Search results for: discrete latent variable
198 The Use of Platelet-rich Plasma in the Treatment of Diabetic Foot Ulcers: A Scoping Review
Authors: Kiran Sharma, Viktor Kunder, Zerha Rizvi, Ricardo Soubelet
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Platelet rich plasma (PRP) has been recognized as a method of treatment in medicine since the 1980s. It primarily functions by releasing cytokines and growth factors that promote wound healing; these growth promoting factors released by PRP enact new processes such as angiogenesis, collagen deposition, and tissue formation that can change wound healing outcomes. Many studies recognize that PRP aids in chronic wound healing, which is advantageous for patients who suffer from chronic diabetic foot ulcers (DFUs). This scoping review aims to examine literature to identify the efficacy of PRP use in the healing of DFUs. Following PRISMA guidelines, we searched randomized-controlled trials involving PRP use in diabetic patients with foot ulcers using PubMed, Medline, CINAHL Complete, and Cochrane Database of Systematic Reviews. We restricted the search to articles published during 2005-2022, full texts in the English language, articles involving patients aged 19 years or older, articles that used PRP on specifically DFUs, articles that included a control group, articles on human subjects. The initial search yielded 119 articles after removing duplicates. Final analysis for relevance yielded 8 articles. In all cases except one, the PRP group showed either faster healing, more complete healing, or a larger percentage of healed participants. There were no situations in the included studies where the control group had a higher rate of healing or decreased wound size as compared to a group with isolated PRP-only use. Only one study did not show conclusive evidence that PRP caused accelerated healing in DFUs, and this study did not have an isolated PRP variable group. Application styles of PRP for treatment were shown to influence the level of healing in patients, with injected PRP appearing to achieve the best results as compared to topical PRP application. However, this was not conclusive due to the involvement of several other variables. Two studies additionally found PRP to be useful in healing refractory DFUs, and one study found that PRP use in patients with additional comorbidities was still more effective in healing DFUs than the standard control groups. The findings of this review suggest that PRP is a useful tool in reducing healing times and improving rates of complete wound healing in DFUs. There is room for further research in the application styles of PRP before conclusive statements can be made on the efficacy of injected versus topical PRP healing based on the findings in this study. The results of this review provide a baseline for further research in PRP use in diabetic patients and can be used by both physicians and public health experts to guide future treatment options for DFUs.Keywords: diabetic foot ulcer, DFU, platelet rich plasma, PRP
Procedia PDF Downloads 75197 Religious Capital and Entrepreneurial Behavior in Small Businesses: The Importance of Entrepreneurial Creativity
Authors: Waleed Omri
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With the growth of the small business sector in emerging markets, developing a better understanding of what drives 'day-to-day' entrepreneurial activities has become an important issue for academicians and practitioners. Innovation, as an entrepreneurial behavior, revolves around individuals who creatively engage in new organizational efforts. In a similar vein, the innovation behaviors and processes at the organizational member level are central to any corporate entrepreneurship strategy. Despite the broadly acknowledged importance of entrepreneurship and innovation at the individual level in the establishment of successful ventures, the literature lacks evidence on how entrepreneurs can effectively harness their skills and knowledge in the workplace. The existing literature illustrates that religion can impact the day-to-day work behavior of entrepreneurs, managers, and employees. Religious beliefs and practices could affect daily entrepreneurial activities by fostering mental abilities and traits such as creativity, intelligence, and self-efficacy. In the present study, we define religious capital as a set of personal and intangible resources, skills, and competencies that emanate from an individual’s religious values, beliefs, practices, and experiences and may be used to increase the quality of economic activities. Religious beliefs and practices give individuals a religious satisfaction, which can lead them to perform better in the workplace. In addition, religious ethics and practices have been linked to various positive employee outcomes in terms of organizational change, job satisfaction, and entrepreneurial intensity. As investigations of their consequences beyond direct task performance are still scarce, we explore if religious capital plays a role in entrepreneurs’ innovative behavior. In sum, this study explores the determinants of individual entrepreneurial behavior by investigating the relationship between religious capital and entrepreneurs’ innovative behavior in the context of small businesses. To further explain and clarify the religious capital-innovative behavior link, the present study proposes a model to examine the mediating role of entrepreneurial creativity. We use both Islamic work ethics (IWE) and Islamic religious practices (IRP) to measure Islamic religious capital. We use structural equation modeling with a robust maximum likelihood estimation to analyze data gathered from 289 Tunisian small businesses and to explore the relationships among the above-described variables. In line with the theory of planned behavior, only religious work ethics are found to increase the innovative behavior of small businesses’ owner-managers. Our findings also clearly demonstrate that the connection between religious capital-related variables and innovative behavior is better understood if the influence of entrepreneurial creativity, as a mediating variable of the aforementioned relationship, is taken into account. By incorporating both religious capital and entrepreneurial creativity into the innovative behavior analysis, this study provides several important practical implications for promoting innovation process in small businesses.Keywords: entrepreneurial behavior, small business, religion, creativity
