Search results for: clinical guidelines

Authors: Rahul Agarwal, Ashutosh Singh

Abstract:

Colorectal cancer (CRC) also refers as bowel cancer or colon cancer. It involves the development of abnormal growth of cells in colon or rectum part of the body. This work leads to the development of a miRNA database in colorectal cancer. We named this database- miCoRe. This database comprises of all validated colon-rectal cancer miRNAs information from various published literature with an effectual knowledge based information retrieval system. miRNAs have been collected from various published literature reports. MySQL is used for main-framework of miCoRe while the front-end was developed in PHP script. The aim of developing miCoRe is to create a comprehensive central repository of colorectal carcinoma miRNAs with all germane information of miRNAs and their target genes. The current version of miCoRe consists of 238 miRNAs which are known to be implicated in malignancy of CRC. Alongside with miRNA information, miCoRe also contains the information related to the target genes of these miRNA. miCoRe furnishes the information about the mechanism of incidence and progression of the disease, which would further help the researchers to look for colorectal specific miRNAs therapies and CRC specific targeted drug designing. Moreover, it will also help in development of biomarkers for the better and early detection of CRC and will help in better clinical management of the disease.

Keywords: colorectal cancer, database, miCoRe, miRNAs

Procedia PDF Downloads 278

Authors: Shivalaxmi Arumugham

Abstract:

Child sexual abuse (CSA) has taken several forms, particularly with the advent of internet technologies that provide pedophiles access to their targets anonymously at an affordable rate. To combat CSA which has far-reaching consequences on the physical and psychological health of the victims, a special act, the Protection of Children from Sexual Offences (POCSO) Act, was formulated amongst the existing laws. With its latest amendment criminalizing various online activities about child pornography also known as child sexual abuse materials in 2019, tremendous pressure is speculated on law enforcement to identify offenders online. Effective investigations of CSA cases help in not only to detect perpetrators but also in preventing the re-victimization of children. Understanding the vulnerability of the child population and that the offenders continue to develop stealthier strategies to operate, it is high time that traditional investigation, where the focus is on apprehending and prosecuting the offender, must make a paradigm shift to proactively investigate to prevent victimization at the first place. One of the proactive policing techniques involves understanding the psychology of the offenders and children and operating undercover to catch the criminals before a real child is victimized. With the fundamental descriptive approach to research, the article attempts to identify the multitude of issues associated with the investigation of child sexual abuse cases currently in practice in India. Then, the article contextualizes the various covert operations carried out by numerous law enforcement agencies across the globe. To provide this comprehensive overview, the paper examines various reports, websites, guidelines, protocols, judicial pronouncements, and research articles. Finally, the paper presents the challenges and ethical issues that are to be considered before getting into undercover operations either in the guise of a pedophile or as a child. The research hopes to contribute to the making of standard operating protocols for investigation officers and other relevant policymakers in this regard.

Keywords: child sexual abuse, cybercrime against children, covert police operations, investigation of CSA

Procedia PDF Downloads 97

Authors: Badar Dhehawi A. Aldhafeeri

Abstract:

Objective: To explore the views and experiences of healthcare providers (HCPs) and their expectations toward pharmacists in mental healthcare, in addition to their acceptance of new pharmacist roles. Barriers and facilitators that are emerging in the process of developing enhanced pharmacist-related roles were also explored. Methods: Qualitative semi-structured face-to-face interviews were conducted with HCPs who had worked in mental health services in Saudi Arabia. The data were thematically analysed using a constant comparison with NVivo software to develop a series of key themes from the interviews. Results: Most HCPs indicated that they rarely interacted with pharmacists. They expected pharmacists to educate both patients and other healthcare workers in the future. Concerns were raised regarding inadequate pharmacy education and lack of clinical training for pharmacists. Conclusion: This study revealed that interactions between HCPs and pharmacists concerning mental health are still limited. A communication strategy for addressing mental health issues should be developed among pharmacists and other HCPs.

Keywords: pharmacist, pharmacy student, saudi arabia, qualitative research

Procedia PDF Downloads 96

Authors: Romel Cordova Shedan

Abstract:

The traditional seismic design is the methodology of Forced Based Design (FBD). The Displacement Based Design (DBD) is a seismic design that considers structural damage to achieve a failure mechanism of the structure before the collapse. It is easier to quantify damage of a structure with displacements rather than forces. Therefore, a structure to achieve an inelastic displacement design with good ductility, it is necessary to be damaged. The first part of this investigation is about differences between the methodologies of DBD and FBD with some DBD advantages. In the second part, there is a study case about a dual building 5-story, which is regular in plan and elevation. The building is located in a seismic zone, which acceleration in firm soil is 45% of the acceleration of gravity. Then it is applied both methodologies into the study case to compare its displacements, shear forces and overturning moments. In the third part, the Dynamic Time History Analysis (DTHA) is done, to compare displacements with DBD and FBD methodologies. Three accelerograms were used and the magnitude of the acceleration scaled to be spectrum compatible with design spectrum. Then, using ASCE 41-13 guidelines, the hinge plastics were assigned to structure. Finally, both methodologies results about study case are compared. It is important to take into account that the seismic performance level of the building for DBD is greater than FBD method. This is due to drifts of DBD are in the order of 2.0% and 2.5% comparing with FBD drifts of 0.7%. Therefore, displacements of DBD is greater than the FBD method. Shear forces of DBD result greater than FBD methodology. These strengths of DBD method ensures that structure achieves design inelastic displacements, because those strengths were obtained due to a displacement spectrum reduction factor which depends on damping and ductility of the dual system. Also, the displacements for the study case for DBD results to be greater than FBD and DTHA. In that way, it proves that the seismic performance level of the building for DBD is greater than FBD method. Due to drifts of DBD which are in the order of 2.0% and 2.5% compared with little FBD drifts of 0.7%.

