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Authors: Jasmeet Kaur, Anup Singh, Shashikant Iyengar, Arun Kumar, Ira Sahay

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Latent autoimmune diabetes in adults (LADA) is an irreversible autoimmune disease that affects insulin production. LADA is characterized by the production of Glutamic acid decarboxylase (GAD) antibodies, which is similar to type 1 diabetes. Individuals with LADA may eventually develop overt diabetes and require insulin. In this condition, the pancreas produces little or no insulin, which is a hormone used by the body to allow glucose to enter cells and produce energy. While type 1 diabetes was traditionally associated with children and teenagers, its prevalence has increased in adults as well. LADA is frequently misdiagnosed as type 2 diabetes, especially in adulthood when type 2 diabetes is more common. LADA develops in adulthood, usually after age 30. Managing LADA involves metabolic control with exogenous insulin and prolonging the life of surviving beta cells, thereby slowing the disease's progression. This case study examines the impact of approximately 3 months of low-carbohydrate dietary intervention in a 42-year-old woman with LADA who was initially misdiagnosed as having type 2 diabetes. Her c-peptide was 0.13 and her HbA1c was 9.3% when this trial began. Low-carbohydrate interventions have been shown to improve blood sugar levels, including fasting, post-meal, and random blood sugar levels, as well as haemoglobin levels, blood pressure, energy levels, sleep quality, and satiety levels. The use of low-carbohydrate dietary intervention significantly reduces both hypo- and hyperglycaemia events. During the 3 months of the study, there were 2 to 3 hyperglycaemic events owing to physical stress and a single hypoglycaemic event. Low-carbohydrate dietary therapies lessen insulin dose inaccuracy, which explains why there were fewer hyperglycaemic and hypoglycaemic events. In three months, the glycated haemoglobin (HbA1c) level was reduced from 9.3% to 6.3%. These improvements occur without the need for caloric restriction or physical activity. Stress management was crucial aspect of the treatment plan as stress-induced neuroendocrine hormones can cause immunological dysregulation. Additionally, supplements that support immune system and reduce inflammation were used as part of the treatment during the trial. Long-term studies are needed to track disease development and corroborate the claim that such dietary treatments can prolong the honeymoon phase in LADA. Various factors can contribute to additional autoimmune attacks, so measuring c-peptide is crucial on a regular basis to determine whether insulin levels need to be adjusted.

Keywords: autoimmune, diabetes, LADA, low_carb, nutrition

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Authors: Mustafa M. Donma, Orkide Donma

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The examination of both serum lipid fractions and body’s lipid composition are quite informative during the evaluation of obesity stages. Within this context, alterations in lipid parameters are commonly observed. The variations in the fat distribution of the body are also noteworthy. Total cholesterol (TC), triglycerides (TRG), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C) are considered as the basic lipid fractions. Fat deposited in trunk and extremities may give considerable amount of information and different messages during discrete health states. Ratios are also derived from distinct fat distribution in these areas. Trunk-to-leg fat ratio (TLFR) and trunk-to-appendicular fat ratio (TAFR) are the most recently introduced ratios. In this study, lipid fractions and TLFR, as well as TAFR, were evaluated, and the distinctions among healthy, obese (OB), and morbid obese (MO) groups were investigated. Three groups [normal body mass index (N-BMI), OB, MO] were constituted from a population aged 6 to 18 years. Ages and sexes of the groups were matched. The study protocol was approved by the Non-interventional Ethics Committee of Tekirdag Namik Kemal University. Written informed consent forms were obtained from the parents of the participants. Anthropometric measurements (height, weight, waist circumference, hip circumference, head circumference, neck circumference) were obtained and recorded during the physical examination. Body mass index values were calculated. Total, trunk, leg, and arm fat mass values were obtained by TANITA Bioelectrical Impedance Analysis. These values were used to calculate TLFR and TAFR. Systolic (SBP) and diastolic blood pressures (DBP) were measured. Routine biochemical tests including TC, TRG, LDL-C, HDL-C, and insulin were performed. Data were evaluated using SPSS software. p value smaller than 0.05 was accepted as statistically significant. There was no difference among the age values and gender ratios of the groups. Any statistically significant difference was not observed in terms of DBP, TLFR as well as serum lipid fractions. Higher SBP values were measured both in OB and MO children than those with N-BMI. TAFR showed a significant difference between N-BMI and OB groups. Statistically significant increases were detected between insulin values of N-BMI group and OB as well as MO groups. There were bivariate correlations between LDL and TLFR (r=0.396; p=0.037) as well as TAFR values (r=0.413; p=0.029) in MO group. When adjusted for SBP and DBP, partial correlations were calculated as (r=0.421; p=0.032) and (r=0.438; p=0.025) for LDL-TLFR as well as LDL-TAFR, respectively. Much stronger partial correlations were obtained for the same couples (r=0.475; p=0.019 and r=0.473; p=0.020, respectively) upon controlling for TRG and HDL-C. Much stronger partial correlations observed in MO children emphasize the potential transition from morbid obesity to metabolic syndrome. These findings have concluded that LDL-C may be suggested as a discriminating parameter between OB and MO children.

Keywords: children, lipid parameters, obesity, trunk-to-leg fat ratio, trunk-to-appendicular fat ratio

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Authors: Jonathan A. Noble

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‘Origins’ is an exhibition designed and installed by MMA Design Studio, at the 2023 Venice Biennale. The instillation formed part of the ‘Dangerous Liaisons’ group exhibition at the Arsenale building. An immersive experience was created for those who visited, where video projection and the bodies of visitors interacted with the scene. Designed by South African architect, Mphethi Morojele – founder and owner of MMA – the primary inspiration for ‘Origins’ was the recent discovery by Professor Karim Sadr in 2019, of a substantial Tswana settlement. Situated in present day Suikerbosrand Nature Reserve, some 45km south of Johannesburg, this precolonial city named Kweneng, has been dated back to the fifteenth century. This remarkable discovery was achieved thanks to advanced aerial, LiDAR scanning technology, which was used to capture the traces of Kweneng, spanning a terrain of some 10km long and 2km wide. Discovered by light (LiDAR) and exhibited through light, Origins presents a simulated experience of Kweneng. The presentation of Kweneng was achieved primarily though video, with a circular projection onto the floor of an animated LiDAR data sequence, and onto the walls a filmed dance sequence choreographed to embody the architectural, spatial and symbolic significance of Kweneng. This paper documents the design process that was involved in the conceptualization, development and final realization of this noteworthy exhibition, with an elucidation upon key social and cultural questions pertaining to precolonial heritage, reimagined histories and postcolonial identity. Periods of change and of social awakening sometimes spark an interest in questions of origin, of cultural lineage and belonging – and which certainly is the case for contemporary, post-Apartheid South Africa. Researching this paper has required primary study of MMA Design Studio’s project archive, including various proposals and other design related documents, conceptual design sketches, architectural drawings and photographs. This material is supported by the authors first-hand interviews with Morejele and others who were involved, especially with respect to the choreography of the interpretive dance, LiDAR visualization techniques and video production that informed the simulated, immersive experience at the exhibition. Presenting a ‘dangerous liaison’ between architecture and dance, Origins looks into the distant past to frame contemporary questions pertaining to intangible heritage, animism and embodiment through architecture and dance – considerations which are required “to survive the future”, says Morojele.

