Search results for: time management

Authors: Danute Karcauskiene, Dalia Ambrazaitiene, Regina Skuodiene, Monika Vilkiene, Regina Repsiene, Ieva Jokubauskaite

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The main ambition for nowadays agriculture is to get the economically effective yield and to secure the soil ecological sustainability. According to the effect on the main soil quality indexes, tillage systems may be separated into two types, conventional and conservation tillage. The goal of this study was to determine the impact of conservation and conventional primary soil tillage methods and soil fertility improvement measures on soil properties and crop productivity. Methods: The soil of the experimental site is Dystric Glossic Retisol (WRB 2014) with texture of sandy loam. The trial was established in 2003 in the experimental field of crop rotation of Vėžaičiai Branch of Lithuanian Research Centre for Agriculture and Forestry. Trial factors and treatments: factor A- primary soil tillage in (autumn): deep ploughing (20-25cm), shallow ploughing (10-12cm), shallow ploughless tillage (8-10cm); factor B – soil fertility improvement measures: plant residues, plant residues + straw, green manure 1st cut + straw, farmyard manure 40tha-1 + straw. The four - course crop rotation consisted of red clover, winter wheat, spring rape and spring barley with undersown. Results: The tillage had no statistically significant effect on topsoil (0-10 cm) pHKCl level, it was 5.5 - 5.7. During all experiment period, the highest soil pHKCl level (5.65) was in the shallow ploughless tillage. The organic fertilizers particularly the biomass of grass and farmyard manure had tendency to increase the soil pHKCl. The content of plant - available phosphorus and potassium significantly increase in the shallow ploughing compared with others tillage systems. The farmyard manure increases those elements in whole arable layer. The dissolved organic carbon concentration was significantly higher in the 0 - 10 cm soil layer in the shallow ploughless tillage compared with deep ploughing. After the incorporation of clover biomass and farmyard manure the concentration of dissolved organic carbon increased in the top soil layer. During all experiment period the largest amount of water stable aggregates was determined in the soil where the shallow ploughless tillage was applied. It was by 12% higher compared with deep ploughing. During all experiment time, the soil moisture was higher in the shallow ploughing and shallow ploughless tillage (9-27%) compared to deep ploughing. The lowest emission of CO2 was determined in the deep ploughing soil. The highest rate of CO2 emission was in shallow ploughless tillage. The addition of organic fertilisers had a tendency to increase the CO2 emission, but there was no statistically significant effect between the different types of organic fertilisers. The crop yield was larger in the deep ploughing soil compared to the shallow and shallow ploughless tillage.

Keywords: reduced tillage, soil structure, soil pH, biological activity, crop productivity

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Authors: O. Sauperl, L. Fras Zemljic

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The textile industry is gaining increasing importance in the field of medical materials. Therefore, presented research is focused on textile materials for external (out-of-body) use. Such materials could be various hygienic textile products (diapers, tampons, sanitary napkins, incontinence products, etc.), protective textiles and various hospital linens (surgical covers, masks, gowns, cloths, bed linens, etc.) wound pillows, bandages, orthopedic socks, etc. Function of tampons and sanitary napkins is not only to provide protection during the menstrual cycle, but their function can be also to take care of physiological or pathological vaginal discharge. In general, women's intimate areas are against infection protected by a low pH value of the vaginal flora. High pH inhibits the development of harmful microorganisms, as it is difficult to be reproduced in an acidic environment. The normal vaginal flora in healthy women is highly colonized by lactobacilli. The lactic acid produced by these organisms maintains the constant acidity of the vagina. If the balance of natural protection breaks, infections can occur. In the market, there exist probiotic tampons as a medical product supplying the vagina with beneficial probiotic lactobacilli. But, many users have concerns about the use of tampons due to the possible dry-out of the vagina as well as the possible toxic shock syndrome, which is the reason that they use mainly sanitary napkins during the menstrual cycle. Functionalization of sanitary napkins with probiotics is, therefore, interesting in regard to maintain a healthy vaginal flora and to offer to users added value of the sanitary napkins in the sense of health- and environmentally-friendly products. For this reason, the presented research is oriented in functionalization of the sanitary napkins with the probiotic paste in order to activate the lactic acid bacteria presented in the core of the functionalized sanitary napkin at the time of the contact with the menstrual fluid. In this way, lactobacilli could penetrate into vagina and by maintaining healthy vaginal flora to reduce the risk of vaginal disorders. In regard to the targeted research problem, the influence of probiotic paste applied onto cotton hygienic napkins on selected properties was studied. The aim of the research was to determine whether the sanitary napkins with the applied probiotic paste may assure suitable vaginal pH to maintain a healthy vaginal flora during the use of this product. Together with this, sorption properties of probiotic functionalized sanitary napkins were evaluated and compared to the untreated one. The research itself was carried out on the basis of tracking and controlling the input parameters, currently defined by Slovenian producer (Tosama d.o.o.) as the most important. Successful functionalization of sanitary pads with the probiotic paste was confirmed by ATR-FTIR spectroscopy. Results of the methods used within the presented research show that the absorption of the pads treated with probiotic paste deteriorates compared to non-treated ones. The coating shows a 6-month stability. Functionalization of sanitary pads with probiotic paste is believed to have a commercial potential for lowering the probability of infection during the menstrual cycle.

Keywords: functionalization, probiotic paste, sanitary pads, textile materials

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Authors: Soumya Awasthi

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The spread of radical ideology is possible not merely through public meetings, protests, and mosques but even in schools, seminaries, and madrasas. The rhetoric created around the relationship between religion and conflict has been the primary factor for instigating global conflicts – when religion is used to achieve broader objectives. There have been numerous cases of religion-driven conflict around the world be it the Jewish revolt between 66 AD and 628 AD or the 1119 AD the Crusades revolt or during the Cold War period or the rise of right-wing politics in India. Some of the major developments which reiterate the significance of religion in the contemporary times include: (1) The emergence of theocracy in Iran in 1979 (2) Resurgence of world-wide religious beliefs in post-Soviet space. (3) Emergence of transnational terrorism shaped by twisted depiction of Islam by the self proclaimed protectors of the religion. Therefore this paper is premised in the argument that religion has always found itself on the periphery of the discipline of International Relations (IR), and has received less attention than it deserves. The focus of the topic is on the discourses of ‘Deobandi’ and its impact both on the geopolitics of the region- particularly in India, Pakistan, and Afghanistan- and also at the global level. Discourse is a mechanism in use since time immemorial and has been a key tool to mobilise masses against the ruling authority. With the help of field surveys, qualitative and analytical method of research in religion and international relations, it has been found that they are numerous madrassas that are running illegally and are unregistered. These seminaries are operating in the Khyber-Pakhtunkhwa and Federally Administered Tribal Area (FATA). During the Soviet invasion of Afghanistan in 1979, relation between religion and geopolitics was highlighted when there was a sudden spread of radical ideas, finding support from countries like Saudi Arabia (who funded the campaign) and Pakistan (which organised the Saudi funds and set up training camps, both educational and military). During this period there was a huge influence of Wahabi theology on the madrasas which started with Deoband philosophy and later became a mix of Wahabi (influenced by Ahmad Ibn Hannabal and Ibn Taimmiya) and Deobandi philosophy, tending towards fundamentalism. Later the impact of regional geopolitics had influence on the global geopolitics when the incidents like attack on the US in 2001, bomb blasts in U.K, Indonesia, Turkey, and Israel in 2000s. In the midst of all this, there were several scholars who pointed towards Deobandi Philosophy as one of the drivers in the creation of armed Islamic groups in Pakistan, Afghanistan. Hence this paper will make an attempt to understand the trend as to how Deobandi religious discourses originating from India have changed over the decades, and who the agents of such changes are. It will throw light on Deoband from pre-independence till date to create a narrative around the religious discourses and Deobandi philosophy and its spill over impact on the map of global and regional security.

Keywords: Deobandi School of Thought, radicalization, regional and global geopolitics, religious discourses, Whabi movement

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Authors: Tanya Kaur Bedi, Shankha Pratim Bhattacharya

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The US Environmental Protection Agency defines indoor air quality as “The air quality within and around buildings, especially as it relates to the health and comfort of building occupants”. According to the 2021 report by the Energy Policy Institute at Chicago, Indian residents, a country which is home to the highest levels of air pollution in the world, lose about 5.9 years from life expectancy due to poor air quality and yet has numerous dwellings dependent on natural ventilation. Currently the urban population spends 90% of the time indoors, this scenario raises a concern for occupant health and well-being. The built environment can affect health directly and indirectly through immediate or long-term exposure to indoor air pollutants. Health effects associated with indoor air pollutants include eye/nose/throat irritation, respiratory diseases, heart disease, and even cancer. This study attempts to demonstrate the causal relationship between the indoor air quality and its determining aspects. Detailed indoor air quality audits were conducted in residential buildings located in Kolkata, India in the months of December and January 2021. According to the air pollution knowledge assessment city program in India, Kolkata is also the second most polluted mega-city after Delhi. Although the air pollution levels are alarming year-long, the winter months are most crucial due to the unfavorable environmental conditions. While emissions remain typically constant throughout the year, cold air is denser and moves slower than warm air, trapping the pollution in place for much longer and consequently is breathed in at a higher rate than the summers. The air pollution monitoring period was selected considering environmental factors and major pollution contributors like traffic and road dust. This study focuses on the relationship between the built environment and the spatial-temporal distribution of air pollutants in and around it. The measured parameters include, temperature, relative humidity, air velocity, particulate matter, volatile organic compounds, formaldehyde, and benzene. A total of 56 rooms were audited, selectively targeting the most dominant middle-income group. The data-collection was conducted using a set of instruments positioned in the human breathing-zone. The study assesses indoor air quality based on factors determining natural ventilation and air pollution dispersion such as surrounding environment, dominant wind, openable window to floor area ratio, windward or leeward side openings, and natural ventilation type in the room: single side or cross-ventilation, floor height, residents cleaning habits, etc.

