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Search results for: information content model

235 Measuring Green Growth Indicators: Implication for Policy

Authors: Hanee Ryu

Abstract:

The former president Lee Myung-bak's administration of Korea presented “green growth” as a catchphrase from 2008. He declared “low-carbon, green growth” the nation's vision for the next decade according to United Nation Framework on Climate Change. The government designed omnidirectional policy for low-carbon and green growth with concentrating all effort of departments. The structural change was expected because this slogan is the identity of the government, which is strongly driven with the whole department. After his administration ends, the purpose of this paper is to quantify the policy effect and to compare with the value of the other OECD countries. The major target values under direct policy objectives were suggested, but it could not capture the entire landscape on which the policy makes changes. This paper figures out the policy impacts through comparing the value of ex-ante between the one of ex-post. Furthermore, each index level of Korea’s low-carbon and green growth comparing with the value of the other OECD countries. To measure the policy effect, indicators international organizations have developed are considered. Environmental Sustainable Index (ESI) and Environmental Performance Index (EPI) have been developed by Yale University’s Center for Environmental Law and Policy and Columbia University’s Center for International Earth Science Information Network in collaboration with the World Economic Forum and Joint Research Center of European Commission. It has been widely used to assess the level of natural resource endowments, pollution level, environmental management efforts and society’s capacity to improve its environmental performance over time. Recently OCED publish the Green Growth Indicator for monitoring progress towards green growth based on internationally comparable data. They build up the conceptual framework and select indicators according to well specified criteria: economic activities, natural asset base, environmental dimension of quality of life and economic opportunities and policy response. It considers the socio-economic context and reflects the characteristic of growth. Some selected indicators are used for measuring the level of changes the green growth policies have induced in this paper. As results, the CO2 productivity and energy productivity show trends of declination. It means that policy intended industry structure shift for achieving carbon emission target affects weakly in the short-term. Increasing green technologies patents might result from the investment of previous period. The increasing of official development aids which can be immediately embarked by political decision with no time lag present only in 2008-2009. It means international collaboration and investment to developing countries via ODA has not succeeded since the initial stage of his administration. The green growth framework makes the public expect structural change, but it shows sporadic effect. It needs organization to manage it in terms of the long-range perspectives. Energy, climate change and green growth are not the issue to be handled in the one period of the administration. The policy mechanism to transfer cost problem to value creation should be developed consistently.

Keywords: comparing ex-ante between ex-post indicator, green growth indicator, implication for green growth policy, measuring policy effect

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234 Regenerating Habitats. A Housing Based on Modular Wooden Systems

Authors: Rui Pedro de Sousa Guimarães Ferreira, Carlos Alberto Maia Domínguez

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Despite the ambitions to achieve climate neutrality by 2050, to fulfill the Paris Agreement's goals, the building and construction sector remains one of the most resource-intensive and greenhouse gas-emitting industries in the world, accounting for 40% of worldwide CO ₂ emissions. Over the past few decades, globalization and population growth have led to an exponential rise in demand in the housing market and, by extension, in the building industry. Considering this housing crisis, it is obvious that we will not stop building in the near future. However, the transition, which has already started, is challenging and complex because it calls for the worldwide participation of numerous organizations in altering how building systems, which have been a part of our everyday existence for over a century, are used. Wood is one of the alternatives that is most frequently used nowadays (under responsible forestry conditions) because of its physical qualities and, most importantly, because it produces fewer carbon emissions during manufacturing than steel or concrete. Furthermore, as wood retains its capacity to store CO ₂ after application and throughout the life of the building, working as a natural carbon filter, it helps to reduce greenhouse gas emissions. After a century-long focus on other materials, in the last few decades, technological advancements have made it possible to innovate systems centered around the use of wood. However, there are still some questions that require further exploration. It is necessary to standardize production and manufacturing processes based on prefabrication and modularization principles to achieve greater precision and optimization of the solutions, decreasing building time, prices, and waste from raw materials. In addition, this approach will make it possible to develop new architectural solutions to solve the rigidity and irreversibility of buildings, two of the most important issues facing housing today. Most current models are still created as inflexible, fixed, monofunctional structures that discourage any kind of regeneration, based on matrices that sustain the conventional family's traditional model and are founded on rigid, impenetrable compartmentalization. Adaptability and flexibility in housing are, and always have been, necessities and key components of architecture. People today need to constantly adapt to their surroundings and themselves because of the fast-paced, disposable, and quickly obsolescent nature of modern items. Migrations on a global scale, different kinds of co-housing, or even personal changes are some of the new questions that buildings have to answer. Designing with the reversibility of construction systems and materials in mind not only allows for the concept of "looping" in construction, with environmental advantages that enable the development of a circular economy in the sector but also unleashes multiple social benefits. In this sense, it is imperative to develop prefabricated and modular construction systems able to address the formalization of a reversible proposition that adjusts to the scale of time and its multiple reformulations, many of which are unpredictable. We must allow buildings to change, grow, or shrink over their lifetime, respecting their nature and, finally, the nature of the people living in them. It´s the ability to anticipate the unexpected, adapt to social factors, and take account of demographic shifts in society to stabilize communities, the foundation of real innovative sustainability.

Keywords: modular, timber, flexibility, housing

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233 Combined Treatment with Microneedling and Chemical Peels Improves Periorbital Wrinkles and Skin Laxity

Authors: G. Kontochristopoulos, T. Spiliopoulos, V. Markantoni, E. Platsidaki, A. Kouris, E. Balamoti, C. Bokotas, G. Haidemenos

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Introduction: There is a high patient demand for periorbital rejuvenation since the facial area is often the first to show visible signs of aging. With advancing age, there are sometimes marked changes that occur in the skin, fat, muscle and bone of the periorbital region, resulting to wrinkles and skin laxity. These changes are among the easiest areas to correct using several minimally invasive techniques, which have become increasingly popular over the last decade. Lasers, radiofrequency, botulinum toxin, fat grafting and fillers are available treatments sometimes in combination to traditional blepharoplasty. This study attempts to show the benefits of a minimally invasive approach to periorbital wrinkles and skin laxity that combine microneedling and 10% trichloroacetic acid (TCA) peels. Method: Eleven female patients aged 34-72 enrolled in the study. They all gave informed consent after receiving detailed information regarding the treatment procedure. Exclusion criteria in the study were previous treatment for the same condition in the past six months, pregnancy, allergy or hypersensitivity to the components, infection, inflammation and photosensitivity on the affected region. All patients had diffuse periorbital wrinkles and mild to moderate upper or lower eyelid skin laxity. They were treated with Automatic Microneedle Therapy System-Handhold and topical application of 10% trichloroacetic acid solution to each periorbital area for five minutes. Needling at a 0,25 mm depth was performed in both latelar (x-y) directions. Subsequently, the peeling agent was applied to each periorbital area for five minutes. Patients were subjected to the above combination every two weeks for a series of four treatments. Subsequently they were followed up regularly every month for two months. The effect was photo-documented. A Physician's and a Patient's Global Assessment Scale was used to evaluate the efficacy of the treatment (0-25% indicated poor response, 25%-50% fair, 50%-75% good and 75%-100% excellent response). Safety was assessed by monitoring early and delayed adverse events. Results: At the end of the study, almost all patients demonstrated significant aesthetic improvement. Physicians assessed a fair and a good improvement in 9(81.8% of patients) and 2(18.1% of patients) participants respectively. Patients Global Assessment rated a fair and a good response in 6 (54.5%) and 5 (45.4%) participants respectively. The procedure was well tolerated and all patients were satisfied. Mild discomfort and transient erythema were quite common during or immediately after the procedure, however only temporary. During the monthly follow up, no complications or scars were observed. Conclusions: Microneedling is known as a simple, office–based collagen induction therapy. Low concentration TCA solution applied to the epidermis that has been more permeable by microneedling, can reach the dermis more effectively. In the present study, chemical peels with 10% TCA acted as an adjuvant to microneedling, as it causes controlled skin damage, promoting regeneration and rejuvenation of tissues. This combined therapy improved periorbital fine lines, wrinkles, and overall appearance of the skin. Thus it constitutes an alternative treatment of periorbital skin aging, with encouraging results and minor side-effects.

Keywords: chemical peels, microneedling, periorbital wrinkles, skin laxity

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232 Photobleaching Kinetics and Epithelial Distribution of Hexylaminoleuilinate Induced PpIX in Rat Bladder Cancer

Authors: Sami El Khatib, Agnès Leroux, Jean-Louis Merlin, François Guillemin, Marie-Ange D’Hallewin

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Photodynamic therapy (PDT) is a treatment modality based on the cytotoxic effect occurring on the target tissues by interaction of a photosensitizer with light in the presence of oxygen. One of the major advances in PDT can be attributed to the use of topical aminolevulinic (ALA) to induce Protoporphyrin IX (PpIX) for the treatment of early stage cancers as well as diagnosis. ALA is a precursor of the heme synthesis pathway. Locally delivered to the target tissue ALA overcomes the negative feedback exerted by heme and promotes the transient formation of PpIX in situ to reach critical effective levels in cells and tissue. Whereas early steps of the heme pathway occur in the cytosol, PpIX synthesis is shown to be held in the mitochondrial membranes and PpIX fluorescence is expected to accumulate in close vicinity of the initial building site and to progressively diffuse to the neighboring cytoplasmic compartment or other lipophylic organelles. PpIX is known to be highly reactive and will be degraded when irradiated with light. PpIX photobleaching is believed to be governed by a singlet oxygen mediated mechanism in the presence of oxidized amino acids and proteins. PpIX photobleaching and subsequent spectral phototransformation were described widely in tumor cells incubated in vitro with ALA solution, or ex vivo in human and porcine mucosa superfused with hexylaminolevulinate (hALA). PpIX photobleaching was also studied in vivo, using animal models such as normal or tumor mice skin and orthotopic rat bladder model. Hexyl aminolevulinate a more potent lipophilic derivative of ALA was proposed as an adjunct to standard cystoscopy in the fluorescence diagnosis of bladder cancer and other malignancies. We have previously reported the effectiveness of hALA mediated PDT of rat bladder cancer. Although normal and tumor bladder epithelium exhibit similar fluorescence intensities after intravesical instillation of two hALA concentrations (8 and 16 mM), the therapeutic response at 8mM and 20J/cm2 was completely different from the one observed at 16mM irradiated with the same light dose. Where the tumor is destroyed, leaving the underlying submucosa and muscle intact after an 8 mM instillation, 16mM sensitization and subsequent illumination results in the complete destruction of the underlying bladder wall but leaves the tumor undamaged. The object of the current study is to try to unravel the underlying mechanism for this apparent contradiction. PpIX extraction showed identical amounts of photosensitizer in tumor bearing bladders at both concentrations. Photobleaching experiments revealed mono-exponential decay curves in both situations but with a two times faster decay constant in case of 16mM bladders. Fluorescence microscopy shows an identical fluorescence pattern for normal bladders at both concentrations and tumor bladders at 8mM with bright spots. Tumor bladders at 16 mM exhibit a more diffuse cytoplasmic fluorescence distribution. The different response to PDT with regard to the initial pro-drug concentration can thus be attributed to the different cellular localization.

