABIOMED.

Keywords: biopolymer blend, ectopic osteoinduction, graphene oxide composite, hydroxyapatite

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251 Owning (up to) the 'Art of the Insane': Re-Claiming Personhood through Copyright Law

Authors: Mathilde Pavis

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From Schumann to Van Gogh, Frida Kahlo, and Ray Charles, the stories narrating the careers of artists with physical or mental disabilities are becoming increasingly popular. From the emergence of ‘pathography’ at the end of 18th century to cinematographic portrayals, the work and lives of differently-abled creative individuals continue to fascinate readers, spectators and researchers. The achievements of those artists form the tip of the iceberg composed of complex politico-cultural movements which continue to advocate for wider recognition of disabled artists’ contribution to western culture. This paper envisages copyright law as a potential tool to such end. It investigates the array of rights available to artists with intellectual disabilities to assert their position as authors of their artwork in the twenty-first-century looking at international and national copyright laws (UK and US). Put simply, this paper questions whether an artist’s intellectual disability could be a barrier to assert their intellectual property rights over their creation. From a legal perspective, basic principles of non-discrimination would contradict the representation of artists’ disability as an obstacle to authorship as granted by intellectual property laws. Yet empirical studies reveal that artists with intellectual disabilities are often denied the opportunity to exercise their intellectual property rights or any form of agency over their work. In practice, it appears that, unlike other non-disabled artists, the prospect for differently-abled creators to make use of their right is contingent to the context in which the creative process takes place. Often will the management of such rights rest with the institution, art therapist or mediator involved in the artists’ work as the latter will have necessitated greater support than their non-disabled peers for a variety of reasons, either medical or practical. Moreover, the financial setbacks suffered by medical institutions and private therapy practices have renewed administrators’ and physicians’ interest in monetising the artworks produced under their supervision. Adding to those economic incentives, the rise of criminal and civil litigation in psychiatric cases has also encouraged the retention of patients’ work by therapists who feel compelled to keep comprehensive medical records to shield themselves from liability in the event of a lawsuit. Unspoken transactions, contracts, implied agreements and consent forms have thus progressively made their way into the relationship between those artists and their therapists or assistants, disregarding any notions of copyright. The question of artists’ authorship finds itself caught in an unusually multi-faceted web of issues formed by tightening purse strings, ethical concerns and the fear of civil or criminal liability. Whilst those issues are playing out behind closed doors, the popularity of what was once called the ‘Art of the Insane’ continues to grow and open new commercial avenues. This socio-economic context exacerbates the need to devise a legal framework able to help practitioners, artists and their advocates navigate through those issues in such a way that neither this minority nor our cultural heritage suffers from the fragmentation of the legal protection available to them.

Keywords: authorship, copyright law, intellectual disabilities, art therapy and mediation

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250 Assessment of Antioxidant and Cholinergic Systems, and Liver Histopathologies in Lithobates catesbeianus Exposed to the Waters of an Urban Stream

Authors: Diego R. Boiarski, Camila M. Toigo, Thais M. Sobjak, Andrey F. P. Santos, Silvia Romao, Ana T. B. Guimaraes

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Anthropogenic activities promote changes in the community’s structures and decrease the species abundance of amphibians. Biological communities of fluvial systems are assemblies of organisms that have adapted to regional conditions, including the physical environment and food resources, and are further refined through interactions with other species. The aim of this study was to assess neurotoxic alterations and in the antioxidant system on tadpoles of Lithobates catesbeianus exposed to waters from Cascavel River, in the south of Brazil. A total of 420 L of water was collected from the Cascavel River, 140 L from each of the three different locations: Site 1 – headwater; Site 2 – stretch of the stream that runs through an urbanized area; Site 3 – a stretch from the rural area. Twelve tadpoles were acclimated in each aquarium (100 L of water) for seven days. The water from each aquarium was replaced with the ones sampled from the river, except the one from the control aquarium. After seven days, a portion of the liver was removed and conditioned for ChE, SOD, CAT and LPO analysis; other part of the tissue was conditioned for histological analysis. The statistical analysis performed was one-way ANOVA, followed by post-hoc Tukey-HSD test, and the multivariate principal components analysis. It was not observed any neurotoxic effect, but a slight increase in SOD activity and elevation of CAT activity in both urban and rural environment. A decrease in LPO reaction was detected, mainly among the tadpoles exposed to the waters from the rural area. The results of the present study demonstrate the alteration of the antioxidant system, as well as liver histopathologies in tadpoles exposed mainly to waters collected in urban and rural environments. These alterations may cause the reduction in the velocity of the metamorphosis process from the tadpoles. Further, were observed histological alterations, highlighting necrotic areas mainly among the animals exposed to urban waters. Those damages can lead to metabolic dysfunction, interfering with survival capacity, diminishing not only individual fitness but for the whole population. In the interpretation synthesis of all biomarkers, the cellular damage gradient is perceptible, characterized by the variables related to the antioxidant system, due to the flow direction of the stream. This result is indicative that along the course of the creek occurs dumping of organic material, which promoted an acute response upon tadpoles of L. catesbeianus. and it was also observed the difference in tissue damage between the experimental groups and the control group, the latter presenting histological alterations, but to a lesser degree than the animals exposed to the waters of the Cascavel river. These damages, caused by reactive oxygen species possibly resulting from the contamination by organic compounds, can lead the animals to a series of metabolic dysfunctions, interfering with its metamorphosis capacity. Interruption of metamorphosis may affect survival, which may impair its growth, development and reproduction, diminishing not only the fitness of each individual but in a long-term, to the entire population.

