Search results for: leading edge vortex (LEV)

Authors: Hugo Carronnier, Wassim Almouallem, Eric Branquet

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Per- and polyfluoroalkyl Substances (PFAS) are a group of man-made refractory compounds that have been widely used in a variety of industrial and commercial products since the 1940s, leading to contamination of groundwater and surface water systems. They are persistent, bioaccumulative and toxic chemicals. Foam fractionation is a potential remedial technique for treating PFAS-contaminated water, taking advantage of the high surface activity to remove them from the solution by adsorption onto the surface of the air bubbles. Nevertheless, traditional foam fractionation technology developed for PFAS is challenging and found to be ineffective in treating the less surface-active compounds. Different chemicals were the subject of investigation as amendments to achieve better removal. However, most amendments are toxic, expensive and complicated to use. In this situation, patent-pending PFAS technology overcomes these challenges by using rather biological amendments. Results from the first laboratory trial showed remarkable results using a simple and cheap BioFoam Fractionation (BioFF) process based on biomimetics. The study showed that the BioFF process is effective in removing greater than 99% of PFOA (C8), PFOS (C8), PFHpS (C7) and PFHxS (C6) in PFAS-contaminated water. For other PFAS such as PFDA (C10) and 6:2 FTAB, a slightly less stable removal between 94% and 96% was achieved while between 34% and 73% removal efficiency was observed for PFBA (C4), PFBS (C4), PFHxA (C6), and Gen-X. In sum, the advantages of the BioFF presented as a low-waste production, a cost and energy-efficient operation and the use of a biodegradable amendment requiring no separation step after treatment, coupled with these first findings, suggest that the BioFF process is a highly applicable treatment technology for PFAS contaminated water. Additional investigations are currently carried on in order to optimize the process and establish a promising strategy for on-site PFAS remediation.

Keywords: PFAS, treatment, foam fractionation, contaminated amendments

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Authors: Prateek Sharma, Venkata Ramachandrarao Maddali, Kapil Kukreja, B. N. Mohapatra

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Waste management is one of the pressing issues of India. Several initiatives by the Indian Government, including the recent one “Swachhata hi Seva” campaign launched by Prime Minister on 15th August 2018, can be one of the game changers to waste disposal. Under this initiative, the government, cement industry and other stakeholders are working hand in hand to dispose of single-use plastics in cement plants in rotary kilns. This is an exemplary effort and a move that establishes the Indian Cement industry as one of the key players in a circular economy. One of the cement plants in Southern India has been mandated by the state government to co-process shredded plastic and refuse-derived fuel (RDF) available in nearby regions as an alternative fuel in their cement plant. The plant has set a target of 25 % thermal substitution rate (TSR) by RDF in the next five years. Most of the cement plants in India and abroad have achieved high TSR through pre calciner firing. But the cement plant doesn’t have the precalciner and has to achieve this daunting task of 25 % TSR by firing through the main kiln burner. Since RDF is a heterogeneous waste with the change in fuel quality, it is difficult to achieve this task; hence plant has to resort to firing some portion of RDF/plastics at kiln inlet. But kiln inlet has reducing conditions as observed during measurements) under baseline condition. The combustion behavior of RDF of different sizes at different firing locations in riser was studied with the help of a computational fluid dynamics tool. It has been concluded that RDF above 50 mm size results in incomplete combustion leading to CO formation. Moreover, best firing location appears to be in the bottom portion of the kiln riser.

Keywords: kiln inlet, plastics, refuse derived fuel, thermal substitution rate

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Authors: Liudmila Garzanova, Lidia Ananyeva, Olga Koneva, Olga Ovsyannikova, Oxana Desinova, Mayya Starovoytova, Rushana Shayahmetova, Anna Khelkovskaya-Sergeeva

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Objectives: The duration of the disease could be one of the leading factors in the effectiveness of therapy in systemic sclerosis (SSc). The aim of the study was to assess how the duration of the disease affects the changes of lung function in patients(pts) with interstitial lung disease (ILD) associated with SSc during long-term RTX therapy. Methods: We prospectively included 113pts with SSc in this study. 85% of pts were female. Mean age was 48.1±13years. The diffuse cutaneous subset of the disease had 62pts, limited–40, overlap–11. The mean disease duration was 6.1±5.4years. Pts were divided into 2 groups depending on the disease duration - group 1 (less than 5 years-63pts) and group 2 (more than 5 years-50 pts). All pts received prednisolone at mean dose of 11.5±4.6 mg/day and 53 of them - immunosuppressants at inclusion. The parameters were evaluated over the periods: at baseline (point 0), 13±2.3mo (point 1), 42±14mo (point 2) and 79±6.5mo (point 3) after initiation of RTX therapy. Cumulative mean dose of RTX in group 1 at point 1 was 1.7±0.6 g, at point 2 = 3.3±1.5g, at point 3 = 3.9±2.3g; in group 2 at point 1 = 1.6±0.6g, at point 2 = 2.7±1.5 g, at point 3 = 3.7±2.6 g. The results are presented in the form of mean values, delta(Δ), median(me), upper and lower quartile. Results. There was a significant increase of forced vital capacity % predicted (FVC) in both groups, but at points 1 and 2 the improvement was more significant in group 1. In group 2, an improvement of FVC was noted with a longer follow-up. Diffusion capacity for carbon monoxide % predicted (DLCO) remained stable at point 1, and then significantly improved by the 3rd year of RTX therapy in both groups. In group 1 at point 1: ΔFVC was 4.7 (me=4; [-1.8;12.3])%, ΔDLCO = -1.2 (me=-0.3; [-5.3;3.6])%, at point 2: ΔFVC = 9.4 (me=7.1; [1;16])%, ΔDLCO =3.7 (me=4.6; [-4.8;10])%, at point 3: ΔFVC = 13 (me=13.4; [2.3;25.8])%, ΔDLCO = 2.3 (me=1.6; [-5.6;11.5])%. In group 2 at point 1: ΔFVC = 3.4 (me=2.3; [-0.8;7.9])%, ΔDLCO = 1.5 (me=1.5; [-1.9;4.9])%; at point 2: ΔFVC = 7.6 (me=8.2; [0;12.6])%, ΔDLCO = 3.5 (me=0.7; [-1.6;10.7]) %; at point 3: ΔFVC = 13.2 (me=10.4; [2.8;15.4])%, ΔDLCO = 3.6 (me=1.7; [-2.4;9.2])%. Conclusion: Patients with an early SSc have more quick response to RTX therapy already in 1 year of follow-up. Patients with a disease duration more than 5 years also have response to therapy, but with longer treatment. RTX is effective option for the treatment of ILD-SSc, regardless of the duration of the disease.

