Search results for: challenges in higher institutions
Commenced in January 2007
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Edition: International
Paper Count: 17004

Search results for: challenges in higher institutions

1554 Tuberculosis and Associated Transient Hyperglycaemia in Peri-Urban South Africa: Implications for Diabetes Screening in High Tuberculosis/HIV Burden Settings

Authors: Mmamapudi Kubjane, Natacha Berkowitz, Rene Goliath, Naomi S. Levitt, Robert J. Wilkinson, Tolu Oni

Abstract:

Background: South Africa remains a high tuberculosis (TB) burden country globally and the burden of diabetes – a TB risk factor is growing rapidly. As an infectious disease, TB also induces transient hyperglycaemia. Therefore, screening for diabetes in newly diagnosed tuberculosis patients may result in misclassification of transient hyperglycaemia as diabetes. Objective: The objective of this study was to determine and compare the prevalence of hyperglycaemia (diabetes and impaired glucose regulation (IGR)) in TB patients and to assess the cross-sectional association between TB and hyperglycaemia at enrolment and after three months of follow-up. Methods: Consecutive adult TB and non-TB participants presenting at a TB clinic in Cape Town were enrolled in this cross-sectional study and follow-up between July 2013 and August 2015. Diabetes was defined as self-reported diabetes, fasting plasma glucose (FPG) ≥ 7.0 mmol·L⁻¹ or glycated haemoglobin (HbA1c) ≥ 6.5%. IGR was defined as FPG 5.5– < 7.0 mmol·L⁻¹ or HbA1c 5.7– < 6.5%. TB patients initiated treatment. After three months, all participants were followed up and screened for diabetes again. The association between TB and hyperglycaemia was assessed using logistic regression adjusting for potential confounders including sex, age, income, hypertension, waist circumference, previous prisoner, marital status, work status, HIV status. Results: Diabetes screening was performed in 852 participants (414 TB and 438 non-TB) at enrolment and in 639 (304 TB and 335 non-TB) at three-month follow-up. The prevalence of HIV-1 infection was 69.6% (95% confidence interval (CI), 64.9–73.8 %) among TB patients, and 58.2% (95% CI, 53.5–62.8 %) among the non-TB participants. Glycaemic levels were much higher in TB patients than in the non-TB participants but decreased over time. Among TB patients, the prevalence of IGR was 65.2% (95% CI 60.1 - 69.9) at enrollment and 21.5% (95% CI 17.2-26.5) at follow-up; and was 50% (45.1 - 54.94) and 32% (95% CI 27.9 - 38.0) respectively, among non-TB participants. The prevalence of diabetes in TB patients was 12.5% (95% CI 9.69 – 16.12%) at enrolment and 9.2% (95% CI, 6.43–13.03%) at follow-up; and was 10.04% (95% CI, 7.55–13.24%) and 8.06% (95% CI, 5.58–11.51) respectively, among non-TB participants. The association between TB and IGT was significant at enrolment (adjusted odds ratio (OR) 2.26 (95% CI, 1.55-3.31) but disappeared at follow-up 0.84 (0.53 - 1.36). However, the TB-diabetes association remained positive and significant both at enrolment (2.41 (95% CI, 1.3-4.34)) and follow-up (OR 3.31 (95% CI, 1.5 - 7.25)). Conclusion: Transient hyperglycaemia exists during tuberculosis. This has implications on diabetes screening in TB patients and suggests a need for diabetes confirmation tests during or after TB treatment. Nonetheless, the association between TB and diabetes noted at enrolment persists at 3 months highlighting the importance of diabetes control and prevention for TB control. Further research is required to investigate the impact of hyperglycaemia (transient or otherwise) on TB outcomes to ascertain the clinical significance of hyperglycemia at enrolment.

Keywords: diabetes, impaired glucose regulation, transient hyperglycaemia, tuberculosis

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1553 Risk of Fatal and Non-Fatal Coronary Heart Disease and Stroke Events among Adult Patients with Hypertension: Basic Markov Model Inputs for Evaluating Cost-Effectiveness of Hypertension Treatment: Systematic Review of Cohort Studies

Authors: Mende Mensa Sorato, Majid Davari, Abbas Kebriaeezadeh, Nizal Sarrafzadegan, Tamiru Shibru, Behzad Fatemi

Abstract:

Markov model, like cardiovascular disease (CVD) policy model based simulation, is being used for evaluating the cost-effectiveness of hypertension treatment. Stroke, angina, myocardial infarction (MI), cardiac arrest, and all-cause mortality were included in this model. Hypertension is a risk factor for a number of vascular and cardiac complications and CVD outcomes. Objective: This systematic review was conducted to evaluate the comprehensiveness of this model across different regions globally. Methods: We searched articles written in the English language from PubMed/Medline, Ovid/Medline, Embase, Scopus, Web of Science, and Google scholar with a systematic search query. Results: Thirteen cohort studies involving a total of 2,165,770 (1,666,554 hypertensive adult population and 499,226 adults with treatment-resistant hypertension) were included in this scoping review. Hypertension is clearly associated with coronary heart disease (CHD) and stroke mortality, unstable angina, stable angina, MI, heart failure (HF), sudden cardiac death, transient ischemic attack, ischemic stroke, subarachnoid hemorrhage, intracranial hemorrhage, peripheral arterial disease (PAD), and abdominal aortic aneurism (AAA). Association between HF and hypertension is variable across regions. Treatment resistant hypertension is associated with a higher relative risk of developing major cardiovascular events and all-cause mortality when compared with non-resistant hypertension. However, it is not included in the previous CVD policy model. Conclusion: The CVD policy model used can be used in most regions for the evaluation of the cost-effectiveness of hypertension treatment. However, hypertension is highly associated with HF in Latin America, the Caribbean, Eastern Europe, and Sub-Saharan Africa. Therefore, it is important to consider HF in the CVD policy model for evaluating the cost-effectiveness of hypertension treatment in these regions. We do not suggest the inclusion of PAD and AAA in the CVD policy model for evaluating the cost-effectiveness of hypertension treatment due to a lack of sufficient evidence. Researchers should consider the effect of treatment-resistant hypertension either by including it in the basic model or during setting the model assumptions.

Keywords: cardiovascular disease policy model, cost-effectiveness analysis, hypertension, systematic review, twelve major cardiovascular events

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1552 Agronomic Test to Determine the Efficiency of Hydrothermally Treated Alkaline Igneous Rocks and Their Potassium Fertilizing Capacity

Authors: Aaron Herve Mbwe Mbissik, Lotfi Khiari, Otmane Raji, Abdellatif Elghali, Abdelkarim Lajili, Muhammad Ouabid, Martin Jemo, Jean-Louis Bodinier

Abstract:

Potassium (K) is an essential macronutrient for plant growth, helping to regulate several physiological and metabolic processes. Evaporite-related potash salts, mainly sylvite minerals (K chloride or KCl), are the principal source of K for the fertilizer industry. However, due to the high potash-supply risk associated with its considerable price fluctuations and uneven geographic distribution for most agriculture-based developing countries, the development of alternative sources of fertilizer K is imperative to maintain adequate crop yield, reduce yield gaps, and food security. Alkaline Igneous rocks containing significant K-rich silicate minerals such as K feldspar are increasingly seen as the best alternative available. However, these rocks may require to be hydrothermally treatment to enhance the release of potassium. In this study, we evaluate the fertilizing capacity of raw and hydrothermally treated K-bearing silicate rocks from different areas in Morocco. The effectiveness of rock powders was tested in a greenhouse experiment using ryegrass (Lolium multiflorum) by comparing them to a control (no K added) and to a conventional fertilizer (muriate of potash: MOP or KCl). The trial was conducted in a randomized complete block design with three replications, and plants were grown on K-depleted soils for three growing cycles. To achieve our objective, in addition to the analysis of the muriate response curve and the different biomasses, we also examined three necessary coefficients, namely: the K uptake, then apparent K recovery (AKR), and the relative K efficiency (RKE). The results showed that based on the optimum economic rate of MOP (230 kg.K.ha⁻¹) and the optimum yield (44 000 kg.K.ha⁻¹), the efficiency of K silicate rocks was as high as that of MOP. Although the plants took up only half of the K supplied by the powdered rock, the hydrothermal material was found to be satisfactory, with a biomass value reaching the optimum economic limit until the second crop cycle. In comparison, the AKR of the MOP (98.6%) and its RKE in the 1st cycle were higher than our materials: 39% and 38%, respectively. Therefore, the raw and hydrothermal materials mixture could be an appropriate solution for long-term agronomic use based on the obtained results.