Keywords: American bullfrog, histopathology, oxidative stress, urban creeks pollution

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249 An Observation of Patient-Professional Communication in the Cambodian Dental Setting

Authors: Christina Tran, Lu Khoo, Andrea Waylen

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Introduction: The evolution of the dental consultation from paternalism to partnership has been well documented in developed Western countries. Great emphasis is now placed on the importance of empowering patients to make decisions regarding their care, obtaining informed consent, and maintaining patient privacy and confidentiality. With the majority of communication occurring non-verbally, clinicians often adopt behaviours which suggest an approachable and positive attitude. However, evidence indicates that in Asia, a paternalistic model may be favored in medicine. The power imbalance occurring in doctor-patient relationships worldwide may be exacerbated by various factors in Southeast Asia: the strong hierarchical culture, and the large education gap between doctor and patient. Further insight into this matter can be gained by observing patient-dentist communication in Cambodia. The dentist:population ratio in Cambodia is approximately 1:33,000, with rural areas remaining extremely underserviced. We have carried out an observational study of communication in a voluntary dental clinic in Cambodia with the aim of describing whether the patient-dentist relationship follows a paternalistic or patient-centred model. Method: Over a period of two weeks, two clinicians provided dental care as part of a voluntary program in two Cambodian settings: a temporary, rural clinic and a permanent clinic in Phnom Penh. The clinicians independently recorded their experiences in diaries, making observations on the verbal and non-verbal communication between patients and staff. General observations such as the clinic environment were also made. The diaries were then compared and analyzed using a thematic approach. Results: The overall themes that emerged were regarding the clinic environment, verbal communication, and non-verbal communication. Regarding the clinic environment, the rural clinic was arranged in order to easily direct patients from one dentist to another, with little emphasis on continuous patient care. There was also little consideration for patient privacy: patients were often treated in the presence of many observers, including other waiting patients. However, the permanent clinic was structured to allow greater patient privacy, with continuous patient care occurring throughout the appointment. Regarding verbal communication, there was a strongly paternalistic approach to gaining consent and giving instruction. Patients rarely asked questions regarding their treatment, with dentists doing little to encourage patient involvement. Non-verbal communication between patients and dentists was generally paternalistic, with the dentist often addressing the supine patient from above. Patients often avoided making eye-contact, which may have indicated discomfort or lack of engagement. Both adult and paediatric patients rarely raised verbal concerns regarding pain during treatment, despite displaying non-verbal signs of experiencing pain. Anxious paediatric patients were sometimes managed with physical restraint by their mothers to facilitate treatment. Conclusion: Patient-professional communication in the Cambodian dental setting was observed to be generally paternalistic in nature, although more patient-centred aspects were observed in the established, urban setting. However, it should be noted that these observations are subjective in nature, and that the patients’ actual perceptions of their communication experience were unexplored. Further observations in variety of dental settings in Cambodia are needed before any definitive conclusions can be made.

Keywords: patient-dentist communication, paternalism, patient-centered, non-verbal communication

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248 Usability Assessment of a Bluetooth-Enabled Resistance Exercise Band among Young Adults

Authors: Lillian M. Seo, Curtis L. Petersen, Ryan J. Halter, David Kotz, John A. Batsis

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Background: Resistance-based exercises effectively enhance muscle strength, which is especially important in older populations as it reduces the risk of disability. Our group developed a Bluetooth-enabled handle for resistance exercise bands that wirelessly transmits relative force data through low-energy Bluetooth to a local smartphone or similar device. The system has the potential to measure home-based exercise interventions, allowing health professionals to monitor compliance. Its feasibility has already been demonstrated in both clinical and field-based settings, but it remained unclear whether the system’s usability persisted upon repeated use. The current study sought to assess the usability of this system and its users’ satisfaction with repeated use by deploying the device among younger adults to gather formative information that can ultimately improve the device’s design for older adults. Methods: A usability study was conducted in which 32 participants used the above system. Participants executed 10 repetitions of four commonly performed exercises: bicep flexion, shoulder abduction, elbow extension, and triceps extension. Each completed three exercise sessions, separated by at least 24 hours to minimize muscle fatigue. At its conclusion, subjects completed an adapted version of the usefulness, satisfaction, and ease (USE) questionnaire – assessing the system across four domains: usability, satisfaction, ease of use, and ease of learning. The 20-item questionnaire examined how strongly a participant agrees with positive statements about the device on a seven-point Likert scale, with one representing ‘strongly disagree’ and seven representing ‘strongly agree.’ Participants’ data were aggregated to calculate mean response values for each question and domain, effectively assessing the device’s performance across different facets of the user experience. Summary force data were visualized using a custom web application. Finally, an optional prompt at the end of the questionnaire allowed for written comments and feedback from participants to elicit qualitative indicators of usability. Results: Of the n=32 participants, 13 (41%) were female; their mean age was 32.4 ± 11.8 years, and no participants had a physical impairment. No usability questions received a mean score < 5 of seven. The four domains’ mean scores were: usefulness 5.66 ± 0.35; satisfaction 6.23 ± 0.06; ease of use 6.25 ± 0.43; and ease of learning 6.50 ± 0.19. Representative quotes of the open-ended feedback include: ‘A non-rigid strap-style handle might be useful for some exercises,’ and, ‘Would need different bands for each exercise as they use different muscle groups with different strength levels.’ General impressions were favorable, supporting the expectation that the device would be a useful tool in exercise interventions. Conclusions: A simple usability assessment of a Bluetooth-enabled resistance exercise band supports a consistent and positive user experience among young adults. This study provides adequate formative data, assuring the next steps can be taken to continue testing and development for the target population of older adults.