Keywords: interstitial lung disease, systemic sclerosis, rituximab, disease duration

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Authors: Camilo Andres Agudelo-Velez, Lina María Martinez-Sanchez, Natalia Perilla-Hernandez, Maria De Los Angeles Rodriguez-Gazquez, Felipe Hernandez-Restrepo, Dayana Andrea Quintero-Moreno, Camilo Ruiz-Mejia, Isabel Cristina Ortiz-Trujillo, Monica Maria Zuluaga-Quintero

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Chronic obstructive pulmonary disease is common condition, characterized by a persistent blockage of airflow, partially reversible and progressive, that represents 5% of total deaths around the world, and it is expected to become the third leading cause of death by 2030. Objective: To establish the clinical and epidemiological profile of patients with chronic obstructive pulmonary disease in a medical institution from the city of Medellin, Colombia. Methods: A cross-sectional study was performed, with a sample of 50 patients with a diagnosis of chronic obstructive pulmonary disease in a private institution in Medellin, during 2015. The software SPSS vr. 20 was used for the statistical analysis. For the quantitative variables, averages, standard deviations, and maximun and minimun values were calculated, while for ordinal and nominal qualitative variables, proportions were estimated. Results: The average age was 73.5±9.3 years, 52% of the patients were women, 50% of them had retired, 46% ere married and 80% lived in the city of Medellín. The mean time of diagnosis was 7.8±1.3 years and 100% of the patients were treated at the internal medicine service. The most common clinical features were: 36% were classified as class D for the disease, 34% had a FEV1 <30%, 88% had a history of smoking and 52% had oxygen therapy at home. Conclusion: It was found that class D was the most common, and the majority of the patients had a history of smoking, indicating the need to strengthen promotion and prevention strategies in this regard.

Keywords: pulmonary disease, chronic obstructive, pulmonary medicine, oxygen inhalation therapy

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Authors: Zainab A. Alaghbri, Labiba A., Esam A.

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Tuberculosis (TB) is the fourth leading cause of death in Yemen and is considered a major priority by the Ministry of Public Health. The war in Yemen has led to the emergence of one of the worst humanitarian crises in the world. These circumstances may lead to exacerbate the situation of tuberculosis. This study aims to describe the trend and incidence of TB in north and east governorates, Yemen 2019-2021 and provide recommendations for interventions. A descriptive analysis was conducted during July to September 2022. Data of TB cases were obtained from the national tuberculosis program as soft copy. The Data included the TB case collected and diagnosed during 2019-2021. The data contains the following variables: Sex, age, governorates, smear-positive cases, extra-pulmonary cases, and treatment outcomes. 16791 TB cases were notified for an overall case notification rate 65.5/100000 for all forms (smear positive and Extra-pulmonary), There was a slightly declined in 2020 and 2021 by 1%. Both the pulmonary smear positive and Extra pulmonary rates were slightly decreased from 8.8 to 7.7 and 13.5 to 12.8 / 100, 000 populations respectively. For Tuberculosis cases by type of patient, the incidence of extra-pulmonary was the highest (12,9, 11.3 and 12,2/100000) over the three years. However, the incidence of pulmonary failure was the lowest. The majority of cases were in the age group 25-34. The overall treatment success rate for smear-positive patients was 88%. Of the 627 patients with documented unsuccessful outcomes (e.g., failure, death, and default), 165 (23%) died, 52 (8.3%) failed treatment, and 410 (65%) defaulted. Overall, the magnitude of tuberculosis decreased over the periods reviewed. The proportion of Extra-pulmonary TB was the highest. The success rate achieved after treatment was below the levels established by the WHO End Tuberculosis Strategy (90%). Failure to complete treatment may be responsible for the low success rate. Monitoring and addressing the risk factors that were associated with treatment outcomes and duration may help improve the likelihood of achieving favorable outcomes among cases of smear-positive pulmonary TB.

Keywords: tuberculosis, trend, incidence, yemen

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Authors: Muhd. Barzani Gasim, Mohd. Ekhwan Toriman, Mohd. Khairul Amri Kamarudin, Azman Azid, Siti Humaira Haron, Muhammad Hafiz Md. Saad

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Malaysia is a country in Southeast Asia that constantly exposed to flooding and landslide. The disaster has caused some troubles such loss of property, loss of life and discomfort of people involved. This problem occurs as a result of climate change leading to increased stream flow rate as a result of disruption to regional hydrological cycles. The aim of the study is to determine hydrologic processes in the east coasts of Peninsular Malaysia, especially in Kelantan Basin. Parameterized to account for the spatial and temporal variability of basin characteristics and their responses to climate variability. For hydrological modeling of the basin, the Soil and Water Assessment Tool (SWAT) model such as relief, soil type, and its use, and historical daily time series of climate and river flow rates are studied. The interpretation of Landsat map/land uses will be applied in this study. The combined of SWAT and climate models, the system will be predicted an increase in future scenario climate precipitation, increase in surface runoff, increase in recharge and increase in the total water yield. As a result, this model has successfully developed the basin analysis by demonstrating analyzing hydrographs visually, good estimates of minimum and maximum flows and severe floods observed during calibration and validation periods.

Keywords: east coasts of Peninsular Malaysia, Kelantan river basin, minimum and maximum flows, severe floods, SWAT model

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Authors: Arsalan Ansari, Muhammad Dawood Idrees, Maria Hafeez

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Use of mobile phones has been increasing considerably over the past decade. Currently, it is one of the main sources of communication and information. Initially, mobile phones were limited to calls and messages, but with the advent of new technology smart phones were being used for many other purposes including video games. Despite of positive outcomes, addiction to video games on mobile phone has become a leading cause of psychological and physiological problems among many people. Several researchers examined the different aspects of behavior addiction with the use of different scales. Objective of this study is to examine any distinction between mobile game addicted and non-addicted players with the use of electroencephalography (EEG), based upon psycho-physiological indicators. The mobile players were asked to play a mobile game and EEG signals were recorded by BIOPAC equipment with AcqKnowledge as data acquisition software. Electrodes were places, following the 10-20 system. EEG was recorded at sampling rate of 200 samples/sec (12,000samples/min). EEG recordings were obtained from the frontal (Fp1, Fp2), parietal (P3, P4), and occipital (O1, O2) lobes of the brain. The frontal lobe is associated with behavioral control, personality, and emotions. The parietal lobe is involved in perception, understanding logic, and arithmetic. The occipital lobe plays a role in visual tasks. For this study, a 60 second time window was chosen for analysis. Preliminary analysis of the signals was carried out with Acqknowledge software of BIOPAC Systems. From the survey based on CGS manual study 2010, it was concluded that five participants out of fifteen were in addictive category. This was used as prior information to group the addicted and non-addicted by physiological analysis. Statistical analysis showed that by applying clustering analysis technique authors were able to categorize the addicted and non-addicted players specifically on theta frequency range of occipital area.

