Search results for: direct current control

Authors: Judit Perjessy, Zsolt Zalan, Ferenc Hegyi, Eniko Horvath-Szanics, Krisztina Takacs, Andras Nagy, Adel Klupacs, Erika Koppany-Szabo, Zhirong Wang, Kaituo Wang, Muying Du, Jianquan Kan

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The post-harvest diseases cause great economic losses in the fruit and vegetables; the prevention of these deterioration has great importance. Against the fungi, which cause most of the diseases, are extensively used the fungicides. However, there are increasing consumer concerns over the presence of pesticide residues in food. An alternative and in recent years, increasingly studied method for the prevention of the diseases is biocontrol, where antagonistic microorganisms are used for the control of fungi. The genera of Lactobacillus is well known and extensively studied, but its applicability as biocontrol agents in post-harvest preservation of fruit and vegetables is poorly investigated. However these bacteria can be found on the surface of the plants and have great antimicrobial activity. In our study we have investigated the chitinase activity, the antifungal effect and the applicability of several Lactobacillus strains to select potential biocontrol agents. We investigated the determination of the environmental parameters of a gene (encoding chitinase) expression and we also investigated the relationship between actual antifungal activity and potential chitinase activity. Mixed cultures were also developed to enhance the antifungal activity and determined the optimal mold spore and bacteria concentration ratio for the appropriate efficacy. Five Lactobacillus strains (L. acidophilus N2, L. delbrueckii subsp. bulgaricus B397, L. sp. 2231, L. sake subsp. sake 2471, L. buchneri 1145) possess chitinase-coding gene from the 43 investigated Lactobacillus strains. Proteins with similar molecular weight and separation properties like bacterial chitinases were detected from these strains, which also possess chitin-binding property. Nevertheless, they were inactive, lacks the chitinolytic activity. In point of the cumulative activity of inhibition, our results showed that certain strains were statistically significant in a positive direction compared to other strains, e.g., L. rhamnosus VT1 and L. Casey 154 have shown great general antifungal effect against 11 molds from the genera Penicillium and Botrytis and isolated from spoiled fruit and vegetables. Also, some mixed cultures (L. rhamnosus VT1 - L. Plantarum 299v) showed significant antifungal effects against the indigenous molds on the surface of apple fruit during the industrial storage experiment. Thus, they could be promising for post-harvest biopreservation.

Keywords: biocontrol, chitinase, Lactobacillus, post-harvest

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Authors: Teagan Fink, Lynn Chong, Michael Hii, Brett Knowles

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Background: Telemedicine is a rapidly advancing field providing healthcare to patients at a distance from their treating clinician. There is a paucity of high-quality evidence detailing the safety and acceptability of telemedicine for postoperative outpatient follow-up. This randomized controlled trial – conducted prior to the COVID 19 pandemic – aimed to assess patient satisfaction and safety (as determined by readmission, reoperation and complication rates) of telephone compared to face-to-face clinic follow-up after uncomplicated general surgical procedures. Methods: Patients following uncomplicated laparoscopic appendicectomy or cholecystectomy and laparoscopic or open umbilical or inguinal hernia repairs were randomized to a telephone or face-to-face outpatient clinic follow-up. Data points including patient demographics, perioperative details and postoperative outcomes (eg. wound healing complications, pain scores, unplanned readmission to hospital and return to daily activities) were compared between groups. Patients also completed a Likert patient satisfaction survey following their consultation. Results: 103 patients were recruited over a 12-month period (21 laparoscopic appendicectomies, 65 laparoscopic cholecystectomies, nine open umbilical hernia repairs, six laparoscopic inguinal hernia repairs and two laparoscopic umbilical hernia repairs). Baseline patient demographics and operative interventions were the same in both groups. Patient or clinician-reported concerns on postoperative pain, use of analgesia, wound healing complications and return to daily activities at clinic follow-up were not significantly different between the two groups. Of the 58 patients randomized to the telemedicine arm, 40% reported high and 60% reported very high patient satisfaction. Telemedicine clinic mean consultation times were significantly shorter than face-to-face consultation times (telemedicine 10.3 +/- 7.2 minutes, face-to-face 19.2 +/- 23.8 minutes, p-value = 0.014). Rates of failing to attend clinic were not significantly different (telemedicine 3%, control 6%). There was no increased rate of postoperative complications in patients followed up by telemedicine compared to in-person. There were no unplanned readmissions, return to theatre, or mortalities in this study. Conclusion: Telemedicine follow-up of patients undergoing uncomplicated general surgery is safe and does not result in any missed diagnosis or higher rates of complications. Telemedicine provides high patient satisfaction and steps to implement this modality in inpatient care should be undertaken.

Keywords: general surgery, telemedicine, patient satisfaction, patient safety

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Authors: M. Siedlikowski, F. Rauch, A. Tsimicalis

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Osteogenesis Imperfecta (OI) is a genetic disorder of childhood onset that causes frequent fractures after minimal physical stress. To date, OI research has focused on medically- and surgically-oriented outcomes with little attention on the perspective of the affected child. It is a challenge to elicit the child’s voice in health care, in other words, their own perspective on their symptoms, but software development offers a way forward. Sisom (Norwegian acronym derived from ‘Si det som det er’ meaning ‘Tell it as it is’) is an award-winning, rigorously tested, interactive, computerized tool that helps children with chronic illnesses express their symptoms to their clinicians. The successful Sisom software tool, that addresses the child directly, has not yet been adapted to attend to symptoms unique to children with OI. The purpose of this study was to develop a Sisom paper prototype for children with OI by seeking the perspectives of end users, particularly, children with OI and clinicians. Our descriptive qualitative study was conducted at Shriners Hospitals for Children® – Canada, which follows the largest cohort of children with OI in North America. Purposive sampling was used to recruit 12 children with OI over three cycles. Nine clinicians oversaw the development process, which involved determining the relevance of current Sisom symptoms, vignettes, and avatars, as well as generating new Sisom OI components. Data, including field notes, transcribed audio-recordings, and drawings, were deductively analyzed using content analysis techniques. Guided by the following framework, data pertaining to symptoms, vignettes, and avatars were coded into five categories: a) Relevant; b) Irrelevant; c) To modify; d) To add; e) Unsure. Overall, 70.8% of Sisom symptoms were deemed relevant for inclusion, with 49.4% directly incorporated, and 21.3% incorporated with changes to syntax, and/or vignette, and/or location. Three additions were made to the ‘Avatar’ island. This allowed children to celebrate their uniqueness: ‘Makes you feel like you’re not like everybody else.’ One new island, ‘About Me’, was added to capture children’s worldviews. One new sub-island, ‘Getting Around’, was added to reflect accessibility issues. These issues were related to the children’s independence, their social lives, as well as the perceptions of others. In being consulted as experts throughout the co-creation of the Sisom OI paper prototype, children coded the Sisom symptoms and provided sound rationales for their chosen codes. In rationalizing their codes, all children shared personal stories about themselves and their relationships, insights about their OI, and an understanding of the strengths and challenges they experience on a day-to-day basis. The child’s perspective on their health is a basic right, and allowing it to be heard is the next frontier in the care of children with genetic diseases. Sisom OI, a methodological breakthrough within OI research, will offer clinicians an innovative and child-centered approach to capture this neglected perspective. It will provide a tool for the delivery of health care in the center that established the worldwide standard of care for children with OI.

Keywords: child health, interactive computerized communication tool, participatory approach, symptom management

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Authors: S. Fares, K. Mellakh, A. Hmouri

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The StorMer project aims to set up a network of researchers to study traditional hydraulic rainwater harvesting systems in the Mediterranean basin, a region suffering from the major impacts of climate change and limited natural water resources. The arid and semi-arid Mediterranean basin has a long history of pioneering water management practices. The region has developed various ancient traditional water management systems, such as cisterns and qanats, to sustainably manage water resources under historical conditions of scarcity. Therefore, the StorMer project brings together Spain, France, Italy, Greece, Jordan and Morocco to explore traditional rainwater harvesting practices and systems in the Mediterranean region and to develop accurate modeling to simulate the performance and sustainability of these technologies under present-day climatic conditions. The ultimate goal of this project was to resuscitate and valorize these practices in the context of contemporary challenges. This project was intended to establish a Mediterranean network to serve as a basis for a more ambitious project. The ultimate objective was to analyze traditional hydraulic systems and create a prototype hydraulic ecosystem using a coupled environmental approach and traditional and ancient know-how, with the aim of reinterpreting them in the light of current techniques. The combination of ‘traditional’ and ‘modern knowledge/techniques’ is expected to lead to proposals for innovative hydraulic systems. The pandemic initially slowed our progress, but in the end it forced us to carry out the fieldwork in Morocco and Saudi Arabia, and so restart the project. With the participation of colleagues from chronologically distant fields (archaeology, sociology), we are now prepared to share our observations and propose the next steps. This interdisciplinary approach should give us a global vision of the project's objectives and challenges. A diachronic approach is needed to tackle the question of the long-term adaptation of societies in a Mediterranean context that has experienced several periods of water stress. The next stage of the StorMer project is the implementation of pilots in non-urbanized regions. These pilots will test the implementation of traditional systems and will be maintained and evaluated in terms of effectiveness, cost and acceptance. Based on these experiences, larger projects will be proposed and could provide information for regional water management policies. One of the most important lessons learned from this project is the highly social nature of managing traditional rainwater harvesting systems. Unlike modern, centralized water infrastructures, these systems often require the involvement of communities, which assume ownership and responsibility for them. This kind of community engagement leads to greater maintenance and, therefore, sustainability of the systems. Knowledge of the socio-cultural characteristics of these communities means that the systems can be adapted to the needs of each location, ensuring greater acceptance and efficiency.

