Search results for: guide for authors
Commenced in January 2007
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Paper Count: 2577

Search results for: guide for authors

297 Study of the Possibility of Adsorption of Heavy Metal Ions on the Surface of Engineered Nanoparticles

Authors: Antonina A. Shumakova, Sergey A. Khotimchenko

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The relevance of research is associated, on the one hand, with an ever-increasing volume of production and the expansion of the scope of application of engineered nanomaterials (ENMs), and on the other hand, with the lack of sufficient scientific information on the nature of the interactions of nanoparticles (NPs) with components of biogenic and abiogenic origin. In particular, studying the effect of ENMs (TiO2 NPs, SiO2 NPs, Al2O3 NPs, fullerenol) on the toxicometric characteristics of common contaminants such as lead and cadmium is an important hygienic task, given the high probability of their joint presence in food products. Data were obtained characterizing a multidirectional change in the toxicity of model toxicants when they are co-administered with various types of ENMs. One explanation for this fact is the difference in the adsorption capacity of ENMs, which was further studied in in vitro studies. For this, a method was proposed based on in vitro modeling of conditions simulating the environment of the small intestine. It should be noted that the obtained data are in good agreement with the results of in vivo experiments: - with the combined administration of lead and TiO2 NPs, there were no significant changes in the accumulation of lead in rat liver; in other organs (kidneys, spleen, testes and brain), the lead content was lower than in animals of the control group; - studying the combined effect of lead and Al2O3 NPs, a multiple and significant increase in the accumulation of lead in rat liver was observed with an increase in the dose of Al2O3 NPs. For other organs, the introduction of various doses of Al2O3 NPs did not significantly affect the bioaccumulation of lead; - with the combined administration of lead and SiO2 NPs in different doses, there was no increase in lead accumulation in all studied organs. Based on the data obtained, it can be assumed that at least three scenarios of the combined effects of ENMs and chemical contaminants on the body: - ENMs quite firmly bind contaminants in the gastrointestinal tract and such a complex becomes inaccessible (or inaccessible) for absorption; in this case, it can be expected that the toxicity of both ENMs and contaminants will decrease; - the complex formed in the gastrointestinal tract has partial solubility and can penetrate biological membranes and / or physiological barriers of the body; in this case, ENMs can play the role of a kind of conductor for contaminants and, thus, their penetration into the internal environment of the body increases, thereby increasing the toxicity of contaminants; - ENMs and contaminants do not interact with each other in any way, therefore the toxicity of each of them is determined only by its quantity and does not depend on the quantity of another component. Authors hypothesized that the degree of adsorption of various elements on the surface of ENMs may be a unique characteristic of their action, allowing a more accurate understanding of the processes occurring in a living organism.

Keywords: absorption, cadmium, engineered nanomaterials, lead

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296 Person-Centered Approaches in Face-to-Face Interventions to Support Enrolment in Cardiac Rehabilitation: A Scoping Review Study

Authors: Birgit Rasmussen, Thomas Maribo, Bente S. Toft

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BACKGROUND: Cardiac rehabilitation is the standard treatment for ischemic heart disease. Cardiac rehabilitation improves quality of life, reduces mortality and the risk of readmission, and provides patients with valuable knowledge and encouragement from peers and staff. Still, less than half of eligible patients enroll. Face-to-face interventions have the potential to support patients' decision-making and increase enrolment in cardiac rehabilitation. However, we lack knowledge of the content and characteristics of interventions. AIM: The aim was to outline and evaluate the content and characteristics of studies that have reported on face-to-face interventions to encourage enrolment in cardiac rehabilitation in patients with ischemic heart disease. METHOD: This scoping review followed the Joanne Briggs Institute methodology. Based on an a-priori protocol that defined the systematic search criteria, six databases were searched for studies published between 2001 and 2023. Two reviewers independently screened and selected studies. All authors discussed the summarized data prior to the narrative presentation. RESULTS: After screening and full text review of 5583 records, 20 studies of heterogeneous design and content were included. Four studies described the key contents in face-to-face interventions to be education, support of autonomy, addressing reasons for change, and emotional and cognitive support while showing understanding. Two studies used motivational interviewing to target patients' experiences and address worries and anticipated difficulties. Four quantitative studies found associations between enrolment and intention to attend, cardiac rehabilitation barriers, exercise self-efficacy, and perceived control. When patients asked questions, enrolment rates were higher, while providing reassurance and optimism could lead to non-attendance if patients had a high degree of worry. In qualitative studies, support to overcome barriers and knowledge about health benefits from participation in cardiac rehabilitation facilitated enrolment. Feeling reassured that the cardiac condition was good could lead to non-attendance. DISCUSSION AND CONCLUSION: To support patients' enrolment in cardiac rehabilitation, it is recommended that interventions integrate a person-centered dialogue. Individual worries and barriers to cardiac rehabilitation should be jointly explored. When talking with patients for whom worries predominate, the recommendation is to focus on the patients' perspectives and avoid too much focus on reassurance and problem-solving. The patients' perspectives, the mechanisms of change, and the process evaluation of the intervention including person-centeredness are relevant to include in future studies.

Keywords: ischemic heart disease, cardiac rehabilitation, enrolment, person-centered, in-hospital interventions

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295 Vagal Nerve Stimulator as a Treatment Approach in CHARGE Syndrome: A Case Report

Authors: Roya Vakili, Lekaa Elhajjmoussa, Barzin Omidi-Shal, Kim Blake

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Objective: The purpose of this case report is to highlight the successful treatment of a patient with Coloboma, Heart defect, Atresia choanae, Retarded growth and development, Genital hypoplasia, Ear anomalies/deafness, (CHARGE syndrome) using a vagal nerve stimulator (VNS). Background: This is the first documented case report, to the authors' best knowledge, for a patient with CHARGE syndrome, epilepsy, autism, and postural orthostatic tachycardia syndrome (POTS) that was successfully treated with an implanted VNS therapeutic device. Methodology: The study is a case report. Results: This is the case of a 24-year-old female patient with CHARGE syndrome (non-random association of anomalies Coloboma, Heart defect, Atresia choanae, Retarded growth and development, Genital hypoplasia, Ear anomalies/deafness) and several other comorbidities including refractory epilepsy, Patent Ductus Arteriosus (PDA) and POTS who had significant improvement of her symptoms after VNS implantation. She was a VNS candidate given her longstanding history of drug-resistant epilepsy and current disposition secondary to CHARGE syndrome. Prior to VNS implantation, she experienced three generalized seizures a year and daily POTS-related symptoms. She was having frequent lightheadedness and syncope spells due to a rapid heart rate and low blood pressure. The VNS device was set to detect a rapid heart rate and send appropriate stimulation anytime the heart rate exceeded 20% of the patient’s normal baseline. The VNS device demonstrated frequent elevated heart rates and concurrent VNS release every 8 minutes in addition to the programmed events. Following VNS installation, the patient became more active, alert, and communicative and was able to verbally communicate with words she was unable to say prior. Her GI symptoms also improved, as she was able to tolerate food better orally in addition to her G and J tube, likely another result of the vagal nerve stimulation. Additionally, the patient’s seizures and POTS-related cardiac events appeared to be well controlled. She had prolonged electroencephalogram (EEG) testing, showing no significant change in epileptiform activity. Improvements in the patient’s disposition are believed to be secondary to parasympathetic stimulation, adequate heart rate control, and GI stimulation, in addition to behavioral changes and other benefits via her implanted VNS. Conclusion: VNS showed promising results in improving the patient's quality of life and managing her diverse symptoms, including dysautonomia, POTs, gastrointestinal mobility, cognitive functioning as well seizure control.

Keywords: autism, POTs, CHARGE, VNS

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294 Architecture, Politics and Religion Synthesis: Political Legitimacy in Early Islamic Iran

Authors: Fahimeh Ghorbani, Alam Saleh

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Ideology, politics and art have always been omnipresent patterns of Islam since its early age. The Islamic empire, expanded from China to Andalusia, has instrumentalized art and architecture to enhance political legitimacy of different dynasties or states throughout its history. Quranic verses utilized to convey ideological messages in the major mosques and mausoleums. Iranians had already been employing art and architecture to propagate their political legitimacy prior to Islam. The land of Iran and its art with strong civilizational pre-Islamic history has been profoundly politicized since the rise of Islam in the region. Early Islamic period in Iran has witnessed introduction of a new architectural language, new formulas for spatial configuration in built spaces, as well as new system of architectural decoration. Studying Iran’s Early Islamic architecture helps in better understanding the process of socio-political identity making of Iranian-Islamic culture, and thus art and architecture. This period also set the stage for formation of glorious architectural movements through Persianate world in later periods. During the Early Islamic period in Iran, the innovative combination of Islamic ideology and Iranian Architecture created formidable ideological tools in politicizing art in the region and beyond. As such, this paper aims to investigate the political history and architectural legacy from late Sassanid to Early Islamic period, delves into the ways in which Early Islamic architecture played role in transforming Persian concepts of kingship, administration, and social organization. In so doing, the study focuses on the Perso-Islamic architectural synthesis under the Samanids and Seljuk dynasty as case studies. The paper also explores how the newly introduced Islamic architecture has been employed to address the question of political legitimacy and to propagate states’ political agenda in early Islamic Iran (650-1250). As for the existing literature, despite its uniqueness and significance, Early Islamic architecture of Iran has received little scholarly attention. However, there exists a sizeable body of scholarship on socio-historic condition of the land of Iran during Early Islamic period which provide a solid base for the project. Methodologically speaking, the authors look into the subject through various lenses. They will conduct historic and archival research in libraries, private collections, and archives in Iran and the related neighbouring countries in Persian, Arabic and English. The methods of visual and formal analysis are applied to examine architectural features of the period. There are also a high number of intriguing, yet poorly examined, published and unpublished documents, old plans, drawings and photos of monuments preserved in Cultural Heritage of Iran Organization which will be consulted.