Keywords: bladder cancer, hexyl-aminolevulinate, photobleaching, confocal fluorescence microscopy

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231 Recognizing Human Actions by Multi-Layer Growing Grid Architecture

Authors: Z. Gharaee

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Recognizing actions performed by others is important in our daily lives since it is necessary for communicating with others in a proper way. We perceive an action by observing the kinematics of motions involved in the performance. We use our experience and concepts to make a correct recognition of the actions. Although building the action concepts is a life-long process, which is repeated throughout life, we are very efficient in applying our learned concepts in analyzing motions and recognizing actions. Experiments on the subjects observing the actions performed by an actor show that an action is recognized after only about two hundred milliseconds of observation. In this study, hierarchical action recognition architecture is proposed by using growing grid layers. The first-layer growing grid receives the pre-processed data of consecutive 3D postures of joint positions and applies some heuristics during the growth phase to allocate areas of the map by inserting new neurons. As a result of training the first-layer growing grid, action pattern vectors are generated by connecting the elicited activations of the learned map. The ordered vector representation layer receives action pattern vectors to create time-invariant vectors of key elicited activations. Time-invariant vectors are sent to second-layer growing grid for categorization. This grid creates the clusters representing the actions. Finally, one-layer neural network developed by a delta rule labels the action categories in the last layer. System performance has been evaluated in an experiment with the publicly available MSR-Action3D dataset. There are actions performed by using different parts of human body: Hand Clap, Two Hands Wave, Side Boxing, Bend, Forward Kick, Side Kick, Jogging, Tennis Serve, Golf Swing, Pick Up and Throw. The growing grid architecture was trained by applying several random selections of generalization test data fed to the system during on average 100 epochs for each training of the first-layer growing grid and around 75 epochs for each training of the second-layer growing grid. The average generalization test accuracy is 92.6%. A comparison analysis between the performance of growing grid architecture and self-organizing map (SOM) architecture in terms of accuracy and learning speed show that the growing grid architecture is superior to the SOM architecture in action recognition task. The SOM architecture completes learning the same dataset of actions in around 150 epochs for each training of the first-layer SOM while it takes 1200 epochs for each training of the second-layer SOM and it achieves the average recognition accuracy of 90% for generalization test data. In summary, using the growing grid network preserves the fundamental features of SOMs, such as topographic organization of neurons, lateral interactions, the abilities of unsupervised learning and representing high dimensional input space in the lower dimensional maps. The architecture also benefits from an automatic size setting mechanism resulting in higher flexibility and robustness. Moreover, by utilizing growing grids the system automatically obtains a prior knowledge of input space during the growth phase and applies this information to expand the map by inserting new neurons wherever there is high representational demand.

Keywords: action recognition, growing grid, hierarchical architecture, neural networks, system performance

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230 Perception of Health Care Providers on the Use of Modern Contraception by Adolescents in Rwanda

Authors: Jocelyne Uwibambe, Ange Thaina Ndizeye, Dinah Ishimwe, Emmanuel Mugabo Byakagaba

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Background: In low- and middle-income countries (LMICs), the use of modern contraceptive methods among women, including adolescents, is still low despite the desire to avoid pregnancy. In addition, countries have set a minimum age for marriage, which is 21 years for most countries, including Rwanda. The Rwandan culture, to a certain extent, and religion, to a greater extent, however, limit the freedom of young women to use contraceptive services because it is wrongly perceived as an encouragement for premarital sexual intercourse. In the end, what doesn’t change is that denying access to contraceptives to either male or female adolescents does not translate into preventing them from sexual activities, hence leading to an ever-increasing number of unwanted pregnancies, possible STIs, HIV, Human Papilloma Virus, and subsequent unsafe abortion followed by avoidable expensive complications. The purpose of this study is to evaluate the perception of healthcare providers regarding contraceptive use among adolescents. Methodology: This was a qualitative study. Interviews were done with different healthcare providers, including doctors, nurses, midwives, and pharmacists, through focused group discussions and in-depth interviews, then the audio was transcribed, translated and thematic coding was done. Results: This study explored the perceptions of healthcare workers regarding the provision of modern contraception to adolescents in Rwanda. The findings revealed that while healthcare providers had a good understanding of family planning and contraception, they were hesitant to provide contraception to adolescents. Sociocultural beliefs played a significant role in shaping their attitudes, as many healthcare workers believed that providing contraception to adolescents would encourage promiscuous behavior and go against cultural norms. Religious beliefs also influenced their reluctance, with some healthcare providers considering premarital sex and contraception as sinful. Lack of knowledge among parents and adolescents themselves was identified as a contributing factor to unwanted pregnancies, as inaccurate information from peers and social media influenced risky sexual behavior. Conditional policies, such as the requirement for parental consent, further hindered adolescents' access to contraception. The study suggested several solutions, including comprehensive sexual and reproductive health education, involving multiple stakeholders, ensuring easy access to contraception, and involving adolescents in policymaking. Overall, this research highlights the need for addressing sociocultural beliefs, improving healthcare providers' knowledge, and revisiting policies to ensure adolescents' reproductive health rights are met in Rwanda. Conclusion: The study highlights the importance of enhancing healthcare provider training, expanding access to modern contraception, implementing community-based interventions, and strengthening policy and programmatic support for adolescent contraception. Addressing these challenges is crucial for improving the provision of family planning services to adolescents in Rwanda and achieving the Sustainable Development Goals related to sexual and reproductive health. Collaborative efforts involving various stakeholders and organizations can contribute to overcoming these barriers and promoting the well-being of adolescents in Rwanda.

Keywords: adolescent, health care providers, contraception, reproductive health

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229 Maternal Obesity in Nigeria: An Exploratory Study

Authors: Ojochenemi J. Onubi, Debbi Marais, Lorna Aucott, Friday Okonofua, Amudha Poobalan

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Background: Obesity is a worldwide epidemic with major health and economic consequences. Pregnancy is a trigger point for the development of obesity, and maternal obesity is associated with significant adverse effects in the mother and child. Nigeria is experiencing a double burden of under- and over-nutrition with rising levels of obesity particularly in women. However, there is scarcity of data on maternal obesity in Nigeria and other African countries. Aims and Objectives: This project aimed at identifying crucial components of potential interventions for maternal obesity in Nigeria. The objectives were to assess the prevalence, effects, and distribution of maternal obesity; knowledge, attitude and practice (KAP) of pregnant women and maternal healthcare providers; and identify existing interventions for maternal obesity in Nigeria. Methodology: A systematic review and meta-analysis were initially conducted to appraise the existing literature on maternal obesity in Africa. Following this, a quantitative questionnaire survey of the KAP of pregnant women and a qualitative interview study of the KAP of Health Care Workers (HCW) were conducted in seven secondary and tertiary hospitals across Nigeria. Quantitative data was analysed using SPSS statistical software, while thematic analysis was conducted for qualitative data. Results: Twenty-nine studies included in the systematic review showed significant prevalence, socio-demographic associations, and adverse effects of maternal obesity on labour, maternal, and child outcomes in Africa. The questionnaire survey of 435 mothers revealed a maternal obesity prevalence of 17.9% among mothers who registered for antenatal care in the first trimester. The mothers received nutrition information from different sources and had insufficient knowledge of their own weight category or recommended Gestational Weight Gain (GWG), causes, complications, and safe ways to manage maternal obesity. However, majority of the mothers were of the opinion that excess GWG is avoided in pregnancy and some practiced weight management (diet and exercise) during pregnancy. For the qualitative study, four main themes were identified: ‘Concerns about obesity in pregnancy’, ‘Barriers to care for obese pregnant women’, ‘Practice of care for obese pregnant women’, and ‘Improving care for obese pregnant women’. HCW expressed concerns about rising levels of maternal obesity, lack of guidelines for the management of obese pregnant women and worries about unintended consequences of antenatal interventions. ‘Barriers’ included lack of contact with obese women before pregnancy, late registration for antenatal care, and perceived maternal barriers such as socio-cultural beliefs of mothers and poverty. ‘Practice’ included anticipatory care and screening for possible complications, general nutrition education during antenatal care and interdisciplinary care for mothers with complications. HCW offered suggestions on improving care for obese women including timing, type, and settings of interventions; and the need for involvement of other stake holders in caring for obese pregnant women. Conclusions: Culturally adaptable/sensitive interventions should be developed for the management of obese pregnant women in Africa. Education and training of mothers and health care workers, and provision of guidelines are some of the components of potential interventions in Nigeria.

Keywords: Africa, maternal, obesity, pregnancy

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228 Study of the Diaphragm Flexibility Effect on the Inelastic Seismic Response of Thin Wall Reinforced Concrete Buildings (TWRCB): A Purpose to Reduce the Uncertainty in the Vulnerability Estimation

Authors: A. Zapata, Orlando Arroyo, R. Bonett

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Over the last two decades, the growing demand for housing in Latin American countries has led to the development of construction projects based on low and medium-rise buildings with thin reinforced concrete walls. This system, known as Thin Walls Reinforced Concrete Buildings (TWRCB), uses walls with thicknesses from 100 to 150 millimetres, with flexural reinforcement formed by welded wire mesh (WWM) with diameters between 5 and 7 millimetres, arranged in one or two layers. These walls often have irregular structural configurations, including combinations of rectangular shapes. Experimental and numerical research conducted in regions where this structural system is commonplace indicates inherent weaknesses, such as limited ductility due to the WWM reinforcement and thin element dimensions. Because of its complexity, numerical analyses have relied on two-dimensional models that don't explicitly account for the floor system, even though it plays a crucial role in distributing seismic forces among the resilient elements. Nonetheless, the numerical analyses assume a rigid diaphragm hypothesis. For this purpose, two study cases of buildings were selected, low-rise and mid-rise characteristics of TWRCB in Colombia. The buildings were analyzed in Opensees using the MVLEM-3D for walls and shell elements to simulate the slabs to involve the effect of coupling diaphragm in the nonlinear behaviour. Three cases are considered: a) models without a slab, b) models with rigid slabs, and c) models with flexible slabs. An incremental static (pushover) and nonlinear dynamic analyses were carried out using a set of 44 far-field ground motions of the FEMA P-695, scaled to 1.0 and 1.5 factors to consider the probability of collapse for the design base earthquake (DBE) and the maximum considered earthquake (MCE) for the model, according to the location sites and hazard zone of the archetypes in the Colombian NSR-10. Shear base capacity, maximum displacement at the roof, walls shear base individual demands and probabilities of collapse were calculated, to evaluate the effect of absence, rigid and flexible slabs in the nonlinear behaviour of the archetype buildings. The pushover results show that the building exhibits an overstrength between 1.1 to 2 when the slab is considered explicitly and depends on the structural walls plan configuration; additionally, the nonlinear behaviour considering no slab is more conservative than if the slab is represented. Include the flexible slab in the analysis remarks the importance to consider the slab contribution in the shear forces distribution between structural elements according to design resistance and rigidity. The dynamic analysis revealed that including the slab reduces the collapse probability of this system due to have lower displacements and deformations, enhancing the safety of residents and the seismic performance. The strategy of including the slab in modelling is important to capture the real effect on the distribution shear forces in walls due to coupling to estimate the correct nonlinear behaviour in this system and the adequate distribution to proportionate the correct resistance and rigidity of the elements in the design to reduce the possibility of damage to the elements during an earthquake.