Keywords: oasis, rainfall harvesting, arid regions, Mediterranean

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Authors: Motaz Alsolaim

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Nowadays, the challenges of running a start-up can be very complex and are perhaps more difficult than at any other time in the past. Changes in technology, manufacturing innovation, and product development, combined with intense competition and market regulations are factors that have put pressure on classic ways of managing firms, thereby forcing change. As a result, the rate of closure, exit or discontinuation of start-ups and young businesses is very high. Despite the essential role of small firms in an economy, they still tend to face obstacles that exert a negative influence on their performance and rate of survival. In fact, it is not easy to determine with any certainty the reasons why small firms fail. For this reason, failure itself is not clearly defined, and its exact causes are hard to diagnose. In this current study, therefore, the barriers to survival will be covered more broadly, especially personal/entrepreneurial, enterprise and environmental factors with regard to various possible reasons for this failure, in order to determine the best solutions and make appropriate recommendations. Methodology: It could be argued that mixed methods might help to improve entrepreneurship research addressing challenges emphasis in previous studies and to achieve the triangulation. Calls for the combined use of quantitative and qualitative research were also made in the entrepreneurship field since entrepreneurship is a multi-faceted area of research. Therefore, explanatory sequential mixed method was used, using questionnaire online survey for entrepreneurs, followed by semi-structure interview. Collecting over 750 surveys and accepting 296 valid surveys, after that 13 interviews from government official seniors, businessmen successful entrepreneurs, and non-successful entrepreneurs. Findings: The first phase findings ( quantitative) shows the obstacles to survive; starting from the personal/ entrepreneurial factors such as; past work experience, lack of skills and interest, are positive factors, while; gender, age and education level of the owner are negative factors. Internal factors such as lack of marketing research and weak business planning are positive. The environmental factors; in economic perspectives; difficulty to find labors, in socio-cultural perspectives; Social restriction and traditions found to be a negative factors. In other hand, from the political perspective; cost of compliance and insufficient government plans found to be a positive factors for small business failure. From infrastructure perspective; lack of skills labor, high level of bureaucracy and lack of information are positive factors. Conclusion: This paper serves to enrich the understanding of failure factors in MENA region more precisely in SA, by minimizing the probability of failure in small-micro entrepreneurial start-up in SA, in the light of the Saudi government’s Vision 2030 plan.

Keywords: small business barriers, start-up business, entrepreneurship, Saudi Arabia

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Authors: Anita Burgund Isakov, Cristina Nunes, Nevenka Zegarac, Ana Antunes

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Contemporary societies are facing a noticeable shift in family realities, urging to need for the development of new policies, service, and practice orientation that has application across different sectors who serves families with children across the world. A challenge for the field of family support is diversity in conceptual assumptions and epistemological frameworks. Since many disciplines and professionals are working in the family support field, there is a need to map and gain a deeper insight into the skills for the workforce in this field. Under the umbrella of the COST action 'The Pan-European Family Support Research Network: A bottom-up, evidence-based and multidisciplinary approach', a review of the current state of knowledge published from the European studies on family support workforce skills standards is performed. Contributing to the aim of mapping and catalogization of skills standards, key stages of literature review were identified in order to extract and systematize the data. We have considered inclusion and exclusion criteria for this literature review. Inclusion criteria were: a) families living with their children and families using family support services; different methodological approaches were included: qualitative, quantitative, mix method, literature review and theoretical reflections various topic appeared in journals like working with families that are facing difficulties or culturally sensitive practice and relationship-based approaches; b) the dates ranged from 1995 to February 2020. Articles published prior to 1995 were excluded due to modernization of family support services across world; c) the sources and languages included peer-reviewed articles published in scientific journals in English. Six databases were searched and once we have extracted all the relevant papers (n=29), we searched the list of reference in each and we found 11 additional papers. In total 40 papers have been extracted from six data basis. Findings could be summarized in: 1) only five countries emerged with production in the specific topic, that is, workforce skills to family support (UK, USA, Canada, Australia, and Spain), 2) studies revealed that diverse skills support family topics were investigated, namely the professional support skills to help families of neglected/abused children or in care; the professional support skills to help families with children who suffer from behavioral problems and families with children with disabilities; and the professional support skills to help minority ethnic parents, 3) social workers were the main targeted professionals' studies albeit other child protection workers were studied too, 4) the workforce skills to family support were grouped in three topics: the qualities of the professionals (attitudes and attributes); technical skills, and specific knowledge. The framework of analyses, literature strategy and findings with study limitations will be further discussed. As an implication, this study contributes and advocates for the structuring of a common base for cross-sectoral and interdisciplinary qualification standards for the family support workforce.

Keywords: family support, skill standards, systemic review, workforce

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Authors: Rasmila Kawan, Sanjay Juvekar, Sandeep Salvi, Gufran Beig, Rainer Sauerborn

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Background: Indoor air pollution especially from the use of biomass fuels, remains a potentially large global health threat. The inefficient use of such fuels in poorly ventilated conditions results in high levels of indoor air pollution, most seriously affecting women and young children. Objectives: The main aim of this study was to measure and compare the lung function of the women exposed in the biomass fuels and LPG fuels and relate it to the indoor emission measured using a structured questionnaire, spirometer and filter based low volume samplers respectively. Methodology: This cross-sectional comparative study was conducted among the women (aged > 18 years) living in rural villages of Pune district who were not diagnosed of chronic pulmonary diseases or any other respiratory diseases and using biomass fuels or LPG for cooking for a minimum period of 5 years or more. Data collection was done from April to June 2017 in dry season. Spirometer was performed using the portable, battery-operated ultrasound Easy One spirometer (Spiro bank II, NDD Medical Technologies, Zurich, Switzerland) to determine the lung function over Forced expiratory volume. The primary outcome variable was forced expiratory volume in 1 second (FEV1). Secondary outcome was chronic obstruction pulmonary disease (post bronchodilator FEV1/ Forced Vital Capacity (FVC) < 70%) as defined by the Global Initiative for Obstructive Lung Disease. Potential confounders such as age, height, weight, smoking history, occupation, educational status were considered. Results: Preliminary results showed that the lung function of the women using Biomass fuels (FEV1/FVC = 85% ± 5.13) had comparatively reduced lung function than the LPG users (FEV1/FVC = 86.40% ± 5.32). The mean PM 2.5 mass concentration in the biomass user’s kitchen was 274.34 ± 314.90 and 85.04 ± 97.82 in the LPG user’s kitchen. Black carbon amount was found higher in the biomass users (black carbon = 46.71 ± 46.59 µg/m³) than LPG users (black carbon=11.08 ± 22.97 µg/m³). Most of the houses used separate kitchen. Almost all the houses that used the clean fuel like LPG had minimum amount of the particulate matter 2.5 which might be due to the background pollution and cross ventilation from the houses using biomass fuels. Conclusions: Therefore, there is an urgent need to adopt various strategies to improve indoor air quality. There is a lacking of current state of climate active pollutants emission from different stove designs and identify major deficiencies that need to be tackled. Moreover, the advancement in research tools, measuring technique in particular, is critical for researchers in developing countries to improve their capability to study the emissions for addressing the growing climate change and public health concerns.

Keywords: black carbon, biomass fuels, indoor air pollution, lung function, particulate matter

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Authors: Flackson Tshuma, James Bennett, Pieter Andreas Swanepoel, Johan Labuschagne, Stephan van der Westhuizen, Francis Rayns

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Amongst other things, tillage and synthetic agrochemicals can be effective methods of seedbed preparation and pest control. Nonetheless, frequent and intensive tillage and excessive application of synthetic agrochemicals, such as herbicides and insecticides, can reduce soil microbial enzyme activity. A decline in soil microbial enzyme activity can negatively affect nutrient cycling and crop productivity. In this study, the effects of four tillage treatments; continuous mouldboard plough; shallow tine-tillage to a depth of about 75 mm; no-tillage; and tillage rotation (involving shallow tine-tillage once every four years in rotation with three years of no-tillage), and two rates of synthetic agrochemicals (standard: with regular application of synthetic agrochemicals; and reduced: fewer synthetic agrochemicals in combination with bio-chemicals/ or bio-stimulants) on soil microbial enzyme activity were investigated between 2018 and 2020 in a typical Mediterranean climate zone in South Africa. Four different bio-stimulants applied contained: Trichoderma asperellum, fulvic acid, silicic acid, and Nereocystis luetkeana extracts, respectively. The study was laid out as a complete randomised block design with four replicated blocks. Each block had 14 plots, and each plot measured 50 m x 6 m. The study aimed to assess the combined impact of tillage practices and reduced rates of synthetic agrochemical application on soil microbial enzyme activity in a dryland cropping system. It was hypothesised that the application of bio-stimulants in combination with minimum soil disturbance will lead to a greater increase in microbial enzyme activity than the effect of applying either in isolation. Six soil cores were randomly and aseptically collected from each plot for microbial enzyme activity analysis from the 0-150 mm layer of a field trial under a dryland crop rotation system in the Swartland region. The activities of four microbial enzymes, β-glucosidase, acid phosphatase, alkaline phosphatase and urease, were assessed. The enzymes are essential for the cycling of glucose, phosphorus, and nitrogen, respectively. Microbial enzyme activity generally increased with a reduction of both tillage intensity and synthetic agrochemical application. The use of the mouldboard plough led to the least (P<0.05) microbial enzyme activity relative to the reduced tillage treatments, whereas the system with bio-stimulants (reduced synthetic agrochemicals) led to the highest (P<0.05) microbial enzyme activity relative to the standard systems. The application of bio-stimulants in combination with reduced tillage, particularly no-tillage, could be beneficial for enzyme activity in a dryland farming system.