Keywords: architecture and dance, Kweneng, MMA design studio, origins, Venice Biennale

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Authors: M. H. A. D. de Silva, R. P. Hewawasam, M. A. G. Iresha

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Macrosomia is common in infants born to not only women diagnosed with gestational diabetes mellitus but also non-diabetic obese women. Maternal Body Mass Index (BMI) correlates with the incidence of large for gestational age infants. Obesity has reached epidemic levels in modern societies. During the past two decades, obesity in children and adolescents has risen significantly in Asian populations including Sri Lanka. There is increasing evidence to believe that infants who are born large for gestational age are more likely to be obese in childhood and adolescence and are at risk of cardiovascular and metabolic complications later in life. It is also established that Asians have lower skeletal muscle mass, low bone mineral content and excess body fat for a given BMI indicating a genetic predisposition in the occurrence of obesity. The objective of this study is to determine the effect of maternal weight, weight gain during pregnancy, c-peptide and insulin concentrations in the cord blood on the birth of appropriate for and large for gestational age infants in a tertiary care center in Southern Sri Lanka. Umbilical cord blood was collected from 90 newborns (Male 40, Female 50; gestational age 35-42 weeks) after double clamping the umbilical cord before separation of the placenta and the concentration of insulin and C-peptide were measured by ELISA technique. Anthropometric parameters of the newborn such as birth weight, length, ponderal index, occipital frontal, chest, hip and calf circumferences were measured, and characteristics of the mother were collected. The relationship between insulin, C-peptide and anthropometrics were assessed by Spearman correlation. The multiple logistic regression analysis examined influences of maternal weight, weight gain during pregnancy, C-peptide and insulin concentrations in cord blood as covariates on the birth of large for gestational age infants. A significant difference (P<0.001) was observed between the insulin levels of infants born large for gestational age (18.73 ± 0.52 µlU/ml) and appropriate for gestational age (13.08 ± 0.56 µlU/ml). Consistently, A significant decrease in concentration (41.68%, P<0.001) was observed between C-peptide levels of infants born large for gestational age and appropriate for gestational age. Cord blood insulin and C-peptide levels had a significant correlation with birth weight (r=0.35, P<0.05) of the newborn at delivery. Maternal weight and BMI which are indicators of maternal nutrition were proven to be directly correlated with birth weight and length. To our knowledge, this relationship was investigated for the first time in a Sri Lankan setting and was also evident in our results. This study confirmed the fact that insulin and C-peptide play a major role in regulating fetal growth. According to the results obtained in this study, we can suggest that the increased BMI of the mother has a direct influence on increased maternal insulin secretion, which may subsequently affect cord insulin and C-peptide levels and also birth weight of the infant.

Keywords: C-peptide, insulin, large for gestational age, maternal weight

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Authors: Remy Mpulumba Badiambile, Paul Musa Obadia, Malick Useni Mutayo, Jeef Numbi Mukanya, Patient Nkulu Banza, Tony Kayembe Kitenge, Erik Smolders, Jean-François Picron, Vincent Haufroid, Célestin Banza Lubaba Nkulu, Benoit Nemery

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Background: In July 2021, the Tshikapa river became heavily polluted by mining wastes from a diamond mine in neighboring Angola, leading to massive killing of fish, as well as disease and even deaths among residents living along the Tshikapa and Kasai rivers, a major contributory of the Congo river. The exact nature of the pollutants was unknown. Methods: In a cross-sectional study conducted in the city of Tshikapa in August 2021, we enrolled by opportunistic sampling 65 residents (11 children < 16y) living alongside the polluted rivers and 65 control residents (5 children) living alongside a non-affected portion of the Kasai river (upstream from the Tshikapa-Kasai confluence). We administered a questionnaire and obtained spot urine samples for measurements of thiocyanate (a metabolite of cyanide) and 26 trace metals (by ICP-MS). Metals (and pH) were also measured in samples of river water. Results: Participants from both groups consumed river water. In the area affected by the pollution, most participants had eaten dead fish. Prevalences of reported health symptoms were higher in the exposed group than among controls: skin rashes (52% vs 0%), diarrhea (40% vs 8%), abdominal pain (8% vs 3%), nausea (3% vs 0%). In polluted water, concentrations [median (range)] were only higher for nickel [(2.2(1.4–3.5)µg/L] and uranium [78(71–91)ng/L] than in non-polluted water [0.8(0.6–1.9)µg/L; 9(7–19)ng/L]. In urine, concentrations [µg/g creatinine, median(IQR)] were significantly higher in the exposed group than in controls for lithium [19.5(12.4–27.3) vs 6.9(5.9–12.1)], thallium [0.41(0.31–0.57) vs 0.19(0.16–0.39)], and uranium [0.026(0.013–0.037)] vs 0.012(0.006–0.024)]. Other elements did not differ between the groups, but levels were higher than reference values for several metals (including manganese, cobalt, nickel, and lead). Urinary thiocyanate concentrations did not differ. Conclusion: This study, after an ecological disaster in the DRC, has documented contamination of river water by nickel and uranium and high urinary levels of some trace metals among affected riverine populations. However, the exact cause of the massive fish kill and disease among residents remains elusive. The capacity to rapidly investigate toxic pollution events must be increased in the area.

Keywords: metal contaminants, river water and human urine, pollution by mining wastes, DR Congo

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Authors: Elkington S. Mnguni

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Water and sanitation services in South Africa are characterized by both achievements and challenges. After the end of apartheid in 1994 the newly elected government faced the challenge of eradicating backlogs with respect to access to basic services, including water and sanitation. Capital investment made in the development of new water and sanitation infrastructure to provide basic services to previously disadvantaged communities has grown, to a certain extent, at the expense of investment in the operation and maintenance of new and existing infrastructure. Challenges resulting from aging infrastructure and poor plant performance highlight the need for investing in the maintenance, rehabilitation, and replacement of existing infrastructure to optimize the return on investment. Advanced water infrastructure asset management (IAM) is key to achieving adequate levels of service, particularly with regard to reliable and high quality drinking water supply, prevention of urban flooding, efficient use of natural resources and prevention of pollution and associated risks. Against this backdrop, this paper presents an appraisal of water and sanitation IAM systems in South Africa’s three utilities, being metropolitan cities in the Gauteng Province. About a quarter of the national population lives in the three rapidly urbanizing cities of Johannesburg, Ekurhuleni and Tshwane, located in a semi-arid region. A literature review has been done and field visits to some of the utility facilities are being conducted. Semi-structured interviews will be conducted with the three utilities. The following critical factors are being analysed in terms of compliance with the national Water Services IAM Strategy (2011) and other applicable legislation: asset registers; capacity of assets; current and predicted demand; funding availability / budget allocations; plans: operation & maintenance, renewal & replacement, and risk management; no-drop status (non-revenue water levels); blue drop status (water quality); green drop status (effluent quality); and skills availability. Some of the key challenges identified in the literature review include: funding constraints, Skills shortage, and wastewater treatment plants operating beyond their design capacities. These challenges will be verified during field visits and research interviews. Gaps between literature and practice will be identified and relevant recommendations made if necessary. The objective of this study is to contribute to the resolution of the challenges brought about by the backlogs in the operation and maintenance of water and sanitation assets in the country in general, and in the three cities in particular, thus improving the sustainability thereof.

Keywords: asset management, backlogs, levels of service, sustainability, water and sanitation infrastructure

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Authors: Zheng Wang, Zhenhong Li, Jon Mills

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Ground-based synthetic aperture radar (GBSAR) represents a powerful remote sensing tool for deformation monitoring towards various geohazards, e.g. landslides, mudflows, avalanches, infrastructure failures, and the subsidence of residential areas. Unlike spaceborne SAR with a fixed revisit period, GBSAR data can be acquired with an adjustable temporal resolution through either continuous or discontinuous operation. However, challenges arise from processing high temporal-resolution continuous GBSAR data, including the extreme cost of computational random-access-memory (RAM), the delay of displacement maps, and the loss of temporal evolution. Moreover, repositioning errors between discontinuous campaigns impede the accurate measurement of surface displacements. Therefore, a versatile package with two complete chains is developed in this study in order to process both continuous and discontinuous GBSAR data and address the aforementioned issues. The first chain is based on a small-baseline subset concept and it processes continuous GBSAR images unit by unit. Images within a window form a basic unit. By taking this strategy, the RAM requirement is reduced to only one unit of images and the chain can theoretically process an infinite number of images. The evolution of surface displacements can be detected as it keeps temporarily-coherent pixels which are present only in some certain units but not in the whole observation period. The chain supports real-time processing of the continuous data and the delay of creating displacement maps can be shortened without waiting for the entire dataset. The other chain aims to measure deformation between discontinuous campaigns. Temporal averaging is carried out on a stack of images in a single campaign in order to improve the signal-to-noise ratio of discontinuous data and minimise the loss of coherence. The temporal-averaged images are then processed by a particular interferometry procedure integrated with advanced interferometric SAR algorithms such as robust coherence estimation, non-local filtering, and selection of partially-coherent pixels. Experiments are conducted using both synthetic and real-world GBSAR data. Displacement time series at the level of a few sub-millimetres are achieved in several applications (e.g. a coastal cliff, a sand dune, a bridge, and a residential area), indicating the feasibility of the developed GBSAR data processing package for deformation monitoring of a wide range of scientific and practical applications.