Keywords: Bluetooth, exercise, mobile health, mHealth, usability

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247 Prospects of Low Immune Response Transplants Based on Acellular Organ Scaffolds

Authors: Inna Kornienko, Svetlana Guryeva, Anatoly Shekhter, Elena Petersen

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Transplantation is an effective treatment option for patients suffering from different end-stage diseases. However, it is plagued by a constant shortage of donor organs and the subsequent need of a lifelong immunosuppressive therapy for the patient. Currently some researchers look towards using of pig organs to replace human organs for transplantation since the matrix derived from porcine organs is a convenient substitute for the human matrix. As an initial step to create a new ex vivo tissue engineered model, optimized protocols have been created to obtain organ-specific acellular matrices and evaluated their potential as tissue engineered scaffolds for culture of normal cells and tumor cell lines. These protocols include decellularization by perfusion in a bioreactor system and immersion-agitation on an orbital shaker with use of various detergents (SDS, Triton X-100) and freezing. Complete decellularization – in terms of residual DNA amount – is an important predictor of probability of immune rejection of materials of natural origin. However, the signs of cellular material may still remain within the matrix even after harsh decellularization protocols. In this regard, the matrices obtained from tissues of low-immunogenic pigs with α3Galactosyl-tranferase gene knock out (GalT-KO) may be a promising alternative to native animal sources. The research included a study of induced effect of frozen and fresh fragments of GalT-KO skin on healing of full-thickness plane wounds in 80 rats. Commercially available wound dressings (Ksenoderm, Hyamatrix and Alloderm) as well as allogenic skin were used as a positive control and untreated wounds were analyzed as a negative control. The results were evaluated on the 4th day after grafting, which corresponds to the time of start of normal wound epithelization. It has been shown that a non-specific immune response in models treated with GalT-Ko pig skin was milder than in all the control groups. Research has been performed to measure technical skin characteristics: stiffness and elasticity properties, corneometry, tevametry, and cutometry. These metrics enabled the evaluation of hydratation level, corneous layer husking level, as well as skin elasticity and micro- and macro-landscape. These preliminary data may contribute to development of personalized transplantable organs from GalT-Ko pigs with significantly limited potential of immune rejection. By applying growth factors to a decellularized skin sample it is possible to achieve various regenerative effects based on the particular situation. In this particular research BMP2 and Heparin-binding EGF-like growth factor have been used. Ideally, a bioengineered organ must be biocompatible, non-immunogenic and support cell growth. Porcine organs are attractive for xenotransplantation if severe immunologic concerns can be bypassed. The results indicate that genetically modified pig tissues with knock-outed α3Galactosyl-tranferase gene may be used for production of low-immunogenic matrix suitable for transplantation.

Keywords: decellularization, low-immunogenic, matrix, scaffolds, transplants

Procedia PDF Downloads 264
246 Red Dawn in the Desert: A World-Systems Analysis of the Maritime Silk Road Initiative

Authors: Toufic Sarieddine

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The current debate on the hegemonic impact of China’s Belt and Road Initiative (BRI) is of two opposing strands: Resilient and absolute US hegemony on the one hand and various models of multipolar hegemony such as bifurcation on the other. Bifurcation theories illustrate an unprecedented division of hegemonic functions between China and the US, whereby Beijing becomes the world’s economic hegemon, leaving Washington the world’s military hegemon and security guarantor. While consensus points to China being the main driver of unipolarity’s rupturing, the debate among bifurcationists is on the location of the first rupture. In this regard, the Middle East and North Africa (MENA) region has seen increasing Chinese foreign direct investment in recent years while that to other regions has declined, ranking it second in 2018 as part of the financing for the Maritime Silk Road Initiative (MSRI). China has also become the top trade partner of 11 states in the MENA region, as well as its top source of machine imports, surpassing the US and achieving an overall trade surplus almost double that of Washington’s. These are among other features outlined in world-systems analysis (WSA) literature which correspond with the emergence of a new hegemon. WSA is further utilized to gauge other facets of China’s increasing involvement in MENA and assess whether bifurcation is unfolding therein. These features of hegemony include the adoption of China’s modi operandi, economic dominance in production, trade, and finance, military capacity, cultural hegemony in ideology, education, and language, and the promotion of a general interest around which to rally potential peripheries (MENA states in this case). China’s modi operandi has seen some adoption with regards to support against the United Nations Convention on the Law of the Sea, oil bonds denominated in the yuan, and financial institutions such as the Shanghai Gold Exchange enjoying increasing Arab patronage. However, recent elections in Qatar, as well as liberal reforms in Saudi Arabia, demonstrate Washington’s stronger normative influence. Meanwhile, Washington’s economic dominance is challenged by China’s sizable machine exports, increasing overall imports, and widening trade surplus, but retains some clout via dominant arms and transport exports, as well as free-trade deals across the region. Militarily, Washington bests Beijing’s arms exports, has a dominant and well-established presence in the region, and successfully blocked Beijing’s attempt to penetrate through the UAE. Culturally, Beijing enjoys higher favorability in Arab public opinion, and its broadcast networks have found some resonance with Arab audiences. In education, the West remains MENA students’ preferred destination. Further, while Mandarin has become increasingly available in schools across MENA, its usage and availability still lag far behind English. Finally, Beijing’s general interest in infrastructure provision and prioritizing economic development over social justice and democracy provides an avenue for increased incorporation between Beijing and the MENA region. The overall analysis shows solid progress towards bifurcation in MENA.

Keywords: belt and road initiative, hegemony, Middle East and North Africa, world-systems analysis

Procedia PDF Downloads 86
245 Investigation of Attitude of Production Workers towards Job Rotation in Automotive Industry against the Background of Demographic Change

