Search results for: substance use and abuse recovery
Commenced in January 2007
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Paper Count: 2590

Search results for: substance use and abuse recovery

460 Role of Empirical Evidence in Law-Making: Case Study from India

Authors: Kaushiki Sanyal, Rajesh Chakrabarti

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In India, on average, about 60 Bills are passed every year in both Houses of Parliament – Lok Sabha and Rajya Sabha (calculated from information on websites of both Houses). These are debated in both Lok Sabha (House of Commons) and Rajya Sabha (Council of States) before they are passed. However, lawmakers rarely use empirical evidence to make a case for a law. Most of the time, they support a law on the basis of anecdote, intuition, and common sense. While these do play a role in law-making, without the necessary empirical evidence, laws often fail to achieve their desired results. The quality of legislative debates is an indicator of the efficacy of the legislative process through which a Bill is enacted. However, the study of legislative debates has not received much attention either in India or worldwide due to the difficulty of objectively measuring the quality of a debate. Broadly, three approaches have emerged in the study of legislative debates. The rational-choice or formal approach shows that speeches vary based on different institutional arrangements, intra-party politics, and the political culture of a country. The discourse approach focuses on the underlying rules and conventions and how they impact the content of the debates. The deliberative approach posits that legislative speech can be reasoned, respectful, and informed. This paper aims to (a) develop a framework to judge the quality of debates by using the deliberative approach; (b) examine the legislative debates of three Bills passed in different periods as a demonstration of the framework, and (c) examine the broader structural issues that disincentive MPs from scrutinizing Bills. The framework would include qualitative and quantitative indicators to judge a debate. The idea is that the framework would provide useful insights into the legislators’ knowledge of the subject, the depth of their scrutiny of Bills, and their inclination toward evidence-based research. The three Bills that the paper plans to examine are as follows: 1. The Narcotics Drugs and Psychotropic Substances Act, 1985: This act was passed to curb drug trafficking and abuse. However, it mostly failed to fulfill its purpose. Consequently, it was amended thrice but without much impact on the ground. 2. The Criminal Laws (Amendment) Act, 2013: This act amended the Indian Penal Code to add a section on human trafficking. The purpose was to curb trafficking and penalise traffickers, pimps, and middlemen. However, the crime rate remains high while the conviction rate is low. 3. The Surrogacy (Regulation) Act, 2021: This act bans commercial surrogacy allowing only relatives to act as surrogates as long as there is no monetary payment. Experts fear that instead of preventing commercial surrogacy, it would drive the activity underground. The consequences would be borne by the surrogate, who would not be protected by law. The purpose of the paper is to objectively analyse the quality of parliamentary debates, get insights into how MPs understand the evidence and deliberate on steps to incentivise them to use empirical evidence.

Keywords: legislature, debates, empirical, India

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459 Delusional Parasitosis (A Rare Primary Psychiatric Diagnosis)

Authors: Jaspinder Kaur, Jatinder Pal Singh

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Introduction- Delusional parasitosis is a rare psychotic illness characterized by a fixed belief of manifesting a parasite in a body when in reality, it was not. Also known as Ekbom syndrome or delusional infestations, or acarophobia. Although the patient has no primary skin pathology, but all skin findings were secondary to skin manipulation by the patient itself, which is why up to 90% of patients first seek consultation from a dermatologist. Most commonly, it was seen in older people with female to male ratio is 2:1. For treatment, the patient first need to be investigated to rule all other possible causes, as Delusional parasitosis can be caused by Vitamin B12 deficiency, pellagra, hepatic and renal disease, diabetes mellitus, multiple sclerosis, and leprosy. When all possible causes ruled out, psychiatric referral to be done. Rule out other psychiatric comorbidities, and treatment should be done accordingly. Patient with delusional parasitosis responds well to second generation antipsychotics and need to continuous medication over years, and relapse is likely if treatment is stopped. Case Presentation- A 79-year-old female, belonging to lower socio-economic status, presented with complaints of itching sensation with erythematous patches over the scalp and multiple scratch excoriations lesion over the scalp, face and neck from the past 7-8 months. She had a feeling of small insect crawling under her skin and scalp area. To reduce the itching and kill the insect, she would scratch and squeeze her skin repeatedly. When the family tried to give her explanation that there was no insect in her body, she would not get convinced, rather got angry and abuse family members for not believing her. Gradually, her sleep would remain disturbed, she would be seen awake at night, seen to be scratching her skin, pull her scalp hair, even squeeze out her healed lesions. She collected her skin debris, scalp hairs and look out for insect. Because of her continuous illness, the patient started to remain sad and had crying spells. Her appetite decreased. She became socially isolated and stopped doing her activities of daily living. Family member’s first consulted dermatologist, investigated thoroughly with routine investigations, autoimmune and malignancy workup. As all investigations were normal, following which patient was referred for psychiatric evaluation. The patient was started on Tablet Olanzapine 2.5 mg, gradually increased to 7.5 mg. Over 1 month, there was reduction in itching, skin pricking. Lesions were gradually healed, and the patient continued to take other dermatological medications and ointment and was in regular follow up with psychiatric liaison from past 2 months with 70-80 % improvement in her symptoms. Conclusion- Delusional parasitosis is a psychiatric disorder of insidious onset, seen commonly in middle and old age people. Both psychiatric and dermatology consultation liaison will help the patient for an early diagnosis and adequate treatment. If a primary psychiatric diagnosis, the patient respond well to second generation antipsychotics but always require a further evaluation and treatment management if it is secondary to some physical or other psychiatric comorbidity.

Keywords: delusional parasitosis, delusional infestations, rare, primary psychiatric diagnosis, antipsychotic agents

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458 Biogas Enhancement Using Iron Oxide Nanoparticles and Multi-Wall Carbon Nanotubes

Authors: John Justo Ambuchi, Zhaohan Zhang, Yujie Feng

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Quick development and usage of nanotechnology have resulted to massive use of various nanoparticles, such as iron oxide nanoparticles (IONPs) and multi-wall carbon nanotubes (MWCNTs). Thus, this study investigated the role of IONPs and MWCNTs in enhancing bioenergy recovery. Results show that IONPs at a concentration of 750 mg/L and MWCNTs at a concentration of 1500 mg/L induced faster substrate utilization and biogas production rates than the control. IONPs exhibited higher carbon oxygen demand (COD) removal efficiency than MWCNTs while on the contrary, MWCNT performance on biogas generation was remarkable than IONPs. Furthermore, scanning electron microscopy (SEM) investigation revealed extracellular polymeric substances (EPS) excretion from AGS had an interaction with nanoparticles. This interaction created a protective barrier to microbial consortia hence reducing their cytotoxicity. Microbial community analyses revealed genus predominance of bacteria of Anaerolineaceae and Longilinea. Their role in biodegradation of the substrate could have highly been boosted by nanoparticles. The archaea predominance of the genus level of Methanosaeta and Methanobacterium enhanced methanation process. The presence of bacteria of genus Geobacter was also reported. Their presence might have significantly contributed to direct interspecies electron transfer in the system. Exposure of AGS to nanoparticles promoted direct interspecies electron transfer among the anaerobic fermenting bacteria and their counterpart methanogens during the anaerobic digestion process. This results provide useful insightful information in understanding the response of microorganisms to IONPs and MWCNTs in the complex natural environment.