Keywords: displacement-based design, displacement spectrum reduction factor, dynamic time history analysis, forced based design

Procedia PDF Downloads 229

Authors: Randa M. Ali, Naguiba F. Loutfy, Osama M. Awad

Abstract:

Background: Leishmaniasis is a worldwide disease, affecting 88 countries, it is estimated that about 350 million people are at risk of leishmaniasis. Overall prevalence is 12 million people with annual mortality of about 60,000. Annual incidence is 1,500,000 cases of cutaneous leishmaniasis (CL) worldwide and half million cases of visceral Leishmaniasis (VL). Objectives: The objective of this study was to assess primary health care physicians knowledge (PHP) and attitude about leishmaniasis and to assess awareness of local inhabitants about the disease and its vector in four areas in west Alexandria, Egypt. Methods: This study was a cross sectional survey that was conducted in four PHC units in west Alexandria. All physicians currently working in these units during the study period were invited to participate in the study, only 20 PHP completed the questionnaire. 60 local inhabitant were selected randomly from the four areas of the study, 15 from each area; Data was collected through two different specially designed questionnaires. Results: 11(55%) percent of the physicians had satisfactory knowledge, they answered more than 9 (60%) questions out of a total 14 questions about leishmaniasis and sandfly. The second part of the questionnaire is concerned with attitude of the primary health care physicians about leishmaniasis, 17 (85%) had good attitude and 3 (15%) had poor attitude. The second questionnaire showed that the awareness of local inhabitants about leishmaniasis and sandly as a vector of the disease is poor and needs to be corrected. Most of the respondents (90%) had not heard about leishmaniasis, Only 3 (5%) of the interviewed inhabitants said they know sandfly and its role in transmission of leishmaniasis. Conclusions: knowledge and attitudes of physicians are acceptable. However, there is, room for improvement and could be done through formal training courses and distribution of guidelines. In addition to raising the awareness of primary health care physicians about the importance of early detection and notification of cases of lesihmaniasis. Moreover, health education for raising awareness of the public regarding the vector and the disease is necessary because related studies have demonstrated that if the inhabitants do not perceive mosquitoes to be responsible for diseases such as malaria they do not take enough measures to protect themselves against the vector.

Keywords: leishmaniasis, PHP, knowledge, attitude, local inhabitants

Procedia PDF Downloads 449

Authors: Helen Pushkarskaya, Michael Smithson, Jane E. Joseph, Christine Corbly, Ifat Levy

Abstract:

Studies of decision making under uncertainty generally focus on imprecise information about outcome probabilities (“ambiguity”). It is not clear, however, whether conflicting information about outcome probabilities affects decision making in the same manner as ambiguity does. Here we combine functional Magnetic Resonance Imaging (fMRI) and a simple gamble design to study this question. In this design, the levels of ambiguity and conflict are parametrically varied, and ambiguity and conflict gambles are matched on both expected value and variance. Behaviorally, participants avoided conflict more than ambiguity, and attitudes toward ambiguity and conflict did not correlate across subjects. Neurally, regional brain activation was differentially modulated by ambiguity level and aversion to ambiguity and by conflict level and aversion to conflict. Activation in the medial prefrontal cortex was correlated with the level of ambiguity and with ambiguity aversion, whereas activation in the ventral striatum was correlated with the level of conflict and with conflict aversion. This novel double dissociation indicates that decision makers process imprecise and conflicting information differently, a finding that has important implications for basic and clinical research.

Keywords: decision making, uncertainty, ambiguity, conflict, fMRI

Procedia PDF Downloads 564

Authors: Tony Jehi, Sujatha Rajaram, Nader majzoub, Joan Sabate

Abstract:

Aging significantly increases the incidence of various cardiometabolic diseases, including cardiovascular disease (CVD). To combat CVD and its associated risk factors, it is imperative to adopt a healthy dietary pattern that is rife with beneficial nutrient and non-nutrient compounds. Unsaturated fats, specifically n-3 polyunsaturated fatty acids (n-3 PUFA), have cardio-protective effects; the opposite is true for saturated fatty acids. What role, if any, does the biomarker of fatty acid intake (specific fatty acids in the erythrocyte) play in predicting cardiometabolic risk among the elderly, a population highly susceptible to increased mortality and morbidity from CVD risk factors, remains unclear. This was a secondary analysis of the Walnuts and Healthy Aging Study. Briefly, elderly (n=192, mean age 69 y) participants followed their usual diet and were randomized into two groups to either eat walnuts daily or abstain from eating walnuts for a period of 2 years. The purpose was to identify potential associations between erythrocyte membrane fatty acids and cardiometabolic risk factors (body weight, blood pressure, blood lipids, and fasting glucose). Erythrocyte n-3 PUFA were inversely associated with total cholesterol (ß = -3.83; p= 0.02), triglycerides (ß = -7.66; p= <0.01), and fasting glucose (ß = -0.19; p=0.03). Specifically, erythrocyte ALA (ß= -1.59; P = 0.04) and DPA (ß= -0.62; P=0.04) were inversely associated with diastolic blood pressure and fasting glucose, respectively. N-6 PUFAs were positively associated with systolic blood pressure (ß=1.10; P=0.02). Mono-unsaturated fatty acids were positively associated with TAG (ß = 4.16; P=0.03). Total saturated fatty acids were not associated with any cardiometabolic risk factors. No association was found between any erythrocyte fatty acid and body weight. In conclusion, erythrocyte n-3 PUFA may be used as a biomarker to predict the cardiometabolic risk among healthy elders, providing support for the American Heart Association guidelines for including n-3 PUFA for preventing CVD.

Keywords: cardiometabolic diseases, erythrocyte fatty acids, elderly, n-3 PUFA

Procedia PDF Downloads 71

Authors: Suhathai Tosangwarn, Philip Clissett, Holly Blake

Abstract:

Background: High prevalence of depression has been reported among older adults living in care homes in Thailand, associated with physical impairment, low social support, low self-esteem and particularly stigma associated with living in a care home. However, little is understood about how such stigma is experienced among Thai care home residents. This study examines residents’ perceptions of stigma and their strategies for coping with stigma. Method/Design: Case study research was used to gain an in-depth view about the stigma of residents’ perspectives and experiences from two care homes in the northeast of Thailand by conducting an in-depth interview and non-participant observation. Qualitative interviews were conducted with 30 older residents (aged >60 years), purposively sampled from both care homes. Non-participant observation was conducted in various public spaces of the care homes, including the dining room, corridors, and activities areas for approximately one to two hours per day at different times; morning and afternoon including weekdays and weekend in both care homes for one month. Thematic analysis was used to analyse the data. Results: The study identified three major themes related to the causes of stigma, the reactions towards stigma and the mitigating factors. Negative beliefs about care homes, negative attitudes, and stereotypes toward the elderly and perceptions of unequal power relations between staff and residents were the main factors precipitating stigma. Consequently, residents exhibited negative emotions and behaviours, including depressive symptoms, while living in care homes. Residents reported the use of particular coping strategies, including accessing support from the public and staff and engaging in care home activities which these helped them to cope with their perception of stigma. Conclusion: Improved understanding of the underlying factors behind perceived stigma in care home residents may help to prevent depression and reduce perceptions of stigma associated with living in a care home, by informing strategy, supportive intervention and guidelines for appropriate care for older Thai residents.

