Search results for: adaptive tabu search
Commenced in January 2007
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Edition: International
Paper Count: 2889

Search results for: adaptive tabu search

279 Market Segmentation of Cruise Ship Passengers: Implications for Marketing of Local Products and Services at Destination Points

Authors: Gunnar Oskarsson, Irena Georgsdottir

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Tourism has been growing incredibly fast during the past years, including the cruise industry, which is gaining increasing popularity among various groups of travelers. It is a challenging task for companies serving cruise ship passengers with local products and services at the point of destination to reach them in due time with information about their offerings, as well learning how to adapt their offerings and messages to the type of customers arriving on each particular occasion. Although some research has been conducted in this sphere, there is still limited knowledge about many specifics within this sector of the tourist industry. The objective of this research is to examine one of these, with the main goal of studying the segmentation of cruise passengers and to learn about marketing practices directed towards them. A qualitative research method, based on in-depth interviews, was used, as this provides an opportunity to gain insight into the participants’ perspectives. Interviews were conducted with 10 respondents from different companies in the tourist industry in Iceland, who interact with cruise passengers on a regular basis in their work environment. The main objective was to gain an understanding of what distinguishes different customer groups, or segments, in this industry, and of the marketing approaches directed towards them. The main findings reveal that participants note the strongest difference between cruise passengers of different nationalities, passengers coming on different ships (size and type), and passengers arriving at different times of the year. A drastic difference was noticed between nationalities in four main segments, American, British, Other European, and Asian customers, although some of these segments could be divided into even further sub-segments. Other important differencing factors were size and type of ships, quality or number of stars on the ship, and travelling time of the year. Companies serving cruise ship passengers, as well as the customers themselves, could benefit if the offerings of services were designed specifically for particular segments within the industry. Concerning marketing towards cruise passengers, the results indicate that it is carried out almost exclusively through the Internet using; a reliable website and, search engine optimization. Marketing is also by word-of-mouth. This research can assist practitioners by offering a deeper understanding of the approaches that may be effective in marketing local products and services to cruise ship passengers, based on their segmentation and by identifying effective ways to reach them. The research, furthermore, provides a valuable contribution to marketing knowledge for the benefit of an increasingly important market segment in a fast growing tourist industry.

Keywords: capabilities, global integration, internationalisation, SMEs

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278 Understanding the Underutilization of Electroconvulsive Therapy in Children and Adolescents

Authors: Carlos M. Goncalves, Luisa Duarte, Teresa Cartaxo

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The aim of this work was to understand the reasons behind the underutilization of electroconvulsive therapy (ECT) in the younger population and raise possible solutions. We conducted a non-systematic review of literature throughout a search on PubMed, using the terms ‘children’, ‘adolescents’ and ‘electroconvulsive’, ‘therapy’. Candidate articles written in languages other than English were excluded. Articles were selected according to title and/or abstract’s content relevance, resulting in a total of 5 articles. ECT is a recognized effective treatment in adults for several psychiatric conditions. As in adults, ECT in children and adolescents is proven most beneficial in the treatment of severe mood disorders, catatonia, and, to a lesser extent, schizophrenia. ECT in adults has also been used to treat autism’s self-injurious behaviours, Tourette’s syndrome and resistant first-episode schizophrenia disorder. Despite growing evidence on its safety and effectiveness in children and adolescents, like those found in adults, ECT remains a controversial and underused treatment in patients this age, even when it is clearly indicated. There are various possible reasons to this; limited awareness among professionals (lack of knowledge and experience among child psychiatrists), stigmatic public opinion (despite positive feedback from patients and families, there is an unfavourable and inaccurate representation in the media, contributing to a negative public opinion), legal restrictions and ethical controversies (restrictive regulations such as a minimum age for administration), lack of randomized trials (the currently available studies are retrospective, with small size samples, and most of the publications are either case reports or case series). This shows the need to raise awareness and knowledge, not only for mental health professionals, but also to the general population, through the media, regarding indications, methods and safety of ECT in order to provide reliable information to the patient and families. Large-scale longitudinal studies are also useful to further demonstrate the efficacy and safety of ECT and can aid in the formulation of algorithms and guidelines as without these changes, the availability of ECT to the younger population will remain restricted by regulations and social stigma. In conclusion, these results highlight that lack of adequate knowledge and accurate information are the most important factors behind the underutilization of ECT in younger population. Mental healthcare professionals occupy a cornerstone position; if data is given by a well-informed healthcare professional instead of the media, general population (including patients and their families) will probably regard the procedure in a more favourable way. So, the starting point should be to improve health care professional’s knowledge and experience on this choice of treatment.

Keywords: adolescents, children, electroconvulsive, therapy

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277 Spatial Organization of Cells over the Process of Pellicle Formation by Pseudomonas alkylphenolica KL28

Authors: Kyoung Lee

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Numerous aerobic bacteria have the ability to form multicellular communities on the surface layer of the air-liquid (A-L) interface as a biofilm called a pellicle. Pellicles occupied at the A-L interface will benefit from the utilization of oxygen from air and nutrient from liquid. Buoyancy of cells can be obtained by high surface tension at the A-L interface. Thus, formation of pellicles is an adaptive advantage in utilization of excess nutrients in the standing culture where oxygen depletion is easily set up due to rapid cell growth. In natural environments, pellicles are commonly observed on the surface of lake or pond contaminated with pollutants. Previously, we have shown that when cultured in standing LB media an alkylphenol-degrading bacteria Pseudomonas alkylphenolia KL28 forms pellicles in a diameter of 0.3-0.5 mm with a thickness of ca 40 µm. The pellicles have unique features for possessing flatness and unusual rigidity. In this study, the biogenesis of the circular pellicles has been investigated by observing the cell organization at early stages of pellicle formation and cell arrangements in pellicle, providing a clue for highly organized cellular arrangement to be adapted to the air-liquid niche. Here, we first monitored developmental patterns of pellicle from monolayer to multicellular organization. Pellicles were shaped by controlled growth of constituent cells which accumulate extracellular polymeric substance. The initial two-dimensional growth was transited to multilayers by a constraint force of accumulated self-produced extracellular polymeric substance. Experiments showed that pellicles are formed by clonal growth and even with knock-out of genes for flagella and pilus formation. In contrast, the mutants in the epm gene cluster for alginate-like polymer biosynthesis were incompetent in cell alignment for initial two-dimensional growth of pellicles. Electron microscopic and confocal laser scanning microscopic studies showed that the fully matured structures are highly packed by matrix-encased cells which have special arrangements. The cells on the surface of the pellicle lie relatively flat and inside longitudinally cross packed. HPLC analysis of the extrapolysaccharide (EPS) hydrolysate from the colonies from LB agar showed a composition with L-fucose, L-rhamnose, D-galactosamine, D-glucosamine, D-galactose, D-glucose, D-mannose. However, that from pellicles showed similar neutral and amino sugar profile but missing galactose. Furthermore, uronic acid analysis of EPS hydrolysates by HPLC showed that mannuronic acid was detected from pellicles not from colonies, indicating the epm-derived polymer is critical for pellicle formation as proved by the epm mutants. This study verified that for the circular pellicle architecture P. alkylphenolica KL28 cells utilized EPS building blocks different from that used for colony construction. These results indicate that P. alkylphenolica KL28 is a clever architect that dictates unique cell arrangements with selected EPS matrix material to construct sophisticated building, circular biofilm pellicles.

Keywords: biofilm, matrix, pellicle, pseudomonas

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276 Evaluation of Antarctic Bacteria as Potential Producers of Cellulolytic Enzymes of Industrial Interest

Authors: Claudio Lamilla, Andrés Santos, Vicente Llanquinao, Jocelyn Hermosilla, Leticia Barrientos

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The industry in general is very interested in improving and optimizing industrial processes in order to reduce the costs involved in obtaining raw materials and production. Thus, an interesting and cost-effective alternative is the incorporation of bioactive metabolites in such processes, being an example of this enzymes which catalyze efficiently a large number of enzymatic reactions of industrial and biotechnological interest. In the search for new sources of these active metabolites, Antarctica is one of the least explored places on our planet where the most drastic cold conditions, salinity, UVA-UVB and liquid water available are present, features that have shaped all life in this very harsh environment, especially bacteria that live in different Antarctic ecosystems, which have had to develop different strategies to adapt to these conditions, producing unique biochemical strategies. In this work the production of cellulolytic enzymes of seven bacterial strains isolated from marine sediments at different sites in the Antarctic was evaluated. Isolation of the strains was performed using serial dilutions in the culture medium at M115°C. The identification of the strains was performed using universal primers (27F and 1492R). The enzyme activity assays were performed on R2A medium, carboxy methyl cellulose (CMC)was added as substrate. Degradation of the substrate was revealed by adding Lugol. The results show that four of the tested strains produce enzymes which degrade CMC substrate. The molecular identifications, showed that these bacteria belong to the genus Streptomyces and Pseudoalteromonas, being Streptomyces strain who showed the highest activity. Only some bacteria in marine sediments have the ability to produce these enzymes, perhaps due to their greater adaptability to degrade at temperatures bordering zero degrees Celsius, some algae that are abundant in this environment and have cellulose as the main structure. The discovery of new enzymes adapted to cold is of great industrial interest, especially for paper, textiles, detergents, biofuels, food and agriculture. These enzymes represent 8% of industrial demand worldwide and is expected to increase their demand in the coming years. Mainly in the paper and food industry are required in extraction processes starch, protein and juices, as well as the animal feed industry where treating vegetables and grains helps improve the nutritional value of the food, all this clearly puts Antarctic microorganisms and their enzymes specifically as a potential contribution to industry and the novel biotechnological applications.