Keywords: indoor air quality, occupant health, urban housing, air pollution, natural ventilation, architecture, urban issues

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Authors: Amjad Ali Khan, Muhammad Ishaq Saqi, Kashif Ali

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The focus of hydrocarbon exploration in Pakistan has been primarily on conventional hydrocarbon resources. Directorate General Petroleum Concessions (DGPC) has taken the lead on the assessment of indigenous unconventional oil and gas resources, which has resulted in a ‘Shale Oil/Gas Resource Assessment Study’ conducted with the help of USAID. This was critically required in the energy-starved Pakistan, where the gap between indigenous oil & gas production and demand continues to widen for a long time. Exploration & exploitation of indigenous unconventional resources of Pakistan have become vital to meet our energy demand and reduction of oil and gas import bill of the country. This study has attempted to bridge a critical gap in geological information about the potential of shale gas & oil in Pakistan in the four formations, i.e., Sembar, Lower Goru, Ranikot and Ghazij in the Middle and Lower Indus Basins, which were selected for the study as for resource assessment for shale gas & oil. The primary objective of the study was to estimate and establish shale oil/gas resource assessment of the study area by carrying out extensive geological analysis of exploration, appraisal and development wells drilled in the Middle and Lower Indus Basins, along with identification of fairway(s) and sweet spots in the study area. The Study covers the Lower parts of the Middle Indus basins located in Sindh, southern Punjab & eastern parts of the Baluchistan provinces, with a total sedimentary area of 271,795 km2. Initially, 1611 wells were reviewed, including 1324 wells drilled through different shale formations. Based on the availability of required technical data, a detailed petrophysical analysis of 124 wells (21 Confidential & 103 in the public domain) has been conducted for the shale gas/oil potential of the above-referred formations. The core & cuttings samples of 32 wells and 33 geochemical reports of prospective Shale Formations were available, which were analyzed to calibrate the results of petrophysical analysis with petrographic/ laboratory analyses to increase the credibility of the Shale Gas Resource assessment. This study has identified the most prospective intervals, mainly in Sembar and Lower Goru Formations, for shale gas/oil exploration in the Middle and Lower Indus Basins of Pakistan. The study recommends seven (07) sweet spots for undertaking pilot projects, which will enable to evaluate of the actual production capability and production sustainability of shale oil/gas reservoirs of Pakistan for formulating future strategies to explore and exploit shale/oil resources of Pakistan including fiscal incentives required for developing shale oil/gas resources of Pakistan. Some E&P Companies are being persuaded to make a consortium for undertaking pilot projects that have shown their willingness to participate in the pilot project at appropriate times. The location for undertaking the pilot project has been finalized as a result of a series of technical sessions by geoscientists of the potential consortium members after the review and evaluation of available studies.

Keywords: conventional resources, petrographic analysis, petrophysical analysis, unconventional resources, shale gas & oil, sweet spots

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Authors: Bernard Morais Joosa

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Kerala, the southern state of India, is known for its accomplishments in universal education and enrollments. Through this mission, the Government proposes comprehensive educational reforms including 1000 Government schools into international standards during the first phase. The idea is not only to improve the infrastructural facilities but also to reform the teaching and learning process to the present day needs by introducing ICT enabled learning and providing smart classrooms. There will be focus on creating educational programmes which are useful for differently abled students. It is also meant to reinforce the teaching–learning process by providing ample opportunities to each student to construct their own knowledge using modern technology tools. The mission will redefine the existing classroom learning process, coordinate resource mobilization efforts and develop ‘Janakeeya Vidyabhyasa Mathruka.' Special packages to support schools which are in existence for over 100 years will also be attempted. The implementation will enlist full involvement and partnership of the Parent Teacher Association. Kerala was the first state in the country to attain 100 percent literacy more than two and a half decades ago. Since then the State has not rested on its laurels. It has moved forward in leaps and bounds conquering targets that no other State could achieve. Now the government of Kerala is taking off towards new goal of comprehensive educational reforms. And it focuses on Betterment of educational surroundings, use of technology in education, renewal of learning method and 1000 schools will be uplifted as Smart Schools. Need to upgrade 1000 schools into international standards and turning classrooms from standard 9 to 12 in high schools and higher secondary into high-tech classrooms and a special unique package for the renovation of schools, which have completed 50 and 100 years. The government intends to focus on developing standards first to eighth standards in tune with the times by engaging the teachers, parents, and alumni to recapture the relevance of public schools. English learning will be encouraged in schools. The idea is not only to improve the infrastructure facilities but also reform the curriculum to the present day needs. Keeping in view the differently-abled friendly approach of the government, there will be focus on creating educational program which is useful for differently abled students. The idea is to address the infrastructural deficiencies being faced by such schools. There will be special emphasis on ensuring internet connectivity to promote IT-friendly existence. A task-force and a full-time chief executive will be in charge of managing the day to day affairs of the mission. Secretary of the Public Education Department will serve as the Mission Secretary and the Chairperson of Task Force. As the Task Force will stress on teacher training and the use of information technology, experts in the field, as well as Directors of SCERT, IT School, SSA, and RMSA, will also be a part of it.

Keywords: educational standards, methodology, pedagogy, technology

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Authors: A. Augustyn, M. Florek, M. Herezniak

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Since the public authorities are constantly pressured by the public opinion to showcase the tangible and measurable results of their efforts, the evaluation of place brand-related activities becomes a necessity. Given the political and social character of place branding process, the legitimization of the branding efforts requires the compliance of the objectives set out in the city brand strategy with the actual needs, expectations, and aspirations of various internal stakeholders. To deliver on the diverse promises, city authorities and brand managers need to translate them into the measurable indicators against which the brand strategy effectiveness will be evaluated. In concert with these observations are the findings from branding and marketing literature with a widespread consensus that places should adopt a more systematic and holistic approach in order to ensure the performance of their brands. However, the measurement of the effectiveness of place branding remains insufficiently explored in theory, even though it is considered a significant step in the process of place brand management. Therefore, the aim of the research presented in the current paper was to collect insights on the nature of effectiveness measurement of city brand strategies and to juxtapose these findings with the theoretical assumptions formed on the basis of the state-of-the-art literature review. To this end, 15 international academic experts (out of 18 initially selected) with affiliation from ten countries (five continents), were individually interviewed. The standardized set of 19 open-ended questions was used for all the interviewees, who had been selected based on their expertise and reputation in the fields of place branding/marketing. Findings were categorized into four modules: (i) conceptualizations of city brand effectiveness, (ii) methodological issues of city brand effectiveness measurement, (iii) the nature of measurement process, (iv) articulation of key performance indicators (KPIs). Within each module, the interviewees offered diverse insights into the subject based on their academic expertise and professional activity as consultants. They proposed that there should be a twofold understanding of effectiveness. The narrow one when it is conceived as the aptitude to achieve specific goals, and the broad one in which city brand effectiveness is seen as an increase in social and economic reality of a place, which in turn poses diverse challenges for the measurement concepts and processes. Moreover, the respondents offered a variety of insights into the methodological issues, particularly about the need for customization and flexibility of the measurement systems, for the employment of interdisciplinary approach to measurement and implications resulting therefrom. Considerable emphasis was put on the inward approach to measurement, namely the necessity to monitor the resident’s evaluation of brand related activities instead of benchmarking cities against the competitive set. Other findings encompass the issues of developing appropriate KPIs for the city brand, managing the measurement process and the inclusion of diverse stakeholders to produce a sound measurement system. Furthermore, the interviewees enumerated the most frequently made mistakes in measurement mainly resulting from the misunderstanding of the nature of city brands. This research was financed by the National Science Centre, Poland, research project no. 2015/19/B/HS4/00380 Towards the categorization of place brand strategy effectiveness indicators – findings from strategic documents of Polish district cities – theoretical and empirical approach.

Keywords: city branding, effectiveness, experts’ insights, measurement

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Authors: Alexia Wu, Joel Ribis, Jean-Christophe Brachet, Emmanuel Clouet, Benoit Arnal, Elodie Rouesne, Stéphane Urvoy, Justine Roubaud, Yves Serruys, Frederic Lepretre

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To enhance the safety of Light Water Reactor, accident tolerant fuel (ATF) claddings materials are under development. In the framework of CEA-AREVA-EDF collaborative program on ATF cladding materials, CEA has engaged specific studies on chromium coated zirconium alloys. Especially for Loss-of-Coolant-Accident situations, chromium coated claddings have shown some additional 'coping' time before achieving full embrittlement of the oxidized cladding, when compared to uncoated references – both tested in steam environment up to 1300°C. Nevertheless, the behavior of chromium coatings and the stability of the Zr-Cr interface under neutron irradiation remain unknown. Two main points are addressed: 1. Bulk Cr behavior under irradiation: Due to its BCC crystallographic structure, Cr is prone to Ductile-to-Brittle-Transition at quite high temperature. Irradiation could be responsible for a significant additional DBTT shift towards higher temperatures. 2. Zircaloy/Cr interface behavior under irradiation: Preliminary TEM examinations of un-irradiated samples revealed a singular Zircaloy-4/Cr interface with nanometric intermetallic phase layers. Such particular interfaces highlight questions of how they would behave under irradiation - intermetallic zirconium phases are known to be more or less stable under irradiations. Another concern is a potential enhancement of chromium diffusion into the zirconium-alpha based substrate. The purpose of this study is then to determine the behavior of such coatings after ion irradiations, as a surrogate to neutron irradiation. Ion irradiations were performed at the Jannus-Saclay facility (France). 20 MeV Kr8+ ions at 400°C with a flux of 2.8x1011 ions.cm-2.s-1 were used to irradiate chromium coatings of 1-2 µm thick on Zircaloy-4 sheets substrate. At the interface, the calculated damage is close to 10 dpa (SRIM, Quick Calculation Damage mode). Thin foil samples were prepared with FIB for both as-received and irradiated coated samples. Transmission Electron Microscopy (TEM) and in-situ tensile tests in a Scanning Electron Microscope are being used to characterize the un-irradiated and irradiated materials. High Resolution TEM highlights a great complexity of the interface before irradiation since it is formed of an alternation of intermetallic phases – C14 and C15. The interfaces formed by these intermetallic phases with chromium and zirconium show semi-coherency. Chemical analysis performed before irradiation shows some iron enrichment at the interface. The chromium coating bulk microstructures and properties are also studied before and after irradiation. On-going in-situ tensile tests focus on the capacity of chromium coatings to sustain some plastic deformation when tested up to 350°C. The stability of the Cr/Zr interface is shown after ion irradiation up to 10 dpa. This observation constitutes the first result after irradiation on these new coated claddings materials.