Keywords: mobile game, addiction, psycho-physiology, EEG analysis

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Authors: Yu-Che Cheng, Min-Lih Chang, Ke-Hao Cheng, Chuan-Cheng Wang

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Taiwan is an island located along the southeastern coast of the Asian continent, located between Japan and the Philippines. It is surrounded by the sea on all sides. However, due to the presence of the Central Mountain Range, the rivers on the east and west coasts of Taiwan are relatively short. This geographical feature results in a phenomenon where, despite having rainfall that is 2.6 times the world average, 58.5% of the rainwater flows into the ocean. Moreover, approximately 80% of the annual rainfall occurs between May and October, leading to distinct wet and dry periods. To address these challenges, Taiwan relies on large reservoirs, storage ponds, and groundwater extraction for water resource allocation. It is necessary to construct water treatment facilities at suitable locations to provide the population with a stable and reliable water supply. In general, the construction of a new water treatment plant requires careful planning and evaluation. The process involves acquiring land and issuing contracts for construction in a sequential manner. With the increasing severity of global warming and climate change, there is a heightened risk of extreme hydrological events and severe water situations in the future. In cases of urgent water supply needs in a region, relying on traditional lengthy processes for constructing water treatment plants might not be sufficient to meet the urgent demand. Therefore, this study aims to explore the use of simplified water treatment procedures and the construction of rapid "temporary water treatment plants" to tackle the challenges posed by extreme climate conditions (such as a century-long drought) and situations where water treatment plant construction cannot keep up with the pace of water source development.

Keywords: temporary water treatment plant, emergency water supply, construction site groundwater, drought

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Authors: Yael Neumann

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Attention deficits are common in people with aphasia (PWA). Two treatment approaches address these deficits: domain-general methods like Play Attention, which focus on cognitive functioning, and domain-specific methods like Language-Specific Attention Treatment (L-SAT), which use linguistically based tasks. Research indicates that L-SAT can improve both attentional deficits and functional language skills, while Play Attention has shown success in enhancing attentional capabilities among school-aged children with attention issues compared to standard cognitive training. This study employed a randomized controlled cross-over single-subject design to evaluate the effectiveness of these two attention treatments over 25 weeks. Four PWA participated, undergoing a battery of eight standardized tests measuring language and cognitive skills. The treatments were counterbalanced. Play Attention used EEG sensors to detect brainwaves, enabling participants to manipulate items in a computer game while learning to suppress theta activity and increase beta activity. An algorithm tracked changes in the theta-to-beta ratio, allowing points to be earned during the games. L-SAT, on the other hand, involved hierarchical language tasks that increased in complexity, requiring greater attention from participants. Results showed that for language tests, Participant 1 (moderate aphasia) aligned with existing literature, showing L-SAT was more effective than Play Attention. However, Participants 2 (very severe) and 3 and 4 (mild) did not conform to this pattern; both treatments yielded similar outcomes. This may be due to the extremes of aphasia severity: the very severe participant faced significant overall deficits, making both approaches equally challenging, while the mild participant performed well initially, leaving limited room for improvement. In attention tests, Participants 1 and 4 exhibited results consistent with prior research, indicating Play Attention was superior to L-SAT. Participant 2, however, showed no significant improvement with either program, although L-SAT had a slight edge on the Visual Elevator task, measuring switching and mental flexibility. This advantage was not sustained at the one-month follow-up, likely due to the participant’s struggles with complex attention tasks. Participant 3's results similarly did not align with prior studies, revealing no difference between the two treatments, possibly due to the challenging nature of the attention measures used. Regarding participation and ecological tests, all participants showed similar mild improvements with both treatments. This limited progress could stem from the short study duration, with only five weeks allocated for each treatment, which may not have been enough time to achieve meaningful changes affecting life participation. In conclusion, the performance of participants appeared influenced by their level of aphasia severity. The moderate PWA’s results were most aligned with existing literature, indicating better attention improvement from the domain-general approach (Play Attention) and better language improvement from the domain-specific approach (L-SAT).

Keywords: attention, language, cognitive rehabilitation, neurofeedback

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Authors: Nesreddine Djafar Henni, Akram Khelaifia, Salah Guettala, Rachid Chebili

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Reinforced concrete shear walls and vertical plate-like elements play a pivotal role in efficiently managing a building's response to seismic forces. This study investigates how the performance of reinforced concrete buildings equipped with shear walls featuring different shear wall-to-frame stiffness ratios aligns with the requirements stipulated in the Algerian seismic code RPA99v2003, particularly in high-seismicity regions. Seven distinct 3D finite element models are developed and evaluated through nonlinear static analysis. Engineering Demand Parameters (EDPs) such as lateral displacement, inter-story drift ratio, shear force, and bending moment along the building height are analyzed. The findings reveal two predominant categories of induced responses: force-based and displacement-based EDPs. Furthermore, as the shear wall-to-frame ratio increases, there is a concurrent increase in force-based EDPs and a decrease in displacement-based ones. Examining the distribution of shear walls from both force and displacement perspectives, model G with the highest stiffness ratio, concentrating stiffness at the building's center, intensifies induced forces. This configuration necessitates additional reinforcements, leading to a conservative design approach. Conversely, model C, with the lowest stiffness ratio, distributes stiffness towards the periphery, resulting in minimized induced shear forces and bending moments, representing an optimal scenario with maximal performance and minimal strength requirements.

Keywords: dual RC buildings, RC shear walls, modeling, static nonlinear pushover analysis, optimization, seismic performance

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Authors: Sina Mahdavi

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Background and Objective: Multiple sclerosis (MS) is an inflammatory autoimmune disease of the CNS that affects the myelination process in the central nervous system (CNS). Complex interactions of various "environmental or infectious" factors may act as triggers in autoimmunity and disease progression. The association between viral infections, especially human endogenous retrovirus (HERV) and MS is one potential cause that is not well understood. This study aims to summarize the available data on HERV infection in MS disease progression. Materials and Methods: For this study, the keywords "Multiple sclerosis", "Human endogenous retrovirus", and "central nervous system" in the databases PubMed, Google Scholar, Sid, and MagIran between 2016 and 2022 were searched and 14 articles chosen, studied, and analyzed. Results: In the leptomeningeal cells of MS patients, a retrovirus-like element associated with reverse transcriptase (RT) activity called multiple sclerosis-associated retroviruses (MSRV) has been identified. HERVs are expressed in the human CNS despite mechanisms to suppress their expression. External factors, especially viral infections such as influenza virus, Epstein-Barr virus, and herpes simplex virus type 1, can activate HERV gene expression. The MSRV coat protein is activated by activating TLR4 at the brain surface, particularly in oligodendroglial progenitor cells and macrophages, leading to immune cascades followed by the downregulation of myelin protein expression. The HERV-K18 envelope gene (env) acts as a superantigen and induces inflammatory responses in patients with MS. Conclusion: There is a high expression of endogenous retroviruses during the course of MS, which indicates the relationship between HERV and MS, that this virus can play a role in the development of MS by creating an inflammatory state. Therefore, measures to modulate the expression of endogenous retroviruses may be effective in reducing inflammatory processes in demyelinated areas of MS patients.