Keywords: K-uptake, AKR, RKE, K-bearing silicate rock, MOP

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1551 Creating a Digital Map to Monitor the Care of People Living with HIV/Aids in Porto Alegre, Brazil: An Experience Report

Authors: Tiago Sigal Linhares, Ana Amélia Nascimento da Silva Bones, Juliana Miola, McArthur Alexander Barrow, Airton Tetelbom Stein

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Introduction: As a result of increased globalization and changing migration trends, it is expected that a significant portion of People Living with HIV/AIDS (PLWHA) will change their place of residence over time. In order to provide better health care, monitor the HIV epidemic and plan urban public health care and policies, there is a growing need to formulate a strategy for monitoring PLWHA care, location and migration patterns. The Porto Alegre District is characterized by a high prevalence of PLWHA and is considered one of the epicenters of HIV epidemic in Latin America. Objectives: The aim of this study is to create a digital and easily editable map in order to create a visual representation of the location of PLWHA and to monitor their migration within the city and the country in an effort to promote longitudinal care. Methods: This Experience Report used Google Maps Map Creator to generate an active digital map showing the location and changes in residence of 165 PLWHA who received care at two Primary Health Care (PHC) clinics, which attended an estimated population of five thousand patients, in downtown Porto Alegre over the last four years. Their current addresses were discovered in the unified Brazilian health care system digital records (e-SUS) and updated on the map. Results: A digital map with PLWHA current residence location was created. It was possible to demonstrate visually areas with a large concentration of PLWHA and the migration of the population within the city as wells as other cities, regions and states. Conclusions: An easily reproducible and free map could aid in PLWHA monitoring, urban public health planning, target interventions and situational diagnosis. Moreover, a visual representation of PLWHA location and migration could help bring more attention and investments to areas with geographic inequities or higher prevalence of PLWHA. It also enables notification of local PHC units of monitored patients inside their area, which are in clinical risk or with treatment abandonment through active case findings, improving the care of PLWHA.

Keywords: health care, medical public health, theoretical and conceptual innovations, urban public health

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1550 Human Rabies Survivors in India: Epidemiological, Immunological and Virological Studies

Authors: Madhusudana S. N., Reeta Mani, Ashwini S. Satishchandra P., Netravati, Udhani V., Fiaz A., Karande S.

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Rabies is an acute encephalitis which is considered 100% fatal despite occasional reports of survivors. However, in recent times more cases of human rabies survivors are being reported. In the last 5 years, there are six laboratories confirmed human rabies survivors in India alone. All cases were children below 15 years and all contracted the disease by dog bites. All of them also had received the full or partial course of rabies vaccination and 4 out of 6 had also received rabies immunoglobulin. All cases were treated in intensive care units in hospitals at Bangalore, Mumbai, Chandigarh, Lucknow and Goa. We report here the results of immunological and virological studies conducted at our laboratory on these patients. The clinical samples that were obtained from these patients were Serum, CSF, nuchal skin biopsy and saliva. Serum and CSF samples were subjected to standard RFFIT for estimation of rabies neutralizing antibodies. Skin biopsy, CSF and saliva were processed by TaqMan real-time PCR for detection of viral RNA. CSF, saliva and skin homogenates were also processed for virus isolation by inoculation of suckling mice. The PBMCs isolated from fresh blood was subjected to ELISPOT assay to determine the type of immune response (Th1/Th2). Both CSF and serum were also investigated for selected cytokines by Luminex assay. The level of antibodies to virus G protein and N protein were determined by ELISA. All survivors had very high titers of RVNA in serum and CSF 100 fold higher than non-survivors and vaccine controls. A five-fold rise in titer could be demonstrated in 4 out of 6 patients. All survivors had a significant increase in antibodies to G protein in both CSF and serum when compared to non-survivors. There was a profound and robust Th1 response in all survivors indicating that interferon gamma could play an important factor in virus clearance. We could isolate viral RNA in only one patient four years after he had developed symptoms. The partial N gene sequencing revealed 99% homology to species I strain prevalent in India. Levels of selected cytokines in CSF and serum did not reveal any difference between survivors and non-survivors. To conclude, survival from rabies is mediated by virus-specific immune responses of the host and clearance of rabies virus from CNS may involve the participation of both Th2 and Th1 immune responses.

Keywords: rabies, rabies treatment, rabies survivors, immune reponse in rabies encephalitis

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1549 Temperamental Determinants of Eye-Hand Coordination Formation in the Special Aerial Gymnastics Instruments (SAGI)

Authors: Zdzisław Kobos, Robert Jędrys, Zbigniew Wochyński

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Motor activity and good health are sine qua non determinants of a proper practice of the profession, especially aviation. Therefore, candidates to the aviation are selected according their psychomotor ability by both specialist medical commissions. Moreover, they must past an examination of the physical fitness. During the studies in the air force academy, eye-hand coordination is formed in two stages. The future aircraft pilots besides all-purpose physical education must practice specialist training on SAGI. Training includes: looping, aerowheel, and gyroscope. Aim of the training on the above listed apparatuses is to form eye-hand coordination during the tasks in the air. Such coordination is necessary to perform various figures in the real flight. Therefore, during the education of the future pilots, determinants of the effective ways of this important parameter of the human body functioning are sought for. Several studies of the sport psychology indicate an important role of the temperament as a factor determining human behavior during the task performance and acquiring operating skills> Polish psychologist Jan Strelau refers to the basic, relatively constant personality features which manifest themselves in the formal characteristics of the human behavior. Temperament, being initially determined by the inborn physiological mechanisms, changes in the course of maturation and some environmental factors and concentrates on the energetic level and reaction characteristics in time. Objectives. This study aimed at seeking a relationship between temperamental features and eye-hand coordination formation during training on SAGI. Material and Methods: Group of 30 students of pilotage was examined in two situations. The first assessment of the eye-hand coordination level was carried out before the beginning of a 30-hour training on SAGI. The second assessment was carried out after training completion. Training lasted for 2 hours once a week. Temperament was evaluated with The Formal Characteristics of Behavior − Temperament Inventory (FCB-TI) developed by Bogdan Zawadzki and Jan Strelau. Eye-hand coordination was assessed with a computer version of the Warsaw System of Psychological Tests. Results: It was found that the training on SAGI increased the level of eye-hand coordination in the examined students. Conclusions: Higher level of the eye-hand coordination was obtained after completion of the training. Moreover, a relationship between eye-hand coordination level and selected temperamental features was statistically significant.

Keywords: temperament, eye-hand coordination, pilot, SAGI

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1548 Profile of Programmed Death Ligand-1 (PD-L1) Expression and PD-L1 Gene Amplification in Indonesian Colorectal Cancer Patients

Authors: Akterono Budiyati, Gita Kusumo, Teguh Putra, Fritzie Rexana, Antonius Kurniawan, Aru Sudoyo, Ahmad Utomo, Andi Utama

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The presence of the programmed death ligand-1 (PD-L1) has been used in multiple clinical trials and approved as biomarker for selecting patients more likely to respond to immune checkpoint inhibitors. However, the expression of PD-L1 is regulated in different ways, which leads to a different significance of its presence. Positive PD-L1 within tumors may result from two mechanisms, induced PD-L1 expression by T-cell presence or genetic mechanism that lead to constitutive PD-L1 expression. Amplification of PD-L1 genes was found as one of genetic mechanism which causes an increase in PD-L1 expression. In case of colorectal cancer (CRC), targeting immune checkpoint inhibitor has been recommended for patients with microsatellite instable (MSI). Although the correlation between PD-L1 expression and MSI status has been widely studied, so far the precise mechanism of PD-L1 gene activation in CRC patients, particularly in MSI population have yet to be clarified. In this present study we have profiled 61 archived formalin fixed paraffin embedded CRC specimens of patients from Medistra Hospital, Jakarta admitted in 2010 - 2016. Immunohistochemistry was performed to measure expression of PD-L1 in tumor cells as well as MSI status using antibodies against PD-L1 and MMR (MLH1, MSH2, PMS2 and MSH6), respectively. PD-L1 expression was measured on tumor cells with cut off of 1% whereas loss of nuclear MMR protein expressions in tumor cells but not in normal or stromal cells indicated presence of MSI. Subset of PD-L1 positive patients was then assessed for copy number variations (CNVs) using single Tube TaqMan Copy Number Assays Gene CD247PD-L1. We also observed KRAS mutation to profile possible genetic mechanism leading to the presence or absence of PD-L1 expression. Analysis of 61 CRC patients revealed 15 patients (24%) expressed PD-L1 on their tumor cell membranes. The prevalence of surface membrane PD-L1 was significantly higher in patients with MSI (87%; 7/8) compared to patients with microsatellite stable (MSS) (15%; 8/53) (P=0.001). Although amplification of PD-L1 gene was not found among PD-L1 positive patients, low-level amplification of PD-L1 gene was commonly observed in MSS patients (75%; 6/8) than in MSI patients (43%; 3/7). Additionally, we found 26% of CRC patients harbored KRAS mutations (16/61), so far the distribution of KRAS status did not correlate with PD-L1 expression. Our data suggest genetic mechanism through amplification of PD-L1 seems not to be the mechanism underlying upregulation of PD-L1 expression in CRC patients. However, further studies are warranted to confirm the results.