Keywords: accident tolerant fuel, HRTEM, interface, ion-irradiation

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Authors: Md. Kabir Azaharul Islam

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Background: The purpose of this interventions was to describe the source and extent to increase health seeking rights and uptake of quality integrated maternal health, family planning and HIV information, clinical-non clinical services, and commodities amongst young people age 10-24 among brothel based Female Sex Worker’s in Bangladesh. Such Knowledge will equip with information to develop more appropriate and effective interventions that address the problem of HIV/AIDS and SRHR within the brothel based female sex worker’s community. Methods: Before start the intervention we observed situation in brothel and identify lack of knowledge about health issues, modern health facility, sexual harassment and violence & health rights. To enable access to the intervention obtained permission from a series of stakeholders within the brothel system. This intervention to the most vulnerable young key people during January 2014 to December, 2015, it designed an intervention that focuses on using peer education and sensitization meeting with self help group leader’s, pimbs, swardarni, house owner, local leaders, law enforcement agencies and target young key people (YKPs) through peer educator’s distributed BCC materials and conducted one to one and group session issues of HIV/AIDS, life skill education, maternal health, sexual reproductive health & rights, gender based violence, STD/STI and drug users in the community. Set up community based satellite clinic to provided clinical-non clinical services and commodities for SRH, FP and HIV including general health among brothel based FSWs. Peer educator frequently move and informed target beneficiaries’ age 10-24 YKPs about satellite clinic as well as time & date in the community. Results: This intervention highly promotes of brothel based FSW utilization of local facility based health providers private and public health facilities.2400 FSWs age 10-24 received information on SRHR, FP and HIV as well as existing health facilities, most of FSWs to received service from traditional healer before intervention. More than 1080 FSWs received clinical-non clinical services and commodities from satellite clinic including 12 ANC, 12 PNC and 25 MR. Most of young FSW age 10-24 are treated bonded girls under swardarni, house owner and pimbs, they have no rights to free movement as per need. As a result, they have no rights for free movement. However the brothel self help group (SHG) has become sensitized flowing this intervention. Conclusions: The majority of female sex workers well being regarding information on SRHR, FP and HIV as well as local health facilities now they feel free to go outside facilities for better health service. not only increased FSWs’ vulnerability to HIV infection and sexual reproductive health rights but also had huge implications for their human rights. This means that even when some clients impinged FSW’s rights (for example avoiding payment for services under the pretext of dissatisfaction), they might not be able to seek redress for fear of being ejected from the brothel. They raise voice national & local level different forum.

Keywords: ANC, HIV, PNC, SRHR

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Authors: Evgenia Papathanasiou, Georgios Kokkotis, Georgios Axiaris, Theodoros Argyropoulos, Nikos Viazis, Olga Giouleme, Konstantinos Gkoumas, Αnthia Gatopoulou, Αggelos Theodoulou, Georgios Theocharis, Αngeliki Theodoropoulou, Μaria Κalogirou, Pantelis Karatzas, Κonstantinos Κatsanos, Theodora Kafetzi, Κonstantinos Κarmiris, Αnastasia Κourikou, Ιoannis E Κoutroubakis, Christos Liatsos, Gerassimos J. Mantzaris, Νicoletta Μathou, Georgia Bellou, George Michalopoulos Αikaterini Μantaka, Penelope Nikolaou, Μichael Oikonomou, Dimitrios Polymeros, George Papatheodoridis, Εvdoxia Stergiou, Κonstantinos Soufleris, Εpameinondas Skouloudis, Μaria Tzouvala, Georgia Tsiolakidou, Εftychia Tsironi, Styliani Tsafaraki, Kalliopi Foteinogiannopoulou, Konstantina Chalakatevaki, Αngeliki Christidou, Dimitrios K. Christodoulou, Giorgos Bamias, Spyridon Michopoulos, Εvanthia Zampeli

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Background: Inflammatory bowel disease (IBD) commonly affects female patients of reproductive age, making the interaction between fertility, pregnancy and IBD an important issue in disease management. The effect of disease activity on the outcome of pregnancy and its impact on neonatal growth is a field of intense research. Close follow-up of pregnant IBD patients by a multidisciplinary team improves maternal and neonatal outcomes. Aim – Methods: Α national retrospective study of pregnancies in women with IBD between 2010-2020 was carried out in 22 IBD reference centers in Greece. Patient characteristics such as disease profile, type of treatment, and disease activity during gestation were analyzed in correlation to the method of delivery, pregnancy outcomes, as well as breastfeeding and offspring health. Results: Two-hundred and twenty-three pregnancies in 175 IBD patients were registered in the study. 122 with Crohn’s disease (CD). Median age during diagnosis was 25.6 years (12-44), with median disease duration of 7.4 years (0-23). One-hundred and twenty-nine patients (58%) were recorded during their first pregnancy. Early pregnancy termination was reported by 48 patients (22%). Pregnancy as a result of in vitro fertilization (IVF) occurred in 15 cases (6.7%). At the beginning of gestation, 165 patients (74%) were under treatment: 48 with anti-TNF agents (29%), 43 with azathioprine (26%), 101 with 5-aminosalicylic acid formulations (61%) and 12 with steroids (7%). We recorded 49 cases of IBD flares (22%) during pregnancy. Two-thirds of them (n=30) were in remission at the onset of the pregnancy. Almost half of them (n=22) required corticosteroid treatment. Patients with ulcerative colitis (UC) were in greater risk of disease flare during pregnancy (p<0.001). All but 3 pregnancies (99.1%) resulted in uncomplicated delivery. In 147 cases (67.1%), cesarean delivery was performed. Two late fetal deaths (0.9%) were reported, both in patients with continuously active disease since the beginning of pregnancy. After delivery, 75 patients (34%) presented with a disease flare, which was associated with active disease at the beginning of pregnancy (p <0.001). Conclusion: The majority of female, Greek IBD patients, had a favorable pregnancy outcome. Active inflammation during gestation and UC diagnosis were associated with a negative impact on pregnancy outcomes. The results of this study are in favor of the continuation of IBD treatment during pregnancy.

Keywords: pregnancy, ulcerative colitis, Crohn disease, flare

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Authors: Natàlia Garcia Soler, Timothy Moss

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Despite the multiple benefits of sustainable urban drainage, as demonstrated in numerous case studies across the world, urban rainwater harvesting techniques are generally restricted to isolated model projects. The leap from niche to mainstream has, in most cities, proved an elusive goal. Why policies promoting rainwater harvesting are limited in their widespread implementation has seldom been subjected to systematic analysis. Much of the literature on the policy, planning and institutional contexts of these techniques focus either on their potential benefits or on project design, but very rarely on a critical-constructive analysis of past experiences of implementation. Moreover, the vast majority of these contributions are restricted to single-case studies. There is a dearth of knowledge with respect to, firstly, policy implementation processes and, secondly, multi-case analysis. Insights from both, the authors argue, are essential to inform more effective rainwater harvesting in cities in the future. This paper presents preliminary findings from a research project on rainwater harvesting in cities from a social science perspective that is funded by the Swedish Research Foundation (Formas). This project – UrbanRain – is examining the challenges and opportunities of mainstreaming rainwater harvesting in three European cities. The paper addresses two research questions: firstly, what lessons can be learned on suitable policy incentives and planning instruments for rainwater harvesting from a meta-analysis of the relevant international literature and, secondly, how far these lessons are reflected in a study of past and ongoing rainwater harvesting projects in a European forerunner city. This two-tier approach frames the structure of the paper. We present, first, the results of the literature analysis on policy and planning issues of urban rainwater harvesting. Here, we analyze quantitatively and qualitatively the literature of the past 15 years on this topic in terms of thematic focus, issues addressed and key findings and draw conclusions on research gaps, highlighting the need for more studies on implementation factors, actor interests, institutional adaptation and multi-level governance. In a second step we focus in on the experiences of rainwater harvesting in Berlin and present the results of a mapping exercise on a wide variety of projects implemented there over the last 30 years. Here, we develop a typology to characterize the rainwater harvesting projects in terms of policy issues (what problems and goals are targeted), project design (which kind of solutions are envisaged), project implementation (how and when they were implemented), location (whether they are in new or existing urban developments) and actors (which stakeholders are involved and how), paying particular attention to the shifting institutional framework in Berlin. Mapping and categorizing these projects is based on a combination of document analysis and expert interviews. The paper concludes by synthesizing the findings, identifying how far the goals, governance structures and instruments applied in the Berlin projects studied reflect the findings emerging from the meta-analysis of the international literature on policy and planning issues of rainwater harvesting and what implications these findings have for mainstreaming such techniques in future practice.