Keywords: multiple sclerosis, human endogenous retrovirus, central nervous system, MSRV

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Authors: Emmanuelle Maria, Pierre Crançon, Gaëtane Lespes

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The knowledge of uranium migration processes within underground environments is a major issue in the environmental risk assessment associated with nuclear activities. This process is identified as strongly controlled by adsorption mechanisms, thus leading to strongly delayed migration paths. Colloidal ligands are likely to significantly increase the mobility of uranium in natural environments. The ability of colloids to mobilize and transport uranium depends on their origin, their nature, their structure, their stability and their reactivity with uranium. Thus, the colloidal mobilization and transport properties are often described as site-specific. In this work, the colloidal phases of two leachates obtained from two different horizons of the same podzolic soil were characterized with a speciation approach. For this purpose, a multi-technique strategy was used, based on Field-Flow Fractionation coupled to Ultraviolet, Multi-Angle Light Scattering and Inductively Coupled Plasma Mass Spectrometry (AF4-UV-MALS-ICPMS), Transmission Electron Microscopy (TEM), Electrospray Ionization Orbitrap Mass Spectrometry (ESI-Orbitrap), and Time-Resolved Laser Fluorescence Spectroscopy (TRLFS-EEM). Thus, elemental composition, size distribution, microscopic structure, colloidal stability and possible organic and/or inorganic content of colloids were determined, as well as their association with uranium. The leachates exhibit differences in their physical and chemical characteristics, mainly in the nature of organic matter constituents. The multi-technique investigation strategy used provides original data about colloidal phase structure and composition, offering a new vision of the way the uranium can be mobilized and transported in the considered soil. This information is a real significant contribution opening the way to our understanding and predicting of the colloidal transport.

Keywords: colloids, migration, multi-technique, speciation, transport, uranium

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Authors: Zahra F. Al-Khateeb, Shenel Shekerzade, Hasna Boumenar, Siân M. Henson, Jordi L. Tremoleda, A. T. Michael-Titus

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Traumatic brain injury (TBI) is the leading cause of disability and death in young adults and also increases the risk ofneurodegeneration. The mechanisms linking moderate to severe TBI to neurodegeneration are not known. It has been proposed that cellular senescence inductionpost-injury could amplify neuroinflammation and induce long-term changes. The impact of these processes after injury to an immature brain has not been characterised yet. We carried out a controlled cortical impact injury (CCI) in juvenile 1 month-old male CD1 mice. Animals were anesthetised and received a unilateral CCI injury. The sham group received anaesthesia and had a craniotomy. A naïve group had no intervention. The brain tissue was analysed at 5 days and 35 days post-injury using immunohistochemistry and markers for microglia, astrocytes, and senescence. Compared tonaïve animals, injured mice showed an increased microglial and astrocytic reaction early post-injury, as reflected in Iba1 and GFAP markers, respectively; the GFAP increase persisted in the later phase. The senescence analysis showed a significant increase inγH2AX-53BP1 nuclear foci, 8-oxoguanine, p19ARF, p16INK4a, and p53 expression in naïve vs. sham groups and naïve vs. CCI groups, at 5 dpi. At 35 days, the difference was no longer statistically significant in all markers. The injury induced a decrease p21 expression vs. the naïve group, at 35 dpi. These results indicate the induction of a complex senescence response after immature brain injury. Some changes occur early and may reflect the activation/proliferation of non-neuronal cells post-injury that had been hindered, whereas changes such as p21 downregulation may reflect a delayed response and pro-repair processes.

Keywords: cellular senescence, traumatic brain injury, brain injury, controlled cortical impact

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Authors: Eva Tvrdá, Boris Botman, Marek Halenár, Tomáš Slanina, Norbert Lukáč

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In vitro storage and processing of animal semen represents a risk factor to spermatozoa vitality, potentially leading to reduced fertility. A variety of substances isolated from natural sources may exhibit protective or antioxidant properties on the spermatozoon, thus extending the lifespan of stored ejaculates. This study compared the ability of different concentrations of the Salvia officinalis extract on the motility, mitochondrial activity, viability and reactive oxygen species (ROS) production by bovine spermatozoa during different time periods (0, 2, 6 and 24 h) of in vitro culture. Spermatozoa motility was assessed using the Computer-assisted sperm analysis (CASA) system. Cell viability was examined using the metabolic activity MTT assay, the eosin-nigrosin staining technique was used to evaluate the sperm viability and ROS generation was quantified using luminometry. The CASA analysis revealed that the motility in the experimental groups supplemented with 0.5-2 µg/mL Salvia extract was significantly lower in comparison with the control (P<0.05; Time 24 h). At the same time, a long-term exposure of spermatozoa to concentrations ranging between 0.05 µg/mL and 2 µg/mL had a negative impact on the mitochondrial metabolism (P<0.05; Time 24 h). The viability staining revealed that 0.001-1 µg/mL Salvia extract had no effects on bovine male gametes, however 2 µg/mL Salvia had a persisting negative effect on spermatozoa (P<0.05). Furthermore 0.05-2 µg/mL Salvia exhibited an immediate ROS-promoting effect on the sperm culture (P>0.05; Time 0 h and 2 h), which remained significant throughout the entire in vitro culture (P<0.05; Time 24 h). Our results point out to the necessity to examine specific effects the biomolecules present in Salvia officinalis may have individually or collectively on the in vitro sperm vitality and oxidative profile.

Keywords: bulls, CASA, MTT test, reactive oxygen species, sage, Salvia officinalis, spermatozoa

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Authors: Svetlana Bialkova, Marnix van Gisbergen

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Advanced Virtual Reality (VR) technologies offer compelling multisensory and interactive experiences applicable in various fields from education to entertainment. However, serious VR applications within the financial sector are scarce, and managing ‘real’ business services with(in) VR is a challenge inviting further investigation. The current research addresses this challenge, by exploring the key parameters influencing the VR business power and the development of appropriate VR applications in real financial business. We conducted profound investigation of both B2B and B2C needs, and how these could be met. In three studies, we have approached experts from leading international banks (finance to computer specialists), and their (potential) customers. Study 1 included focus group discussions with experts. First, participants could experience different VR devices such as Samsung Gear VR, then a structured discussion was held. The outcomes are analyzed and summarized in a portfolio. Study 2 further used the portfolio analyzer to profile the management of real business services with(in) VR. Again experts participated, where first being introduced with Samsung Gear, then experiencing it and being interviewed. Based on the outcomes, a survey was developed to interview (potential) customers and test ideas created (Study 3). The results suggest that developing proper system architectures to connect people and to connect devices is crucial for building up powerful business with(in) VR. From one side, connecting devices, e.g., pairing mobile Head Mounted Displays for VR with smart-phones and/or wearable technologies would be appropriate way “to have” customers anywhere, anytime with a brand and/or business. Developing VR Apps, providing detailed real time visualization of performance and infrastructure types could enable 3D VR navigation, 3D contents viewing, but also being opportunity for connecting people in collaborative platforms. The outcomes of the current research are summarized in a model which could be applied to unlock the real business power of VR.