Keywords: colorectal cancer, gene amplification, microsatellite instable, programmed death ligand-1

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1547 Mechanical Properties of Enset Fibers Obtained from Different Breeds of Enset Plant

Authors: Diriba T. Balcha, Boris Kulig, Oliver Hensel, Eyassu Woldesenbet

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Enset fiber is agricultural waste and available in a surplus amount in Ethiopia. However, the hypothesized variation in properties of this fiber due to diversity of its plant source breed, fiber position within plant stem and chemical treatment duration had not proven that its application for the development of composite products is problematic. Currently, limited data are known on the functional properties of the fiber as a potential functional fiber. Thus, an effort is made in this study to narrow the knowledge gaps by characterizing it. The experimental design was conducted using Design-Expert software and the tensile test was conducted on Enset fiber from 10 breeds: Dego, Dirbo, Gishera, Itine, Siskela, Neciho, Yesherkinke, Tuzuma, Ankogena, and Kucharkia. The effects of 5% Na-OH surface treatment duration and fiber location along and across the plant pseudostem was also investigated. The test result shows that the rupture stress variation is not significant among the fibers from 10 Enset breeds. However, strain variation is significant among the fibers from 10 Enset breeds that breed Dego fiber has the highest strain before failure. Surface treated fibers showed improved rupture strength and elastic modulus per 24 hours of treatment duration. Also, the result showed that chemical treatment can deteriorate the load-bearing capacity of the fiber. The raw fiber has the higher load-bearing capacity than the treated fiber. And, it was noted that both the rupture stress and strain increase in the top to bottom gradient, whereas there is no significant variation across the stem. Elastic modulus variation both along and across the stem was insignificant. The rupture stress, elastic modulus, and strain result of Enset fiber are 360.11 ± 181.86 MPa, 12.80 ± 6.85 GPa and 0.04 ± 0.02 mm/mm, respectively. These results show that Enset fiber is comparable to other natural fibers such as abaca, banana, and sisal fibers and can be used as alternatives natural fiber for composites application. Besides, the insignificant variation of properties among breeds and across stem is essential for all breeds and all leaf sheath of the Enset fiber plant for fiber extraction. The use of short natural fiber over the long is preferable to reduce the significant variation of properties along the stem or fiber direction. In conclusion, Enset fiber application for composite product design and development is mechanically feasible.

Keywords: Agricultural waste, Chemical treatment, Fiber characteristics, Natural fiber

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1546 Outpatient Pelvic Nerve and Muscle Treatment Reduces Pain and Improves Functionality for Patients with Chronic Pelvic Pain and Erectile Dysfunction

Authors: Allyson Augusta Shrikhande, Alexa Rains, Tayyaba Ahmed, Marjorie Mamsaang, Rakhi Vyas, Janaki Natarajan, Erika Moody, Christian Reutter, Kimberlee Leishear, Yogita Tailor, Sandra Sandhu-Restaino, Lora Liu, Neha James, Rosemarie Filart

Abstract:

Characterized by consistent difficulty getting and keeping an erection firm enough for intercourse, Erectile Dysfunction may affect up to 15% of adult men. Although awareness and access to treatment have improved in recent years, many patients do not actively seek diagnosis or treatment due to the stigma surrounding this condition. Patients who do seek treatment are often dissatisfied by the efficacy of the medication. The condition inhibits patients’ quality of life by worsening mental health and relationships. The purpose of this study was to test the effectiveness of an outpatient neuromuscular treatment protocol in treating the symptoms of Chronic Pelvic Pain and Erectile Dysfunction, improving pain and function. 56 patients ages 20-79 presented to an outpatient clinic for treatment of pelvic pain and Erectile Dysfunction symptoms. These symptoms had persisted for an average of 4 years. All patients underwent external ultrasound-guided hydro-dissection technique targeted at pelvic peripheral nerves in combination with pelvic floor musculature trigger-point injections. To measure the effects of this treatment, a five question Erectile Dysfunction questionnaire was completed by each patient at their first visit to a clinic and three months after treatment began. Answers were summed for a total score of 5-25, with a higher score indicating optimal function. The average score before treatment was 14.125 (SD 5.411) (a=0.05; CI 12.708-15.542), which increased by 18% to an average of 16.625 (SD 6.423) (a=0.05; CI 14.943-18.307) after treatment (P=0.0004). Secondary outcome variables included a Visual Analogue Scale (VAS) to measure pelvic pain intensity and the Functional Pelvic Pain Scale (FPPS) to measure function across multiple areas. VAS scores reduced by 51% after three months. Before treatment, the mean VAS score was 5.87, and the posttreatment mean VAS score was 2.89. Pelvic pain functionality improved by 34% after three months. Pretreatment FPPS scores averaged at 7.48, decreasing to 4.91 after treatment. These results indicate that this unique treatment was very effective at relieving pain and increasing function for patients with Erectile Dysfunction.

Keywords: chronic pelvic pain, erectile dysfunction, nonsurgical, outpatient, trigger point injections

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1545 The Environmental Impacts of Textiles Reuse and Recycling: A Review on Life-Cycle-Assessment Publications

Authors: Samuele Abagnato, Lucia Rigamonti

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Life-Cycle-Assessment (LCA) is an effective tool to quantify the environmental impacts of reuse models and recycling technologies for textiles. In this work, publications in the last ten years about LCA on textile waste are classified according to location, goal and scope, functional unit, waste composition, impact assessment method, impact categories, and sensitivity analysis. Twenty papers have been selected: 50% are focused only on recycling, 30% only on reuse, the 15% on both, while only one paper considers only the final disposal of the waste. It is found that reuse is generally the best way to decrease the environmental impacts of textiles waste management because of the avoided impacts of manufacturing a new item. In the comparison between a product made with recycled yarns and a product from virgin materials, in general, the first option is less impact, especially for the categories of climate change, water depletion, and land occupation, while for other categories, such as eutrophication or ecotoxicity, under certain conditions the impacts of the recycled fibres can be higher. Cultivation seems to have quite high impacts when natural fibres are involved, especially in the land use and water depletion categories, while manufacturing requires a remarkable amount of electricity, with its associated impact on climate change. In the analysis of the reuse processes, relevant importance is covered by the laundry phase, with water consumption and impacts related to the use of detergents. About the sensitivity analysis, it can be stated that one of the main variables that influence the LCA results and that needs to be further investigated in the modeling of the LCA system about this topic is the substitution rate between recycled and virgin fibres, that is the amount of recycled material that can be used in place of virgin one. Related to this, also the yield of the recycling processes has a strong influence on the results of the impact. The substitution rate is also important in the modeling of the reuse processes because it represents the number of avoided new items bought in place of the reused ones. Another aspect that appears to have a large influence on the impacts is consumer behaviour during the use phase (for example, the number of uses between two laundry cycles). In conclusion, to have a deeper knowledge of the impacts of a life-cycle approach of textile waste, further data and research are needed in the modeling of the substitution rate and of the use phase habits of the consumers.

Keywords: environmental impacts, life-cycle-assessment, textiles recycling, textiles reuse, textiles waste management

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1544 Factors Affecting Cesarean Section among Women in Qatar Using Multiple Indicator Cluster Survey Database

Authors: Sahar Elsaleh, Ghada Farhat, Shaikha Al-Derham, Fasih Alam

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Background: Cesarean section (CS) delivery is one of the major concerns both in developing and developed countries. The rate of CS deliveries are on the rise globally, and especially in Qatar. Many socio-economic, demographic, clinical and institutional factors play an important role for cesarean sections. This study aims to investigate factors affecting the prevalence of CS among women in Qatar using the UNICEF’s Multiple Indicator Cluster Survey (MICS) 2012 database. Methods: The study has focused on the women’s questionnaire of the MICS, which was successfully distributed to 5699 participants. Following study inclusion and exclusion criteria, a final sample of 761 women aged 19- 49 years who had at least one delivery of giving birth in their lifetime before the survey were included. A number of socio-economic, demographic, clinical and institutional factors, identified through literature review and available in the data, were considered for the analyses. Bivariate and multivariate logistic regression models, along with a multi-level modeling to investigate clustering effect, were undertaken to identify the factors that affect CS prevalence in Qatar. Results: From the bivariate analyses the study has shown that, a number of categorical factors are statistically significantly associated with the dependent variable (CS). When identifying the factors from a multivariate logistic regression, the study found that only three categorical factors -‘age of women’, ‘place at delivery’ and ‘baby weight’ appeared to be significantly affecting the CS among women in Qatar. Although the MICS dataset is based on a cluster survey, an exploratory multi-level analysis did not show any clustering effect, i.e. no significant variation in results at higher level (households), suggesting that all analyses at lower level (individual respondent) are valid without any significant bias in results. Conclusion: The study found a statistically significant association between the dependent variable (CS delivery) and age of women, frequency of TV watching, assistance at birth and place of birth. These results need to be interpreted cautiously; however, it can be used as evidence-base for further research on cesarean section delivery in Qatar.