Keywords: antarctic, bacteria, biotechnological, cellulolytic enzymes

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275 The Relationship Between Teachers’ Attachment Insecurity and Their Classroom Management Efficacy

Authors: Amber Hatch, Eric Wright, Feihong Wang

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Research suggests that attachment in close relationships affects one’s emotional processes, mindfulness, conflict-management behaviors, and interpersonal interactions. Attachment insecurity is often associated with maladaptive social interactions and suboptimal relationship qualities. Past studies have considered how the nature of emotion regulation and mindfulness in teachers may be related to student or classroom outcomes. Still, no research has examined how the relationship between such internal experiences and classroom management outcomes may also be related to teachers’ attachment insecurity. This study examined the interrelationships between teachers’ attachment insecurity, mindfulness tendencies, emotion regulation abilities, and classroom management efficacy as indexed by students’ classroom behavior and teachers’ response effectiveness. Teachers’ attachment insecurity was evaluated using the global ECRS-SF, which measures both attachment anxiety and avoidance. The present study includes a convenient sample of 357 American elementary school teachers who responded to a survey regarding their classroom management efficacy, attachment in/security, dispositional mindfulness, emotion regulation strategies, and difficulties in emotion regulation, primarily assessed via pre-existing instruments. Good construct validity was demonstrated for all scales used in the survey. Sample demographics, including gender (94% female), race (92% White), age (M = 41.9 yrs.), years of teaching experience (M = 15.2 yrs.), and education level were similar to the population from which it was drawn, (i.e., American elementary school teachers). However, white women were slightly overrepresented in our sample. Correlational results suggest that teacher attachment insecurity is associated with poorer classroom management efficacy as indexed by students’ disruptive behavior and teachers’ response effectiveness. Attachment anxiety was a much stronger predictor of adverse student behaviors and ineffective teacher responses to adverse behaviors than attachment avoidance. Mindfulness, emotion regulation abilities, and years of teaching experience predicted positive classroom management outcomes. Attachment insecurity and mindfulness were more strongly related to frequent adverse student behaviors, while emotion regulation abilities were more strongly related to teachers’ response effectiveness. The teaching experience was negatively related to attachment insecurity and positively related to mindfulness and emotion regulation abilities. Although the data were cross-sectional, path analyses revealed that attachment insecurity is directly related to classroom management efficacy. Through two routes, this relationship is further mediated by emotion regulation and mindfulness in teachers. The first route of indirect effect suggests double mediation by teacher’s emotion regulation and then teacher mindfulness in the relationship between teacher attachment insecurity and classroom management efficacy. The second indirect effect suggests mindfulness directly mediated the relationship between attachment insecurity and classroom management efficacy, resulting in improved model fit statistics. However, this indirect effect is much smaller than the double mediation route through emotion regulation and mindfulness in teachers. Given the significant predication of teacher attachment insecurity, mindfulness, and emotion regulation on teachers’ classroom management efficacy both directly and indirectly, the authors recommend improving teachers’ classroom management efficacy via a three-pronged approach aiming at enhancing teachers’ secure attachment and supporting their learning adaptive emotion regulation strategies and mindfulness techniques.

Keywords: Classroom management efficacy, student behavior, teacher attachment, teacher emotion regulation, teacher mindfulness

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274 Epidemiology of Gestational Choriocarcinoma: A Systematic Review

Authors: Farah Amalina Mohamed Affandi, Redhwan Ahmad Al-Naggar, Seok Mui Wang, Thanikasalam Kathiresan

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Gestational choriocarcinoma is a condition in which there is an abnormal growth or a tumor inside the women’s uterus after conception. It is a type of gestational trophoblastic disease which is relatively rare and malignant. The current epidemiological data of this disease are inadequate. The purposes of this study are to examine the epidemiology of choriocarcinoma and their risk factors based on all available population-based and hospital-based data of the disease. In this study, we searched The MEDLINE and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases using the keywords ‘choriocarcinoma’, ‘gestational’, ‘gestational choriocarcinoma’ and ‘epidemiology’. We included only human studies published in English between 1995 and 2015 to ensure up to date evidence. Case studies, case reports, animal studies, letters to the editor, news, and review articles were excluded. Retrieved articles were screened in three phases. In the first phase, any articles that did not match the inclusion criteria based solely on titles were excluded. In the second phase, the abstracts of remaining articles were screened thoroughly; any articles that did not meet our inclusion criteria were excluded. In the final phase, full texts of the remaining articles were read and assessed to exclude articles that did not meet the inclusion criteria or any articles that fulfilled the exclusion criteria. Duplicates articles were also removed. Systematic reviews and meta-analysis were excluded. Extracted data were summarized in table and figures descriptively. The reference lists of included studies were thoroughly reviewed in search for other relevant studies. A total of ten studies met all the selection criteria. Nine were retrospective studies and one was cohort study. Total numbers of 4563 cases of choriocarcinoma were reviewed from several countries which are Korea, Japan, South Africa, USA, New Mexico, Finland, Turkey, China, Brazil and The Netherlands. Different studies included different range of age with their mean age of 28.5 to 30.0 years. All studies investigated on the disease’s incidence rate, only two studies examined on the risk factors or associations of the disease. Approximately 20% of the studies showed a reduction in the incidence of choriocarcinoma while the other 80% showed inconsistencies in rate. Associations of age, fertility age, occupations and socio-demographic with the status remains unclear. There is limited information on the epidemiological aspects of gestational choriocarcinoma. The observed results indicated there was a decrease in the incidence rate of gestational choriocarcinoma globally. These could be due to the reduction in the incidence of molar pregnancy and the efficacy of the treatment, mainly by chemotherapy.

Keywords: epidemiology, gestational choriocarcinoma, incidence, prevalence, risk factor

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273 Testing of Canadian Integrated Healthcare and Social Services Initiatives with an Evidence-Based Case Definition for Healthcare and Social Services Integrations

Authors: S. Cheng, C. Catallo

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Introduction: Canada's healthcare and social services systems are failing high risk, vulnerable older adults. Care for vulnerable older Canadians (65 and older) is not optimal in Canada. It does not address the care needs of vulnerable, high risk adults using a holistic approach. Given the growing aging population, and the care needs for seniors with complex conditions is one of the highest in Canada's health care system, there is a sense of urgency to optimize care. Integration of health and social services is an emerging trend in Canada when compared to European countries. There is no common and universal understanding of healthcare and social services integration within the country. Consequently, a clear understanding and definition of integrated health and social services are absent in Canada. Objectives: A study was undertaken to develop a case definition for integrated health and social care initiatives that serve older adults, which was then tested against three Canadian integrated initiatives. Methodology: A limited literature review was undertaken to identify common characteristics of integrated health and social care initiatives that serve older adults, and comprised both scientific and grey literature, in order to develop a case definition. Three Canadian integrated initiatives that are located in the province of Ontario, were identified using an online search and a screening process. They were surveyed to determine if the literature-based integration definition applied to them. Results: The literature showed that there were 24 common healthcare and social services integration characteristics that could be categorized into ten themes: 1) patient-care approach; 2) program goals; 3) measurement; 4) service and care quality; 5) accountability and responsibility; 6) information sharing; 7) Decision-making and problem-solving; 8) culture; 9) leadership; and 10) staff and professional interaction. The three initiatives showed agreement on all the integration characteristics except for those characteristics associated with healthcare and social care professional interaction, collaborative leadership and shared culture. This disagreement may be due to several reasons, including the existing governance divide between the healthcare and social services sectors within the province of Ontario that has created a ripple effect in how professions in the two different sectors interact. In addition, the three initiatives may be at maturing levels of integration, which may explain disagreement on the characteristics associated with leadership and culture. Conclusions: The development of a case definition for healthcare and social services integration that incorporates common integration characteristics can act as a useful instrument in identifying integrated healthcare and social services, particularly given the emerging and evolutionary state of this phenomenon within Canada.