Keywords: bio-stimulants, soil microbial enzymes, synthetic agrochemicals, tillage

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Authors: Shailendra Kumar Singh

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With the rise of New Linguistic World Order in the 21st century, the Aged Pragmatics is palpitating on the edge of theoretical irrelevance. What appears to be a new sociolinguistic reality is that the enlightening combination of alternative west, inclusive globalization and techno-revolution is adding novel recipes to communicative actions, style and gain among new linguistic breed which is being neither dominated nor powered by the western supremacy. The paper has the following main, interrelated, aims: it is intended to introduce the concept of alternative pragmatics that can offer what exactly is needed for our emerging societal realities; it asserts as to how the basic pillar of linguistic success in the new linguistic world order rests upon linguistic temptation and calibration of all; and it also reviews an inevitability of emerging economies in shaping the communication trends at a time when the western world is struggling to maintain the same control on the others exercised in the past. In particular, the paper seeks answers for the following questions: (a) Do we need an alternative pragmatics, one with alternativist leaning in an era of inclusive globalization and alternative west? (b) What are the pulses of shift which are encapsulating emergence of new communicative behavior among the new linguistic breed by breaking yesterday’s linguistic rigidity? (c) Or, what are those shifts which are making linguistic shift more perceptible? (d) Is New Linguistic World Order succeeding in reversing linguistic priorities of `who speaks, what language, where, how, why, to whom and in which condition’ with no parallel in the history? (e) What is explicit about the contemporary world of 21st century which makes linguistic world all exciting and widely celebrative phenomenon and that is also forced into our vision? (f) What factors will hold key to the future of yesterday’s `influential languages’ and today’s `emerging languages’ as world is in the paradigm transition? (g) Is the collapse of Aged Pragmatics good for the 21st century for understanding the difference between pragmatism of old linguistic world and new linguistic world order? New Linguistic world Order today, unlike in the past, is about a branding of new world with liberal world view for a particular form of ideal to be imagined in the 21st century. At this time without question it is hope that a new set of ideals with popular vocabulary will become the implicit pragmatic model as one of benign majoritarianism in all aspects of sociolinguistic reality. It appears to be a reality that we live in an extraordinary linguistic world with no parallel in the past. In particular, the paper also highlights the paradigm shifts: Demographic, Social-psychological, technological and power. These shifts are impacting linguistic shift which is unique in itself. The paper will highlight linguistic shift in details in which alternative west plays a major role without challenging the west because it is an era of inclusive globalization in which almost everyone takes equal responsibility.

Keywords: inclusive globalization, new linguistic world order, linguistic shift, world order

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Authors: S. Arias

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New housing developments and the technological changes that this implies, adapt the styles of living of its residents, as well as new family structures and forms of work due to the particular needs of a specific group of people which involves different techniques of dealing with, organize, equip and use a particular territory. Currently, own their own space is increasingly important and the cities are faced with the challenge of providing the opportunity for such demands, as well as energy, water and waste removal necessary in the process of construction and occupation of new human settlements. Until the day of today, not has failed to give full response to these demands and needs, resulting in cities that grow without control, badly used land, avenues and congested streets. Buildings and dwellings have an important impact on the environment and on the health of the people, therefore environmental quality associated with the comfort of humans to the sustainable development of natural resources. Applied to architecture, this concept involves the incorporation of new technologies in all the constructive process of a dwelling, changing customs of developers and users, what must be a greater effort in planning energy savings and thus reducing the emissions Greenhouse Gases (GHG) depending on the geographical location where it is planned to develop. Since the techniques of occupation of the territory are not the same everywhere, must take into account that these depend on the geographical, social, political, economic and climatic-environmental circumstances of place, which in modified according to the degree of development reached. In the analysis that must be undertaken to check the degree of sustainability of the place, it is necessary to make estimates of the energy used in artificial air conditioning and lighting. In the same way is required to diagnose the availability and distribution of the water resources used for hygiene and for the cooling of artificially air-conditioned spaces, as well as the waste resulting from these technological processes. Based on the results obtained through the different stages of the analysis, it is possible to perform an energy audit in the process of proposing recommendations of sustainability in architectural spaces in search of energy saving, rational use of water and natural resources optimization. The above can be carried out through the development of a sustainable building code in develop technical recommendations to the regional characteristics of each study site. These codes would seek to build bases to promote a building regulations applicable to new human settlements looking for is generated at the same time quality, protection and safety in them. This building regulation must be consistent with other regulations both national and municipal and State, such as the laws of human settlements, urban development and zoning regulations.

Keywords: building regulations, housing, sustainability, technology

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Authors: Ahmed O. Apampa, Yinusa A. Jimoh

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The potential economic viability and environmental benefits of using a biomass waste, such as corn cob ash (CCA) as pozzolan in stabilizing soils for road pavement construction in a sub-tropical region was investigated. Corn cob was obtained from Maya in South West Nigeria and processed to ash of characteristics similar to Class C Fly Ash pozzolan as specified in ASTM C618-12. This was then blended with ordinary Portland cement in the CCA:OPC ratios of 1:1, 1:2 and 2:1. Each of these blends was then mixed with lateritic soil of ASHTO classification A-2-6(3) in varying percentages from 0 – 7.5% at 1.5% intervals. The soil-CCA-Cement mixtures were thereafter tested for geotechnical index properties including the BS Proctor Compaction, California Bearing Ratio (CBR) and the Unconfined Compression Strength Test. The tests were repeated for soil-cement mix without any CCA blending. The cost of the binder inputs and optimal blends of CCA:OPC in the stabilized soil were thereafter analyzed by developing algorithms that relate the experimental data on strength parameters (Unconfined Compression Strength, UCS and California Bearing Ratio, CBR) with the bivariate independent variables CCA and OPC content, using Matlab R2011b. An optimization problem was then set up minimizing the cost of chemical stabilization of laterite with CCA and OPC, subject to the constraints of minimum strength specifications. The Evolutionary Engine as well as the Generalized Reduced Gradient option of the Solver of MS Excel 2010 were used separately on the cells to obtain the optimal blend of CCA:OPC. The optimal blend attaining the required strength of 1800 kN/m2 was determined for the 1:2 CCA:OPC as 5.4% mix (OPC content 3.6%) compared with 4.2% for the OPC only option; and as 6.2% mix for the 1:1 blend (OPC content 3%). The 2:1 blend did not attain the required strength, though over a 100% gain in UCS value was obtained over the control sample with 0% binder. Upon the fact that 0.97 tonne of CO2 is released for every tonne of cement used (OEE, 2001), the reduced OPC requirement to attain the same result indicates the possibility of reducing the net CO2 contribution of the construction industry to the environment ranging from 14 – 28.5% if CCA:OPC blends are widely used in soil stabilization, going by the results of this study. The paper concludes by recommending that Nigeria and other developing countries in the sub-tropics with abundant stock of biomass waste should look in the direction of intensifying the use of biomass waste as fuel and the derived ash for the production of pozzolans for road-works, thereby reducing overall green house gas emissions and in compliance with the objectives of the United Nations Framework on Climate Change.