Keywords: ground-based synthetic aperture radar, interferometry, small baseline subset algorithm, deformation monitoring

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Authors: Akinola Helen Olufunke, Soetan Olatunbosun Jonathan, Adeleye Oludamola

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Introduction: Antibiotic resistance has grown significantly, which is a major cause for concern. There have not been many significant developments in antibiotics over the past few decades, and practically all of the ones that are currently in use are losing effectiveness against pathogenic germs. Researchers are starting to focus more on the physiologically active compounds found in plants, particularly phytobiotics in poultry production. Consumption of chicken products is among the greatest in the country, but numerous nations, including Nigeria, use excessive amounts of necessary antibiotics in poultry farming, endangering the safety of such goods (through antimicrobial residues). Drug resistance has become a widespread issue as a result of the risky use of antibiotics in the chicken production industry. In order to replace antibiotics, biotic or natural products like phytobiotics (also known as botanicals or phytogenics) have drawn a lot of interest. Phytobiotics or their components are thought to be a relatively recent category of natural herbs that have acquired acceptance and favor among chicken farmers. The addition of several phytobiotic additions to poultry feed has demonstrated its capacity to improve both the broiler and layer populations' productivity. Design: Experimental research design and cross-sectional study was carried out at every 300 purposively selected farming household in the six-geopolitical zone in Nigeria. Data Analysis: A semi-structured questionnaire was administered to each farmer, and quantitative data were analyzed using Statistical Package for Social Science (SPSS) while the Chi-square test was used to analyze factors mitigating the use of Phytobiotics. Result: The result shows that the benefits associated with the use of phytobiotics are contributed to growth promotion in chickens and enhancement of productive performance of broiler and layer, which could be attributed to their antioxidant activity. The result further revealed that factors mitigating the use of phytobiotics were lack of knowledge in the use of phytobiotics, overdose or underdose usage, and seasonal availability of the phytobiotics. Others are the educational level of the farmers, intrinsic motivation, income poultry farming experience, price of phytobiotics based additives feeds, and intensity of extension agents in visiting them. Conclusion: The difficulties associated with using phytobiotics in chicken farms limit their willingness to boost productivity. The study found that most farmers were ignorant, which prevented them from handling this notion and turning their poultry into a viable enterprise while also allowing them to be creative. They believed that packing phytobiotics-based additive feed was expensive, and lastly, the seasonal availability of some phytobiotics. Recommendation: Further research in phytobiotics use in Nigeria should be carried out in order to establish its efficiency, safety, and awareness.

Keywords: mitigating, antibiotics, phytobiotics, poultry farming

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Authors: Sunidhi Sood, Drashti Narendrakumar Shah, Aakarsh Sharma, Nirali Harsh Panchal, Maria Karizhenskaia

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Cancer is a global health concern, causing a significant number of deaths, with chemotherapy being a standard treatment method. However, chemotherapy often induces side effects that profoundly impact the physical and emotional well-being of patients, lowering their overall quality of life (QoL). This research aims to investigate the potential of music and art therapy as holistic adjunctive therapy for cancer patients undergoing chemotherapy, offering non-pharmacological support. This is achieved through a comprehensive review of existing literature with a focus on the following themes, including stress and anxiety alleviation, emotional expression and coping skill development, transformative changes, and pain management with mood upliftment. A systematic search was conducted using Medline, Google Scholar, and St. Lawrence College Library, considering original, peer-reviewed research papers published from 2014 to 2023. The review solely incorporated studies focusing on the impact of music and art therapy on the health and overall well-being of cancer patients undergoing chemotherapy in North America. The findings from 16 studies involving pediatric oncology patients, females affected by breast cancer, and general oncology patients show that music and art therapies significantly reduce anxiety (standardized mean difference: -1.10) and improve perceived stress (median change: -4.0) and overall quality of life in cancer patients undergoing chemotherapy. Furthermore, music therapy has demonstrated the potential to decrease anxiety, depression, and pain during infusion treatments (average changes in resilience scale: 3.4 and 4.83 for instrumental and vocal music therapy, respectively). This data calls for consideration of the integration of music and art therapy into supportive care programs for cancer patients undergoing chemotherapy. Moreover, it provides guidance to healthcare professionals and policymakers, facilitating the development of patient-centered strategies for cancer care in Canada. Further research is needed in collaboration with qualified therapists to examine its applicability and explore and evaluate patients' perceptions and expectations in order to optimize the therapeutic benefits and overall patient experience. In conclusion, integrating music and art therapy in cancer care promises to substantially enhance the well-being and psychosocial state of patients undergoing chemotherapy. However, due to the small population size considered in existing studies, further research is needed to bridge the knowledge gap and ensure a comprehensive, patient-centered approach, ultimately enhancing the quality of life (QoL) for individuals facing the challenges of cancer treatment.

Keywords: anxiety, cancer, chemotherapy, depression, music and art therapy, pain management, quality of life

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Authors: Taurino S. R. Neto, Epitácio D. S. Neto, Flávio Signorelli, Gustavo G. M. Balbi, Alex H. Higashi, Mário Luiz R. Monteiro, Eloisa Bonfá, Danieli C. O. Andrade, Leandro C. Zacharias

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Purpose: To perform a multimodal evaluation, including the use of Optical Coherence Angiotomography (OCTA), in patients with primary antiphospholipid syndrome (PAPS) without ocular complaints and to compare them with healthy individuals. Methods: A complete structural and functional ophthalmological evaluation using OCTA and microperimetry (MP) exam in patients with PAPS, followed at a tertiary rheumatology outpatient clinic, was performed. All ophthalmologic manifestations were recorded and then statistical analysis was performed for comparative purposes; p <0.05 was considered statistically significant. Results: 104 eyes of 52 subjects (26 patients with PAPS without ocular complaints and 26 healthy individuals) were included. Among PAPS patients, 21 were female (80.8%) and 21 (80.8%) were Caucasians. Thrombotic PAPS was the main clinical criteria manifestation (100%); 65.4% had venous and 34.6% had arterial thrombosis. Obstetrical criteria were present in 34.6% of all thrombotic PAPS patients. Lupus anticoagulant was present in all patients. 19.2% of PAPS patients presented ophthalmologic findings against none of the healthy individuals. The most common retinal change was paracentral acute middle maculopathy (PAMM) (3 patients, 5 eyes), followed by drusen-like deposits (1 patient, 2 eyes) and pachychoroid pigment epitheliopathy (1 patient, 1 eye). Systemic hypertension and hyperlipidaemia were present in 100% of the PAPS patients with PAMM, while only six patients (26.1%) with PAPS without PAMM presented these two risk factors together. In the quantitative OCTA evaluation, we found significant differences between PAPS patients and controls in both the superficial vascular complex (SVC) and deep vascular complex (DVC) in the high-speed protocol, as well as in the SVC in the high-resolution protocol. In the analysis of the foveal avascular zone (FAZ) parameters, the PAPS group had a larger area of FAZ in the DVC using the high-speed method compared to the control group (p=0.047). In the quantitative analysis of the MP, the PAPS group had lower central (p=0.041) and global (p<0.001) retinal sensitivity compared to the control group, as well as in the sector analysis, with the exception of the inferior sector. In the quantitative evaluation of fixation stability, there was a trend towards worse stability in the PAPS subgroup with PAMM in both studied methods. Conclusions: PAMM was observed in 11.5% of PAPS patients with no previous ocular complaints. Systemic hypertension concomitant with hyperlipidemia was the most commonly associated risk factor for PAMM in patients with PAPS. PAPS patients present lower vascular density and retinal sensitivity compared to the control group, even in patients without PAMM.