Keywords: thin wall reinforced concrete buildings, coupling slab, rigid diaphragm, flexible diaphragm

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227 Top-Down, Middle-Out, Bottom-Up: A Design Approach to Transforming Prison

Authors: Roland F. Karthaus, Rachel S. O'Brien

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Over the past decade, the authors have undertaken applied research aimed at enabling transformation within the prison service to improve conditions and outcomes for those living, working and visiting in prisons in the UK and the communities they serve. The research has taken place against a context of reducing resources and public discontent at increasing levels of violence, deteriorating conditions and persistently high levels of re-offending. Top-down governmental policies have mainly been ineffectual and in some cases counter-productive. The prison service is characterised by hierarchical organisation, and the research has applied design thinking at multiple levels to challenge and precipitate change: top-down, middle-out and bottom-up. The research employs three distinct but related approaches, system design (top-down): working at the national policy level to analyse the changing policy context, identifying opportunities and challenges; engaging with the Ministry of Justice commissioners and sector organisations to facilitate debate, introducing new evidence and provoking creative thinking, place-based design (middle-out): working with individual prison establishments as pilots to illustrate and test the potential for local empowerment, creative change, and improved architecture within place-specific contexts and organisational hierarchies, everyday design (bottom-up): working with individuals in the system to explore the potential for localised, significant, demonstrator changes; including collaborative design, capacity building and empowerment in skills, employment, communication, training, and other activities. The research spans a series of projects, through which the methodological approach has developed responsively. The projects include a place-based model for the re-purposing of Ministry of Justice land assets for the purposes of rehabilitation; an evidence-based guide to improve prison design for health and well-being; capacity-based employment, skills and self-build project as a template for future open prisons. The overarching research has enabled knowledge to be developed and disseminated through policy and academic networks. Whilst the research remains live and continuing; key findings are emerging as a basis for a new methodological approach to effecting change in the UK prison service. An interdisciplinary approach is necessary to overcome the barriers between distinct areas of the prison service. Sometimes referred to as total environments, prisons encompass entire social and physical environments which themselves are orchestrated by institutional arms of government, resulting in complex systems that cannot be meaningfully engaged through narrow disciplinary lenses. A scalar approach is necessary to connect strategic policies with individual experiences and potential, through the medium of individual prison establishments, operating as discrete entities within the system. A reflexive process is necessary to connect research with action in a responsive mode, learning to adapt as the system itself is changing. The role of individuals in the system, their latent knowledge and experience and their ability to engage and become agents of change are essential. Whilst the specific characteristics of the UK prison system are unique, the approach is internationally applicable.

Keywords: architecture, design, policy, prison, system, transformation

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226 Experimental Study of the Antibacterial Activity and Modeling of Non-isothermal Crystallization Kinetics of Sintered Seashell Reinforced Poly(Lactic Acid) And Poly(Butylene Succinate) Biocomposites Planned for 3D Printing

Authors: Mohammed S. Razali, Kamel Khimeche, Dahah Hichem, Ammar Boudjellal, Djamel E. Kaderi, Nourddine Ramdani

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The use of additive manufacturing technologies has revolutionized various aspects of our daily lives. In particular, 3D printing has greatly advanced biomedical applications. While fused filament fabrication (FFF) technologies have made it easy to produce or prototype various medical devices, it is crucial to minimize the risk of contamination. New materials with antibacterial properties, such as those containing compounded silver nanoparticles, have emerged on the market. In a previous study, we prepared a newly sintered seashell filler (SSh) from bio-based seashells found along the Mediterranean coast using a suitable heat treatment process. We then prepared a series of polylactic acid (PLA) and polybutylene succinate (PBS) biocomposites filled with these SSh particles using a melt mixing technique with a twin-screw extruder to use them as feedstock filaments for 3D printing. The study consisted of two parts: evaluating the antibacterial activity of newly prepared biocomposites made of PLA and PBS reinforced with a sintered seashell in the first part and experimental and modeling analysis of the non-isothermal crystallization kinetics of these biocomposites in the second part. In the first part, the bactericidal activity of the biocomposites against three different bacteria, including Gram-negative bacteria such as (E. coli and Pseudomonas aeruginosa), as well as Gram-positive bacteria such as (Staphylococcus aureus), was examined. The PLA-based biocomposite containing 20 wt.% of SSh particles exhibited an inhibition zone with radial diameters of 8mm and 6mm against E. coli and Pseudo. Au, respectively, while no bacterial activity was observed against Staphylococcus aureus. In the second part, the focus was on investigating the effect of the sintered seashell filler particles on the non-isothermal crystallization kinetics of PLA and PBS 3D-printing composite materials. The objective was to understand the impact of the filler particles on the crystallization mechanism of both PLA and PBS during the cooling process of a melt-extruded filament in (FFF) to manage the dimensional accuracy and mechanical properties of the final printed part. We conducted a non-isothermal melt crystallization kinetic study of a series of PLA-SS and PBS-SS composites using differential scanning calorimetry at various cooling rates. We analyzed the obtained kinetic data using different crystallization kinetic models such as modified Avrami, Ozawa, and Mo's methods. Dynamic mode describes the relative crystallinity as a function of temperature; it found that time half crystallinity (t1/2) of neat PLA decreased from 17 min to 7.3 min for PLA+5 SSh and the (t1/2) of virgin PBS was reduced from 3.5 min to 2.8 min for the composite containing 5wt.% of SSh. We found that the coated SS particles with stearic acid acted as nucleating agents and had a nucleation activity, as observed through polarized optical microscopy. Moreover, we evaluated the effective energy barrier of the non-isothermal crystallization process using the Iso conversional methods of Flynn-Wall-Ozawa (F-W-O) and Kissinger-Akahira-Sunose (K-A-S). The study provides significant insights into the crystallization behavior of PLA and PBS biocomposites.

Keywords: avrami model, bio-based reinforcement, dsc, gram-negative bacteria, gram-positive bacteria, isoconversional methods, non-isothermal crystallization kinetics, poly(butylene succinate), poly(lactic acid), antbactirial activity

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225 Memories of Lost Fathers: The Unfinished Transmission of Generational Values in Hungarian Cinema by Peter Falanga

Authors: Peter Falanga

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During the process of de-Stalinization that began in 1956 with the Twentieth Congress of the Soviet Communist Party, many filmmakers in Hungary chose to explore their country’s political discomforts by using Socialist Realism as a negative model against which they could react to the dominating ideology. A renewed national film industry and a more permissive political regime would allow filmmakers to take to task the plight of the preceding generation who had experienced the fatal political turmoil of both World Wars and the purges of Stalin. What follows is no longer the multigenerational unity found in Socialist Realism wherein both the old and the young embrace Stalin’s revolutionary optimism; instead, the protagonists are parentless, and thus their connection to the previous generation is partially severed. In these films, violent historical forces leave one generation to search for both a connection with their family’s past, and for moral guidance to direct their future. István Szabó’s Father (1966), Márta Mészáros Diary for My Children (1984), and Pál Gábor’s Angi Vera (1978) each consider the fraught relationship between successive generations through the lens of postwar youth. A characteristic each of their protagonist’s share is that they are all missing one or both parents, and cope with familial loss either through recalling memories of their parents in dream-like sequences, or, in the case of Angi Vera, through embracing the surrogate paternalism that the Communist Party promises to provide. This paper considers the argument these films present about the progress of Hungarian history, and how this topic is explored in more recent films that similarly focus on the transmission of generational values. Scholars such as László Strausz and John Cunningham have written on the continuous concern with the transmission of generational values in more recent films such as István Szabó’s Sunshine (1999), Béla Tarr’s Werckmeister Harmonies (2000), György Pálfi’s Taxidermia (2006), Ágnes Kocsis’ Pál Adrienn (2010), and Kornél Mundruczó’s Evolution (2021). These films, they argue, make intimate portrayals of the various sweeping political changes in Hungary’s history and question how these epochs or events have impacted Hungarian identities. If these films attempt to personalize historical shifts of Hungary, then what is the significance of featuring characters who have lost one or both parents? An attempt to understand this coherent trend in Hungarian cinema will profit from examining the earlier, celebrated films of Szabó, Mészáros, and Gábor, who inaugurated this preoccupation with generational values. The pervasive interplay of dreams and memory in their films invites an additional element to their argument concerning historical progression. This paper incorporates Richard Teniman’s notion of the “dialectics of memory” in which memory is in a constant process of negation and reinvention to explain why these Directors prefer to explore Hungarian identity through the disarranged form of psychological realism over the linear causality structure of historical realism.