Keywords: cesarean section, factors, multiple indicator cluster survey, MICS database, Qatar

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1543 Dynamic Facades: A Literature Review on Double-Skin Façade with Lightweight Materials

Authors: Victor Mantilla, Romeu Vicente, António Figueiredo, Victor Ferreira, Sandra Sorte

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Integrating dynamic facades into contemporary building design is shaping a new era of energy efficiency and user comfort. These innovative facades, often constructed using lightweight construction systems and materials, offer an opportunity to have a responsive and adaptive nature to the dynamic behavior of the outdoor climate. Therefore, in regions characterized by high fluctuations in daily temperatures, the ability to adapt to environmental changes is of paramount importance and a challenge. This paper presents a thorough review of the state of the art on double-skin facades (DSF), focusing on lightweight solutions for the external envelope. Dynamic facades featuring elements like movable shading devices, phase change materials, and advanced control systems have revolutionized the built environment. They offer a promising path for reducing energy consumption while enhancing occupant well-being. Lightweight construction systems are increasingly becoming the choice for the constitution of these facade solutions, offering benefits such as reduced structural loads and reduced construction waste, improving overall sustainability. However, the performance of dynamic facades based on low thermal inertia solutions in climatic contexts with high thermal amplitude is still in need of research since their ability to adapt is traduced in variability/manipulation of the thermal transmittance coefficient (U-value). Emerging technologies can enable such a dynamic thermal behavior through innovative materials, changes in geometry and control to optimize the facade performance. These innovations will allow a facade system to respond to shifting outdoor temperature, relative humidity, wind, and solar radiation conditions, ensuring that energy efficiency and occupant comfort are both met/coupled. This review addresses the potential configuration of double-skin facades, particularly concerning their responsiveness to seasonal variations in temperature, with a specific focus on addressing the challenges posed by winter and summer conditions. Notably, the design of a dynamic facade is significantly shaped by several pivotal factors, including the choice of materials, geometric considerations, and the implementation of effective monitoring systems. Within the realm of double skin facades, various configurations are explored, encompassing exhaust air, supply air, and thermal buffering mechanisms. According to the review places a specific emphasis on the thermal dynamics at play, closely examining the impact of factors such as the color of the facade, the slat angle's dimensions, and the positioning and type of shading devices employed in these innovative architectural structures.This paper will synthesize the current research trends in this field, with the presentation of case studies and technological innovations with a comprehensive understanding of the cutting-edge solutions propelling the evolution of building envelopes in the face of climate change, namely focusing on double-skin lightweight solutions to create sustainable, adaptable, and responsive building envelopes. As indicated in the review, flexible and lightweight systems have broad applicability across all building sectors, and there is a growing recognition that retrofitting existing buildings may emerge as the predominant approach.

Keywords: adaptive, control systems, dynamic facades, energy efficiency, responsive, thermal comfort, thermal transmittance

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1542 A Descriptive Study on Water Scarcity as a One Health Challenge among the Osiram Community, Kajiado County, Kenya

Authors: Damiano Omari, Topirian Kerempe, Dibo Sama, Walter Wafula, Sharon Chepkoech, Chrispine Juma, Gilbert Kirui, Simon Mburu, Susan Keino

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The One Health concept was officially adopted by the international organizations and scholarly bodies in 1984. It aims at combining human, animal and environmental components to address global health challenges. Using collaborative efforts optimal health to people, animals, and the environment can be achieved. One health approach plays a significant approach role in prevention and control of zoonosis diseases. It has also been noted that 75% of new emerging human infectious diseases are zoonotic. In Kenya, one health has been embraced and strongly advocated for by One Health East and Central Africa (OHCEA). It was inaugurated on 17th of October 2010 at a historic meeting facilitated by USAID with participants from 7 public health schools, seven faculties of veterinary medicine in Eastern Africa and 2 American universities (Tufts and University of Minnesota) in addition to respond project staff. The study was conducted in Loitoktok Sub County, specifically in the Amboseli Ecosystem. The Amboseli ecosystem covers an area of 5,700 square kilometers and stretches between Mt. Kilimanjaro, Chyulu Hills, Tsavo West National park and the Kenya/Tanzania border. The area is arid to semi-arid and is more suitable for pastoralism with a high potential for conservation of wildlife and tourism enterprises. The ecosystem consists of the Amboseli National Park, which is surrounded by six group ranches which include Kimana, Olgulului, Selengei, Mbirikani, Kuku and Rombo in Loitoktok District. The Manyatta of study was Osiram Cultural Manyatta in Mbirikani group ranch. Apart from visiting the Manyatta, we also visited the sub-county hospital, slaughter slab, forest service, Kimana market, and the Amboseli National Park. The aim of the study was to identify the one health issues facing the community. This was done by a conducting a community needs assessment and prioritization. Different methods were used in data collection for the qualitative and numerical data. They include among others; key informant interviews and focus group discussions. We also guided the community members in drawing their Resource Map this helped identify the major resources in their land and also help them identify some of the issues they were facing. Matrix piling, root cause analysis, and force field analysis tools were used to establish the one health related priority issues facing community members. Skits were also used to present to the community interventions to the major one health issues. Some of the prioritized needs among the community were water scarcity and inadequate markets for their beadwork. The group intervened on the various needs of the Manyatta. For water scarcity, we educated the community on water harvesting methods using gutters as well as proper storage by the use of tanks and earth dams. The community was also encouraged to recycle and conserve water. To improve markets; we educated the community to upload their products online, a page was opened for them and uploading the photos was demonstrated to them. They were also encouraged to be innovative to attract more clients.

Keywords: Amboseli ecosystem, community interventions, community needs assessment and prioritization, one health issues

Procedia PDF Downloads 155
1541 Digital Adoption of Sales Support Tools for Farmers: A Technology Organization Environment Framework Analysis

Authors: Sylvie Michel, François Cocula

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Digital agriculture is an approach that exploits information and communication technologies. These encompass data acquisition tools like mobile applications, satellites, sensors, connected devices, and smartphones. Additionally, it involves transfer and storage technologies such as 3G/4G coverage, low-bandwidth terrestrial or satellite networks, and cloud-based systems. Furthermore, embedded or remote processing technologies, including drones and robots for process automation, along with high-speed communication networks accessible through supercomputers, are integral components of this approach. While farm-level adoption studies regarding digital agricultural technologies have emerged in recent years, they remain relatively limited in comparison to other agricultural practices. To bridge this gap, this study delves into understanding farmers' intention to adopt digital tools, employing the technology, organization, environment framework. A qualitative research design encompassed semi-structured interviews, totaling fifteen in number, conducted with key stakeholders both prior to and following the 2020-2021 COVID-19 lockdowns in France. Subsequently, the interview transcripts underwent thorough thematic content analysis, and the data and verbatim were triangulated for validation. A coding process aimed to systematically organize the data, ensuring an orderly and structured classification. Our research extends its contribution by delineating sub-dimensions within each primary dimension. A total of nine sub-dimensions were identified, categorized as follows: perceived usefulness for communication, perceived usefulness for productivity, and perceived ease of use constitute the first dimension; technological resources, financial resources, and human capabilities constitute the second dimension, while market pressure, institutional pressure, and the COVID-19 situation constitute the third dimension. Furthermore, this analysis enriches the TOE framework by incorporating entrepreneurial orientation as a moderating variable. Managerial orientation emerges as a pivotal factor influencing adoption intention, with producers acknowledging the significance of utilizing digital sales support tools to combat "greenwashing" and elevate their overall brand image. Specifically, it illustrates that producers recognize the potential of digital tools in time-saving and streamlining sales processes, leading to heightened productivity. Moreover, it highlights that the intent to adopt digital sales support tools is influenced by a market mimicry effect. Additionally, it demonstrates a negative association between the intent to adopt these tools and the pressure exerted by institutional partners. Finally, this research establishes a positive link between the intent to adopt digital sales support tools and economic fluctuations, notably during the COVID-19 pandemic. The adoption of sales support tools in agriculture is a multifaceted challenge encompassing three dimensions and nine sub-dimensions. The research delves into the adoption of digital farming technologies at the farm level through the TOE framework. This analysis provides significant insights beneficial for policymakers, stakeholders, and farmers. These insights are instrumental in making informed decisions to facilitate a successful digital transition in agriculture, effectively addressing sector-specific challenges.

Keywords: adoption, digital agriculture, e-commerce, TOE framework

Procedia PDF Downloads 43
1540 In vitro Establishment and Characterization of Oral Squamous Cell Carcinoma Derived Cancer Stem-Like Cells

Authors: Varsha Salian, Shama Rao, N. Narendra, B. Mohana Kumar

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Evolving evidence proposes the existence of a highly tumorigenic subpopulation of undifferentiated, self-renewing cancer stem cells, responsible for exhibiting resistance to conventional anti-cancer therapy, recurrence, metastasis and heterogeneous tumor formation. Importantly, the mechanisms exploited by cancer stem cells to resist chemotherapy are very less understood. Oral squamous cell carcinoma (OSCC) is one of the most regularly diagnosed cancer types in India and is associated commonly with alcohol and tobacco use. Therefore, the isolation and in vitro characterization of cancer stem-like cells from patients with OSCC is a critical step to advance the understanding of the chemoresistance processes and for designing therapeutic strategies. With this, the present study aimed to establish and characterize cancer stem-like cells in vitro from OSCC. The primary cultures of cancer stem-like cell lines were established from the tissue biopsies of patients with clinical evidence of an ulceroproliferative lesion and histopathological confirmation of OSCC. The viability of cells assessed by trypan blue exclusion assay showed more than 95% at passage 1 (P1), P2 and P3. Replication rate was performed by plating cells in 12-well plate and counting them at various time points of culture. Cells had a more marked proliferative activity and the average doubling time was less than 20 hrs. After being cultured for 10 to 14 days, cancer stem-like cells gradually aggregated and formed sphere-like bodies. More spheroid bodies were observed when cultured in DMEM/F-12 under low serum conditions. Interestingly, cells with higher proliferative activity had a tendency to form more sphere-like bodies. Expression of specific markers, including membrane proteins or cell enzymes, such as CD24, CD29, CD44, CD133, and aldehyde dehydrogenase 1 (ALDH1) is being explored for further characterization of cancer stem-like cells. To summarize the findings, the establishment of OSCC derived cancer stem-like cells may provide scope for better understanding the cause for recurrence and metastasis in oral epithelial malignancies. Particularly, identification and characterization studies on cancer stem-like cells in Indian population seem to be lacking thus provoking the need for such studies in a population where alcohol consumption and tobacco chewing are major risk habits.