Procedia PDF Downloads 244196 Assessing Acute Toxicity and Endocrine Disruption Potential of Selected Packages Internal Layers Extracts
Authors: N. Szczepanska, B. Kudlak, G. Yotova, S. Tsakovski, J. Namiesnik
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In the scientific literature related to the widely understood issue of packaging materials designed to have contact with food (food contact materials), there is much information on raw materials used for their production, as well as their physiochemical properties, types, and parameters. However, not much attention is given to the issues concerning migration of toxic substances from packaging and its actual influence on the health of the final consumer, even though health protection and food safety are the priority tasks. The goal of this study was to estimate the impact of particular foodstuff packaging type, food production, and storage conditions on the degree of leaching of potentially toxic compounds and endocrine disruptors to foodstuffs using the acute toxicity test Microtox and XenoScreen YES YAS assay. The selected foodstuff packaging materials were metal cans used for fish storage and tetrapak. Five stimulants respectful to specific kinds of food were chosen in order to assess global migration: distilled water for aqueous foods with a pH above 4.5; acetic acid at 3% in distilled water for acidic aqueous food with pH below 4.5; ethanol at 5% for any food that may contain alcohol; dimethyl sulfoxide (DMSO) and artificial saliva were used in regard to the possibility of using it as an simulation medium. For each packaging three independent variables (temperature and contact time) factorial design simulant was performed. Xenobiotics migration from epoxy resins was studied at three different temperatures (25°C, 65°C, and 121°C) and extraction time of 12h, 48h and 2 weeks. Such experimental design leads to 9 experiments for each food simulant as conditions for each experiment are obtained by combination of temperature and contact time levels. Each experiment was run in triplicate for acute toxicity and in duplicate for estrogen disruption potential determination. Multi-factor analysis of variation (MANOVA) was used to evaluate the effects of the three main factors solvent, temperature (temperature regime for cup), contact time and their interactions on the respected dependent variable (acute toxicity or estrogen disruption potential). From all stimulants studied the most toxic were can and tetrapak lining acetic acid extracts that are indication for significant migration of toxic compounds. This migration increased with increase of contact time and temperature and justified the hypothesis that food products with low pH values cause significant damage internal resin filling. Can lining extracts of all simulation medias excluding distilled water and artificial saliva proved to contain androgen agonists even at 25°C and extraction time of 12h. For tetrapak extracts significant endocrine potential for acetic acid, DMSO and saliva were detected.Keywords: food packaging, extraction, migration, toxicity, biotest
Procedia PDF Downloads 181195 Modeling the Relation between Discretionary Accrual Earnings Management, International Financial Reporting Standards and Corporate Governance
Authors: Ikechukwu Ndu
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This study examines the econometric modeling of the relation between discretionary accrual earnings management, International Financial Reporting Standards (IFRS), and certain corporate governance factors with regard to listed Nigerian non-financial firms. Although discretionary accrual earnings management is a well-known and global problem that has an adverse impact on users of the financial statements, its relationship with IFRS and corporate governance is neither adequately researched nor properly systematically investigated in Nigeria. The dearth of research in the relation between discretionary accrual earnings management, IFRS and corporate governance in Nigeria has made it difficult for academics, practitioners, government setting bodies, regulators and international bodies to achieve a clearer understanding of how discretionary accrual earnings management relates to IFRS and certain corporate governance characteristics. This is the first study to the author’s best knowledge to date that makes interesting research contributions that significantly add to the literature of discretionary accrual earnings management and its relation with corporate governance and IFRS pertaining to the Nigerian context. A comprehensive review is undertaken of the literature of discretionary total accrual earnings management, IFRS, and certain corporate governance characteristics as well as the data, models, methodologies, and different estimators used in the study. Secondary financial statement, IFRS, and corporate governance data are sourced from Bloomberg database and published financial statements of Nigerian non-financial firms for the period 2004 to 2016. The methodology uses both the total and working capital accrual basis. This study has a number of interesting preliminary findings. First, there is a negative relationship between the level of discretionary accrual earnings management and the adoption of IFRS. However, this relationship does not appear to be statistically significant. Second, there is a significant negative relationship between the size of the board of directors and discretionary accrual earnings management. Third, CEO Separation of roles does not constrain earnings management, indicating the need to preserve relationships, personal connections, and maintain bonded friendships between the CEO, Chairman, and