Keywords: Canada, case definition, healthcare and social services integration, integration, seniors health, services delivery

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272 Unraveling the Gut-Brain Connection in Alcohol Use Disorder: Microbiome Dysbiosis and Probiotic Therapy as Emerging Treatment Pathways

Authors: Noah Emil Glisik

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Alcohol use disorder (AUD) presents significant health challenges worldwide and is particularly concerning in Slovenia, where high alcohol consumption contributes to elevated rates of comorbidities, including depression and suicide. This review examines emerging evidence linking gut microbiome dysbiosis to AUD, exploring whether gut microbiome alterations merely result from alcohol use or actively contribute to the persistence of addiction. Additionally, it discusses how microbial changes may influence psychological symptoms, including anxiety and depressive states, which are closely associated with suicidality in this population. To address gaps in existing research, a systematic literature search was conducted through PubMed, Web of Science, and ScienceDirect. Inclusion criteria focused on studies examining gut microbiome changes in AUD, particularly those assessing gut-brain axis interactions and microbial species impacting inflammation and neurotransmitter pathways. Studies were excluded if they lacked peer review or did not specifically assess microbiome effects on mental health outcomes. A qualitative literature review approach was applied, synthesizing findings into key themes on microbial changes, neuroinflammatory pathways, and treatment implications. Data were organized into tables to provide a clear comparison of microbiota alterations across studies, highlighting specific bacterial species and their potential effects on AUD. This review emphasizes patterns in AUD patients, where reductions in anti-inflammatory species, such as Faecalibacterium prausnitzii and Roseburia intestinalis, coincide with increases in pro-inflammatory bacteria like Enterococcus faecalisand Lactobacillus rhamnosus. These shifts contribute to increased gut permeability and systemic inflammation, potentially influencing the kynurenine pathway, which is linked to depressive symptoms and elevated alcohol cravings. Furthermore, the review explores the potential of probiotic therapies targeting these microbial imbalances as adjunctive treatments for AUD, particularly those focusing on strains that support anti-inflammatory pathways and gut barrier integrity. Restoring microbial homeostasis through probiotics or fecal microbiota transplantation may not only reduce inflammation but also alleviate mental health symptoms associated with addiction, including suicidality. The findings underscore the need for further clinical trials assessing microbiome-targeted therapies as innovative, multifaceted approaches to AUD treatment in Slovenia and beyond.

Keywords: alcohol use disorder, gut-brain axis, microbiome dysbiosis, probiotic therapy.

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271 Effects of Abiotic Stress on the Phytochemical Content and Bioactivity of Pistacia lentiscus L.

Authors: S. Mamoucha, N. Tsafantakis, Α. Ioannidis, S. Chatzipanagiotou, C. Nikolaou, L. Skaltsounis, N. Fokialakis, N. Christodoulakis

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Introduction: Plant secondary metabolites (SM) can be grouped into three chemically distinct groups: terpenes, phenolics, and nitrogen-containing compounds. For many years the adaptive significance of SM was unknown. They were thought to be functionless end-products. Currently it is accepted that many secondary metabolites (also known as natural products) have important ecological roles in plants. For instance, they serve as attractants (odor, color, taste) for pollinators and seed-dispersing animals. Moreover, they protect plants from herbivores, microbial pathogens and from environmental stress (high and low temperatures, drought, alkalinity, salinity, radiation etc). It is well known that both biotic and abiotic stress often increase the accumulation of SM. The local climatic conditions, seasonal changes, external factors such as light, temperature, humidity affect the biosynthesis and composition of secondary metabolites. A well known dioecious evergreen plant, Pistacia lentiscus L. (mastic tree), was selected in order to study the metabolic variations occur in response to the different climate conditions, due to the seasonal variation and its effect on the biosynthesis of bioactive compounds. Materials-methods: Young and mature leaves were collected in January and July 2014, dried and extracted by accelerated solvent extraction (Dionex ASE™ 350) using solvents of increased polarity (DCM, MeOH, and H2O). GC-MS and UHPLC-HRMS analysis were carried out in order to define the nature and the relative abundance of SM. The antibacterial activity was evaluated by using the Agar Disc Diffusion Assay against ATCC and clinical isolates strains: Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Candida albicans, Streptococcus mutans and Klebsiella pneumoniae. All tests were carried out in duplicate and the average radii of the inhibition zones were calculated for each extract. Results: According to the phytochemical profile obtained from each extract, the biosynthesis of SM varied both qualitatively and quantitatively under the two different types of seasonal stress. With exception of the biologically inactive nonpolar DCM extract of July, all extracts inhibited the growth of most of the investigated microorganisms. A clear positive correlation has been observed between the relative abundance of SM and the bioactivity of the DCM extracts of January and July. Observed changes during phytochemical analysis were mainly focused on the triterpenoid content. On the other hand, the bioactivity of the polar extracts (MeOH and H2O) of January and July resulted practically invariable against most of the microorganisms, besides the significant variation of the SM content due to the seasonal variation. Conclusion: Our results clearly confirmed the hypothesis of abiotic stress as an important regulating factor that significantly affects the biosynthesis of secondary metabolites and thus the presence of bioactive compounds. Acknowledgment: This work was supported by IKY - State Scholarship Foundation, Athens, Greece.

Keywords: antibacterial screening, phytochemical profile, Pistacia lentiscus, abiotic stress

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270 Determinants of Psychological Distress in Teenagers and Young Adults Affected by Cancer: A Systematic Review

Authors: Anna Bak-Klimek, Emily Spencer, Siew Lee, Karen Campbell, Wendy McInally

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Background & Significance: Over half of Teenagers and Young Adults (TYAs) say that they experience psychological distress after cancer diagnosis and TYAs with cancer are at higher risk of developing distress compared to other age groups. Despite this there are no age-appropriate interventions to help TYAs manage distress and there is a lack of conceptual understanding of what causes distress in this population group. This makes it difficult to design a targeted, developmentally appropriate intervention. This review aims to identify the key determinants of distress in TYAs affected by cancer and to propose an integrative model of cancer-related distress for TYAs. Method: A literature search was performed in Cochrane Database of Systematic Reviews, MEDLINE, PsycINFO, CINAHL, EMBASE and PsycArticles in May-June, 2022. Quantitative literature was systematically reviewed on the relationship between psychological distress experienced by TYAs affected by cancer and a wide range of factors i.e. individual (demographic, psychological, developmental, and clinical factors) and contextual (social/environmental) factors. Evidence was synthesized and correlates were categorized using the Biopsychosocial Model. The full protocol is available from PROSPERO (CRD42022322069) Results: Thirty eligible quantitative studies met criteria for the review. A total of twenty-six studies were cross-sectional, three were longitudinal and one study was a case control study. The evidence on the relationship between the socio-demographic, illness and treatment-related factors and psychological distress is inconsistent and unclear. There is however consistent evidence on the link between psychological factors and psychological distress. For instance, the use of cognitive and defence coping, negative meta-cognitive beliefs, less optimism, a lack of sense of meaning and lower resilience levels were significantly associated with higher psychological distress. Furthermore, developmental factors such as poor self-image, identity issues and perceived conflict were strongly associated with higher distress levels. Conclusions: The current review suggests that psychological and developmental factors such as ineffective coping strategies, poor self-image and identity issues may play a key role in the development of psychological distress in TYAs affected by cancer. The review proposes a Positive Developmental Psychology Model of Distress for Teenagers and Young Adults affected by cancer. The review highlights that implementation of psychological interventions that foster optimism, improve resilience and address self-image may result in reduced distress in TYA’s with cancer.

Keywords: cancer, determinant, psychological distress, teenager and young adult, theoretical model

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269 Observational Versus Angioembolisation in Blunt Splenic Trauma: A Systematic Review

Authors: E. Gopi, E. Devaindran

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Objective: Non-operative management of blunt splenic trauma have started to overtake the traditional splenectomy in recent years across the grade of splenic injury. The two main non-operative methods are observation and angioembolisation. However, the post management convalescence in these groups are still being investigated. The study attempts to quantify the clinical indicators among the two in particular complications, mortalities, conversions to operative management and duration of inpatient stay. Methodology: A systematic search was done via PUBMED, MEDLINE, and EMBASE. A total of 639 articles identified and subsequently 68 articles were identified post duplicates, full text, and inclusion and exclusion criteria. Main exclusions were non-English articles without English translation, pure observational or angioembolisation articles of which no comparison data could be identified and articles looking into pure hemodynamically unstable patients. Results: 24 non randomized controlled trial, 5 clinical control trial and 39 retrospective studies analyzing a total of 23700 patients with blunt splenic trauma. Discrepancies in data were noted in the group who had observational management versus angioembolisation in particular as data was compared among the classes of splenic rupture, the protocol of management in different centers, availability of angiogram suite, and the study design. Further variability was also noted in the angioembolisation arm as the preference for treatment differs between distal versus proximal splenic artery involvement. Overall the cumulative mortality in both observational and angioembolisation group were similar, 2.78% and 5.97% respectively. The cause of death however is not directly attributed to the management itself but rather patient comorbidities, other associated injuries and conversions to splenectomy leading to post splenectomy complications. The cumulative morbidity among each group appears to be same approximately 12% in observational versus 15% in angioembolisation. However, the type of complications varies with the observational group having higher rates of inpatient stay and intrabdominal hematoma infection and angioembolisation group developing more splenic infarcts and bleeds. There were significant disparity in reporting the actual data on duration of inpatient stay and complications to allow a statistically significant quantitative analysis to be done, 15 articles however are currently being considered. Conclusions: Observational management appears to be much effective in managing lower grade splenic trauma (grade 1 and 2) where else angioembolisation appears to play a bigger role in intermediate grades (grade 3-4) in ensuring splenic function preservation. Care has to be taken however in the angioembolisation group in view of distal splenic infarct group compromising splenic function. The cumulated data of 15 articles are now being considered for a meta-analysis.