Keywords: corn cob ash, biomass waste, lateritic soil, unconfined compression strength, CO2 emission

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Authors: Bessy Thuranira

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Buildings, as they are designed and used, may contribute to serious environmental problems because of excessive consumption of energy and other natural resources. Buildings in the informal settlements particularly, due to their unplanned physical structure and design, have significantly contributed the global energy problematic scenario typified by high-level inefficiencies. Energy used in buildings in Africa is estimated to be the highest of the total national electricity consumption. Over the last decade, assessments of energy consumption and efficiency/inefficiency has focused on formal and modern buildings. This study seeks to go off the beaten path, by focusing on energy use in informal settlements. Operationally, it sought to establish the contribution of informal buildings in the overall energy consumption in the city and the country at large. This study was carried out in Mukuru kwa Reuben informal settlement where there is distinct manifestation of different settlement morphologies within a small locality. The research narrowed down to three villages (Mombasa, Kosovo and Railway villages) within the settlement, that were representative of the different slum housing typologies. Due to the unpredictability nature and informality in slums, this study takes a multi-methodology approach. Detailed energy audits and measurements are carried out to predict total building consumption, and document building design and envelope, typology, materials and occupancy levels. Moreover, the study uses semi-structured interviews and to access energy supply, cost, access and consumption patterns. Observations and photographs are also used to shed more light on these parameters. The study reveals the high energy inefficiencies in slum buildings mainly related to sub-standard equipment and appliances, building design and settlement layout, poor access and utilization/consumption patterns of energy. The impacts of this inefficiency are high economic burden to the poor, high levels of pollution, lack of thermal comfort and emissions to the environment. The study highlights a set of urban planning and building design principles that can be used to retrofit slums into more energy efficient settlements. The study explores principles of responsive settlement layouts/plans and appropriate building designs that use the beneficial elements of nature to achieve natural lighting, natural ventilation, and solar control to create thermally comfortable, energy efficient, and environmentally responsive buildings/settlements. As energy efficiency in informal settlements is a relatively less explored area of efficiency, it requires further research and policy recommendations, for which this paper will set a background.

Keywords: energy efficiency, informal settlements, renewable energy, settlement layout

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Authors: Yuta Kurashina, Chikahiro Imashiro, Kiyoshi Ohnuma, Kenjiro Takemura

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Research objectives and goals: To realize clinical applications of regenerative medicine, a mass cell culture is highly required. In a conventional cell culture, trypsinization was employed for cell detachment. However, trypsinization causes proliferation decrease due to injury of cell membrane. In order to detach cells using an enzyme-free method, therefore, this study proposes a novel cell detachment method capable of detaching adherent cells using acoustic radiation pressure exposed to the dish by the assistance of serum-free medium with ITS liquid medium supplement. Methods used In order to generate acoustic radiation pressure, a piezoelectric ceramic plate was glued on a glass plate to configure an ultrasonic transducer. The glass plate and a chamber wall compose a chamber in which a culture dish is placed in glycerol. Glycerol transmits acoustic radiation pressure to adhered cells on the culture dish. To excite a resonance vibration of transducer, AC signal with 29-31 kHz (swept) and 150, 300, and 450 V was input to the transducer for 5 min. As a pretreatment to reduce cell adhesivity, serum-free medium with ITS liquid medium supplement was spread to the culture dish before exposed to acoustic radiation pressure. To evaluate the proposed cell detachment method, C2C12 myoblast cells (8.0 × 104 cells) were cultured on a ø35 culture dish for 48 hr, and then the medium was replaced with the serum-free medium with ITS liquid medium supplement for 24 hr. We replaced the medium with phosphate buffered saline and incubated cells for 10 min. After that, cells were exposed to the acoustic radiation pressure for 5 min. We also collected cells by using trypsinization as control. Cells collected by the proposed method and trypsinization were respectively reseeded in ø60 culture dishes and cultured for 24 hr. Then, the number of proliferated cells was counted. Results achieved: By a phase contrast microscope imaging, shrink of lamellipodia was observed before exposed to acoustic radiation pressure, and no cells remained on the culture dish after the exposed of acoustic radiation pressure. This result suggests that serum-free medium with ITS liquid inhibits adhesivity of cells and acoustic radiation pressure detaches cells from the dish. Moreover, the number of proliferated cells 24 hr after collected by the proposed method with 150 and 300 V is the same or more than that by trypsinization, i.e., cells were proliferated 15% higher with the proposed method using acoustic radiation pressure than with the traditional cell collecting method of trypsinization. These results proved that cells were able to be collected by using the appropriate exposure of acoustic radiation pressure. Conclusions: This study proposed a cell detachment method using acoustic radiation pressure by the assistance of serum-free medium. The proposed method provides an enzyme-free cell detachment method so that it may be used in future clinical applications instead of trypsinization.

Keywords: acoustic radiation pressure, cell detachment, enzyme free, ultrasonic transducer

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Authors: Angelo Garofalo, Laura Donato, Maria Concetta Carnevale, Enrico Drioli, Omar Alharbi, Saad Aljlil, Alessandra Criscuoli, Catia Algieri

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Nowadays, water scarcity may be considered one of the most important and serious questions concerning our community: in fact, there is a remarkable mismatch between water supply and water demand. Exploitation of natural fresh water resources combined with higher water demand has led to an increased requirement for alternative water resources. In this context, desalination provides such an alternative source, offering water otherwise not accessible for irrigational, industrial and municipal use. Considering the various drawbacks of the polymeric membranes, zeolite membranes represent a potential device for water desalination owing to their high thermal and chemical stability. In this area wide attention was focused on the MFI (silicalite, ZSM-5) membranes, having a pore size lower (about 5.5 Å) than the major kinetic diameters of hydrated ions. In the present work, a scale-up for the preparation of supported silicalite membranes was performed. Therefore, tubular membranes 30 cm long were synthesized by using the secondary growth method coupled with the cross flow seeding procedure. The secondary growth presents two steps: seeding and growth of zeolite crystals on the support. This process, decoupling zeolite nucleation from crystals growth, permits to control the conditions of each step separately. The seeding procedure consists of a cross-flow filtration through a porous support coupled with the support rotation and tilting. The combination of these three different aspects allows a homogeneous and uniform coverage of the support with the zeolite seeds. After characterization by scanning electron microscope (SEM), X-ray diffractometry (XRD) and Energy-dispersive X-ray (EDX) analysis, the prepared membranes were tested by means of single gas permeation and then by Vacuum Membrane Distillation (VMD) using both deionized water and NaCl solutions. The experimental results evidenced the possibility to perform the scale up for the preparation of almost defect free silicalite membranes. VMD tests indicated the possibility to prepare membranes that exhibit interesting performance in terms of fluxes and salt rejections for concentrations from 0.2 M to 0.9 M. Furthermore, it was possible to restore the original performance of the membrane after an identified cleaning procedure. Acknowledgements: The authors gratefully acknowledge the support of the King Abdulaziz City for Science and Technology (KACST) for funding the research Project 895/33 entitled ‘Preparation and Characterization of Zeolite Membranes for Water Treatment’.

Keywords: desalination, MFI membranes, secondary growth, vacuum membrane distillation

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Authors: Anthony S. Machi, Joseph Minardi

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We present a case report of left atrial myxoma diagnosed by bedside transesophageal (TEE) ultrasound. Left atrial myxoma is the most common benign cardiac tumor and can obstruct blood flow and cause valvular insufficiency. Common symptoms consist of dyspnea, pulmonary edema and other features of left heart failure in addition to thrombus release in the form of tumor fragments. The availability of bedside ultrasound equipment is essential for the quick diagnosis and treatment of various emergency conditions including cardiac neoplasms. A 48-year-old Caucasian female with a four-year history of an untreated renal mass and anemia presented to the ED with two months of sharp, intermittent, bilateral flank pain radiating into the abdomen. She also reported intermittent vomiting and constipation along with generalized body aches, night sweats, and 100-pound weight loss over last year. She had a CT in 2013 showing a 3 cm left renal mass and a second CT in April 2016 showing a 3.8 cm left renal mass along with a past medical history of diverticulosis, chronic bronchitis, dyspnea on exertion, uncontrolled hypertension, and hyperlipidemia. Her maternal family history is positive for breast cancer, hypertension, and Type II Diabetes. Her paternal family history is positive for stroke. She was a current everyday smoker with an 11 pack/year history. Alcohol and drug use were denied. Physical exam was notable for a Grade II/IV systolic murmur at the right upper sternal border, dyspnea on exertion without angina, and a tender left lower quadrant. Her vitals and labs were notable for a blood pressure of 144/96, heart rate of 96 beats per minute, pulse oximetry of 96%, hemoglobin of 7.6 g/dL, hypokalemia, hypochloremia, and multiple other abnormalities. Physicians ordered a CT to evaluate her flank pain which revealed a 7.2 x 8.9 x 10.5 cm mixed cystic/solid mass in the lower pole of the left kidney and a filling defect in the left atrium. Bedside TEE was ordered to follow up on the filling defect. TEE reported an ejection fraction of 60-65% and visualized a mobile 6 x 3 cm mass in the left atrium attached to the interatrial septum extending into the mitral valve. Cardiothoracic Surgery and Urology were consulted and confirmed a diagnosis of left atrial myxoma and clear cell renal cell carcinoma. The patient returned a week later due to worsening nausea and vomiting and underwent emergent nephrectomy, lymph node dissection, and colostomy due to a necrotic colon. Her condition declined over the next four months due to lung and brain metastases, infections, and other complications until she passed away.