Keywords: care home, depression, older adult, stigma, Thailand

Procedia PDF Downloads 454

Authors: Briohny H. Spencer, Russ Chess-Williams, Catherine McDermott, Shailendra Anoopkumar-Dukie, David Christie

Abstract:

Background: Prostate cancer is the second most common cancer diagnosed in men worldwide and the most prevalent in Australian men. In 2015, it was estimated that approximately 18,000 new cases of prostate cancer were diagnosed in Australia. Currently, for localised disease, androgen depravation therapy (ADT) and radiotherapy are a major part of the curative management of prostate cancer. ADT acts to reduce the levels of circulating androgens, primarily testosterone and the locally produced androgen, dihydrotestosterone (DHT), or by preventing the subsequent activation of the androgen receptor. Thus, the growth of the cancerous cells can be reduced or ceased. Radiation techniques such as brachytherapy (radiation delivered directly to the prostate by transperineal implant) or external beam radiation therapy (exposure to a sufficient dose of radiation aimed at eradicating malignant cells) are also common techniques used in the treatment of this condition. Radiotherapy (RT) has significant limitations, including reduced effectiveness in treating malignant cells present in hypoxic microenvironments leading to radio-resistance and poor clinical outcomes and also the significant side effects for the patients. Alpha1-adrenoceptor antagonists are used for many prostate cancer patients to control lower urinary tract symptoms, due to the progression of the disease itself or may arise as an adverse effect of the radiotherapy treatment. In Australia, a significant number (not a majority) of patients receive a α1-ADR antagonist and four drugs are available including prazosin, terazosin, alfuzosin and tamsulosin. There is currently limited published data on the effects of α1-ADR antagonists during radiotherapy, but it suggests these medications may improve patient outcomes by enhancing the effect of radiotherapy. Aim: To determine the impact of α1-ADR antagonists treatments on time to biochemical relapse following radiotherapy. Methods: A retrospective study of male patients receiving radiotherapy for biopsy-proven localised prostate cancer was undertaken to compare cancer outcomes for drug-naïve patients and those receiving α1-ADR antagonist treatments. Ethical approval for the collection of data at Genesis CancerCare QLD was obtained and biochemical relapse (defined by a PSA rise of >2ng/mL above the nadir) was recorded in months. Rates of biochemical relapse, prostate specific antigen doubling time (PSADT) and Kaplan-Meier survival curves were also compared. Treatment groups were those receiving α1-ADR antagonists treatment before or concurrent with their radiotherapy. Data was statistically analysed using One-way ANOVA and results expressed as mean ± standard deviation. Major findings: The mean time to biochemical relapse for tamsulosin, prazosin, alfuzosin and controls were 45.3±17.4 (n=36), 41.5±19.6 (n=11), 29.3±6.02 (n=6) and 36.5±17.6 (n=16) months respectively. Tamsulosin, prazosin but not alfuzosin delayed time to biochemical relapse although the differences were not statistically significant. Conclusion: Preliminary data for the prior and/or concurrent use of tamsulosin and prazosin showed a positive trend in delaying time to biochemical relapse although no statistical significance was shown. Larger clinical studies are indicated and with thousands of patient records yet to be analysed, it may determine if there is a significant effect of these drugs on control of prostate cancer.

Keywords: alpha1-adrenoceptor antagonists, biochemical relapse, prostate cancer, radiotherapy

Procedia PDF Downloads 374

Authors: Van Truong Pham

Abstract:

Background: Self-management was described as a potential strategy for blood pressure control in patients with hypertension. However, the effects of self-management interventions on blood pressure, self-efficacy, medication adherence, and body mass index (BMI) in older adults with hypertension have not been systematically evaluated. We evaluated the effects of self-management interventions on systolic blood pressure (SBP) and diastolic blood pressure (DBP), self-efficacy, medication adherence, and BMI in hypertensive older adults. Methods: We followed the recommended guidelines of preferred reporting items for systematic reviews and meta-analyses. Searches in electronic databases including CINAHL, Cochrane Library, Embase, Ovid-Medline, PubMed, Scopus, Web of Science, and other sources were performed to include all relevant studies up to April 2019. Studies selection, data extraction, and quality assessment were performed by two reviewers independently. We summarized intervention effects as Hedges' g values and 95% confidence intervals (CI) using a random-effects model. Data were analyzed using Comprehensive Meta-Analysis software 2.0. Results: Twelve randomized controlled trials met our inclusion criteria. The results revealed that self-management interventions significantly improved blood pressure control, self-efficacy, medication adherence, whereas the effect of self-management on BMI was not significant in older adult patients with hypertension. The following Hedges' g (effect size) values were obtained: SBP, -0.34 (95% CI, -0.51 to -0.17, p < 0.001); DBP, -0.18 (95% CI, -0.30 to -0.05, p < 0.001); self-efficacy, 0.93 (95%CI, 0.50 to 1.36, p < 0.001); medication adherence, 1.72 (95%CI, 0.44 to 3.00, p=0.008); and BMI, -0.57 (95%CI, -1.62 to 0.48, p = 0.286). Conclusions: Self-management interventions significantly improved blood pressure control, self-efficacy, and medication adherence. However, the effects of self-management on obesity control were not supported by the evidence. Healthcare providers should implement self-management interventions to strengthen patients' role in managing their health care.