Keywords: blunt splenic trauma, conservative, non-operative, angioembolisation

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268 Gluten Intolerance, Celiac Disease, and Neuropsychiatric Disorders: A Translational Perspective

Authors: Jessica A. Hellings, Piyushkumar Jani

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Background: Systemic autoimmune disorders are increasingly implicated in neuropsychiatric illness, especially in the setting of treatment resistance in individuals of all ages. Gluten allergy in fullest extent results in celiac disease, affecting multiple organs including central nervous system (CNS). Clinicians often lack awareness of the association between neuropsychiatric illness and gluten allergy, partly since many such research studies are published in immunology and gastroenterology journals. Methods: Following a Pubmed literature search and online searches on celiac disease websites, 40 articles are critically reviewed in detail. This work reviews celiac disease, gluten intolerance and current evidence of their relationship to neuropsychiatric and systemic illnesses. The review also covers current work-up and diagnosis, as well as dietary interventions, gluten restriction outcomes, and future research directions. Results: Gluten allergy in susceptible individuals damages the small intestine, producing a leaky gut and malabsorption state, as well as allowing antibodies into the bloodstream, which attack major organs. Lack of amino acid precursors for neurotransmitter synthesis together with antibody-associated brain changes and hypoperfusion may result in neuropsychiatric illness. This is well documented; however, studies in neuropsychiatry are often small. In the large CATIE trial, subjects with schizophrenia had significantly increased antibodies to tissue transglutaminase (TTG), and antigliadin antibodies, both significantly greater gluten antibodies than in control subjects. On later follow up, TTG-6 antibodies were identified in these subjects’ brains but not in their intestines. Significant evidence mostly from small studies also exists for gluten allergy and celiac-related depression, anxiety disorders, attention-deficit/hyperactivity disorder, autism spectrum disorders, ataxia, and epilepsy. Dietary restriction of gluten resulted in remission in several published cases, including for treatment-resistant schizophrenia. Conclusions: Ongoing and larger studies are needed of the diagnosis and treatment efficacy of the gluten-free diet in neuropsychiatric illness. Clinicians should ask about the patient history of anemia, hypothyroidism, irritable bowel syndrome and family history of benefit from the gluten-free diet, not limited to but especially in cases of treatment resistance. Obtaining gluten antibodies by a simple blood test, and referral for gastrointestinal work-up in positive cases should be considered.

Keywords: celiac, gluten, neuropsychiatric, translational

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267 An Audit on the Role of Sentinel Node Biopsy in High-Risk Ductal Carcinoma in Situ and Intracystic Papillary Carcinoma

Authors: M. Sulieman, H. Arabiyat, H. Ali, K. Potiszil, I. Abbas, R. English, P. King, I. Brown, P. Drew

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Introduction: The incidence of breast ductal Carcinoma in Situ (DCIS) has been increasing; it currently represents up 20-25% of all breast carcinomas. Some aspects of DCIS management are still controversial, mainly due to the heterogeneity of its clinical presentation and of its biological and pathological characteristics. In DCIS, histological diagnosis obtained preoperatively, carries the risk of sampling error if the presence of invasive cancer is subsequently diagnosed. The mammographic extent over than 4–5 cm and the presence of architectural distortion, focal asymmetric density or mass on mammography are proven important risk factors of preoperative histological under staging. Intracystic papillary cancer (IPC) is a rare form of breast carcinoma. Despite being previously compared to DCIS it has been shown to present histologically with invasion of the basement membrane and even metastasis. SLNB – Carries the risk of associated comorbidity that should be considered when planning surgery for DCIS and IPC. Objectives: The aim of this Audit was to better define a ‘high risk’ group of patients with pre-op diagnosis of non-invasive cancer undergoing breast conserving surgery, who would benefit from sentinel node biopsy. Method: Retrospective data collection of all patients with ductal carcinoma in situ over 5 years. 636 patients identified, and after exclusion criteria applied: 394 patients were included. High risk defined as: Extensive micro-calcification >40mm OR any mass forming DCIS. IPC: Winpath search from for the term ‘papillary carcinoma’ in any breast specimen for 5 years duration;.29 patients were included in this group. Results: DCIS: 188 deemed high risk due to >40mm calcification or a mass forming (radiological or palpable) 61% of those had a mastectomy and 32% BCS. Overall, in that high-risk group - the number with invasive disease was 38%. Of those high-risk DCIS pts 85% had a SLN - 80% at the time of surgery and 5% at a second operation. For the BCS patients - 42% had SLN at time of surgery and 13% (8 patients) at a second operation. 15 (7.9%) pts in the high-risk group had a positive SLNB, 11 having a mastectomy and 4 having BCS. IPC: The provisional diagnosis of encysted papillary carcinoma is upgraded to an invasive carcinoma on final histology in around a third of cases. This has may have implications when deciding whether to offer sentinel node removal at the time of therapeutic surgery. Conclusions: We have defined a ‘high risk’ group of pts with pre-op diagnosis of non-invasive cancer undergoing BCS, who would benefit from SLNB at the time of the surgery. In patients with high-risk features; the risk of invasive disease is up to 40% but the risk of nodal involvement is approximately 8%. The risk of morbidity from SLN is up to about 5% especially the risk of lymphedema.

Keywords: breast ductal carcinoma in Situ (DCIS), intracystic papillary carcinoma (IPC), sentinel node biopsy (SLNB), high-risk, non-invasive, cancer disease

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266 A Distributed Smart Battery Management System – sBMS, for Stationary Energy Storage Applications

Authors: António J. Gano, Carmen Rangel

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Currently, electric energy storage systems for stationary applications have known an increasing interest, namely with the integration of local renewable energy power sources into energy communities. Li-ion batteries are considered the leading electric storage devices to achieve this integration, and Battery Management Systems (BMS) are decisive for their control and optimum performance. In this work, the advancement of a smart BMS (sBMS) prototype with a modular distributed topology is described. The system, still under development, has a distributed architecture with modular characteristics to operate with different battery pack topologies and charge capacities, integrating adaptive algorithms for functional state real-time monitoring and management of multicellular Li-ion batteries, and is intended for application in the context of a local energy community fed by renewable energy sources. This sBMS system includes different developed hardware units: (1) Cell monitoring units (CMUs) for interfacing with each individual cell or module monitoring within the battery pack; (2) Battery monitoring and switching unit (BMU) for global battery pack monitoring, thermal control and functional operating state switching; (3) Main management and local control unit (MCU) for local sBMS’s management and control, also serving as a communications gateway to external systems and devices. This architecture is fully expandable to battery packs with a large number of cells, or modules, interconnected in series, as the several units have local data acquisition and processing capabilities, communicating over a standard CAN bus and will be able to operate almost autonomously. The CMU units are intended to be used with Li-ion cells but can be used with other cell chemistries, with output voltages within the 2.5 to 5 V range. The different unit’s characteristics and specifications are described, including the different implemented hardware solutions. The developed hardware supports both passive and active methods for charge equalization, considered fundamental functionalities for optimizing the performance and the useful lifetime of a Li-ion battery package. The functional characteristics of the different units of this sBMS system, including different process variables data acquisition using a flexible set of sensors, can support the development of custom algorithms for estimating the parameters defining the functional states of the battery pack (State-of-Charge, State-of-Health, etc.) as well as different charge equalizing strategies and algorithms. This sBMS system is intended to interface with other systems and devices using standard communication protocols, like those used by the Internet of Things. In the future, this sBMS architecture can evolve to a fully decentralized topology, with all the units using Wi-Fi protocols and integrating a mesh network, making unnecessary the MCU unit. The status of the work in progress is reported, leading to conclusions on the system already executed, considering the implemented hardware solution, not only as fully functional advanced and configurable battery management system but also as a platform for developing custom algorithms and optimizing strategies to achieve better performance of electric energy stationary storage devices.

Keywords: Li-ion battery, smart BMS, stationary electric storage, distributed BMS

Procedia PDF Downloads 101
265 The Hypoglycaemic and Antioxidant Effects of Ethanolic Extract of Curcuma Longa Rhizomes Alone and with Two Pepper Adjuvants in Alloxan-Induced Diabetic Rats

Authors: J. O. Ezekwesili-Ofili, L. I. Okorafor, S. C. Nsofor

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Diabetes mellitus is a carbohydrate metabolism disorder due to an absolute or relative deficiency of insulin secretion, action or both. Many known hypoglycaemic drugs are known to produce serious side effects. However, the search for safer and more effective agents has shifted to plant products, including foods and spices. One of such is the rhizome of Curcuma longa or turmeric, which is a spice with high medicinal value. A drawback in the use of C. longa is the poor bioavailability of curcumin, the active ingredient. It has been reported that piperine, an alkaloid present in peppers increases the bioavailability of curcumin. This work therefore investigated the hypoglycaemic and antioxidant effects of ethanolic extract of C. longa rhizomes, alone and with two pepper adjuvants in alloxan-induced diabetic rats. A total of 48 rats were divided into 6 groups of 8 rats each. Groups A–E were induced with diabetes using 150mg/kg body weight of alloxan monohydrate, while group F was normoglycaemic: Group A: Diabetic; fed with 400 mg/g body weight of turmeric extract; group B: Diabetic, fed with 400 mg/kg b. w. and 200mg/kg b. w of ethanolic extract of seeds of Piper guinensee; group C: Diabetic, fed with 400 mg/kg b. w. and 200 mg /kg b. w. of ethanolic extract of seeds of Capsicum annum var cameroun, group D: Diabetic, treated with standard drug, glibenclamide (0.3mg/kg body weight), group E: Diabetic; no treatment i.e. Positive control and group F: non diabetic, no treatment i.e. Negative control. Blood glucose levels were monitored for 14 days using a glucometer. The levels of the antioxidant enzymes; glutathione peroxidase, catalase and superoxide dismutase were also assayed in serum. The ethanolic extracts of C. longa rhizomes at the dose given (400 mg/kg b. w) significantly reduced the blood glucose levels of the diabetic rats (p<0.05) comparable to the standard drug. Co administration of extract of the peppers did not significantly increase the efficiency of the extract, although C. annum var cameroun showed greater effect, though not significantly. The antioxidant effect of the extract was significant in diabetic rats. The use of piperine-containing peppers enhanced the antioxidant effect. Phytochemical analyses of the ethanolic extract of C. longa showed the presence of alkaloids, flavonoids, steroids, saponins, tannins, glycosides, and terpenoids. These results suggest that the ethanolic extract of C. longa had antidiabetic with antioxidant effects and could thus be of benefit in the treatment and management of diabetes as well as ameliorate pro-oxidant effects that may lead to diabetic complications. However, while the addition of piperine did not affect the antidiabetic effect of C. longa, the antioxidant effect was greatly enhanced.