Keywords: business power, B2B, B2C, VR applications

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Authors: N. Agon, T. Kavka, J. Vierendeels, M. Hrabovský, G. Van Oost

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A plasma jet model was developed with a rigorous method for calculating the thermophysical properties of the gas mixture without mixing rules. A simplified model approach to account for the anode effects was incorporated in this model to allow the valorization of the simulations with experimental results. The radial heat transfer was under-predicted by the model because of the limitations of the radiation model, but the calculated evolution of centerline temperature, velocity and gas composition downstream of the torch exit corresponded well with the measured values. The CFD modeling of thermal plasmas is either focused on development of the plasma arc or the flow of the plasma jet outside of the plasma torch. In the former case, the Maxwell equations are coupled with the Navier-Stokes equations to account for electromagnetic effects which control the movements of the anode arc attachment. In plasma jet simulations, however, the computational domain starts from the exit nozzle of the plasma torch and the influence of the arc attachment fluctuations on the plasma jet flow field is not included in the calculations. In that case, the thermal plasma flow is described by temperature, velocity and concentration profiles at the torch exit nozzle and no electromagnetic effects are taken into account. This simplified approach is widely used in literature and generally acceptable for plasma torches with a circular anode inside the torch chamber. The unique DC hybrid water/gas-stabilized plasma torch developed at the Institute of Plasma Physics of the Czech Academy of Sciences on the other hand, consists of a rotating anode disk, located outside of the torch chamber. Neglecting the effects of the anode arc attachment downstream of the torch exit nozzle leads to erroneous predictions of the flow field. With the simplified approach introduced in this model, the Joule heating between the exit nozzle and the anode attachment position of the plasma arc is modeled by a volume heat source and the jet deflection caused by the anode processes by a momentum source at the anode surface. Furthermore, radiation effects are included by the net emission coefficient (NEC) method and diffusion is modeled with the combined diffusion coefficient method. The time-averaged simulation results are compared with numerous experimental measurements. The radial temperature profiles were obtained by spectroscopic measurements at different axial positions downstream of the exit nozzle. The velocity profiles were evaluated from the time-dependent evolution of flow structures, recorded by photodiode arrays. The shape of the plasma jet was compared with charge-coupled device (CCD) camera pictures. In the cooler regions, the temperature was measured by enthalpy probe downstream of the exit nozzle and by thermocouples in radial direction around the torch nozzle. The model results correspond well with the experimental measurements. The decrease in centerline temperature and velocity is predicted within an acceptable range and the shape of the jet closely resembles the jet structure in the recorded images. The temperatures at the edge of the jet are underestimated due to the absence of radial radiative heat transfer in the model.

Keywords: anode arc attachment, CFD modeling, experimental comparison, thermal plasma jet

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Authors: Sweta Sinha

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Rapid evolution of technology has changed language pedagogy as well as perspectives on language use, leading to strategic changes in discourse studies. We are now firmly embedded in a time when digital technologies have become an integral part of our daily lives. This has led to generalized approaches to English Language Teaching (ELT) which has raised two-pronged concerns in linguistically diverse settings: a) the diverse linguistic background of the learner might interfere/ intervene with the learning process and b) the differential level of already acquired knowledge of target language might make the classroom practices too easy or too difficult for the target group of learners. ELT needs a more systematic and differential pedagogical approach for greater efficiency and accuracy. The present research analyses the need of identifying learner groups based on different levels of target language proficiency based on a longitudinal study done on 150 undergraduate students. The learners were divided into five groups based on their performance on a twenty point scale in Listening Speaking Reading and Writing (LSRW). The groups were then subjected to varying durations of technology aided language learning sessions and their performance was recorded again on the same scale. Identifying groups and introducing differential teaching and learning strategies led to better results compared to generalized teaching strategies. Language teaching includes different aspects: the organizational, the technological, the sociological, the psychological, the pedagogical and the linguistic. And a facilitator must account for all these aspects in a carefully devised differential approach meeting the challenge of learner diversity. Apart from the justification of the formation of differential groups the paper attempts to devise framework to account for all these aspects in order to make ELT in multilingual setting much more effective.

Keywords: differential groups, English language teaching, language pedagogy, multilingualism, technology aided language learning

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Authors: Manar Al-Ateeq

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The building construction industry plays a major role in the economy of the word and the state of Kuwait. This paper evaluates existing new civil site engineers, describes a new system for improvement and insures the importance of prequalifying and developing for new engineers. In order to have a strong base in engineering, educational institutes and workplaces should be responsible to continuously train engineers and update them with new methods and techniques in engineering. As to achieve that, school of engineering should constantly update computational resources to be used in the professions. A survey was prepared for graduated Engineers based on stated objectives to understand the status of graduate engineers in both the public and private sector. Interviews were made with different sectors in Kuwait, and several visits were made to different training centers within different workplaces in Kuwait to evaluate training process and try to improve it. Virtual Reality (VR) technology could be applied as a complement to three-dimensional (3D) modeling, leading to better communication whether in job training, in education or in professional practice. Techniques of 3D modeling and VR can be applied to develop the models related to the construction process. The 3D models can support rehabilitation design as it can be considered as a great tool for monitoring failure and defaults in structures; also it can support decisions based on the visual analyses of alternative solutions. Therefore, teaching computer-aided design (CAD) and VR techniques in school will help engineering students in order to prepare them to site work and also will assist them to consider these technologies as important supports in their later professional practice. This teaching technique will show how the construction works developed, allow the visual simulation of progression of each type of work and help them to know more about the necessary equipment needed for tasks and how it works on site.