Keywords: self-management, meta-analysis, blood pressure control, self-efficacy, medication adherence, body mass index

Procedia PDF Downloads 128

Authors: Duchel Jeanedvi Kinouani Kinavouidi, Christian Aimé Kayath, Etienne Nguimbi

Abstract:

Biosurfactants are amphipathic molecules produced by many microorganisms, usually bacteria, fungi, and yeasts. +ey possesses the property of reducing the tension of the membrane interfaces. No studies have been conducted on Shigella species showing the role of biosurfactant-like molecules (BLM) in pathogenicity. +e aim of this study is to assess the ability of Shigella environmental and clinical strains to produce BLM and investigate the involvement of biosurfactants in pathogenicity. Our study has shown that BLM is secreted in the extracellular medium with EI24 ranging from 80% to 100%. +e secretion depends on the type III secretion system (T3SS). Moreover, our results have shown that S. flexneri, S. boydii, and S. sonnei are able to interact with hydrophobic areas with 17.64%, 21.42%, and 22.22% hydrophobicity, respectively. BLM secretion is totally prevented due to the inhibition of T3SS by 100 mM benzoic and 1.5 mg/ml salicylic acids. P. aeruginosa harboring T3SS is able to produce 100% of BLM in the presence or in the absence of both T3SS inhibitors. +e secreted BLM are extractable with an organic solvent such as chloroform, and this could entirely be considered a lipopeptide or polypeptide compound. Secretion of BLM allows some Shigella strains to induce multicellular phenomena like ‘swarming.’

Keywords: shigella flexneri, biosurfactant, T3SS, Lipopeptide

Procedia PDF Downloads 9

Authors: Hossain A, Hossain S.

Abstract:

Introduction: In a small cohort, we sought to assess the magnetic resonance spectroscopy's (MRS) ability to predict the presence of metastatic lesions. Method: A Popular Diagnostic Centre Limited enrolled patients with neuroepithelial tumors. The 1H CSI MRS of the brain allows us to detect changes in the concentration of specific metabolites caused by metastatic lesions. Among these metabolites are N-acetyl-aspartate (NNA), creatine (Cr), and choline (Cho). For Cho, NAA, Cr, and Cr₂, the metabolic ratio was calculated using the division method. Results: The NAA values were 0.63 and 5.65 for tumor cells, 1.86 and 5.66 for normal cells, and 1.86 and 5.66 for normal cells 2. NAA values for normal cells 1 were 1.84, 10.6, and 1.86 for normal cells 2, respectively. Cho levels were as low as 0.8 and 10.53 in the tumor cell, compared to 1.12 and 2.7 in the normal cell 1 and 1.24 and 6.36 in the normal cell 2. Cho/Cr₂ barely distinguished itself from the other ratios in terms of significance. For tumor cells, the ratios of Cho/NAA, Cho/Cr₂, NAA/Cho, and NAA/Cr₂ were significant. Normal cell 1 had significant Cho/NAA, Cho/Cr, NAA/Cho, and NAA/Cr ratios. Conclusion: The clinical result can be improved by using 1H-MRSI to guide the size of resection for metastatic lesions. Even though it is non-invasive and doesn't present any difficulties during the procedure, MRS has been shown to predict the detection of metastatic lesions.

Keywords: metabolite ratio, MRI images, metastatic lesion, MR spectroscopy, N-acetyl-aspartate

Procedia PDF Downloads 96

Authors: Camilo Cerda Sarabia, Fernanda Bravo Cornejo, Diego Santibanez Oyarce, Hugo Osses Prado, Esteban Gómez Terán, Belén Diaz Diaz, Raúl Caulier-Cisterna, Jorge Vergara-Quezada, Ana Moya-Beltrán

Abstract:

Antimicrobial resistance (AMR) represents a significant and rapidly escalating global health threat. Projections estimate that by 2050, AMR infections could claim up to 10 million lives annually. Respiratory infections, in particular, pose a severe risk not only to individual patients but also to the broader public health system. Despite the alarming rise in resistant respiratory infections, AMR within the lung microbiome (microbial community) remains underexplored and poorly characterized. The lungs, as a complex and dynamic microbial environment, host diverse communities of microorganisms whose interactions and resistance mechanisms are not fully understood. Unlike studies that focus on individual genomes, analyzing the entire microbiome provides a comprehensive perspective on microbial interactions, resistance gene transfer, and community dynamics, which are crucial for understanding AMR. However, this holistic approach introduces significant computational challenges and exposes the limitations of traditional analytical methods such as the difficulty of identifying the AMR. Machine learning has emerged as a powerful tool to overcome these challenges, offering the ability to analyze complex genomic data and uncover novel insights into AMR that might be overlooked by conventional approaches. This study investigates microbial resistance within the lung microbiome using unsupervised machine learning approaches to uncover resistance patterns and potential clinical associations. it downloaded and selected lung microbiome data from HumanMetagenomeDB based on metadata characteristics such as relevant clinical information, patient demographics, environmental factors, and sample collection methods. The metadata was further complemented by details on antibiotic usage, disease status, and other relevant descriptions. The sequencing data underwent stringent quality control, followed by a functional profiling focus on identifying resistance genes through specialized databases like Antibiotic Resistance Database (CARD) which contains sequences of AMR gene sequence and resistance profiles. Subsequent analyses employed unsupervised machine learning techniques to unravel the structure and diversity of resistomes in the microbial community. Some of the methods employed were clustering methods such as K-Means and Hierarchical Clustering enabled the identification of sample groups based on their resistance gene profiles. The work was implemented in python, leveraging a range of libraries such as biopython for biological sequence manipulation, NumPy for numerical operations, Scikit-learn for machine learning, Matplotlib for data visualization and Pandas for data manipulation. The findings from this study provide insights into the distribution and dynamics of antimicrobial resistance within the lung microbiome. By leveraging unsupervised machine learning, we identified novel resistance patterns and potential drivers within the microbial community.

Keywords: antibiotic resistance, microbial community, unsupervised machine learning., sequences of AMR gene

Procedia PDF Downloads 23

Authors: May Haggag, Ezzat Fahmy, Mohamed Abdel-Mooty, Sherif Safar

Abstract:

Sandwich sections have a very complex nature due to variability of behavior of different materials within the section. Cracking, crushing and yielding capacity of constituent materials enforces high complexity of the section. Furthermore, slippage between the different layers adds to the section complex behavior. Conventional methods implemented in current industrial guidelines do not account for the above complexities. Thus, a throughout study is needed to understand the true behavior of the sandwich panels thus, increase the ability to use them effectively and efficiently. The purpose of this paper is to conduct numerical investigation using ANSYS software for the structural behavior of sandwich wall section under eccentric loading. Sandwich walls studied herein are composed of two RC faces, a foam core and linking shear connectors. Faces are modeled using solid elements and reinforcement together with connectors are modeled using link elements. The analysis conducted herein is nonlinear static analysis incorporating material nonlinearity, crashing and crushing of concrete and yielding of steel. The model is validated by comparing it to test results in literature. After validation, the model is used to establish extensive parametric analysis to investigate the effect of three key parameters on the axial force bending moment interaction diagram of the walls. These parameters are the concrete compressive strength, face thickness and number of shear connectors. Furthermore, the results of the parametric study are used to predict a coefficient that links the interaction diagram of a solid wall to that of a sandwich wall. The equation is predicted using the parametric study data and regression analysis. The predicted α was used to construct the interaction diagram of the investigated wall and the results were compared with ANSYS results and showed good agreement.