Keywords: antiphospholipid syndrome, optical coherence angio tomography, optical coherence tomography, retina

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Authors: Prince S. Campbell, Janine B. Adams, Melusi Thwala, Opeoluwa Oyedele, Paula E. Melariri

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Schistosomiasis, often known as bilharzia, is a parasitic water-borne disease caused by trematode flatworms of the genus Schistosoma. Schistosomiasis infection and prevention have been found to be influenced by a range of socio-cultural risk factors, including human characteristics (e.g., gender, age, education, knowledge, attitude, and practices), as well as environmental and economic elements. Lack of awareness of the disease may also contribute to an individual's tendency to participate in behaviours or activities that heighten their susceptibility to infection. The current study assessed the community knowledge, attitude and practices (KAP) on schistosomiasis and implemented an educational intervention following pre-test interviews. A cross-sectional quasi-experimental research design was used in this quantitative study. Pre- and post-intervention interview format surveys were conducted using a structured questionnaire, targeting individuals aged 18–65 years residing within 5 km of select water bodies. The questionnaire contained 54 close-ended questions about schistosomiasis causes, transmission, and clinical symptoms and the participants were interviewed face-to-face in their homes. Data was captured on Question Pro and analyzed using Microsoft Office Excel 365 (2019) and R (version 4.3.1) software. Overall, 380 individuals completed the pre and post-intervention assessments; 194 and 185 were males (51.1%) and females (48.7%), respectively. A notable 91.3% of participants did not know about schistosomiasis in the pre-intervention phase; however, the mean post-intervention test score (9.4 ± 1.4) for knowledge among participants was higher than the pre-intervention test score (2.2 ± 2.1) indicating a good and improved knowledge of schistosomiasis among the participants. Furthermore, the paired samples t-test results demonstrated that the increase in knowledge levels was statistically significant (p<0.001). Also, the post-intervention improvement of both practice (p<0.001) and attitude (p<0.001) levels was statistically significant. A positive correlation (r=0.23, p<0.001) was found between knowledge and attitude in the pre-intervention stage. Knowledgeable participants had a more positive attitude towards obtaining medical assistance and disease prevention. Moreover, attitudes and practices correlated negatively (r=-0.13, p=0.013) post-intervention; hence, those with positive attitudes did not engage in risky water-related practices, which was the desired outcome. The educational intervention had a favourable impact on the KAP of the study population as the majority were able to recall the disease aetiology, symptoms, transmission pattern, and preventative measures three months post-intervention. Nevertheless, previous research has suggested that participants were unable to recall information about the disease following the intervention. Consequently, research should prioritize behavioural modification strategies that may result in a more persistent outcome in terms of the participants' knowledge, which could ultimately contribute to the development of long-term positive attitudes and practices.

Keywords: educational intervention, knowledge, attitudes and practices, schistosomiasis

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Authors: Abid Hussain, Binay Kumar

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Environment-friendly lead-free Na₀.₅₂K₀.₄₄Li₀.₀₄Nb₀.₈₄Ta₀.₁₀Sb₀.₀₆O₃ (NKLNTS) ceramic was synthesized by solid-state reaction method in search of a potential candidate to replace lead-based ceramics such as PbZrO₃-PbTiO₃ (PZT), Pb(Mg₁/₃Nb₂/₃)O₃-PbTiO₃ (PMN-PT) etc., for various applications. The ceramic was calcined at temperature 850 ᵒC and sintered at 1090 ᵒC. The powder X-Ray Diffraction (XRD) pattern revealed the formation of pure perovskite phase having tetragonal symmetry with space group P4mm of the synthesized ceramic. The surface morphology of the ceramic was studied using Field Emission Scanning Electron Microscopy (FESEM) technique. The well-defined grains with homogeneous microstructure were observed. The average grain size was found to be ~ 0.6 µm. A very large value of piezoelectric charge coefficient (d₃₃ ~ 754 pm/V) was obtained for the synthesized ceramic which indicated its potential for use in transducers and actuators. In dielectric measurements, a high value of ferroelectric to paraelectric phase transition temperature (Tm~305 ᵒC), a high value of maximum dielectric permittivity ~ 2110 (at 1 kHz) and a very small value of dielectric loss ( < 0.6) were obtained which suggested the utility of NKLNTS ceramic in high-temperature ferroelectric devices. Also, the degree of diffuseness (γ) was found to be 1.61 which confirmed a relaxor ferroelectric behavior in NKLNTS ceramic. P-E hysteresis loop was traced and the value of spontaneous polarization was found to be ~11μC/cm² at room temperature. The pyroelectric coefficient was obtained to be very high (p ∼ 1870 μCm⁻² ᵒC⁻¹) for the present case indicating its applicability in pyroelectric detector applications including fire and burglar alarms, infrared imaging, etc. NKLNTS ceramic showed fatigue free behavior over 107 switching cycles. Remanent hysteresis task was performed to determine the true-remanent (or intrinsic) polarization of NKLNTS ceramic by eliminating non-switchable components which showed that a major portion (83.10 %) of the remanent polarization (Pr) is switchable in the sample which makes NKLNTS ceramic a suitable material for memory switching devices applications. Time-Dependent Compensated (TDC) hysteresis task was carried out which revealed resistive leakage free nature of the ceramic. The performance of NKLNTS ceramic was found to be superior to many lead based piezoceramics and hence can effectively replace them for use in piezoelectric, pyroelectric and long duration ferroelectric applications.

Keywords: dielectric properties, ferroelectric properties , lead free ceramic, piezoelectric property, solid state reaction, true-remanent polarization

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Authors: Dongwoo Kang, Yunsung Yoo, Injun Kim, Jongin Lee, Jinwon Park

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Since industrial revolution, energy usage by human-beings has been drastically increased resulting in the enormous emissions of carbon dioxide into the atmosphere. High concentration of carbon dioxide is well recognized as the main reason for the climate change by breaking the heat equilibrium of the earth. In order to decrease the amount of carbon dioxide emission, lots of technologies have been developed. One of the methods is to capture carbon dioxide after combustion process using liquid type absorbents. However, for some nations, captured carbon dioxide cannot be treated and stored properly due to their geological structures. Also, captured carbon dioxide can be leaked out when crust activities are active. Hence, the method to convert carbon dioxide as stable and useful products were developed. It is usually called CCU, that is, Carbon Capture and Utilization. There are several ways to convert carbon dioxide into useful substances. For example, carbon dioxide can be converted and used as fuels such as diesel, plastics, and polymers. However, these types of technologies require lots of energy to make stable carbon dioxide into a reactive one. Hence, converting it into metal carbonates salts have been studied widely. When carbon dioxide is captured by alkanolamine-based liquid absorbents, it exists as ionic forms such as carbonate, carbamate, and bicarbonate. When adequate metal ions are added, metal carbonate salt can be produced by ionic reaction with fast reaction kinetics. However, finding metal sources can be one of the problems for this method to be commercialized. If natural resources such as calcium oxide were used to supply calcium ions, it is not thought to have the economic feasibility to use natural resources to treat carbon dioxide. In this research, high concentrated industrial wastewater produced from refined salt production facility have been used as metal supplying source, especially for calcium cations. To ensure purity of final products, calcium ions were selectively separated in the form of gypsum dihydrate. After that, carbon dioxide is captured using alkanolamine-based absorbents making carbon dioxide into reactive ionic form. And then, high purity calcium carbonate salt was produced. The existence of calcium carbonate was confirmed by X-Ray Diffraction (XRD) and Scanning Electron Microscopy (SEM) images. Also, carbon dioxide loading curves for absorption, conversion, and desorption were provided. Also, in order to investigate the possibility of the absorbent reuse, reabsorption experiments were performed either. Produced calcium carbonate as final products is seemed to have potential to be used in various industrial fields including cement and paper making industries and pharmaceutical engineering fields.