executive directors. Fourth, there is a significant negative relationship between discretionary accrual earnings management and the use of a Big Four firm as an auditor. Fifth, including shareholders in the audit committee, leads to a reduction in discretionary accrual earnings management. Sixth, the debt and return on assets (ROA) variables are significant and positively related to discretionary accrual earnings management. Finally, the company size variable indicated by the log of assets is surprisingly not found to be statistically significant and indicates that all Nigerian companies irrespective of size engage in discretionary accrual management. In conclusion, this study provides key insights that enable a better understanding of the relationship between discretionary accrual earnings management, IFRS, and corporate governance in the Nigerian context. It is expected that the results of this study will be of interest to academics, practitioners, regulators, governments, international bodies and other parties involved in policy setting and economic development in areas of financial reporting, securities regulation, accounting harmonization, and corporate governance.Keywords: discretionary accrual earnings management, earnings manipulation, IFRS, corporate governance
Procedia PDF Downloads 144194 The Influence of Argumentation Strategy on Student’s Web-Based Argumentation in Different Scientific Concepts
Authors: Xinyue Jiao, Yu-Ren Lin
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Argumentation is an essential aspect of scientific thinking which has been widely concerned in recent reform of science education. The purpose of the present studies was to explore the influences of two variables termed ‘the argumentation strategy’ and ‘the kind of science concept’ on student’s web-based argumentation. The first variable was divided into either monological (which refers to individual’s internal discourse and inner chain reasoning) or dialectical (which refers to dialogue interaction between/among people). The other one was also divided into either descriptive (i.e., macro-level concept, such as phenomenon can be observed and tested directly) or theoretical (i.e., micro-level concept which is abstract, and cannot be tested directly in nature). The present study applied the quasi-experimental design in which 138 7th grade students were invited and then assigned to either monological group (N=70) or dialectical group (N=68) randomly. An argumentation learning program called ‘the PWAL’ was developed to improve their scientific argumentation abilities, such as arguing from multiple perspectives and based on scientific evidence. There were two versions of PWAL created. For the individual version, students can propose argument only through knowledge recall and self-reflecting process. On the other hand, the students were allowed to construct arguments through peers’ communication in the collaborative version. The PWAL involved three descriptive science concept-based topics (unit 1, 3 and 5) and three theoretical concept-based topics (unit 2, 4 and 6). Three kinds of scaffoldings were embedded into the PWAL: a) argument template, which was used for constructing evidence-based argument; b) the model of the Toulmin’s TAP, which shows the structure and elements of a sound argument; c) the discussion block, which enabled the students to review what had been proposed during the argumentation. Both quantitative and qualitative data were collected and analyzed. An analytical framework for coding students’ arguments proposed in the PWAL was constructed. The results showed that the argumentation approach has a significant effect on argumentation only in theoretical topics (f(1, 136)=48.2, p < .001, η2=2.62). The post-hoc analysis showed the students in the collaborative group perform significantly better than the students in the individual group (mean difference=2.27). However, there is no significant difference between the two groups regarding their argumentation in descriptive topics. Secondly, the students made significant progress in the PWAL from the earlier descriptive or theoretical topic to the later one. The results enabled us to conclude that the PWAL was effective for students’ argumentation. And the students’ peers’ interaction was essential for students to argue scientifically especially for the theoretical topic. The follow-up qualitative analysis showed student tended to generate arguments through critical dialogue interactions in the theoretical topic which promoted them to use more critiques and to evaluate and co-construct each other’s arguments. More explanations regarding the students’ web-based argumentation and the suggestions for the development of web-based science learning were proposed in our discussions.Keywords: argumentation, collaborative learning, scientific concepts, web-based learning
Procedia PDF Downloads 104193 Unification of Lactic Acid Bacteria and Aloe Vera for Healthy Gut
Authors: Pavitra Sharma, Anuradha Singh, Nupur Mathur
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There exist more than 100 trillion bacteria in the digestive system of human-beings. Such bacteria are referred to as gut microbiota. Gut microbiota comprises around 75% of our immune system. The bacteria that comprise the gut microbiota are unique to every individual and their composition keeps changing with time owing to factors such as the host’s age, diet, genes, environment, and external medication. Of these factors, the variable easiest to control is one’s diet. By modulating one’s diet, one can ensure an optimal composition of the gut microbiota yielding several health benefits. Prebiotics and probiotics are two compounds that have been considered as viable options to modulate the host’s diet. Prebiotics are basically plant products that support the growth of good bacteria in the host’s gut. Examples include garden asparagus, aloe vera etc. Probiotics are living microorganisms that exist in our intestines and play an integral role in promoting digestive health and supporting our immune system in general. Examples