Keywords: anaerobic granular sludge, extracellular polymeric substances, iron oxide nanoparticles, multi-wall carbon nanotubes

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457 Contraception in Guatemala, Panajachel and the Surrounding Areas: Barriers Affecting Women’s Contraceptive Usage

Authors: Natasha Bhate

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Contraception is important in helping to reduce maternal and infant mortality rates by allowing women to control the number and spacing in-between their children. It also reduces the need for unsafe abortions. Women worldwide use contraception; however, the contraceptive prevalence rate is still relatively low in Central American countries like Guatemala. There is also an unmet need for contraception in Guatemala, which is more significant in rural, indigenous women due to barriers preventing contraceptive use. The study objective was to investigate and analyse the current barriers women face, in Guatemala, Panajachel and the surrounding areas, in using contraception, with a view of identifying ways to overcome these barriers. This included exploring the contraceptive barriers women believe exist and the influence of males in contraceptive decision making. The study took place at a charity in Panajachel, Guatemala, and had a cross-sectional, qualitative design to allow an in-depth understanding of information gathered. This particular study design was also chosen to help inform the charity with qualitative research analysis, in view of their intent to create a local reproductive health programme. A semi-structured interview design, including photo facilitation to improve cross-cultural communication, with interpreter assistance, was utilized. A pilot interview was initially conducted with small improvements required. Participants were recruited through purposive and convenience sampling. The study host at the charity acted as a gatekeeper; participants were identified through attendance of the charity’s women’s-initiative programme workshops. 20 participants were selected and agreed to study participation with two not attending; a total of 18 participants were interviewed in June 2017. Interviews were audio-recorded and data were stored on encrypted memory sticks. Framework analysis was used to analyse the data using NVivo11 software. The University of Leeds granted ethical approval for the research. Religion, language, the community, and fear of sickness were examples of existing contraceptive barrier themes recognized by many participants. The influence of men was also an important barrier identified, with themes of machismo and abuse preventing contraceptive use in some women. Women from more rural areas were believed to still face barriers which some participants did not encounter anymore, such as distance and affordability of contraceptives. Participants believed that informative workshops in various settings were an ideal method of overcoming existing contraceptive barriers and allowing women to be more empowered. The involvement of men in such workshops was also deemed important by participants to help reduce their negative influence in contraceptive usage. Overall, four recommendations following this study were made, including contraceptive educational courses, a gender equality campaign, couple-focused contraceptive workshops, and further qualitative research to gain a better insight into men’s opinions regarding women using contraception.

Keywords: barrier, contraception, machismo, religion

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456 Alkaloid Levels in Experimental Lines of Ryegrass in Southtern Chile

Authors: Leonardo Parra, Manuel Chacón-Fuentes, Andrés Quiroz

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One of the most important factors in beef and dairy production in the world as well as also in Chile, is related to the correct choice of cultivars or mixtures of forage grasses and legumes to ensure high yields and quality of grassland. However, a great problem is the persistence of the grasses as a result of the action of different hypogeous as epigean pests. The complex insect pests associated with grassland include white grubs (Hylamorpha elegans, Phytoloema herrmanni), blackworm (Dalaca pallens) and Argentine stem weevil (Listronotus bonariensis). In Chile, the principal strategy utilized for controlling this pest is chemical control, through the use of synthetic insecticides, however, underground feeding habits of larval and flight activity of adults makes this uneconomic method. Furthermore, due to problems including environmental degradation, development of resistance and chemical residues, there is a worldwide interest in the use of alternative environmentally friendly pest control methods. In this sense, in recent years there has been an increasing interest in determining the role of endophyte fungi in controlling epigean and hypogeous pest. Endophytes from ryegrass (Lolium perenne), establish a biotrophic relationship with the host, defined as mutualistic symbiosis. The plant-fungi association produces a “cocktail of alkaloids” where peramine is the main toxic substance present in endophyte of ryegrass and responsible for damage reduction of L. bonariensis. In the last decade, few studies have been developed on the effectiveness of new ryegrass cultivars carriers of endophyte in controlling insect pests. Therefore, the aim of this research is to provide knowledge concerning to evaluate the alkaloid content, such as peramine and Lolitrem B, present in new experimental lines of ryegrass and feasible to be used in grasslands of southern Chile. For this, during 2016, ryegrass plants of six experimental lines and two commercial cultivars sown at the Instituto de Investigaciones Agropecuarias Carrillanca (Vilcún, Chile) were collected and subjected to a process of chemical extraction to identify and quantify the presence of peramine and lolitrem B by the technique of liquid chromatography of high resolution (HPLC). The results indicated that the experimental lines EL-1 and EL-3 had high content of peramine (0.25 and 0.43 ppm, respectively) than with lolitrem B (0.061 and 0.19 ppm, respectively). Furthermore, the higher contents of lolitrem B were detected in the EL-4 and commercial cultivar Alto (positive control) with 0.08 and 0.17 ppm, respectively. Peramine and lolitrem B were not detected in the cultivar Jumbo (negative control). These results suggest that EL-3 would have potential as future cultivate because it has high content of peramine, alkaloid responsible for controlling insect pest. However, their current role on the complex insects attacking ryegrass grasslands should be evaluated. The information obtained in this research could be used to improve control strategies against hypogeous and epigean pests of grassland in southern Chile and also to reduce the use of synthetic pesticides.

Keywords: HPLC, Lolitrem B, peramine, pest

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455 Saving Energy through Scalable Architecture

Authors: John Lamb, Robert Epstein, Vasundhara L. Bhupathi, Sanjeev Kumar Marimekala

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In this paper, we focus on the importance of scalable architecture for data centers and buildings in general to help an enterprise achieve environmental sustainability. The scalable architecture helps in many ways, such as adaptability to the business and user requirements, promotes high availability and disaster recovery solutions that are cost effective and low maintenance. The scalable architecture also plays a vital role in three core areas of sustainability: economy, environment, and social, which are also known as the 3 pillars of a sustainability model. If the architecture is scalable, it has many advantages. A few examples are that scalable architecture helps businesses and industries to adapt to changing technology, drive innovation, promote platform independence, and build resilience against natural disasters. Most importantly, having a scalable architecture helps industries bring in cost-effective measures for energy consumption, reduce wastage, increase productivity, and enable a robust environment. It also helps in the reduction of carbon emissions with advanced monitoring and metering capabilities. Scalable architectures help in reducing waste by optimizing the designs to utilize materials efficiently, minimize resources, decrease carbon footprints by using low-impact materials that are environmentally friendly. In this paper we also emphasize the importance of cultural shift towards the reuse and recycling of natural resources for a balanced ecosystem and maintain a circular economy. Also, since all of us are involved in the use of computers, much of the scalable architecture we have studied is related to data centers.

Keywords: scalable architectures, sustainability, application design, disruptive technology, machine learning and natural language processing, AI, social media platform, cloud computing, advanced networking and storage devices, advanced monitoring and metering infrastructure, climate change

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454 Neurological Complication of Bariatric Surgery: A Cross-sectional Study from Saudi Arabia

Authors: H. A. Algahtani, A. S. Khan, O. Alzahrani, N. Hussein, M. A. Khan, Loudhi Y. I. Soliman

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Objective: To report on the Saudi experience (developing country) of neurological complications from bariatric surgery. The literature on the subject is reviewed. Method: This is a cross sectional study done in King Abdul Aziz Medical City Jeddah, WR, where we reviewed all charts of the patients who underwent bariatric surgery between January 1st, 2009 to December 31st , 2014. Personal and clinical data including age, sex, BMI, comorbidities, type of procedure, duration of stay in hospital, complications and postoperative follow up were collected. In addition follow up visit and remote complication if present were collected. All patients with neurological complications were reviewed in details including their clinical examination, laboratory and imaging results, treatment and prognosis. This report is essentially descriptive with no statistical analysis performed. Results: Fifteen cases were collected in this study (3%). Axonal polyneuropathy was the most frequent neurological complica¬tion, but cases of Wernicke syndrome, vitamin B12 deficiency, Guillain-Barre syndrome and cupper deficiency were also identified. Fourteen patients (93.3%) had full recovery from the neurological signs and symptoms but unfortunately one patient died. Conclusion: Bariatric surgery, a procedure that is continuously increasing in popularity, is not free of potential neurological complications. A clear education, guidelines and follow-up program should be planned and practiced. Facts should be clearly presented to the individual undergoing this type of surgery. Although a clear cause-effect relation cannot be established for the present cases, the cumulative literature on the subject makes it important to warn the patient of the potential risks of this procedure.