Authors: Franciska Weise, Ralph Bruder

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Due to the demographic change in Germany along with the declining birth rate and the increasing age of population, the share of older people in society is rising. This development is also reflected in the work force of German companies. Therefore companies should focus on improving ergonomics, especially in the area of age-related work design. Literature shows that studies on age-related work design have been carried out in the past, some of whose results have been put into practice. However, there is still a need for further research. One of the most important methods for taking into account the needs of an aging population is job rotation. This method aims at preventing or reducing health risks and inappropriate physical strain. It is conceived as a systematic change of workplaces within a group. Existing literature does not cover any methods for the investigation of the attitudes of employees towards job rotation. However, in order to evaluate job rotation, it is essential to have knowledge of the views of people towards rotation. In addition to an investigation of attitudes, the design of rotation plays a crucial role. The sequence of activities and the rotation frequency influence the worker and as well the work result. The evaluation of preliminary talks on the shop floor showed that team speakers and foremen share a common understanding of job rotation. In practice, different varieties of job rotation exist. One important aspect is the frequency of rotation. It is possible to rotate never, more than one time or even during every break, or more often than every break. It depends on the opportunity or possibility to rotate whenever workers want to rotate. From the preliminary talks some challenges can be derived. For example a rotation in the whole team is not possible, if a team member requires to be trained for a new task. In order to be able to determine the relation of the design and the attitude towards job rotation, a questionnaire is carried out in the vehicle manufacturing. The questionnaire will be employed to determine the different varieties of job rotation that exist in production, as well as the attitudes of workers towards those different frequencies of job rotation. In addition, younger and older employees will be compared with regard to their rotation frequency and their attitudes towards rotation. There are three kinds of age groups. Three questions are under examination. The first question is whether older employees rotate less frequently than younger employees. Also it is investigated to know whether the frequency of job rotation and the attitude towards the frequency of job rotation are interconnected. Moreover, the attitudes of the different age groups towards the frequency of rotation will be examined. Up to now 144 employees, all working in production, took part in the survey. 36.8 % were younger than thirty, 37.5 % were between thirty und forty-four and 25.7 % were above forty-five years old. The data shows no difference between the three age groups in relation to the frequency of job rotation (N=139, median=4, Chi²=.859, df=2, p=.651). Most employees rotate between six and seven workplaces per day. In addition there is a statistically significant correlation between the frequency of job rotation and the attitude towards the frequency (Spearman-Rho: 2-sided=.008, correlation coefficient=.223). Less than four workplaces per day are not enough for the employees. The third question, which differences can be found between older and younger people who rotate in a different way and with different attitudes towards job rotation, cannot be possible answered. Till now the data shows that younger people would like to rotate very often. Regarding to older people no correlation can be found with acceptable significance. The results of the survey will be used to improve the current practice of job rotation. In addition, the discussions during the survey are expected to help sensitize the employees with respect to rotation issues, and to contribute to optimizing rotation by means of qualification and an improved design of job rotation. Together with the employees and the results of the survey there must be found standards which show how to rotate in an ergonomic way while consider the attitude towards job rotation.

Keywords: job rotation, age-related work design, questionnaire, automotive industry

Procedia PDF Downloads 288
244 Development of a Context Specific Planning Model for Achieving a Sustainable Urban City

Authors: Jothilakshmy Nagammal

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This research paper deals with the different case studies, where the Form-Based Codes are adopted in general and the different implementation methods in particular are discussed to develop a method for formulating a new planning model. The organizing principle of the Form-Based Codes, the transect is used to zone the city into various context specific transects. An approach is adopted to develop the new planning model, city Specific Planning Model (CSPM), as a tool to achieve sustainability for any city in general. A case study comparison method in terms of the planning tools used, the code process adopted and the various control regulations implemented in thirty two different cities are done. The analysis shows that there are a variety of ways to implement form-based zoning concepts: Specific plans, a parallel or optional form-based code, transect-based code /smart code, required form-based standards or design guidelines. The case studies describe the positive and negative results from based zoning, Where it is implemented. From the different case studies on the method of the FBC, it is understood that the scale for formulating the Form-Based Code varies from parts of the city to the whole city. The regulating plan is prepared with the organizing principle as the transect in most of the cases. The various implementation methods adopted in these case studies for the formulation of Form-Based Codes are special districts like the Transit Oriented Development (TOD), traditional Neighbourhood Development (TND), specific plan and Street based. The implementation methods vary from mandatory, integrated and floating. To attain sustainability the research takes the approach of developing a regulating plan, using the transect as the organizing principle for the entire area of the city in general in formulating the Form-Based Codes for the selected Special Districts in the study area in specific, street based. Planning is most powerful when it is embedded in the broader context of systemic change and improvement. Systemic is best thought of as holistic, contextualized and stake holder-owned, While systematic can be thought of more as linear, generalisable, and typically top-down or expert driven. The systemic approach is a process that is based on the system theory and system design principles, which are too often ill understood by the general population and policy makers. The system theory embraces the importance of a global perspective, multiple components, interdependencies and interconnections in any system. In addition, the recognition that a change in one part of a system necessarily alters the rest of the system is a cornerstone of the system theory. The proposed regulating plan taking the transect as an organizing principle and Form-Based Codes to achieve sustainability of the city has to be a hybrid code, which is to be integrated within the existing system - A Systemic Approach with a Systematic Process. This approach of introducing a few form based zones into a conventional code could be effective in the phased replacement of an existing code. It could also be an effective way of responding to the near-term pressure of physical change in “sensitive” areas of the community. With this approach and method the new Context Specific Planning Model is created towards achieving sustainability is explained in detail this research paper.

Keywords: context based planning model, form based code, transect, systemic approach

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243 Low- and High-Temperature Methods of CNTs Synthesis for Medicine

Authors: Grzegorz Raniszewski, Zbigniew Kolacinski, Lukasz Szymanski, Slawomir Wiak, Lukasz Pietrzak, Dariusz Koza