Keywords: Iran, Islamic architecture, early Islamic Iran, early Islamic architecture, politicized art, political legitimacy, propaganda, aesthetics

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293 Development of a Novel Ankle-Foot Orthotic Using a User Centered Approach for Improved Satisfaction

Authors: Ahlad Neti, Elisa Arch, Martha Hall

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Studies have shown that individuals who use Ankle-Foot-Orthoses (AFOs) have a high level of dissatisfaction regarding their current AFOs. Studies point to the focus on technical design with little attention given to the user perspective as a source of AFO designs that leave users dissatisfied. To design a new AFO that satisfies users and thereby improves their quality of life, the reasons for their dissatisfaction and their wants and needs for an improved AFO design must be identified. There has been little research into the user perspective on AFO use and desired improvements, so the relationship between AFO design and satisfaction in daily use must be assessed to develop appropriate metrics and constraints prior to designing a novel AFO. To assess the user perspective on AFO design, structured interviews were conducted with 7 individuals (average age of 64.29±8.81 years) who use AFOs. All interviews were transcribed and coded to identify common themes using Grounded Theory Method in NVivo 12. Qualitative analysis of these results identified sources of user dissatisfaction such as heaviness, bulk, and uncomfortable material and overall needs and wants for an AFO. Beyond the user perspective, certain objective factors must be considered in the construction of metrics and constraints to ensure that the AFO fulfills its medical purpose. These more objective metrics are rooted in a common medical device market and technical standards. Given the large body of research concerning these standards, these objective metrics and constraints were derived through a literature review. Through these two methods, a comprehensive list of metrics and constraints accounting for both the user perspective on AFO design and the AFO’s medical purpose was compiled. These metrics and constraints will establish the framework for designing a new AFO that carries out its medical purpose while also improving the user experience. The metrics can be categorized into several overarching areas for AFO improvement. Categories of user perspective related metrics include comfort, discreteness, aesthetics, ease of use, and compatibility with clothing. Categories of medical purpose related metrics include biomechanical functionality, durability, and affordability. These metrics were used to guide an iterative prototyping process. Six concepts were ideated and compared using system-level analysis. From these six concepts, two concepts – the piano wire model and the segmented model – were selected to move forward into prototyping. Evaluation of non-functional prototypes of the piano wire and segmented models determined that the piano wire model better fulfilled the metrics by offering increased stability, longer durability, fewer points for failure, and a strong enough core component to allow a sock to cover over the AFO while maintaining the overall structure. As such, the piano wire AFO has moved forward into the functional prototyping phase, and healthy subject testing is being designed and recruited to conduct design validation and verification.

Keywords: ankle-foot orthotic, assistive technology, human centered design, medical devices

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292 Possibility of Membrane Filtration to Treatment of Effluent from Digestate

Authors: Marcin Debowski, Marcin Zielinski, Magdalena Zielinska, Paulina Rusanowska

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The problem with digestate management is one of the most important factors influencing on the development and operation of biogas plant. Turbidity and bacterial contamination negatively affect the growth of algae, which can limit the use of the effluent in the production of algae biomass on a large scale. These problems can be overcome by cultivating of algae species resistant to environmental factors, such as Chlorella sp., Scenedesmus sp., or reducing load of organic compounds to prevent bacterial contamination. The effluent requires dilution and/or purification. One of the methods of effluent treatment is the use of a membrane technology such as microfiltration (MF), ultrafiltration (UF), nanofiltration (NF) and reverse osmosis (RO), depending on the membrane pore size and the cut off point. Membranes are a physical barrier to solids and particles larger than the size of the pores. MF membranes have the largest pores and are used to remove turbidity, suspensions, bacteria and some viruses. UF membranes remove also color, odor and organic compounds with high molecular weight. In treatment of wastewater or other waste streams, MF and UF can provide a sufficient degree of purification. NF membranes are used to remove natural organic matter from waters, water disinfection products and sulfates. RO membranes are applied to remove monovalent ions such as Na⁺ or K⁺. The effluent was used in UF for medium to cultivation of two microalgae: Chlorella sp. and Phaeodactylum tricornutum. Growth rates of Chlorella sp. and P. tricornutum were similar: 0.216 d⁻¹ and 0.200 d⁻¹ (Chlorella sp.); 0.128 d⁻¹ and 0.126 d⁻¹ (P. tricornutum), on synthetic medium and permeate from UF, respectively. The final biomass composition was also similar, regardless of the medium. Removal of nitrogen was 92% and 71% by Chlorella sp. and P. tricornutum, respectively. The fermentation effluents after UF and dilution were also used for cultivation of algae Scenedesmus sp. that is resistant to environmental conditions. The authors recommended the development of biorafinery based on the production of algae for the biogas production. There are examples of using a multi-stage membrane system to purify the liquid fraction from digestate. After the initial UF, RO is used to remove ammonium nitrogen and COD. To obtain a permeate with a concentration of ammonium nitrogen allowing to discharge it into the environment, it was necessary to apply three-stage RO. The composition of the permeate after two-stage RO was: COD 50–60 mg/dm³, dry solids 0 mg/dm³, ammonium nitrogen 300–320 mg/dm³, total nitrogen 320–340 mg/dm³, total phosphorus 53 mg/dm³. However compostion of permeate after three-stage RO was: COD < 5 mg/dm³, dry solids 0 mg/dm³, ammonium nitrogen 0 mg/dm³, total nitrogen 3.5 mg/dm³, total phosphorus < 0,05 mg/dm³. Last stage of RO might be replaced by ion exchange process. The negative aspect of membrane filtration systems is the fact that the permeate is about 50% of the introduced volume, the remainder is the retentate. The management of a retentate might involve recirculation to a biogas plant.

Keywords: digestate, membrane filtration, microalgae cultivation, Chlorella sp.

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291 A Tutorial on Model Predictive Control for Spacecraft Maneuvering Problem with Theory, Experimentation and Applications

Authors: O. B. Iskender, K. V. Ling, V. Dubanchet, L. Simonini

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This paper discusses the recent advances and future prospects of spacecraft position and attitude control using Model Predictive Control (MPC). First, the challenges of the space missions are summarized, in particular, taking into account the errors, uncertainties, and constraints imposed by the mission, spacecraft and, onboard processing capabilities. The summary of space mission errors and uncertainties provided in categories; initial condition errors, unmodeled disturbances, sensor, and actuator errors. These previous constraints are classified into two categories: physical and geometric constraints. Last, real-time implementation capability is discussed regarding the required computation time and the impact of sensor and actuator errors based on the Hardware-In-The-Loop (HIL) experiments. The rationales behind the scenarios’ are also presented in the scope of space applications as formation flying, attitude control, rendezvous and docking, rover steering, and precision landing. The objectives of these missions are explained, and the generic constrained MPC problem formulations are summarized. Three key design elements used in MPC design: the prediction model, the constraints formulation and the objective cost function are discussed. The prediction models can be linear time invariant or time varying depending on the geometry of the orbit, whether it is circular or elliptic. The constraints can be given as linear inequalities for input or output constraints, which can be written in the same form. Moreover, the recent convexification techniques for the non-convex geometrical constraints (i.e., plume impingement, Field-of-View (FOV)) are presented in detail. Next, different objectives are provided in a mathematical framework and explained accordingly. Thirdly, because MPC implementation relies on finding in real-time the solution to constrained optimization problems, computational aspects are also examined. In particular, high-speed implementation capabilities and HIL challenges are presented towards representative space avionics. This covers an analysis of future space processors as well as the requirements of sensors and actuators on the HIL experiments outputs. The HIL tests are investigated for kinematic and dynamic tests where robotic arms and floating robots are used respectively. Eventually, the proposed algorithms and experimental setups are introduced and compared with the authors' previous work and future plans. The paper concludes with a conjecture that MPC paradigm is a promising framework at the crossroads of space applications while could be further advanced based on the challenges mentioned throughout the paper and the unaddressed gap.