Keywords: sandwich walls, interaction diagrams, numerical modeling, eccentricity, reinforced concrete

Procedia PDF Downloads 403

Authors: Onosedeba Mary Ayayia

Abstract:

Inclusive education has emerged as a critical global imperative, aiming to provide equitable educational opportunities for all, regardless of their abilities or disabilities. In Africa, the pursuit of inclusive education faces significant challenges, particularly concerning the development and implementation of inclusive curricula tailored to the diverse needs of students with disabilities. This study delves into the heart of this issue, seeking to address the pressing problem of exclusion and marginalization of students with disabilities in mainstream educational systems across the continent. The problem is complex, entailing issues of limited access to tailored curricula, shortages of qualified teachers in special needs education, stigmatization, limited research and data, policy gaps, inadequate resources, and limited community awareness. These challenges perpetuate a system where students with disabilities are systematically excluded from quality education, limiting their future opportunities and societal contributions. This research proposes a comprehensive examination of the current state of inclusive curriculum development and implementation in Africa. Through an innovative and explicit exploration of the problem, the study aims to identify effective strategies, guidelines, and best practices that can inform the development of inclusive curricula. These curricula will be designed to address the diverse learning needs of students with disabilities, promote teacher capacity building, combat stigmatization, generate essential data, enhance policy coherence, allocate adequate resources, and raise community awareness. The goal of this research is to contribute to the advancement of inclusive education in Africa by fostering an educational environment where every student, regardless of ability or disability, has equitable access to quality education. Through this endeavor, the study aligns with the broader global pursuit of social inclusion and educational equity, emphasizing the importance of inclusive curricula as a foundational step towards a more inclusive and just society.

Keywords: inclusive education, special education, curriculum development, Africa

Procedia PDF Downloads 64

Authors: Ramanish Ravishankar, Azar Hussain, Mahmoud Loubani, Mubarak Chaudhry

Abstract:

Background and Aims: Currently, there are no strict guidelines in cardiopulmonary bypass temperature management in cardiac surgery not involving the aortic arch. This study aims to compare patient outcomes undergoing mild hypothermia and normothermia. The aim of this study was to compare patient outcomes between mild hypothermia and normothermia undergoing on-pump cardiac surgery not involving the aortic arch. Methods: This was a retrospective cohort study from January 2015 until May 2023. Patients who underwent cardiac surgery with cardiopulmonary bypass temperatures ≥32oC were included and stratified into mild hypothermia (32oC – 35oC) and normothermia (>35oC) cohorts. Propensity matching was applied through the nearest neighbour method (1:1) using the risk factors detailed in the EuroScore using RStudio. The primary outcome was mortality. Secondary outcomes included post-op stay, intensive care unit readmission, re-admission, stroke, and renal complications. Patients who had major aortic surgery and off-pump operations were excluded. Results: Each cohort had 1675 patients. There was a significant increase in overall mortality with the mild hypothermia cohort (3.59% vs. 2.32%; p=0.04912). There was also a greater stroke incidence (2.09% vs. 1.13%; p=0.0396) and transient ischaemic attack (TIA) risk (3.1% vs. 1.49%; p=0.0027). There was no significant difference in renal complications (9.13% vs. 7.88%; p=0.2155). Conclusions: Patient’s who underwent mild hypothermia during cardiopulmonary bypass have a significantly greater mortality, stroke, and transient ischaemic attack incidence. Mild hypothermia does not appear to provide any benefit over normothermia and does not appear to provide any neuroprotective benefits. This shows different results to that of other major studies; further trials and studies need to be conducted to reach a consensus.

Keywords: cardiac surgery, therapeutic hypothermia, neuroprotection, cardiopulmonary bypass

Procedia PDF Downloads 68

Authors: Eun Ho Kim

Abstract:

Innovations have conjured up a mode of treating GBM cancer cells in the newly diagnosed patients in a period of 4.9 months at an improved median OS, which brings along only a few minor side effects in the phase III of the clinical trial. This mode has been termed the Alternating Electric Fields (AEF). The study at hand is aimed at determining whether the AEF treatment is beneficial in sensitizing the GBM cancer cells through the process of increasing the AEF –induced senescence. The methodology to obtain the findings for this research ranged across various components, such as obtaining and testing SA-β-gal staining, flow cytometry, Western blotting, morphology, and Positron Emission Tomography (PET) / Computed Tomography (CT), immunohistochemical staining and microarray. The number of cells that displayed a senescence-specific morphology and positive SA-ß-Gal activity gradually increased up to 5 days. These results suggest that p16, p21 and p27 are essential regulators of AEF -induced senescence via NF-κB activation. The results showed that the AEF treatment is functional in enhancing the AEF –induced senescence in the GBM cells via an apoptosis- independent mechanism. This research concludes that this mode of treatment is a trustworthy protocol that can be effectively employed to overcome the limitations of the conventional mode of treatment on GBM.

Keywords: alternating electric fields, senescence, glioblastoma, cell death

Procedia PDF Downloads 92

Authors: R. Gounina-Allouane, I. Moussaoui, N. Boukahel

Abstract:

Bacillus antimicrobial metabolites, especially those of Bacillus thuringiensis (Bt), are of great interest for research because of health risks generated by the excessive use of chemical additives as well as the propagation of resistant microbial strains, caused by the massive treatment with antibiotics. The objective of this study was the selection of Bt strains producing antimicrobial peptides (bacteriocins), and the partial purification of the most powerful bacteriocins, then the determination of their spectra of antimicrobial action. A collection of twenty one Bt strains isolated from soil at Boumerdès (northern of Algeria) was used for screening strains having an antagonistic activity against phylogenetically closed bacteria. Spectra of antagonistic activity of two selected strains was determined against other Bt strains, Gram positive and Gram negative bacterial strains of clinical origin and others from ATCC collection as well as yeasts isolated in human dermatology. Bacteriocins of these two strains were partially purified and their effect on the kinetics of growth of the most sensitive microbial strains was studied. The bacteriocinogenic strains were biochemically characterized and their sensitivity to antibiotics was studied.