Keywords: bariatric surgery, neurological complications, neuropathy, Wenicke syndrome

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453 Technology in Commercial Law Enforcement: Tanzania, Canada, and Singapore Comparatively

Authors: Katarina Revocati Mteule

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The background of this research arises from global demands for fair business opportunities. As one of responses to these demands, nations embarked on reforms in commercial laws. In 1990s Tanzania resorted to economic transformation through liberalization to attract more investments included reform in commercial laws enforcement. This research scrutinizes the effectiveness of reforms in Tanzania in comparison with Canada and Singapore and the role of technology. The methodology to be used is doctrinal legal research mixed with international comparative legal research. It involves comparative analysis of library, online, and internet resources as well as Case Laws and Statutory Laws. Tanzania, Canada and Singapore are sampled comparators basing on their distinct level of economic development. The criteria of analysis includes the nature of reforms, type of technology, technological infrastructure and human resource technical competence in each country. As the world progresses towards reforms in commercial laws, improvements in law, policy, and regulatory frameworks are paramount. Specifically, commercial laws are essential in contract enforcement and dispute resolution and how it copes with modern technologies is a concern. Harnessing the best technology is necessary to cope with the modernity in world businesses. In line with this, Tanzania is improving its business environment, including law enforcement mechanisms that are supportive to investments. Reforms such as specialized commercial law enforcement coupled with alternative dispute resolutions such as arbitration, mediation, and reconciliation are emphasized. Court technology as one of the reform tools given high priority. This research evaluates the progress and the effectiveness of the reforms in Commercial Laws towards friendly business environment in Tanzania in comparison with Canada and Singapore. The experience of Tanzania is compared with Canada and Singapore to see what to improve for each country to enhance quick and fair enforcement of commercial law. The research proposes necessary global standards of procedures and in national laws to offer a business-friendly environment and the use of appropriate technology. Solutions are proposed in tackling the challenges of delays in enforcing Commercial Laws such as case management, funding, legal and procedural hindrances, laxity among staff, and abuse of Court process among litigants, all in line with modern technology. It is the finding of the research that proper use of technology has managed to reduce case backlogs and time taken to resolve a commercial dispute, to increase court integrity by minimizing human contacts in commercial law enforcement which may lead to solicitation of favors and saving of parties’ time due to online service. Among the three countries, each one is facing a distinct challenge due to the level of poverty and remoteness from online service. How solutions are found in one country is a lesson to another. To conclude, this paper is suggesting solutions for improving the commercial law enforcement mechanisms in line with modern technology. The call for technological transformation is essential for the enforcement of commercial laws.

Keywords: commercial law, enforcement, technology

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452 Regenerative Therapeutic Effect of Statin Nanoparticle-Loaded Adipose-Derived Stem Cells on Myocardial Infarction

Authors: Masaaki Ii, Takashi Saito, Yasuhiko Tabata, Shintaro Nemoto

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Background: Clinical trials of autologous adipose-derived stem cell (AdSC) therapy for ischemic heart diseases (IHD) are now on-going. We have investigated the hypothesis that combination of AdSCs and statin, an agent with pleiotropic effects, could augment the therapeutic effect on myocardial infarction (MI). Methods and Results: Human AdSC functions with different doses of simvastatin-conjugated nanoparticle (STNP) uptake were evaluated by in vitro assays. STNP promoted the migration activity without changing the proliferation activity, and also up-regulated growth factors. Next, MI was induced by LAD ligation in nude mice, and the mice were assigned in the following groups 3 days after MI: 1) PBS (control), 2) NP-AdSCs (50000 cells), 3) STNP, and 4) STNP-AdSCs (50000 cells). Cardiac functional recovery assessed by echocardiography was improved at 4 weeks after surgery in STNP-AdSC group. Masson’s trichrome-stained sections revealed that LV fibrosis length was reduced, and the number of TUNEL-positive cardiomyocytes was less in STNP-AdSC group. Surprisingly, a number of de novo endogenous Nkx-2.5/GATA4 positive immature cardiomyocytes as well as massive vascular formation were observed in outer layer of infarcted myocardium despite of a few recruited/retained transfused STNP-AdSCs 4 weeks after MI in STNP-AdSC group. Finally, massive myocardial regeneration was observed 8 weeks after MI. Conclusions: Intravenously injected small number of statin nanoparticle-loaded hAdSCs exhibited a potent therapeutic effect inducing endogenous cardiac tissue regeneration.

Keywords: statin, drug delivery system, stem cells, cardiac regeneration

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451 Effect of Cryogenic Pre-stretching on the Room Temperature Tensile Behavior of AZ61 Magnesium Alloy and Dominant Grain Growth Mechanisms During Subsequent Annealing

Authors: Umer Masood Chaudry, Hafiz Muhammad Rehan Tariq, Chung-soo Kim, Tea-sung Jun

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This study explored the influence of pre-stretching temperature on the microstructural characteristics and deformation behavior of AZ61 magnesium alloy and its implications on grain growth during subsequent annealing. AZ61 alloy was stretched to 5% plastic strain along rolling (RD) and transverse direction (TD) at room (RT) and cryogenic temperature (-150 oC, CT) followed by annealing at 320 oC for 1 h to investigate the twinning and dislocation evolution and its consequent effect on the flow stress, plastic strain and strain hardening rate. Compared to RT-stretched samples, significant improvement in yield stress, strain hardening rate and moderate reduction in elongation to failure were witnessed for CT-stretched samples along RD and TD. The subsequent EBSD analysis revealed the increased fraction of fine {10-12} twins and nucleation of multiple {10-12} twin variants caused by higher local stress concentration at the grain boundaries in CT-stretched samples as manifested by the kernel average misorientation. This higher twin fraction and twin-twin interaction imposed the strengthening by restricting the mean free path of dislocations, leading to higher flow stress and strain hardening rate. During annealing of the RT/CT-stretched samples, the residual strain energy and twin boundaries were decreased due to static recovery, leading to a coarse-grained twin-free microstructure. Strain induced boundary migration (SBIM) was found to be the predominant mechanism governing the grain growth during annealing via movement of high angle grain boundaries.

Keywords: magnesium, twinning, twinning variant selection, EBSD, cryogenic deformation

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450 Organisational Culture and the Role of the Mental Health Nurse: An Ethnography of the New Graduate Nurse Experience

Authors: Mary-Ellen Hooper, Graeme Browne, Anthony Paul O'Brien

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Background: It has been reported that the experience of the organisational workplace culture for new graduate mental health nurses plays an important role in their attraction and retention to the discipline. Additionally, other research indicates that a negative workplace culture contributes to their dissatisfaction and attrition rate. Method: An ethnographic research design was applied to explore the subcultural experiences of new graduate nurses as they encounter mental health nursing. Data was collected between April and September 2017 across 6 separate Australian, NSW, mental health units. Data comprised of semi-structured interviews (n=24) and 31 episodes of field observation (62 hours). A total number of 26 new graduate and recent graduate nurses participated in the study – 14 new graduate nurses and 12 recently graduated nurses. Results: A key finding from this study was the New Graduate difficulty in articulating the role the of mental health nurse. Participants described a dichotomy between their ideological view of the mental health nurse and the reality of clinical practice. The participants’ ideological view of the mental health nurse involved providing holistic and individualised care within a flexible framework. Participants, however, described feeling powerless to change the recovery practices within the mental health service(s) because of their low status within the hierarchy. Resulting in participants choosing to fit into the existing culture, or considering leaving the field altogether. Conclusion: An incongruence between the values and ideals of an organisational culture and the reality shock of practice are shown to contribute to role ambiguity within its members. New graduate nurses entering the culture of mental health nursing describe role ambiguity resulting in dissatisfaction with practice. The culture and philosophy inherent to a service are posited to be crucial in creating positive experiences for graduate nurses.