Keywords: convex optimization, model predictive control, rendezvous and docking, spacecraft autonomy

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290 Computational Homogenization of Thin Walled Structures: On the Influence of the Global vs Local Applied Plane Stress Condition

Authors: M. Beusink, E. W. C. Coenen

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The increased application of novel structural materials, such as high grade asphalt, concrete and laminated composites, has sparked the need for a better understanding of the often complex, non-linear mechanical behavior of such materials. The effective macroscopic mechanical response is generally dependent on the applied load path. Moreover, it is also significantly influenced by the microstructure of the material, e.g. embedded fibers, voids and/or grain morphology. At present, multiscale techniques are widely adopted to assess micro-macro interactions in a numerically efficient way. Computational homogenization techniques have been successfully applied over a wide range of engineering cases, e.g. cases involving first order and second order continua, thin shells and cohesive zone models. Most of these homogenization methods rely on Representative Volume Elements (RVE), which model the relevant microstructural details in a confined volume. Imposed through kinematical constraints or boundary conditions, a RVE can be subjected to a microscopic load sequence. This provides the RVE's effective stress-strain response, which can serve as constitutive input for macroscale analyses. Simultaneously, such a study of a RVE gives insight into fine scale phenomena such as microstructural damage and its evolution. It has been reported by several authors that the type of boundary conditions applied to the RVE affect the resulting homogenized stress-strain response. As a consequence, dedicated boundary conditions have been proposed to appropriately deal with this concern. For the specific case of a planar assumption for the analyzed structure, e.g. plane strain, axisymmetric or plane stress, this assumption needs to be addressed consistently in all considered scales. Although in many multiscale studies a planar condition has been employed, the related impact on the multiscale solution has not been explicitly investigated. This work therefore focuses on the influence of the planar assumption for multiscale modeling. In particular the plane stress case is highlighted, by proposing three different implementation strategies which are compatible with a first-order computational homogenization framework. The first method consists of applying classical plane stress theory at the microscale, whereas with the second method a generalized plane stress condition is assumed at the RVE level. For the third method, the plane stress condition is applied at the macroscale by requiring that the resulting macroscopic out-of-plane forces are equal to zero. These strategies are assessed through a numerical study of a thin walled structure and the resulting effective macroscale stress-strain response is compared. It is shown that there is a clear influence of the length scale at which the planar condition is applied.

Keywords: first-order computational homogenization, planar analysis, multiscale, microstrucutures

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289 Knowledge Management Processes as a Driver of Knowledge-Worker Performance in Public Health Sector of Pakistan

Authors: Shahid Razzaq

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The governments around the globe have started taking into considerations the knowledge management dynamics while formulating, implementing, and evaluating the strategies, with or without the conscious realization, for the different public sector organizations and public policy developments. Health Department of Punjab province in Pakistan is striving to deliver quality healthcare services to the community through an efficient and effective service delivery system. Despite of this struggle some employee performance issues yet exists in the form of challenge to government. To overcome these issues department took several steps including HR strategies, use of technologies and focus of hard issues. Consequently, this study was attempted to highlight the importance of soft issue that is knowledge management in its true essence to tackle their performance issues. Knowledge management in public sector is quite an ignored area in the knowledge management-a growing multidisciplinary research discipline. Knowledge-based view of the firm theory asserts the knowledge is the most deliberate resource that can result in competitive advantage for an organization over the other competing organizations. In the context of our study it means for gaining employee performance, organizations have to increase the heterogeneous knowledge bases. The study uses the cross-sectional and quantitative research design. The data is collected from the knowledge workers of Health Department of Punjab, the biggest province of Pakistan. A total of 341 sample size is achieved. The SmartPLS 3 Version 2.6 is used for analyzing the data. The data examination revealed that knowledge management processes has a strong impact on knowledge worker performance. All hypotheses are accepted according to the results. Therefore, it can be summed up that to increase the employee performance knowledge management activities should be implemented. Health Department within province of Punjab introduces the knowledge management infrastructure and systems to make effective availability of knowledge for the service staff. This knowledge management infrastructure resulted in an increase in the knowledge management process in different remote hospitals, basic health units and care centers which resulted in greater service provisions to public. This study is to have theoretical and practical significances. In terms of theoretical contribution, this study is to establish the relationship between knowledge management and performance for the first time. In case of the practical contribution, this study is to give an insight to public sector organizations and government about role of knowledge management in employ performance. Therefore, public policymakers are strongly advised to implement the activities of knowledge management for enhancing the performance of knowledge workers. The current research validated the substantial role of knowledge management in persuading and creating employee arrogances and behavioral objectives. To the best of authors’ knowledge, this study contribute to the impact of knowledge management on employee performance as its originality.

Keywords: employee performance, knowledge management, public sector, soft issues

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288 A Comparative Approach for Modeling the Toxicity of Metal Mixtures in Two Ecologically Related Three-Spined (Gasterosteus aculeatus L.) And Nine-Spined (Pungitius pungitius L.) Sticklebacks

Authors: Tomas Makaras

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Sticklebacks (Gasterosteiformes) are increasingly used in ecological and evolutionary research and become well-established role as model species for biologists. However, ecotoxicology studies concerning behavioural effects in sticklebacks regarding stress responses, mainly induced by chemical mixtures, have hardly been addressed. Moreover, although many authors in their studies emphasised the similarity between three-spined and nine-spined stickleback in morphological, neuroanatomical and behavioural adaptations to environmental changes, several comparative studies have revealed considerable differences between these species in and their susceptibility and resistance to variousstressors in laboratory experiments. The hypothesis of this study was that three-spined and nine-spined stickleback species will demonstrate apparent differences in response patterns and sensitivity to metal-based chemicals stimuli. For this purpose, we investigated the swimming behaviour (including mortality rate based on 96-h LC50 values) of two ecologically similar three-spined (Gasterosteusaculeatus) and nine-spined sticklebacks (Pungitiuspungitius) to short-term (up to 24 h) metal mixture (MIX) exposure. We evaluated the relevance and efficacy of behavioural responses of test species in the early toxicity assessment of chemical mixtures. Fish exposed to six (Zn, Pb, Cd, Cu, Ni and Cr) metals in the mixture were either singled out by the Water Framework Directive as priority or as relevant substances in surface water, which was prepared according to the environmental quality standards (EQSs) of these metals set for inland waters in the European Union (EU) (Directive 2013/39/EU). Based on acute toxicity results, G. aculeatus found to be slightly (1.4-fold) more tolerant of MIX impact than those of P. pungitius specimens. The performed behavioural analysis showed the main effect on the interaction between time, species and treatment variables. Although both species exposed to MIX revealed a decreasing tendency in swimming activity, these species’ responsiveness to MIX was somewhat different. Substantial changes in the activity of G. aculeatus were established after 3-h exposure to MIX solutions, which was 1.43-fold lower, while in the case of P. pungitius, 1.96-fold higher than established 96-h LC50 values for each species. This study demonstrated species-specific differences in response sensitivity to metal-based water pollution, indicating behavioural insensitivity of P. pungitiuscompared to G. aculeatus. While many studies highlight the usefulness and suitability of nine-spined sticklebacks for evolutionary and ecological research, attested by their increasing popularity in these fields, great caution must be exercised when using them as model species in ecotoxicological research to probe metal contamination. Meanwhile, G. aculeatus showed to be a promising bioindicator species in the environmental ecotoxicology field.

Keywords: acute toxicity, comparative behaviour, metal mixture, swimming activity

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287 Case-Based Options Counseling Panel To Supplement An Indiana Medical School’s Pre-Clinical Family Planning and Abortion Education Curriculum

Authors: Alexandra McKinzie, Lucy Brown, Sarah Komanapalli, Sarah Swiezy, Caitlin Bernard

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Background: While 25% of US women will seek an abortion before age 45, targeted laws have led to a decline in abortion clinics, subsequently leaving 96% of Indiana counties and the 70% of Hoosier women residing in these counties without access to services they desperately need.1,2 Despite the need for a physician workforce that is educated and able to provide full-spectrum reproductive health care, few medical institutions have a standardized family planning and abortion pre-clinical curriculum. Methods: A Qualtrics survey was disseminated to students from Indiana University School of Medicine (IUSM) to evaluate (1) student interest in curriculum reform, (2) self-assessed preparedness to counsel on contraceptive and pregnancy options, and (3) preferred modality of instruction for family planning and abortion topics. Based on the pre-panel survey feedback, a case-based pregnancy options counseling panel will be implemented in the students’ pre-clinical, didactic course Endocrine, Reproductive, Musculoskeletal, Dermatologic Systems (ERMD) in February 2022. A Qualtrics post-panel survey will be disseminated to evaluate students’ perceived efficacy and quality of the panel, as well as their self-assessed preparedness to counsel on pregnancy options. Results: Participants in the pre-panel survey (n=303) were primarily female (61.72%) and White (74.43%). Across all class levels, many (60.80%) students expected to learn about family planning and abortion in their pre-clinical education. While most (84-88%) participants felt prepared to counsel about common, non-controversial pharmacotherapies (e.g. beta-blockers and diuretics), only 20% of students felt prepared to counsel on abortion options. Overall, 85.67% of students believed that IUSM should enhance its reproductive health coverage in pre-clinical, didactic courses. Traditional lectures, panels, and direct clinical exposure were the most popular instructional modalities. Expected Results: The authors predict that following the panel, students will indicate improved confidence in providing pregnancy options counseling. Additionally, students will provide constructive feedback on the structure and content of the panel for incorporation into future years’ curriculum. Conclusions: IUSM students overwhelmingly expressed interest in expanding their pre-clinical curriculum’s coverage of family planning and abortion topics. To specifically improve students’ self-assessed preparedness to provide pregnancy options counseling and address students’ self-cited learning gaps, a case-based provider panel session will be implemented in response to students’ preferred modality feedback.