Keywords: film theory, Eastern European Studies, film history, Eastern European History

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224 Using Statistical Significance and Prediction to Test Long/Short Term Public Services and Patients' Cohorts: A Case Study in Scotland

Authors: Raptis Sotirios

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Health and social care (HSc) services planning and scheduling are facing unprecedented challenges due to the pandemic pressure and also suffer from unplanned spending that is negatively impacted by the global financial crisis. Data-driven can help to improve policies, plan and design services provision schedules using algorithms assist healthcare managers’ to face unexpected demands using fewer resources. The paper discusses services packing using statistical significance tests and machine learning (ML) to evaluate demands similarity and coupling. This is achieved by predicting the range of the demand (class) using ML methods such as CART, random forests (RF), and logistic regression (LGR). The significance tests Chi-Squared test and Student test are used on data over a 39 years span for which HSc services data exist for services delivered in Scotland. The demands are probabilistically associated through statistical hypotheses that assume that the target service’s demands are statistically dependent on other demands as a NULL hypothesis. This linkage can be confirmed or not by the data. Complementarily, ML methods are used to linearly predict the above target demands from the statistically found associations and extend the linear dependence of the target’s demand to independent demands forming, thus groups of services. Statistical tests confirm ML couplings making the prediction also statistically meaningful and prove that a target service can be matched reliably to other services, and ML shows these indicated relationships can also be linear ones. Zero paddings were used for missing years records and illustrated better such relationships both for limited years and in the entire span offering long term data visualizations while limited years groups explained how well patients numbers can be related in short periods or can change over time as opposed to behaviors across more years. The prediction performance of the associations is measured using Receiver Operating Characteristic(ROC) AUC and ACC metrics as well as the statistical tests, Chi-Squared and Student. Co-plots and comparison tables for RF, CART, and LGR as well as p-values and Information Exchange(IE), are provided showing the specific behavior of the ML and of the statistical tests and the behavior using different learning ratios. The impact of k-NN and cross-correlation and C-Means first groupings is also studied over limited years and the entire span. It was found that CART was generally behind RF and LGR, but in some interesting cases, LGR reached an AUC=0 falling below CART, while the ACC was as high as 0.912, showing that ML methods can be confused padding or by data irregularities or outliers. On average, 3 linear predictors were sufficient, LGR was found competing RF well, and CART followed with the same performance at higher learning ratios. Services were packed only if when significance level(p-value) of their association coefficient was more than 0.05. Social factors relationships were observed between home care services and treatment of old people, birth weights, alcoholism, drug abuse, and emergency admissions. The work found that different HSc services can be well packed as plans of limited years, across various services sectors, learning configurations, as confirmed using statistical hypotheses.

Keywords: class, cohorts, data frames, grouping, prediction, prob-ability, services

Procedia PDF Downloads 210
223 Structural Monitoring of Externally Confined RC Columns with Inadequate Lap-Splices, Using Fibre-Bragg-Grating Sensors

Authors: Petros M. Chronopoulos, Evangelos Z. Astreinidis

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A major issue of the structural assessment and rehabilitation of existing RC structures is the inadequate lap-splicing of the longitudinal reinforcement. Although prohibited by modern Design Codes, the practice of arranging lap-splices inside the critical regions of RC elements was commonly applied in the past. Today this practice is still the rule, at least for conventional new buildings. Therefore, a lot of relevant research is ongoing in many earthquake prone countries. The rehabilitation of deficient lap-splices of RC elements by means of external confinement is widely accepted as the most efficient technique. If correctly applied, this versatile technique offers a limited increase of flexural capacity and a considerable increase of local ductility and of axial and shear capacities. Moreover, this intervention does not affect the stiffness of the elements and does not affect the dynamic characteristics of the structure. This technique has been extensively discussed and researched contributing to vast accumulation of technical and scientific knowledge that has been reported in relevant books, reports and papers, and included in recent Design Codes and Guides. These references are mostly dealing with modeling and redesign, covering both the enhanced (axial and) shear capacity (due to the additional external closed hoops or jackets) and the increased ductility (due to the confining action, preventing the unzipping of lap-splices and the buckling of continuous reinforcement). An analytical and experimental program devoted to RC members with lap-splices is completed in the Lab. of RC/NTU of Athens/GR. This program aims at the proposal of a rational and safe theoretical model and the calibration of the relevant Design Codes’ provisions. Tests, on forty two (42) full scale specimens, covering mostly beams and columns (not walls), strengthened or not, with adequate or inadequate lap-splices, have been already performed and evaluated. In this paper, the results of twelve (12) specimens under fully reversed cyclic actions are presented and discussed. In eight (8) specimens the lap-splices were inadequate (splicing length of 20 or 30 bar diameters) and they were retrofitted before testing by means of additional external confinement. The two (2) most commonly applied confining materials were used in this study, namely steel and FRPs. More specifically, jackets made of CFRP wraps or light cages made of mild steel were applied. The main parameters of these tests were (i) the degree of confinement (internal and external), and (ii) the length of lap-splices, equal to 20, 30 or 45 bar diameters. These tests were thoroughly instrumented and monitored, by means of conventional (LVDTs, strain gages, etc.) and innovative (optic fibre-Bragg-grating) sensors. This allowed for a thorough investigation of the most influencing design parameter, namely the hoop-stress developed in the confining material. Based on these test results and on comparisons with the provisions of modern Design Codes, it could be argued that shorter (than the normative) lap-splices, commonly found in old structures, could still be effective and safe (at least for lengths more than an absolute minimum), depending on the required ductility, if a properly arranged and adequately detailed external confinement is applied.

Keywords: concrete, fibre-Bragg-grating sensors, lap-splices, retrofitting / rehabilitation

Procedia PDF Downloads 239
222 Foucault and Governmentality: International Organizations and State Power

Authors: Sara Dragisic

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Using the theoretical analysis of the birth of biopolitics that Foucault performed through the history of liberalism and neoliberalism, in this paper we will try to show how, precisely through problematizing the role of international institutions, the model of governance differs from previous ways of objectifying body and life. Are the state and its mechanisms still a Leviathan to fight against, or can it be even the driver of resistance against the proponents of modern governance and the biopolitical power? Do paradigmatic examples of biopolitics still appear through sovereignty and (international) law, or is it precisely this sphere that shows a significant dose of incompetence and powerlessness in relation to, not only the economic sphere (Foucault’s critique of neoliberalism) but also the new politics of freedom? Have the struggle for freedom and human rights, as well as the war on terrorism, opened a new spectrum of biopolitical processes, which are manifested precisely through new international institutions and humanitarian discourse? We will try to answer these questions, in the following way. On the one hand, we will show that the views of authors such as Agamben and Hardt and Negri, in whom the state and sovereignty are seen as enemies to be defeated or overcome, fail to see how such attempts could translate into the politicization of life like it is done in many examples through the doctrine of liberal interventionism and humanitarianism. On the other hand, we will point out that it is precisely the humanitarian discourse and the defense of the right to intervention that can be the incentive and basis for the politicization of the category of life and lead to the selective application of human rights. Zizek example of the killing of United Nations workers and doctors in a village during the Vietnam War, who were targeted even before police or soldiers, because they were precisely seen as a powerful instrument of American imperialism (as they were sincerely trying to help the population), will be focus of this part of the analysis. We’ll ask the question whether such interpretation is a kind of liquidation of the extreme left of the political (Laclau) or on this basis can be explained at least in part the need to review the functioning of international organizations, ranging from those dealing with humanitarian aid (and humanitarian military interventions) to those dealing with protection and the security of the population, primarily from growing terrorism. Based on the above examples, we will also explain how the discourse of terrorism itself plays a dual role: it can appear as a tool of liberal biopolitics, although, more superficially, it mostly appears as an enemy that wants to destroy the liberal system and its values. This brings us to the basic problem that this paper will tackle: do the mechanisms of institutional struggle for human rights and freedoms, which is often seen as opposed to the security mechanisms of the state, serve the governance of citizens in such a way that the latter themselves participate in producing biopolitical governmental practices? Is the freedom today "nothing but the correlative development of apparatuses of security" (Foucault)? Or, we can continue this line of Foucault’s argumentation and enhance the interpretation with the important question of what precisely today reflects the change in the rationality of governance in which society is transformed from a passive object into a subject of its own production. Finally, in order to understand the skills of biopolitical governance in modern civil society, it is necessary to pay attention to the status of international organizations, which seem to have become a significant place for the implementation of global governance. In this sense, the power of sovereignty can turn out to be an insufficiently strong power of security policy, which can go hand in hand with freedom policies, through neoliberal governmental techniques.

Keywords: neoliberalism, Foucault, sovereignty, biopolitics, international organizations, NGOs, Agamben, Hardt&Negri, Zizek, security, state power

Procedia PDF Downloads 182
221 The Association between Gene Polymorphisms of GPX, SEPP1, and SEP15, Plasma Selenium Levels, Urinary Total Arsenic Concentrations, and Prostate Cancer

Authors: Yu-Mei Hsueh, Wei-Jen Chen, Yung-Kai Huang, Cheng-Shiuan Tsai, Kuo-Cheng Yeh

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Prostate cancer occurs in men over the age of 50, and rank sixth of the top ten cancers in Taiwan, and the incidence increased gradually over the past decade in Taiwan. Arsenic is confirmed as a carcinogen by International Agency for Research on (IARC). Arsenic induces oxidative stress may be a risk factor for prostate cancer, but the mechanism is not clear. Selenium is an important antioxidant element. Whether the association between plasma selenium levels and risk of prostate cancer are modified by different genotype of selenoprotein is still unknown. Glutathione peroxidase, selenoprotein P (SEPP1) and 15 kDa selenoprotein (SEP 15) are selenoprotein and regulates selenium transport and the oxidation and reduction reaction. However, the association between gene polymorphisms of selenoprotein and prostate cancer is not yet clear. The aim of this study is to determine the relationship between plasma selenium, polymorphism of selenoprotein, urinary total arsenic concentration and prostate cancer. This study is a hospital-based case-control study. Three hundred twenty-two cases of prostate cancer and age (±5 years) 1:1 matched 322 control group were recruited from National Taiwan University Hospital, Taipei Medical University Hospital, and Wan Fang Hospital. Well-trained personnel carried out standardized personal interviews based on a structured questionnaire. Information collected included demographic and socioeconomic characteristics, lifestyle and disease history. Blood and urine samples were also collected at the same time. The Research Ethics Committee of National Taiwan University Hospital, Taipei, Taiwan, approved the study. All patients provided informed consent forms before sample and data collection. Buffy coat was to extract DNA, and the polymerase chain reaction - restriction fragment length polymorphism (PCR-RFLP) was used to measure the genotypes of SEPP1 rs3797310, SEP15 rs5859, GPX1 rs1050450, GPX2 rs4902346, GPX3 rs4958872, and GPX4 rs2075710. Plasma concentrations of selenium were determined by inductively coupled plasma mass spectrometry (ICP-MS).Urinary arsenic species concentrations were measured by high-performance liquid chromatography links hydride generator and atomic absorption spectrometer (HPLC-HG-AAS). Subject with high education level compared to those with low educational level had a lower prostate cancer odds ratio (OR) Mainland Chinese and aboriginal people had a lower OR of prostate cancer compared to Fukien Taiwanese. After adjustment for age, educational level, subjects with GPX1 rs1050450 CT and TT genotype compared to the CC genotype have lower, OR of prostate cancer, the OR and 95% confidence interval (Cl) was 0.53 (0.31-0.90). SEPP1 rs3797310 CT+TT genotype compared to those with CC genotype had a marginally significantly lower OR of PC. The low levels of plasma selenium and the high urinary total arsenic concentrations had the high OR of prostate cancer in a significant dose-response manner, and SEPP1 rs3797310 genotype modified this joint association.