include yogurt, kimchi, kombucha etc. In the context of modulating the host’s diet, the key attribute of prebiotics is that they support the growth of probiotics. By developing the right combination of prebiotics and probiotics, food products or supplements can be created to enhance the host’s health. An effective combination of prebiotics and probiotics that yields health benefits to the host is referred to as synbiotics. Synbiotics comprise of an optimal proportion of prebiotics and probiotics, their application benefits the host’s health more than the application of prebiotics and probiotics used in isolation. When applied to food supplements, synbiotics preserve the beneficial probiotic bacteria during storage period and during the bacteria’s passage through the intestinal tract. When applied to the gastrointestinal tract, the composition of the synbiotics assumes paramount importance. Reason being that for synbiotics to be effective in the gastrointestinal tract, the chosen probiotic must be able to survive in the stomach’s acidic environment and manifest tolerance towards bile and pancreatic secretions. Further, not every prebiotic stimulates the growth of a particular probiotic. The prebiotic chosen should be one that not only maintains 2 balance in the host’s digestive system, but also provides the required nutrition to probiotics. Hence in each application of synbiotics, the prebiotic-probiotic combination needs to be carefully selected. Once the combination is finalized, the exact proportion of prebiotics and probiotics to be used needs to be considered. When determining this proportion, only that amount of a prebiotic should be used that activates metabolism of the required number of probiotics. It was observed that while probiotics are active is both the small and large intestine, the effect of prebiotics is observed primarily in the large intestine. Hence in the host’s small intestine, synbiotics are likely to have the maximum efficacy. In small intestine, prebiotics not only assist in the growth of probiotics, but they also enable probiotics to exhibit a higher tolerance to pH levels, oxygenation, and intestinal temperatureKeywords: microbiota, probiotics, prebiotics, synbiotics
Procedia PDF Downloads 135192 Authentic Connection between the Deity and the Individual Human Being Is Vital for Psychological, Biological, and Social Health
Authors: Sukran Karatas
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Authentic energy network interrelations between the Creator and the creations as well as from creations to creations are the most important points for the worlds of physics and metaphysic to unite together and work in harmony, both within human beings, on the other hand, have the ability to choose their own life style voluntarily. However, it includes the automated involuntary spirit, soul and body working systems together with the voluntary actions, which involve personal, cultural and universal, rational or irrational variable values. Therefore, it is necessary for human beings to know the methods of existing authentic energy network connections to be able to communicate correlate and accommodate the physical and metaphysical entities as a proper functioning unity; this is essential for complete human psychological, biological and social well-being. Authentic knowledge is necessary for human beings to verify the position of self within self and with others to regulate conscious and voluntary actions accordingly in order to prevent oppressions and frictions within self and between self and others. Unfortunately, the absence of genuine individual and universal basic knowledge about how to establish an authentic energy network connection within self, with the deity and the environment is the most problematic issue even in the twenty-first century. The second most problematic issue is how to maintain freedom, equality and justice among human beings during these strictly interwoven network connections, which naturally involve physical, metaphysical and behavioral actions of the self and the others. The third and probably the most complicated problem is the scientific identification and the authentication of the deity. This not only provides the whole power and control over the choosers to set their life orders but also to establish perfect physical and metaphysical links as fully coordinated functional energy network. This thus indicates that choosing an authentic deity is the key-point that influences automated, emotional, and behavioral actions altogether, which shapes human perception, personal actions, and life orders. Therefore, we will be considering the existing ‘four types of energy wave end boundary behaviors’, comprising, free end, fixed end boundary behaviors, as well as boundary behaviors from denser medium to less dense medium and from less dense medium to denser medium. Consequently, this article aims to demonstrate that the authentication and the choice of deity has an important effect on individual psychological, biological and social health. It is hoped that it will encourage new researches in the field of authentic energy network connections to establish the best position and the most correct interrelation connections with self and others without violating the authorized orders and the borders of one another to live happier and healthier lives together. In addition, the book ‘Deity and Freedom, Equality, Justice in History, Philosophy, Science’ has more detailed information for those interested in this subject.Keywords: deity, energy network, power, freedom, equality, justice, happiness, sadness, hope, fear, psychology, biology, sociology
Procedia PDF Downloads 346191 Impact of National Institutions on Corporate Social Performance
Authors: Debdatta Mukherjee, Abhiman Das, Amit Garg