Keywords: options counseling, family planning, abortion, curriculum reform, case-based panel

Procedia PDF Downloads 127
286 Wrestling with Religion: A Theodramatic Exploration of Morality in Popular Culture

Authors: Nicholas Fieseler

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The nature of religion implicit in popular culture is relevant both in and out of the university. The traditional rules-based conception of religion and the ethical systems that emerge from them do not necessarily convey the behavior of daily life as it exists apart from spaces deemed sacred. This paper proposes to examine the religion implicit in the popular culture phenomenon of professional wrestling and how that affects the understanding of popular religion. Pro wrestling, while frequently dismissed, offers a unique manner through which to re-examine religion in popular culture. A global phenomenon, pro wrestling occupies a distinct space in numerous countries and presents a legitimate reflection of human behavior cross-culturally on a scale few other phenomena can equal. Given its global viewership of millions, it should be recognized as a significant means of interpreting the human attraction to violence and its association with religion in general. Hans Urs von Balthasar’s theory of Theodrama will be used to interrogate the inchoate religion within pro wrestling. While Balthasar developed theodrama within the confines of Christian theology; theodrama contains remarkable versatility in its potential utility. Since theodrama re-envisions reality as drama, the actions of every human actor on the stage contributes to the play’s development, and all action contains some transcendent value. It is in this sense that even the “low brow” activity of pro wrestling may be understood in religious terms. Moreover, a pro wrestling storyline acts as a play within a play: the struggles in a pro wrestling match reflect the human attitudes toward life as it exists in the sacred and profane realms. The indistinct lines separating traditionally good (face) from traditionally bad (heel)wrestlers mirror the moral ambiguity in which many people interpret life. This blurred distinction between good and bad, and large segments of an audience’s embrace of the heel wrestlers, reveal ethical constraints that guide the everyday values of pro wrestling spectators, a moral ambivalence that is often overlooked by traditional religious systems, and which has hitherto been neglected in the academic literature on pro wrestling. The significance of interpreting the religion implicit in pro wrestling through a the dramatic lens extends beyond pro wrestling specifically and can examine the religion implicit in popular culture in general. The use of theodrama mitigates the rigid separation often ascribed to areas deemed sacred/ profane, ortranscendent / immanent, enabling a re-evaluation of religion and ethical systems as practiced in popular culture. The use of theodrama will be expressed by utilizing the pro wrestling match as a literary text that reflects the society from which it emerges. This analysis will also reveal the complex nature of religion in popular culture and provides new directions for the academic study of religion. This project consciously bridges the academic and popular realms. The goal of the research is not to add only to the academic literature on implicit religion in popular culture but to publish it in a form which speaks to those outside the standard academic audiences for such work.

Keywords: ethics, popular religion, professional wrestling, theodrama

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285 The Link between Strategic Sense-Making and Performance in Dubai Public Sector

Authors: Mohammad Rahman, Guy Burton, Megan Mathias

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Strategic management as an organizational practice was adopted by the public sector in the New Public Management (NPM) era that began in most parts of the world in the 1980s. Strategy as a new public management concept was subscribed by governments in both developed and developing world, as they were persuaded that clearly defined vision, mission and goals, as well as programs and projects - aligned with the goals - could potentially help achieve government vision at the national level and organizational goals at the service-delivery level. The advocates for strategic management in the public sector saw an inherent link between strategy and performance, claiming that the implementation of organizational strategy has an effect on the overall performance of an organization. Arguably, many government entities that have failed in enhancing team and individual performance had poorly-designed strategy or weak strategy implementation. Another key argument about low-level performance is linked with lack of strategic sense-making and orientation by middle managers in particular. Scholars maintain that employees at all levels need to understand strategic management plan in order to facilitate its implementation. Therefore, involving employees (particularly the middle managers) from the beginning potentially helps an organization avoid the drop in performance, and on the contrary would increase their commitment. The United Arab Emirates (UAE) is well known for adopting public sector reform strategies and tools since the 1990s. This observation is contextually pertinent in the case of the Government of Dubai, which has provided a Strategy Execution Guide to all of its entities to achieve high level strategic success in service delivery. The Dubai public sector also adopts road maps for e-Government, Smart Dubai, Expo 2020, investment, environment, education, health and other sectors. Evidently, some of these strategies are bringing tangible (e.g. Smart Dubai transformation) results in a transformational manner. However, the amount of academic research and literature on the strategy process vis-à-vis staff performance in the Government of Dubai is limited. In this backdrop, this study examines how individual performance of public sector employees in Dubai is linked with their sense-making, engagement and orientation with strategy development and implementation processes. Based on a theoretical framework, this study will undertake a sample-based questionnaire survey amongst middle managers in Dubai public sector to (a) measure the level of engagement of middle managers in strategy development and implementation processes as perceived by them; (b) observe the organizational landscape in which role expectations are placed on middle managers; and (c) examine the impact of employee engagement in strategy development process and the conditions for role expectations on individual performance. The paper is expected to provide new insights on the interface between strategic sense-making and performance in order to contribute a better understanding of the current culture/practices of staff engagement in strategic management in the public sector of Dubai.

Keywords: employee performance, government of Dubai, middle managers, strategic sense-making

Procedia PDF Downloads 179
284 Research on Internet Attention of Tourism and Marketing Strategy in Northeast Sichuan Economic Zone in China Based on Baidu Index

Authors: Chuanqiao Zheng, Wei Zeng, Haozhen Lin

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As of March 2020, the number of Chinese netizens has reached 904 million. The proportion of Internet users accessing the Internet through mobile phones is as high as 99.3%. Under the background of 'Internet +', tourists have a stronger sense of independence in the choice of tourism destinations and tourism products. Tourists are more inclined to learn about the relevant information on tourism destinations and other tourists' evaluations of tourist products through the Internet. The search engine, as an integrated platform that contains a wealth of information, is highly valuable to the analysis of the characteristics of the Internet attention given to various tourism destinations, through big data mining and analysis. This article uses the Baidu Index as the data source, which is one of the products of Baidu Search. The Baidu Index is based on big data, which collects and shares the search results of a large number of Internet users on the Baidu search engine. The big data used in this article includes search index, demand map, population profile, etc. The main research methods used are: (1) based on the search index, analyzing the Internet attention given to the tourism in five cities in Northeast Sichuan at different times, so as to obtain the overall trend and individual characteristics of tourism development in the region; (2) based on the demand map and the population profile, analyzing the demographic characteristics and market positioning of the tourist groups in these cities to understand the characteristics and needs of the target groups; (3) correlating the Internet attention data with the permanent population of each province in China in the corresponding to construct the Boston matrix of the Internet attention rate of the Northeast Sichuan tourism, obtain the tourism target markets, and then propose development strategies for different markets. The study has found that: a) the Internet attention given to the tourism in the region can be categorized into tourist off-season and peak season; the Internet attention given to tourism in different cities is quite different. b) tourists look for information including tour guide information, ticket information, traffic information, weather information, and information on the competing tourism cities; with regard to the population profile, the main group of potential tourists searching for the keywords of tourism in the five prefecture-level cities in Northeast Sichuan are youth. The male to female ratio is about 6 to 4, with males being predominant. c) through the construction of the Boston matrix, it is concluded that the star market for tourism in the Northeast Sichuan Economic Zone includes Sichuan and Shaanxi; the cash cows market includes Hainan and Ningxia; the question market includes Jiangsu and Shanghai; the dog market includes Hubei and Jiangxi. The study concludes with the following planning strategies and recommendations: i) creating a diversified business format that integrates cultural and tourism; ii) creating a brand image of niche tourism; iii) focusing on the development of tourism products; iv) innovating composite three-dimensional marketing channels.

Keywords: Baidu Index, big data, internet attention, tourism

Procedia PDF Downloads 109
283 A Sustainable Pt/BaCe₁₋ₓ₋ᵧZrₓGdᵧO₃ Catalyst for Dry Reforming of Methane-Derived from Recycled Primary Pt

Authors: Alessio Varotto, Lorenzo Freschi, Umberto Pasqual Laverdura, Anastasia Moschovi, Davide Pumiglia, Iakovos Yakoumis, Marta Feroci, Maria Luisa Grilli

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Dry reforming of Methane (DRM) is considered one of the most valuable technologies for green-house gas valorization thanks to the fact that through this reaction, it is possible to obtain syngas, a mixture of H₂ and CO in an H₂/CO ratio suitable for utilization in the Fischer-Tropsch process of high value-added chemicals and fuels. Challenges of the DRM process are the reduction of costs due to the high temperature of the process and the high cost of precious metals of the catalyst, the metal particles sintering, and carbon deposition on the catalysts’ surface. The aim of this study is to demonstrate the feasibility of the synthesis of catalysts using a leachate solution containing Pt coming directly from the recovery of spent diesel oxidation catalysts (DOCs) without further purification. An unusual perovskite support for DRM, the BaCe₁₋ₓ₋ᵧZrₓGdᵧO₃ (BCZG) perovskite, has been chosen as the catalyst support because of its high thermal stability and capability to produce oxygen vacancies, which suppress the carbon deposition and enhance the catalytic activity of the catalyst. BCZG perovskite has been synthesized by a sol-gel modified Pechini process and calcinated in air at 1100 °C. BCZG supports have been impregnated with a Pt-containing leachate solution of DOC, obtained by a mild hydrometallurgical recovery process, as reported elsewhere by some of the authors of this manuscript. For comparison reasons, a synthetic solution obtained by digesting commercial Pt-black powder in aqua regia was used for BCZG support impregnation. Pt nominal content was 2% in both BCZG-based catalysts formed by real and synthetic solutions. The structure and morphology of catalysts were characterized by X-Ray Diffraction (XRD) and Scanning Electron Microscopy (SEM). Thermogravimetric Analysis (TGA) was used to study the thermal stability of the catalyst’s samples. Brunauer-Emmett-Teller (BET) analysis provided a high surface area of the catalysts. H₂-TPR (Temperature Programmed Reduction) analysis was used to study the consumption of hydrogen for reducibility, and it was associated with H₂-TPD characterization to study the dispersion of Pt on the surface of the support and calculate the number of active sites used by the precious metal. Dry reforming of methane (DRM) reaction, carried out in a fixed bed reactor, showed a high conversion efficiency of CO₂ and CH4. At 850°C, CO₂ and CH₄ conversion were close to 100% for the catalyst obtained with the aqua regia-based solution of commercial Pt-black, and ~70% (for CH₄) and ~80 % (for CO₂) in the case of real HCl-based leachate solution. H₂/CO ratios were ~0.9 and ~0.70 in the first and latter cases, respectively. As far as we know, this is the first pioneering work in which a BCGZ catalyst and a real Pt-containing leachate solution were successfully employed for DRM reaction.