Keywords: three dimensional modeling (3DM), civil engineers (CE), professional practice (PP), virtual reality (VR)

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Authors: Adrián P. Gómez Mañas

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Autonomous vehicles have already transformed urban policies and cities. This is the main assumption of our research, which aims to understand how the representations of the possible arrival of autonomous vehicles already transform priorities or actions in transport and more largely, urban policies. This research is done within the framework of a Ph.D. doctorate directed by Professor Xavier Desjardins at the Sorbonne University of Paris. Our hypotheses are: (i) the perspectives, representations, and imaginaries on autonomous vehicles already affect the stakeholders of urban policies; (ii) the discourses on the opportunities or threats of autonomous vehicles reflect the current strategies of the stakeholders. Each stakeholder tries to integrate a discourse on autonomous vehicles that allows them to change as little as possible their current tactics and strategies. The objective is to eventually make a comparison between three different cases: Paris, United Arab Emirates, and Bogota. We chose those territories because their contexts are very different, but they all have important interests in mobility and innovation, and they all have started to reflect on the subject of self-driving mobility. The main methodology used is to interview actors of the metropolitan area (local officials, leading urban and transport planners, influent experts, and private companies). This work is supplemented with conferences, official documents, press articles, and websites. The objective is to understand: 1) What they know about autonomous vehicles and where does their knowledge come from; 2) What they expect from autonomous vehicles; 3) How their ideas about autonomous vehicles are transforming their action and strategy in managing daily mobility, investing in transport, designing public spaces and urban planning. We are going to present the research and some preliminary results; we will show that autonomous vehicles are often viewed by public authorities as a lever to reach something else. We will also present that speeches are very influenced by local context (political, geographical, economic, etc.), creating an interesting balance between global and local influences. We will analyze the differences and similarities between the three cases and will try to understand which are the causes.

Keywords: autonomous vehicles, self-driving mobility, urban planning, urban mobility, transport, public policies

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Authors: Arman Kishan, Mark Haft, Steve Li, Duc Nguyen, Dawn Laporte

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Objective: Patients with Type 2 diabetes (T2DM) often face higher postoperative complication rates. Limited data exist on outcomes in T2DM patients undergoing carpal tunnel release (CTR). This study aims to compare complication rates between endoscopic CTR (ECTR) and open CTR (OCTR) in patients with T2DM. Methods: This was a retrospective cohort study using the TriNetX database of 56741 patients with T2DM undergoing ECTR (N= 14,949) or OCTR (N= 41,792). Demographic data, medical comorbidities, and complication rates were analyzed. We used multivariable analysis to identify differences in postoperative complication rates between the two treatment methods in patients with T2DM. Results: Patients with T2DM undergoing ECTR had a significantly lower incidence of 90-day wound infection (p < 0.001), 90-day wound dehiscence (p < 0.001), and nerve injury (p < 0.001) when compared to patients who underwent OCTR. After matching, there was a significantly higher number of T2DM patients undergoing ECTR who had peripheral vascular disease (p = 0.045) and hypertension (p = 0.020) when compared to the OCTR group. These patients also had a lower incidence of fluid and electrolyte disorders (p = 0.002) and chronic blood loss anemia (p = 0.025). Conclusion: ECTR presents a superior choice for T2DM patients undergoing CTR, yielding significantly lower rates of wound infection, wound dehiscence, and nerve injury within 90 days post-surgery—reducing the risk by 31%, 48%, and 59%, respectively. These findings support the adoption of ECTR as the preferred method in this patient population, potentially leading to improved postoperative outcomes.

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, carpal tunnel syndrome, postoperative complications in patients with diabetes mellitus

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Authors: Flora Tajiki

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Infertility is a pervasive issue affecting women globally, profoundly impacting their psychological well-being and quality of life. This case study traces the six-year journey of a 35-year-old Iranian woman who married at 29 and grappled with infertility and premature menopause. Three years post-marriage, her initial pregnancy resulted in a miscarriage, followed by a year without successful conception. Diagnostic evaluations revealed small ovaries and a low AMH level of 0.19, leading to a diagnosis of premature menopause. Despite her primary therapist's recommendation to use a donated egg, she opted to pursue a comprehensive lifestyle modification approach through remote consultation with the author. The regimen encompassed regular physical activity, weight management, stress control, sleep regulation, meditation, abdominal massages, diaphragmatic breathing, and dietary changes toward a high-protein, low-carbohydrate diet. The recommended diet included nuts such as almonds and pistachios, as well as sprouted grains like wheat and mung beans. She was further advised to maintain adequate hydration and eliminate sugar, milk, preservatives, and processed foods. Regular follow-ups were conducted. Approximately three months into the regimen, the lifestyle overhaul led to a weight reduction from 99 kg to 89 kg and improved stress management. Remarkably, despite a continued decrease in AMH levels, she conceived naturally four months after adopting these lifestyle changes and is now the mother of a healthy 10-month-old girl. Similar cases under this healthy lifestyle approach, despite having low AMH levels, also resulted in successful pregnancies without IVF or hormone therapy. This underscores that AMH levels are not the sole determinant of fertility and that lifestyle modifications can play a significant role in overcoming infertility and achieving natural conception.

Keywords: egg donation, infertility, lifestyle Modification, natural conception, premature menopause

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Authors: Noemi Schneider, Richard Blaese, Pietro Morandi, Brigitte Liebig

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While women are increasingly frequent among the founders of innovative companies and advanced researchers in many university research institutes today, they are still an exception among initiators of research-based spin-offs. This also applies to countries such as Switzerland, which does have a leading position in international innovation rankings. Starting from a gender-sensitive neo-institutionalist perspective, this paper examines formal and non-formal institutional framework conditions for academic spin-offs at Swiss universities of applied sciences. This field, which stresses vocational education and practice-oriented research, seems to conserve the gender gap in the area of establishing research-based spin-offs spin-off rates strongly. The analysis starts from a survey conducted in 2017 and 2018 at all seven public universities of applied sciences in Switzerland as well as on an evaluation of expert interviews performed with heads of start-up centers, where also spin-offs from universities of applied sciences get support. The results show the mechanisms, which contribute to gender gaps in academic entrepreneurship in higher education. University's female employees have hardly been discovered as target groups. Thus, only 10.5% of universities of applied sciences offer specific support measures for women in academia. And only 1 out of 7 universities of applied sciences offer mentoring programs for female entrepreneurs while in addition there are no financial resources available to support female founders in academia. Moreover, the awareness of the gender gap in academic entrepreneurship is low among founding commissioners. A consistent transfer strategy might be key for bringing in line the formal and non-formal preconditions relevant for the formation of research-based spin-offs and for providing an effective incentive structure to promote women.