Keywords: antimicrobial peptides, Bacillus thuringiensis, bacteriocin, partial purification

Procedia PDF Downloads 358

Authors: Roman Major, Klaudia Trembecka- Wojciga, Juergen Markus Lackner, Boguslaw Major

Abstract:

The future and the development of science is therefore seen in interdisciplinary areas such as bio medical engineering. Self-assembled structures, similar to stem cell niches would inhibit fast division process and subsequently capture the stem cells from the blood flow. By means of surface topography and the stiffness as well as micro structure progenitor cells should be differentiated towards the formation of endothelial cells monolayer which effectively will inhibit activation of the coagulation cascade. The idea of the material surface development met the interest of the clinical institutions, which support the development of science in this area and are waiting for scientific solutions that could contribute to the development of heart assist systems. This would improve the efficiency of the treatment of patients with myocardial failure, supported with artificial heart assist systems. Innovative materials would enable the redesign, in the post project activity, construction of ventricular heart assist.

Keywords: bio-inspired materials, electron microscopy, haemocompatibility, niche-like structures, thin coatings

Procedia PDF Downloads 478

Authors: Jayita Mukhopadhyay

Abstract:

Even though more than six decades has passed since the death of India’s iconic thinker and mass leader Mahatma Gandhi, the world besieged by terrorism may still take a leaf out of his philosophical discourse on non-violence and attempt to turn his theory into praxis to save mankind. The greatest soul world has ever produced, a man of divine fire, an apostle of peace and non-violence, a revolutionary, a visionary, a social reformer and deliverer of the downtrodden, Father of the nation, these and numerous other epithets have been used by eminent personalities and scholars while describing Mahatma Gandhi. Gandhi was a relentless fighter and mass mobiliser who awakened a sleeping giant, the common men and women of India, shook them out of their docile, fatalistic mould, invigorated them with his doctrine of ahimsa and satyagraha (non violence and strict adherence to truth), instilled in them nationalist zeal and patriotic fervour and turned them into determined, steadfast freedom fighters. Under his leadership, the national liberation movement got a new life and ultimately succeeded in ending the era of foreign domination. And he did all these while resisting a natural tendency of his people to respond violently to unspeakable violence and atrocities unleashed by the colonial British administration desperate to keep India in its empire. In this paper, an attempt will be made to unravel Gandhi’s elucidation of the concept of non-violent resistance, along with non-cooperation and civil disobedience and their actual application through political practices which succeeded in capturing the imagination of not only India’s teeming millions but the entire world. The methodology of analytical study will be used as Gandhi’s own writings and those by noted scholars on Gandhi will be examined extensively to establish contemporary relevance of his thought, his invaluable guidelines about how to cope with poverty, inequality, exploitation, repression and marginalization of some sections of society and resultant radicalization of some disturbed members of human race, the very conditions which spawn terrorism in today’s world.

Keywords: India, non cooperation, non violence, terrorism

Procedia PDF Downloads 324

Authors: Soumaya Mrabet, Imen Akkari, Amira Atig, Elhem Ben Jazia

Abstract:

Introduction: Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease of unknown cause. Concomitant autoimmune disorders have been described in 30–50% of patients with AIH. The aim of our study is to determine the prevalence and the type of autoimmune disorders associated with AIH. Material and Methods: It is a retrospective study over a period of 16 years (2000-2015) including all patients followed for AIH. The diagnosis of AHI was based on the criteria of the revised International AIH group scoring system (IAIHG). Results: Twenty-for patients (21 women and 3 men) followed for AIH were collected. The mean age was 39 years (17-65 years). Among these patients, 11 patients(45.8%) had at least one autoimmune disease associated to AIH. These diseases were Hashimoto's thyroiditis (n = 5), Gougerot Sjogren syndrome (n=5), Primary biliary cirrhosis (n=2), Primitive sclerosant Cholangitis (n=1), Addison disease (n = 1) and systemic sclerosis (n=1). Patients were treated with corticosteroids alone or with azathioprine associated to the specific treatment of associated diseases with complete remission of AIH in 90% of cases and clinical improvement of other diseases. Conclusion: In our study, the prevalence of autoimmune diseases in AIH patients was 45.8%. These diseases were dominated by autoimmune thyroiditis and Gougerot Sjogren syndrome. The investigation of autoimmune diseases in autoimmune hepatitis must be systematic because of their frequency and the importance of adequate management.

Keywords: autoimmune diseases, autoimmune hepatitis, autoimmune thyroiditis, gougerot sjogren syndrome

Procedia PDF Downloads 263

Authors: Zahra R. Almansoor

Abstract:

Background: Selective serotonin reuptake inhibitors (SSRI’s) and cognitive behavioural therapy (CBT) are the main treatment methods used for patients with obsessive compulsive disorder (OCD) under the National Institute of Health and Care Excellence (NICE) guidelines. Yet many patients are left with residual symptoms or remit, so several other therapeutic approaches have been explored. Objective: The objective was to systematically review the available literature regarding the treatment efficacy of current and potential approaches and diagnostic strategies. Method: First, studies were examined concerning diagnosis, prognosis, and influencing factors. Then, one reviewer conducted a systematic search of six databases using stringent search terms. Results of studies exploring the efficacy of treatment interventions were analysed and compared separately for adults and children. This review was limited to randomised controlled trials (RCT’s) conducted from 2016 onwards, and an improved Y-BOCS (Yale- Brown obsessive compulsive scale) score was the primary outcome measure. Results: Technology-based interventions including internet-based cognitive behavioural therapy (iCBT) were deemed as potentially effective. Discrepancy remains about the benefits of SSRI use past one year, but potential medication adjuncts include amantadine. Treatments such as association splitting and family and mindfulness strategies also have future potential. Conclusion: A range of potential therapies exist, either as treatment adjuncts to current interventions or as sole therapies. To further improve efficacy, it may be necessary to remodel the current NICE stepped-care model, especially regarding the potential use of lower intensity, cheaper treatments, including iCBT. Although many interventions show promise, further research is warranted to confirm this.