Keywords: bedside ultrasound, echocardiography, emergency medicine, left atrial myxoma

Procedia PDF Downloads 332

Authors: Mojtaba Eshraghi Arani

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Ship financing is the vital element in the development of shipping industry because while the ship constitutes the owners’ main asset, she is considered a reliable security in the financiers’ viewpoint as well. However, it is most probable that a financier who has accepted a ship as security will face many creditors who are privileged and rank before him for collecting, out of the ship, the money that they are owed. In fact, according to the current rule of maritime law, which was established by “Convention Internationale pour l’Unification de Certaines Règles Relatives aux Privilèges et Hypothèques Maritimes, Brussels, 10 April 1926”, the mortgages, hypotheques, and other charges on vessels rank after several secured claims referred to as “maritime liens”. Such maritime liens are an exhaustive list of claims including but not limited to “expenses incurred in the common interest of the creditors to preserve the vessel or to procure its sale and the distribution of the proceeds of sale”, “tonnage dues, light or harbour dues, and other public taxes and charges of the same character”, “claims arising out of the contract of engagement of the master, crew and other persons hired on board”, “remuneration for assistance and salvage”, “the contribution of the vessel in general average”, “indemnities for collision or other damage caused to works forming part of harbours, docks, etc,” “indemnities for personal injury to passengers or crew or for loss of or damage to cargo”, “claims resulting form contracts entered into or acts done by the master”. The same rule survived with only some minor change in the categories of maritime liens in the substitute conventions 1967 and 1993. The status que in maritime law have always been considered as a major obstacle to the development of shipping market and has inevitably led to increase in the interest rates and other related costs of ship financing. It seems that the national and international policy makers have yet to change their mind being worried about the deviation from the old marine traditions. However, it is crystal clear that the continuation of status que will harm, to a great extent, the shipowners and, consequently, the international merchants as a whole. It is argued in this article that the raison d'être for many categories of maritime liens cease to exist anymore, in view of which, the international community has to recognize only a minimum category of maritime liens which are created in the common interests of all creditors; to this effect, only two category of “compensation due for the salvage of ship” and “extraordinary expenses indispensable for the preservation of the ship” can be declared as taking priority over the mortgagee rights, in anology with the Geneva Convention on the International Recognition of Rights in Aircrafts (1948). A qualitative method with the concept of interpretation of data collection has been used in this manuscript. The source of the data is the analysis of international conventions and domestic laws.

Keywords: ship finance, mortgage, maritime liens, brussels convenion, geneva convention 1948

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Authors: Alexander Guzman Urbina, Atsushi Aoyama

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The sustainability of traditional technologies employed in energy and chemical infrastructure brings a big challenge for our society. Making decisions related with safety of industrial infrastructure, the values of accidental risk are becoming relevant points for discussion. However, the challenge is the reliability of the models employed to get the risk data. Such models usually involve large number of variables and with large amounts of uncertainty. The most efficient techniques to overcome those problems are built using Artificial Intelligence (AI), and more specifically using hybrid systems such as Neuro-Fuzzy algorithms. Therefore, this paper aims to introduce a hybrid algorithm for risk assessment trained using near-miss accident data. As mentioned above the sustainability of traditional technologies related with energy and chemical infrastructure constitutes one of the major challenges that today’s societies and firms are facing. Besides that, the adaptation of those technologies to the effects of the climate change in sensible environments represents a critical concern for safety and risk management. Regarding this issue argue that social consequences of catastrophic risks are increasing rapidly, due mainly to the concentration of people and energy infrastructure in hazard-prone areas, aggravated by the lack of knowledge about the risks. Additional to the social consequences described above, and considering the industrial sector as critical infrastructure due to its large impact to the economy in case of a failure the relevance of industrial safety has become a critical issue for the current society. Then, regarding the safety concern, pipeline operators and regulators have been performing risk assessments in attempts to evaluate accurately probabilities of failure of the infrastructure, and consequences associated with those failures. However, estimating accidental risks in critical infrastructure involves a substantial effort and costs due to number of variables involved, complexity and lack of information. Therefore, this paper aims to introduce a well trained algorithm for risk assessment using deep learning, which could be capable to deal efficiently with the complexity and uncertainty. The advantage point of the deep learning using near-miss accidents data is that it could be employed in risk assessment as an efficient engineering tool to treat the uncertainty of the risk values in complex environments. The basic idea of using a Near-Miss Deep Learning Approach for Neuro-Fuzzy Risk Assessment in Pipelines is focused in the objective of improve the validity of the risk values learning from near-miss accidents and imitating the human expertise scoring risks and setting tolerance levels. In summary, the method of Deep Learning for Neuro-Fuzzy Risk Assessment involves a regression analysis called group method of data handling (GMDH), which consists in the determination of the optimal configuration of the risk assessment model and its parameters employing polynomial theory.

Keywords: deep learning, risk assessment, neuro fuzzy, pipelines

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Authors: Anitha Muralidhara, Victor Engelen, Christophe Len, Pascal Pandard, Guy Marlair

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Production of bio-based chemicals and materials from lignocellulosic biomass is gaining tremendous importance in advanced bio-refineries while aiming towards progressive replacement of petroleum based chemicals in transportation fuels and commodity polymers. One such attempt has resulted in the production of key furan derivatives (FD) such as furfural, HMF, MMF etc., via acid catalyzed dehydration (ACD) of C6 and C5 sugars, which are further converted into key chemicals or intermediates (such as Furandicarboxylic acid, Furfuryl alcohol etc.,). In subsequent processes, many high potential FD are produced, that can be converted into high added value polymers or high energy density biofuels. During ACD, an unavoidable polyfuranic byproduct is generated which is called humins. The family of FD is very large with varying chemical structures and diverse physicochemical properties. Accordingly, the associated risk profiles may largely vary. Hazardous Material (Haz-mat) classification systems such as GHS (CLP in the EU) and the UN TDG Model Regulations for transport of dangerous goods are one of the preliminary requirements for all chemicals for their appropriate classification, labelling, packaging, safe storage, and transportation. Considering the growing application routes of FD, it becomes important to notice the limited access to safety related information (safety data sheets available only for famous compounds such as HMF, furfural etc.,) in these internationally recognized haz-mat classification systems. However, these classifications do not necessarily provide information about the extent of risk involved when the chemical is used in any specific application. Factors such as thermal stability, speed of combustion, chemical incompatibilities, etc., can equally influence the safety profile of a compound, that are clearly out of the scope of any haz-mat classification system. Irrespective of the bio-based origin, FD has so far received inconsistent remarks concerning their toxicity profiles. With such inconsistencies, there is a fear that, a large family of FD may also follow extreme judgmental scenarios like ionic liquids, by ranking some compounds as extremely thermally stable, non-flammable, etc., Unless clarified, these messages could lead to misleading judgements while ranking the chemical based on its hazard rating. Safety is a key aspect in any sustainable biorefinery operation/facility, which is often underscored or neglected. To fill up these existing data gaps and to address ambiguities and discrepancies, the current study focuses on giving preliminary insights on safety assessment of FD and their potential targeted by-products. With the available information in the literature and obtained experimental results, physicochemical safety, environmental safety as well as (a scenario based) fire safety profiles of key FD, as well as side streams such as humins and levulinic acid, will be considered. With this, the study focuses on defining patterns and trends that gives coherent safety related information for existing and newly synthesized FD in the market for better functionality and sustainable applications.

Keywords: furanics, humins, safety, thermal and fire hazard, toxicity

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Authors: Soran Aminiaghdam, Christian Rode, Reinhard Blickhan, Astrid Zech

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Despite considerable studies on the impact of imposed trunk posture on human walking, less is known about such locomotion while negotiating changes in ground level. The aim of this study was to investigate the behavior of the VBCOM in response to a two-fold expected perturbation, namely alterations in body posture and in ground level. To this end, the kinematic data and ground reaction forces of twelve able participants were collected. We analyzed the vertical position of the body center of mass (VBCOM) from the ground determined by the body segmental analysis method relative to the laboratory coordinate system at touchdown and toe-off instants during walking across uneven ground — characterized by perturbation contact (a 10-cm visible drop) and pre- and post-perturbation contacts — in comparison to unperturbed level contact while maintaining three postures (regular erect, ~30° and ~50° of trunk flexion from the vertical). The VBCOM was normalized to the distance between the greater trochanter marker and the lateral malleoli marker at the instant of TD. Moreover, we calculated the backward rotation during step-down as the difference of the maximum of the trunk angle in the pre-perturbation contact and the minimal trunk angle in the perturbation contact. Two-way repeated measures ANOVAs revealed contact-specific effects of posture on the VBCOM at touchdown (F = 5.96, p = 0.00). As indicated by the analysis of simple main effects, during unperturbed level and pre-perturbation contacts, no between-posture differences for the VBCOM at touchdown were found. In the perturbation contact, trunk-flexed gaits showed a significant increase of VBCOM as compared to the pre-perturbation contact. In the post-perturbation contact, the VBCOM demonstrated a significant decrease in all gait postures relative to the preceding corresponding contacts with no between-posture differences. Main effects of posture revealed that the VBCOM at toe-off significantly decreased in trunk-flexed gaits relative to the regular erect gait. For the main effect of contact, the VBCOM at toe-off demonstrated changes across perturbation and post-perturbation contacts as compared to the unperturbed level contact. Furthermore, participants exhibited a backward trunk rotation during step-down possibly to control the angular momentum of their whole body. A more pronounced backward trunk rotation (2- to 3-fold compared with level contacts) in trunk-flexed walking contributed to the observed elevated VBCOM during the step-down which may have facilitated drop negotiation. These results may shed light on the interaction between posture and locomotion in able gait, and specifically on the behavior of the body center of mass during perturbed locomotion.