Keywords: institutional framework, planning, policy, project implementation, urban rainwater management

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Authors: Varsha Puri, Sharon Hudson, Ian Kim

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Background: Incest-related childhood sexual abuse (IRCSA) is challenging to study due to the shame and secrecy experienced by its survivors. Ramifications of IRCSA worsen when it is unidentified, and interventions are not made. IRCSA perspectives are essential for future prevention and intervention strategies. However, there is limited understanding of this population’s experiences, perspectives, and long-term struggles. To date, research for IRCSA has utilized data from treatment programs and qualitative research with cohorts of 10-20 people, much of the data is from 10-40 years prior. Methods. In June 2018, an anonymous online survey was posted to multiple social media sites (e.g., Facebook IRCSA groups) and sexual abuse resource sites. Survey responses were collected for a year. The survey collected non-identifying demographics, IRCSA experiences, and outcomes data. Results: We obtained 1310 completed surveys. Demographics of all ages, racial backgrounds, financial backgrounds, and genders were obtained; the majority identified as white (81%) and female (76%). Childhood sexual abuse (CSA) started before the age of 6 in 49% and was endured for more than one year in 84% of respondents, and 39% reported ten or more years of abuse. CSA by multiple perpetrators occurred in 58%, while 8% had ten or more perpetrators. CSA by perpetrators under 21 years old was reported by 46%. Female perpetrators were reported by 28% of respondents. Fathers were the highest reported sexual abusers at 60%, and mothers were reported at 17%. Only 16% reported that at least one of their perpetrators was prosecuted for sexual abuse of a minor. Respondents confirmed that 54% of the time, they informed an adult of the abuse; only 2% agreed that “an intervention was made by the family that protected me.” A majority reported that IRCSA has negatively impacted their intimate/sexual relationships (96%) and mental health (96%). A majority reported negative impacts on biological family relationships (88%), physical health (73%), finances (59%), educational achievement (57%), and employment (56%). When asked about suffering from addiction, 85% of respondents answered yes. Prevention strategies selected most by respondents include early school education around CSA prevention (67%), removing the statute of limitations for reporting CSA (69%), and improved laws protecting IRCSA survivors (63%). Conclusion: The data document that IRCSA can be pervasive, and the dearth of intervention and support for survivors have major lasting impacts. Survivors have a unique and valuable perspective on what interventions are needed to prevent IRCSA and support survivors; their voice has long been unheard in crafting prevention and intervention policies and services. These results thus provide an important call to action from these critical stakeholders. Pediatricians should recognize that perpetrators can be pediatric patients, women, and parents. Pediatricians can advocate for more early CSA prevention education and policy changes that remove the statute of limitations for reporting CSA.

Keywords: incest, childhood sexual abuse, incest-related childhood sexual abuse, incest survivor

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Authors: Neritan Shkodrani

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On November 26, 2019, an earthquake hit the central western part of Albania. It was assessed as Mw 6.4. Its epicenter was located offshore north western Durrës, about 7 km north of the city. In this paper, the consequences of settlements of very soft soils have been discussed for the case of a residential building, mentioned as “K Building”, which was suffering a significant tilting after the earthquake. “KBuilding” is an RC framed building having 12+1 (basement) storiesand a floor area of 21000 m2. The construction of the building was completed in 2012. “KBuilding”, located in Durres city, suffered severe non-structural damage during November 26, 2019, Durrës Earthquake sequences. During the in-site inspections immediately after the earthquake, the general condition of the buildings, the presence of observable settlements on the ground, and the crack situation in the structure were determined, and damage inspection were performed. It was significant to note that the “K Building” presented tilting that might be attributed, as it was believed at the beginning, partially to the failure of the columns of the ground floor and partially to liquefaction phenomena, but it did not collapse. At the first moment was not clear if the foundation had a bearing capacity failure or the foundation failed because of the soil liquefaction. Geotechnical soil investigations by using CPTU test were executed, and their data are usedto evaluatebearing capacity, consolidation settlement of the mat foundation, and soil liquefaction since they were believed to be the main reasons of this building tilting.Geotechnical soil investigation consist in 5 (five) Static Cone Penetration tests with pore pressure measurement (piezocone test). They reached a penetration depth of 20.0 m to 30.0 mand, clearly shown the presence of very soft and organic soils in the soil profile of the site. Geotechnical CPT based analysis of bearing capacity, consolidation, and secondary settlement are applied, and results are reported for each test. These results shown very small values of allowable bearing capacity and very high values of consolidation and secondary settlements. Liquefaction analysis based on the data of CPTU tests and the characteristics of ground shaking of the mentioned earthquake has shown the possibility of liquefaction for some layers of the considered soil profile, but the estimated vertical settlements are at a small range and clearly shown that the main reason of the building tilting was not related to the consequences of liquefaction, but was an existing settlement caused from the applied bearing pressure of this building. All the CPTU tests were carried out on August 2021, almost two years after the November 26, 2019, Durrës Earthquake and when the building itself was demolished. After removing the mat foundation on September 2021, it was possible to carry out CPTU tests even on the footprint of the existing building, which made possible to observe the effects of long time applied of foundation bearing pressure to the consolidation on the considered soil profile.

Keywords: bearing capacity, cone penetration test, consolidation settlement, secondary settlement, soil liquefaction, etc

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Authors: Robert E. Kenney, Richard B. Aguilar, Efrain Antunez, Gregory Schor-Haskin, Rafael Rey, Catie Falcon, Luis Arce

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This study sought to explore the effect of Sarapin injections on chronic knee pain (CKP). Many adults suffer from CKP which is most often attributed to osteoarthritis. Current treatment regimens for CKP involve the use NSAIDS medications, injections with steroids/analgesic, platelet rich plasma injections, or orthopedic surgical interventions. Sarapin is a commercially available homeopathic aqueous extract from the pitcher plant. Studies on the use of Sarapin as a treatment for cervical, thoracic, and lumbosacral facet joint nerve blocks have been performed with mixed results. There is little available evidence on the use of Sarapin in CKP. This study examines the effect of a series of 3 weekly injections of aqueous Sarapin in 95 elderly patients with CKP in a primary care setting. Cano Health, a primary care group, identified 95 successive patients with CKP from its multimodal physiotherapy program for chronic pain. Patients underwent evaluation by a clinician, underwent diagnostic Xrays of the knees, and the treatment plan with three weekly Sarapin injections was discussed. A pain and functional limitation survey (a modified Lower Extremity Functional Scale (mLEFS)) was administered prior to initiating treatment (Entry Survey (ES)). Each patient received an intraarticular injection of 2 cc of aqueous Sarapin with 1cc 1% lidocaine during weeks 1, 2 and 3. The mLEFS was administered again at week 4, one week after the third Sarapin injection (Exit Survey (ExS)). Demographics: Mean Age 62 +/- 9.8; 73% female; 89% Hispanic/Latino; mean time between ES and ExS was 27.5 +/-8.2 days. Survey: The mLEFS was based on a published Lower Extremity Functional Scale and each patient rated their pain or functional limitation from 0 (no difficulty) to 5 (severe difficulty) for 10 questions. Answers were summed and compared. Maximum score for severe difficulty would be 50 points. Results: Mean pain/functional scores: ES was 30.3 +/-12.1 and ExS was 19.5 +/- 12.5. This represents a relative improvement of 35.7% (P<0.00001). A total of 81% (77/95) of the patients showed improvement in symptoms at week four as assessed by the mLEFS. There were 11 patients who reported an increase in their survey scores while 7 patients reported no change. When evaluating the cohort that reported improvement, the ES was 30.9 +/-11.4 and ExS was 16.3 +/-9.8 yielding a 47.2% relative improvement (P<0.00001). Injections were well tolerated, and no adverse events were reported. Conclusions: In this cohort of 95 elderly patients with CKP, treatment with 3 weekly injections of Sarapin significantly improved pain and function as assessed by a mLEFS survey. The majority (81%) of patients responded positively to therapy, 12% had worsening symptoms and 7% reported no change. The use of intraarticular injections of Sarapin for CKP was shown to be an effective modality of treatment. Sarapin’s low cost, tolerability, and ease of use make it an attractive alternative to NSAIDS, steroids, PRP or surgical intervention for this common debilitating condition.

Keywords: Sarapin, intraarticular, chronic knee pain, osteoarthritis

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Authors: Tim Vollmer, Andrea Greven, Malte Brettel

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Family firms represent the predominant business structure worldwide, accounting for 90 percent of all operational businesses. These firms are essential to society and the economy. In the past decade, family firm exits increased by 72%; and in the next five years, 95,000 German family firms will be sold, acquired, or liquidated. For family firms, socioemotional wealth represents the frame of reference and value to preserve when making decisions. Family firm exits threaten the socioemotional wealth, as in extreme scenarios, economic logic may take over. So, a dilemma arises: Maintaining socioemotional wealth versus pursuing financial wealth. Family firm researchers agree that family involvement leads to specific goals, behaviors, and outcomes. For instance, the desire to protect socioemotional wealth when selling the firm and the focus on particular exit success dimensions, depending on the family's role inside the firm. However, despite the regularity of family firm exits, there is little research on the effect of family involvement on the family firm CEOs' perceived exit performance. We investigate the family firm CEOs' perceived exit performance, which we call exit success. Considering the deficiencies in the literature, we identify two research gaps. First, it remains unclear how family involvement affects the dimensions of exit success. Hence, we provide evidence of which success dimensions matter most depending on the family's involvement and how to differentiate successful from unsuccessful exits. Second, prior work has analyzed family involvement in the socioemotional wealth context but found contradictory findings. This work considers, for example, the family generation in control and identifies the tipping point of economic objectives becoming preferable over socioemotional wealth-related goals. This paper theorizes and empirically investigates, through the lens of socioemotional wealth and conflict theory, how socioemotional wealth mediates the relationship between family involvement and family firms' exit success. We analyze family firms' exit success dimensions of personal financial benefits, personal reputation, employee benefits, and firm mission persistence. Family involvement considers the family firms' heterogeneity in ownership, management, and generation. We use a quantitative approach in the form of an online survey by drawing on 116 responses from former family firm CEOs'. This study highlights that socioemotional wealth mediates the relationship between the dimensions of family involvement and exit success. The greater socioemotional wealth, the greater the family firm CEOs focus on the pro-organizational exit success dimensions of employee benefits and firm mission persistence. In contrast, the self-regarding dimension of personal financial benefits is significantly negatively affected. An important finding is that later generations and the number of family managers involved significantly negatively affect the two pro-organizational dimensions of exit success. Family ownership does not show any significant effect. Our work widens implications for research, theory, and practice by contributing in two meaningful ways. First, our results offer insights to differentiate successful from unsuccessful family firm exits and provide evidence of which success dimensions matter and which to focus on, most dependent on the family's role inside the firm. Second, our article advances research and empirical understanding of family firms and socioemotional wealth by clarifying contradictory findings.