Keywords: family and group treatment, mindfulness strategies, novel treatment approaches, standard treatment, technology-based interventions

Procedia PDF Downloads 119

Authors: Tahmeena Ali, Andrew Francis, Keong Yap, Sharynn Schuster

Abstract:

Social anxiety is a chronic and debilitating condition characterized by fear and avoidance of social situations. Several risk factors have emerged, which emphasize the role of early childhood experiences in the development of this condition. As such, the current study tested the hypothesis that early maladaptive schemas (EMSs) mediate the relationship between retrospectively reported parental criticism and social anxiety whilst controlling the effects of depression. Three hundred and thirty-four non-clinical participants completed an online questionnaire consisting of self-report measures of parental criticism, EMSs of disconnection and rejection, and symptoms of social anxiety and depression. The mediation analysis confirmed the hypothesized model, indicating that EMSs mediated the relationship between parental criticism and social anxiety symptoms when controlling for depression. Whilst the current study is limited due to its cross-sectional design, the findings lend support to the developmental formulations of social anxiety and have important therapeutic implications for treatment.

Keywords: early maladaptive schema, parental criticism, schema, social anxiety

Procedia PDF Downloads 270

Authors: H. Namazi, H. T. N. Kuan

Abstract:

Brain activity can be measured by acquiring and analyzing EEG signals from an individual. In fact, the human brain response to external and internal stimuli is mapped in his EEG signals. During years some methods such as Fourier transform, wavelet transform, empirical mode decomposition, etc. have been used to analyze the EEG signals in order to find the effect of stimuli, especially external stimuli. But each of these methods has some weak points in analysis of EEG signals. For instance, Fourier transform and wavelet transform methods are linear signal analysis methods which are not good to be used for analysis of EEG signals as nonlinear signals. In this research we analyze the brain response to visual stimuli by extracting information in the form of various measures from EEG signals using a software developed by our research group. The used measures are Jeffrey’s measure, Fractal dimension and Hurst exponent. The results of these analyses are useful not only for fundamental understanding of brain response to visual stimuli but provide us with very good recommendations for clinical purposes.

Keywords: visual stimuli, brain response, EEG signal, fractal dimension, hurst exponent, Jeffrey’s measure

Procedia PDF Downloads 561

Authors: Smriti Pahwa, Karishma Vats, Aditi Macwan, Jija Dutt, Sumukhi Vaid

Abstract:

Age approporiate complementary feeding has been stressed upon for sound young child nutrition and appropriate growth. National Infant and Young Child Feeding guidelines, policies and programs indicate cognizance of the issue taken by the country’s government, policy makers and technical experts. However, it is important that ordinary people, the caregivers of young children too understand the importance of appropriate feeding. For this, an interface might be required where ordinary people could participate in assessing the gaps in IYCF as a first step to take subsequent action. In this context an attempt was made to extrapolate a citizen led learning level survey that has been involving around 25000 ordinary citizens to reach out to 600,000 children annually for over a decade in India. Based on this philosophy of involving ordinary people in simple assessments to produce understandable actionable evidence, a rapid diet assessment tool was developed and collected from caregivers of 90 < 3year children from two urban clusters in Ahmedabad and Baroda, Gujarat. Target sample for pilot was selected after cluster census. Around half the mothers reported that they had not yet introduced water or other fluids to their < 6 month babies. However, about a third were already feeding them food other than mother’s milk. Although complementary feeding was initiated in almost all (95%) children more than 6 months old, frequency was suboptimal in 60%; in 80% cases no measure was taken to either improve energy or nutrient density; only 33% were fed protective foods; Green Leafy Vegetables consumption was negligible (1.4%). Anganwadi food was not consumed. By engaging ordinary people to generate evidence and understand the gaps, such assessments have the potential to be used to generate useful evidence for action at scale as well as locally.

Keywords: citizen led, grass root engagement, IYCF (Infant and Young Child Feeding), rapid diet assessment, under nutrition

Procedia PDF Downloads 172

Authors: Bea Carmel H. Casiding, Charmaine A. Guy, Funny Jovis P. Malasan, Katrina Chelsea B. Manlutac, Danielle Ann N. Novilla, Marianne R. Oliveros, Magnolia C. Sibulo

Abstract:

Moon jellyfish, Aurelia aurita, has become a popular research organism for diverse studies. Recent studies have verified the prevention of blood clotting properties of the moon jellyfish tentacle extract through in vitro methods. The purpose of this study was to validate the blood clotting ability of A. aurita tentacle extract using in vivo method of experimentation. The tentacles of A. aurita jellyfish were excised and filtered then centrifuged at 3000xg for 10 minutes. The crude nematocyst extract was suspended in 1:6 ratios with phosphate buffer solution and sonicated for three periods of 20 seconds each at 50 Hz. Protein concentration of the extract was determined using Bradford Assay. Bovine serum albumin was the standard solution used with the following concentrations: 35.0, 70.0, 105.0, 140.0, 175.0, 210.0, 245.0, and 280.0 µg/mL. The absorbance was read at 595 nm. Toxicity testing from OECD guidelines was adapted. The extract suspended in phosphate-buffered saline solution was arbitrarily set into three doses (0.1mg/kg, 0.3mg/kg, 0.5mg/kg) and were administered daily for five days to the experimental groups of five male Sprague-Dawley rats (one dose per group). Before and after the administration period, bleeding time and clotting time tests were performed. The One-way Analysis of Variance (ANOVA) was used to analyze the difference of before and after bleeding time and clotting time from the three treatment groups, time, positive and negative control groups. The average protein concentration of the sonicated crude tentacle extract was 206.5 µg/mL. The highest dose administered (0.5mg/kg) produced significant increase in the time for both bleeding and clotting tests. However, the preceding lower dose (0.3mg/kg) only was significantly effective for clotting time test. The protein contained in the tentacle extract with a concentration of 206.5 mcg/mL and dose of 0.3 mg/kg and 0.5 mg/kg of A. aurita elicited anticoagulating activity.

Keywords: anticoagulant, bleeding time test, clotting time test, moon jellyfish

Procedia PDF Downloads 397

Authors: Mo Zhou, Samantha Ashby, Lyn Ebert

Abstract:

In China, the changes that men experience in the perinatal period are not well researched. Men are also at risk of maladaptation to parenthood. The aim of this research is to review current studies regarding changes that Chinese men experience during transitioning to parenthood. 5 databases were employed to search relevant papers. The search found 128 articles. Based on the inclusion and exclusion criteria, 35 articles were included in this integrative review. Results showed the changes that Chinese fathers experienced during the transition to parenthood can be divided into two aspects: family relationships and mental problems. During transition to parenthood, fathers usually experienced an increase in their disappointment with marital conflict resolution and decreased sexual intimacy with their partner. Mental health declined, with fathers often feeling depressed and/or anxious during this time. Some men were diagnosed with clinical depression. The predictors of these changes included three domains: personal background (age and income), family background (gender of infant, relationship status and unplanned child) and cultural background (‘doing the month’, Confucianism, policy, social support).