Keywords: antioxidant, Curcuma longa rhizome, hypoglycaemic, pepper adjuvants, piperine

Procedia PDF Downloads 236
264 Valorization of Lignocellulosic Wastes– Evaluation of Its Toxicity When Used in Adsorption Systems

Authors: Isabel Brás, Artur Figueirinha, Bruno Esteves, Luísa P. Cruz-Lopes

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The agriculture lignocellulosic by-products are receiving increased attention, namely in the search for filter materials that retain contaminants from water. These by-products, specifically almond and hazelnut shells are abundant in Portugal once almond and hazelnuts production is a local important activity. Hazelnut and almond shells have as main constituents lignin, cellulose and hemicelluloses, water soluble extractives and tannins. Along the adsorption of heavy metals from contaminated waters, water soluble compounds can leach from shells and have a negative impact in the environment. Usually, the chemical characterization of treated water by itself may not show environmental impact caused by the discharges when parameters obey to legal quality standards for water. Only biological systems can detect the toxic effects of the water constituents. Therefore, the evaluation of toxicity by biological tests is very important when deciding the suitability for safe water discharge or for irrigation applications. The main purpose of the present work was to assess the potential impacts of waters after been treated for heavy metal removal by hazelnut and almond shells adsorption systems, with short term acute toxicity tests. To conduct the study, water at pH 6 with 25 mg.L-1 of lead, was treated with 10 g of shell per litre of wastewater, for 24 hours. This procedure was followed for each bark. Afterwards the water was collected for toxicological assays; namely bacterial resistance, seed germination, Lemna minor L. test and plant grow. The effect in isolated bacteria strains was determined by disc diffusion method and the germination index of seed was evaluated using lettuce, with temperature and humidity germination control for 7 days. For aquatic higher organism, Lemnas were used with 4 days contact time with shell solutions, in controlled light and temperature. For terrestrial higher plants, biomass production was evaluated after 14 days of tomato germination had occurred in soil, with controlled humidity, light and temperature. Toxicity tests of water treated with shells revealed in some extent effects in the tested organisms, with the test assays showing a close behaviour as the control, leading to the conclusion that its further utilization may not be considered to create a serious risk to the environment.

Keywords: lignocellulosic wastes, adsorption, acute toxicity tests, risk assessment

Procedia PDF Downloads 366
263 Characteristics-Based Lq-Control of Cracking Reactor by Integral Reinforcement

Authors: Jana Abu Ahmada, Zaineb Mohamed, Ilyasse Aksikas

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The linear quadratic control system of hyperbolic first order partial differential equations (PDEs) are presented. The aim of this research is to control chemical reactions. This is achieved by converting the PDEs system to ordinary differential equations (ODEs) using the method of characteristics to reduce the system to control it by using the integral reinforcement learning. The designed controller is applied to a catalytic cracking reactor. Background—Transport-Reaction systems cover a large chemical and bio-chemical processes. They are best described by nonlinear PDEs derived from mass and energy balances. As a main application to be considered in this work is the catalytic cracking reactor. Indeed, the cracking reactor is widely used to convert high-boiling, high-molecular weight hydrocarbon fractions of petroleum crude oils into more valuable gasoline, olefinic gases, and others. On the other hand, control of PDEs systems is an important and rich area of research. One of the main control techniques is feedback control. This type of control utilizes information coming from the system to correct its trajectories and drive it to a desired state. Moreover, feedback control rejects disturbances and reduces the variation effects on the plant parameters. Linear-quadratic control is a feedback control since the developed optimal input is expressed as feedback on the system state to exponentially stabilize and drive a linear plant to the steady-state while minimizing a cost criterion. The integral reinforcement learning policy iteration technique is a strong method that solves the linear quadratic regulator problem for continuous-time systems online in real time, using only partial information about the system dynamics (i.e. the drift dynamics A of the system need not be known), and without requiring measurements of the state derivative. This is, in effect, a direct (i.e. no system identification procedure is employed) adaptive control scheme for partially unknown linear systems that converges to the optimal control solution. Contribution—The goal of this research is to Develop a characteristics-based optimal controller for a class of hyperbolic PDEs and apply the developed controller to a catalytic cracking reactor model. In the first part, developing an algorithm to control a class of hyperbolic PDEs system will be investigated. The method of characteristics will be employed to convert the PDEs system into a system of ODEs. Then, the control problem will be solved along the characteristic curves. The reinforcement technique is implemented to find the state-feedback matrix. In the other half, applying the developed algorithm to the important application of a catalytic cracking reactor. The main objective is to use the inlet fraction of gas oil as a manipulated variable to drive the process state towards desired trajectories. The outcome of this challenging research would yield the potential to provide a significant technological innovation for the gas industries since the catalytic cracking reactor is one of the most important conversion processes in petroleum refineries.

Keywords: PDEs, reinforcement iteration, method of characteristics, riccati equation, cracking reactor

Procedia PDF Downloads 91
262 Stress Reduction Techniques for First Responders: Scientifically Proven Methods

Authors: Esther Ranero Carrazana, Maria Karla Ramirez Valdes

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First responders, including firefighters, police officers, and emergency medical personnel, are frequently exposed to high-stress scenarios that significantly increase their risk of mental health issues such as depression, anxiety, and post-traumatic stress disorder (PTSD). Their work involves life-threatening situations, witnessing suffering, and making critical decisions under pressure, all contributing to psychological strain. The objectives of this research on "Stress Reduction Techniques for First Responders: Scientifically Proven Methods" are as follows. One of them is to evaluate the effectiveness of stress reduction techniques. The primary objective is to assess the efficacy of various scientifically proven stress reduction techniques explicitly tailored for first responders. Heart Rate Variability (HRV) Training, Interoception and Exteroception, Sensory Integration, and Body Perception Awareness are scrutinized for their ability to mitigate stress-related symptoms. Furthermore, we evaluate and enhance the understanding of stress mechanisms in first responders by exploring how different techniques influence the physiological and psychological responses to stress. The study aims to deepen the understanding of stress mechanisms in high-risk professions. Additionally, the study promotes psychological resilience by seeking to identify and recommend methods that can significantly enhance the psychological resilience of first responders, thereby supporting their mental health and operational efficiency in high-stress environments. Guide training and policy development is an additional objective to provide evidence-based recommendations that can be used to guide training programs and policy development aimed at improving the mental health and well-being of first responders. Lastly, the study aims to contribute valuable insights to the existing body of knowledge in stress management, specifically tailored to the unique needs of first responders. This study involved a comprehensive literature review assessing the effectiveness of various stress reduction techniques tailored for first responders. Techniques evaluated include Heart Rate Variability (HRV) Training, Interoception and Exteroception, Sensory Integration, and Body Perception Awareness, focusing on their ability to alleviate stress-related symptoms. The review indicates promising results for several stress reduction methods. HRV Training demonstrates the potential to reflect stress vulnerability and enhance physiological and behavioral flexibility. Interoception and Exteroception help modulate the stress response by enhancing awareness of the body's internal state and its interaction with the environment. Sensory integration plays a crucial role in adaptive responses to stress by focusing on individual senses and their integration. Therefore, body perception awareness addresses stress and anxiety through enhanced body perception and mindfulness. The evaluated techniques show significant potential in reducing stress and improving the mental health of first responders. Implementing these scientifically supported methods into routine training could significantly enhance their psychological resilience and operational effectiveness in high-stress environments.