Keywords: exit success, family firm exit, perceived exit performance, socioemotional wealth

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Authors: Maher Z. Mohammed, Barry G. Clarke

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As an alternative to stone column in fine grained soils, it is possible to create stiffened columns of soils using electroosmosis (electroosmotic piles). This program of this research is to establish the effectiveness and efficiency of the process in different soils. The aim of this study is to assess the capability of electroosmosis treatment in a range of composite soils. The combined electroosmotic and preloading equipment developed by Nizar and Clarke (2013) was used with an octagonal array of anodes surrounding a single cathode in a nominal 250mm diameter 300mm deep cylinder of soil and 80mm anode to cathode distance. Copper coiled springs were used as electrodes to allow the soil to consolidate either due to an external vertical applied load or electroosmosis. The equipment was modified to allow the temperature to be monitored during the test. Electroosmotic tests were performed on China Clay Grade E kaolin and calcium bentonite (Bentonex CB) mixed with sand fraction C (BS 1881 part 131) at different ratios by weight; (0, 23, 33, 50 and 67%) subjected to applied voltages (5, 10, 15 and 20). The soil slurry was prepared by mixing the dry soil with water to 1.5 times the liquid limit of the soil mixture. The mineralogical and geotechnical properties of the tested soils were measured before the electroosmosis treatment began. In the electroosmosis cell tests, the settlement, expelled water, variation of electrical current and applied voltage, and the generated heat was monitored during the test time for 24 osmotic tests. Water content was measured at the end of each test. The electroosmotic tests are divided into three phases. In Phase 1, 15 kPa was applied to simulate a working platform and produce a uniform soil which had been deposited as a slurry. 50 kPa was used in Phase 3 to simulate a surcharge load. The electroosmotic treatment was only performed during Phase 2 where a constant voltage was applied through the electrodes in addition to the 15 kPa pressure. This phase was stopped when no further water was expelled from the cell, indicating the electroosmotic process had stopped due to either the degradation of the anode or the flow due to the hydraulic gradient exactly balanced the electroosmotic flow resulting in no flow. Control tests for each soil mixture were carried out to assess the behaviour of the soil samples subjected to only an increase of vertical pressure, which is 15kPa in Phase 1 and 50kPa in Phase 3. Analysis of the experimental results from this study showed a significant dewatering effect on the soil slurries. The water discharged by the electroosmotic treatment process decreased as the sand content increased. Soil temperature increased significantly when electrical power was applied and drops when applied DC power turned off or when the electrode degraded. The highest increase in temperature was found in pure clays at higher applied voltage after about 8 hours of electroosmosis test.

Keywords: electrokinetic treatment, electrical conductivity, electroosmotic consolidation, electroosmosis permeability ratio

Procedia PDF Downloads 159

Authors: Amenah Dhannoon, Ciaran Martin Hurley, Laura Wrafter, Podraic J. Regan

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Introduction: The COVID-19 pandemic continues to present unprecedented challenges for healthcare systems. This has resulted in the pragmatic shift in the practice of plastic surgery units worldwide. During this period, many units reported a significant fall in urgent melanoma referrals, leading to patients presenting with advanced disease requiring more extensive surgery and inferior outcomes. Our objective was to evaluate our unit's experience with both non-invasive and invasive melanoma during the COVID-19 pandemic and characterize our experience and contrast it to that experienced by our neighbors in the UK, mainland Europe and North America. Methods: a retrospective chart review was performed on all patients diagnosed with invasive and non-invasive cutaneous melanoma between March to December of 2019 (control) compared to 2020 (COVID-19 pandemic) in a single plastic surgery unit in Ireland. Patient demographics, referral source, surgical procedures, tumour characteristics, radiological findings, oncological therapies and follow-up were recorded. All data were anonymized and stored in Microsoft Excel. Results: A total of 589 patients were included in the study. Of these, 314 (53%) with invasive melanoma, compared to 275 (47%) with the non-invasive disease. Overall, more patients were diagnosed with both invasive and non-invasive melanoma in 2020 than in 2019 (p<0.05). However, significantly longer waiting times in 2020 (64 days) compared to 2019 (28 days) (p<0.05), with the majority of the referral being from GP in 2019 (83%) compared to 61% in 2020. Positive sentinel lymph node were higher in 2019 at 56% (n=28) compared to 24% (n=22) in 2020. There was no statistically significant difference in the tutor characteristics or metastasis status. Discussion: While other countries have noticed a fall in the melanoma diagnosis. Our units experienced a higher number of disease diagnoses. This can be due to multiple reasons. In Ireland, the government reached an early agreement with the private sector to continue elective surgery on an urgent basis in private hospitals. This allowed access to local anesthetic procedures and local skin cancer cases were triaged to non-COVID-19 provider centers. Our unit also adapted a fast, effective and minimal patient contact strategy for triaging skin cancer based on telemedicine. Thirdly, a skin cancer nurse specialist maintained patient follow-ups and triaging a dedicated email service. Finally, our plastic surgery service continued to maintain a virtual complex skin cancer multidisciplinary team meeting during the pandemic, ensuring local clinical governance has adhered to each clinical case. Conclusion: Our study highlights that with the prompt efficient restructuring of services, we could reserve successful management of skin cancer even in the most devastating times. It is important to reflect on the success during the pandemic and emphasize the importance of preparation for a potentially difficult future

Keywords: malignant melanoma, skin cancer, COVID-19, triage

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Authors: Pinar Erturk, Sevde Altuntas, Fatih Buyukserin

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In order to obtain an effective integration between an implant and a bone, implant surfaces should have similar properties to bone tissue surfaces. Especially mimicry of the chemical, mechanical and topographic properties of the implant to the bone is crucial for fast and effective osseointegration. Titanium-based biomaterials are more preferred in clinical use, and there are studies of coating these implants with oxide layers that have chemical/nanotopographic properties stimulating cell interactions for enhanced osseointegration. There are low success rates of current implantations, especially in craniofacial implant applications, which are large and vital zones, and the oxide layer coating increases bone-implant integration providing long-lasting implants without requiring revision surgery. Our aim in this study is to examine bone-cell behavior on titanium implants with an aluminum oxide layer (AAO) on effective osseointegration potential in the deformation of large zones with difficult spontaneous healing. In our study, aluminum layer coated titanium surfaces were anodized in sulfuric, phosphoric, and oxalic acid, which are the most common used AAO anodization electrolytes. After morphologic, chemical, and mechanical tests on AAO coated Ti substrates, viability, adhesion, and mineralization of adult bone cells on these substrates were analyzed. Besides with atomic layer deposition (ALD) as a sensitive and conformal technique, these surfaces were coated with pure alumina (5 nm); thus, cell studies were performed on ALD-coated nanoporous oxide layers with suppressed ionic content too. Lastly, in order to investigate the effect of the topography on the cell behavior, flat non-porous alumina layers on silicon wafers formed by ALD were compared with the porous ones. Cell viability ratio was similar between anodized surfaces, but pure alumina coated titanium and anodized surfaces showed a higher viability ratio compared to bare titanium and bare anodized ones. Alumina coated titanium surfaces, which anodized in phosphoric acid, showed significantly different mineralization ratios after 21 days over other bare titanium and titanium surfaces which anodized in other electrolytes. Bare titanium was the second surface that had the highest mineralization ratio. Otherwise, titanium, which is anodized in oxalic acid electrolyte, demonstrated the lowest mineralization. No significant difference was shown between bare titanium and anodized surfaces except AAO titanium surface anodized in phosphoric acid. Currently, osteogenic activities of these cells on the genetic level are investigated by quantitative real-time polymerase chain reaction (qRT-PCR) analysis results of RUNX-2, VEGF, OPG, and osteopontin genes. Also, as a result of the activities of the genes mentioned before, Western Blot will be used for protein detection. Acknowledgment: The project is supported by The Scientific and Technological Research Council of Turkey.