Keywords: dry reforming of methane, perovskite, PGM, recycled Pt, syngas

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282 Solutions to Reduce CO2 Emissions in Autonomous Robotics

Authors: Antoni Grau, Yolanda Bolea, Alberto Sanfeliu

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Mobile robots can be used in many different applications, including mapping, search, rescue, reconnaissance, hazard detection, and carpet cleaning, exploration, etc. However, they are limited due to their reliance on traditional energy sources such as electricity and oil which cannot always provide a convenient energy source in all situations. In an ever more eco-conscious world, solar energy offers the most environmentally clean option of all energy sources. Electricity presents threats of pollution resulting from its production process, and oil poses a huge threat to the environment. Not only does it pose harm by the toxic emissions (for instance CO2 emissions), it produces the combustion process necessary to produce energy, but there is the ever present risk of oil spillages and damages to ecosystems. Solar energy can help to mitigate carbon emissions by replacing more carbon intensive sources of heat and power. The challenge of this work is to propose the design and the implementation of electric battery recharge stations. Those recharge docks are based on the use of renewable energy such as solar energy (with photovoltaic panels) with the object to reduce the CO2 emissions. In this paper, a comparative study of the CO2 emission productions (from the use of different energy sources: natural gas, gas oil, fuel and solar panels) in the charging process of the Segway PT batteries is carried out. To make the study with solar energy, a photovoltaic panel, and a Buck-Boost DC/DC block has been used. Specifically, the STP005S-12/Db solar panel has been used to carry out our experiments. This module is a 5Wp-photovoltaic (PV) module, configured with 36 monocrystalline cells serially connected. With those elements, a battery recharge station is made to recharge the robot batteries. For the energy storage DC/DC block, a series of ultracapacitors have been used. Due to the variation of the PV panel with the temperature and irradiation, and the non-integer behavior of the ultracapacitors as well as the non-linearities of the whole system, authors have been used a fractional control method to achieve that solar panels supply the maximum allowed power to recharge the robots in the lesser time. Greenhouse gas emissions for production of electricity vary due to regional differences in source fuel. The impact of an energy technology on the climate can be characterised by its carbon emission intensity, a measure of the amount of CO2, or CO2 equivalent emitted by unit of energy generated. In our work, the coal is the fossil energy more hazardous, providing a 53% more of gas emissions than natural gas and a 30% more than fuel. Moreover, it is remarkable that existing fossil fuel technologies produce high carbon emission intensity through the combustion of carbon-rich fuels, whilst renewable technologies such as solar produce little or no emissions during operation, but may incur emissions during manufacture. The solar energy thus can help to mitigate carbon emissions.

Keywords: autonomous robots, CO2 emissions, DC/DC buck-boost, solar energy

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281 The Effect of Emotional Intelligence on Physiological Stress of Managers

Authors: Mikko Salminen, Simo Järvelä, Niklas Ravaja

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One of the central models of emotional intelligence (EI) is that of Mayer and Salovey’s, which includes ability to monitor own feelings and emotions and those of others, ability to discriminate different emotions, and to use this information to guide thinking and actions. There is vast amount of previous research where positive links between EI and, for example, leadership successfulness, work outcomes, work wellbeing and organizational climate have been reported. EI has also a role in the effectiveness of work teams, and the effects of EI are especially prominent in jobs requiring emotional labor. Thus, also the organizational context must be taken into account when considering the effects of EI on work outcomes. Based on previous research, it is suggested that EI can also protect managers from the negative consequences of stress. Stress may have many detrimental effects on the manager’s performance in essential work tasks. Previous studies have highlighted the effects of stress on, not only health, but also, for example, on cognitive tasks such as decision-making, which is important in managerial work. The motivation for the current study came from the notion that, unfortunately, many stressed individuals may not be aware of the circumstance; periods of stress-induced physiological arousal may be prolonged if there is not enough time for recovery. To tackle this problem, physiological stress levels of managers were collected using recording of heart rate variability (HRV). The goal was to use this data to provide the managers with feedback on their stress levels. The managers could access this feedback using a www-based learning environment. In the learning environment, in addition to the feedback on stress level and other collected data, also developmental tasks were provided. For example, those with high stress levels were sent instructions for mindfulness exercises. The current study focuses on the relation between the measured physiological stress levels and EI of the managers. In a pilot study, 33 managers from various fields wore the Firstbeat Bodyguard HRV measurement devices for three consecutive days and nights. From the collected HRV data periods (minutes) of stress and recovery were detected using dedicated software. The effects of EI on HRV-calculated stress indexes were studied using Linear Mixed Models procedure in SPSS. There was a statistically significant effect of total EI, defined as an average score of Schutte’s emotional intelligence test, on the percentage of stress minutes during the whole measurement period (p=.025). More stress minutes were detected on those managers who had lower emotional intelligence. It is suggested, that high EI provided managers with better tools to cope with stress. Managing of own emotions helps the manager in controlling possible negative emotions evoked by, e.g., critical feedback or increasing workload. High EI managers may also be more competent in detecting emotions of others, which would lead to smoother interactions and less conflicts. Given the recent trend to different quantified-self applications, it is suggested that monitoring of bio-signals would prove to be a fruitful direction to further develop new tools for managerial and leadership coaching.

Keywords: emotional intelligence, leadership, heart rate variability, personality, stress

Procedia PDF Downloads 207
280 Stability Analysis of Hossack Suspension Systems in High Performance Motorcycles

Authors: Ciro Moreno-Ramirez, Maria Tomas-Rodriguez, Simos A. Evangelou

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A motorcycle's front end links the front wheel to the motorcycle's chassis and has two main functions: the front wheel suspension and the vehicle steering. Up to this date, several suspension systems have been developed in order to achieve the best possible front end behavior, being the telescopic fork the most common one and already subjected to several years of study in terms of its kinematics, dynamics, stability and control. A motorcycle telescopic fork suspension model consists of a couple of outer tubes which contain the suspension components (coil springs and dampers) internally and two inner tubes which slide into the outer ones allowing the suspension travel. The outer tubes are attached to the frame through two triple trees which connect the front end to the main frame through the steering bearings and allow the front wheel to turn about the steering axis. This system keeps the front wheel's displacement in a straight line parallel to the steering axis. However, there exist alternative suspension designs that allow different trajectories of the front wheel with the suspension travel. In this contribution, the authors investigate an alternative front suspension system (Hossack suspension) and its influence on the motorcycle nonlinear dynamics to identify and reduce stability risks that a new suspension systems may introduce in the motorcycle dynamics. Based on an existing high-fidelity motorcycle mathematical model, the front end geometry is modified to accommodate a Hossack suspension system. It is characterized by a double wishbone design that varies the front end geometry on certain maneuverings and, consequently, the machine's behavior/response. It consists of a double wishbone structure directly attached to the chassis. In here, the kinematics of this system and its impact on the motorcycle performance/stability are analyzed and compared to the well known telescopic fork suspension system. The framework of this research is the mathematical modelling and numerical simulation. Full stability analyses are performed in order to understand how the motorcycle dynamics may be affected by the newly introduced front end design. This study is carried out by a combination of nonlinear dynamical simulation and root-loci methods. A modal analysis is performed in order to get a deeper understanding of the different modes of oscillation and how the Hossack suspension system affects them. The results show that different kinematic designs of a double wishbone suspension systems do not modify the general motorcycle's stability. The normal modes properties remain unaffected by the new geometrical configurations. However, these normal modes differ from one suspension system to the other. It is seen that the normal modes behaviour depends on various important dynamic parameters, such as the front frame flexibility, the steering damping coefficient and the centre of mass location.