Keywords: first responders, HRV training, mental health, sensory integration, stress reduction

Procedia PDF Downloads 37
261 Cicadas: A Clinician-assisted, Closed-loop Technology, Mobile App for Adolescents with Autism Spectrum Disorders

Authors: Bruno Biagianti, Angela Tseng, Kathy Wannaviroj, Allison Corlett, Megan DuBois, Kyu Lee, Suma Jacob

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Background: ASD is characterized by pervasive Sensory Processing Abnormalities (SPA) and social cognitive deficits that persist throughout the course of the illness and have been linked to functional abnormalities in specific neural systems that underlie the perception, processing, and representation of sensory information. SPA and social cognitive deficits are associated with difficulties in interpersonal relationships, poor development of social skills, reduced social interactions and lower academic performance. Importantly, they can hamper the effects of established evidence-based psychological treatments—including PEERS (Program for the Education and Enrichment of Relationship Skills), a parent/caregiver-assisted, 16-weeks social skills intervention—which nonetheless requires a functional brain capable of assimilating and retaining information and skills. As a matter of fact, some adolescents benefit from PEERS more than others, calling for strategies to increase treatment response rates. Objective: We will present interim data on CICADAS (Care Improving Cognition for ADolescents on the Autism Spectrum)—a clinician-assisted, closed-loop technology mobile application for adolescents with ASD. Via ten mobile assessments, CICADAS captures data on sensory processing abnormalities and associated cognitive deficits. These data populate a machine learning algorithm that tailors the delivery of ten neuroplasticity-based social cognitive training (NB-SCT) exercises targeting sensory processing abnormalities. Methods: In collaboration with the Autism Spectrum and Neurodevelopmental Disorders Clinic at the University of Minnesota, we conducted a fully remote, three-arm, randomized crossover trial with adolescents with ASD to document the acceptability of CICADAS and evaluate its potential as a stand-alone treatment or as a treatment enhancer of PEERS. Twenty-four adolescents with ASD (ages 11-18) have been initially randomized to 16 weeks of PEERS + CICADAS (Arm A) vs. 16 weeks of PEERS + computer games vs. 16 weeks of CICADAS alone (Arm C). After 16 weeks, the full battery of assessments has been remotely administered. Results: We have evaluated the acceptability of CICADAS by examining adherence rates, engagement patterns, and exit survey data. We found that: 1) CICADAS is able to serve as a treatment enhancer for PEERS, inducing greater improvements in sensory processing, cognition, symptom reduction, social skills and behaviors, as well as the quality of life compared to computer games; 2) the concurrent delivery of PEERS and CICADAS induces greater improvements in study outcomes compared to CICADAS only. Conclusion: While preliminary, our results indicate that the individualized assessment and treatment approach designed in CICADAS seems effective in inducing adaptive long-term learning about social-emotional events. CICADAS-induced enhancement of processing and cognition facilitates the application of PEERS skills in the environment of adolescents with ASD, thus improving their real-world functioning.

Keywords: ASD, social skills, cognitive training, mobile app

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260 Sustainability from Ecocity to Ecocampus: An Exploratory Study on Spanish Universities' Water Management

Authors: Leyla A. Sandoval Hamón, Fernando Casani

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Sustainability has been integrated into the cities’ agenda due to the impact that they generate. The dimensions of greater proliferation of sustainability, which are taken as a reference, are economic, social and environmental. Thus, the decisions of management of the sustainable cities search a balance between these dimensions in order to provide environment-friendly alternatives. In this context, urban models (where water consumption, energy consumption, waste production, among others) that have emerged in harmony with the environment, are known as Ecocity. A similar model, but on a smaller scale, is ‘Ecocampus’ that is developed in universities (considered ‘small cities’ due to its complex structure). So, sustainable practices are being implemented in the management of university campus activities, following different relevant lines of work. The universities have a strategic role in society, and their activities can strengthen policies, strategies, and measures of sustainability, both internal and external to the organization. Because of their mission in knowledge creation and transfer, these institutions can promote and disseminate more advanced activities in sustainability. This model replica also implies challenges in the sustainable management of water, energy, waste, transportation, among others, inside the campus. The challenge that this paper focuses on is the water management, taking into account that the universities consume big amounts of this resource. The purpose of this paper is to analyze the sustainability experience, with emphasis on water management, of two different campuses belonging to two different Spanish universities - one urban campus in a historic city and the other a suburban campus in the outskirts of a large city. Both universities are in the top hundred of international rankings of sustainable universities. The methodology adopts a qualitative method based on the technique of in-depth interviews and focus-group discussions with administrative and academic staff of the ‘Ecocampus’ offices, the organizational units for sustainability management, from the two Spanish universities. The hypotheses indicate that sustainable policies in terms of water management are best in campuses without big green spaces and where the buildings are built or rebuilt with modern style. The sustainability efforts of the university are independent of the kind of (urban – suburban) campus but an important aspect to improve is the degree of awareness of the university community about water scarcity. In general, the paper suggests that higher institutions adapt their sustainability policies depending on the location and features of the campus and their engagement with the water conservation. Many Spanish universities have proposed policies, good practices, and measures of sustainability. In fact, some offices or centers of Ecocampus have been founded. The originality of this study is to learn from the different experiences of sustainability policies of universities.

Keywords: ecocampus, ecocity, sustainability, water management

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259 Torn Between the Lines of Border: The Pakhtuns of Pakistan and Afghanistan in Search of Identity

Authors: Priyanka Dutta Chowdhury

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A globalized connected world, calling loud for a composite culture, was still not able to erase the pain of a desired nationalism based on cultural identity. In the South Asian region, the random drawing of the boundaries without taking the ethnic aspect into consideration have always challenged the very basis of the existence of certain groups. The urge to reunify with the fellow brothers on both sides of the border have always called for a chaos and schism in the countries of this region. Sometimes this became a tool to bargain with the state and find a favorable position in the power structure on the basis of cultural identity. In Pakistan and Afghanistan, the Pakhtuns who are divided across the border of the two countries, from the inception of creation of Pakistan have posed various challenges and hampered the growth of a consolidated nation. The Pakhtuns or Pashtuns of both Pakistan and Afghanistan have a strong cultural affinity which blurs their physical distancing and calls for a nationalism based on this ethnic affiliation. Both the sides wanted to create Pakhtunistan unifying all the Pakhtuns of the region. For long, this group have denied to accept the Durand line separating the two. This was an area of concern especially for the Pakhtuns of Pakistan torn between the decision either to join Afghanistan, create a nation of their own or be a part of Pakistan. This ethnic issue became a bone of contention between the two countries. Later, though well absorbed and recognized in the respective countries, they have fought for their identity and claimed for a dominant position in the politics of the nations. Because of the porous borders often influx of refugees was seen especially during Afghan Wars and later many extremists’ groups were born from them especially the Taliban. In the recent string of events, when the Taliban, who are mostly Pakhtuns ethnically, came in power in Afghanistan, a wave of sympathy arose in Pakistan. This gave a strengthening position to the religious Pakhtuns across the border. It is to be noted here that a fragmented Pakhtun identity between the religious and seculars were clearly visible, voicing for their place in the political hierarchy of the country with a vision distinct from each other especially in Pakistan. In this context the paper tries to evaluate the reasons for this cultural turmoil between the countries and this ethnic group. It also aims to analyze the concept of how the identity politics still holds its relevance in the contemporary world. Additionally, the recent trend of fragmented identity points towards instrumentalization of this ethnic groups, who are engaged in the bargaining process with the state for a robust position in the power structure. In the end, the paper aims to deduct from the theoretical conditions of identity politics, whether this is a primordial or a situational tool to have a visibility in the power structure of the contemporary world.

Keywords: cultural identity, identity politics, instrumentalization of identity pakhtuns, power structure

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258 Compressed Natural Gas (CNG) Injector Research for Dual Fuel Engine

Authors: Adam Majczak, Grzegorz Barański, Marcin Szlachetka

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Environmental considerations necessitate the search for new energy sources. One of the available solutions is a partial replacement of diesel fuel by compressed natural gas (CNG) in the compression ignition engines. This type of the engines is used mainly in vans and trucks. These units are also gaining more and more popularity in the passenger car market. In Europe, this part of the market share reaches 50%. Diesel engines are also used in industry in such vehicles as ship or locomotives. Diesel engines have higher emissions of nitrogen oxides in comparison to spark ignition engines. This can be currently limited by optimizing the combustion process and the use of additional systems such as exhaust gas recirculation or AdBlue technology. As a result of the combustion process of diesel fuel also particulate matter (PM) that are harmful to the human health are emitted. Their emission is limited by the use of a particulate filter. One of the method for toxic components emission reduction may be the use of liquid gas fuel such as propane and butane (LPG) or compressed natural gas (CNG). In addition to the environmental aspects, there are also economic reasons for the use of gaseous fuels to power diesel engines. A total or partial replacement of diesel gas is possible. Depending on the used technology and the percentage of diesel fuel replacement, it is possible to reduce the content of nitrogen oxides in the exhaust gas even by 30%, particulate matter (PM) by 95 % carbon monoxide and by 20%, in relation to original diesel fuel. The research object is prototype gas injector designed for direct injection of compressed natural gas (CNG) in compression ignition engines. The construction of the injector allows for it positioning in the glow plug socket, so that the gas is injected directly into the combustion chamber. The cycle analysis of the four-cylinder Andoria ADCR engine with a capacity of 2.6 dm3 for different crankshaft rotational speeds allowed to determine the necessary time for fuel injection. Because of that, it was possible to determine the required mass flow rate of the injector, for replacing as much of the original fuel by gaseous fuel. To ensure a high value of flow inside the injector, supply pressure equal to 1 MPa was applied. High gas supply pressure requires high value of valve opening forces. For this purpose, an injector with hydraulic control system, using a liquid under pressure for the opening process was designed. On the basis of air pressure measurements in the flow line after the injector, the analysis of opening and closing of the valve was made. Measurements of outflow mass of the injector were also carried out. The results showed that the designed injector meets the requirements necessary to supply ADCR engine by the CNG fuel.