Keywords: alumina, craniofacial implant, MG-63 cell line, osseointegration, oxalic acid, phosphoric acid, sulphuric acid, titanium

Procedia PDF Downloads 127

Authors: K. K. Balavenkatraman, B. Bertschi, K. Bigot, A. Grevot, A. Doelemeyer, S. D. Chibout, A. Wolf, F. Pognan, N. Manevski, O. Kretz, P. Swart, K. Litherland, J. Ashton-Chess, B. Ling, R. Wettstein, D. J. Schaefer

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Skin toxicity is poorly detected during preclinical studies, and drug-induced side effects in humans such as rashes, hyperplasia or more serious events like bullous pemphigus or toxic epidermal necrolysis represent an important hurdle for clinical development. In vitro keratinocyte-based epidermal skin models are suitable for the detection of chemical-induced irritancy, but do not recapitulate the biological complexity of full skin and fail to detect potential serious side-effects. Normal healthy skin explants may represent a valuable complementary tool, having the advantage of retaining the full skin architecture and the resident immune cell diversity. This study investigated several conditions for the maintenance of good morphological structure after several days of culture and the retention of phase II metabolism for 24 hours in skin explants in vitro. Human skin samples were collected with informed consent from patients undergoing plastic surgery and immediately transferred and processed in our laboratory by removing the underlying dermal fat. Punch biopsies of 4 mm diameter were cultured in an air-liquid interface using transwell filters. Different cultural conditions such as the effect of calcium, temperature and cultivation media were tested for a period of 14 days and explants were histologically examined after Hematoxylin and Eosin staining. Our results demonstrated that the use of Williams E Medium at 32°C maintained the physiological integrity of the skin for approximately one week. Upon prolonged incubation, the upper layers of the epidermis become thickened and some dead cells are present. Interestingly, these effects were prevented by addition of EGFR inhibitors such as Afatinib or Erlotinib. Phase II metabolism of the skin such as glucuronidation (4-methyl umbeliferone), sulfation (minoxidil), N-acetyltransferase (p-toluidene), catechol methylation (2,3-dehydroxy naphthalene), and glutathione conjugation (chlorodinitro benzene) were analyzed by using LCMS. Our results demonstrated that the human skin explants possess metabolic activity for a period of at least 24 hours for all the substrates tested. A time course for glucuronidation with 4-methyl umbeliferone was performed and a linear correlation was obtained over a period of 24 hours. Longer-term culture studies will indicate the possible evolution of such metabolic activities. In summary, these results demonstrate that human skin explants maintain a normal structure for several days in vitro and are metabolically active for at least the first 24 hours. Hence, with further characterisation, this model may be suitable for the study of drug-induced toxicity.

Keywords: human skin explant, phase II metabolism, epidermal growth factor receptor, toxicity

Procedia PDF Downloads 276

Authors: Getaneh Berie Tarekegn, Li-Chia Tai

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With the rapid advancement of artificial intelligence, low-power built-in sensors on Internet of Things devices, and communication technologies, location-aware services have become increasingly popular and have permeated every aspect of people’s lives. Global navigation satellite systems (GNSSs) are the default method of providing continuous positioning services for ground and aerial vehicles, as well as consumer devices (smartphones, watches, notepads, etc.). However, the environment affects satellite positioning systems, particularly indoors, in dense urban and suburban cities enclosed by skyscrapers, or when deep shadows obscure satellite signals. This is because (1) indoor environments are more complicated due to the presence of many objects surrounding them; (2) reflection within the building is highly dependent on the surrounding environment, including the positions of objects and human activity; and (3) satellite signals cannot be reached in an indoor environment, and GNSS doesn't have enough power to penetrate building walls. GPS is also highly power-hungry, which poses a severe challenge for battery-powered IoT devices. Due to these challenges, IoT applications are limited. Consequently, precise, seamless, and ubiquitous Positioning, Navigation and Timing (PNT) systems are crucial for many artificial intelligence Internet of Things (AI-IoT) applications in the era of smart cities. Their applications include traffic monitoring, emergency alarming, environmental monitoring, location-based advertising, intelligent transportation, and smart health care. This paper proposes a generative AI-based positioning scheme for large-scale wireless settings using fingerprinting techniques. In this article, we presented a novel semi-supervised deep convolutional generative adversarial network (S-DCGAN)-based radio map construction method for real-time device localization. We also employed a reliable signal fingerprint feature extraction method with t-distributed stochastic neighbor embedding (t-SNE), which extracts dominant features while eliminating noise from hybrid WLAN and long-term evolution (LTE) fingerprints. The proposed scheme reduced the workload of site surveying required to build the fingerprint database by up to 78.5% and significantly improved positioning accuracy. The results show that the average positioning error of GAILoc is less than 0.39 m, and more than 90% of the errors are less than 0.82 m. According to numerical results, SRCLoc improves positioning performance and reduces radio map construction costs significantly compared to traditional methods.

Keywords: location-aware services, feature extraction technique, generative adversarial network, long short-term memory, support vector machine

Procedia PDF Downloads 40

Authors: Marisa Rio, Sharanya Bola, Richard H. W. Funk, Gerald Gerlach

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Cell migration, wound healing and regeneration are some of the physiological phenomena in which electric fields (EFs) have proven to have an important function. Physiologically, cells experience electrical signals in the form of transmembrane potentials, ion fluxes through protein channels as well as electric fields at their surface. As soon as a wound is created, the disruption of the epithelial layers generates an electric field of ca. 40-200 mV/mm, directing cell migration towards the wound site, starting the healing process. In vitro electrotaxis, experiments have shown cells respond to DC EFs polarizing and migrating towards one of the poles (cathode or anode). A standard electrotaxis experiment consists of an electrotaxis chamber where cells are cultured, a DC power source and agar salt bridges that help delaying toxic products from the electrodes to attain the cell surface. The electric field strengths used in such an experiment are uniform and homogeneous. In contrast, the endogenous electric field strength around a wound tend to be multi-field and non-homogeneous. In this study, we present a custom device that enables electrotaxis experiments in non-homogeneous DC electric fields. Its main feature involves the replacement of conventional metallic electrodes, separated from the electrotaxis channel by agarose gel bridges, through electrolyte-filled microchannels. The connection to the DC source is made by Ag/AgCl electrodes, incased in agarose gel and placed at the end of each microfluidic channel. An SU-8 membrane closes the fluidic channels and simultaneously serves as the single connection from each of them to the central electrotaxis chamber. The electric field distribution and current density were numerically simulated with the steady-state electric conduction module from ANSYS 16.0. Simulation data confirms the application of nonhomogeneous EF of physiological strength. To validate the biocompatibility of the device cellular viability of the photoreceptor-derived 661W cell line was accessed. The cells have not shown any signs of apoptosis, damage or detachment during stimulation. Furthermore, immunofluorescence staining, namely by vinculin and actin labelling, allowed the assessment of adhesion efficiency and orientation of the cytoskeleton, respectively. Cellular motility in the presence and absence of applied DC EFs was verified. The movement of individual cells was tracked for the duration of the experiments, confirming the EF-induced, cathodal-directed motility of the studied cell line. The in vitro monolayer wound assay, or “scratch assay” is a standard protocol to quantitatively access cell migration in vitro. It encompasses the growth of a confluent cell monolayer followed by the mechanic creation of a scratch, representing a wound. Hence, wound dynamics was monitored over time and compared for control and applied the electric field to quantify cellular population motility.

Keywords: DC non-homogeneous electric fields, electrotaxis, microfluidic biochip, wound healing

Procedia PDF Downloads 267

Authors: Garima Singh

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Objectives: Behavioral Crisis Center (BCC) is a community solution to a community problem. There has been an exponential increase in the incidence and prevalence of mental health crises around the world. The effects of the crisis negatively impact our patients and their families and strain the law enforcement and emergency room. The goal of the multi-disciplinary care model is to break the crisis cycle and provide 24-7 rapid access to an acre and crisis stabilization. We initiated our first BCC care center in 2020 in the midst of the COVID pandemic and have seen a remarkable improvement in patient ‘care and positive financial outcome. Background: Mental illnesses are common in the United States. Nearly one in five U.S. adults live with a mental illness (52.9 million in 2020). This number represented 21.0% of all U.S. adults. To address some of these challenges and help our community, In May 2020, we opened our first Behavioral crisis center (BCC). Since then, we have served more than 2500 patients and is the first southwest Missouri’s first 24/7 facility for crisis–level behavioral health and substance use needs. It has been proven to be a more effective place than emergency departments, jails, or local law enforcement. Methods: BCC was started in 2020 to serve the unmet need of the community and provide access to behavioral health and substance use services identified in the community. Funding was possible with significant investment from the county and Missouri Foundation for Health, with contributions from medical partners. It is a multi-disciplinary care center consisting of Physicians, nurse practitioners, nurses, behavioral technicians, peer support specialists, clinical intake specialists, and clinical coordinators and hospitality specialists. The center provides services including psychiatry care, outpatient therapy, community support services, primary care, peer support and engagement. It is connected to a residential treatment facility for substance use treatment for continuity of care and bridging the gap, which has resulted in the completion of treatment and better outcomes. Results: BCC has proven to be a great resource to the community and the Missouri Health Coalition is providing funding to replicate the model in other regions and work on a similar model for children and adolescents. Overall, 29% of the patients seen at BCC are stabilized and discharged with outpatient care. 50% needed acute stabilization in a hospital setting and 21% required long-term admission, mostly for substance use treatment. The local emergency room had a 42% reduction in behavioral health encounters compared to the previous 3 years. Also, by a quick transfer to BCC, the average stay in ER was reduced by 10 hours and time to follow up behavioral health assessment decreased by an average of 4 hours. Uninsured patients are also provided Medicaid application assistance which has benefited 55% of individuals receiving care at BCC. Conclusions: BCC is impacting community health and improving access to quality care and substance use treatment. It is a great investment for our patients and families.