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In recent years, there is a growing interest about corporate social responsibility of firms in both academic literature and business world. Since business forms a part of society incorporating socio-environment concerns into its value chain, activities are vital for ensuring mutual sustainability and prosperity. But, until now most of the works have been either descriptive or normative rather than positivist in tone. Even the few ones with a positivist approach have mostly studied the link between corporate financial performance and corporate social performance. However, these studies have been severely criticized by many eminent authors on grounds that they lack a theoretical basis for their findings. They have also argued that apart from corporate financial performance, there must be certain other crucial influences that are likely to determine corporate social performance of firms. In fact, several studies have indicated that firms operating in distinct national institutions show significant variations in the corporate social responsibility practices that they undertake. This clearly suggests that the institutional context of a country in which the firms operate is a key determinant of corporate social performance of firms. Therefore, this paper uses an institutional framework to understand why corporate social performance of firms vary across countries. It examines the impact of country level institutions on corporate social performance using a sample of 3240 global publicly-held firms across 33 countries covering the period 2010-2015. The country level institutions include public institutions, private institutions, markets and capacity to innovate. Econometric Analysis has been mainly used to assess this impact. A three way panel data analysis using fixed effects has been used to test and validate appropriate hypotheses. Most of the empirical findings confirm our hypotheses and the economic significance indicates the specific impact of each variable and their importance relative to others. The results suggest that institutional determinants like ethical behavior of private institutions, goods market, labor market and innovation capacity of a country are significantly related to the corporate social performance of firms. Based on our findings, few implications for policy makers from across the world have also been suggested. The institutions in a country should promote competition. The government should use policy levers for upgrading home demands, like setting challenging yet flexible safety, quality and environment standards, and framing policies governing buyer information, providing innovative recourses to low quality goods and services and promoting early adoption of new and technologically advanced products. Moreover, the institution building in a country should be such that they facilitate and improve the capacity of firms to innovate. Therefore, the proposed study argues that country level institutions impact corporate social performance of firms, empirically validates the same, suggest policy implications and attempts to contribute to an extended understanding of corporate social responsibility and corporate social performance in a multinational context.Keywords: corporate social performance, corporate social responsibility, institutions, markets
Procedia PDF Downloads 166190 Evolving Credit Scoring Models using Genetic Programming and Language Integrated Query Expression Trees
Authors: Alexandru-Ion Marinescu
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There exist a plethora of methods in the scientific literature which tackle the well-established task of credit score evaluation. In its most abstract form, a credit scoring algorithm takes as input several credit applicant properties, such as age, marital status, employment status, loan duration, etc. and must output a binary response variable (i.e. “GOOD” or “BAD”) stating whether the client is susceptible to payment return delays. Data imbalance is a common occurrence among financial institution databases, with the majority being classified as “GOOD” clients (clients that respect the loan return calendar) alongside a small percentage of “BAD” clients. But it is the “BAD” clients we are interested in since accurately predicting their behavior is crucial in preventing unwanted loss for loan providers. We add to this whole context the constraint that the algorithm must yield an actual, tractable mathematical formula, which is friendlier towards financial analysts. To this end, we have turned to genetic algorithms and genetic programming, aiming to evolve actual mathematical expressions using specially tailored mutation and crossover operators. As far as data representation is concerned, we employ a very flexible mechanism – LINQ expression trees, readily available in the C# programming language, enabling us to construct executable pieces of code at runtime. As the title implies, they model trees, with intermediate nodes being operators (addition, subtraction, multiplication, division) or mathematical functions (sin, cos, abs, round, etc.) and leaf nodes storing either constants or variables. There is a one-to-one correspondence between the client properties and the formula variables. The mutation and crossover operators work on a flattened version of the tree, obtained via a pre-order traversal. A consequence of our chosen technique is that we can identify and discard client properties which do not take part in the final score evaluation, effectively acting as a dimensionality reduction scheme. We compare ourselves with state of the art approaches, such as support vector machines, Bayesian networks, and extreme learning machines, to name a few. The data sets we benchmark against amount to a total of 8, of which we mention the well-known Australian credit and German credit data sets, and the performance indicators are the following: percentage correctly classified, area under curve, partial Gini index, H-measure, Brier score and Kolmogorov-Smirnov statistic, respectively. Finally, we obtain encouraging results, which, although placing us in the lower half of the hierarchy, drive us to further refine the algorithm.Keywords: expression trees, financial credit scoring, genetic algorithm, genetic programming, symbolic evolution
Procedia PDF Downloads 117189 Development and Experimental Evaluation of a Semiactive Friction Damper