Keywords: alkanolamine, calcium carbonate, climate change, seawater, industrial wastewater

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Authors: Anteneh Dagnachew Sewenet, Paola Pisano

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

Keywords: circularity, circular economy, sustainability, innovation

Procedia PDF Downloads 98

Authors: Luana Guerra, Silvio C. Sampaio, Vladimir Pavan Margarido, Ralpho R. Reis

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Brazil is the world's largest consumer of pesticides. The excessive use of these compounds has negative impacts on animal and human life, the environment, and food security. Bees, crucial for pollination, are exposed to pesticides during the collection of nectar and pollen, posing risks to their health and the food chain, including honey contamination. Aquatic sediments are also affected, impacting water quality and the microbiota. Therefore, the analysis of aquatic sediments and bee honey is essential to identify environmental contamination and monitor ecosystems. The aim of this study was to use samples of honey from honeybees (Apis mellifera) and aquatic sediment as bioindicators of environmental contamination by pesticides and their relationship with agricultural use in the surrounding areas. The sample collections of sediment and honey were carried out in two stages. The first stage was conducted in the Bituruna municipality region in the second half of the year 2022, and the second stage took place in the regions of Laranjeiras do Sul, Quedas do Iguaçu, and Nova Laranjeiras in the first half of the year 2023. In total, 10 collection points were selected, with 5 points in the first stage and 5 points in the second stage, where one sediment sample and one honey sample were collected for each point, totaling 20 samples. The honey and sediment samples were analyzed at the Laboratory of the Paraná Institute of Technology, with ten samples of honey and ten samples of sediment. The selected extraction method was QuEChERS, and the analysis of the components present in the sample was performed using liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). The pesticides Azoxystrobin, Epoxiconazole, Boscalid, Carbendazim, Haloxifope, Fomesafen, Fipronil, Chlorantraniliprole, Imidacloprid, and Bifenthrin were detected in the sediment samples from the study area in Laranjeiras do Sul, Paraná, with Carbendazim being the compound with the highest concentration (0.47 mg/kg). The honey samples obtained from the apiaries showed satisfactory results, as they did not show any detection or quantification of the analyzed pesticides, except for Point 9, which had the fungicide tebuconazole but with a concentration Keywords: contamination, water research, agrochemicals, beekeeping activity

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

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

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

Procedia PDF Downloads 390

Authors: Estefanya Vazquez-Casaubon, Veroline Cauberghe, Dieneke Van de Sompel, Hayley Pearce

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Working together to reduce the anthropogenic impact should be a collective action, including effort within the household. In the matter, children are considered to have an important role in influencing the household to reduce the environmental impact through reversed socialization where children motivate and increase the concern of the parents towards environmental protection. Previous studies reveal that communication between parents and kids is key for effective reversed socialization. However, multiple barriers have been identified in the literature, such as the acceptance of the influence from the kids, the properties of the communication, among other factors. Based on the previous evidence, the present study aims to assess barriers and facilitators of communication at the household level that have an impact on reversed socialization. More precisely, the study examines how parents’ climate change coping strategy (problem-focused, meaning-focused, disregarding) influences the valence and the type of the communication related to climate change, and eventually the extent to which they report their beliefs and behaviours to be influenced by the pro-environmental perspectives of their children; i.e. reversed socialization. Via an online survey, 723 Belgian parents self-reported on communication about environmental protection and risk within their household (such as the frequency of exchange about topics related to climate change sourced from school, the household rules, imparting knowledge to the children, and outer factors like media or peer pressure, the emotional valence of the communication), their perceived socialization, and personal factors (coping mechanisms towards climate change). The results, using structural equation modelling, revealed that parents applying a problem-solving coping strategy related to climate change, appear to communicate more often in a positive than in a negative manner. Parents with a disregarding coping style towards climate change appear to communicate less often in a positive way within the household. Parents that cope via meaning-making of climate change showed to communicate less often in either a positive or negative way. Moreover, the perceived valence of the communication (positive or negative) influenced the frequency and type of household communication. Positive emotions increased the frequency of the communication overall. However, the direct effect of neither of the coping mechanisms on the reversed socialization was significant. High frequency of communication about the media, environmental views of the household members among other external topics had a positive impact on the perceived socialization, followed by discussions school-related; while parental instructing had a negative impact on the perceived socialization. Moreover, the frequency of communication was strongly affected by the perceived valence of the communication (positive or negative). The results go in line with previous evidence that a higher frequency of communication facilitates reversed socialization. Hence the results outstand how the coping mechanisms of the parents can be either a facilitator when they cope via problem-solving, while parents that disregard might avert frequent communication about climate change at the household.

Keywords: communication, parents’ coping mechanisms, environmental protection, household, perceived socialization

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Authors: Laura Isabel Guarin, Juliana Vargas, Philippe Chang

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The analysis and study of Open Channel flow dynamics for River applications has been based on flow modelling using discreet numerical models based on hydrodynamic equations. The overall spatial characteristics of rivers, i.e. its length to depth to width ratio generally allows one to correctly disregard processes occurring in the vertical or transverse dimensions thus imposing hydrostatic pressure conditions and considering solely a 1D flow model along the river length. Through a calibration process an accurate flow model may thus be developed allowing for channel study and extrapolation of various scenarios. The Magdalena River in Colombia is a large river basin draining the country from South to North with 1550 km with 0.0024 average slope and 275 average width across. The river displays high water level fluctuation and is characterized by a series of meanders. The city of La Dorada has been affected over the years by serious flooding in the rainy and dry seasons. As the meander is evolving at a steady pace repeated flooding has endangered a number of neighborhoods. This study has been undertaken in pro of correctly model flow characteristics of the river in this region in order to evaluate various scenarios and provide decision makers with erosion control measures options and a forecasting tool. Two field campaigns have been completed over the dry and rainy seasons including extensive topographical and channel survey using Topcon GR5 DGPS and River Surveyor ADCP. Also in order to characterize the erosion process occurring through the meander, extensive suspended and river bed samples were retrieved as well as soil perforation over the banks. Hence based on DEM ground digital mapping survey and field data a 2DH flow model was prepared using the Iber freeware based on the finite volume method in a non-structured mesh environment. The calibration process was carried out comparing available historical data of nearby hydrologic gauging station. Although the model was able to effectively predict overall flow processes in the region, its spatial characteristics and limitations related to pressure conditions did not allow for an accurate representation of erosion processes occurring over specific bank areas and dwellings. As such a significant helical flow has been observed through the meander. Furthermore, the rapidly changing channel cross section as a consequence of severe erosion has hindered the model’s ability to provide decision makers with a valid up to date planning tool.

Keywords: erosion, finite volume method, flow dynamics, flow modelling, meander

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

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

Keywords: agricultural landscapes, food, indicator species, shelter

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Authors: Luxi He, Tianfang Zhang, Zhengbin He, Songlin Yi

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Heat treatment has been widely recognized for its effectiveness in enhancing the physicochemical properties of wood, including hygroscopicity and dimensional stability. Nonetheless, the non-negligible volumetric shrinkage and loss of mechanical strength resulting from heat treatment may diminish the wood recovery and its product value. In this study, tung oil was used to alleviate heat-induced shrinkage and reduction in mechanical properties of wood during heat treatment. Tung oil was chosen as a modifier because it is a traditional Chinese plant oil that has been widely used for over a thousand years to protect wooden furniture and buildings due to its biodegradable and non-toxic properties. The effects of different heating media (air, tung oil) and their effective treatment parameters (temperature, duration) on the changes in the physical properties (morphological characteristics, pore structures, micromechanical properties), and chemical properties (chemical structures, chemical composition) of wood were investigated by using scanning electron microscopy, confocal laser scanning microscopy, atomic force microscopy, X-ray photoelectron spectroscopy, and dynamic vapor sorption. Meanwhile, the correlation between the mass changes and the color change, volumetric shrinkage, and hygroscopicity was also investigated. The results showed that the thermal degradation of wood cell wall components was the most important factor contributing to the changes in heat-induced shrinkage, color, and moisture adsorption of wood. In air-heat-treated wood samples, there was a significant correlation between mass change and heat-induced shrinkage, brightness, and moisture adsorption. However, the presence of impregnated tung oil in oil-heat-treated wood appears to disrupt these correlations among physical properties. The results of micromechanical properties demonstrated a significant decrease in elastic modulus following high-temperature heat treatment, which was mitigated by tung oil treatment. Chemical structure and compositional analyses indicated that the changes in chemical structure primarily stem from the degradation of hemicellulose and cellulose, and the presence of tung oil created an oxygen-insulating environment that slowed down this degradation process. Morphological observation results showed that tung oil permeated the wood structure and penetrated the cell walls through transportation channels, altering the micro-morphology of the cell wall surface, obstructing primary water passages (e.g., vessels and pits), and impeding the release of volatile degradation products as well as the infiltration and diffusion of water. In summary, tung oil treatment represents an environmentally friendly and efficient method for maximizing wood recovery and increasing product value. This approach holds significant potential for industrial applications in wood heat treatment.