Keywords: BCC, behvaioral health, community health care, addiction treatment

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Authors: Coriolano Salvini

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The increasing utilization of renewable energy sources for electric power production calls for the introduction of energy storage systems to match the electric demand along the time. Although many countries are pursuing as a final goal a “decarbonized” electrical system, in the next decades the traditional fossil fuel fed power plant still will play a relevant role in fulfilling the electric demand. Presently, such plants provide grid ancillary services (frequency control, grid balance, reserve, etc.) by adapting the output power to the grid requirements. An interesting option is represented by the possibility to use traditional plants to improve the grid storage capabilities. The present paper is addressed to small-medium size systems suited for distributed energy storage. The proposed Energy Storage System (ESS) is based on a Compressed Air Energy Storage (CAES) integrated into a Gas-Steam Combined Cycle (GSCC) or a Gas Turbine based CHP plants. The systems can be incorporated in an ex novo built plant or added to an already existing one. To avoid any geological restriction related to the availability of natural compressed air reservoirs, artificial storage is addressed. During the charging phase, electric power is absorbed from the grid by an electric driven intercooled/aftercooled compressor. In the course of the discharge phase, the compressed stored air is sent to a heat transfer device fed by hot gas taken upstream the Heat Recovery Steam Generator (HRSG) and subsequently expanded for power production. To maximize the output power, a staged reheated expansion process is adopted. The specific power production related to the kilogram per second of exhaust gas used to heat the stored air is two/three times larger than that achieved if the gas were used to produce steam in the HRSG. As a result, a relevant power augmentation is attained with respect to normal GSCC plant operations without additional use of fuel. Therefore, the excess of output power can be considered “fuel free” and the storage system can be compared to “pure” ESSs such as electrochemical, pumped hydro or adiabatic CAES. Representative cases featured by different power absorption, production capability, and storage capacity have been taken into consideration. For each case, a technical optimization aimed at maximizing the storage efficiency has been carried out. On the basis of the resulting storage pressure and volume, number of compression and expansion stages, air heater arrangement and process quantities found for each case, a cost estimation of the storage systems has been performed. Storage efficiencies from 0.6 to 0.7 have been assessed. Capital costs in the range of 400-800 €/kW and 500-1000 €/kWh have been estimated. Such figures are similar or lower to those featuring alternative storage technologies.

Keywords: artificial air storage reservoir, compressed air energy storage (CAES), gas steam combined cycle (GSCC), techno-economic analysis

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Authors: Elisa Boatti, Ulisse Stefanelli, Alessandro Reali, Ferdinando Auricchio

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Thanks to their unusual properties, shape memory alloys (SMAs) are good candidates for advanced applications in a wide range of engineering fields, such as automotive, robotics, civil, biomedical, aerospace. In the last decades, the ever-growing interest for such materials has boosted several research studies aimed at modeling their complex nonlinear behavior in an effective and robust way. Since the constitutive response of SMAs is strongly thermomechanically coupled, the investigation of the non-isothermal evolution of the material must be taken into consideration. The present study considers an existing three-dimensional phenomenological model for SMAs, able to reproduce the main SMA properties while maintaining a simple user-friendly structure, and proposes a variational reformulation of the full non-isothermal version of the model. While the considered model has been thoroughly assessed in an isothermal setting, the proposed formulation allows to take into account the full nonisothermal problem. In particular, the reformulation is inspired to the GENERIC (General Equations for Non-Equilibrium Reversible-Irreversible Coupling) formalism, and is based on a generalized gradient flow of the total entropy, related to thermal and mechanical variables. Such phrasing of the model is new and allows for a discussion of the model from both a theoretical and a numerical point of view. Moreover, it directly implies the dissipativity of the flow. A semi-implicit time-discrete scheme is also presented for the fully coupled thermomechanical system, and is proven unconditionally stable and convergent. The correspondent algorithm is then implemented, under a space-homogeneous temperature field assumption, and tested under different conditions. The core of the algorithm is composed of a mechanical subproblem and a thermal subproblem. The iterative scheme is solved by a generalized Newton method. Numerous uniaxial and biaxial tests are reported to assess the performance of the model and algorithm, including variable imposed strain, strain rate, heat exchange properties, and external temperature. In particular, the heat exchange with the environment is the only source of rate-dependency in the model. The reported curves clearly display the interdependence between phase transformation strain and material temperature. The full thermomechanical coupling allows to reproduce the exothermic and endothermic effects during respectively forward and backward phase transformation. The numerical tests have thus demonstrated that the model can appropriately reproduce the coupled SMA behavior in different loading conditions and rates. Moreover, the algorithm has proved effective and robust. Further developments are being considered, such as the extension of the formulation to the finite-strain setting and the study of the boundary value problem.

Keywords: generalized gradient flow, GENERIC formalism, shape memory alloys, thermomechanical coupling

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Authors: Marie Alexandre, Jean Bernatchez

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This paper focuses on the complexity of the face-to-face-to-distance learning transition process. Our research action aims to support the process of transition from classroom to distance learning for teachers in higher education with regard to pedagogical practices that can meet the various needs of students using digital learning environments. In Quebec and elsewhere in the world, the advent of digital education is helping to transform teaching, which is significantly changing the role of teachers. While distance education implies a dissociation of teaching and learning to a variable degree in space and time, distance education (DE) is becoming more and increasingly becoming a preferred option for maintaining the delivery of certain programs and providing access to programs and to provide access to quality activities throughout Quebec. Given the impact of teaching practices on educational success, this paper reports on the results of three research objectives: 1) To document teachers' knowledge of teaching in distance education through the design, experimentation and production of a repertoire of the determinants of pedagogical practices in response to students' needs. 2) Explain, according to a gendered logic, the adequacy between the pedagogical practices implemented in distance learning and the response to the profiles and needs expressed by students using digital learning environments; 3) Produce a model of a support approach during the process of transition from classroom to distance learning at the college level. A mixed methodology, i.e., a quantitative component (questionnaire survey) and a qualitative component (explanatory interviews and living lab) was used in cycles that were part of an ongoing validation process. The intervention includes the establishment of a professional collaboration group, webinars training webinars for the participating teachers on the didactic issue of knowledge-teaching in FAD, the didactic use of technologies, and the differentiated socialization models of educational success in college education. All of the tools developed will be used by partners in the target environment as well as by all teacher educators, students in initial teacher training, practicing teachers, and the general public. The results show that access to training leading to qualifications and commitment to educational success reflects the existing links between the people in the educational community. The relational stakes of being present in distance education take on multiple configurations and different dimensions of learning testify to needs and realities that are sometimes distinct depending on the life cycle. This project will be of interest to partners in the targeted field as well as to all teacher trainers, students in initial teacher training, practicing college teachers, and to university professors. The entire educational community will benefit from digital resources in education. The scientific knowledge resulting from this action research will benefit researchers in the fields of pedagogy, didactics, teacher training and pedagogy in higher education in a digital context.

Keywords: action research, didactics, digital learning environment, distance learning, higher education, pedagogy technological, pedagogical content knowledge

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Authors: Nourhan Hussein Fanaki, Hoda Mohamed Gamal El-Din Omar, Nihal Kadry Moussa, Eva Adel Edward Farid

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The resistance of staphylococci to various antibiotics has become a major concern for health care professionals. The efficacy of the combinations of selected glycopeptides (vancomycin and teicoplanin) with gentamicin or rifampicin, as well as that of gentamicin/rifampicin combination, was studied against selected pathogenic staphylococcus isolated from Egypt. The molecular distribution of genes conferring resistance to these four antibiotics was detected among tested clinical isolates. Antibiotic combinations were studied using the checkerboard technique and the time-kill assay (in both the stationary and log phases). Induction of resistance to glycopeptides in staphylococci was tried in the absence and presence of diclofenac sodium as inducer. Transmission electron microscopy was used to study the effect of glycopeptides on the ultrastructure of the cell wall of staphylococci. Attempts were made to cure gentamicin resistance plasmids and to study the transfer of these plasmids by conjugation. Trials for the transformation of the successfully isolated gentamicin resistance plasmid to competent cells were carried out. The detection of genes conferring resistance to the tested antibiotics was performed using the polymerase chain reaction. The studied antibiotic combinations proved their efficacy, especially when tested during the log phase. Induction of resistance to glycopeptides in staphylococci was more promising in presence of diclofenac sodium, compared to its absence. Transmission electron microscopy revealed the thickening of bacterial cell wall in staphylococcus clinical isolates due to the presence of tested glycopeptides. Curing of gentamicin resistance plasmids was only successful in 2 out of 9 tested isolates, with a curing rate of 1 percent for each. Both isolates, when used as donors in conjugation experiments, yielded promising conjugation frequencies ranging between 5.4 X 10-2 and 7.48 X 10-2 colony forming unit/donor cells. Plasmid isolation was only successful in one out of the two tested isolates. However, low transformation efficiency (59.7 transformants/microgram plasmid DNA) of such plasmids was obtained. Negative regulators of autolysis, such as arlR, lytR and lrgB, as well as cell-wall associated genes, such as pbp4 and/or pbp2, were detected in staphylococcus isolates with reduced susceptibility to the tested glycopeptides. Concerning rifampicin resistance genes, rpoBstaph was detected in 75 percent of the tested staphylococcus isolates. It could be concluded that in vitro studies emphasized the usefulness of the combination of vancomycin or teicoplanin with gentamicin or rifampicin, as well as that of gentamicin with rifampicin, against staphylococci showing varying resistance patterns. However, further in vivo studies are required to ensure the safety and efficacy of such combinations. Diclofenac sodium can act as an inducer of resistance to glycopeptides in staphylococci. Cell-wall thickness is a major contributor to such resistance among them. Gentamicin resistance in these strains could be chromosomally or plasmid mediated. Multiple mutations in the rpoB gene could mediate staphylococcus resistance to rifampicin.