Authors: Juan S. Mantilla, Peter Thomson
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Seismic events may result in discomfort on occupants of the buildings, structural damage or even buildings collapse. Traditional design aims to reduce dynamic response of structures by increasing stiffness, thus increasing the construction costs and the design forces. Structural control systems arise as an alternative to reduce these dynamic responses. A commonly used control systems in buildings are the passive friction dampers, which adds energy dissipation through damping mechanisms induced by sliding friction between their surfaces. Passive friction dampers are usually implemented on the diagonal of braced buildings, but such devices have the disadvantage that are optimal for a range of sliding force and out of that range its efficiency decreases. The above implies that each passive friction damper is designed, built and commercialized for a specific sliding/clamping force, in which the damper shift from a locked state to a slip state, where dissipates energy through friction. The risk of having a variation in the efficiency of the device according to the sliding force is that the dynamic properties of the building can change as result of many factor, even damage caused by a seismic event. In this case the expected forces in the building can change and thus considerably reduce the efficiency of the damper (that is designed for a specific sliding force). It is also evident than when a seismic event occurs the forces in each floor varies in the time what means that the damper's efficiency is not the best at all times. Semi-Active Friction devices adapt its sliding force trying to maintain its motion in the slipping phase as much as possible, because of this, the effectiveness of the device depends on the control strategy used. This paper deals with the development and performance evaluation of a low cost Semiactive Variable Friction Damper (SAVFD) in reduced scale to reduce vibrations of structures subject to earthquakes. The SAVFD consist in a (1) hydraulic brake adapted to (2) a servomotor which is controlled with an (3) Arduino board and acquires accelerations or displacement from (4) sensors in the immediately upper and lower floors and a (5) power supply that can be a pair of common batteries. A test structure, based on a Benchmark structure for structural control, was design and constructed. The SAVFD and the structure are experimentally characterized. A numerical model of the structure and the SAVFD is developed based on the dynamic characterization. Decentralized control algorithms were modeled and later tested experimentally using shaking table test using earthquake and frequency chirp signals. The controlled structure with the SAVFD achieved reductions greater than 80% in relative displacements and accelerations in comparison to the uncontrolled structure.Keywords: earthquake response, friction damper, semiactive control, shaking table
Procedia PDF Downloads 378188 Microalgae Technology for Nutraceuticals
Authors: Weixing Tan
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Production of nutraceuticals from microalgae—a virtually untapped natural phyto-based source of which there are 200,000 to 1,000,000 species—offers a sustainable and healthy alternative to conventionally sourced nutraceuticals for the market. Microalgae can be grown organically using only natural sunlight, water and nutrients at an extremely fast rate, e.g. 10-100 times more efficiently than crops or trees. However, the commercial success of microalgae products at scale remains limited largely due to the lack of economically viable technologies. There are two major microalgae production systems or technologies currently available: 1) the open system as represented by open pond technology and 2) the closed system such as photobioreactors (PBR). Each carries its own unique features and challenges. Although an open system requires a lower initial capital investment relative to a PBR, it conveys many unavoidable drawbacks; for example, much lower productivity, difficulty in contamination control/cleaning, inconsistent product quality, inconvenience in automation, restriction in location selection, and unsuitability for cold areas – all directly linked to the system openness and flat underground design. On the other hand, a PBR system has characteristics almost entirely opposite to the open system, such as higher initial capital investment, better productivity, better contamination and environmental control, wider suitability in different climates, ease in automation, higher and consistent product quality, higher energy demand (particularly if using artificial lights), and variable operational expenses if not automated. Although closed systems like PBRs are not highly competitive yet in current nutraceutical supply market, technological advances can be made, in particular for the PBR technology, to narrow the gap significantly. One example is a readily scalable P2P Microalgae PBR Technology at Grande Prairie Regional College, Canada, developed over 11 years considering return on investment (ROI) for key production processes. The P2P PBR system is approaching economic viability at a pre-commercial stage due to five ROI-integrated major components. They include: (1) optimum use of free sunlight through attenuation (patented); (2) simple, economical, and chemical-free harvesting (patent ready to file); (3) optimum pH- and nutrient-balanced culture medium (published), (4) reliable water and nutrient recycling system (trade secret); and (5) low-cost automated system design (trade secret). These innovations have allowed P2P Microalgae Technology to increase daily yield to 106 g/m2/day of Chlorella vulgaris, which contains 50% proteins and 2-3% omega-3. Based on the current market prices and scale-up factors, this P2P PBR system presents as a promising microalgae technology for market competitive nutraceutical supply.Keywords: microalgae technology, nutraceuticals, open pond, photobioreactor PBR, return on investment ROI, technological advances