Keywords: prostate cancer, plasma selenium concentration, urinary total arsenic concentrations, glutathione peroxidase, selenoprotein P, selenoprotein 15, gene polymorphism

Procedia PDF Downloads 254
220 The Impact of ChatGPT on the Healthcare Domain: Perspectives from Healthcare Majors

Authors: Su Yen Chen

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Extensive research on ChatGPT has revealed its capabilities and limitations across various clinical, educational, and research contexts, emphasizing crucial issues such as accuracy, transparency, and ethical usage. Studies applying the Technology Acceptance Model (TAM) and Uses and Gratifications Theory have deepened our understanding of the factors that drive user acceptance and satisfaction of ChatGPT for general use. These insights are particularly valuable for examining healthcare-specific behaviors, trust levels, and perceived risks. Despite these advancements, there remains a notable gap in our understanding of how general user perceptions of AI translate into its practical applications within the healthcare sector. This study focuses on examining the perceptions of ChatGPT's impact among 266 healthcare majors in Taiwan, exploring its implications for their career development and utility in clinical practice, medical education, and research. By employing a structured survey with precisely defined subscales, this research aims to probe the breadth of ChatGPT's applications within healthcare, assessing both the perceived benefits and the challenges it presents. The findings from the survey reveal that perceptions and usage of ChatGPT among healthcare majors vary significantly, influenced by factors such as its perceived utility, risk, novelty, and trustworthiness. Graduate students and those who perceive ChatGPT as more beneficial and less risky are particularly inclined to use it more frequently. This increased usage is closely linked to significant impacts on personal career development. Furthermore, ChatGPT's perceived usefulness contributes to its broader impact within the healthcare domain, suggesting that both innovation and practical utility are key drivers of acceptance and perceived effectiveness in professional healthcare settings. Trust emerges as an important factor, especially in clinical settings where the stakes are high. The trust that healthcare professionals place in ChatGPT significantly affects its integration into clinical practice and influences outcomes in medical education and research. Thus, ChatGPT's reliability and practical value are critical for its successful adoption in these areas. However, an interesting paradox arises with regard to ease of use. While making ChatGPT more user-friendly is generally seen as beneficial, it also raises concerns among users who have lower levels of trust and perceive higher risks associated with its use. This complex interplay between ease of use and safety concerns necessitates a careful balance, highlighting the need for robust security measures and clear, transparent communication about how AI systems work and their limitations. The study suggests several strategic approaches to enhance the adoption and integration of AI in healthcare. These include targeted training programs for healthcare professionals to increase familiarity with AI technologies, reduce perceived risks, and build trust. Ensuring transparency and conducting rigorous testing are also vital to foster trust and reliability. Moreover, comprehensive policy frameworks are needed to guide the implementation of AI technologies, ensuring high standards of patient safety, privacy, and ethical use. These measures are crucial for fostering broader acceptance of AI in healthcare, as the study contributes to enriching the discourse on AI's role by detailing how various factors affect its adoption and impact.

Keywords: ChatGPT, healthcare, survey study, IT adoption, behaviour, applcation, concerns

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219 An Investigation into the Social Determinants of Crowdfunding Effectiveness in developing, non-Western contexts: Some Evidence from Thailand

Authors: Khin Thi Htun, James Jain, Tim Andrews

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This study examines the under-researched phenomenon of crowdfunding use and effectiveness in developing non-western markets. More precisely, using an institutional theoretical lens, the research explores the attitudes, motivations, and practice surrounding the initiation, development, and receipt of crowdfunding campaignsin a business context symptomatic of widely dissimilar regulatory, normative cognitive institutional ‘pillars’ to those studied – and utilized in practice - to date. As, in essence, a form of alternative finance, crowdfunding is used primarily to fund a wide range of projects through the securement of small amounts of money from a large pool of investors/participants. Being tied almost inextricably to e-commerce channels, the practice of crowdfunding typically sources its means and communicates the purpose of each venture mainly, though not exclusively, online. The wide range of projects supported to date span social entrepreneurship, community benefits initiatives, creative and artistic endeavors, assistance to disadvantaged social cohorts, and small business start-ups. Adopting a longitudinal, comparative approach, the study reported here embodies an investigation centered on six case start-up campaigns within the Thai societal context, covering a range of fundings calls and cause choices. Data was sourced from a variety of respondents using semi-structured interviews, observation (direct and participant), and company information. Results suggest that the motives and effectiveness of crowdfunding campaigns differ significantly in non-western consumer contexts from the norms that have evolved to date in mature Western contexts(particularly the US and UK). Specifically, whereas data on the different regulatory pressures showed relatively insignificant variation, the results regarding cognitive and, especially, normative dissimilarities between the Thai and US/UK institutional profiles surfaced potentially important differences with far-reaching implications. Particular issuesto emerge from our data concerned consumer motivation in terms of support and engagement with different types of campaigns. This was found to stem from social norms symptomatic of ‘collectivist’ and ‘relations based/particularist’ cultural assistance behavior, in turn, linked to deeply-held societal values regarding interpersonal network (‘in group’) reciprocity. This research serves to refine and extend the limited body of knowledge to date on crowdfunding by exploring the phenomenon in a non-western, non-developed country contextswhere social norms and values differ. This was achieved through uncovering and explicating the effects of cultural dissimilarity on motivation, decision-making, construed ethics, and general engagement with crowdfunding ideas. Implications for theory into e-marketing and cross-cultural marketing, as well as for practitioners seeking to develop effective crowdfunding campaigns in a Southeast Asian cultural environment, are discussed to conclude the paper.

Keywords: crowdfunding, national culture, e-marketing, cross-cultural business

Procedia PDF Downloads 141
218 Selected Macrophyte Populations Promotes Coupled Nitrification and Denitrification Function in Eutrophic Urban Wetland Ecosystem

Authors: Rupak Kumar Sarma, Ratul Saikia

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Macrophytes encompass major functional group in eutrophic wetland ecosystems. As a key functional element of freshwater lakes, they play a crucial role in regulating various wetland biogeochemical cycles, as well as maintain the biodiversity at the ecosystem level. The high carbon-rich underground biomass of macrophyte populations may harbour diverse microbial community having significant potential in maintaining different biogeochemical cycles. The present investigation was designed to study the macrophyte-microbe interaction in coupled nitrification and denitrification, considering Deepor Beel Lake (a Ramsar conservation site) of North East India as a model eutrophic system. Highly eutrophic sites of Deepor Beel were selected based on sediment oxygen demand and inorganic phosphorus and nitrogen (P&N) concentration. Sediment redox potential and depth of the lake was chosen as the benchmark for collecting the plant and sediment samples. The average highest depth in winter (January 2016) and summer (July 2016) were recorded as 20ft (6.096m) and 35ft (10.668m) respectively. Both sampling depth and sampling seasons had the distinct effect on variation in macrophyte community composition. Overall, the dominant macrophytic populations in the lake were Nymphaea alba, Hydrilla verticillata, Utricularia flexuosa, Vallisneria spiralis, Najas indica, Monochoria hastaefolia, Trapa bispinosa, Ipomea fistulosa, Hygrorhiza aristata, Polygonum hydropiper, Eichhornia crassipes and Euryale ferox. There was a distinct correlation in the variation of major sediment physicochemical parameters with change in macrophyte community compositions. Quantitative estimation revealed an almost even accumulation of nitrate and nitrite in the sediment samples dominated by the plant species Eichhornia crassipes, Nymphaea alba, Hydrilla verticillata, Vallisneria spiralis, Euryale ferox and Monochoria hastaefolia, which might have signified a stable nitrification and denitrification process in the sites dominated by the selected aquatic plants. This was further examined by a systematic analysis of microbial populations through culture dependent and independent approach. Culture-dependent bacterial community study revealed the higher population of nitrifiers and denitrifiers in the sediment samples dominated by the six macrophyte species. However, culture-independent study with bacterial 16S rDNA V3-V4 metagenome sequencing revealed the overall similar type of bacterial phylum in all the sediment samples collected during the study. Thus, there might be the possibility of uneven distribution of nitrifying and denitrifying molecular markers among the sediment samples collected during the investigation. The diversity and abundance of the nitrifying and denitrifying molecular markers in the sediment samples are under investigation. Thus, the role of different aquatic plant functional types in microorganism mediated nitrogen cycle coupling could be screened out further from the present initial investigation.

Keywords: denitrification, macrophyte, metagenome, microorganism, nitrification

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217 Complex Dynamics in a Morphologically Heterogeneous Biological Medium

Authors: Turky Al-Qahtani, Roustem Miftahof

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Introduction: Under common assumptions of excitabi-lity, morphological (cellular) homogeneity, and spatial structural anomalies added as required, it has been shown that biological systems are able to display travelling wave dynamics. Being not self-sustainable, existence depends on the electrophysiological state of transmembrane ion channels and it requires an extrinsic/intrinsic periodic source. However, organs in the body are highly multicellular, heterogeneous, and their functionality is the outcome of electro-mechanical conjugation, rather than excitability only. Thus, peristalsis in the gut relies on spatiotemporal myoelectrical pattern formations between the mechanical, represented by smooth muscle cells (SM), and the control, comprised of a chain of primary sensory and motor neurones, components. Synaptically linked through the afferent and efferent pathways, they form a functional unit (FU) of the gut. Aims: These are: i) to study numerically the complex dynamics, and ii) to investigate the possibility of self-sustained myoelectrical activity in the FU. Methods: The FU recreates the following sequence of physiological events: deformation of mechanoreceptors of located in SM; generation and propagation of electrical waves of depolarisation - spikes - along the axon to the soma of the primary neurone; discharge of the primary neurone and spike propagation towards the motor neurone; burst of the motor neurone and transduction of spikes to SM, subsequently producing forces of contraction. These are governed by a system of nonlinear partial and ordinary differential equations being a modified version of the Hodgkin-Huxley model and SM fibre mechanics. In numerical experiments; the source of excitation is mechanical stretches of SM at a fixed amplitude and variable frequencies. Results: Low frequency (0.5 < v < 2 Hz) stimuli cause the propagation of spikes in the neuronal chain and, finally, the generation of active forces by SM. However, induced contractions are not sufficient to initiate travelling wave dynamics in the control system. At frequencies, 2 < v < 4 Hz, multiple low amplitude and short-lasting contractions are observed in SM after the termination of stretching. For frequencies (0.5 < v < 4 Hz), primary and sensory neurones demonstrate strong connectivity and coherent electrical activity. Significant qualitative and quantitative changes in dynamics of myoelectical patterns with a transition to a self-organised mode are recorded with the high degree of stretches at v = 4.5 Hz. Increased rates of deformation lead to the production of high amplitude signals at the mechanoreceptors with subsequent self-sustained excitation within the neuronal chain. Remarkably, the connection between neurones weakens resulting in incoherent firing. Further increase in a frequency of stimulation (v > 4.5 Hz) has a detrimental effect on the system. The mechanical and control systems become disconnected and exhibit uncoordinated electromechanical activity. Conclusion: To our knowledge, the existence of periodic activity in a multicellular, functionally heterogeneous biological system with mechano-electrical dynamics, such as the FU, has been demonstrated for the first time. These findings support the notion of possible peristalsis in the gut even in the absence of intrinsic sources - pacemaker cells. Results could be implicated in the pathogenesis of intestinal dysrythmia, a medical condition associated with motor dysfunction.