Keywords: glycopeptides, combinations, induction, diclofenac, transmission electron microscopy, polymerase chain reaction

Procedia PDF Downloads 287

Authors: L. P. Gomes, G. F. Araújo, Y. M. L. Cordeiro, C. T. Andrade, E. M. Del Aguila, V. M. F. Paschoalin

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The application of nanoscale materials and nanostructures is an emerging area, these since materials may provide solutions to technological and environmental challenges in order to preserve the environment and natural resources. To reach this goal, the increasing demand must be accompanied by 'green' synthesis methods. Chitosan is a natural, nontoxic, biopolymer derived by the deacetylation of chitin and has great potential for a wide range of applications in the biological and biomedical areas, due to its biodegradability, biocompatibility, non-toxicity and versatile chemical and physical properties. Chitosan also presents high antimicrobial activities against a wide variety of pathogenic and spoilage microorganisms. Ultrasonication is a common tool for the preparation and processing of polymer nanoparticles. It is particularly effective in breaking up aggregates and in reducing the size and polydispersity of nanoparticles. High-intensity ultrasonication has the potential to modify chitosan molecular weight and, thus, alter or improve chitosan functional properties. The aim of this study was to evaluate the influence of sonication intensity and time on the changes of commercial chitosan characteristics, such as molecular weight and its potential antibacterial activity against Gram-negative bacteria. The nanoparticles (NPs) were produced from two commercial chitosans, of medium molecular weight (CS-MMW) and low molecular weight (CS-LMW) from Sigma-Aldrich®. These samples (2%) were solubilized in 100 mM sodium acetate pH 4.0, placed on ice and irradiated with an ultrasound SONIC ultrasonic probe (model 750 W), equipped with a 1/2" microtip during 30 min at 4°C. It was used on constant duty cycle and 40% amplitude with 1/1s intervals. The ultrasonic degradation of CS-MMW and CS-LMW were followed up by means of ζ-potential (Brookhaven Instruments, model 90Plus) and dynamic light scattering (DLS) measurements. After sonication, the concentrated samples were diluted 100 times and placed in fluorescence quartz cuvettes (Hellma 111-QS, 10 mm light path). The distributions of the colloidal particles were calculated from the DLS and ζ-potential are measurements taken for the CS-MMW and CS-LMW solutions before and after (CS-MMW30 and CS-LMW30) sonication for 30 min. Regarding the results for the chitosan sample, the major bands can be distinguished centered at Radius hydrodynamic (Rh), showed different distributions for CS-MMW (Rh=690.0 nm, ζ=26.52±2.4), CS-LMW (Rh=607.4 and 2805.4 nm, ζ=24.51±1.29), CS-MMW30 (Rh=201.5 and 1064.1 nm, ζ=24.78±2.4) and CS-LMW30 (Rh=492.5, ζ=26.12±0.85). The minimal inhibitory concentration (MIC) was determined using different chitosan samples concentrations. MIC values were determined against to E. coli (106 cells) harvested from an LB medium (Luria-Bertani BD™) after 18h growth at 37 ºC. Subsequently, the cell suspension was serially diluted in saline solution (0.8% NaCl) and plated on solid LB at 37°C for 18 h. Colony-forming units were counted. The samples showed different MICs against E. coli for CS-LMW (1.5mg), CS-MMW30 (1.5 mg/mL) and CS-LMW30 (1.0 mg/mL). The results demonstrate that the production of nanoparticles by modification of their molecular weight by ultrasonication is simple to be performed and dispense acid solvent addition. Molecular weight modifications are enough to provoke changes in the antimicrobial potential of the nanoparticles produced in this way.

Keywords: antimicrobial agent, chitosan, green production, nanoparticles

Procedia PDF Downloads 320

Authors: Eleni Maistrou, D. Kosmopoulos, Carolina Moretti, Amalia Konidi, Katerina Boulougoura

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InterArch is an ongoing research project that has been running since September 2020. It aims to propose the design of a site-based digital application for archaeological sites and outdoor guided tours, supporting virtual and augmented reality technology. The research project is co‐financed by the European Union and Greek national funds, through the Operational Program Competitiveness, Entrepreneurship, and Innovation, under the call RESEARCH - CREATE – INNOVATE (project code: Τ2ΕΔΚ-01659). It involves mutual collaboration between academic and cultural institutions and the contribution of an IT applications development company. The research will be completed by July 2023 and will run as a pilot project for the city of Ancient Messene, a place of outstanding natural beauty in the west of Peloponnese, which is considered one of the most important archaeological sites in Greece. The applied research project integrates an interactive approach to the natural environment, aiming at a manifold sensory experience. It combines the physical space of the archaeological site with the digital space of archaeological and cultural data while at the same time, it embraces storytelling processes by engaging an interdisciplinary approach that familiarizes the user with multiple semantic interpretations. The mingling of the real-world environment with its digital and cultural components by using augmented reality techniques could potentially transform the visit on-site into an immersive multimodal sensory experience. To this purpose, an extensive spatial analysis along with a detailed evaluation of the existing digital and non-digital archives is proposed in our project, intending to correlate natural landscape morphology (including archaeological material remains and environmental characteristics) with the extensive historical records and cultural digital data. On-site research was carried out, during which visitors’ itineraries were monitored and tracked throughout the archaeological visit using GPS locators. The results provide our project with useful insight concerning the way visitors engage and interact with their surroundings, depending on the sequence of their itineraries and the duration of stay at each location. InterArch aims to propose the design of a site-based digital application for archaeological sites and outdoor guided tours, supporting virtual and augmented reality technology. Extensive spatial analysis, along with a detailed evaluation of the existing digital and non-digital archives, is used in our project, intending to correlate natural landscape morphology with the extensive historical records and cultural digital data. The results of the on-site research provide our project with useful insight concerning the way visitors engage and interact with their surroundings, depending on the sequence of their itineraries and the duration of stay at each location.

Keywords: archaeological site, digital space, semantic interpretations, cultural heritage

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Authors: Daniel Tscharnuter, Eliza Truszkiewicz, Gerald Pinter

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High-quality surfaces of plastic parts can be achieved in a very cost-effective manner using in-mold processes, where e.g. scratch resistant or high gloss polymer films are pre-formed and subsequently receive their support structure by injection molding. The pre-forming may be done by high-pressure forming. In this process, a polymer sheet is heated and subsequently formed into the mold by pressurized air. Due to the heat transfer to the cooled mold the polymer temperature drops below its glass transition temperature. This ensures that the deformed microstructure is retained after depressurizing, giving the sheet its final formed shape. The development of a forming process relies heavily on the experience of engineers and trial-and-error procedures. Repeated mold design and testing cycles are however both time- and cost-intensive. It is, therefore, desirable to study the process using reliable computer simulations. Through simulations, the construction of the mold and the effect of various process parameters, e.g. temperature levels, non-uniform heating or timing and magnitude of pressure, on the deformation of the polymer sheet can be analyzed. Detailed knowledge of the deformation is particularly important in the forming of polymer films with integrated electro-optical functions. Care must be taken in the placement of devices, sensors and electrical and optical paths, which are far more sensitive to deformation than the polymers. Reliable numerical prediction of the deformation of the polymer sheets requires sophisticated material models. Polymer films are often either transversely isotropic or orthotropic due to molecular orientations induced during manufacturing. The anisotropic behavior affects the resulting strain field in the deformed film. For example, parts of the same shape but different strain fields may be created by varying the orientation of the film with respect to the mold. The numerical simulation of the high-pressure forming of such films thus requires material models that can capture the nonlinear anisotropic mechanical behavior. There are numerous commercial polymer grades for the engineers to choose from when developing a new part. The effort required for comprehensive material characterization may be prohibitive, especially when several materials are candidates for a specific application. We, therefore, propose a class of models for compressible hyperelasticity, which may be determined from basic experimental data and which can capture key features of the mechanical response. Invariant-based hyperelastic models with a reduced number of invariants are formulated in a semi-numerical way, such that the models are determined from a single uniaxial tensile tests for isotropic materials, or two tensile tests in the principal directions for transversely isotropic or orthotropic materials. The simulation of the high pressure forming of an orthotropic polymer film is finally done using an orthotropic formulation of the hyperelastic model.

Keywords: hyperelastic, anisotropic, polymer film, thermoforming

Procedia PDF Downloads 613

Authors: Ting-I Lin

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Objective: This article explores the nursing care experience of a 51-year-old terminal lung cancer patient admitted to the intensive care unit (ICU) following an upper right lobectomy. The patient initially sought emergency treatment due to worsening cough and dyspnea, which led to the placement of an endotracheal tube following sudden deterioration. Subsequent CT scans and chest X-rays revealed a tumor in the upper right lung with metastases to the lungs, liver, bones, and adrenal glands. The patient underwent a right upper lobectomy and a wedge resection of the right middle lobe. Pathology staging: T4N3M1c and the patient was diagnosed with advanced cancer postoperatively. Method: During the care period, nursing staff continuously monitored the patient’s physiological data through observations, direct care, interviews, physical assessments, and review of the patient’s medical records. The nursing team collaborated with the critical care team and the palliative care team, using Gordon's Eleven Functional Health Patterns to conduct a comprehensive assessment. The key health problems identified included pain related to postoperative cancer resection and invasive devices, fear of death due to rapid disease progression, and altered tissue perfusion associated with hemodynamic instability. Results: Postoperatively, the patient experienced pain from the surgical wound and dyspnea due to extensive metastasis, often leading to confusion. Through the adjustment of pain medication, the patient’s discomfort was alleviated, using Morphine 8 mg in 0.9% normal saline 60 ml IV drip q6h prn, and Ultracet 37.5 mg/325 mg 1# PO q6h. Additionally, lavender essential oil inhalation and limb massage were provided for 15 minutes four times a day. The patient’s FLACC pain score decreased from 7 to below 3. After respiratory training, the endotracheal tube was successfully removed, and the patient was weaned off the ventilator. Triflow exercises were used to promote alveolar expansion, with the goal of achieving 2 balls for 10 seconds, 5 repetitions per session, 6-8 times a day. The patient’s breathing stabilized at 16-18 breaths per minute, body temperature remained between 35.8°C and 36.1°C, and the mean arterial pressure was maintained between 60-80 mmHg. Conclusion: The critical care team and the palliative care team held a family meeting to discuss not only the patient’s care but also the emotional well-being of the family. Visiting hours were increased to two times per day, one hour each time, allowing the patient and family to express love and gratitude, which strengthened their emotional connection and reduced the patient’s anxiety from severe to mild. The family expressed that they had no regrets. After the patient was transferred to the general ward, the nursing team continued to provide end-of-life care with genuine empathy, compassion, and religious support, helping both the patient and family through the final stage of life.

Keywords: multiple metastases, lung cancer, palliative care, nursing experience

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