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One of the most promising area for carbon nanotubes (CNTs) application is medicine. One of the most devastating diseases is cancer. Carbon nanotubes may be used as carriers of a slowly released drug. It is possible to use of electromagnetic waves to destroy cancer cells by the carbon nanotubes (CNTs). In our research we focused on thermal ablation by ferromagnetic carbon nanotubes (Fe-CNTs). In the cancer cell hyperthermia functionalized carbon nanotubes are exposed to radio frequency electromagnetic field. Properly functionalized Fe-CNTs join the cancer cells. Heat generated in nanoparticles connected to nanotubes warm up nanotubes and then the target tissue. When the temperature in tumor tissue exceeds 316 K the necrosis of cancer cells may be observed. Several techniques can be used for Fe-CNTs synthesis. In our work, we use high-temperature methods where arc-discharge is applied. Low-temperature systems are microwave plasma with assisted chemical vapor deposition (MPCVD) and hybrid physical-chemical vapor deposition (HPCVD). In the arc discharge system, the plasma reactor works with a pressure of He up to 0,5 atm. The electric arc burns between two graphite rods. Vapors of carbon move from the anode, through a short arc column and forms CNTs which can be collected either from the reactor walls or cathode deposit. This method is suitable for the production of multi-wall and single-wall CNTs. A disadvantage of high-temperature methods is a low purification, short length, random size and multi-directional distribution. In MPCVD system plasma is generated in waveguide connected to the microwave generator. Then containing carbon and ferromagnetic elements plasma flux go to the quartz tube. The additional resistance heating can be applied to increase the reaction effectiveness and efficiency. CNTs nucleation occurs on the quartz tube walls. It is also possible to use substrates to improve carbon nanotubes growth. HPCVD system involves both chemical decomposition of carbon containing gases and vaporization of a solid or liquid source of catalyst. In this system, a tube furnace is applied. A mixture of working and carbon-containing gases go through the quartz tube placed inside the furnace. As a catalyst ferrocene vapors can be used. Fe-CNTs may be collected then either from the quartz tube walls or on the substrates. Low-temperature methods are characterized by higher purity product. Moreover, carbon nanotubes from tested CVD systems were partially filled with the iron. Regardless of the method of Fe-CNTs synthesis the final product always needs to be purified for applications in medicine. The simplest method of purification is an oxidation of the amorphous carbon. Carbon nanotubes dedicated for cancer cell thermal ablation need to be additionally treated by acids for defects amplification on the CNTs surface what facilitates biofunctionalization. Application of ferromagnetic nanotubes for cancer treatment is a promising method of fighting with cancer for the next decade. Acknowledgment: The research work has been financed from the budget of science as a research project No. PBS2/A5/31/2013

Keywords: arc discharge, cancer, carbon nanotubes, CVD, thermal ablation

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242 The Achievements and Challenges of Physics Teachers When Implementing Problem-Based Learning: An Exploratory Study Applied to Rural High Schools

Authors: Osman Ali, Jeanne Kriek

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Introduction: The current instructional approach entrenched in memorizing does not assist conceptual understanding in science. Instructional approaches that encourage research, investigation, and experimentation, which depict how scientists work, should be encouraged. One such teaching strategy is problem-based learning (PBL). PBL has many advantages; enhanced self-directed learning and improved problem-solving and critical thinking skills. However, despite many advantages, PBL has challenges. Research confirmed is time-consuming and difficult to formulate ill-structured questions. Professional development interventions are needed for in-service educators to adopt the PBL strategy. The purposively selected educators had to implement PBL in their classrooms after the intervention to develop their practice and then reflect on the implementation. They had to indicate their achievements and challenges. This study differs from previous studies as the rural educators were subjected to implementing PBL in their classrooms and reflected on their experiences, beliefs, and attitudes regarding PBL. Theoretical Framework: The study reinforced Vygotskian sociocultural theory. According to Vygotsky, the development of a child's cognitive is sustained by the interaction between the child and more able peers in his immediate environment. The theory suggests that social interactions in small groups create an opportunity for learners to form concepts and skills on their own better than working individually. PBL emphasized learning in small groups. Research Methodology: An exploratory case study was employed. The reason is that the study was not necessarily for specific conclusive evidence. Non-probability purposive sampling was adopted to choose eight schools from 89 rural public schools. In each school, two educators were approached, teaching physical sciences in grades 10 and 11 (N = 16). The research instruments were questionnaires, interviews, and lesson observation protocol. Two open-ended questionnaires were developed before and after intervention and analyzed thematically. Three themes were identified. The semi-structured interviews and responses were coded and transcribed into three themes. Subsequently, the Reform Teaching Observation Protocol (RTOP) was adopted for lesson observation and was analyzed using five constructs. Results: Evidence from analyzing the questionnaires before and after the intervention shows that participants knew better what was required to develop an ill-structured problem during the implementation. Furthermore, indications from the interviews are that participants had positive views about the PBL strategy. They stated that they only act as facilitators, and learners’ problem-solving and critical thinking skills are enhanced. They suggested a change in curriculum to adopt the PBL strategy. However, most participants may not continue to apply the PBL strategy stating that it is time-consuming and difficult to complete the Annual Teaching Plan (ATP). They complained about materials and equipment and learners' readiness to work. Evidence from RTOP shows that after the intervention, participants learn to encourage exploration and use learners' questions and comments to determine the direction and focus of classroom discussions.

Keywords: problem-solving, self-directed, critical thinking, intervention

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241 Method of Nursing Education: History Review