Keywords: cancer stem-like cells, characterization, in vitro, oral squamous cell carcinoma

Procedia PDF Downloads 201
1539 Solymorph: Design and Fabrication of AI-Driven Kinetic Facades with Soft Robotics for Optimized Building Energy Performance

Authors: Mohammadreza Kashizadeh, Mohammadamin Hashemi

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Solymorph, a kinetic building facade designed for optimal energy capture and architectural expression, is explored in this paper. The system integrates photovoltaic panels with soft robotic actuators for precise solar tracking, resulting in enhanced electricity generation compared to static facades. Driven by the growing interest in dynamic building envelopes, the exploration of novel facade systems is necessitated. Increased energy generation and regulation of energy flow within buildings are potential benefits offered by integrating photovoltaic (PV) panels as kinetic elements. However, incorporating these technologies into mainstream architecture presents challenges due to the complexity of coordinating multiple systems. To address this, Solymorph leverages soft robotic actuators, known for their compliance, resilience, and ease of integration. Additionally, the project investigates the potential for employing Large Language Models (LLMs) to streamline the design process. The research methodology involved design development, material selection, component fabrication, and system assembly. Grasshopper (GH) was employed within the digital design environment for parametric modeling and scripting logic, and an LLM was experimented with to generate Python code for the creation of a random surface with user-defined parameters. Various techniques, including casting, 3D printing, and laser cutting, were utilized to fabricate the physical components. Finally, a modular assembly approach was adopted to facilitate installation and maintenance. A case study focusing on the application of Solymorph to an existing library building at Politecnico di Milano is presented. The facade system is divided into sub-frames to optimize solar exposure while maintaining a visually appealing aesthetic. Preliminary structural analyses were conducted using Karamba3D to assess deflection behavior and axial loads within the cable net structure. Additionally, Finite Element (FE) simulations were performed in Abaqus to evaluate the mechanical response of the soft robotic actuators under pneumatic pressure. To validate the design, a physical prototype was created using a mold adapted for a 3D printer's limitations. Casting Silicone Rubber Sil 15 was used for its flexibility and durability. The 3D-printed mold components were assembled, filled with the silicone mixture, and cured. After demolding, nodes and cables were 3D-printed and connected to form the structure, demonstrating the feasibility of the design. Solymorph demonstrates the potential of soft robotics and Artificial Intelligence (AI) for advancements in sustainable building design and construction. The project successfully integrates these technologies to create a dynamic facade system that optimizes energy generation and architectural expression. While limitations exist, Solymorph paves the way for future advancements in energy-efficient facade design. Continued research efforts will focus on cost reduction, improved system performance, and broader applicability.

Keywords: artificial intelligence, energy efficiency, kinetic photovoltaics, pneumatic control, soft robotics, sustainable building

Procedia PDF Downloads 41
1538 An Intelligence-Led Methodologly for Detecting Dark Actors in Human Trafficking Networks

Authors: Andrew D. Henshaw, James M. Austin

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Introduction: Human trafficking is an increasingly serious transnational criminal enterprise and social security issue. Despite ongoing efforts to mitigate the phenomenon and a significant expansion of security scrutiny over past decades, it is not receding. This is true for many nations in Southeast Asia, widely recognized as the global hub for trafficked persons, including men, women, and children. Clearly, human trafficking is difficult to address because there are numerous drivers, causes, and motivators for it to persist, such as non-military and non-traditional security challenges, i.e., climate change, global warming displacement, and natural disasters. These make displaced persons and refugees particularly vulnerable. The issue is so large conservative estimates put a dollar value at around $150 billion-plus per year (Niethammer, 2020) spanning sexual slavery and exploitation, forced labor, construction, mining and in conflict roles, and forced marriages of girls and women. Coupled with corruption throughout military, police, and civil authorities around the world, and the active hands of powerful transnational criminal organizations, it is likely that such figures are grossly underestimated as human trafficking is misreported, under-detected, and deliberately obfuscated to protect those profiting from it. For example, the 2022 UN report on human trafficking shows a 56% reduction in convictions in that year alone (UNODC, 2022). Our Approach: To better understand this, our research utilizes a bespoke methodology. Applying a JAM (Juxtaposition Assessment Matrix), which we previously developed to detect flows of dark money around the globe (Henshaw, A & Austin, J, 2021), we now focus on the human trafficking paradigm. Indeed, utilizing a JAM methodology has identified key indicators of human trafficking not previously explored in depth. Being a set of structured analytical techniques that provide panoramic interpretations of the subject matter, this iteration of the JAM further incorporates behavioral and driver indicators, including the employment of Open-Source Artificial Intelligence (OS-AI) across multiple collection points. The extracted behavioral data was then applied to identify non-traditional indicators as they contribute to human trafficking. Furthermore, as the JAM OS-AI analyses data from the inverted position, i.e., the viewpoint of the traffickers, it examines the behavioral and physical traits required to succeed. This transposed examination of the requirements of success delivers potential leverage points for exploitation in the fight against human trafficking in a new and novel way. Findings: Our approach identified new innovative datasets that have previously been overlooked or, at best, undervalued. For example, the JAM OS-AI approach identified critical 'dark agent' lynchpins within human trafficking that are difficult to detect and harder to connect to actors and agents within a network. Our preliminary data suggests this is in part due to the fact that ‘dark agents’ in extant research have been difficult to detect and potentially much harder to directly connect to the actors and organizations in human trafficking networks. Our research demonstrates that using new investigative techniques such as OS-AI-aided JAM introduces a powerful toolset to increase understanding of human trafficking and transnational crime and illuminate networks that, to date, avoid global law enforcement scrutiny.

Keywords: human trafficking, open-source intelligence, transnational crime, human security, international human rights, intelligence analysis, JAM OS-AI, Dark Money

Procedia PDF Downloads 74
1537 Promoting Self-Esteem and Social Integration in Secondary German Schools: An Evaluation Study

Authors: Susanne Manes, Anni Glaeser, Katharina Wick, Bernhard Strauss, Uwe Berger

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Introduction: Over the last decades growing rates of mental health concerns among children and adolescents have been observed. At the same time, physical well-being of children and adolescents becomes increasingly impaired as well. Schools play an important role in preventing mental and physical disorders and in promoting well-being. Self-esteem, as well as social integration, are vital influence factors for mental and physical well-being. The purpose of this study was to develop and evaluate the program 'VorteilJena' for secondary schools in Germany focusing on self-esteem and social integration to improve mental and physical well-being. Method: The school-based health promotion program was designed for students in 5th grade and higher. It consists of several short pedagogical exercises instructed by a teacher and were integrated into the regular class over the course of ten weeks. The exercises focused on fostering social integration using either tasks improving team spirit or exercises that increase tolerance and sense of belonging. Other exercises focused on strengthening the self-esteem of the students. Additionally, the program included a poster exhibition titled 'Belonging' which was put up in the school buildings. The exhibition comprised ten posters which addressed relevant risk factors and resources related to social integration and self-esteem. The study was a randomized controlled sequential study with a pre and post measurement conducted in ten German schools. A total of 1642 students (44% male) were recruited. Their age ranged from 9 to 21 years (M=12.93 years; SD= 2.11). The program was conducted in classes ranging from 5th to 12th grade. Results: The program improved wellbeing, self-esteem and social integration of the involved students compared to the control group. Differential effects depending on implementation rates or age of the students will be analyzed. Moreover, implications for future school-based health promotion programs targeting self-esteem and social integration will be discussed. Conclusion: Social integration considerably influences self-esteem and well-being of students and can be targeted by school-based programs including short and modest exercises. Since a sufficient implementation of health promotion programs is essential, the present program due to its practicability represents a good opportunity to install health promotion focusing on social integration in schools.

Keywords: social integration, well-being, health promotion in schools, self-esteem

Procedia PDF Downloads 186
1536 Estimating Groundwater Seepage Rates: Case Study at Zegveld, Netherlands

Authors: Wondmyibza Tsegaye Bayou, Johannes C. Nonner, Joost Heijkers

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This study aimed to identify and estimate dynamic groundwater seepage rates using four comparative methods; the Darcian approach, the water balance approach, the tracer method, and modeling. The theoretical background to these methods is put together in this study. The methodology was applied to a case study area at Zegveld following the advice of the Water Board Stichtse Rijnlanden. Data collection has been from various offices and a field campaign in the winter of 2008/09. In this complex confining layer of the study area, the location of the phreatic groundwater table is at a shallow depth compared to the piezometric water level. Data were available for the model years 1989 to 2000 and winter 2008/09. The higher groundwater table shows predominately-downward seepage in the study area. Results of the study indicated that net recharge to the groundwater table (precipitation excess) and the ditch system are the principal sources for seepage across the complex confining layer. Especially in the summer season, the contribution from the ditches is significant. Water is supplied from River Meije through a pumping system to meet the ditches' water demand. The groundwater seepage rate was distributed unevenly throughout the study area at the nature reserve averaging 0.60 mm/day for the model years 1989 to 2000 and 0.70 mm/day for winter 2008/09. Due to data restrictions, the seepage rates were mainly determined based on the Darcian method. Furthermore, the water balance approach and the tracer methods are applied to compute the flow exchange within the ditch system. The site had various validated groundwater levels and vertical flow resistance data sources. The phreatic groundwater level map compared with TNO-DINO groundwater level data values overestimated the groundwater level depth by 28 cm. The hydraulic resistance values obtained based on the 3D geological map compared with the TNO-DINO data agreed with the model values before calibration. On the other hand, the calibrated model significantly underestimated the downward seepage in the area compared with the field-based computations following the Darcian approach.