Keywords: culture, mental health nurse, mental health nursing role, new graduate nurse

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449 Seismic Protection of Automated Stocker System by Customized Viscous Fluid Dampers

Authors: Y. P. Wang, J. K. Chen, C. H. Lee, G. H. Huang, M. C. Wang, S. W. Chen, Y. T. Kuan, H. C. Lin, C. Y. Huang, W. H. Liang, W. C. Lin, H. C. Yu

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The hi-tech industries in the Science Park at southern Taiwan were heavily damaged by a strong earthquake early 2016. The financial loss in this event was attributed primarily to the automated stocker system handling fully processed products, and recovery of the automated stocker system from the aftermath proved to contribute major lead time. Therefore, development of effective means for protection of stockers against earthquakes has become the highest priority for risk minimization and business continuity. This study proposes to mitigate the seismic response of the stockers by introducing viscous fluid dampers in between the ceiling and the top of the stockers. The stocker is expected to vibrate less violently with a passive control force on top. Linear damper is considered in this application with an optimal damping coefficient determined from a preliminary parametric study. The damper is small in size in comparison with those adopted for building or bridge applications. Component test of the dampers has been carried out to make sure they meet the design requirement. Shake table tests have been further conducted to verify the proposed scheme under realistic earthquake conditions. Encouraging results have been achieved by effectively reducing the seismic responses of up to 60% and preventing the FOUPs from falling off the shelves that would otherwise be the case if left unprotected. Effectiveness of adopting a viscous fluid damper for seismic control of the stocker on top against the ceiling has been confirmed. This technique has been adopted by Macronix International Co., LTD for seismic retrofit of existing stockers. Demonstrative projects on the application of the proposed technique are planned underway for other companies in the display industry as well.

Keywords: hi-tech industries, seismic protection, automated stocker system, viscous fluid damper

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448 Development of a Sustainable Municipal Solid Waste Management for an Urban Area: Case Study from a Developing Country

Authors: Anil Kumar Gupta, Dronadula Venkata Sai Praneeth, Brajesh Dubey, Arundhuti Devi, Suravi Kalita, Khanindra Sharma

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Increase in urbanization and industrialization have led to improve in the standard of living. However, at the same time, the challenges due to improper solid waste management are also increasing. Municipal Solid Waste management is considered as a vital step in the development of urban infrastructure. The present study focuses on developing a solid waste management plan for an urban area in a developing country. The current scenario of solid waste management practices at various urban bodies in India is summarized. Guwahati city in the northeastern part of the country and is also one of the targeted smart cities (under the governments Smart Cities program) was chosen as case study to develop and implement the solid waste management plan. The whole city was divided into various divisions and waste samples were collected according to American Society for Testing and Materials (ASTM) - D5231-92 - 2016 for each division in the city and a composite sample prepared to represent the waste from the entire city. The solid waste characterization in terms of physical and chemical which includes mainly proximate and ultimate analysis were carried out. Existing primary and secondary collection systems were studied and possibilities of enhancing the collection systems were discussed. The composition of solid waste for the overall city was found to be as: organic matters 38%, plastic 27%, paper + cardboard 15%, Textile 9%, inert 7% and others 4%. During the conference presentation, further characterization results in terms of Thermal gravimetric analysis (TGA), pH and water holding capacity will be discussed. The waste management options optimizing activities such as recycling, recovery, reuse and reduce will be presented and discussed.

Keywords: proximate, recycling, thermal gravimetric analysis (TGA), solid waste management

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447 Hydrodynamics of Periphyton Biofilters in Recirculating Aquaculture

Authors: Adam N. Bell, Sarina J. Ergas, Michael Nystrom, Nathan P. Brennan, Kevan L. Main

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Integrated Multi-Trophic Aquaculture systems (IMTA) have the potential to improve the sustainability of seafood production, generate organic fertilizer and feed, remove waste discharges and reduce energy use. IMTA can include periphyton biofilters where algae and microbes grow on surfaces, along with caught detritus and amphipods. Periphyton biofilters provide many advantages: nitrification, denitrification, primary production and ecological diversity. The goal of this study was to determine how biofilter hydraulic residence time (τ) effects periphyton biomass production, dissolved oxygen (DO) and nutrient removal. A pilot scale recirculating aquaculture system (RAS) was designed, constructed and operated at different hydraulic residence times (τ= 1, 2, 4, 6, 8 hours per tank). For each τ, a conservative tracer study was conducted to investigate system hydrodynamics. Data on periphyton weights, pH, nitrogen species, phosphorus, temperature and DO were collected. The tracer study for τ =1 hour revealed that the normalized time < τ, indicating short-circuiting. Periphyton biomass production rate was relatively unaffected by τ (R_e<1 for all τ). Average ammonia nitrogen removal was > 75% for all trials. Nitrate and nitrite did not accumulate in the RAS for τ≥4 hours due to enhanced denitrification in anoxic zones. For τ≥4 hours DO concentration was at a maximum of 4 mg L-1 after 14:00, and decreased to 0 mg L-1 during nighttime. At τ=1 hour, the RAS stayed > 2 mg L-1 and DO was more evenly distributed. For the validation trial, the culture tank was stocked with Centropomus undecimalis (common snook) and the system was operated at τ= 1 hr. Preliminary results showed that a RAS with an integrated periphyton biofilter could support fish health with low nutrient concentrations DO > 6 mg L-1.

Keywords: sustainable aquaculture, resource recovery, nitrogen, microalgae, hydrodynamics, integrated multi-trophic aquaculture

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446 Efficacy of Light-Emitting Diode-Mediated Photobiomodulation in Tendon Healing in a Murine Model

Authors: Sukwoong Kang

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Background: The application of light-emitting diode (LED)-dependent photobiomodulation (PBM) in promoting post-tendon injury healing has been recently reported. Despite the establishment of a theoretical basis for ligament restoration through PBM, the lack of any empirical evidence deems this therapeutic strategy contentious. Therefore, the aim of this study was to investigate the potency of LED-based PBM in facilitating tendon healing in a murine model. Methods: Migration kinetics were analyzed at two specific wavelengths: 630 and 880 nm. The Achilles tendon in the hind limbs of Balb/c mice was severed via Achilles tendon transection. Subsequently, the mice were randomized into LED non-irradiation and LED irradiation groups. Mice with intact tendons were employed as healthy controls. The wounds were LED-irradiated for 20 min daily for two days. Histological properties, tendon healing mediators, and inflammatory mediators were screened on day 14. Results: The roundness of the nuclei and fiber structure, indicating the degree of infiltrated inflammatory cells and severity of fiber fragmentation, respectively, were considerably lower in the LED irradiation group than in the LED non-irradiation group. Immunohistochemical analysis depicted an increase in tenocytes (SCX+ cells) and a recovery of wounds with reduced fibrosis (lower collagen 3 and TGF-β1) in the LED irradiation group during healing; conversely, the LED non-irradiation group exhibited tissue fibrosis. The ratio of M2 macrophages to total macrophages was higher in the LED irradiation group than in the injured group. Conclusion: LED-based PBM in the Achilles tendon rupture murine model effectuated a rapid restoration of histological and immunochemical outcomes. The aforementioned findings suggest that LED-based PBM presents remarkable potential as an adjunct therapeutic for tendon healing and warrants further research to standardize various parameters to advance and establish it as a reliable treatment regime.