Authors: Cristina Maria Mendoza Sanchez, Maria Angeles Navarro Perán

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Introduction: Nursing as a profession, from its initial formation and after its development in practice, has been built and identified mainly from its technical competence and professionalization within the positivist approach of the XIX century that provides a conception of the disease built on the basis of to the biomedical paradigm, where the care provided is more focused on the physiological processes and the disease than on the suffering person understood as a whole. The main issue that is in need of study here is a review of the nursing profession's history to get to know how the nursing profession was before the XIX century. It is unclear if there were organizations or people with knowledge about looking after others or if many people survived by chance. The holistic care, in which the appearance of the disease directly affects all its dimensions: physical, emotional, cognitive, social and spiritual. It is not a concept from the 21st century. It is common practice, most probably since established life in this world, with the final purpose of covering all these perspectives through quality care. Objective: In this paper, we describe and analyze the history of education in nursing learning in terms of reviewing and analysing theoretical foundations of clinical teaching and learning in nursing, with the final purpose of determining and describing the development of the nursing profession along the history. Method: We have done a descriptive systematic review study, doing a systematically searched of manuscripts and articles in the following health science databases: Pubmed, Scopus, Web of Science, Temperamentvm and CINAHL. The selection of articles has been made according to PRISMA criteria, doing a critical reading of the full text using the CASPe method. A compliment to this, we have read a range of historical and contemporary sources to support the review, such as manuals of Florence Nightingale and John of God as primary manuscripts to establish the origin of modern nursing and her professionalization. We have considered and applied ethical considerations of data processing. Results: After applying inclusion and exclusion criteria in our search, in Pubmed, Scopus, Web of Science, Temperamentvm and CINAHL, we have obtained 51 research articles. We have analyzed them in such a way that we have distinguished them by year of publication and the type of study. With the articles obtained, we can see the importance of our background as a profession before modern times in public health and as a review of our past to face challenges in the near future. Discussion: The important influence of key figures other than Nightingale has been overlooked and it emerges that nursing management and development of the professional body has a longer and more complex history than is generally accepted. Conclusions: There is a paucity of studies on the subject of the review to be able to extract very precise evidence and recommendations about nursing before modern times. But even so, as more representative data, an increase in research about nursing history has been observed. In light of the aspects analyzed, the need for new research in the history of nursing emerges from this perspective; in order to germinate studies of the historical construction of care before the XIX century and theories created then. We can assure that pieces of knowledge and ways of care were taught before the XIX century, but they were not called theories, as these concepts were created in modern times.

Keywords: nursing history, nursing theory, Saint John of God, Florence Nightingale, learning, nursing education

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240 Bio-Hub Ecosystems: Profitability through Circularity for Sustainable Forestry, Energy, Agriculture and Aquaculture

Authors: Kimberly Samaha

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The Bio-Hub Ecosystem model was developed to address a critical area of concern within the global energy market regarding biomass as a feedstock for power plants. Yet the lack of an economically-viable business model for bioenergy facilities has resulted in the continuation of idled and decommissioned plants. This study analyzed data and submittals to the Born Global Maine Innovation Challenge. The Innovation Challenge was a global innovation challenge to identify process innovations that could address a ‘whole-tree’ approach of maximizing the products, byproducts, energy value and process slip-streams into a circular zero-waste design. Participating companies were at various stages of developing bioproducts and included biofuels, lignin-based products, carbon capture platforms and biochar used as both a filtration medium and as a soil amendment product. This case study shows the QCA (Qualitative Comparative Analysis) methodology of the prequalification process and the resulting techno-economic model that was developed for the maximizing profitability of the Bio-Hub Ecosystem through continuous expansion of system waste streams into valuable process inputs for co-hosts. A full site plan for the integration of co-hosts (biorefinery, land-based shrimp and salmon aquaculture farms, a tomato green-house and a hops farm) at an operating forestry-based biomass to energy plant in West Enfield, Maine USA. This model and process for evaluating the profitability not only proposes models for integration of forestry, aquaculture and agriculture in cradle-to-cradle linkages of what have typically been linear systems, but the proposal also allows for the early measurement of the circularity and impact of resource use and investment risk mitigation, for these systems. In this particular study, profitability is assessed at two levels CAPEX (Capital Expenditures) and in OPEX (Operating Expenditures). Given that these projects start with repurposing facilities where the industrial level infrastructure is already built, permitted and interconnected to the grid, the addition of co-hosts first realizes a dramatic reduction in permitting, development times and costs. In addition, using the biomass energy plant’s waste streams such as heat, hot water, CO₂ and fly ash as valuable inputs to their operations and a significant decrease in the OPEX costs, increasing overall profitability to each of the co-hosts bottom line. This case study utilizes a proprietary techno-economic model to demonstrate how utilizing waste streams of a biomass energy plant and/or biorefinery, results in significant reduction in OPEX for both the biomass plants and the agriculture and aquaculture co-hosts. Economically viable Bio-Hubs with favorable environmental and community impacts may prove critical in garnering local and federal government support for pilot programs and more wide-scale adoption, especially for those living in severely economically depressed rural areas where aging industrial sites have been shuttered and local economies devastated.

Keywords: bio-economy, biomass energy, financing, zero-waste

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239 A Critical Analysis of How the Role of the Imam Can Best Meet the Changing Social, Cultural, and Faith-Based Needs of Muslim Families in 21st Century Britain

Authors: Christine Hough, Eddie Abbott-Halpin, Tariq Mahmood, Jessica Giles

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This paper draws together the findings from two research studies, each undertaken with cohorts of South Asian Muslim respondents located in the North of England between 2017 and 2019. The first study, entitled Faith Family and Crime (FFC), investigated the extent to which a Muslim family’s social and health well-being is affected by a family member’s involvement in the Criminal Justice System (CJS). This study captured a range of data through a detailed questionnaire and structured interviews. The data from the interview transcripts were analysed using open coding and an application of aspects of the grounded theory approach. The findings provide clear evidence that the respondents were neither well-informed nor supported throughout the processes of the CJS, from arrest to post-sentencing. These experiences gave rise to mental and physical stress, potentially unfair sentencing, and a significant breakdown in communication within the respondents’ families. They serve to highlight a particular aspect of complexity in the current needs of those South Asian Muslim families who find themselves involved in the CJS and is closely connected to family structure, culture, and faith. The second study, referred to throughout this paper as #ImamsBritain (that provides the majority of content for this paper), explores how Imams, in their role as community faith leaders, can best address the complex – and changing - needs of South Asian Muslims families, such as those that emerged in the findings from FFC. The changing socio-economic and political climates of the last thirty or so years have brought about significant changes to the lives of Muslim families, and these have created more complex levels of social, cultural, and faith-based needs for families and individuals. As a consequence, Imams now have much greater demands made of them, and so their role has undergone far-reaching changes in response to this. The #ImamsBritain respondents identified a pressing need to develop a wider range of pastoral and counseling skills, which they saw as extending far beyond the traditional role of the Imam as a religious teacher and spiritual guide. The #ImamsBritain project was conducted with a cohort of British Imams in the North of England. Data was collected firstly through a questionnaire that related to the respondents’ training and development needs and then analysed in depth using the Delphi approach. Through Delphi, the data were scrutinized in depth using interpretative content analysis. The findings from this project reflect the respondents’ individual perceptions of the kind of training and development they need to fulfill their role in 21st Century Britain. They also provide a unique framework for constructing a professional guide for Imams in Great Britain. The discussions and critical analyses in this paper draw on the discourses of professionalization and pastoral care and relevant reports and reviews on Imam training in Europe and Canada.