Keywords: CNG, diesel engine, gas flow, gas injector

Procedia PDF Downloads 493
257 Prenatal Genetic Screening and Counselling Competency Challenges of Nurse-Midwife

Authors: Girija Madhavanprabhakaran, Frincy Franacis, Sheeba Elizabeth John

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Introduction: A wide range of prenatal genetic screening is introduced with increasing incidences of congenital anomalies even in low-risk pregnancies and is an emerging standard of care. Being frontline caretakers, the role and responsibilities of nurses and midwives are critical as they are working along with couples to provide evidence-based supportive educative care. The increasing genetic disorders and advances in prenatal genetic screening with limited genetic counselling facilities urge nurses and midwifery nurses with essential competencies to help couples to take informed decision. Objective: This integrative literature review aimed to explore nurse midwives’ knowledge and role in prenatal screening and genetic counselling competency and the challenges faced by them to cater to all pregnant women to empower their autonomy in decision making and ensuring psychological comfort. Method: An electronic search using keywords prenatal screening, genetic counselling, prenatal counselling, nurse midwife, nursing education, genetics, and genomics were done in the PUBMED, SCOPUS and Medline, Google Scholar. Finally, based on inclusion criteria, 8 relevant articles were included. Results: The main review results suggest that nurses and midwives lack essential support, knowledge, or confidence to be able to provide genetic counselling and help the couples ethically to ensure client autonomy and decision making. The majority of nurses and midwives reported inadequate levels of knowledge on genetic screening and their roles in obtaining family history, pedigrees, and providing genetic information for an affected client or high-risk families. The deficiency of well-recognized and influential clinical academic midwives in midwifery practice is also reported. Evidence recommended to update and provide sound educational training to improve nurse-midwife competence and confidence. Conclusion: Overcoming the challenges to achieving informed choices about fetal anomaly screening globally is a major concern. Lack of adequate knowledge and counselling competency, communication insufficiency, need for education and policy are major areas to address. Prenatal nurses' and midwives’ knowledge on prenatal genetic screening and essential counselling competencies can ensure services to the majority of pregnant women around the globe to be better-informed decision-makers and enhances their autonomy, and reduces ethical dilemmas.

Keywords: challenges, genetic counselling, prenatal screening, prenatal counselling

Procedia PDF Downloads 200
256 Improved Elastoplastic Bounding Surface Model for the Mathematical Modeling of Geomaterials

Authors: Andres Nieto-Leal, Victor N. Kaliakin, Tania P. Molina

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The nature of most engineering materials is quite complex. It is, therefore, difficult to devise a general mathematical model that will cover all possible ranges and types of excitation and behavior of a given material. As a result, the development of mathematical models is based upon simplifying assumptions regarding material behavior. Such simplifications result in some material idealization; for example, one of the simplest material idealization is to assume that the material behavior obeys the elasticity. However, soils are nonhomogeneous, anisotropic, path-dependent materials that exhibit nonlinear stress-strain relationships, changes in volume under shear, dilatancy, as well as time-, rate- and temperature-dependent behavior. Over the years, many constitutive models, possessing different levels of sophistication, have been developed to simulate the behavior geomaterials, particularly cohesive soils. Early in the development of constitutive models, it became evident that elastic or standard elastoplastic formulations, employing purely isotropic hardening and predicated in the existence of a yield surface surrounding a purely elastic domain, were incapable of realistically simulating the behavior of geomaterials. Accordingly, more sophisticated constitutive models have been developed; for example, the bounding surface elastoplasticity. The essence of the bounding surface concept is the hypothesis that plastic deformations can occur for stress states either within or on the bounding surface. Thus, unlike classical yield surface elastoplasticity, the plastic states are not restricted only to those lying on a surface. Elastoplastic bounding surface models have been improved; however, there is still need to improve their capabilities in simulating the response of anisotropically consolidated cohesive soils, especially the response in extension tests. Thus, in this work an improved constitutive model that can more accurately predict diverse stress-strain phenomena exhibited by cohesive soils was developed. Particularly, an improved rotational hardening rule that better simulate the response of cohesive soils in extension. The generalized definition of the bounding surface model provides a convenient and elegant framework for unifying various previous versions of the model for anisotropically consolidated cohesive soils. The Generalized Bounding Surface Model for cohesive soils is a fully three-dimensional, time-dependent model that accounts for both inherent and stress induced anisotropy employing a non-associative flow rule. The model numerical implementation in a computer code followed an adaptive multistep integration scheme in conjunction with local iteration and radial return. The one-step trapezoidal rule was used to get the stiffness matrix that defines the relationship between the stress increment and the strain increment. After testing the model in simulating the response of cohesive soils through extensive comparisons of model simulations to experimental data, it has been shown to give quite good simulations. The new model successfully simulates the response of different cohesive soils; for example, Cardiff Kaolin, Spestone Kaolin, and Lower Cromer Till. The simulated undrained stress paths, stress-strain response, and excess pore pressures are in very good agreement with the experimental values, especially in extension.

Keywords: bounding surface elastoplasticity, cohesive soils, constitutive model, modeling of geomaterials

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255 Exploring the Impact of Input Sequence Lengths on Long Short-Term Memory-Based Streamflow Prediction in Flashy Catchments

Authors: Farzad Hosseini Hossein Abadi, Cristina Prieto Sierra, Cesar Álvarez Díaz

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Predicting streamflow accurately in flashy catchments prone to floods is a major research and operational challenge in hydrological modeling. Recent advancements in deep learning, particularly Long Short-Term Memory (LSTM) networks, have shown to be promising in achieving accurate hydrological predictions at daily and hourly time scales. In this work, a multi-timescale LSTM (MTS-LSTM) network was applied to the context of regional hydrological predictions at an hourly time scale in flashy catchments. The case study includes 40 catchments allocated in the Basque Country, north of Spain. We explore the impact of hyperparameters on the performance of streamflow predictions given by regional deep learning models through systematic hyperparameter tuning - where optimal regional values for different catchments are identified. The results show that predictions are highly accurate, with Nash-Sutcliffe (NSE) and Kling-Gupta (KGE) metrics values as high as 0.98 and 0.97, respectively. A principal component analysis reveals that a hyperparameter related to the length of the input sequence contributes most significantly to the prediction performance. The findings suggest that input sequence lengths have a crucial impact on the model prediction performance. Moreover, employing catchment-scale analysis reveals distinct sequence lengths for individual basins, highlighting the necessity of customizing this hyperparameter based on each catchment’s characteristics. This aligns with well known “uniqueness of the place” paradigm. In prior research, tuning the length of the input sequence of LSTMs has received limited focus in the field of streamflow prediction. Initially it was set to 365 days to capture a full annual water cycle. Later, performing limited systematic hyper-tuning using grid search, revealed a modification to 270 days. However, despite the significance of this hyperparameter in hydrological predictions, usually studies have overlooked its tuning and fixed it to 365 days. This study, employing a simultaneous systematic hyperparameter tuning approach, emphasizes the critical role of input sequence length as an influential hyperparameter in configuring LSTMs for regional streamflow prediction. Proper tuning of this hyperparameter is essential for achieving accurate hourly predictions using deep learning models.

Keywords: LSTMs, streamflow, hyperparameters, hydrology

Procedia PDF Downloads 70
254 Randomized Controlled Trial for the Management of Pain and Anxiety Using Virtual Reality During the Care of Older Hospitalized Patients

Authors: Corbel Camille, Le Cerf Flora, Capriz Françoise, Vaillant-Ciszewicz Anne-Julie, Breaud Jean, Guerin Olivier, Corveleyn Xavier

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Background: The medical environment can generate stressful and anxiety-provoking situations for patients, particularly during painful care procedures for the older population. These stressful environments have deleterious effects on the quality of care and can even put the patient at risk and set the care team up for failure. The search for a solution is, therefore, imperative. The development of new technologies, such as virtual reality (VR), seems to be an answer to this problem. Objectives: The objective of this study is to compare the effects of virtual reality on pain and anxiety when caring for older hospitalized people with the effects of usual care. More precisely, different individual factors (age, cognitive level, individual preferences, etc.) and different virtual reality universes (personalized or non-personalized) are studied to understand the role of these factors in reducing pain and anxiety during care procedures. The aim of this study is to improve the quality of life of patients and caregivers in their work environment. Method: This mono-centered, randomized, controlled study was conducted from September 2023 to September 2024 on 120 participants recruited from the geriatric departments of the Cimiez Hospital, Nice, France. Participants are randomized into three groups: a control group, a personalized VR group and a non-personalized VR group. Each participant is followed during a painful care session. Data are collected before, during and after the care, using measures of pain (Algoplus and numerical scale) and anxiety (Hospital anxiety scale and numerical scale). Physiological assessments with an oximeter are also performed to collect both heart and respiratory rate measurements. The implementation of the care will be assessed among healthcare providers to evaluate its effects on the difficulty and fatigue associated with the care. Additionally, a questionnaire (System Usability Scale) will be administered at the conclusion of the study to determine the willingness of healthcare providers to integrate VR into their daily care practices. Result: The preliminary results indicate significant effects on anxiety (p=.001) and pain (p=<.001) following the VR intervention during care, as compared to the control group. Conclusion: The preliminary results suggest that VRI appears to be a suitable and effective method for reducing anxiety and pain among older hospitalized individuals compared with standard care. Finally, the experiences of healthcare professionals involved will also be considered to assess the impact of these interventions on working conditions and patient support.