Keywords: photobiomodulation, light-emitting diode, tendon, regeneration

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445 Indian Bankruptcy Code 2016: Impact On Cross-Border Insolvency, an Analysis

Authors: Astha Sinha, Anjali Kanagali

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India has been tackling with less than sophisticated legislations when it comes to recovery of debt and bankruptcy situations for a while now. There were multiple overlapping laws and adjudication forums dealing with financial failures and insolvency of companies/individuals in India without really aiding the timely recover of defaulted assets. It remained dicey for businesses to invest in India since there was a lack of legal and institutional machinery for dealing with debt defaults as per the global standards. After much deliberation, the Indian Draft Insolvency code received the presidential assent on May 28, 2016 bringing the Bankruptcy and Insolvency Code, 2016 into existence. The Code is expected to bring about great progress for the country and specifically has the two standout developments. The first is that it calls for resolution of corporate insolvency within a period of 180 days extendable by 90 days hence bringing about security in the minds of investors. Second is that it calls for the creation of a new class of insolvency professionals whose primary function shall be helping sick companies and banks with their takeovers, provides for setting up an Insolvency and Bankruptcy Board to regulate the same and provides for a two stage process of liquidation. The Code is estimated to help India move up its ranking on the World Bank’s ease of doing business index. It is currently ranked at the 130th position lower than some of the sub-saharan African countries. Besides this, however, there are various areas in which the Code falls short such as lack of provisions for aiding the issue of cross-border insolvency, impact on Medium and Small Enterprises in India etc. This paper aims to analyze the provisions of the new Bankruptcy and Insolvency Code, 2016 and its contribution in making India a more desirable location for doing business. It shall also emphasize on the cross-border insolvency issues, practices followed by other countries to resolve the same and the way forward for India to strengthen its Bankruptcy and Insolvency framework.

Keywords: bankruptcy and insolvency code 2016, cross-border insolvency provisions in the 2016 code, Ease of doing business and bankruptcy code, highlights of the new Indian bankruptcy code 2016

Procedia PDF Downloads 247
444 High and Low Salinity Polymer in Omani Oil Field

Authors: Intisar Al Busaidi, Rashid Al Maamari, Daowoud Al Mahroqi, Mahvash Karimi

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In recent years, some research studies have been performed on the hybrid application of polymer and low salinity water flooding (LSWF). Numerous technical and economic benefits of low salinity polymer flooding (LSPF) have been reported. However, as with any EOR technology, there are various risks involved in using LSPF. Ions exchange between porous media and brine is one of the Crude oil/ brine/ rocks (COBR) reactions that is identified as a potential risk in LSPF. To the best of our knowledge, this conclusion was drawn based on bulk rheology measurements, and no explanation was provided on how water chemistry changed in the presence of polymer. Therefore, this study aimed to understand rock/ brine interactions with high and low salinity brine in the absence and presence of polymer with Omani reservoir core plugs. Many single-core flooding experiments were performed with low and high salinity polymer solutions to investigate the influence of partially hydrolyzed polyacrylic amide with different brine salinities on cation exchange reactions. Ion chromatography (IC), total organic carbon (TOC), rheological, and pH measurements were conducted for produced aqueous phase. A higher increase in pH and lower polymer adsorption was observed in LSPF compared with conventional polymer flooding. In addition, IC measurements showed that all produced fluids in the absence and presence of polymer showed elevated Ca²⁺, Mg²⁺, K+, Cl- and SO₄²⁻ ions compared to the injected fluids. However, the divalent cations levels, mainly Ca²⁺, were the highest and remained elevated for several pore volumes in the presence of LSP. The results are in line with rheological measurements where the highest viscosity reduction was recorded with the highest level of Ca²⁺ production. Despite the viscosity loss due to cation exchange reactions, LSP can be an attractive alternative to conventional polymer flooding in the Marmul field.

Keywords: polymer, ions, exchange, recovery, low salinity

Procedia PDF Downloads 86
443 Impact of Individual Resilience on Organizational Resilience: An Exploratory Study

Authors: Mitansha, Suzanne Wilkinson, Regan Potangaroa

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The built environment is designed, maintained, operated, and decommissioned by construction organisations, which play a significant role in providing physical resources and rebuilding infrastructures during major crises and disasters. It is evident that enhancing the resilience of construction organisations allows better responding ability and speedy recovery from disasters and acts as a boon for the nation in the face of significant disruptions. As individuals are the integral component of any organisation, hence, individual resilience is considered a critical aspect, which may boost organisational resilience of construction sector. It has been observed that individual resilience is indirectly supported by organisation’s citizenship behaviour, job performance, and career success. Not only this, it also tends to hold a directly proportional relation with job satisfaction, physical and emotional well-being affected by organisation’s work culture, whereas the resilience of organisation increases as a result of positive adaption, growth and collective learning of the employees as an entity. Moreover, indicators like Situation awareness in staff and crisis related issues, effective vulnerability management, organisational leadership and culture ensured by approachable, encouraging and people-oriented leaders, are prominent for achieving organisational resilience. It, thus, becomes perceptible that both, organisational and individual resiliencies have the potential to influence each other. Consequently, it arises a major question that how these characteristics are associated and tend to behave with respect to each other The study, thus, aims to explore the overlapping dimensions of organisational and individual resilience to determine the impact boundaries. The research methodology of the paper would be based on systematic literature review specifically focused on the resilience of construction industry. This would provide a direct comparison of characteristics influencing individual and organisational resilience and will present the most significant indicators of individual resilience, that can eventually help to enhance the resilience of construction organisations amidst any disaster or crisis.

Keywords: construction industry, individual resilience, organizational resilience, overlapping dimension

Procedia PDF Downloads 78
442 Magnetic Nano-Composite of Self-Doped Polyaniline Nanofibers for Magnetic Dispersive Micro Solid Phase Extraction Applications

Authors: Hatem I. Mokhtar, Randa A. Abd-El-Salam, Ghada M. Hadad

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An improved nano-composite of self-doped polyaniline nanofibers and silica-coated magnetite nanoparticles were prepared and evaluated for suitability to magnetic dispersive micro solid-phase extraction. The work focused on optimization of the composite capacity to extract four fluoroquinolones (FQs) antibiotics, ciprofloxacin, enrofloxacin, danofloxacin, and difloxacin from water and improvement of composite stability towards acid and atmospheric degradation. Self-doped polyaniline nanofibers were prepared by oxidative co-polymerization of aniline with anthranilic acid. Magnetite nanopariticles were prepared by alkaline co-precipitation and coated with silica by silicate hydrolysis on magnetite nanoparticles surface at pH 6.5. The composite was formed by self-assembly by mixing self-doped polyaniline nanofibers with silica-coated magnetite nanoparticles dispersions in ethanol. The composite structure was confirmed by transmission electron microscopy (TEM). Self-doped polyaniline nanofibers and magnetite chemical structures were confirmed by FT-IR while silica coating of the magnetite was confirmed by Energy Dispersion X-ray Spectroscopy (EDS). Improved stability of the composite magnetic component was evidenced by resistance to degrade in 2N HCl solution. The adsorption capacity of self-doped polyaniline nanofibers based composite was higher than previously reported corresponding composite prepared from polyaniline nanofibers instead of self-doped polyaniline nanofibers. Adsorption-pH profile for the studied FQs on the prepared composite revealed that the best pH for adsorption was in range of 6.5 to 7. Best extraction recovery values were obtained at pH 7 using phosphate buffer. The best solvent for FQs desorption was found to be 0.1N HCl in methanol:water (8:2; v/v) mixture. 20 mL of Spiked water sample with studied FQs were preconcentrated using 4.8 mg of composite and resulting extracts were analysed by HPLC-UV method. The prepared composite represented a suitable adsorbent phase for magnetic dispersive micro-solid phase application.

Keywords: fluoroquinolones, magnetic dispersive micro extraction, nano-composite, self-doped polyaniline nanofibers

Procedia PDF Downloads 103
441 Performance Analysis of a Planar Membrane Humidifier for PEM Fuel Cell

Authors: Yu-Hsuan Chang, Jian-Hao Su, Chen-Yu Chen, Wei-Mon Yan

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In this work, the experimental measurement was applied to examine the membrane type and flow field design on the performance of a planar membrane humidifier. The performance indexes were used to evaluate the planar membrane humidifier. The performance indexes of the membrane humidifier include the dew point approach temperature (DPAT), water recovery ratio (WRR), water flux (J) and pressure loss (P). The experiments contain mainly three parts. In the first part, a single membrane humidifier was tested using different flow field under different dry-inlet temperatures. The measured results show that the dew point approach temperature decreases with increasing the depth of flow channel at the same width of flow channel. However, the WRR and J reduce with an increase in the dry air-inlet temperature. The pressure loss tests indicate that pressure loss decreases with increasing the hydraulic diameter of flow channel, resulting from an increase in Darcy friction. Owing to the comparison of humidifier performances and pressure losses, the flow channel of width W=1 and height H=1.5 was selected as the channel design of the multi-membrane humidifier in the second part of experiment. In the second part, the multi-membrane humidifier was used to evaluate the humidification performance under different relative humidity and flow rates. The measurement results indicate that the humidifier at both lower temperature and relative humidity of inlet dry air have higher DPAT but lower J and WRR. In addition, the counter flow approach has better mass and heat transfer performance than the parallel flow approach. Moreover, the effects of dry air temperature, relative humidity and humidification approach are not significant to the pressure loss in the planar membrane humidifier. For the third part, different membranes were tested in this work in order to find out which kind membrane is appropriate for humidifier.