Keywords: tung oil, heat treatment, physicochemical properties, wood cell walls

Procedia PDF Downloads 67

Authors: Rebin Mzhda Mohammed, Hoshmand Ali Hama Agha

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Excess skin, often consequential to substantial weight loss or the aging process, introduces physical discomfort, obstructs daily activities, and undermines an individual's self-esteem. As these challenges become increasingly prevalent, the need to explore viable solutions grows in significance. Extra skin removal surgery, colloquially known as body contouring surgery, has emerged as a compelling intervention to ameliorate the physical and psychological burdens of excess skin. This study undertakes a comprehensive review to illuminate the intricacies of extra skin removal surgery, encompassing its diverse procedures, associated risks, benefits, and psychological implications on patients. The methodological approach adopted involves a systematic and exhaustive review of pertinent scholarly literature sourced from reputable databases, including PubMed, Google Scholar, and specialized cosmetic surgery journals. Articles are meticulously curated based on their relevance, credibility, and recency. Subsequently, data from these sources are synthesized and categorized, facilitating a comprehensive understanding of the subject matter. Qualitative analysis serves to unravel the nuanced psychological effects, while quantitative data, where available, are harnessed to underpin the study's conclusions. In terms of major findings, the research underscores the manifold advantages of extra skin removal surgery. Patients experience a notable improvement in physical comfort, amplified mobility, enhanced self-confidence, and a newfound ability to don clothing comfortably. Nonetheless, the benefits are juxtaposed with potential risks, encompassing infection, scarring, hematoma, delayed healing, and the challenge of achieving symmetry. A salient discovery is the profound psychological impact of the surgery, as patients consistently report elevated body image satisfaction, heightened self-esteem, and a substantial enhancement in overall quality of life. In summation, this research accentuates the pivotal role of extra skin removal surgery in ameliorating the intricate interplay of physical and psychological difficulties posed by excess skin. By elucidating the diverse procedures, associated risks, and psychological outcomes, the study contributes to a comprehensive and informed comprehension of the surgery's multifaceted effects. Therefore, individuals contemplating this transformative surgical option are equipped with comprehensive insights, ultimately fostering informed decision-making, guided by the expertise of medical professionals.

Keywords: extra skin removal surgery, body contouring, abdominoplasty, brachioplasty, thigh lift, body lift, benefits, risks, psychological effects

Procedia PDF Downloads 64

Authors: Dejene Ermias Mekango, Mussie Alemayehu, Gebremedhin Berhe Gebregergs, Araya Abrha Medhanye, Gelila Goba

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Background: Maternal near miss (MNM) can be used as a proxy indicator of maternal mortality ratio. There is a huge gap in life time risk between Sub-Saharan Africa and developed countries. In Ethiopia, a significant number of women die each year from complications during pregnancy, childbirth and the post-partum period. Besides, a few studies have been performed on MNM, and little is known regarding determinant factors. This study aims to identify determinants of MNM among women in Tigray region, Northern Ethiopia. Methods: a case-control study in hospital found in Tigray region, Ethiopia was conducted from January 30 - March 30, 2016. The sample included 103 cases and 205 controls recruited from women seeking obstetric care at six public hospitals. Clients having a life-threatening obstetric complication including haemorrhage, hypertensive diseases of pregnancy, dystocia, infections, and anemia or clinical signs of severe anemia in women without haemorrhage were taken as cases and those with normal obstetric outcomes were considered as controls. Cases were selected based on proportional to size allocation while systematic sampling was employed for controls. Data were analyzed using SPSS version 20.0. Binary and multiple variable logistic regression (odds ratio) analyses were calculated with 95% CI. Results: The largest proportion of cases and controls was among the ages of20–29 years, accounting for37.9 %( 39) of cases and 31.7 %( 65) of controls. Roughly 90% of cases and controls were married. About two-thirds of controls and 45.6 %( 47) of cases had gestational age between 37-41 weeks. History of chronic medical conditions was reported in 55.3 %(57) of cases and 33.2%(68) of controls. Women with no formal education [AOR=3.2;95%CI:1.24, 8.12],being less than 16 years old at first pregnancy [AOR=2.5; 95%CI:1.12,5.63],induced labor[AOR=3; 95%CI:1.44, 6.17], history of Cesarean section (C-section) [AOR=4.6; 95%CI: 1.98, 7.61] or chronic medical disorder[AOR=3.5;95%CI:1.78, 6.93], and women who traveled more than 60 minutes before reaching their final place of care[AOR=2.8;95% CI: 1.19,6.35] all had higher odds of experiencing MNM. Conclusions: The Government of Ethiopia should continue its effort to address the lack of road and health facility access as well as education, which will help reduce MNM. Work should also be continued to educate women and providers about common predictors of MNM like the history of C-section, chronic illness, and teenage pregnancy. These efforts should be carried out at the facility, community, and individual levels. The targeted follow-up to women with a history of chronic disease and C-section could also be a practical way to reduce MNM.

Keywords: maternal near miss, severe obstetric hemorrhage, hypertensive disorder, c-section, Tigray, Ethiopia

Procedia PDF Downloads 216

Authors: Mohammad Hassan Ziraksaz

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Fuel atomizers are used in a wide range of IC engines, turbojets and a variety of liquid propellant rocket engines. As the fuel spray fully develops its characters approach their ultimate amounts. Fuel spray characters such as SMD, injection pressure, mass flow rate, droplet velocity and spray cone angle play important roles to atomize the liquid fuel to finely atomized fuel droplets and finally form the fine fuel spray. Well performed, fully developed, fine spray without any defections, brings the idea of finding an experimental relation between the main effective spray characters. Extracting an experimental relation between SMD and other fuel spray physical characters in swirl fuel atomizers is the main scope of this experimental work. Droplet velocity, fuel mass flow rate, SMD and spray cone angle are the parameters which are measured. A set of twelve reverse engineering atomizers without any spray defections and a set of eight original atomizers as referenced well-performed spray are contributed in this work. More than 350 tests, mostly repeated, were performed. This work shows that although spray cone angle plays a very effective role in spray formation, after formation, it smoothly approaches to an almost constant amount while the other characters are changed to create fine droplets. Therefore, the work to find the relation between the characters is focused on SMD, droplet velocity, fuel mass flow rate, and injection pressure. The process of fuel spray formation begins in 5 Psig injection pressures, where a tiny fuel onion attaches to the injector tip and ended in 250 Psig injection pressure, were fully developed fine fuel spray forms. Injection pressure is gradually increased to observe how the spray forms. In each step, all parameters are measured and recorded carefully to provide a data bank. Various diagrams have been drawn to study the behavior of the parameters in more detail. Experiments and graphs show that the power equation can best show changes in parameters. The SMD experimental relation with pressure P, fuel mass flow rate Q ̇ and droplet velocity V extracted individually in pairs. Therefore, the proportional relation of SMD with other parameters is founded. Now it is time to find an experimental relation including all the parameters. Using obtained proportional relation, replacing the parameters with experimentally measured ones and drawing the graphs of experimental SMD versus proportion SMD (〖SMD〗_P), a correctional equation and consequently the final experimental equation is obtained. This experimental equation is specified to use for swirl fuel atomizers and the use of this experimental equation in different conditions shows about 3% error, which is expected to achieve lower error and consequently higher accuracy by increasing the number of experiments and increasing the accuracy of data collection.