Keywords: criminal justice system, faith and culture, Imams, Muslim community leadership, professionalization, South Asian family structure

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238 Opportunities in Self-care Abortion and Telemedicine: Findings from a Study in Colombia

Authors: Paola Montenegro, Maria de los Angeles Balaguera Villa

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In February 2022 Colombia achieved a historic milestone in ensuring universal access to abortion rights with ruling C-055 of 2022 decriminalising abortion up to 24 weeks of gestation. In the context of this triumph and the expansion of telemedicine services in the wake of the COVID-19 pandemic, this research studied the acceptability of self-care abortion in young people (13 - 28 years) through a telemedicine service and also explored the primary needs that should be the focus of such care. The results shine light on a more comprehensive understanding of opportunities and challenges of teleabortion practices in a context that combines overall higher access to technology and low access to reliable information of safe abortion, stigma, and scarcity especially felt by transnational migrants, racialised people, trans men and non-binary people. Through a mixed methods approach, this study collected 5.736 responses to a virtual survey disseminated nationwide in Colombia and 47 in-person interviews (24 of them with people who were assigned female at birth and 21 with local key stakeholders in the abortion ecosystem). Quantitative data was analyzed using Stata SE Version 16.0 and qualitative analysis was completed through NVivo using thematic analysis. Key findings of the research suggest that self-care abortion is practice with growing acceptability among young people, but important adjustments must be made to meet quality of care expectations of users. Elements like quick responses from providers, lower costs, and accessible information were defined by users as decisive factors to choose over the abortion service provider. In general, the narratives in participants about quality care were centred on the promotion of autonomy and the provision of accompaniment and care practices, also perceived as transformative and currently absent of most health care services. The most staggering findings from the investigation are related to current barriers faced by young people in abortion contexts even when the legal barriers have: high rates of scepticism and distrust associated with pitfalls of telehealth and structural challenges associated with lacking communications infrastructure, among a few of them. Other important barriers to safe self-care abortion identified by participants surfaced like lack of privacy and confidentiality (especially in rural areas of the country), difficulties accessing reliable information, high costs of procedures and expenses related to travel costs or having to cease economic activities, waiting times, and stigma are among the primary barriers to abortion identified by participants. Especially in a scenario marked by unprecedented social, political and economic disruptions due to the COVID-19 pandemic, the commitment to design better care services that can be adapted to the identities, experiences, social contexts and possibilities of the user population is more necessary than ever. In this sense, the possibility of expanding access to services through telemedicine brings us closer to the opportunity to rethink the role of health care models in transforming the role of individuals and communities to make autonomous, safe and informed decisions about their own health and well-being.

Keywords: contraception, family planning, premarital fertility, unplanned pregnancy

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237 Drones, Rebels and Bombs: Explaining the Role of Private Security and Expertise in a Post-piratical Indian Ocean

Authors: Jessica Kate Simonds

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The last successful hijacking perpetrated by Somali pirates in 2012 represented a critical turning point for the identity and brand of Indian Ocean (IO) insecurity, coined in this paper as the era of the post-piratical. This paper explores the broadening of the PMSC business model to account and contribute to the design of a new IO security environment that prioritises foreign and insurgency drone activity and Houthi rebel operations as the main threat to merchant shipping in the post-2012 era. This study is situated within a longer history of analysing maritime insecurity and also contributes a bespoke conceptual framework that understands the sea as a space that is produced and reproduced relative to existing and emerging threats to merchant shipping based on bespoke models of information sharing and intelligence acquisition. This paper also makes a prominent empirical contribution by drawing on a post-positivist methodology, data drawn from original semi-structured interviews with senior maritime insurers and active merchant seafarers that is triangulated with industry-produced guidance such as the BMP series as primary data sources. Each set is analysed through qualitative discourse and content analysis and supported by the quantitative data sets provided by the IMB Piracy Reporting center and intelligence networks. This analysis reveals that mechanisms such as the IGP&I Maritime Security Committee and intelligence divisions of PMSC’s have driven the exchanges of knowledge between land and sea and thus the reproduction of the maritime security environment through new regulations and guidance to account dones, rebels and bombs as the key challenges in the IO, beyond piracy. A contribution of this paper is the argument that experts who may not be in the highest-profile jobs are the architects of maritime insecurity based on their detailed knowledge and connections to vessels in transit. This paper shares the original insights of those who have served in critical decision making spaces to demonstrate that the development and refinement of industry produced deterrence guidance that has been accredited to the mitigation of piracy, have shaped new editions such as BMP 5 that now serve to frame a new security environment that prioritises the mitigation of risks from drones and WBEID’s from both state and insurgency risk groups. By highlighting the experiences and perspectives of key players on both land and at sea, the key finding of this paper is outlining that as pirates experienced a financial boom by profiteering from their bespoke business model during the peak of successful hijackings, the private security market encountered a similar level of financial success and guaranteed risk environment in which to prospect business. Thus, the reproduction of the Indian Ocean as a maritime security environment reflects a new found purpose for PMSC’s as part of the broader conglomerate of maritime insurers, regulators, shipowners and managers who continue to redirect the security consciousness and IO brand of insecurity.