Keywords: center of mass, perturbation, posture, uneven ground, walking

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Authors: Jerry Fiave, Dacosta Aboagye, Stephen Ayisi-Addo, Mabel Kissiwah Asafo, Felix Osei-Sarpong, Ebenezer Kye-Mensah, Renee Opare-Otoo

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Background: Acceptability and preference of social and behaviour change (SBC) materials by target audiences is an important determinant of effective health communication outcomes. In Ghana, however, pre-test and post-test studies on acceptability and preference of specific SBC materials for specific audiences are rare. The aim of this study was therefore to assess the acceptability and preference of printed posters on COVID-19 related stigma as suitable SBC materials for health workers to influence behaviours that promote uptake of HIV-focused services. Methods: A total of 218 health workers who provide HIV-focused services were purposively sampled in 16 polyclinics where the posters were distributed in the Greater Accra region of Ghana. Data was collected in March 2021 using an adapted self-administered questionnaire in Google forms deployed via WhatsApp to participants. The data were imported into SPSS version 27 where chi-square test and regression analyses were performed to establish association as well as strength of association between variables respectively. Results: A total of 142 participants (physicians, nurses, midwives, lab scientists, health promoters, diseases control officers) made up of 85(60%) females and 57(40%) males responded to the questionnaire, giving a response rate of 65.14%. Only 88 (61.97%) of the respondents were exposed to the posters. The majority of those exposed said the posters were informative [82(93.18%)], relevant [85(96.59%)] and attractive [83(94.32%)]. They [82(93.20%)] also rated the material as acceptable with no statistically significant association between category of health worker and acceptability of the posters (X =1.631, df=5, p=0.898). However, participants’ most preferred forms of material on COVID-19 related stigma were social media [38(26.76%)], television [33(23.24%)], SMS [19(13.38%)], and radio [18(12.70%)]. Clinical health workers were 4.88 times more likely to prefer online or electronic versions of SBC materials than nonclinical health workers [AOR= 4.88 (95% CI= 0.31-0.98), p=0.034]. Conclusions: Printed posters on COVID-19 related stigma are acceptable SBC materials in communicating behaviour change messages that target health workers in promoting uptake of HIV-focused services. Posters are however, not among the most preferred materials for health workers. It is therefore recommended that material assessment studies are conducted to inform the development of acceptable and preferred materials for target audiences.

Keywords: acceptability, AIDS, HIV, posters, preference, SBC, stigma, social and behaviour change communication

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Authors: Armine Vahanyan

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Humanity has been still coping with the new COVID-19 pandemic. Healthcare providers, economists, psychologists, and other specialists speak about the impact of the virus on different spheres of our life. In the list of similar discussions, the impact of pandemics on global education is of utmost importance. Ideally, providing quality education services should be crucial, and the ways education programs are being adapted will determine the success or failure of the service providers. The paper aims to summarize the research touching upon the current situation of higher education in Armenia. The research includes data from official reports, surveys among education leads, faculty, and students, as well as personal observations and consideration. Through descriptive analysis, the findings of the research are being presented from various aspects. Interim results of the research unveiled two major issues in the sector of higher education in Armenia. On the one hand, the entire compulsory digitization of instruction, assessment, and grading has evoked serious gaps related to the lack of technical competencies. There is an urgent need for professional development programs that will address most of the concerns due to the shift to the online instruction mode. On the other hand, online teaching and learning require revision and adaptation of the existing curricula. Given that the content of certain programs may not be compromised, the teaching methods, the assignments, and evaluation require profound transformation, which will still be in line with course learning outcomes and student learning outcomes. The given paper focuses on the ways the mentioned issues are being addressed in Armenia. The extent of commitment for changes and adaptability to the new situation varies from the government-funded and private universities. In particular, the paper compares and contrasts activities and measures taken at the Armenian State Pedagogical University and the American University of Armenia. Thus, the Pedagogical University focused on the use of Google Classroom as the only means for teaching and learning as well as adopted the compulsory synchronous instruction mode. The American University, on the contrary, kept practicing the academic freedom, enabling both synchronous and asynchronous instruction modes, ensuring alignment of the course learning outcomes and student learning outcomes. The State University utilized the assignments and assessment, which would work for the on-campus instruction mode, while the American university employed a variety of assignments applicable for online teaching mode. The latter has suggested the utilization of multiple apps, internet sources, and online library access for a better online instant. Discussions with faculty through online forums and/or professional development workshops also facilitate restructuring and adaptation of the courses. Finally, the paper will synthesize the results of the undertaken research and will outline the e-learning perspectives and opportunities boosted by the known devastating healthcare issue.

Keywords: assessment, compulsory digitization of education services, online teaching, instruction mode, program restructuring

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Authors: Amina Sa'id Muhammad, Asmau Ishaq Alhassan, Beba Raymond, Fatima Bello

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Severe acute malnutrition (SAM) remains a major killer of children under five years of age. Nigeria has the second highest burden of stunted children in the world, with a national prevalence rate of 32 percent of children under five. An estimated 2 million children in Nigeria suffer from severe acute malnutrition (SAM), and 3.9% of children in northwest Nigeria suffer from SAM, which is significantly higher than the national average of 2.1%. Community-Based Management of Acute Malnutrition (CMAM) has proven to be an effective intervention in the treatment of SAM in children using Ready-to-Use Therapeutic Food (RUTF). Ready-to-use therapeutic food (RUTF) is a key component for the treatment of Severe Acute Malnutrition. It contains all the energy and nutrients required for rapid catch-up growth and used particularly in the treatment of children over 6 months of age with SAM without medical complications. However, almost all RUTFs are currently imported to Nigeria from other countries. Shortages of RUTF due to logistics (shipping costs, delays, donor fatigue etc) and funding issues present a threat to the achievement of the 2030 World Health Assembly (WHA) targets for reducing malnutrition in addition to 2030 SDGs 2 (Zero Hunger), 3 (Good Health and Wellbeing), 12 (Responsible Consumption and Production), and 17 (Partnerships for the Goals), thus undermining its effectiveness in combating malnutrition On the other hand, the availability of human and material resources that will aid local production of RUTF presents an opportunity to fill in the gap in regular RUTF supply. About one thousand Nigerian children die of malnutrition-related causes every day, reaching a total of 361,000 each year. Owing to the high burden of malnutrition in Nigeria, the local production of RUTF is a logical step, that will ensure increased availability, acceptability, access, and efficiency in supply, and at lower costs. Objective(s): The objectives of this study were therefore, to formulate RUTF from locally available resources and to determine its energy and nutrients composition, incommensurate with the standard/commercial RUTF. Methods: Three samples of RUTF were formulated using locally available resources (soya beans, wheat, rice, baobab, brown-sugar, date palm and soya oil); which were subjected to various analysis to determine their energy/proximate composition, vitamin and mineral contents and organoleptic properties were also determined using sensory evaluation. Results: The energy values of the three samples of locally produced RUTF were found to be in conformity with WHO recommendation of ≥ 500 kcal per 100g. The energy values of the three RUTF samples produced in the current study were found to be 563.08, 503.67 and 528.98 kcal respectively. Sample A, B and C had protein content of 13.56% 16.71% and 14.62% respectively, which were higher than that of commercial RUTF (10.9%). Conclusions/recommendations: The locally formulated RUTF samples had energy value of more than 500 kcal per 100g; with an appreciable amount of macro and micro nutrients. The appearance, taste, flavor and general acceptability of the formulated RUTF samples were also commendable.

Keywords: energy, malnutrition, nutrients, RUTF

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Authors: William Elnemer, Nauman Hussain, Samir Al-Ali, Henry Shu, Diane Ghanem, Babar Shafiq