Keywords: groundwater seepage, phreatic water table, piezometric water level, nature reserve, Zegveld, The Netherlands

Procedia PDF Downloads 69
1535 Effects of Roasting as Preservative Method on Food Value of the Runner Groundnuts, Arachis hypogaea

Authors: M. Y. Maila, H. P. Makhubele

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Roasting is one of the oldest preservation method used in foods such as nuts and seeds. It is a process by which heat is applied to dry foodstuffs without the use of oil or water as a carrier. Groundnut seeds, also known as peanuts when sun dried or roasted, are among the oldest oil crops that are mostly consumed as a snack, after roasting in many parts of South Africa. However, roasting can denature proteins, destroy amino acids, decrease nutritive value and induce undesirable chemical changes in the final product. The aim of this study, therefore, was to evaluate the effect of various roasting times on the food value of the runner groundnut seeds. A constant temperature of 160 °C and various time-intervals (20, 30, 40, 50 and 60 min) were used for roasting groundnut seeds in an oven. Roasted groundnut seeds were then cooled and milled to flour. The milled sundried, raw groundnuts served as reference. The proximate analysis (moisture, energy and crude fats) was performed and the results were determined using standard methods. The antioxidant content was determined using HPLC. Mineral (cobalt, chromium, silicon and iron) contents were determined by first digesting the ash of sundried and roasted seed samples in 3M Hydrochloric acid and then determined by Atomic Absorption Spectrometry. All results were subjected to ANOVA through SAS software. Relative to the reference, roasting time significantly (p ≤ 0.05) reduced moisture (71%–88%), energy (74%) and crude fat (5%–64%) of the runner groundnut seeds, whereas the antioxidant content was significantly (p ≤ 0.05) increased (35%–72%) with increasing roasting time. Similarly, the tested mineral contents of the roasted runner groundnut seeds were also significantly (p ≤ 0.05) reduced at all roasting times: cobalt (21%–83%), chromium (48%–106%) and silicon (58%–77%). However, the iron content was significantly (p ≤ 0.05) unaffected. Generally, the tested runner groundnut seeds had higher food value in the raw state than in the roasted state, except for the antioxidant content. Moisture is a critical factor affecting the shelf life, texture and flavor of the final product. Loss of moisture ensures prolonged shelf life, which contribute to the stability of the roasted peanuts. Also, increased antioxidant content in roasted groundnuts is essential in other health-promoting compounds. In conclusion, the overall reduction in the proximate and mineral contents of the runner groundnuts seeds due to roasting is sufficient to suggest influences of roasting time on the food value of the final product and shelf life.

Keywords: dry roasting, legume, oil source, peanuts

Procedia PDF Downloads 268
1534 On Consolidated Predictive Model of the Natural History of Breast Cancer Considering Primary Tumor and Primary Distant Metastases Growth

Authors: Ella Tyuryumina, Alexey Neznanov

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Finding algorithms to predict the growth of tumors has piqued the interest of researchers ever since the early days of cancer research. A number of studies were carried out as an attempt to obtain reliable data on the natural history of breast cancer growth. Mathematical modeling can play a very important role in the prognosis of tumor process of breast cancer. However, mathematical models describe primary tumor growth and metastases growth separately. Consequently, we propose a mathematical growth model for primary tumor and primary metastases which may help to improve predicting accuracy of breast cancer progression using an original mathematical model referred to CoM-IV and corresponding software. We are interested in: 1) modelling the whole natural history of primary tumor and primary metastases; 2) developing adequate and precise CoM-IV which reflects relations between PT and MTS; 3) analyzing the CoM-IV scope of application; 4) implementing the model as a software tool. The CoM-IV is based on exponential tumor growth model and consists of a system of determinate nonlinear and linear equations; corresponds to TNM classification. It allows to calculate different growth periods of primary tumor and primary metastases: 1) ‘non-visible period’ for primary tumor; 2) ‘non-visible period’ for primary metastases; 3) ‘visible period’ for primary metastases. The new predictive tool: 1) is a solid foundation to develop future studies of breast cancer models; 2) does not require any expensive diagnostic tests; 3) is the first predictor which makes forecast using only current patient data, the others are based on the additional statistical data. Thus, the CoM-IV model and predictive software: a) detect different growth periods of primary tumor and primary metastases; b) make forecast of the period of primary metastases appearance; c) have higher average prediction accuracy than the other tools; d) can improve forecasts on survival of BC and facilitate optimization of diagnostic tests. The following are calculated by CoM-IV: the number of doublings for ‘nonvisible’ and ‘visible’ growth period of primary metastases; tumor volume doubling time (days) for ‘nonvisible’ and ‘visible’ growth period of primary metastases. The CoM-IV enables, for the first time, to predict the whole natural history of primary tumor and primary metastases growth on each stage (pT1, pT2, pT3, pT4) relying only on primary tumor sizes. Summarizing: a) CoM-IV describes correctly primary tumor and primary distant metastases growth of IV (T1-4N0-3M1) stage with (N1-3) or without regional metastases in lymph nodes (N0); b) facilitates the understanding of the appearance period and manifestation of primary metastases.

Keywords: breast cancer, exponential growth model, mathematical modelling, primary metastases, primary tumor, survival

Procedia PDF Downloads 319
1533 Improving the Detection of Depression in Sri Lanka: Cross-Sectional Study Evaluating the Efficacy of a 2-Question Screen for Depression

Authors: Prasad Urvashi, Wynn Yezarni, Williams Shehan, Ravindran Arun

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Introduction: Primary health services are often the first point of contact that patients with mental illness have with the healthcare system. A number of tools have been developed to increase detection of depression in the context of primary care. However, one challenge amongst many includes utilizing these tools within the limited primary care consultation timeframe. Therefore, short questionnaires that screen for depression that are just as effective as more comprehensive diagnostic tools may be beneficial in improving detection rates of patients visiting a primary care setting. Objective: To develop and determine the sensitivity and specificity of a 2-Question Questionnaire (2-QQ) to screen for depression in in a suburban primary care clinic in Ragama, Sri Lanka. The purpose is to develop a short screening tool for depression that is culturally adapted in order to increase the detection of depression in the Sri Lankan patient population. Methods: This was a cross-sectional study involving two steps. Step one: verbal administration of 2-QQ to patients by their primary care physician. Step two: completion of the Peradeniya Depression Scale, a validated diagnostic tool for depression, the patient after their consultation with the primary care physician. The results from the PDS were then correlated to the results from the 2-QQ for each patient to determine sensitivity and specificity of the 2-QQ. Results: A score of 1/+ on the 2-QQ was most sensitive but least specific. Thus, setting the threshold at this level is effective for correctly identifying depressed patients, but also inaccurately captures patients who are not depressed. A score of 6 on the 2-QQ was most specific but least sensitive. Setting the threshold at this level is effective for correctly identifying patients without depression, but not very effective at capturing patients with depression. Discussion: In the context of primary care, it may be worthwhile setting the 2-QQ screen at a lower threshold for positivity (such as a score of 1 or above). This would generate a high test sensitivity and thus capture the majority of patients that have depression. On the other hand, by setting a low threshold for positivity, patients who do not have depression but score higher than 1 on the 2-QQ will also be falsely identified as testing positive for depression. However, the benefits of identifying patients who present with depression may outweigh the harms of falsely identifying a non-depressed patient. It is our hope that the 2-QQ will serve as a quick primary screen for depression in the primary care setting and serve as a catalyst to identify and treat individuals with depression.

Keywords: depression, primary care, screening tool, Sri Lanka

Procedia PDF Downloads 234
1532 Hydrothermal Aging Behavior of Continuous Carbon Fiber Reinforced Polyamide 6 Composites

Authors: Jifeng Zhang , Yongpeng Lei

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Continuous carbon fiber reinforced polyamide 6 (CF/PA6) composites are potential for application in the automotive industry due to their high specific strength and stiffness. However, PA6 resin is sensitive to the moisture in the hydrothermal environment and CF/PA6 composites might undergo several physical and chemical changes, such as plasticization, swelling, and hydrolysis, which induces a reduction of mechanical properties. So far, little research has been reported on the assessment of the effects of hydrothermal aging on the mechanical properties of continuous CF/PA6 composite. This study deals with the effects of hydrothermal aging on moisture absorption and mechanical properties of polyamide 6 (PA6) and polyamide 6 reinforced with continuous carbon fibers composites (CF/PA6) by immersion in distilled water at 30 ℃, 50 ℃, 70 ℃, and 90 ℃. Degradation of mechanical performance has been monitored, depending on the water absorption content and the aging temperature. The experimental results reveal that under the same aging condition, the PA6 resin absorbs more water than the CF/PA6 composite, while the water diffusion coefficient of CF/PA6 composite is higher than that of PA6 resin because of interfacial diffusion channel. In mechanical properties degradation process, an exponential reduction in tensile strength and elastic modulus are observed in PA6 resin as aging temperature and water absorption content increases. The degradation trend of flexural properties of CF/PA6 is the same as that of tensile properties of PA6 resin. Moreover, the water content plays a decisive role in mechanical degradation compared with aging temperature. In contrast, hydrothermal environment has mild effect on the tensile properties of CF/PA6 composites. The elongation at breakage of PA6 resin and CF/PA6 reaches the highest value when their water content reaches 6% and 4%, respectively. Dynamic mechanical analysis (DMA) and scanning electron microscope (SEM) were also used to explain the mechanism of mechanical properties alteration. After exposed to the hydrothermal environment, the Tg (glass transition temperature) of samples decreases dramatically with water content increase. This reduction can be ascribed to the plasticization effect of water. For the unaged specimens, the fibers surface is coated with resin and the main fracture mode is fiber breakage, indicating that a good adhesion between fiber and matrix. However, with absorbed water content increasing, the fracture mode transforms to fiber pullout. Finally, based on Arrhenius methodology, a predictive model with relate to the temperature and water content has been presented to estimate the retention of mechanical properties for PA6 and CF/PA6.