Keywords: nonlinear mechanical systems, motorcycle dynamics, suspension systems, stability

Procedia PDF Downloads 209
279 Quantitative Wide-Field Swept-Source Optical Coherence Tomography Angiography and Visual Outcomes in Retinal Artery Occlusion

Authors: Yifan Lu, Ying Cui, Ying Zhu, Edward S. Lu, Rebecca Zeng, Rohan Bajaj, Raviv Katz, Rongrong Le, Jay C. Wang, John B. Miller

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Purpose: Retinal artery occlusion (RAO) is an ophthalmic emergency that can lead to poor visual outcome and is associated with an increased risk of cerebral stroke and cardiovascular events. Fluorescein angiography (FA) is the traditional diagnostic tool for RAO; however, wide-field swept-source optical coherence tomography angiography (WF SS-OCTA), as a nascent imaging technology, is able to provide quick and non-invasive angiographic information with a wide field of view. In this study, we looked for associations between OCT-A vascular metrics and visual acuity in patients with prior diagnosis of RAO. Methods: Patients with diagnoses of central retinal artery occlusion (CRAO) or branched retinal artery occlusion (BRAO) were included. A 6mm x 6mm Angio and a 15mm x 15mm AngioPlex Montage OCT-A image were obtained for both eyes in each patient using the Zeiss Plex Elite 9000 WF SS-OCTA device. Each 6mm x 6mm image was divided into nine Early Treatment Diabetic Retinopathy Study (ETDRS) subfields. The average measurement of the central foveal subfield, inner ring, and outer ring was calculated for each parameter. Non-perfusion area (NPA) was manually measured using 15mm x 15mm Montage images. A linear regression model was utilized to identify a correlation between the imaging metrics and visual acuity. A P-value less than 0.05 was considered to be statistically significant. Results: Twenty-five subjects were included in the study. For RAO eyes, there was a statistically significant negative correlation between vision and retinal thickness as well as superficial capillary plexus vessel density (SCP VD). A negative correlation was found between vision and deep capillary plexus vessel density (DCP VD) without statistical significance. There was a positive correlation between vision and choroidal thickness as well as choroidal volume without statistical significance. No statistically significant correlation was found between vision and the above metrics in contralateral eyes. For NPA measurements, no significant correlation was found between vision and NPA. Conclusions: This is the first study to our best knowledge to investigate the utility of WF SS-OCTA in RAO and to demonstrate correlations between various retinal vascular imaging metrics and visual outcomes. Further investigations should explore the associations between these imaging findings and cardiovascular risk as RAO patients are at elevated risk for symptomatic stroke. The results of this study provide a basis to understand the structural changes involved in visual outcomes in RAO. Furthermore, they may help guide management of RAO and prevention of cerebral stroke and cardiovascular accidents in patients with RAO.

Keywords: OCTA, swept-source OCT, retinal artery occlusion, Zeiss Plex Elite

Procedia PDF Downloads 120
278 Nano-MFC (Nano Microbial Fuel Cell): Utilization of Carbon Nano Tube to Increase Efficiency of Microbial Fuel Cell Power as an Effective, Efficient and Environmentally Friendly Alternative Energy Sources

Authors: Annisa Ulfah Pristya, Andi Setiawan

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Electricity is the primary requirement today's world, including Indonesia. This is because electricity is a source of electrical energy that is flexible to use. Fossil energy sources are the major energy source that is used as a source of energy power plants. Unfortunately, this conversion process impacts on the depletion of fossil fuel reserves and causes an increase in the amount of CO2 in the atmosphere, disrupting health, ozone depletion, and the greenhouse effect. Solutions have been applied are solar cells, ocean wave power, the wind, water, and so forth. However, low efficiency and complicated treatment led to most people and industry in Indonesia still using fossil fuels. Referring to this Fuel Cell was developed. Fuel Cells are electrochemical technology that continuously converts chemical energy into electrical energy for the fuel and oxidizer are the efficiency is considerably higher than the previous natural source of electrical energy, which is 40-60%. However, Fuel Cells still have some weaknesses in terms of the use of an expensive platinum catalyst which is limited and not environmentally friendly. Because of it, required the simultaneous source of electrical energy and environmentally friendly. On the other hand, Indonesia is a rich country in marine sediments and organic content that is never exhausted. Stacking the organic component can be an alternative energy source continued development of fuel cell is A Microbial Fuel Cell. Microbial Fuel Cells (MFC) is a tool that uses bacteria to generate electricity from organic and non-organic compounds. MFC same tools as usual fuel cell composed of an anode, cathode and electrolyte. Its main advantage is the catalyst in the microbial fuel cell is a microorganism and working conditions carried out in neutral solution, low temperatures, and environmentally friendly than previous fuel cells (Chemistry Fuel Cell). However, when compared to Chemistry Fuel Cell, MFC only have an efficiency of 40%. Therefore, the authors provide a solution in the form of Nano-MFC (Nano Microbial Fuel Cell): Utilization of Carbon Nano Tube to Increase Efficiency of Microbial Fuel Cell Power as an Effective, Efficient and Environmentally Friendly Alternative Energy Source. Nano-MFC has the advantage of an effective, high efficiency, cheap and environmental friendly. Related stakeholders that helped are government ministers, especially Energy Minister, the Institute for Research, as well as the industry as a production executive facilitator. strategic steps undertaken to achieve that begin from conduct preliminary research, then lab scale testing, and dissemination and build cooperation with related parties (MOU), conduct last research and its applications in the field, then do the licensing and production of Nano-MFC on an industrial scale and publications to the public.

Keywords: CNT, efficiency, electric, microorganisms, sediment

Procedia PDF Downloads 391
277 Optimizing the Pair Carbon Xerogels-Electrolyte for High Performance Supercapacitors

Authors: Boriana Karamanova, Svetlana Veleva, Luybomir Soserov, Ana Arenillas, Francesco Lufrano, Antonia Stoyanova

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Supercapacitors have received a lot of research attention and are promising energy storage devices due to their high power and long cycle life. In order to developed an advanced device with significant capacity for storing charge and cheap carbon materials, efforts must focus not only on improving synthesis by controlling the morphology and pore size but also on improving electrode-electrolyte compatibility of the resulting systems. The present study examines the relationship between the surface chemistry of two activated carbon xerogels, the electrolyte type, and the electrochemical properties of supercapacitors. Activated carbon xerogels were prepared by varying the initial pH of the resorcinol-formaldehyde aqueous solution. The materials produced are physicochemical characterized by DTA/TGA, porous characterization, and SEM analysis. The carbon xerogel based electrodes were prepared by spreading over glass plate a slurry containing the carbon gel, graphite, and poly vinylidene difluoride (PVDF) binder. The layer formed was dried consecutively at different temperatures and then detached by water. After, the layer was dried again to improve its mechanical stability. The developed electrode materials and the Aquivion® E87-05S membrane (Solvay Specialty Polymers), socked in Na2SO4 as a polymer electrolyte, were used to assembly the solid-state supercapacitor. Symmetric supercapacitor cells composed by same electrodes and 1 M KOH electrolytes are also assembled and tested for comparison. The supercapacitor performances are verified by different electrochemical methods - cyclic voltammetry, galvanostatic charge/discharge measurements, electrochemical impedance spectroscopy, and long-term durability tests in neutral and alkaline electrolytes. Specific capacitances, energy, and power density, energy efficiencies, and durability were compared into studied supercapacitors. Ex-situ physicochemical analyses on the synthesized materials have also been performed, which provide information about chemical and structural changes in the electrode morphology during charge / discharge durability tests. They are discussed on the basis of electrode-electrolyte interaction. The obtained correlations could be of significance in order to design sustainable solid-state supercapacitors with high power and energy density. Acknowledgement: This research is funded by the Ministry of Education and Science of Bulgaria under the National Program "European Scientific Networks" (Agreement D01-286 / 07.10.2020, D01-78/30.03.2021). Authors gratefully acknowledge.

Keywords: carbon xerogel, electrochemical tests, neutral and alkaline electrolytes, supercapacitors

Procedia PDF Downloads 119
276 Developing a Roadmap by Integrating of Environmental Indicators with the Nitrogen Footprint in an Agriculture Region, Hualien, Taiwan

Authors: Ming-Chien Su, Yi-Zih Chen, Nien-Hsin Kao, Hideaki Shibata

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The major component of the atmosphere is nitrogen, yet atmospheric nitrogen has limited availability for biological use. Human activities have produced different types of nitrogen related compounds such as nitrogen oxides from combustion, nitrogen fertilizers from farming, and the nitrogen compounds from waste and wastewater, all of which have impacted the environment. Many studies have indicated the N-footprint is dominated by food, followed by housing, transportation, and goods and services sectors. To solve the impact issues from agricultural land, nitrogen cycle research is one of the key solutions. The study site is located in Hualien County, Taiwan, a major rice and food production area of Taiwan. Importantly, environmentally friendly farming has been promoted for years, and an environmental indicator system has been established by previous authors based on the concept of resilience capacity index (RCI) and environmental performance index (EPI). Nitrogen management is required for food production, as excess N causes environmental pollution. Therefore it is very important to develop a roadmap of the nitrogen footprint, and to integrate it with environmental indicators. The key focus of the study thus addresses (1) understanding the environmental impact caused by the nitrogen cycle of food products and (2) uncovering the trend of the N-footprint of agricultural products in Hualien, Taiwan. The N-footprint model was applied, which included both crops and energy consumption in the area. All data were adapted from government statistics databases and crosschecked for consistency before modeling. The actions involved with agricultural production were evaluated and analyzed for nitrogen loss to the environment, as well as measuring the impacts to humans and the environment. The results showed that rice makes up the largest share of agricultural production by weight, at 80%. The dominant meat production is pork (52%) and poultry (40%); fish and seafood were at similar levels to pork production. The average per capita food consumption in Taiwan is 2643.38 kcal capita−1 d−1, primarily from rice (430.58 kcal), meats (184.93 kcal) and wheat (ca. 356.44 kcal). The average protein uptake is 87.34 g capita−1 d−1, and 51% is mainly from meat, milk, and eggs. The preliminary results showed that the nitrogen footprint of food production is 34 kg N per capita per year, congruent with the results of Shibata et al. (2014) for Japan. These results provide a better understanding of the nitrogen demand and loss in the environment, and the roadmap can furthermore support the establishment of nitrogen policy and strategy. Additionally, the results serve to develop a roadmap of the nitrogen cycle of an environmentally friendly farming area, thus illuminating the nitrogen demand and loss of such areas.