Keywords: complex dynamics, functional unit, the gut, dysrythmia

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216 Composite Electrospun Aligned PLGA/Curcumin/Heparin Nanofibrous Membranes for Wound Dressing Application

Authors: Jyh-Ping Chen, Yu-Tin Lai

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Wound healing is a complicated process involving overlapping hemostasis, inflammation, proliferation, and maturation phases. Ideal wound dressings can replace native skin functions in full thickness skin wounds through faster healing rate and also by reducing scar formation. Poly(lactic-co-glycolic acid) (PLGA) is an U.S. FDA approved biodegradable polymer to be used as ideal wound dressing material. Several in vitro and in vivo studies have demonstrated the effectiveness of curcumin in decreasing the release of inflammatory cytokines, inhibiting enzymes associated with inflammations, and scavenging free radicals that are the major cause of inflammation during wound healing. Heparin has binding affinities to various growth factors. With the unique and beneficial features offered by those molecules toward the complex process of wound healing, we postulate a composite wound dressing constructed from PLGA, curcumin and heparin would be a good candidate to accelerate scarless wound healing. In this work, we use electrospinning to prepare curcumin-loaded aligned PLGA nanofibrous membranes (PC NFMs). PC NFMs were further subject to oxygen plasma modification and surfaced-grafted with heparin through carbodiimide-mediated covalent bond formation to prepare curcumin-loaded PLGA-g-heparin (PCH) NFMs. The nanofibrous membranes could act as three-dimensional scaffolds to attract fibroblast migration, reduce inflammation, and increase wound-healing related growth factors concentrations at wound sites. From scanning electron microscopy analysis, the nanofibers in each NFM are with diameters ranging from 456 to 479 nm and with alignment angles within  0.5°. The NFMs show high tensile strength and good water absorptivity and provide suitable pore size for nutrients/wastes transport. Exposure of human dermal fibroblasts to the extraction medium of PC or PCH NFM showed significant protective effects against hydrogen peroxide than PLGA NFM. In vitro wound healing assays also showed that the extraction medium of PCH NFM showed significantly better migration ability toward fibroblasts than PC NFM, which is further better than PLGA NFM. The in vivo healing efficiency of the NFMs was further evaluated by a full thickness excisional wound healing diabetic rat model. After 14 days, PCH NFMs exhibits 86% wound closure rate, which is significantly different from other groups (79% for PC and 73% for PLGA NFM). Real-time PCR analysis indicated PC and PCH NFMs down regulated anti-oxidative enzymes like glutathione peroxidase (GPx) and superoxide dismutase (SOD), which are well-known transcription factors involved in cellular inflammatory responses to stimuli. From histology, the wound area treated with PCH NFMs showed more vascular lumen formation from immunohistochemistry of α-smooth muscle actin. The wound site also had more collagen type III (65.8%) expression and less collagen type I (3.5%) expression, indicating scar-less wound healing. From Western blot analysis, the PCH NFM showed good affinity toward growth factors from increased concentration of transforming growth factor-β (TGF-β) and fibroblast growth factor-2 (FGF-2) at the wound site to accelerate wound healing. From the results, we suggest PCH NFM as a promising candidate for wound dressing applications.

Keywords: Curcumin, heparin, nanofibrous membrane, poly(lactic-co-glycolic acid) (PLGA), wound dressing

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215 Active Learning Methods in Mathematics

Authors: Daniela Velichová

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Plenty of ideas on how to adopt active learning methods in education are available nowadays. Mathematics is a subject where the active involvement of students is required in particular in order to achieve desirable results regarding sustainable knowledge and deep understanding. The present article is based on the outcomes of an Erasmus+ project DrIVE-MATH, that was aimed at developing a novel and integrated framework to teach maths classes in engineering courses at the university level. It is fundamental for students from the early years of their academic life to have agile minds. They must be prepared to adapt to their future working environments, where enterprises’ views are always evolving, where all collaborate in teams, and relations between peers are thought for the well-being of the whole - workers and company profit. This reality imposes new requirements on higher education in terms of adaptation of different pedagogical methods, such as project-based and active-learning methods used within the course curricula. Active learning methodologies are regarded as an effective way to prepare students to meet the challenges posed by enterprises and to help them in building critical thinking, analytic reasoning, and insight to the solved complex problems from different perspectives. Fostering learning-by-doing activities in the pedagogical process can help students to achieve learning independence, as they could acquire deeper conceptual understanding by experimenting with the abstract concept in a more interesting, useful, and meaningful way. Clear information about learning outcomes and goals might help students to take more responsibility for their learning results. Active learning methods implemented by the project team members in their teaching practice, eduScrum and Jigsaw in particular, proved to provide better scientific and soft skills support to students than classical teaching methods. EduScrum method enables teachers to generate a working environment that stimulates students' working habits and self-initiative as they become aware of their responsibilities within the team, their own acquired knowledge, and their abilities to solve problems independently, though in collaboration with other team members. This method enhances collaborative learning, as students are working in teams towards a common goal - knowledge acquisition, while they are interacting with each other and evaluated individually. Teams consisting of 4-5 students work together on a list of problems - sprint; each member is responsible for solving one of them, while the group leader – a master, is responsible for the whole team. A similar principle is behind the Jigsaw technique, where the classroom activity makes students dependent on each other to succeed. Students are divided into groups, and assignments are split into pieces, which need to be assembled by the whole group to complete the (Jigsaw) puzzle. In this paper, analysis of students’ perceptions concerning the achievement of deeper conceptual understanding in mathematics and the development of soft skills, such as self-motivation, critical thinking, flexibility, leadership, responsibility, teamwork, negotiation, and conflict management, is presented. Some new challenges are discussed as brought by introducing active learning methods in the basic mathematics courses. A few examples of sprints developed and used in teaching basic maths courses at technical universities are presented in addition.

Keywords: active learning methods, collaborative learning, conceptual understanding, eduScrum, Jigsaw, soft skills

Procedia PDF Downloads 38
214 Providing Leadership in Nigerian University Education Research Enterprise: The Imperative of Research Ethics

Authors: O. O. Oku, K. S. Jerry-Alagbaoso

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It is universally acknowledged that the primary function of universities is the generation and dissemination of knowledge. This mission is pursued through the research component of the university programme especially at the post-graduate level. The senior academic staff teach, supervise and provide general academic leadership to post-graduate students who are expected to carry out research leading to the presentation of dissertation as requirement for the award of doctoral degree in their various disciplines. Carrying out the research enterprises involves a lot of corroboration among individuals and communities. The need to safeguard the interest of everyone involved in the enterprise makes the development of ethical standard in research imperative. Ensuring the development and effective application of such ethical standard falls within the leadership role of the vice –chancellors, Deans of post-graduate schools/ faculties, Heads of Departments and supervisors. It is the relevance and application of such ethical standard in Nigerian university research efforts that this study discussed. The study adopted the descriptive research design. A researcher-made 4 point rating scale was used to elicit information from the post-graduate dissertation supervisors sampled from one university each from the six geo-political zones in Nigeria using the purposive sampling technique. The data collected was analysed using the mean score and standard deviation. The findings of the study include among others that there are several cases of unethical practices by Ph.D dissertation students in Nigerian universities. Prominent among these include duplicating research topics, making unauthorized copies of data paper or computer programme, failing to acknowledge contributions of relevant people and authors, rigging an experiment to prempt the result among others. Some of the causes of the unethical practices according to the respondents include inadequate funding of universities resulting in inadequate remuneration for university teachers, inadequacy of equipment and infrastructures, poor supervision of Ph.D students,’ poverty on the side of the student researchers and non-application of sanctions on violators. Improved funding of the Nigerian universities system with emphasis on both staff and student research efforts, admitting academic oriented students into the Ph.D programme and ensuring the application of appropriate sanctions in cases of unethical conduct in research featured prominently in the needed leadership imperatives. Based on the findings of the study, the researchers recommend the development of university research policies that is closely tied to each university’s strategic plan. Such plan should explain the research focus that will attract more funding and direct students interest towards it without violating the principle of academic freedom. The plan should also incorporate the establishment of a research administration office to provide the necessary link between the students and funding agencies and also organise training for supervisors on leadership activities expected of them while educating students on the processes involved in carrying out a qualitative and acceptable research study. Such exercise should include the ethical principles and guidelines that comprise all parts of research from research topic through the literature review to the design and the truthful reporting of results.