Keywords: anxiety, care, pain, older adults, virtual reality

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253 Barrier Membrane Influence Histology of Guided Bone Regenerations: A Systematic Review and Meta-Analysis

Authors: Laura Canagueral-Pellice, Antonio Munar-Frau, Adaia Valls-Ontanon, Joao Carames, Federico Hernandez-Alfaro, Jordi Caballe-Serrano

Abstract:

Objective: Guided bone regeneration (GBR) aims to replace the missing bone with a new structure to achieve long-term stability of rehabilitations. The aim of the present systematic review and meta-analysis is to determine the effect of barrier membranes on histological outcomes after GBR procedures. Moreover, the effect of the grafting material and tissue gain were analyzed. Materials & methods: Two independent reviewers performed an electronic search in Pubmed and Scopus, identifying all eligible publications up to March 2020. Only randomized controlled trials (RCTs) assessing a histological analysis of augmented areas were included. Results: A total of 6 publications were included for the present systematic review. A total of 110 biopsied sites were analysed; 10 corresponded to vertical bone augmentation procedures, whereas 100 analysed horizontal regeneration procedures. A mean tissue gain of 3 ± 1.48mm was obtained for horizontal defects. Histological assessment of new bone formation, residual particle and sub-epithelial connective tissue (SCT) was reported. The four main barrier membranes used were natural collagen membranes, e-PTFE, polylactic resorbable membranes and acellular dermal matrix membranes (AMDG). The analysis demonstrated that resorbable membranes result in higher values of new bone formation and lower values of residual particles and SCT. Xenograft resulted in lower new bone formation compared to allograft; however, no statistically significant differences were observed regarding residual particle and SCT. Overall, regeneration procedures adding autogenous bone, plasma derivate or growth factors achieved in general greater new bone formation and tissue gain. Conclusions: There is limited evidence favoring the effect of a certain type of barrier membrane in GBR. Data needs to be evaluated carefully; however, resorbable membranes are correlated with greater new bone formation values, especially when combined with allograft materials and/or the addition of autogenous bone, platelet reach plasma (PRP) or growth factors in the regeneration area. More studies assessing the histological outcomes of different GBR protocols and procedures testing different biomaterials are needed to maximize the clinical and histological outcomes in bone regeneration science.

Keywords: barrier membrane, graft material, guided bone regeneration, implant surgery, histology

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252 Developing Communicative Skills in Foreign Languages by Video Tasks

Authors: Ekaterina G. Lipatova

Abstract:

The developing potential of a video task in teaching foreign languages involves the opportunities to improve four aspects of speech production process: listening, reading, speaking and writing. A video represents the sequence of actions, realized in the pictures logically connected and verbalized speech flow that simplifies and stimulates the process of perception. In this connection listening skills of students are developed effectively as well as their intellectual properties such as synthesizing, analyzing and generalizing the information. In terms of teaching capacity, a video task, in our opinion, is more stimulating than a traditional listening, since it involves the student into the plot of the communicative situation, emotional background and potentially makes them react to the gist in the cognitive and communicative ways. To be an effective method of teaching the video task should be structured in the way of psycho-linguistic characteristics of speech production process, in other words, should include three phases: before-watching, while-watching and after-watching. The system of tasks provided to each phase might involve the situations on reflecting to the video content in the forms of filling-the-gap tasks, multiple choice, True-or-False tasks (reading skills), exercises on expressing the opinion, project fulfilling (writing and speaking skills). In the before-watching phase we offer the students to adjust their perception mechanism to the topic and the problem of the chosen video by such task as “what do you know about such a problem?”, “is it new for you?”, “have you ever faced the situation of…?”. Then we proceed with the lexical and grammatical analysis of language units that form the body of a speech sample to lessen the perception and develop the student’s lexicon. The goal of while-watching phase is to build the student’s awareness about the problem presented in the video and challenge their inner attitude towards what they have seen by identifying the mistakes in the statements about the video content or making the summary, justifying their understanding. Finally, we move on to development of their speech skills within the communicative situation they observed and learnt by stimulating them to search the similar ideas in their backgrounds and represent them orally or in the written form or express their own opinion on the problem. It is compulsory to highlight, that a video task should contain the urgent, valid and interesting event related to the future profession of the student, since it will help to activate cognitive, emotional, verbal and ethic capacity of students. Also, logically structured video tasks are easily integrated into the system of e-learning and can provide the opportunity for the students to work with the foreign language on their own.

Keywords: communicative situation, perception mechanism, speech production process, speech skills

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251 Institutional Cooperation to Foster Economic Development: Universities and Social Enterprises

Authors: Khrystyna Pavlyk

Abstract:

In the OECD countries, percentage of adults with higher education degrees has increased by 10 % during 2000-2010. Continuously increasing demand for higher education gives universities a chance of becoming key players in socio-economic development of a territory (region or city) via knowledge creation, knowledge transfer, and knowledge spillovers. During previous decade, universities have tried to support spin-offs and start-ups, introduced courses on sustainability and corporate social responsibility. While much has been done, new trends are starting to emerge in search of better approaches. Recently a number of universities created centers that conduct research in a field social entrepreneurship, which in turn underpin educational programs run at these universities. The list includes but is not limited to the Centre for Social Economy at University of Liège, Institute for Social Innovation at ESADE, Skoll Centre for Social Entrepreneurship at Oxford, Centre for Social Entrepreneurship at Rosklide, Social Entrepreneurship Initiative at INSEAD. Existing literature already examined social entrepreneurship centers in terms of position in the institutional structure, initial and additional funding, teaching initiatives, research achievements, and outreach activities. At the same time, Universities can become social enterprises themselves. Previous research revealed that universities use both business and social entrepreneurship models. Universities which are mainly driven by a social mission are more likely to transform into social entrepreneurial institutions. At the same time, currently, there is no clear understanding of what social entrepreneurship in higher education is about and thus social entrepreneurship in higher education needs to be studied and promoted at the same time. Main roles which socially oriented university can play in city development include: buyer (implementation of socially focused local procurement programs creates partnerships focused on local sustainable growth.); seller (centers created by universities can sell socially oriented goods and services, e.g. in consultancy.); employer (Universities can employ socially vulnerable groups.); business incubator (which will help current student to start their social enterprises). In the paper, we will analyze these in more detail. We will also examine a number of indicators that can be used to assess the impact, both direct and indirect, that universities can have on city's economy. At the same time, originality of this paper mainly lies not in methodological approaches used, but in countries evaluated. Social entrepreneurship is still treated as a relatively new phenomenon in post-transitional countries where social services were provided only by the state for many decades. Paper will provide data and example’s both from developed countries (the US and EU), and those located in CIS and CEE region.

Keywords: social enterprise, university, regional economic development, comparative study

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250 Designing Form, Meanings, and Relationships for Future Industrial Products. Case Study Observation of PAD

Authors: Elisabetta Cianfanelli, Margherita Tufarelli, Paolo Pupparo

Abstract:

The dialectical mediation between desires and objects or between mass production and consumption continues to evolve over time. This relationship is influenced both by variable geometries of contexts that are distant from the mere design of product form and by aspects rooted in the very definition of industrial design. In particular, the overcoming of macro-areas of innovation in the technological, social, cultural, formal, and morphological spheres, supported by recent theories in critical and speculative design, seems to be moving further and further away from the design of the formal dimension of advanced products. The articulated fabric of theories and practices that feed the definition of “hyperobjects”, and no longer objects describes a common tension in all areas of design and production of industrial products. The latter are increasingly detached from the design of the form and meaning of the same in mass productions, thus losing the quality of products capable of social transformation. For years we have been living in a transformative moment as regards the design process in the definition of the industrial product. We are faced with a dichotomy in which there is, on the one hand, a reactionary aversion to the new techniques of industrial production and, on the other hand, a sterile adoption of the techniques of mass production that we can now consider traditional. This ambiguity becomes even more evident when we talk about industrial products, and we realize that we are moving further and further away from the concepts of "form" as a synthesis of a design thought aimed at the aesthetic-emotional component as well as the functional one. The design of forms and their contents, as statutes of social acts, allows us to investigate the tension on mass production that crosses seasons, trends, technicalities, and sterile determinisms. The design culture has always determined the formal qualities of objects as a sum of aesthetic characteristics functional and structural relationships that define a product as a coherent unit. The contribution proposes a reflection and a series of practical experiences of research on the form of advanced products. This form is understood as a kaleidoscope of relationships through the search for an identity, the desire for democratization, and between these two, the exploration of the aesthetic factor. The study of form also corresponds to the study of production processes, technological innovations, the definition of standards, distribution, advertising, the vicissitudes of taste and lifestyles. Specifically, we will investigate how the genesis of new forms for new meanings introduces a change in the relative innovative production techniques. It becomes, therefore, fundamental to investigate, through the reflections and the case studies exposed inside the contribution, also the new techniques of production and elaboration of the forms of the products, as new immanent and determining element inside the planning process.

Keywords: industrial design, product advanced design, mass productions, new meanings

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