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Introduction: The incidence of infection in open tibial shaft injuries varies depending on the severity of the injury, with rates ranging from 1.8% for Gustilo-Anderson type I to 42.9% for type IIIB fractures. The timely administration of antibiotics upon presentation to the emergency department (ED) is an essential component of fracture management, and evidence indicates that prompt delivery of antibiotics is associated with improved outcomes. The objective of this study is to identify factors that contribute to the expedient administration of antibiotics. Methods: This is a retrospective study of open tibial shaft fractures at an academic Level I trauma center. Current Procedural Terminology (CPT) codes identified all patients treated for open tibial shaft fractures between 2015 and 2021. Open fractures were identified by reviewing ED and provider notes, and with ballistic fractures were considered open. Chart reviews were performed to extract demographics, fracture characteristics, postoperative outcomes, time to operative room, time to antibiotic order, and delivery. Univariate statistical analysis compared patients who received early antibiotics (EA), which were delivered within one hour of ED presentation, and those who received late antibiotics (LA), which were delivered outside of one hour of ED presentation. A multivariate analysis was performed to investigate patient, fracture, and transport/ED characteristics contributing to faster delivery of antibiotics. The multivariate analysis included the dependent variables: ballistic fracture, activation of Delta Trauma, Gustilo-Andersen (Type III vs. Type I and II), AO-OTA Classification (Type C vs. Type A and B), arrival between 7 am and 11 pm, and arrival via Emergency Medical Services (EMS) or walk-in. Results: Seventy ED patients with open tibial shaft fractures were identified. Of these, 39 patients (55.7%) received EA, while 31 patients (44.3%) received LA. Univariate analysis shows that the arrival via EMS as opposed to walk-in (97.4% vs. 74.2%, respectively, p = 0.01) and activation of Delta Trauma (89.7% vs. 51.6%, respectively, p < 0.001) was significantly higher in the EA group vs. the LA group. Additionally, EA cases had significantly shorter intervals between the antibiotic order and delivery when compared to LA cases (0.02 hours vs. 0.35 hours, p = 0.007). No other significant differences were found in terms of postoperative outcomes or fracture characteristics. Multivariate analysis shows that a Delta Trauma Response, arrival via EMS, and presentation between 7 am and 11 pm were independent predictors of a shorter time to antibiotic administration (Odds Ratio = 11.9, 30.7, and 5.4, p = 0.001, 0.016, and 0.013, respectively). Discussion: Earlier antibiotic delivery is associated with arrival to the ED between 7 am and 11 pm, arrival via EMS, and a coordinated Delta Trauma activation. Our findings indicate that in cases where administering antibiotics is critical to achieving positive outcomes, it is advisable to employ a coordinated Delta Trauma response. Hospital personnel should be attentive to the rapid administration of antibiotics to patients with open fractures who arrive via walk-in or during late-night hours.

Keywords: antibiotics, emergency department, fracture management, open tibial shaft fractures, orthopaedic surgery, time to or, trauma fractures

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Authors: Leja Salciute

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Mental health difficulties are one of the reasons for abnormal feeding behaviour. This is especially evident in a crisis situation. Abnormal feeding behaviour occurs when individuals use food as a method to provide relief for these negative emotions. The study aimed to discover an association between emotional regulation, mental health difficulties and disruption in feeding behaviours in the UK in times of crisis. A mixed-methods design was used. Abnormal feeding behaviour was measured using the Binge Eating Disorder Screener-7, SCOFF scale, Crisis impact scale, Difficulties in Emotion Regulation Scale and demographics. The sample comprised 342 participants with a history of excessive overeating. The participants (male= 198, female= 141 and other= 3) came from the general population and they were aged 16 and over. Participants ranged in age from 16 to 89. Findings from the survey concluded that difficulties with emotion regulation were found to be associated with abnormal feeding behaviours. Mental health difficulties correlated significantly with changes in individuals’ lives, such as work or routines. Individuals differed in their abnormal feeding behaviour in terms of their age, that is, younger individuals showed less struggle with their eating patterns while older individuals faced greater struggles with their abnormal feeding behaviour. Emotion regulation significantly influenced abnormal feeding behaviour. Results from qualitative data suggest four common themes that were identified: demonstration of gratitude, negative emotions, disruptions to social life, and financial loss. For example, participants developed and gained an awareness of being grateful for the simple things in life even when participants experienced hardships. The results also suggested that emotional eating acted like a sedative that allowed the participant to run away from their painful reality. Crisis situation negatively affected relationships among participants and induced negativity related to social interaction. Finally, the respondents highlighted that the presence of uncertainty made it hard to plan ahead and look forward to the future. Although respondents experienced negative emotions and financial losses, some of them still managed to allocate time for themselves and enjoy their time off during crisis. However, majority of respondents referred to their inability to control their external circumstances and turned to and relied upon food overconsumption instead. This had a negative effect on their mental health and presented disruptions in feeding behaviour. It was recommended for individuals in times of crisis to seek psychological support in the form of Cognitive Behavioural Therapy (CBT).

Keywords: binge eating, maladaptive eating behaviours, mental health, negative emotions in crisis

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Authors: Somya Sharma

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Ahalya, the critically acclaimed short film, is known to demolish the gender constructs of the age old myth of Ahalya. The paper tries to crack the overt meaning of the short film by reading between the dialogues and deconstructing the idea of the pseudo feminism in the short film Ahalya by Sujoy Ghosh. The film, by subverting the role of male character by making it seem submissive as compared to the female character's role seems to be just a surface level reading of the text. It seems that Sujoy Ghosh has played not just with changing the paradigm, but also trying to alter the history by doing so. The age old myth of putting Ahalya as a part of the five virgins (panchkanya) of Hindu mythology is explored in the paper. God's manoeuvre cannot be questioned and the two male characters tend to again shape the deed and the life of the female character, Ahalya. It is of importance to note that even in the 21st century, progressive actors like Radhika Apte fail to acknowledge the politics of altering history, not in a progressive way. The film blinds the viewer in the first watch to fall for the female strength and ownership of her sexuality, which is reflected in the opening scene itself where she opens the gate for the police man Indra Sen (representing God Indra who seduced her) who is charmed by her white dress. White, in Hindu mythology, stands for mourning, and this can be a hint towards the prophecy of what is about to come. Ahalya, bold, strong, and confident in this scene seems to be in total ownership of her sexual identity. Further, as the film progresses, control of Ahalya over her acts becomes even more dominant. In the myth of Ahalya, Gautama Maharishi, her husband, who wins her by Brahma's courtesy, curses her for her infidelity. She is then turned into a stone because of the curse and is redeemed when Lord Rama's foot brushes the stone. In the film, it is with the help of Ahalya that Goutam Sadhu turns Indra Sen into a stone doll. Ahalya is seen as a seductress who bewitches Indra Sen, and because the latter falls for the trap laid by the husband wife duo, he is turned into a doll. The attempt made by the paper is to read Ahalya as a character of the stand in wife who is yet again a pawn in the play of Goutama's revenge from Indra (who in the myth is able to escape from any curse or punishment for the act). The paper, therefore, reverts the idea which has till now been signified by the film and attempts to study the feminism this film appropriates. It is essential to break down the structure formed by such overt transgressing films in order to provide a real outlook of how feminism is twisted and moulded according to a man’s wishes.

Keywords: deconstructing, Hindu mythology, Panchkanya, predominant feminism, seductress, stone doll

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Authors: Afentoula Mavrodi, Andreas Georgiou, Georgios Tsiotras, Vassilis Aletras

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Placing a monetary value on a quality-adjusted-life-year (QALY) is of utmost importance in economic evaluation. Identifying the population’s preferences is critical in order to understand some of the reasons driving variations in the assigned monetary value. Yet, evidence of the motives behind value assignment to a QALY by the general public is limited. Developing an instrument that would capture the population’s motives could be proven valuable to policy-makers, to guide them in allocating different values to a QALY based on users’ motivations. The aim of this study was to identify the most relevant motives and develop an appropriate instrument to assess them. To design the instrument, we employed: a) the EQ-5D-3L tool to assess participants’ current health status, and b) the Willingness-to-Pay (WTP) approach, within the Contingent Valuation (CV) Method framework, to elicit the monetary value. Advancing the open-ended approach adopted to assess solely protest bidders’ motives; a variety of follow-up item-specific statements were designed (deductive approach), aiming to evaluate motives of both protest bidders and participants willing to pay for the hypothetical treatment under consideration. The initial design of the survey instrument was the outcome of an extensive literature review. This instrument was revised based on 15 semi-structured interviews that took place in September 2018 and a pilot study held during two months (October-November) in 2018. Individuals with different educational, occupational and economical backgrounds and adequate verbal skills were recruited to complete the semi-structured interviews. The follow-up motivation statements of both protest bidders and those willing to pay were revised and rephrased after the semi-structured interviews. In total 4 statements for protest bidders and 3 statements for those willing to pay for the treatment were chosen to be included in the survey tool. Using the CATI (Computer Assisted Telephone Interview) method, a randomly selected sample of 97 persons living in Thessaloniki, Greece, completed the questionnaire on two occasions over a period of 4 weeks. Based on pilot study results, a test-retest reliability assessment was performed using the intra-class correlation coefficient (ICC). All statements formulated for protest bidders showed acceptable reliability (ICC values of 0.84 (95% CI: 0.67, 0.92) and above). Similarly, all statements for those willing to pay for the treatment showed high reliability (ICC values of 0.86 (95% CI: 0.78, 0.91) and above). Overall, the instrument designed in this study was reliable with regards to the item-specific statements assessing participants’ motivation. Validation of the instrument will take place in a future study. For a holistic WTP per QALY instrument, participants’ motivation must be addressed broadly. The instrument developed in this study captured a variety of motives and provided insight with regards to the method through which the latter are evaluated. Last but not least, it extended motive assessment to all study participants and not only protest bidders.