Keywords: gender, science-based spin-off, universities of applied sciences, knowledge transfer strategy

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Authors: Mattahias Maj, Fabio Tatzgern, Karl Adam, Damir Kahrimanovic, Markus Varga

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Torpedo ladles are necessary transport carriages in steel production to move the molten crude iron from the blast furnace to the steel refining plant. This requires the ladles to be high temperature resistant and insulate well to preserve the temperature and hold the risk of solidification at bay. Therefore, the involved refractories lining the inside of the torpedo ladles are chosen mostly according to their thermal properties, although wear of the materials by the liquid iron is also of major importance. In this work, we combined investigations of the thermal behaviour with wear studies of the lining over the whole lifetime of a torpedo ladle. Additional numerical simulations enabled a detailed model of the mechanical loads and temperature propagation at the various stations (heating, filling, emptying, cooling). The core of the investigation were detailed 3D measurements of the ladle’s cavity and thereby quantitative information of the wear progress at different time intervals during the lifetime of the ladles. The measurements allowed for a separation of different wear zones according to severity, namely the “splash zone” where the melt directly hits the ladle, the “melt zone” where during transport always liquid melt is present, and the “slag zone”, where the slag floats on the melt causing the most severe wear loss. Numerical simulations of the filling process were taken to calculate stress levels and temperature gradients, which led to the different onset of wear on those zones. Thermal imaging and punctual temperature measurements allowed for a study of the thermal consequences entailed by the wear onset. Additional “classical” damage analysis of the worn refractories complete the investigation. Thereby the wear mechanisms leading to the substantial wear loss were disclosed.

Keywords: high temperature, tribology, liquid-solid interaction, refractories, thermography

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Authors: Vijaya Nhaloor, Suja Kumari Leela, Jose Devadasan

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Planning of neighbourhood development strategies in Tier 2 Indian city is highly significant when it has also been selected as a Smart city by the Ministry of Urban Development in India. Smart city mission of India proposes the development of infrastructure in a city in an inclusive way. Thiruvananthapuram, the capital city of Kerala state, India, has been selected as the city to conduct the research. The master plan for the city of Thiruvananthapuram envisions it as a Compact city and proposes densification as a tool for development. Densification may adversely affect the quality of life after a tipping point. This may lead to urban decay which in turn directly or indirectly affects the surrounding neighbourhoods also, thus spreading blight areas in the city. The author thinks that density in urban planning is not a well detailed subject in India, with respect to its varied links on infrastructure, quality of life, transportation, scope of vertical planning, affordability etc. Neighbourhoods are vital tissues of an urban area, and their development directly affects the development of the region. The methodology would involve skimming of proactive neighbourhood planning principles compatible with the Smart city mission in India. United Nations proposes sustainability as a way of planning development of a neighbourhood. After defining various terminologies involved, a framework shall be developed to analyse an existing neighbourhood and prepare planning guidelines in a sustainable manner. The framework shall comply with international and national policy guidelines. The research shall explore and identify a neighbourhood with the potential to meet the housing demand from the investment regions nearby and analyse its potential and weakness as per this framework. Later, a set of indicators shall be enlisted to guide the development of the neighbourhood, leading to recommendations that shall serve as a replicable model for the other neighbourhoods in the Smart city.

Keywords: key indicators, neighbourhood planning, sustainability, smart city

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Authors: Ru-Yu Lien, Shih-Hsin Hung, Shu-Fen Lu, Ju-Jen Shie, Wen-Ju Yang, Yuann-Meei Tzeng, Chien-Ying Wang

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Background: The quality of care in intensive care units (ICUs) is crucial, especially for terminally ill patients. Shared decision-making (SDM) with families is essential to ensure appropriate care and reduce suffering. Aim: This study explores the effectiveness of an end-of-life decision support Patient Decision Aid (PDA) in an ICU setting. Methods: This study employed a cross-sectional research design conducted in an ICU from August 2020 to June 2023. Participants included family members of end-of-life patients aged 20 or older. A total of 319 participants. Family members of end-of-life patients received the PDA, and data were collected after they made medical decisions. Data collection involved providing family members with a PDA during family meetings. A post-PDA questionnaire with 17 questions assessed PDA effectiveness and anxiety levels. Statistical analysis was performed using SPSS 22.0. Results: The PDA significantly reduced anxiety levels among family members (p < 0.001). It helped them organize their thoughts, prepare for discussions with doctors, and understand critical decision factors. Most importantly, it influenced decision outcomes, with a shift towards palliative care and withdrawal of life-sustaining treatment. Conclusion: This study highlights the importance of family-centered end-of-life care in ICUs. PDAs promote informed decision-making, reduce conflicts, and enhance patient and family involvement. These tools align patient values and goals with medical recommendations, ultimately leading to decisions that prioritize comfort and quality of life. Implementing PDAs in healthcare systems can ensure that patients' care aligns with their values.

Keywords: shared decision-making, patient decision aid, end-of-life care, intensive care unit, family-centered care

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Authors: Edison E. Haro, Akindele G. Odeshi, Jerzy A. Szpunar

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Hybrid bio-composites are developed for use in protective armor through positive hybridization offered by reinforcement of high-density polyethylene (HDPE) with Kevlar short fibers and palm wood micro-fillers. The manufacturing process involved a combination of extrusion and compression molding techniques. The mechanical behavior of Kevlar fiber reinforced HDPE with and without palm wood filler additions are compared. The effect of the weight fraction of the added palm wood micro-fillers is also determined. The Young modulus was found to increase as the weight fraction of organic micro-particles increased. However, the flexural strength decreased with increasing weight fraction of added micro-fillers. The interfacial interactions between the components were investigated using scanning electron microscopy. The influence of the size, random alignment and distribution of the natural micro-particles was evaluated. Ballistic impact and dynamic shock loading tests were performed to determine the optimum proportion of Kevlar short fibers and organic micro-fillers needed to improve impact strength of the HDPE. These results indicate a positive hybridization by deposition of organic micro-fillers on the surface of short Kevlar fibers used in reinforcing the thermoplastic matrix leading to enhancement of the mechanical strength and dynamic impact behavior of these materials. Therefore, these hybrid bio-composites can be promising materials for different applications against high velocity impacts.

Keywords: hybrid bio-composites, organic nano-fillers, dynamic shocking loading, ballistic impacts, energy absorption

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Authors: Susan Lanz, Gary T. Burke, Omid Omidvar

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The intention to transfer ownership control across family generations is acknowledged to be central to developing a theoretical understanding of how family businesses differ and are distinct as a business group. However, in practice, most business-owning families face challenges to transfer their business ownership from one family generation to the next. To date, researchers have paid little attention to how and when ownership is passed across family generations and what the dynamics of such transitions are. This is primarily due to the prevailing assumption that ownership transfer is an unimportant and legalistic issue that occurs within a wider family management succession process. Yet, the limited evidence available suggests that family ownership transfer occurs inside and outside of the management succession process and is a difficult process for business-owning families to navigate. As a result, many otherwise viable family businesses are closing, leading to unnecessary loss of jobs and knowledge. This qualitative paper examines how family members understand and navigate the ownership transfer process. This study uses an inductive qualitative research design, conducted through in-depth interviews within eight business-owning families. It draws on family development theory and shows how a wide range of family-related events and dynamics outside of family business involvement underlie and shape the ownership transfer process. The findings extend the theory on how these events trigger ownership transfer and how they shape the ownership meanings held within business-owning families. This study found that ownership transfer meanings extend beyond that of transferring the legal control and financial appropriation rights of shareholders. The study concludes there are three different stages in the process of ownership transfer -symbolic, re-balancing, and protectionist. Each stage creates distinct family social constructions of the rights of family members to hold business ownership, and each stage occurs within a specific family development phase.