Procedia PDF Downloads 157187 Single Centre Retrospective Analysis of MR Imaging in Placenta Accreta Spectrum Disorder with Histopathological Correlation
Authors: Frank Dorrian, Aniket Adhikari
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The placenta accreta spectrum (PAS), which includes placenta accreta, increta, and percreta, is characterized by the abnormal implantation of placental chorionic villi beyond the decidua basalis. Key risk factors include placenta previa, prior cesarean sections, advanced maternal age, uterine surgeries, multiparity, pelvic radiation, and in vitro fertilization (IVF). The incidence of PAS has increased tenfold over the past 50 years, largely due to rising cesarean rates. PAS is associated with significant peripartum and postpartum hemorrhage. Magnetic resonance imaging (MRI) and ultrasound assist in the evaluation of PAS, enabling a multidisciplinary approach to mitigate morbidity and mortality. This study retrospectively analyzed PAS cases at Royal Prince Alfred Hospital, Sydney, Australia. Using the SAR-ESUR joint consensus statement, seven imaging signs were reassessed for their sensitivity and specificity in predicting PAS, with histopathological correlation. The standardized MRI protocols for PAS at the institution were also reviewed. Data were collected from the picture archiving and communication system (PACS) records from 2010 to July 2024, focusing on cases where MR imaging and confirmed histopathology or operative notes were available. This single-center, observational study provides insights into the reliability of MRI for PAS detection and the optimization of imaging protocols for accurate diagnosis. The findings demonstrate that intraplacental dark bands serve as highly sensitive markers for diagnosing PAS, achieving sensitivities of 88.9%, 85.7%, and 100% for placenta accreta, increta, and percreta, respectively, with a combined specificity of 42.9%. Sensitivity for abnormal vascularization was lower (33.3%, 28.6%, and 50%), with a specificity of 57.1%. The placenta bulge exhibited sensitivities of 55.5%, 57.1%, and 100%, with a specificity of 57.1%. Loss of the T2 hypointense interface had sensitivities of 66.6%, 85.7%, and 100%, with 42.9% specificity. Myometrial thinning showed high sensitivity across PAS conditions (88.9%, 71.4%, and 100%) and a specificity of 57.1%. Bladder wall thinning was sensitive only for placenta percreta (50%) but had a specificity of 100%. Focal exophytic mass displayed variable sensitivity (22.9%, 42.9%, and 100%) with a specificity of 85.7%. These results highlight the diagnostic variability among markers, with intraplacental dark bands and myometrial thinning being useful in detecting abnormal placentation, though they lack high specificity. The literature and the results of our study highlight that while no single feature can definitively diagnose PAS, the presence of multiple features -especially when combined with elevated clinical risk- significantly increases the likelihood of an underlying PAS. A thorough understanding of the range of MRI findings associated with PAS, along with awareness of the clinical significance of each sign, helps the radiologist more accurately diagnose the condition and assist in surgical planning, ultimately improving patient care.Keywords: placenta, accreta, spectrum, MRI
Procedia PDF Downloads 8186 Spatial Climate Changes in the Province of Macerata, Central Italy, Analyzed by GIS Software
Authors: Matteo Gentilucci, Marco Materazzi, Gilberto Pambianchi
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Climate change is an increasingly central issue in the world, because it affects many of human activities. In this context regional studies are of great importance because they sometimes differ from the general trend. This research focuses on a small area of central Italy which overlooks the Adriatic Sea, the province of Macerata. The aim is to analyze space-based climate changes, for precipitation and temperatures, in the last 3 climatological standard normals (1961-1990; 1971-2000; 1981-2010) through GIS software. The data collected from 30 weather stations for temperature and 61 rain gauges for precipitation were subject to quality controls: validation and homogenization. These data were fundamental for the spatialization of the variables (temperature and precipitation) through geostatistical techniques. To assess the best geostatistical technique for interpolation, the results of cross correlation were used. The co-kriging method with altitude as independent variable produced the best cross validation results for all time periods, among the methods analysed, with 'root mean square error standardized' close to 1, 'mean standardized error' close to 0, 'average standard error' and 'root mean square error' with similar values. The maps resulting from the analysis were compared by subtraction between rasters, producing 3 maps of annual variation and three other maps for each month of the year (1961/1990-1971/2000; 1971/2000-1981/2010; 1961/1990-1981/2010). The results show an increase in average annual temperature of about 0.1°C between 1961-1990 and 1971-2000 and 0.6 °C between 1961-1990 and 1981-2010. Instead annual precipitation shows an opposite trend, with an average difference from 1961-1990 to 1971-2000 of about 35 mm and from 1961-1990 to 1981-2010 of about 60 mm. Furthermore, the differences in the areas have been highlighted with area graphs and summarized in several tables as descriptive analysis. In fact for temperature between 1961-1990 and 1971-2000 the most areally represented frequency is 0.08°C (77.04 Km² on a total of about 2800 km²) with a kurtosis of 3.95 and a skewness of 2.19. Instead, the differences for temperatures from 1961-1990 to 1981-2010 show a most areally represented frequency of 0.83 °C, with -0.45 as kurtosis and 0.92 as skewness (36.9 km²). Therefore it can be said that distribution is more pointed for 1961/1990-1971/2000 and smoother but more intense in the growth for 1961/1990-1981/2010. In contrast, precipitation shows a very similar shape of distribution, although with different intensities, for both variations periods (first period 1961/1990-1971/2000 and second one 1961/1990-1981/2010) with similar values of kurtosis (1st = 1.93; 2nd = 1.34), skewness (1st = 1.81; 2nd = 1.62 for the second) and area of the most represented frequency (1st = 60.72 km²; 2nd = 52.80 km²). In conclusion, this methodology of analysis allows the assessment of small scale climate change for each month of the year and could be further investigated in relation to regional atmospheric dynamics.Keywords: climate change, GIS, interpolation, co-kriging