Keywords: droplet velocity, experimental relation, mass flow rate, SMD, swirl fuel atomizer

Procedia PDF Downloads 157

Authors: Marcela De Oliveira, Marina P. Da Silva, Fernando C. G. Da Rocha, Jorge M. Santos, Jaime S. Cardoso, Paulo N. Lisboa-Filho

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Multiple Sclerosis (MS) is an immune-mediated disease of the central nervous system characterized by neurodegeneration, inflammation, demyelination, and axonal loss. Magnetic resonance imaging (MRI), due to the richness in the information details provided, is the gold standard exam for diagnosis and follow-up of neurodegenerative diseases, such as MS. Brain atrophy, the gradual loss of brain volume, is quite extensive in multiple sclerosis, nearly 0.5-1.35% per year, far off the limits of normal aging. Thus, the brain volume quantification becomes an essential task for future analysis of the occurrence atrophy. The analysis of MRI has become a tedious and complex task for clinicians, who have to manually extract important information. This manual analysis is prone to errors and is time consuming due to various intra- and inter-operator variability. Nowadays, computerized methods for MRI segmentation have been extensively used to assist doctors in quantitative analyzes for disease diagnosis and monitoring. Thus, the purpose of this work was to evaluate the brain volume in MRI of MS patients. We used MRI scans with 30 slices of the five patients diagnosed with multiple sclerosis according to the McDonald criteria. The computational methods for the analysis of images were carried out in two steps: segmentation of the brain and brain volume quantification. The first image processing step was to perform brain extraction by skull stripping from the original image. In the skull stripper for MRI images of the brain, the algorithm registers a grayscale atlas image to the grayscale patient image. The associated brain mask is propagated using the registration transformation. Then this mask is eroded and used for a refined brain extraction based on level-sets (edge of the brain-skull border with dedicated expansion, curvature, and advection terms). In the second step, the brain volume quantification was performed by counting the voxels belonging to the segmentation mask and converted in cc. We observed an average brain volume of 1469.5 cc. We concluded that the automatic method applied in this work can be used for the brain extraction process and brain volume quantification in MRI. The development and use of computer programs can contribute to assist health professionals in the diagnosis and monitoring of patients with neurodegenerative diseases. In future works, we expect to implement more automated methods for the assessment of cerebral atrophy and brain lesions quantification, including machine-learning approaches. Acknowledgements: This work was supported by a grant from Brazilian agency Fundação de Amparo à Pesquisa do Estado de São Paulo (number 2019/16362-5).

Keywords: brain volume, magnetic resonance imaging, multiple sclerosis, skull stripper

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Authors: Ladislav Écsi, Roland Jančo

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Contemporary multiplicative plasticity models assume that the body's intermediate configuration consists of an assembly of locally unloaded neighbourhoods of material particles that cannot be reassembled together to give the overall stress-free intermediate configuration since the neighbourhoods are not necessarily compatible with each other. As a result, the plastic deformation gradient, an inelastic component in the multiplicative split of the deformation gradient, cannot be integrated, and the material particle moves from the initial configuration to the intermediate configuration without a position vector and a plastic displacement field when plastic flow occurs. Such behaviour is incompatible with the continuum theory and the continuum physics of elastoplastic deformations, and the related material models can hardly be denoted as truly continuum-based. The paper presents a proper continuum-based reformulation of current problems in finite strain plasticity. It will be shown that the incompatible neighbourhoods in real material are modelled by the product of the plastic multiplier and the yield surface normal when the plastic flow is defined in the current configuration. The incompatible plastic factor can also model the neighbourhoods as the solution of the system of differential equations whose coefficient matrix is the above product when the plastic flow is defined in the intermediate configuration. The incompatible tensors replace the compatible spatial plastic velocity gradient in the former case or the compatible plastic deformation gradient in the latter case in the definition of the plastic flow rule. They act as local imperfections but have the same position vector as the compatible plastic velocity gradient or the compatible plastic deformation gradient in the definitions of the related plastic flow rules. The unstressed intermediate configuration, the unloaded configuration after the plastic flow, where the residual stresses have been removed, can always be calculated by integrating either the compatible plastic velocity gradient or the compatible plastic deformation gradient. However, the corresponding plastic displacement field becomes permanent with both elastic and plastic components. The residual strains and stresses originate from the difference between the compatible plastic/permanent displacement field gradient and the prescribed incompatible second-order tensor characterizing the plastic flow in the definition of the plastic flow rule, which becomes an assignment statement rather than an equilibrium equation. The above also means that the elastic and plastic factors in the multiplicative split of the deformation gradient are, in reality, gradients and that there is no problem with the continuum physics of elastoplastic deformations. The formulation is demonstrated in a numerical example using the regularized Mooney-Rivlin material model and modified equilibrium statements where the intermediate configuration is calculated, whose analysis results are compared with the identical material model using the current equilibrium statements. The advantages and disadvantages of each formulation, including their relationship with multiplicative plasticity, are also discussed.

Keywords: finite strain plasticity, continuum formulation, regularized Mooney-Rivlin material model, compatibility

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Authors: N. Garrós, P. Bustos, N. Beirampour, R. Mohammadi, M. Mallandrich, A.C. Calpena, H. Colom

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Atopic dermatitis (AD) is a persistent skin condition characterized by chronic inflammation caused by an autoimmune response. It is a prevalent clinical issue that requires continual treatment to enhance the patient's quality of life. Systemic therapy often involves the use of glucocorticoids or immunosuppressants to manage symptoms. Our objective was to create and assess topical liposomal formulations containing Baricitinib (BNB), a reversible inhibitor of Janus-associated kinase (JAK), which is involved in various immune responses. These formulations were intended to address flare-ups and improve treatment outcomes for AD. We created three distinct liposomal formulations by combining different amounts of 1-palmitoyl-2-oleoyl-glycero-3-phosphocholine (POPC), cholesterol (CHOL), and ceramide (CER): (i) pure POPC, (ii) POPC mixed with CHOL (at a ratio of 8:2, mol/mol), and (iii) POPC mixed with CHOL and CER (at a ratio of 3.6:2.4:4.0 mol/mol/mol). We conducted various tests to determine the formulations' skin tolerance, irritancy capacity, and their ability to cause erythema and edema on altered skin. We also assessed the transepidermal water loss (TEWL) and skin hydration of rabbits to evaluate the efficacy of the formulations. Histological analysis, the HET-CAM test, and the modified Draize test were all used in the evaluation process. The histological analysis revealed that liposome POPC and POPC:CHOL avoided any damage to the tissues structures. The HET-CAM test showed no irritation effect caused by any of the three liposomes, and the modified Draize test showed a good Draize score for erythema and edema. Liposome POPC effectively counteracted the impact of xylol on the skin, and no erythema or edema was observed during the study. TEWL values were constant for all the liposomes with similar values to the negative control (within the range 8 - 15 g/h·m2, which means a healthy value for rabbits), whereas the positive control showed a significant increase. The skin hydration values were constant and followed the trend of the negative control, while the positive control showed a steady increase during the tolerance study. In conclusion, the developed formulations containing BNB exhibited no harmful or irritating effects, they did not demonstrate any irritant potential in the HET-CAM test and liposomes POPC and POPC:CHOL did not cause any structural alteration according to the histological analysis. These positive findings suggest that additional research is necessary to evaluate the efficacy of these liposomal formulations in animal models of the disease, including mutant animals. Furthermore, before proceeding to clinical trials, biochemical investigations should be conducted to better understand the mechanisms of action involved in these formulations.

Keywords: baricitinib, HET-CAM test, histological study, JAK inhibitor, liposomes, modified draize test

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Authors: Julien Benomar

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The World Bank report published in April 2023 called “Migrants, Refugees and Society” allows us to first distinguish migrants in search of economic opportunities and refugees that flee a situation of danger and choose their destination based on their immediate need for safety. Amongst those two categories, the report distinguished people having professional skills adapted to the labor market of the host country and those who have not. Out of that distinction of four categories, we choose to focus our research on refugees that do not have professional skills adapted to the labor market of the host country. Given that refugees generally have no recourse to public assistance schemes and cannot count on the support of their entourage or support network, we propose to examine the extent to which external assistance, such as international humanitarian action, is likely to accompany refugees' transition to financial empowerment through entrepreneurship. To this end, we propose to carry out a case study structured in three stages: (i) an exchange with a Non-Governmental Organisation (NGO) active in supporting refugee populations from Congo and Burundi to Rwanda, enabling us to (i.i) define together a financial empowerment income, and (i. ii) learn about the content of the support measures taken for the beneficiaries of the humanitarian project; (ii) monitor the population of 118 beneficiaries, including 73 refugees and 45 Rwandans (reference population); (iii) conduct a participatory analysis to identify the level of performance of the project and areas for improvement. The case study thus involved the staff of an international NGO active in helping refugees from Rwanda since 2015 and the staff of a Luxembourg NGO that has been funding this economic aid project through entrepreneurship since 2021. The case study thus involved the staff of an international NGO active in helping refugees from Rwanda since 2015 and the staff of a Luxembourg NGO, which has been funding this economic aid through an entrepreneurship project since 2021, and took place over a 48-day period between April and May 2023. The main results are of two types: (i) the need to associate indicators for monitoring the impact of the project on the indirect beneficiaries of the project (refugee community) and (ii) the identification of success factors making it possible to bring concrete and relevant responses to the constraints encountered. The first result thus made it possible to identify the following indicators: Indicator of community potential ((jobs, training or mentoring) promoted by the activity of the entrepreneur), Indicator of social contribution (tax paid by the entrepreneur), Indicator of resilience (savings and loan capacity generated, and finally impact on social cohesion. The second result made it possible to identify that among the 7 success factors tested, the sector of activity chosen and the level of experience in the sector of the future activity are those that stand out the most clearly.