Keywords: academic leadership, ethical standards, research stakeholders, research enterprise

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213 Gamification of eHealth Business Cases to Enhance Rich Learning Experience

Authors: Kari Björn

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Introduction of games has expanded the application area of computer-aided learning tools to wide variety of age groups of learners. Serious games engage the learners into a real-world -type of simulation and potentially enrich the learning experience. Institutional background of a Bachelor’s level engineering program in Information and Communication Technology is introduced, with detailed focus on one of its majors, Health Technology. As part of a Customer Oriented Software Application thematic semester, one particular course of “eHealth Business and Solutions” is described and reflected in a gamified framework. Learning a consistent view into vast literature of business management, strategies, marketing and finance in a very limited time enforces selection of topics relevant to the industry. Health Technology is a novel and growing industry with a growing sector in consumer wearable devices and homecare applications. The business sector is attracting new entrepreneurs and impatient investor funds. From engineering education point of view the sector is driven by miniaturizing electronics, sensors and wireless applications. However, the market is highly consumer-driven and usability, safety and data integrity requirements are extremely high. When the same technology is used in analysis or treatment of patients, very strict regulatory measures are enforced. The paper introduces a course structure using gamification as a tool to learn the most essential in a new market: customer value proposition design, followed by a market entry game. Students analyze the existing market size and pricing structure of eHealth web-service market and enter the market as a steering group of their company, competing against the legacy players and with each other. The market is growing but has its rules of demand and supply balance. New products can be developed with an R&D-investment, and targeted to market with unique quality- and price-combinations. Product cost structure can be improved by investing to enhanced production capacity. Investments can be funded optionally by foreign capital. Students make management decisions and face the dynamics of the market competition in form of income statement and balance sheet after each decision cycle. The focus of the learning outcome is to understand customer value creation to be the source of cash flow. The benefit of gamification is to enrich the learning experience on structure and meaning of financial statements. The paper describes the gamification approach and discusses outcomes after two course implementations. Along the case description of learning challenges, some unexpected misconceptions are noted. Improvements of the game or the semi-gamified teaching pedagogy are discussed. The case description serves as an additional support to new game coordinator, as well as helps to improve the method. Overall, the gamified approach has helped to engage engineering student to business studies in an energizing way.

Keywords: engineering education, integrated curriculum, learning experience, learning outcomes

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212 Flexural Response of Sandwiches with Micro Lattice Cores Manufactured via Selective Laser Sintering

Authors: Emre Kara, Ali Kurşun, Halil Aykul

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The lightweight sandwiches obtained with the use of various core materials such as foams, honeycomb, lattice structures etc., which have high energy absorbing capacity and high strength to weight ratio, are suitable for several applications in transport industry (automotive, aerospace, shipbuilding industry) where saving of fuel consumption, load carrying capacity increase, safety of vehicles and decrease of emission of harmful gases are very important aspects. While the sandwich structures with foams and honeycombs have been applied for many years, there is a growing interest on a new generation sandwiches with micro lattice cores. In order to produce these core structures, various production methods were created with the development of the technology. One of these production technologies is an additive manufacturing technique called selective laser sintering/melting (SLS/SLM) which is very popular nowadays because of saving of production time and achieving the production of complex topologies. The static bending and the dynamic low velocity impact tests of the sandwiches with carbon fiber/epoxy skins and the micro lattice cores produced via SLS/SLM were already reported in just a few studies. The goal of this investigation was the analysis of the flexural response of the sandwiches consisting of glass fiber reinforced plastic (GFRP) skins and the micro lattice cores manufactured via SLS under thermo-mechanical loads in order to compare the results in terms of peak load and absorbed energy values respect to the effect of core cell size, temperature and support span length. The micro lattice cores were manufactured using SLS technology that creates the product drawn by a 3D computer aided design (CAD) software. The lattice cores which were designed as body centered cubic (BCC) model having two different cell sizes (d= 2 and 2.5 mm) with the strut diameter of 0.3 mm were produced using titanium alloy (Ti6Al4V) powder. During the production of all the core materials, the same production parameters such as laser power, laser beam diameter, building direction etc. were kept constant. Vacuum Infusion (VI) method was used to produce skin materials, made of [0°/90°] woven S-Glass prepreg laminates. The combination of the core and skins were implemented under VI. Three point bending tests were carried out by a servo-hydraulic test machine with different values of support span distances (L = 30, 45, and 60 mm) under various temperature values (T = 23, 40 and 60 °C) in order to analyze the influences of support span and temperature values. The failure mode of the collapsed sandwiches has been investigated using 3D computed tomography (CT) that allows a three-dimensional reconstruction of the analyzed object. The main results of the bending tests are: load-deflection curves, peak force and absorbed energy values. The results were compared according to the effect of cell size, support span and temperature values. The obtained results have particular importance for applications that require lightweight structures with a high capacity of energy dissipation, such as the transport industry, where problems of collision and crash have increased in the last years.

Keywords: light-weight sandwich structures, micro lattice cores, selective laser sintering, transport application

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211 A Vision-Based Early Warning System to Prevent Elephant-Train Collisions

Authors: Shanaka Gunasekara, Maleen Jayasuriya, Nalin Harischandra, Lilantha Samaranayake, Gamini Dissanayake

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One serious facet of the worsening Human-Elephant conflict (HEC) in nations such as Sri Lanka involves elephant-train collisions. Endangered Asian elephants are maimed or killed during such accidents, which also often result in orphaned or disabled elephants, contributing to the phenomenon of lone elephants. These lone elephants are found to be more likely to attack villages and showcase aggressive behaviour, which further exacerbates the overall HEC. Furthermore, Railway Services incur significant financial losses and disruptions to services annually due to such accidents. Most elephant-train collisions occur due to a lack of adequate reaction time. This is due to the significant stopping distance requirements of trains, as the full braking force needs to be avoided to minimise the risk of derailment. Thus, poor driver visibility at sharp turns, nighttime operation, and poor weather conditions are often contributing factors to this problem. Initial investigations also indicate that most collisions occur in localised “hotspots” where elephant pathways/corridors intersect with railway tracks that border grazing land and watering holes. Taking these factors into consideration, this work proposes the leveraging of recent developments in Convolutional Neural Network (CNN) technology to detect elephants using an RGB/infrared capable camera around known hotspots along the railway track. The CNN was trained using a curated dataset of elephants collected on field visits to elephant sanctuaries and wildlife parks in Sri Lanka. With this vision-based detection system at its core, a prototype unit of an early warning system was designed and tested. This weatherised and waterproofed unit consists of a Reolink security camera which provides a wide field of view and range, an Nvidia Jetson Xavier computing unit, a rechargeable battery, and a solar panel for self-sufficient functioning. The prototype unit was designed to be a low-cost, low-power and small footprint device that can be mounted on infrastructures such as poles or trees. If an elephant is detected, an early warning message is communicated to the train driver using the GSM network. A mobile app for this purpose was also designed to ensure that the warning is clearly communicated. A centralized control station manages and communicates all information through the train station network to ensure coordination among important stakeholders. Initial results indicate that detection accuracy is sufficient under varying lighting situations, provided comprehensive training datasets that represent a wide range of challenging conditions are available. The overall hardware prototype was shown to be robust and reliable. We envision a network of such units may help contribute to reducing the problem of elephant-train collisions and has the potential to act as an important surveillance mechanism in dealing with the broader issue of human-elephant conflicts.

Keywords: computer vision, deep learning, human-elephant conflict, wildlife early warning technology

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210 Innovative Technologies of Distant Spectral Temperature Control

Authors: Leonid Zhukov, Dmytro Petrenko

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Optical thermometry has no alternative in many cases of industrial most effective continuous temperature control. Classical optical thermometry technologies can be used on available for pyrometers controlled objects with stable radiation characteristics and transmissivity of the intermediate medium. Without using temperature corrections, it is possible in the case of a “black” body for energy pyrometry and the cases of “black” and “grey” bodies for spectral ratio pyrometry or with using corrections – for any colored bodies. Consequently, with increasing the number of operating waves, optical thermometry possibilities to reduce methodical errors significantly expand. That is why, in recent 25-30 years, research works have been reoriented on more perfect spectral (multicolor) thermometry technologies. There are two physical material substances, i.e., substance (controlled object) and electromagnetic field (thermal radiation), to be operated in optical thermometry. Heat is transferred by radiation; therefore, radiation has the energy, entropy, and temperature. Optical thermometry was originating simultaneously with the developing of thermal radiation theory when the concept and the term "radiation temperature" was not used, and therefore concepts and terms "conditional temperatures" or "pseudo temperature" of controlled objects were introduced. They do not correspond to the physical sense and definitions of temperature in thermodynamics, molecular-kinetic theory, and statistical physics. Launched by the scientific thermometric society, discussion about the possibilities of temperature measurements of objects, including colored bodies, using the temperatures of their radiation is not finished. Are the information about controlled objects transferred by their radiation enough for temperature measurements? The positive and negative answers on this fundamental question divided experts into two opposite camps. Recent achievements of spectral thermometry develop events in her favour and don’t leave any hope for skeptics. This article presents the results of investigations and developments in the field of spectral thermometry carried out by the authors in the Department of Thermometry and Physics-Chemical Investigations. The authors have many-year’s of experience in the field of modern optical thermometry technologies. Innovative technologies of optical continuous temperature control have been developed: symmetric-wave, two-color compensative, and based on obtained nonlinearity equation of spectral emissivity distribution linear, two-range, and parabolic. Тhe technologies are based on direct measurements of physically substantiated and proposed by Prof. L. Zhukov, radiation temperatures with the next calculation of the controlled object temperature using this radiation temperatures and corresponding mathematical models. Тhe technologies significantly increase metrological characteristics of continuous contactless and light-guide temperature control in energy, metallurgical, ceramic, glassy, and other productions. For example, under the same conditions, the methodical errors of proposed technologies are less than the errors of known spectral and classical technologies in 2 and 3-13 times, respectively. Innovative technologies provide quality products obtaining at the lowest possible resource-including energy costs. More than 600 publications have been published on the completed developments, including more than 100 domestic patents, as well as 34 patents in Australia, Bulgaria, Germany, France, Canada, the USA, Sweden, and Japan. The developments have been implemented in the enterprises of USA, as well as Western Europe and Asia, including Germany and Japan.