Keywords: maritime security, private security, risk intelligence, political geography, international relations, political economy, maritime law, security studies

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236 Quality Assessment of Pedestrian Streets in Iran: Case Study of Saf, Tehran

Authors: Fstemeh Rais Esmaili, Ehsan Ranjbar

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Pedestrian streets as one type of urban public spaces have an important role in improving the quality of urban life. In Iran, planning and designing of pedestrian streets is in its primary steps. In spite of starting this approach in Iran, and designing several pedestrian streets, there are still not organized studies about quality assessment of pedestrian streets. As a result, the strength and weakness points of the initial experiences have not been utilized. This inattention to quality assessment have caused designing pedestrian streets to be limited to just vehicles traffic control and preliminary actions like paving; so that, special potentials of pedestrian streets for creating social, livable and dynamic public spaces have not been used. This article, as an organized study about quality assessment of pedestrian streets in Iran, tries to reach two main goals: first, introducing a framework for quality assessment of pedestrian streets in Iran, and second, creating a context for improving the quality of pedestrian streets especially for further experiences. The main research methods are description and context analyzing. With respect to comparative analysis of ideas about quality, considering international and local case studies and analyzing existing condition of Saf Pedestrian Street, a particular model for quality assessment has been introduced. In this model, main components and assessment criteria have been presented. On the basis of this model, questionnaire and checklist for assessment have been prepared. The questionnaire and interview have been used to assess qualities which are in direct contact with people and the checklist has been used for analyzing visual qualities by authors through observation. Some results of questionnaire and checklist show that 7 of 11 primary components, diversity, flexibility, cleanness, legibility and imaginably, identity, livability, form and physical setting are rated low and very low in quality degree. Three components, efficiency, comfort and distinctiveness, have medium and low quality degree and one component, access, linkage and permeability has high quality degree. Therefore, based on implemented analyzing process, Saf Pedestrian Street needs to be improved and these quality improvement priorities are determined based on presented criteria. Adaption of final results with existing condition illustrates the shortage of services for satisfying user’s needs, inflexibility and impossibility of using spaces in various times, lack of facilities for different climatic conditions, lack of facilities such as drinking fountain, inappropriate designing of existing urban furniture like garbage cans, and creating pollution and unsuitable view, lack of visual attractions, neglecting disabled persons in designing entrances, shortage of benches and their undesirable designing, lack of vegetation, absence of special characters making it different from other streets, preventing people taking part in the space causing lack of affiliation, lack of appropriate elements for leisure time and lack of exhilaration in the space. On the other hand, these results present high access and permeability, high safety, less sound pollution and more relief, comfortable movement along the way due to suitable pavement and economic efficiency, as the strength points of Saf pedestrian street.

Keywords: pedestrian streets, quality assessment, quality criteria, Saf Pedestrian Street

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235 Epidemiological Patterns of Pediatric Fever of Unknown Origin

Authors: Arup Dutta, Badrul Alam, Sayed M. Wazed, Taslima Newaz, Srobonti Dutta

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Background: In today's world, with modern science and contemporary technology, a lot of diseases may be quickly identified and ruled out, but children's fever of unknown origin (FUO) still presents diagnostic difficulties in clinical settings. Any fever that reaches 38 °C and lasts for more than seven days without a known cause is now classified as a fever of unknown origin (FUO). Despite tremendous progress in the medical sector, fever of unknown origin, or FOU, persists as a major health issue and a major contributor to morbidity and mortality, particularly in children, and its spectrum is sometimes unpredictable. The etiology is influenced by geographic location, age, socioeconomic level, frequency of antibiotic resistance, and genetic vulnerability. Since there are currently no known diagnostic algorithms, doctors are forced to evaluate each patient one at a time with extreme caution. A persistent fever poses difficulties for both the patient and the doctor. This prospective, observational study was carried out in a Bangladeshi tertiary care hospital from June 2018 to May 2019 with the goal of identifying the epidemiological patterns of fever of unknown origin in pediatric patients. Methods: It was a hospital-based prospective observational study carried out on 106 children (between 2 months and 12 years) with prolonged fever of >38.0 °C lasting for more than 7 days without a clear source. Children with additional chronic diseases or known immunodeficiency problems were not allowed. Clinical practices that helped determine the definitive etiology were assessed. Initial testing included a complete blood count, a routine urine examination, PBF, a chest X-ray, CRP measurement, blood cultures, serology and additional pertinent investigations. The analysis focused mostly on the etiological results. The standard program SPSS 21 was used to analyze all of the study data. Findings: A total of 106 patients identified as having FUO were assessed, with over half (57.5%) being female and the majority (40.6%) falling within the 1 to 3-year age range. The study categorized the etiological outcomes into five groups: infections, malignancies, connective tissue conditions, miscellaneous, and undiagnosed. In the group that was being studied, infections were found to be the main cause in 44.3% of cases. Undiagnosed cases came in at 31.1%, cancers at 10.4%, other causes at 8.5%, and connective tissue disorders at 4.7%. Hepato-splenomegaly was seen in people with enteric fever, malaria, acute lymphoid leukemia, lymphoma, and hepatic abscesses, either by itself or in combination with other conditions. About 53% of people who were not diagnosed also had hepato-splenomegaly at the same time. Conclusion: Infections are the primary cause of PUO (pyrexia of unknown origin) in children, with undiagnosed cases being the second most common cause. An incremental approach is beneficial in the process of diagnosing a condition. Non-invasive examinations are used to diagnose infections and connective tissue disorders, while invasive investigations are used to diagnose cancer and other ailments. According to this study, the prevalence of undiagnosed diseases is still remarkable, so extensive historical analysis and physical examinations are necessary in order to provide a precise diagnosis.

Keywords: children, diagnostic challenges, fever of unknown origin, pediatric fever, undiagnosed diseases

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