Keywords: entrepreuneurship, refugees, financial empowerment, international aid

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Authors: A. Kavita Murugkar, B. Anurag Kashyap

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With the Rights for Persons with Disabilities Act (RPWD Act) 2016, the Indian government has made it mandatory for all establishments, including Heritage Sites, to be accessible for People with Disabilities. However, recent access audit surveys done under the Accessible India Campaign by Ministry of Culture indicate that there are very few accessibility measures provided in the Heritage sites for people with disabilities. Though there are some measures for the mobility impaired, surveys brought out that there are almost no provisions for people with vision impairment (PwVI) in heritage sites thus depriving them of a reasonable physical & intellectual access that facilitates an enjoyable experience and enriching interpretation of the Heritage Site. There is a growing need to develop multisensory interpretative tools that can help the PwVI in perceiving heritage sites in the absence of vision. The purpose of this research was to examine the usability of an audio-tactile model as a haptic and sound-based strategy for augmenting the perception and experience of PwVI in a heritage site. The first phase of the project was a multi-stage phenomenological experimental study with visually impaired users to investigate the design parameters for developing an audio-tactile model for PwVI. The findings from this phase included user preferences related to the physical design of the model such as the size, scale, materials, details, etc., and the information that it will carry such as braille, audio output, tactile text, etc. This was followed by the second phase in which a working prototype of an audio-tactile model is designed and developed for a heritage site based on the findings from the first phase of the study. A nationally listed heritage site from the author’s city was selected for making the model. The model was lastly tested by visually impaired users for final refinements and validation. The prototype developed empowers People with Vision Impairment to navigate independently in heritage sites. Such a model if installed in every heritage site, can serve as a technological guide for the Person with Vision Impairment, giving information of the architecture, details, planning & scale of the buildings, the entrances, location of important features, lifts, staircases, and available, accessible facilities. The model was constructed using 3D modeling and digital printing technology. Though designed for the Indian context, this assistive technology for the blind can be explored for wider applications across the globe. Such an accessible solution can change the otherwise “incomplete’’ perception of the disabled visitor, in this case, a visually impaired visitor and augment the quality of their experience in heritage sites.

Keywords: accessibility, architectural perception, audio tactile model , inclusive heritage, multi-sensory perception, visual impairment, visitor experience

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Authors: Irina Veselova, Maria Makedonskaya, Olga Eremina, Alexandr Sidorov, Eugene Goodilin, Tatyana Shekhovtsova

Abstract:

Such catecholamines as dopamine, norepinephrine, and epinephrine are the principal neurotransmitters in the sympathetic nervous system. Catecholamines and their metabolites are considered to be important markers of socially significant diseases such as atherosclerosis, diabetes, coronary heart disease, carcinogenesis, Alzheimer's and Parkinson's diseases. Currently, neurotransmitters can be studied via electrochemical and chromatographic techniques that allow their characterizing and quantification, although these techniques can only provide crude spatial information. Besides, the difficulty of catecholamine determination in biological materials is associated with their low normal concentrations (~ 1 nM) in biomaterials, which may become even one more order lower because of some disorders. In addition, in blood they are rapidly oxidized by monoaminooxidases from thrombocytes and, for this reason, the determination of neurotransmitter metabolism indicators in an organism should be very rapid (15—30 min), especially in critical states. Unfortunately, modern instrumental analysis does not offer a complex solution of this problem: despite its high sensitivity and selectivity, HPLC-MS cannot provide sufficiently rapid analysis, while enzymatic biosensors and immunoassays for the determination of the considered analytes lack sufficient sensitivity and reproducibility. Fluorescent and SERS-sensors remain a compelling technology for approaching the general problem of selective neurotransmitter detection. In recent years, a number of catecholamine sensors have been reported including RNA aptamers, fluorescent ribonucleopeptide (RNP) complexes, and boronic acid based synthetic receptors and the sensor operated in a turn-off mode. In this work we present the fluorescent and SERS turn-on sensor systems based on the bio- or chemorecognizing nanostructured films {chitosan/collagen-Tb/Eu/Cu-nanoparticles-indicator reagents} that provide the selective recognition, visualization, and sensing of the above mentioned catecholamines on the level of nanomolar concentrations in biomaterials (cell cultures, tissue etc.). We have (1) developed optically transparent porous films and gels of chitosan/collagen; (2) ensured functionalization of the surface by molecules-'recognizers' (by impregnation and immobilization of components of the indicator systems: biorecognizing and auxiliary reagents); (3) performed computer simulation for theoretical prediction and interpretation of some properties of the developed materials and obtained analytical signals in biomaterials. We are grateful for the financial support of this research from Russian Foundation for Basic Research (grants no. 15-03-05064 a, and 15-29-01330 ofi_m).

Keywords: biomaterials, fluorescent and SERS-recognition, neurotransmitters, solid-phase turn-on sensor system

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Authors: Nir Nissim, Ran Yahalom, Tomer Lancewiki, Yuval Elovici, Boaz Lerner

Abstract:

Background: Attackers increasingly take advantage of innocent users who tend to use USB devices casually, assuming these devices benign when in fact they may carry an embedded malicious behavior or hidden malware. USB devices have many properties and capabilities that have become the subject of malicious operations. Many of the recent attacks targeting individuals, and especially organizations, utilize popular and widely used USB devices, such as mice, keyboards, flash drives, printers, and smartphones. However, current detection tools, techniques, and solutions generally fail to detect both the known and unknown attacks launched via USB devices. Significance: We propose USBWARE, a project that focuses on the vulnerabilities of USB devices and centers on the development of a comprehensive detection framework that relies upon a crucial attack repository. USBWARE will allow researchers and companies to better understand the vulnerabilities and attacks associated with USB devices as well as providing a comprehensive platform for developing detection solutions. Methodology: The framework of USBWARE is aimed at accurate detection of both known and unknown USB-based attacks by a process that efficiently enhances the framework's detection capabilities over time. The framework will integrate two main security approaches in order to enhance the detection of USB-based attacks associated with a variety of USB devices. The first approach is aimed at the detection of known attacks and their variants, whereas the second approach focuses on the detection of unknown attacks. USBWARE will consist of six independent but complimentary detection modules, each detecting attacks based on a different approach or discipline. These modules include novel ideas and algorithms inspired from or already developed within our team's domains of expertise, including cyber security, electrical and signal processing, machine learning, and computational biology. The establishment and maintenance of the USBWARE’s dynamic and up-to-date attack repository will strengthen the capabilities of the USBWARE detection framework. The attack repository’s infrastructure will enable researchers to record, document, create, and simulate existing and new USB-based attacks. This data will be used to maintain the detection framework’s updatability by incorporating knowledge regarding new attacks. Based on our experience in the cyber security domain, we aim to design the USBWARE framework so that it will have several characteristics that are crucial for this type of cyber-security detection solution. Specifically, the USBWARE framework should be: Novel, Multidisciplinary, Trusted, Lightweight, Extendable, Modular and Updatable and Adaptable. Major Findings: Based on our initial survey, we have already found more than 23 types of USB-based attacks, divided into six major categories. Our preliminary evaluation and proof of concepts showed that our detection modules can be used for efficient detection of several basic known USB attacks. Further research, development, and enhancements are required so that USBWARE will be capable to cover all of the major known USB attacks and to detect unknown attacks. Conclusion: USBWARE is a crucial detection framework that must be further enhanced and developed.

Keywords: USB, device, cyber security, attack, detection

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