Keywords: water management, planar membrane humidifier, heat and mass transfer, pressure loss, PEM fuel cell

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440 The Effect of Second Victim-Related Distress on Work-Related Outcomes in Tertiary Care, Kelantan, Malaysia

Authors: Ahmad Zulfahmi Mohd Kamaruzaman, Mohd Ismail Ibrahim, Ariffin Marzuki Mokhtar, Maizun Mohd Zain, Saiful Nazri Satiman, Mohd Najib Majdi Yaacob

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Background: Aftermath any patient safety incidents, the involved healthcare providers possibly sustained second victim-related distress (second victim distress and reduced their professional efficacy), with subsequent negative work-related outcomes or vice versa cultivating resilience. This study aimed to investigate the factors affecting negative work-related outcomes and resilience, with the triad of support; colleague, supervisor, and institutional support as the hypothetical mediators. Methods: This was a cross sectional study recruiting a total of 733 healthcare providers from three tertiary care in Kelantan, Malaysia. Three steps of hierarchical linear regression were developed for each outcome; negative work-related outcomes and resilience. Then, four multiple mediator models of support triad were analyzed. Results: Second victim distress, professional efficacy, and the support triad contributed significantly for each regression model. In the pathway of professional efficacy on each negative work-related outcomes and resilience, colleague support partially mediated the relationship. As for second victim distress on negative work related outcomes, colleague and supervisor support were the partial mediator, and on resilience; all support triad also produced a similar effect. Conclusion: Second victim distress, professional efficacy, and the support triad influenced the relationship with the negative work-related outcomes and resilience. Support triad as the mediators ameliorated the effect in between and explained the urgency of having good support for recovery post encountering patient safety incidents.

Keywords: second victims, patient safety incidents, hierarchical linear regression, mediation, support

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439 Calculating Asphaltenes Precipitation Onset Pressure by Using Cardanol as Precipitation Inhibitor: A Strategy to Increment the Oil Well Production

Authors: Camilo A. Guerrero-Martin, Erik Montes Paez, Marcia C. K. Oliveira, Jonathan Campos, Elizabete F. Lucas

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Asphaltenes precipitation is considered as a formation damage problem, which can reduce the oil recovery factor. It fouls piping and surface installations, as well as cause serious flow assurance complications and decline oil well production. Therefore, researchers have shown an interest in chemical treatments to control this phenomenon. The aim of this paper is to assess the asphaltenes precipitation onset of crude oils in the presence of cardanol, by titrating the crude with n-heptane. Moreover, based on this results obtained at atmosphere pressure, the asphaltenes precipitation onset pressure were calculated to predict asphaltenes precipitation in the reservoir, by using differential liberation and refractive index data of the oils. The influence of cardanol concentrations in the asphaltenes stabilization of three Brazilian crude oils samples (with similar API densities) was studied. Therefore, four formulations of cardanol in toluene were prepared: 0, 3, 5, 10 and 15 m/m%. The formulations were added to the crude at 2:98 ratio. The petroleum samples were characterized by API density, elemental analysis and differential liberation test. The asphaltenes precipitation onset (APO) was determined by titrating with n-heptane and monitoring with near-infrared (NIR). UV-Vis spectroscopy experiments were also done to assess the precipitate asphaltenes content. The asphaltenes precipitation envelopes (APE) were also determined by numerical simulation (Multiflash). In addition, the adequate artificial lift systems (ALS) for the oils were selected. It was based on the downhole well profile and a screening methodology. Finally, the oil flowrates were modelling by NODAL analysis production system in the PIPESIM software. The results of this study show that the asphaltenes precipitation onset of the crude oils were 2.2, 2.3 and 6.0 mL of n-heptane/g of oil. The cardanol was an effective inhibitor of asphaltenes precipitation for the crude oils used in this study, since it displaces the precipitation pressure of the oil to lower values. This indicates that cardanol can increase the oil wells productivity.

Keywords: asphaltenes, NODAL analysis production system, precipitation pressure onset, inhibitory molecule

Procedia PDF Downloads 156
438 Effects of Virtual Reality on the Upper Extremity Spasticity and Motor Function in Patients with Stroke: A Single Blinded Randomized Controlled Trial

Authors: Kasra Afsahi, Maryam Soheilifar, S. Hossein Hosseini, Omid Seyed Esmaeili, Rouzbeh Kezemi, Noushin Mehrbod, Nazanin Vahed, Tahereh Hajiahmad, Noureddin Nakhostin Ansari

Abstract:

Background: Stroke is a disabling neurological disease. Rehabilitative therapies are important treatment methods. This clinical trial was done to compare the effects of VR beside conventional rehabilitation versus conventional rehabilitation alone on spasticity and motor function in stroke patients. Materials and Methods: In this open-label randomized controlled clinical trial, 40 consecutive patients with stable first-ever ischemic stroke in the past three to 12 months that were referred to a rehabilitation clinic in Tehran, Iran, in 2020 were enrolled. After signing the informed written consent form, subjects were randomly assigned by block randomization of five in each block as cases with 1:1 into two groups of 20 cases; conventional plus VR therapy group: 45-minute conventional therapy session plus 15-minute VR therapy, and conventional group: 60-minute conventional therapy session. VR rehabilitation is designed and developed with different stages. Outcomes were modified Ashworth scale, recovery stage score for motor function, range of motion (ROM) of shoulder abduction/wrist extension, and patients’ satisfaction rate. Data were compared after study termination. Results: The satisfaction rate among the patients was significantly better in the combination group (P=0.003). Only wrist extension was varied between groups and was better in the combination group. The variables generally had a statistically significant difference (P < 0.05). Conclusion: Virtual reality plus conventional rehabilitation therapy is superior versus conventional rehabilitation alone on the wrist and elbow spasticity and motor function in patients with stroke.

Keywords: stroke, virtual therapy, rehabilitation, treatment

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437 Using Multi-Specialist Team to Care for a Breast Cancer Patient Who Received Total Mastectomy during Pregnancy

Authors: Yun-Tsuen Chen, Shih-Ting Huang, Pi-Fen Cheng, Heng-Hua Wang, Hui-Zhu Chen

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This paper discusses the experience of caring for a patient diagnosed with breast cancer and later received total mastectomy during a 2nd trimester pregnancy. She was hospitalized from January 31 to February 4, 2018. Using 'Gordon’s 11 Functional Health Patterns' through physical exams and interviews, the researcher assessed the patient’s physical and mental health and determined the patient to have anxiety, acute pain, and body image disturbance. After establishing a strong relationship with the patient, the researcher helped the patient express her anxiety and personal feelings. A multi-specialist team was formed to evaluate both the patient and her unborn child, before, during, and after surgery. This individualized care allowed the patient and her child to optimize the post-operative results. Aside from medication, the patient also received non-medicinal treatment, including improvement of sleep quality with body positioning, diaphragmatic breathing exercises for pain and stress relief after surgery. Throughout hospitalization, the patient’s physical and emotional needs were addressed daily with listening sessions and empathy. The patient’s husband was also incorporated in the patient’s recovery by teaching both he and the patient how to change the sterile wound dressing, which may have the added benefit of improving marital relationships through shared activities of nurturing. The patient was also given advice about how to improve self-confidence through clothing. Lastly, the patient was encouraged to join a support group for breast cancer patients. Through the sharing of experience in groups and within the family, the patient was helped to adapt to the change of her appearance and re-establish her self-confidence. This level of care expedited the patient’s return to her family life and role of being a mother.