Keywords: agriculture productions, energy consumption, environmental indicator, nitrogen footprint

Procedia PDF Downloads 288
275 Restructurasation of the Concept of Empire in the Social Consciousness of Modern Americans

Authors: Maxim Kravchenko

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The paper looks into the structure and contents of the concept of empire in the social consciousness of modern Americans. To construct the model of this socially and politically relevant concept we have conducted an experiment with respondents born and living in the USA. Empire is seen as a historic notion describing such entities as the British empire, the Russian empire, the Ottoman empire and others. It seems that the democratic regime adopted by most countries worldwide is incompatible with imperial status of a country. Yet there are countries which tend to dominate in the contemporary world and though they are not routinely referred to as empires, in many respects they are reminiscent of historical empires. Thus, the central hypothesis of the study is that the concept of empire is cultivated in some states through the intermediary of the mass media though it undergoes a certain transformation to meet the expectations of a democratic society. The transformation implies that certain components which were historically embedded in its structure are drawn to the margins of the hierarchical structure of the concept whereas other components tend to become central to the concept. This process can be referred to as restructuration of the concept of empire. To verify this hypothesis we have conducted a study which falls into two stages. First we looked into the definition of empire featured in dictionaries, the dominant conceptual components of empire are: importance, territory/lands, recognition, independence, authority/power, supreme/absolute. However, the analysis of 100 articles from American newspapers chosen at random revealed that authors rarely use the word «empire» in its basic meaning (7%). More often «empire» is used when speaking about countries, which no longer exist or when speaking about some corporations (like Apple or Google). At the second stage of the study we conducted an associative experiment with the citizens of the USA aged 19 to 45. The purpose of the experiment was to find out the dominant components of the concept of empire and to construct the model of the transformed concept. The experiment stipulated that respondents should give the first association, which crosses their mind, on reading such stimulus phrases as “strong military”, “strong economy” and others. The list of stimuli features various words and phrases associated with empire including the words representing the dominant components of the concept of empire. Then the associations provided by the respondents were classified into thematic clusters. For instance, the associations to the stimulus “strong military” were compartmentalized into three groups: 1) a country with strong military forces (North Korea, the USA, Russia, China); 2) negative impression of strong military (war, anarchy, conflict); 3) positive impression of strong military (peace, safety, responsibility). The experiment findings suggest that the concept of empire is currently undergoing a transformation which brings about a number of changes. Among them predominance of positively assessed components of the concept; emergence of two poles in the structure of the concept, that is “hero” vs. “enemy”; marginalization of any negatively assessed components.

Keywords: associative experiment, conceptual components, empire, restructurasation of the concept

Procedia PDF Downloads 297
274 Storage of Organic Carbon in Chemical Fractions in Acid Soil as Influenced by Different Liming

Authors: Ieva Jokubauskaite, Alvyra Slepetiene, Danute Karcauskiene, Inga Liaudanskiene, Kristina Amaleviciute

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Soil organic carbon (SOC) is the key soil quality and ecological stability indicator, therefore, carbon accumulation in stable forms not only supports and increases the organic matter content in the soil, but also has a positive effect on the quality of soil and the whole ecosystem. Soil liming is one of the most common ways to improve the carbon sequestration in the soil. Determination of the optimum intensity and combinations of liming in order to ensure the optimal carbon quantitative and qualitative parameters is one of the most important tasks of this work. The field experiments were carried out at the Vezaiciai Branch of Lithuanian Research Centre for Agriculture and Forestry (LRCAF) during the 2011–2013 period. The effect of liming with different intensity (at a rate 0.5 every 7 years and 2.0 every 3-4 years) was investigated in the topsoil of acid moraine loam Bathygleyic Dystric Glossic Retisol. Chemical analyses were carried out at the Chemical Research Laboratory of Institute of Agriculture, LRCAF. Soil samples for chemical analyses were taken from the topsoil after harvesting. SOC was determined by the Tyurin method modified by Nikitin, measuring with spectrometer Cary 50 (VARIAN) at 590 nm wavelength using glucose standards. SOC fractional composition was determined by Ponomareva and Plotnikova version of classical Tyurin method. Dissolved organic carbon (DOC) was analyzed using an ion chromatograph SKALAR in water extract at soil-water ratio 1:5. Spectral properties (E4/E6 ratio) of humic acids were determined by measuring the absorbance of humic and fulvic acids solutions at 465 and 665 nm. Our study showed a negative statistically significant effect of periodical liming (at 0.5 and 2.0 liming rates) on SOC content in the soil. The content of SOC was 1.45% in the unlimed treatment, while in periodically limed at 2.0 liming rate every 3–4 years it was approximately by 0.18 percentage points lower. It was revealed that liming significantly decreased the DOC concentration in the soil. The lowest concentration of DOC (0.156 g kg-1) was established in the most intensively limed (2.0 liming rate every 3–4 years) treatment. Soil liming exerted an increase of all humic acids and fulvic acid bounded with calcium fractions content in the topsoil. Soil liming resulted in the accumulation of valuable humic acids. Due to the applied liming, the HR/FR ratio, indicating the quality of humus increased to 1.08 compared with that in unlimed soil (0.81). Intensive soil liming promoted the formation of humic acids in which groups of carboxylic and phenolic compounds predominated. These humic acids are characterized by a higher degree of condensation of aromatic compounds and in this way determine the intensive organic matter humification processes in the soil. The results of this research provide us with the clear information on the characteristics of SOC change, which could be very useful to guide the climate policy and sustainable soil management.

Keywords: acid soil, carbon sequestration, long–term liming, soil organic carbon

Procedia PDF Downloads 206
273 Mining Scientific Literature to Discover Potential Research Data Sources: An Exploratory Study in the Field of Haemato-Oncology

Authors: A. Anastasiou, K. S. Tingay

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Background: Discovering suitable datasets is an important part of health research, particularly for projects working with clinical data from patients organized in cohorts (cohort data), but with the proliferation of so many national and international initiatives, it is becoming increasingly difficult for research teams to locate real world datasets that are most relevant to their project objectives. We present a method for identifying healthcare institutes in the European Union (EU) which may hold haemato-oncology (HO) data. A key enabler of this research was the bibInsight platform, a scientometric data management and analysis system developed by the authors at Swansea University. Method: A PubMed search was conducted using HO clinical terms taken from previous work. The resulting XML file was processed using the bibInsight platform, linking affiliations to the Global Research Identifier Database (GRID). GRID is an international, standardized list of institutions, including the city and country in which the institution exists, as well as a category of the main business type, e.g., Academic, Healthcare, Government, Company. Countries were limited to the 28 current EU members, and institute type to 'Healthcare'. An article was considered valid if at least one author was affiliated with an EU-based healthcare institute. Results: The PubMed search produced 21,310 articles, consisting of 9,885 distinct affiliations with correspondence in GRID. Of these articles, 760 were from EU countries, and 390 of these were healthcare institutes. One affiliation was excluded as being a veterinary hospital. Two EU countries did not have any publications in our analysis dataset. The results were analysed by country and by individual healthcare institute. Networks both within the EU and internationally show institutional collaborations, which may suggest a willingness to share data for research purposes. Geographical mapping can ensure that data has broad population coverage. Collaborations with industry or government may exclude healthcare institutes that may have embargos or additional costs associated with data access. Conclusions: Data reuse is becoming increasingly important both for ensuring the validity of results, and economy of available resources. The ability to identify potential, specific data sources from over twenty thousand articles in less than an hour could assist in improving knowledge of, and access to, data sources. As our method has not yet specified if these healthcare institutes are holding data, or merely publishing on that topic, future work will involve text mining of data-specific concordant terms to identify numbers of participants, demographics, study methodologies, and sub-topics of interest.

Keywords: data reuse, data discovery, data linkage, journal articles, text mining

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272 Diagnostic Performance of Mean Platelet Volume in the Diagnosis of Acute Myocardial Infarction: A Meta-Analysis

Authors: Kathrina Aseanne Acapulco-Gomez, Shayne Julieane Morales, Tzar Francis Verame

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Mean platelet volume (MPV) is the most accurate measure of the size of platelets and is routinely measured by most automated hematological analyzers. Several studies have shown associations between MPV and cardiovascular risks and outcomes. Although its measurement may provide useful data, MPV remains to be a diagnostic tool that is yet to be included in routine clinical decision making. The aim of this systematic review and meta-analysis is to determine summary estimates of the diagnostic accuracy of mean platelet volume for the diagnosis of myocardial infarction among adult patients with angina and/or its equivalents in terms of sensitivity, specificity, diagnostic odds ratio, and likelihood ratios, and to determine the difference of the mean MPV values between those with MI and those in the non-MI controls. The primary search was done through search in electronic databases PubMed, Cochrane Review CENTRAL, HERDIN (Health Research and Development Information Network), Google Scholar, Philippine Journal of Pathology, and Philippine College of Physicians Philippine Journal of Internal Medicine. The reference list of original reports was also searched. Cross-sectional, cohort, and case-control articles studying the diagnostic performance of mean platelet volume in the diagnosis of acute myocardial infarction in adult patients were included in the study. Studies were included if: (1) CBC was taken upon presentation to the ER or upon admission (within 24 hours of symptom onset); (2) myocardial infarction was diagnosed with serum markers, ECG, or according to accepted guidelines by the Cardiology societies (American Heart Association (AHA), American College of Cardiology (ACC), European Society of Cardiology (ESC); and, (3) if outcomes were measured as significant difference AND/OR sensitivity and specificity. The authors independently screened for inclusion of all the identified potential studies as a result of the search. Eligible studies were appraised using well-defined criteria. Any disagreement between the reviewers was resolved through discussion and consensus. The overall mean MPV value of those with MI (9.702 fl; 95% CI 9.07 – 10.33) was higher than in those of the non-MI control group (8.85 fl; 95% CI 8.23 – 9.46). Interpretation of the calculated t-value of 2.0827 showed that there was a significant difference in the mean MPV values of those with MI and those of the non-MI controls. The summary sensitivity (Se) and specificity (Sp) for MPV were 0.66 (95% CI; 0.59 - 0.73) and 0.60 (95% CI; 0.43 – 0.75), respectively. The pooled diagnostic odds ratio (DOR) was 2.92 (95% CI; 1.90 – 4.50). The positive likelihood ratio of MPV in the diagnosis of myocardial infarction was 1.65 (95% CI; 1.20 – 22.27), and the negative likelihood ratio was 0.56 (95% CI; 0.50 – 0.64). The intended role for MPV in the diagnostic pathway of myocardial infarction would perhaps be best as a triage tool. With a DOR of 2.92, MPV values can discriminate between those who have MI and those without. For a patient with angina presenting with elevated MPV values, it is 1.65 times more likely that he has MI. Thus, it is implied that the decision to treat a patient with angina or its equivalents as a case of MI could be supported by an elevated MPV value.