Keywords: contingent valuation method, instrument, motives, quality-adjusted life-year, willingness-to-pay

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Authors: Susana Gonçalves, Joana Lencart, Anabela Gregório Dias

Abstract:

Introduction: In combination with chemotherapy, Total Body Irradiation (TBI) is most used as part of the conditioning regimen prior to allogeneic hematopoietic stem cell transplantation. Conventional TBI techniques have a long application time but non-conformality of beam-application with the inability to individually spare organs at risk. Our institution’s intention is to start using Volumetric Modulated Arc Therapy (VMAT) techniques to increase homogeneity of delivered radiation. As a first approach, a dosimetric plan was performed on a computed tomography (CT) scan of a Rando Alderson antropomorfic phantom (head and torso), using a set of six arcs distributed along the phantom. However, a full body anthropomorphic phantom is essential to carry out technique validation and implementation. Our aim is to define the physical and chemical characteristics and the ideal manufacturing procedure of upper and lower limbs to our anthropomorphic phantom, for later validate TBI using VMAT. Materials and Methods: To study the better fit between our phantom and limbs, a CT scan of Rando Alderson anthropomorphic phantom was acquired. CT was performed on GE Healthcare equipment (model Optima CT580 W), with slice thickness of 2.5 mm. This CT was also used to access the electronic density of soft tissue and bone through Hounsfield units (HU) analysis. Results: CT images were analyzed and measures were made for the ideal upper and lower limbs. Upper limbs should be build under the following measures: 43cm length and 7cm diameter (next to the shoulder section). Lower limbs should be build under the following measures: 79cm length and 16.5cm diameter (next to the thigh section). As expected, soft tissue and bone have very different electronic density. This is important to choose and analyze different materials to better represent soft tissue and bone characteristics. The approximate HU values of the soft tissue and for bone shall be 35HU and 250HU, respectively. Conclusion: At the moment, several compounds are being developed based on different types of resins and additives in order to be able to control and mimic the various constituent densities of the tissues. Concurrently, several manufacturing techniques are being explored to make it possible to produce the upper and lower limbs in a simple and non-expensive way, in order to finally carry out a systematic and appropriate study of the total body irradiation. This preliminary study was a good starting point to demonstrate the feasibility of TBI with VMAT.

Keywords: TBI, VMAT, anthropomorphic phantom, tissue equivalent materials

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Authors: Panupong Lohrattanarungrot, Falan Srisuriyachai

Abstract:

Polymer flooding is a well-known technique used for controlling mobility ratio in heterogeneous reservoirs, leading to improvement of sweep efficiency as well as wellbore profile. However, low injectivity of viscous polymer solution attenuates oil recovery rate and consecutively adds extra operating cost. An attempt of this study is to improve injectivity of polymer solution while maintaining recovery factor, enhancing effectiveness of polymer flooding method. This study is performed by using reservoir simulation program to modify conventional single polymer slug into sequential polymer flooding, emphasizing on increasing of injectivity and also reduction of polymer amount. Selection of operating conditions for single slug polymer including pre-injected water, polymer concentration and polymer slug size is firstly performed for a layered-heterogeneous reservoir with Lorenz coefficient (Lk) of 0.32. A selected single slug polymer flooding scheme is modified into sequential polymer flooding with reduction of polymer concentration in two different modes: Constant polymer mass and reduction of polymer mass. Effects of Residual Resistance Factor (RRF) is also evaluated. From simulation results, it is observed that first polymer slug with the highest concentration has the main function to buffer between displacing phase and reservoir oil. Moreover, part of polymer from this slug is also sacrificed for adsorption. Reduction of polymer concentration in the following slug prevents bypassing due to unfavorable mobility ratio. At the same time, following slugs with lower viscosity can be injected easily through formation, improving injectivity of the whole process. A sequential polymer flooding with reduction of polymer mass shows great benefit by reducing total production time and amount of polymer consumed up to 10% without any downside effect. The only advantage of using constant polymer mass is slightly increment of recovery factor (up to 1.4%) while total production time is almost the same. Increasing of residual resistance factor of polymer solution yields a benefit on mobility control by reducing effective permeability to water. Nevertheless, higher adsorption results in low injectivity, extending total production time. Modifying single polymer slug into sequence of reduced polymer concentration yields major benefits on reducing production time as well as polymer mass. With certain design of polymer flooding scheme, recovery factor can even be further increased. This study shows that application of sequential polymer flooding can be certainly applied to reservoir with high value of heterogeneity since it requires nothing complex for real implementation but just a proper design of polymer slug size and concentration.

Keywords: polymer flooding, sequential, heterogeneous reservoir, residual resistance factor

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Authors: Sigal Portnoy, Jason Friedman, Eitan Raveh

Abstract:

Introduction: Sensory substitution is possible due to the capacity of our brain to adapt to information transmitted by a synthetic receptor via an alternative sensory system. Practical sensory substitution systems are being developed in order to increase the functionality of individuals with sensory loss, e.g. amputees. For upper limb prosthetic-users the loss of tactile feedback compels them to allocate visual attention to their prosthesis. The effect of adding vibrotactile feedback (VTF) to the applied force has been studied, however its effect on the allocation if visual attention during dual-tasking and the response during misleading visual feedback have not been studied. We hypothesized that VTF will improve the performance and reduce visual attention during dual-task assignments in healthy individuals using a robotic hand and improve the performance in a standardized functional test, despite the presence of misleading visual feedback. Methods: For the dual-task paradigm, twenty healthy subjects were instructed to toggle two keyboard arrow keys with the left hand to retain a moving virtual car on a road on a screen. During the game, instructions for various activities, e.g. mix the sugar in the glass with a spoon, appeared on the screen. The subject performed these tasks with a robotic hand, attached to the right hand. The robotic hand was controlled by the activity of the flexors and extensors of the right wrist, recorded using surface EMG electrodes. Pressure sensors were attached at the tips of the robotic hand and induced VTF using vibrotactile actuators attached to the right arm of the subject. An eye-tracking system tracked to visual attention of the subject during the trials. The trials were repeated twice, with and without the VTF. Additionally, the subjects performed the modified box and blocks, hidden from eyesight, in a motion laboratory. A virtual presentation of a misleading visual feedback was be presented on a screen so that twice during the trial, the virtual block fell while the physical block was still held by the subject. Results: This is an ongoing study, which current results are detailed below. We are continuing these trials with transradial myoelectric prosthesis-users. In the healthy group, the VTF did not reduce the visual attention or improve performance during dual-tasking for the tasks that were typed transfer-to-target, e.g. place the eraser on the shelf. An improvement was observed for other tasks. For example, the average±standard deviation of time to complete the sugar-mixing task was 13.7±17.2s and 19.3±9.1s with and without the VTF, respectively. Also, the number of gaze shifts from the screen to the hand during this task were 15.5±23.7 and 20.0±11.6, with and without the VTF, respectively. The response of the subjects to the misleading visual feedback did not differ between the two conditions, i.e. with and without VTF. Conclusions: Our interim results suggest that the performance of certain activities of daily living may be improved by VTF. The substitution of visual sensory input by tactile feedback might require a long training period so that brain plasticity can occur and allow adaptation to the new condition.

Keywords: prosthetics, rehabilitation, sensory substitution, upper limb amputation

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Authors: Santi Maneewatchararangsri, Wanpen Chaicumpa, Patcharin Saengjaruk, Urai Chaisri

Abstract:

Leptospirosis is a globally neglected disease that continues to be a significant public health and veterinary burden, with millions of cases reported each year. Early and accurate differential diagnosis of leptospirosis from other febrile illnesses and the development of a broad spectrum of leptospirosis vaccines are needed. The LipL32 outer membrane lipoprotein is a member of Leptospira adhesive matrices and has been found to exert hemolytic activity to erythrocytes in vitro. Therefore, LipL32 is regarded as a potential target for diagnosis, broad-spectrum leptospirosis vaccines, and for passive immunotherapy. In this study, we established LipL32-specific mouse monoclonal antibodies, mAbLPF1 and mAbLPF2, and their respective mouse- and humanized-engineered single chain variable fragment (ScFv). Their antibodies’ neutralizing activities against Leptospira-mediated hemolysis in vitro, and the therapeutic efficacy of mAbs against heterologous Leptospira infected hamsters were demonstrated. The epitope peptide of mAb LPF1 was mapped to a non-contiguous carboxy-terminal β-turn and amphipathic α-helix of LipL32 structure contributing to phospholipid/host cell adhesion and membrane insertion. We found that the mAbLPF2 epitope was located on the interacting loop of peptide binding groove of the LipL32 molecule responsible for interactions with host constituents. Epitope sequences are highly conserved among Leptospira spp. and are absent from the LipL32 superfamily of other microorganisms. Both epitopes are surface-exposed, readily accessible by mAbs, and immunogenic. However, they are less dominant when revealed by LipL32-specific immunoglobulins from leptospirosis-patient sera and rabbit hyperimmune serum raised by whole Leptospira. Our study also demonstrated an adhesion inhibitory activity of LipL32 protein to host membrane components and cells mediated by mAbs as well as an anti-hemolytic activity of the respective antibodies. The therapeutic antibodies, particularly the humanized-ScFv, have a potential for further development as non-drug therapeutic agent for human leptospirosis, especially in subjects allergic to antibiotics. The epitope peptides recognized by two therapeutic mAbs have potential use as tools for structure-function studies. Finally, protective peptides may be used as a target for epitope-based vaccines for control of leptospirosis.

Keywords: leptospira lipl32-specific antibodies, therapeutic epitopes, epitopes characterization, immunotherapy

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