Keywords: continuous carbon fiber reinforced polyamide 6 composite, hydrothermal aging, Arrhenius methodology, interface

Procedia PDF Downloads 112
1531 Investigation of Deep Eutectic Solvents for Microwave Assisted Extraction and Headspace Gas Chromatographic Determination of Hexanal in Fat-Rich Food

Authors: Birute Bugelyte, Ingrida Jurkute, Vida Vickackaite

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The most complicated step of the determination of volatile compounds in complex matrices is the separation of analytes from the matrix. Traditional analyte separation methods (liquid extraction, Soxhlet extraction) require a lot of time and labour; moreover, there is a risk to lose the volatile analytes. In recent years, headspace gas chromatography has been used to determine volatile compounds. To date, traditional extraction solvents have been used in headspace gas chromatography. As a rule, such solvents are rather volatile; therefore, a large amount of solvent vapour enters into the headspace together with the analyte. Because of that, the determination sensitivity of the analyte is reduced, a huge solvent peak in the chromatogram can overlap with the peaks of the analyts. The sensitivity is also limited by the fact that the sample can’t be heated at a higher temperature than the solvent boiling point. In 2018 it was suggested to replace traditional headspace gas chromatographic solvents with non-volatile, eco-friendly, biodegradable, inexpensive, and easy to prepare deep eutectic solvents (DESs). Generally, deep eutectic solvents have low vapour pressure, a relatively wide liquid range, much lower melting point than that of any of their individual components. Those features make DESs very attractive as matrix media for application in headspace gas chromatography. Also, DESs are polar compounds, so they can be applied for microwave assisted extraction. The aim of this work was to investigate the possibility of applying deep eutectic solvents for microwave assisted extraction and headspace gas chromatographic determination of hexanal in fat-rich food. Hexanal is considered one of the most suitable indicators of lipid oxidation degree as it is the main secondary oxidation product of linoleic acid, which is one of the principal fatty acids of many edible oils. Eight hydrophilic and hydrophobic deep eutectic solvents have been synthesized, and the influence of the temperature and microwaves on their headspace gas chromatographic behaviour has been investigated. Using the most suitable DES, microwave assisted extraction conditions and headspace gas chromatographic conditions have been optimized for the determination of hexanal in potato chips. Under optimized conditions, the quality parameters of the prepared technique have been determined. The suggested technique was applied for the determination of hexanal in potato chips and other fat-rich food.

Keywords: deep eutectic solvents, headspace gas chromatography, hexanal, microwave assisted extraction

Procedia PDF Downloads 175
1530 Numerical Board Game for Low-Income Preschoolers

Authors: Gozde Inal Kiziltepe, Ozgun Uyanik

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There is growing evidence that socioeconomic (SES)-related differences in mathematical knowledge primarily start in early childhood period. Preschoolers from low-income families are likely to perform substantially worse in mathematical knowledge than their counterparts from middle and higher income families. The differences are seen on a wide range of recognizing written numerals, counting, adding and subtracting, and comparing numerical magnitudes. Early differences in numerical knowledge have a permanent effect childrens’ mathematical knowledge in other grades. In this respect, analyzing the effect of number board game on the number knowledge of 48-60 month-old children from disadvantaged low-income families constitutes the main objective of the study. Participants were the 71 preschoolers from a childcare center which served low-income urban families. Children were randomly assigned to the number board condition or to the color board condition. The number board condition included 35 children and the color board game condition included 36 children. Both board games were 50 cm long and 30 cm high; had ‘The Great Race’ written across the top; and included 11 horizontally arranged, different colored squares of equal sizes with the leftmost square labeled ‘Start’. The numerical board had the numbers 1–10 in the rightmost 10 squares; the color board had different colors in those squares. A rabbit or a bear token were presented to children for selecting, and on each trial spun a spinner to determine whether the token would move one or two spaces. The number condition spinner had a ‘1’ half and a ‘2’ half; the color condition spinner had colors that matched the colors of the squares on the board. Children met one-on-one with an experimenter for four 15- to 20-min sessions within a 2-week period. In the first and fourth sessions, children were administered identical pretest and posttest measures of numerical knowledge. All children were presented three numerical tasks and one subtest presented in the following order: counting, numerical magnitude comparison, numerical identification and Count Objects – Circle Number Probe subtest of Early Numeracy Assessment. In addition, same numerical tasks and subtest were given as a follow-up test four weeks after the post-test administration. Findings obtained from the study; showed that there was a meaningful difference between scores of children who played a color board game in favor of children who played number board game.

Keywords: low income, numerical board game, numerical knowledge, preschool education

Procedia PDF Downloads 336
1529 Reviving Customs: Examining the Vernacular Habitus in Modern Marathi Film via the Tamasha Genre

Authors: Amar Ramesh Wayal

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Marathi cinema, an integral part of India’s diverse film industry, has significantly evolved in its storytelling and aesthetics, with the Tamasha genre being central to this evolution. Tamasha, a traditional form of Marathi theatre, features vibrant dance and music, especially the rhythmic and often suggestive musical genre, lavani. It gained cinematic prominence in the 1960s with Anant Mane’s Sangtye Aika (1959), which brought and popularized Tamasha to the silver screen, and V. Shantaram’s Pinjra (1972), an iconic Tamasha drama. Despite early success, Tamasha films declined in popularity until Natarang (2010) revitalized interest in this traditional form. This study examines the relevance and evolution of the Tamasha genre in Marathi cinema through contemporary films like Ek Hota Vidushak by Jabbar Patel (1992), Natarang (2010) by Ravi Jadhav, and Tamasha Live (2022) by Sanjay Jadhav. The selection of the films is based on their significant roles in the evolution of the Tamasha in Marathi cinema. Ek Hota Vidushak explores socio-political themes through Tamasha, Natarang depicts the struggles and emotional depth of Tamasha performers, and Tamasha Live integrates traditional Tamasha into modern cinema. By analysing films from different periods, this study highlights the genre’s reinterpretation and adaptation over time. The study employs a qualitative approach, utilizing textual analysis and cultural critique to examine the portrayal and evolution of Tamasha in selected films. It aims to illuminate the complex relationship between tradition and modernity in Marathi cinema through Foucauldian discourse analysis and Pierre Bourdieu’s concept of “vernacular habitus,” which refers to local, indigenous cultural spaces that shape people’s perceptions and expressions. By analyzing these films, the study seeks to understand how traditional cultural forms are integrated into contemporary cinematic narratives. However, this method has limitations, such as subjectivity in interpretation and the need for extensive contextual knowledge. Qualitative research can be subject to researcher bias, affecting analysis and conclusions. To mitigate this, this study maintains rigorous reflexivity and transparency regarding the researcher’s positionality. Furthermore, findings from specific film analyses may not be universally applicable to all Tamasha films or broader Marathi cinema. To enhance the study’s robustness, future research could incorporate comparative or quantitative data to complement qualitative insights. Despite these challenges, qualitative research is crucial for exploring cultural artifacts and their significance within specific contexts. By triangulating qualitative findings with diverse perspectives and acknowledging limitations, this study aims to provide a nuanced understanding of how Tamasha cinema preserves and revitalizes Maharashtra’s folk traditions while adapting them to contemporary contexts. Analyzing films by Jabbar Patel, Ravi Jadhav, and Sanjay Jadhav shows how these filmmakers balance traditional aesthetics with modern storytelling, bridging historical continuity with contemporary relevance. This study offers insights into how indigenous traditions like Tamasha continue to shape and define cinematic narratives in Maharashtra.