Keywords: mean platelet volume, MPV, myocardial infarction, angina, chest pain

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271 Brand Building in Higher Education: A Grounded Theory Investigation of the Impact of the ‘Positive-Visualization-Course in Brand Identity’ upon Freshmen Student's Perception

Authors: Maria Kountouridou, Dino Domic

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Within an increasingly competitive and dynamic environment, the higher education sector is becoming more commodified, with the concept of branding to become exceedingly imperative and an inextricable ingredient for the university’s success. Branding in higher education has proven to be an effective strategy that managed to receive considerable attention in the recent few years, and a growing number of articles have begun to appear in the literature. However, a clear void in the literature confirms that the concept of students’ perceptions towards the university’s brand image has not been researched extensively. An investigation on this central concept is of paramount importance since it will facilitate the development of an inductively generated theoretical model concerning branding in higher education. This research focuses on examining the impact of the ‘positive-visualization-course in brand identity’ upon the perception of freshmen students towards a university’s brand image. A grounded theory methodology has been selected, consisting of semi-structured interviews. Forty-two students have participated in the research, among which twenty-five women and seventeen men. The identification of the sample emerged through the use of the snowball sampling technique. The participants were divided into two groups (experimental and control group) after the researcher had taken into consideration the factor ‘program of study’, to eliminate any possible interaction between the participants of each group. An experiment was carried out where a ‘positive-visualization-course in brand identity’ was conducted among the participants of the experimental group, while the participants of the control group have not been exposed to the course. For the purpose of this research, the term ‘positive-visualization-course in brand identity’ refers to a course where brand history, past achievements/recognitions/awards, its values, and its mission are presented. Prior to the course implementation, face-to-face semi-structured interviews were carried out among the participants of both groups, with the aim of examining the freshmen students’ perceptions towards the university’s brand image. One week after the course implementation, the researcher carried out semi-structured interviews with the participants of the experimental group only in order to identify whether students’ perceptions had been affected after the course completion. Four months after the course completion, semi-structured interviews were carried out among the participants of both groups. Eight months after the course completion, semi-structured interviews were conducted with the aim of identifying the freshmen students’ updated perceptions. Data has been analyzed using substantive coding (open and selective coding), theoretical coding, field memos, and constant comparative analysis. The findings strongly suggest that the ‘positive-visualization-course in brand identity’ can positively affect freshmen students’ perceptions towards a university’s brand image. Additionally, other factors conduce to the formation of perception throughout the months. This study contributes and expands upon the existing literature by presenting an inductively generated theoretical model to guide future research in the links between ‘positive-visualization-course in brand identity’ and the perception of freshmen students towards a university’s brand image.

Keywords: brand image, brand name, branding, higher education marketing, perception

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270 Study on Changes of Land Use impacting the Process of Urbanization, by Using Landsat Data in African Regions: A Case Study in Kigali, Rwanda

Authors: Delphine Mukaneza, Lin Qiao, Wang Pengxin, Li Yan, Chen Yingyi

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Human activities on land use make the land-cover gradually change or transit. In this study, we examined the use of Landsat TM data to detect the land use change of Kigali between 1987 and 2009 using remote sensing techniques and analysis of data using ENVI and ArcGIS, a GIS software. Six different categories of land use were distinguished: bare soil, built up land, wetland, water, vegetation, and others. With remote sensing techniques, we analyzed land use data in 1987, 1999 and 2009, changed areas were found and a dynamic situation of land use in Kigali city was found during the 22 years studied. According to relevant Landsat data, the research focused on land use change in accordance with the role of remote sensing in the process of urbanization. The result of the work has shown the rapid increase of built up land between 1987 and 1999 and a big decrease of vegetation caused by the rebuild of the city after the 1994 genocide, while in the period of 1999 to 2009 there was a reduction in built up land and vegetation, after the authority of Kigali city established, a Master Plan where all constructions which were not in the range of the master Plan were destroyed. Rwanda's capital, Kigali City, through the expansion of the urban area, it is increasing the internal employment rate and attracts business investors and the service sector to improve their economy, which will increase the population growth and provide a better life. The overall planning of the city of Kigali considers the environment, land use, infrastructure, cultural and socio-economic factors, the economic development and population forecast, urban development, and constraints specification. To achieve the above purpose, the Government has set for the overall planning of city Kigali, different stages of the detailed description of the design, strategy and action plan that would guide Kigali planners and members of the public in the future to have more detailed regional plans and practical measures. Thus, land use change is significantly the performance of Kigali active human area, which plays an important role for the country to take certain decisions. Another area to take into account is the natural situation of Kigali city. Agriculture in the region does not occupy a dominant position, and with the population growth and socio-economic development, the construction area will gradually rise and speed up the process of urbanization. Thus, as a developing country, Rwanda's population continues to grow and there is low rate of utilization of land, where urbanization remains low. As mentioned earlier, the 1994 genocide massacres, population growth and urbanization processes, have been the factors driving the dramatic changes in land use. The focus on further research would be on analysis of Rwanda’s natural resources, social and economic factors that could be, the driving force of land use change.

Keywords: land use change, urbanization, Kigali City, Landsat

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269 Origins: An Interpretive History of MMA Design Studio’s Exhibition for the 2023 Venice Biennale

Authors: Jonathan A. Noble

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

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

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268 Cost Based Analysis of Risk Stratification Tool for Prediction and Management of High Risk Choledocholithiasis Patients

Authors: Shreya Saxena

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Background: Choledocholithiasis is a common complication of gallstone disease. Risk scoring systems exist to guide the need for further imaging or endoscopy in managing choledocholithiasis. We completed an audit to review the American Society for Gastrointestinal Endoscopy (ASGE) scoring system for prediction and management of choledocholithiasis against the current practice at a tertiary hospital to assess its utility in resource optimisation. We have now conducted a cost focused sub-analysis on patients categorized high-risk for choledocholithiasis according to the guidelines to determine any associated cost benefits. Method: Data collection from our prior audit was used to retrospectively identify thirteen patients considered high-risk for choledocholithiasis. Their ongoing management was mapped against the guidelines. Individual costs for the key investigations were obtained from our hospital financial data. Total cost for the different management pathways identified in clinical practice were calculated and compared against predicted costs associated with recommendations in the guidelines. We excluded the cost of laparoscopic cholecystectomy and considered a set figure for per day hospital admission related expenses. Results: Based on our previous audit data, we identified a77% positive predictive value for the ASGE risk stratification tool to determine patients at high-risk of choledocholithiasis. 47% (6/13) had an magnetic resonance cholangiopancreatography (MRCP) prior to endoscopic retrograde cholangiopancreatography (ERCP), whilst 53% (7/13) went straight for ERCP. The average length of stay in the hospital was 7 days, with an additional day and cost of £328.00 (£117 for ERCP) for patients awaiting an MRCP prior to ERCP. Per day hospital admission was valued at £838.69. When calculating total cost, we assumed all patients had admission bloods and ultrasound done as the gold standard. In doing an MRCP prior to ERCP, there was a 130% increase in cost incurred (£580.04 vs £252.04) per patient. When also considering hospital admission and the average length of stay, it was an additional £1166.69 per patient. We then calculated the exact costs incurred by the department, over a three-month period, for all patients, for key investigations or procedures done in the management of choledocholithiasis. This was compared to an estimate cost derived from the recommended pathways in the ASGE guidelines. Overall, 81% (£2048.45) saving was associated with following the guidelines compared to clinical practice. Conclusion: MRCP is the most expensive test associated with the diagnosis and management of choledocholithiasis. The ASGE guidelines recommend endoscopy without an MRCP in patients stratified as high-risk for choledocholithiasis. Our audit that focused on assessing the utility of the ASGE risk scoring system showed it to be relatively reliable for identifying high-risk patients. Our cost analysis has shown significant cost savings per patient and when considering the average length of stay associated with direct endoscopy rather than an additional MRCP. Part of this is also because of an increased average length of stay associated with waiting for an MRCP. The above data supports the ASGE guidelines for the management of high-risk for choledocholithiasis patients from a cost perspective. The only caveat is our small data set that may impact the validity of our average length of hospital stay figures and hence total cost calculations.

Keywords: cost-analysis, choledocholithiasis, risk stratification tool, general surgery

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