Keywords: business-owning family, family development theory, ownership transfer, process

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Authors: I. Benhsine, M. Hellou, F. Lominé, Y. Roques

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During the manufacture of fertilizer, it is necessary to add water for granulation purposes. The water content is then removed or reduced using rotary dryers. They are commonly used to dry wet granular materials and they are usually fitted with lifting flights. The transport of granular materials occurs when particles cascade from the lifting flights and fall into the air stream. Each cascade consists of a lifting and a falling cycle. Lifting flights are thus of great importance for the transport of granular materials along the dryer. They also enhance the contact between solid particles and the air stream. Optimization of the drying process needs an understanding of the behavior of granular materials inside a rotary dryer. Different approaches exist to study the movement of granular materials inside the dryer. Most common of them are based on empirical formulations or on study the movement of the bulk material. In the present work, we are interested in the behavior of each particle in the cross section of the dryer using Discrete Element Method (DEM) to understand. In this paper, we focus on studying the hold-up, the cascade patterns, the falling time and the falling length of the particles leaving the flights. We will be using two segment flights. Three different profiles are used: a straight flight (180° between both segments), an angled flight (with an angle of 150°), and a right-angled flight (90°). The profile of the flight affects significantly the movement of the particles in the dryer. Changing the flight angle changes the flight capacity which leads to different discharging profile of the flight, thus affecting the hold-up in the flight. When the angle of the flight is reduced, the range of the discharge angle increases leading to a more uniformed cascade pattern in time. The falling length and the falling time of the particles also increase up to a maximum value then they start decreasing. Moreover, the results show an increase in the falling length and the falling time up to 70% and 50%, respectively, when using a right-angled flight instead of a straight one.

Keywords: discrete element method, granular materials, lifting flight, rotary dryer

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Authors: Lucia Liu, Matthew Koziol

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Obsessive-compulsive disorder (OCD), a long-lasting anxiety disorder involving recurrent, intrusive thoughts, affects over 2 million adults in the United States. Transcranial magnetic stimulation (TMS) stands out as a noninvasive, cutting-edge therapy that has been shown to reduce symptoms in patients with treatment-resistant OCD. The Food and Drug Administration (FDA) approved protocol pairs TMS sessions with individualized symptom provocation, aiming to improve the susceptibility of brain circuits to stimulation. However, limited standardization or guidance exists on how to conduct symptom provocation and which methods are most effective. This study aims to compare the effect of internal versus external techniques to induce obsessional stress in a clinical setting during TMS therapy. Two symptom provocation methods, (i) Asking patients thought-provoking questions about their obsessions (internal) and (ii) Requesting patients to perform obsession-related tasks (external), were employed in a crossover design with repeated measurement. Thirty-six treatments of NeuroStar TMS were administered to each of two patients over 8 weeks in an outpatient clinic. Patient One received 18 sessions of internal provocation followed by 18 sessions of external provocation, while Patient Two received 18 sessions of external provocation followed by 18 sessions of internal provocation. The primary outcome was the level of self-reported obsessional stress on a visual analog scale from 1 to 10. The secondary outcome was self-reported OCD severity, collected biweekly in a four-level Likert-scale (1 to 4) of bad, fair, good and excellent. Outcomes were compared and tested between provocation arms through repeated measures ANOVA, accounting for intra-patient correlations. Ages were 42 for Patient One (male, White) and 57 for Patient Two (male, White). Both patients had similar moderate symptoms at baseline, as determined through the Yale-Brown Obsessive Compulsive Scale (YBOCS). When comparing obsessional stress induced across the two arms of internal and external provocation methods, the mean (SD) was 6.03 (1.18) for internal and 4.01 (1.28) for external strategies (P=0.0019); ranges were 3 to 8 for internal and 2 to 8 for external strategies. Internal provocation yielded 5 (31.25%) bad, 6 (33.33%) fair, 3 (18.75%) good, and 2 (12.5%) excellent responses for OCD status, while external provocation yielded 5 (31.25%) bad, 9 (56.25%) fair, 1 (6.25%) good, and 1 (6.25%) excellent responses (P=0.58). Internal symptom provocation tactics had a significantly stronger impact on inducing obsessional stress and led to better OCD status (non-significant). This could be attributed to the fact that answering questions may prompt patients to reflect more on their lived experiences and struggles with OCD. In the future, clinical trials with larger sample sizes are warranted to validate this finding. Results support the increased integration of internal methods into structured provocation protocols, potentially reducing the time required for provocation and achieving greater treatment response to TMS.

Keywords: obsessive-compulsive disorder, transcranial magnetic stimulation, mental health, symptom provocation

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Authors: Danila Zuffetti, Lorenzo Chiesa

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Background: A hospice narrative interview aims at putting the sick at the core of disease and treatment allowing them to explore their most intimate facets. The aim of this work is to favor authentic narration by leading towards awareness and acceptance of terminality and to face death with serenity. Narration in palliative care aims at helping to reduce the chaos generated by the disease and to elaborate interpretations on the course of reality, besides, the narration delivered to the doctor is fundamental and communicates the meaning given to symptoms. Methods: The narrative interview has become a regular activity in the Castellini Foundation since 2017. Patients take part every week, and for more days, in one hour sessions, in a welcoming and empathic setting and the interaction with the operator leads to a gradual awareness of their terminality. Patients are submitted with free answer questions with the purpose of facilitating and stimulating self-narration. Narration has not always been linear, but patients are left free to shift in time to revisit their disease process by making use of different tools, such as digital storytelling. Results: The answers provided by the patients show to which extent the narrative interview is an instrument allowing the analysis of the stories and gives the possibility to better understand and deepen the different implications of patient and caregiver’s background. Conclusion: The narration work in the hospice demonstrates that narrative medicine is an added value. This instrument has proven useful not only in the support of patients but also for the palliative doctor to identify wishes for accompanying them to the end with dignity and serenity. The narrative interview favors the construction of an authentic therapeutic relationship. The sick are taken wholly in charge, and they are guaranteed a high quality of life until their very last instant.

Keywords: construction of an authentic therapy relationship, gradual awareness of their terminality, narrative interview, reduce the chaos generated by the desease

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