Keywords: China, men, fatherhood, life change, postpartum

Procedia PDF Downloads 162

Authors: Brendan Mooney

Abstract:

We often do not consider the quality of the way we express ourselves as being fundamental to well-being. Society focuses predominantly on what we do, not the way we do it, to our great detriment. For example, those who have experienced domestic violence often comment that it was not what was said that hurt the most but the way it was said. In other words, the quality in the way the words were used communicated far more than the actual words themselves. This is an important area of focus for practitioners who may be inclined to emphasize who said what but not bring equal, if not more, focus to the quality of one’s expression. The aim of this study is to highlight how and why the way we express ourselves is more important than what we express, which includes words and all behaviors. Given we are a sensitive species it matters to pay attention to the communication that is not said. For example, we have the ability to recognize that a person is upset or angry by the way they walk into a room, even if they do not say anything or look at anyone. Our sensitivity allows us to detect even the slightest change in another’s emotional state, irrespective of what their exterior behaviors may be exhibiting. This study will focus on the importance of recognizing the quality in the way we express as being fundamental to wellbeing, as it allows us to easily and simply navigate life and relationships without needing to experience the usual pitfalls that otherwise prevail. This research utilizes clinical experience, client observations and client feedback, and several case studies were utilized to illustrate real-life examples of the above. This study is not so much a model of life but a way of life that confirms our deepest nature, that we are incredibly sensitive and far more so than we appreciate or utilize in everyday practical human life.

Keywords: communication, integrity, quality, sensitivity, wellbeing

Procedia PDF Downloads 35

Authors: Adriana Haulica

Abstract:

Powered by Machine Learning, Precise medicine is tailored by now to use genetic and molecular profiling, with the aim of optimizing the therapeutic benefits for cohorts of patients. As the majority of Machine Language algorithms come from heuristics, the outputs have contextual validity. This is not very restrictive in the sense that medicine itself is not an exact science. Meanwhile, the progress made in Molecular Biology, Bioinformatics, Computational Biology, and Precise Medicine, correlated with the huge amount of human biology data and the increase in computational power, opens new healthcare challenges. A more accurate diagnosis is needed along with real-time treatments by processing as much as possible from the available information. The purpose of this paper is to present a deeper vision for the future of Artificial Intelligence in Precise medicine. In fact, actual Machine Learning algorithms use standard mathematical knowledge, mostly Euclidian metrics and standard computation rules. The loss of information arising from the classical methods prevents obtaining 100% evidence on the diagnosis process. To overcome these problems, we introduce MEDICOMPILLS, a new architectural concept tool of information processing in Precise medicine that delivers diagnosis and therapy advice. This tool processes poly-field digital resources: global knowledge related to biomedicine in a direct or indirect manner but also technical databases, Natural Language Processing algorithms, and strong class optimization functions. As the name suggests, the heart of this tool is a compiler. The approach is completely new, tailored for omics and clinical data. Firstly, the intrinsic biological intuition is different from the well-known “a needle in a haystack” approach usually used when Machine Learning algorithms have to process differential genomic or molecular data to find biomarkers. Also, even if the input is seized from various types of data, the working engine inside the MEDICOMPILLS does not search for patterns as an integrative tool. This approach deciphers the biological meaning of input data up to the metabolic and physiologic mechanisms, based on a compiler with grammars issued from bio-algebra-inspired mathematics. It translates input data into bio-semantic units with the help of contextual information iteratively until Bio-Logical operations can be performed on the base of the “common denominator “rule. The rigorousness of MEDICOMPILLS comes from the structure of the contextual information on functions, built to be analogous to mathematical “proofs”. The major impact of this architecture is expressed by the high accuracy of the diagnosis. Detected as a multiple conditions diagnostic, constituted by some main diseases along with unhealthy biological states, this format is highly suitable for therapy proposal and disease prevention. The use of MEDICOMPILLS architecture is highly beneficial for the healthcare industry. The expectation is to generate a strategic trend in Precise medicine, making medicine more like an exact science and reducing the considerable risk of errors in diagnostics and therapies. The tool can be used by pharmaceutical laboratories for the discovery of new cures. It will also contribute to better design of clinical trials and speed them up.

Keywords: bio-semantic units, multiple conditions diagnosis, NLP, omics

Procedia PDF Downloads 70

Authors: J. Izan, E.I. Tengku Azmina, F. Pey Thing

Abstract:

Sustainability has been introduced globally since the emerging of the advancement of technology and product development in various aspects. This concept is regarded highly, listed among the seventeenth elements in Sustainable Development Goals (SDG), especially by developed countries in any of their development plans and being considered in the development of the developing countries. It is such as the concept of sustainability can undeniably provide a medium where the cost used by energy consumption and pollution problems can be greatly reduced. In Malaysia, many rules and policies had been advocated to achieve sustainability; however, the practice and implementation as well the enforcement to ensure its implementation are still not great. University, as an educational institution, shall practice and implement sustainability concepts in as much aspect as possible as a positive example for a wider community. University Malaysia Terengganu (UMT) has already published a blueprint guide in 2015, aims to introduce and implement sustainable practice in the university, and solid waste is one of the key elements highlighted. This study was conducted to determine the status of solid waste management practice among the university community associated with several factors that facilitate the room for sustainable management, as drawn in the established blueprint document. The quantitative analysis was carried out via survey conducted online, acquired the questions on green campus concept and implementation in general and solid waste in particular. The results showed that community UMT showed a high level of awareness and knowledge on sustainable solid waste; however, low percentage in managing solid waste in a sustainable manner. Respondents suggested that stringent guidelines and the establishment of policy greatly help in the realization and enforcement of sustainable solid waste handling and management. Facilities such as waste collection centre with separation and segregation containers will motivate the community to practice 3Rs on a daily basis. This will eventually reduce the generation of waste need to be sent to landfill hence reduce the disposal cost. Prolong, and continuous campaign on sustainable solid waste management need to be carried out more frequently.

Keywords: management, solid waste, sustainability, university

Procedia PDF Downloads 102