Keywords: Marathi cinema, Tamasha genre, vernacular habitus, discourse analysis, cultural evolution

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1528 Moderate Electric Field Influence on Carotenoids Extraction Time from Heterochlorella luteoviridis

Authors: Débora P. Jaeschke, Eduardo A. Merlo, Rosane Rech, Giovana D. Mercali, Ligia D. F. Marczak

Abstract:

Carotenoids are high value added pigments that can be alternatively extracted from some microalgae species. However, the application of carotenoids synthetized by microalgae is still limited due to the utilization of organic toxic solvents. In this context, studies involving alternative extraction methods have been conducted with more sustainable solvents to replace and reduce the solvent volume and the extraction time. The aim of the present work was to evaluate the extraction time of carotenoids from the microalgae Heterochlorella luteoviridis using moderate electric field (MEF) as a pre-treatment to the extraction. The extraction methodology consisted of a pre-treatment in the presence of MEF (180 V) and ethanol (25 %, v/v) for 10 min, followed by a diffusive step performed for 50 min using a higher ethanol concentration (75 %, v/v). The extraction experiments were conducted at 30 °C and, to keep the temperature at this value, it was used an extraction cell with a water jacket that was connected to a water bath. Also, to enable the evaluation of MEF effect on the extraction, control experiments were performed using the same cell and conditions without voltage application. During the extraction experiments, samples were withdrawn at 1, 5 and 10 min of the pre-treatment and at 1, 5, 30, 40 and 50 min of the diffusive step. Samples were, then, centrifuged and carotenoids analyses were performed in the supernatant. Furthermore, an exhaustive extraction with ethyl acetate and methanol was performed, and the carotenoids content found for this analyses was considered as the total carotenoids content of the microalgae. The results showed that the application of MEF as a pre-treatment to the extraction influenced the extraction yield and the extraction time during the diffusive step; after the MEF pre-treatment and 50 min of the diffusive step, it was possible to extract up to 60 % of the total carotenoids content. Also, results found for carotenoids concentration of the extracts withdrawn at 5 and 30 min of the diffusive step did not presented statistical difference, meaning that carotenoids diffusion occurs mainly in the very beginning of the extraction. On the other hand, the results for control experiments showed that carotenoids diffusion occurs mostly during 30 min of the diffusive step, which evidenced MEF effect on the extraction time. Moreover, carotenoids concentration on samples withdrawn during the pre-treatment (1, 5 and 10 min) were below the quantification limit of the analyses, indicating that the extraction occurred in the diffusive step, when ethanol (75 %, v/v) was added to the medium. It is possible that MEF promoted cell membrane permeabilization and, when ethanol (75 %) was added, carotenoids interacted with the solvent and the diffusion occurred easily. Based on the results, it is possible to infer that MEF promoted the decrease of carotenoids extraction time due to the increasing of the permeability of the cell membrane which facilitates the diffusion from the cell to the medium.

Keywords: moderate electric field (MEF), pigments, microalgae, ethanol

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1527 Infestation in Omani Date Palm Orchards by Dubas Bug Is Related to Tree Density

Authors: Lalit Kumar, Rashid Al Shidi

Abstract:

Phoenix dactylifera (date palm) is a major crop in many middle-eastern countries, including Oman. The Dubas bug Ommatissus lybicus is the main pest that affects date palm crops. However not all plantations are infested. It is still uncertain why some plantations get infested while others are not. This research investigated whether tree density and the system of planting (random versus systematic) had any relationship with infestation and levels of infestation. Remote Sensing and Geographic Information Systems were used to determine the density of trees (number of trees per unit area) while infestation levels were determined by manual counting of insects on 40 leaflets from two fronds on each tree, with a total of 20-60 trees in each village. The infestation was recorded as the average number of insects per leaflet. For tree density estimation, WorldView-3 scenes, with eight bands and 2m spatial resolution, were used. The Local maxima method, which depends on locating of the pixel of highest brightness inside a certain exploration window, was used to identify the trees in the image and delineating individual trees. This information was then used to determine whether the plantation was random or systematic. The ordinary least square regression (OLS) was used to test the global correlation between tree density and infestation level and the Geographic Weight Regression (GWR) was used to find the local spatial relationship. The accuracy of detecting trees varied from 83–99% in agricultural lands with systematic planting patterns to 50–70% in natural forest areas. Results revealed that the density of the trees in most of the villages was higher than the recommended planting number (120–125 trees/hectare). For infestation correlations, the GWR model showed a good positive significant relationship between infestation and tree density in the spring season with R² = 0.60 and medium positive significant relationship in the autumn season, with R² = 0.30. In contrast, the OLS model results showed a weaker positive significant relationship in the spring season with R² = 0.02, p < 0.05 and insignificant relationship in the autumn season with R² = 0.01, p > 0.05. The results showed a positive correlation between infestation and tree density, which suggests the infestation severity increased as the density of date palm trees increased. The correlation result showed that the density alone was responsible for about 60% of the increase in the infestation. This information can be used by the relevant authorities to better control infestations as well as to manage their pesticide spraying programs.

Keywords: dubas bug, date palm, tree density, infestation levels

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1526 Systems Strengthening for Sustainable Family Planning Service Provision in Uganda

Authors: D. Muyama, M. Luyiga, P. Buyungo, D. Chemonges, M. Namukwaya, L. Ssekabembe, B. Lukwago, D. Kyamagwa

Abstract:

Context: The study focuses on the sustainability of health interventions in Uganda, particularly in the private sector, beyond donor-funded project periods. The Population Services International (PSI) implemented the Women Health Project (WHP) to ensure continued access to quality family planning, cervical cancer screening, and post-abortion care services through private clinics. Research Aim: The aim of the study is to assess the continued access to quality family planning, cervical cancer screening, and post-abortion care services through the private sector after the closure or reduction in funding of the WHP. Methodology: PSI trained and mentored 83 clinics to establish functional systems in self-regulatory quality improvement, supply chain, referral, and demand creation. The clinics were also connected to the national reporting system and utilized Ministry of Health reporting tools. An assessment tool with six criteria was designed and used to evaluate the progress of the clinics. Clinics scoring 75% and above were considered independent and graduated from the program. Findings: Out of the 83 private clinics, 56 successfully met the graduation criteria and graduated from the program, while 25 lost interest and were gradually dropped. Two clinics failed to achieve the criteria due to leadership challenges. The 59 graduating clinics continued to provide high-quality family planning services, including IUD, implant, Depo-Provera, oral contraceptives, and post-abortion care. All graduating clinics were reassessed and found to still be capable of offering services, attributing their success to government stock availability and acquired skills through mentorships. The clinics expressed appreciation to PSI for the sustainable plan that allowed them to operate beyond the project period. Theoretical Importance: This study contributes to the understanding of sustainability planning and the importance of clinic owners' attitudes and buy-in for continued service provision. It emphasizes the implementation of sustainability plans through existing structures to leverage available resources and ensure continuity of care. Data Collection and Analysis Procedures: The study collected data through the assessment tool that evaluated the progress of clinics based on the established criteria. The tool was scored out of 100%, and clinics scoring above 75% were deemed independent. The findings were analyzed quantitatively to determine the success rate of clinics in meeting the graduation criteria. Questions Addressed: The study addresses the question of whether private clinics in Uganda can sustain the provision of family planning, cervical cancer screening, and post-abortion care services after the closure or reduction in funding of the WHP. Conclusion: The study concludes that the attitude and buy-in of clinic owners are essential for sustainability planning. Implementing sustainability plans through existing structures and leveraging available resources are crucial for the continuity of care after the end of a project or reduced funding. The findings highlight the importance of establishing sustainable plans to ensure continued access to essential health services beyond the project period. Contributions: This study contributes to the existing knowledge for programmers implementing or intending to implement donor-funded projects. It provides insights into designing sustainable plans that enable the independent operation of clinics even after the end of a project.

Keywords: graduation, family planning, systems strengthening, sustainability

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1525 Cytokine Profiling in Cultured Endometrial Cells after Hormonal Treatment

Authors: Mark Gavriel, Ariel J. Jaffa, Dan Grisaru, David Elad

Abstract:

The human endometrium-myometrium interface (EMI) is the uterine inner barrier without a separatig layer. It is composed of endometrial epithelial cells (EEC) and endometrial stromal cells (ESC) in the endometrium and myometrial smooth muscle cells (MSMC) in the myometrium. The EMI undergoes structural remodeling during the menstruation cycle which are essential for human reproduction. Recently, we co-cultured a layer-by-layer in vitro model of EEC, ESC and MSMC on a synthetic membrane for mechanobiology experiments. We also treated the model with progesterone and β-estradiol in order to mimic the in vivo receptive uterus In the present study we analyzed the cytokines profile in a single layer of EEC the hormonal treated in vitro model of the EMI. The methodologies of this research include simple tissue-engineering . First, we cultured commercial EEC (RL95-2, ATCC® CRL-1671™) in 24-wellplate. Then, we applied an hormonal stimuli protocol with 17-β-estradiol and progesterone in time dependent concentration according to the human physiology that mimics the menstrual cycle. We collected cell supernatant samples of control, pre-ovulation, ovulation and post-ovulaton periods for analysis of the secreted proteins and cytokines. The cytokine profiling was performed using the Proteome Profiler Human XL Cytokine Array Kit (R&D Systems, Inc., USA) that can detect105 human soluble cytokines. The relative quantification of all the cytokines will be analyzed using xMAP – LUMINEX. We conducted a fishing expedition with the 4 membranes Proteome Profiler. We processed the images, quantified the spots intensity and normalized these values by the negative control and reference spots at the membrane. Analyses of the relative quantities that reflected change higher than 5% of the control points of the kit revealed the The results clearly showed that there are significant changes in the cytokine level for inflammation and angiogenesis pathways. Analysis of tissue-engineered models of the uterine wall will enable deeper investigation of molecular and biomechanical aspects of early reproductive stages (e.g. the window of implantation) or developments of pathologies.

Keywords: tissue-engineering, hormonal stimuli, reproduction, multi-layer uterine model, progesterone, β-estradiol, receptive uterine model, fertility

Procedia PDF Downloads 112