Keywords: anxiety, body image disturbance, breast cancer during pregnancy, multi-specialist team

Procedia PDF Downloads 80
436 Effectiveness of Dry Needling with and without Ultrasound Guidance in Patients with Knee Osteoarthritis and Patellofemoral Pain Syndrome: A Systematic Review and Meta-Analysis

Authors: Johnson C. Y. Pang, Amy S. N. Fu, Ryan K. L. Lee, Allan C. L. Fu

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Dry needling (DN) is one of the puncturing methods that involves the insertion of needles into the tender spots of the human body without the injection of any substance. DN has long been used to treat the patient with knee pain caused by knee osteoarthritis (KOA) and patellofemoral pain syndrome (PFPS), but the effectiveness is still inconsistent. This study aimed to conduct a systematic review and meta-analysis to assess the intervention methods and effects of DN with and without ultrasound guidance for treating pain and dysfunctions in people with KOA and PFPS. Design: This systematic review adhered to the PRISMA reporting guidelines. The registration number of the study protocol published in the PROSPERO database was CRD42021221419. Six electronic databases were searched manually through CINAHL Complete (1976-2020), Cochrane Library (1996-2020), EMBASE (1947-2020), Medline (1946-2020), PubMed (1966-2020), and Psychinfo (1806-2020) in November 2020. Randomized controlled trials (RCTs) and controlled clinical trials were included to examine the effects of DN on knee pain, including KOA and PFPS. The key concepts included were: DN, acupuncture, ultrasound guidance, KOA, and PFPS. Risk of bias assessment and qualitative analysis were conducted by two independent reviewers using the PEDro score. Results: Fourteen articles met the inclusion criteria, and eight of them were high-quality papers in accordance with the PEDro score. There were variations in the techniques of DN. These included the direction, depth of insertion, number of needles, duration of stay, needle manipulation, and the number of treatment sessions. Meta-analysis was conducted on eight articles. DN group showed positive short-term effects (from immediate after DN to less than 3 months) on pain reduction for both KOA and PFPS with the overall standardized mean difference (SMD) of -1.549 (95% CI=-0.588 to -2.511); with great heterogeneity (P=0.002, I²=96.3%). In subgroup analysis, DN demonstrated significant effects in pain reduction on PFPS (p < 0.001) that could not be found in subjects with KOA (P=0.302). At 3-month post-intervention, DN also induced significant pain reduction in both subjects with KOA and PFPS with an overall SMD of -0.916 (95% CI=-0.133 to -1.699, and great heterogeneity (P=0.022, I²=95.63%). Besides, DN induced significant short-term improvement in function with the overall SMD=6.069; 95% CI=8.595 to 3.544; with great heterogeneity (P<0.001, I²=98.56%) when analyzed was conducted on both KOA and PFPS groups. In subgroup analysis, only PFPS showed a positive result with SMD=6.089, P<0.001; while KOA showed statistically insignificant with P=0.198 in short-term effect. Similarly, at 3-month post-intervention, significant improvement in function after DN was found when the analysis was conducted in both groups with the overall SMD=5.840; 95% CI=9.252 to 2.428; with great heterogeneity (P<0.001, I²=99.1%), but only PFPS showed significant improvement in sub-group analysis (P=0.002, I²=99.1%). Conclusions: The application of DN in KOA and PFPS patients varies among practitioners. DN is effective in reducing pain and dysfunction at short-term and 3-month post-intervention in individuals with PFPS. To our best knowledge, no study has reported the effects of DN with ultrasound guidance on KOA and PFPS. The longer-term effects of DN on KOA and PFPS are waiting for further study.

Keywords: dry needling, knee osteoarthritis, patellofemoral pain syndrome, ultrasound guidance

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435 Minimal Invasive Esophagectomy for Esophageal Cancer: An Institutional Review From a Dedicated Centre of Pakistan

Authors: Nighat Bakhtiar, Ali Raza Khan, Shahid Khan Khattak, Aamir Ali Syed

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Introduction: Chemoradiation followed by resection has been the standard therapy for resectable (cT1-4aN0-3M0) esophageal carcinoma. The optimal surgical approach remains a matter of debate. Therefore, the purpose of this study was to share our experiences of minimal invasive esophagectomies concerning morbidity, mortality and oncological quality. This study aims to enlighten the world about the surgical outcomes after minimally invasive esophagectomy at Shaukat Khanum Hospital Lahore. Objective: The purpose of this study is to review an institutional experience of Surgical outcomes of Minimal Invasive esophagectomies for esophageal cancer. Methodology: This retrospective study was performed after ethical approval at Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) Pakistan. Patients who underwent Minimal Invasive esophagectomies for esophageal cancer from March 2018 to March 2023 were selected. Data was collected through the human information system (HIS) electronic database of SKMCH&RC. Data was described using mean and median with minimum and maximum values for quantitative variables. For categorical variables, a number of observations and percentages were reported. Results: A total of 621 patients were included in the study, with the mean age of the patient was 39 years, ranging between 18-58 years. Mean Body Mass Index of patients was 21.2.1±4.1. Neo-adjuvant chemoradiotherapy was given to all patients. The mean operative time was 210.36 ± 64.51 minutes, and the mean blood loss was 121 milliliters. There was one mortality in 90 days, while the mean postoperative hospital stay was 6.58 days with a 4.64 standard deviation. The anastomotic leak rate was 4.2%. Chyle leak was observed in 12 patients. Conclusion: The minimal invasive technique is a safe approach for esophageal cancers, with minimal complications and fast recovery.

Keywords: minimal invasive, esophagectomy, laparscopic, cancer

Procedia PDF Downloads 48
434 Environmental Assessment of Roll-to-Roll Printed Smart Label

Authors: M. Torres, A. Moulay, M. Zhuldybina, M. Rozel, N. D. Trinh, C. Bois

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Printed electronics are a fast-growing market as their applications cover a large range of industrial needs, their production cost is low, and the additive printing techniques consume less materials than subtractive manufacturing methods used in traditional electronics. With the growing demand for printed electronics, there are concerns about their harmful and irreversible contribution to the environment. Indeed, it is estimated that 80% of the environmental load of a product is determined by the choices made at the conception stage. Therefore, examination through a life cycle approach at the developing stage of a novel product is the best way to identify potential environmental issues and make proactive decisions. Life cycle analysis (LCA) is a comprehensive scientific method to assess the environmental impacts of a product in its different stages of life: extraction of raw materials, manufacture and distribution, use, and end-of-life. Impacts and major hotspots are identified and evaluated through a broad range of environmental impact categories of the ReCiPe (H) middle point method. At the conception stage, the LCA is a tool that provides an environmental point of view on the choice of materials and processes and weights-in on the balance between performance materials and eco-friendly materials. Using the life cycle approach, the current work aims to provide a cradle-to-grave life cycle assessment of a roll-to-roll hybrid printed smart label designed for the food cold chain. Furthermore, this presentation will present the environmental impact of metallic conductive inks, a comparison with promising conductive polymers, evaluation of energy vs. performance of industrial printing processes, a full assessment of the impact from the smart label applied on a cellulosic-based substrate during the recycling process and the possible recovery of precious metals and rare earth elements.