Keywords: emissivity, radiation temperature, object temperature, spectral thermometry

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209 Qualitative Evaluation of the Morris Collection Conservation Project at the Sainsbury Centre of Visual Arts in the Context of Agile, Lean and Hybrid Project Management Approaches

Authors: Maria Ledinskaya

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This paper examines the Morris Collection Conservation Project at the Sainsbury Centre for Visual Arts in the context of Agile, Lean, and Hybrid project management. It is part case study and part literature review. To date, relatively little has been written about non-traditional project management approaches in heritage conservation. This paper seeks to introduce Agile, Lean, and Hybrid project management concepts from business, software development, and manufacturing fields to museum conservation, by referencing their practical application on a recent museum-based conservation project. The Morris Collection Conservation Project was carried out in 2019-2021 in Norwich, UK, and concerned the remedial conservation of around 150 Abstract Constructivist artworks bequeathed to the Sainsbury Centre for Visual Arts by private collectors Michael and Joyce Morris. The first part introduces the chronological timeline and key elements of the project. It describes a medium-size conservation project of moderate complexity, which was planned and delivered in an environment with multiple known unknowns – unresearched collection, unknown condition and materials, unconfirmed budget. The project was also impacted by the unknown unknowns of the COVID-19 pandemic, such as indeterminate lockdowns, and the need to accommodate social distancing and remote communications. The author, a staff conservator at the Sainsbury Centre who acted as project manager on the Morris Collection Conservation Project, presents an incremental, iterative, and value-based approach to managing a conservation project in an uncertain environment. Subsequent sections examine the project from the point of view of Traditional, Agile, Lean, and Hybrid project management. The author argues that most academic writing on project management in conservation has focussed on a Traditional plan-driven approach – also known as Waterfall project management – which has significant drawbacks in today’s museum environment, due to its over-reliance on prediction-based planning and its low tolerance to change. In the last 20 years, alternative Agile, Lean and Hybrid approaches to project management have been widely adopted in software development, manufacturing, and other industries, although their recognition in the museum sector has been slow. Using examples from the Morris Collection Conservation Project, the author introduces key principles and tools of Agile, Lean, and Hybrid project management and presents a series of arguments on the effectiveness of these alternative methodologies in museum conservation, as well as the ethical and practical challenges to their implementation. These project management approaches are discussed in the context of consequentialist, relativist, and utilitarian developments in contemporary conservation ethics, particularly with respect to change management, bespoke ethics, shared decision-making, and value-based cost-benefit conservation strategy. The author concludes that the Morris Collection Conservation Project had multiple Agile and Lean features which were instrumental to the successful delivery of the project. These key features are identified as distributed decision making, a co-located cross-disciplinary team, servant leadership, focus on value-added work, flexible planning done in shorter sprint cycles, light documentation, and emphasis on reducing procedural, financial, and logistical waste. Overall, the author’s findings point largely in favour of a Hybrid model which combines traditional and alternative project processes and tools to suit the specific needs of the project.

Keywords: project management, conservation, waterfall, agile, lean, hybrid

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208 Surveillance of Artemisinin Resistance Markers and Their Impact on Treatment Outcomes in Malaria Patients in an Endemic Area of South-Western Nigeria

Authors: Abiodun Amusan, Olugbenga Akinola, Kazeem Akano, María Hernández-Castañeda, Jenna Dick, Akintunde Sowunmi, Geoffrey Hart, Grace Gbotosho

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Introduction: Artemisinin-based Combination Therapy (ACTs) is the cornerstone malaria treatment option in most malaria-endemic countries. Unfortunately, the malaria control effort is constantly being threatened by resistance of Plasmodium falciparum to ACTs. The recent evidence of artemisinin resistance in East Africa and its possibility of spreading to other African regions portends an imminent health catastrophe. This study aimed at evaluating the occurrence, prevalence, and influence of artemisinin-resistance markers on treatment outcomes in Ibadan before and after post-adoption of artemisinin combination therapy (ACTs) in Nigeria in 2005. Method: The study involved day zero dry blood spot (DBS) obtained from malaria patients during retrospective (2000-2005) and prospective (2021) studies. A cohort in the prospective study received oral dihydroartemisinin-piperaquine and underwent a 42-day follow-up to observe treatment outcomes. Genomic DNA was extracted from the DBS samples using a QIAamp blood extraction kit. Fragments of P. falciparum kelch13 (Pfkelch13), P. falciparum coronin (Pfcoronin), P. falciparum multidrug resistance 2 (PfMDR2), and P. falciparum chloroquine resistance transporter (PfCRT) genes were amplified and sequenced on a sanger sequencing platform to identify artemisinin resistance-associated mutations. Mutations were identified by aligning sequenced data with reference sequences obtained from the National Center for Biotechnology Information. Data were analyzed using descriptive statistics and student t-tests. Results: Mean parasite clearance time (PCT) and fever clearance time (FCT) were 2.1 ± 0.6 days (95% CI: 1.97-2.24) and 1.3 ± 0.7 days (95% CI: 1.1-1.6) respectively. Four mutations, K189T [34/53(64.2%)], R255K [2/53(3.8%)], K189N [1/53(1.9%)] and N217H [1/53(1.9%)] were identified within the N-terminal (Coiled-coil containing) domain of Pfkelch13. No artemisinin resistance-associated mutation usually found within the β-propeller domain of the Pfkelch13 gene was found in these analyzed samples. However, K189T and R255K mutations showed a significant correlation with longer parasite clearance time in the patients (P<0.002). The observed Pfkelch13 gene changes did not influence the baseline mean parasitemia (P = 0.44). P76S [17/100 (17%)] and V62M [1/100 (1%)] changes were identified in the Pfcoronin gene fragment without any influence on the parasitological parameters. No change was observed in the PfMDR2 gene, while no artemisinin resistance-associated mutation was found in the PfCRT gene. Furthermore, a sample each in the retrospective study contained the Pfkelch13 K189T and Pfcoronin P76S mutations. Conclusion: The study revealed absence of genetic-based evidence of artemisinin resistance in the study population at the time of study. The high frequency of K189T Pfkelch13 mutation and its correlation with increased parasite clearance time in this study may depict geographical variation of resistance mediators and imminent artemisinin resistance, respectively. The study also revealed an inherent potential of parasites to harbour drug-resistant genotypes before the introduction of ACTs in Nigeria.

Keywords: artemisinin resistance, plasmodium falciparum, Pfkelch13 mutations, Pfcoronin

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207 Iran’s Sexual and Reproductive Rights Roll-Back: An Overview of Iran’s New Population Policies

Authors: Raha Bahreini

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This paper discusses the roll-back of women’s sexual and reproductive rights in the Islamic Republic of Iran, which has come in the wake of a striking shift in the country’s official population policies. Since the late 1980s, Iran has won worldwide praise for its sexual and reproductive health and services, which have contributed to a steady decline in the country’s fertility rate–from 7.0 births per women in 1980 to 5.5 in 1988, 2.8 in 1996 and 1.85 in 2014. This is owed to a significant increase in the voluntary use of modern contraception in both rural and urban areas. In 1976, only 37 per cent of women were using at least one method of contraception; by 2014 this figure had reportedly risen to a high of nearly 79 per cent for married girls and women living in urban areas and 73.78 per cent for those living in rural areas. Such progress may soon be halted. In July 2012, Iran’s Supreme Leader Ayatollah Sayed Ali Khamenei denounced Iran’s family planning policies as an imitation of Western lifestyle. He exhorted the authorities to increase Iran’s population to 150 to 200 million (from around 78.5 million), including by cutting subsidies for contraceptive methods and dismantling the state’s Family and Population Planning Programme. Shortly thereafter, Iran’s Minister of Health and Medical Education announced the scrapping of the budget for the state-funded Family and Population Planning Programme. Iran’s Parliament subsequently introduced two bills; the Comprehensive Population and Exaltation of Family Bill (Bill 315), and the Bill to Increase Fertility Rates and Prevent Population Decline (Bill 446). Bill 446 outlaws voluntary tubectomies, which are believed to be the second most common method of modern contraception in Iran, and blocks access to information about contraception, denying women the opportunity to make informed decisions about the number and spacing of their children. Coupled with the elimination of state funding for Iran’s Family and Population Programme, the move would undoubtedly result in greater numbers of unwanted pregnancies, forcing more women to seek illegal and unsafe abortions. Bill 315 proposes various discriminatory measures in the areas of employment, divorce, and protection from domestic violence in order to promote a culture wherein wifedom and child-bearing is seen as women’s primary duty. The Bill, for example, instructs private and public entities to prioritize, in sequence, men with children, married men without children and married women with children when hiring for certain jobs. It also bans the recruitment of single individuals as family law lawyers, public and private school teachers and members of the academic boards of universities and higher education institutes. The paper discusses the consequences of these initiatives which would, if continued, set the human rights of women and girls in Iran back by decades, leaving them with a future shaped by increased inequality, discrimination, poor health, limited choices and restricted freedoms, in breach of Iran’s international human rights obligations.

Keywords: family planning and reproductive health, gender equality and empowerment of women, human rights, population growth

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206 Partnering With Key Stakeholders for Successful Implementation of Inhaled Analgesia for Specific Emergency Department Presentations

Authors: Sarah Hazelwood, Janice Hay

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Methoxyflurane is an inhaled analgesic administered via a disposable inhaler, which has been used in Australia for 40 years for the management of pain in children & adults. However, there is a lack of data for methoxyflurane as a frontline analgesic medication within the emergency department (ED). This study will investigate the usefulness of methoxyflurane in a private inner-city ED. The study concluded that the inclusion of all key stakeholders in the prescribing, administering & use of this new process led to comprehensive uptake & vastly positive outcomes for consumer & health professionals. Method: A 12-week prospective pilot study was completed utilizing patients presenting to the ED in pain (numeric pain rating score > 4) that fit the requirement of methoxyflurane use (as outlined in the Australian Prescriber information package). Nurses completed a formatted spreadsheet for each interaction where methoxyflurane was used. Patient demographics, day, time, initial numeric pain score, analgesic response time, the reason for use, staff concern (free text), & patient feedback (free text), & discharge time was documented. When clinical concern was raised, the researcher retrieved & reviewed patient notes. Results: 140 methoxyflurane inhalers were used. 60% of patients were 31 years of age & over (n=82) with 16% aged 70+. The gender split; 51% male: 49% female. Trauma-related pain (57%) saw the highest use of administration, with the evening hours (1500-2259) seeing the greatest numbers used (39%). Tuesday, Thursday & Sunday shared the highest daily use throughout the study. A minimum numerical pain score of 4/10 (n=13, 9%), with the ranges of 5 - 7/10 (moderate pain) being given by almost 50% of patients. Only 3 instances of pain scores increased post use of methoxyflurane (all other entries showed pain score < initial rating). Patients & staff noted obvious analgesic response within 3 minutes (n= 96, 81%, of administration). Nurses documented a change in patient vital signs for 4 of the 15 patient-related concerns; the remaining concerns were due to “gagging” on the taste, or “having a coughing episode”; one patient tried to leave the department before the procedure was attended (very euphoric state). Upon review of the staff concerns – no adverse events occurred & return to therapeutic vitals occurred within 10 minutes. Length of stay for patients was compared with similar presentations (such as dislocated shoulder or ankle fracture) & saw an average 40-minute decrease in time to discharge. Methoxyflurane treatment was rated “positively” by > 80% of patients – with remaining feedback related to mild & transient concerns. Staff similarly noted a positive response to methoxyflurane as an analgesic & as an added tool for frontline analgesic purposes. Conclusion: Methoxyflurane should be used on suitable patient presentations requiring immediate, short term pain relief. As a highly portable, non-narcotic avenue to treat pain this study showed obvious therapeutic benefit, positive feedback, & a shorter length of stay in the ED. By partnering with key stake holders, this study determined methoxyflurane use decreased work load, decreased wait time to analgesia, and increased patient satisfaction.

Keywords: analgesia, benefits, emergency, methoxyflurane

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