Keywords: Eco-design, label, life cycle assessment, printed electronics

Procedia PDF Downloads 142
433 Developing and Standardizing Individual Care Plan for Children in Conflict with Law in the State of Kerala

Authors: Kavitha Puthanveedu, Kasi Sekar, Preeti Jacob, Kavita Jangam

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In India, The Juvenile Justice (Care and Protection of Children) Act, 2015, the law related to children alleged and found to be in conflict with law, proposes to address to the rehabilitation of children in conflict with law by catering to the basic rights by providing care and protection, development, treatment, and social re-integration. A major concern in addressing the issues of children in conflict with law in Kerala the southernmost state in India identified were: 1. Lack of psychological assessment for children in conflict with law, 2. Poor psychosocial intervention for children in conflict with law on bail, 3. Lack of psychosocial intervention or proper care and protection of CCL residing at observation and special home, 4. Lack convergence with systems related with mental health care. Aim: To develop individual care plan for children in conflict with law. Methodology: NIMHANS a premier Institute of Mental Health and Neurosciences, collaborated with Social Justice Department, Govt. of Kerala to address this issue by developing a participatory methodology to implement psychosocial care in the existing services by integrating the activities through multidisciplinary and multisectoral approach as per the Sec. 18 of JJAct 2015. Developing individual care plan: Key informant interviews, focus group discussion with multiple stakeholders consisting of legal officers, police, child protection officials, counselors, and home staff were conducted. Case studies were conducted among children in conflict with law. A checklist on 80 psychosocial problems among children in conflict with law was prepared with eight major issues identified through the quantitative process such as family and parental characteristic, family interactions and relationships, stressful life event, social and environmental factors, child’s individual characteristics, education, child labour and high-risk behavior. Standardised scales were used to identify the anxiety, caseness, suicidality and substance use among the children. This provided a background data understand the psychosocial problems experienced by children in conflict with law. In the second stage, a detailed plan of action was developed involving multiple stakeholders that include Special juvenile police unit, DCPO, JJB, and NGOs. The individual care plan was reviewed by a panel of 4 experts working in the area of children, followed by the review by multiple stakeholders in juvenile justice system such as Magistrates, JJB members, legal cum probation officers, district child protection officers, social workers and counselors. Necessary changes were made in the individual care plan in each stage which was pilot tested with 45 children for a period of one month and standardized for administering among children in conflict with law. Result: The individual care plan developed through scientific process was standardized and currently administered among children in conflict with law in the state of Kerala in the 3 districts that will be further implemented in other 14 districts. The program was successful in developing a systematic approach for the psychosocial intervention of children in conflict with law that can be a forerunner for other states in India.

Keywords: psychosocial care, individual care plan, multidisciplinary, multisectoral

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432 Biomaterials Solutions to Medical Problems: A Technical Review

Authors: Ashish Thakur

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This technical paper was written in view of focusing the biomaterials and its various applications in modern industries. Author tires to elaborate not only the medical, infect plenty of application in other industries. The scope of the research area covers the wide range of physical, biological and chemical sciences that underpin the design of biomaterials and the clinical disciplines in which they are used. A biomaterial is now defined as a substance that has been engineered to take a form which, alone or as part of a complex system, is used to direct, by control of interactions with components of living systems, the course of any therapeutic or diagnostic procedure. Biomaterials are invariably in contact with living tissues. Thus, interactions between the surface of a synthetic material and biological environment must be well understood. This paper reviews the benefits and challenges associated with surface modification of the metals in biomedical applications. The paper also elaborates how the surface characteristics of metallic biomaterials, such as surface chemistry, topography, surface charge, and wettability, influence the protein adsorption and subsequent cell behavior in terms of adhesion, proliferation, and differentiation at the biomaterial–tissue interface. The chapter also highlights various techniques required for surface modification and coating of metallic biomaterials, including physicochemical and biochemical surface treatments and calcium phosphate and oxide coatings. In this review, the attention is focused on the biomaterial-associated infections, from which the need for anti-infective biomaterials originates. Biomaterial-associated infections differ markedly for epidemiology, aetiology and severity, depending mainly on the anatomic site, on the time of biomaterial application, and on the depth of the tissues harbouring the prosthesis. Here, the diversity and complexity of the different scenarios where medical devices are currently utilised are explored, providing an overview of the emblematic applicative fields and of the requirements for anti-infective biomaterials. In addition to this, chapter introduces nanomedicine and the use of both natural and synthetic polymeric biomaterials, focuses on specific current polymeric nanomedicine applications and research, and concludes with the challenges of nanomedicine research. Infection is currently regarded as the most severe and devastating complication associated to the use of biomaterials. Osteoporosis is a worldwide disease with a very high prevalence in humans older than 50. The main clinical consequences are bone fractures, which often lead to patient disability or even death. A number of commercial biomaterials are currently used to treat osteoporotic bone fractures, but most of these have not been specifically designed for that purpose. Many drug- or cell-loaded biomaterials have been proposed in research laboratories, but very few have received approval for commercial use. Polymeric nanomaterial-based therapeutics plays a key role in the field of medicine in treatment areas such as drug delivery, tissue engineering, cancer, diabetes, and neurodegenerative diseases. Advantages in the use of polymers over other materials for nanomedicine include increased functionality, design flexibility, improved processability, and, in some cases, biocompatibility.

Keywords: nanomedicine, tissue, infections, biomaterials

Procedia PDF Downloads 242
431 Wood Dust and Nanoparticle Exposure among Workers during a New Building Construction

Authors: Atin Adhikari, Aniruddha Mitra, Abbas Rashidi, Imaobong Ekpo, Jefferson Doehling, Alexis Pawlak, Shane Lewis, Jacob Schwartz

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Building constructions in the US involve numerous wooden structures. Woods are routinely used in walls, framing floors, framing stairs, and making of landings in building constructions. Cross-laminated timbers are currently being used as construction materials for tall buildings. Numerous workers are involved in these timber based constructions, and wood dust is one of the most common occupational exposures for them. Wood dust is a complex substance composed of cellulose, polyoses and other substances. According to US OSHA, exposure to wood dust is associated with a variety of adverse health effects among workers, including dermatitis, allergic respiratory effects, mucosal and nonallergic respiratory effects, and cancers. The amount and size of particles released as wood dust differ according to the operations performed on woods. For example, shattering of wood during sanding operations produces finer particles than does chipping in sawing and milling industries. To our knowledge, how shattering, cutting and sanding of woods and wood slabs during new building construction release fine particles and nanoparticles are largely unknown. General belief is that the dust generated during timber cutting and sanding tasks are mostly large particles. Consequently, little attention has been given to the generated submicron ultrafine and nanoparticles and their exposure levels. These data are, however, critically important because recent laboratory studies have demonstrated cytotoxicity of nanoparticles on lung epithelial cells. The above-described knowledge gaps were addressed in this study by a novel newly developed nanoparticle monitor and conventional particle counters. This study was conducted in a large new building construction site in southern Georgia primarily during the framing of wooden side walls, inner partition walls, and landings. Exposure levels of nanoparticles (n = 10) were measured by a newly developed nanoparticle counter (TSI NanoScan SMPS Model 3910) at four different distances (5, 10, 15, and 30 m) from the work location. Other airborne particles (number of particles/m3) including PM2.5 and PM10 were monitored using a 6-channel (0.3, 0.5, 1.0, 2.5, 5.0 and 10 µm) particle counter at 15 m, 30 m, and 75 m distances at both upwind and downwind directions. Mass concentration of PM2.5 and PM10 (µg/m³) were measured by using a DustTrak Aerosol Monitor. Temperature and relative humidity levels were recorded. Wind velocity was measured by a hot wire anemometer. Concentration ranges of nanoparticles of 13 particle sizes were: 11.5 nm: 221 – 816/cm³; 15.4 nm: 696 – 1735/cm³; 20.5 nm: 879 – 1957/cm³; 27.4 nm: 1164 – 2903/cm³; 36.5 nm: 1138 – 2640/cm³; 48.7 nm: 938 – 1650/cm³; 64.9 nm: 759 – 1284/cm³; 86.6 nm: 705 – 1019/cm³; 115.5 nm: 494 – 1031/cm³; 154 nm: 417 – 806/cm³; 205.4 nm: 240 – 471/cm³; 273.8 nm: 45 – 92/cm³; and 365.2 nm: Keywords: wood dust, industrial hygiene, aerosol, occupational exposure

Procedia PDF Downloads 169