Procedia PDF Downloads 127185 Exploration Tools for Tantalum-Bearing Pegmatites along Kibara Belt, Central and Southwestern Uganda
Authors: Sadat Sembatya
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Tantalum metal is used in addressing capacitance challenge in the 21st-century technology growth. Tantalum is rarely found in its elemental form. Hence it’s often found with niobium and the radioactive elements of thorium and uranium. Industrial processes are required to extract pure tantalum. Its deposits are mainly oxide associated and exist in Ta-Nb oxides such as tapiolite, wodginite, ixiolite, rutile and pyrochlore-supergroup minerals are of minor importance. The stability and chemical inertness of tantalum makes it a valuable substance for laboratory equipment and a substitute for platinum. Each period of Tantalum ore formation is characterized by specific mineralogical and geochemical features. Compositions of Columbite-Group Minerals (CGM) are variable: Fe-rich types predominate in the Man Shield (Sierra Leone), the Congo Craton (DR Congo), the Kamativi Belt (Zimbabwe) and the Jos Plateau (Nigeria). Mn-rich columbite-tantalite is typical of the Alto Ligonha Province (Mozambique), the Arabian-Nubian Shield (Egypt, Ethiopia) and the Tantalite Valley pegmatites (southern Namibia). There are large compositional variations through Fe-Mn fractionation, followed by Nb-Ta fractionation. These are typical for pegmatites usually associated with very coarse quartz-feldspar-mica granites. They are young granitic systems of the Kibara Belt of Central Africa and the Older Granites of Nigeria. Unlike ‘simple’ Be-pegmatites, most Ta-Nb rich pegmatites have the most complex zoning. Hence we need systematic exploration tools to find and rapidly assess the potential of different pegmatites. The pegmatites exist as known deposits (e.g., abandoned mines) and the exposed or buried pegmatites. We investigate rocks and minerals to trace for the possibility of the effect of hydrothermal alteration mainly for exposed pegmatites, do mineralogical study to prove evidence of gradual replacement and geochemistry to report the availability of trace elements which are good indicators of mineralisation. Pegmatites are not good geophysical responders resulting to the exclusion of the geophysics option. As for more advanced prospecting, we bulk samples from different zones first to establish their grades and characteristics, then make a pilot test plant because of big samples to aid in the quantitative characterization of zones, and then drill to reveal distribution and extent of different zones but not necessarily grade due to nugget effect. Rapid assessment tools are needed to assess grade and degree of fractionation in order to ‘rule in’ or ‘rule out’ a given pegmatite for future work. Pegmatite exploration is also unique, high risk and expensive hence right traceability system and certification for 3Ts are highly needed.Keywords: exploration, mineralogy, pegmatites, tantalum
Procedia PDF Downloads 149184 Thermal Imaging of Aircraft Piston Engine in Laboratory Conditions
Authors: Lukasz Grabowski, Marcin Szlachetka, Tytus Tulwin
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The main task of the engine cooling system is to maintain its average operating temperatures within strictly defined limits. Too high or too low average temperatures result in accelerated wear or even damage to the engine or its individual components. In order to avoid local overheating or significant temperature gradients, leading to high stresses in the component, the aim is to ensure an even flow of air. In the case of analyses related to heat exchange, one of the main problems is the comparison of temperature fields because standard measuring instruments such as thermocouples or thermistors only provide information about the course of temperature at a given point. Thermal imaging tests can be helpful in this case. With appropriate camera settings and taking into account environmental conditions, we are able to obtain accurate temperature fields in the form of thermograms. Emission of heat from the engine to the engine compartment is an important issue when designing a cooling system. Also, in the case of liquid cooling, the main sources of heat in the form of emissions from the engine block, cylinders, etc. should be identified. It is important to redesign the engine compartment ventilation system. Ensuring proper cooling of aircraft reciprocating engine is difficult not only because of variable operating range but mainly because of different cooling conditions related to the change of speed or altitude of flight. Engine temperature also has a direct and significant impact on the properties of engine oil, which under the influence of this parameter changes, in particular, its viscosity. Too low or too high, its value can be a result of fast wear of engine parts. One of the ways to determine the temperatures occurring on individual parts of the engine is the use of thermal imaging measurements. The article presents the results of preliminary thermal imaging tests of aircraft piston diesel engine with a maximum power of about 100 HP. In order to perform the heat emission tests of the tested engine, the ThermaCAM S65 thermovision monitoring system from FLIR (Forward-Looking Infrared) together with the ThermaCAM Researcher Professional software was used. The measurements were carried out after the engine warm up. The engine speed was 5300 rpm The measurements were taken for the following environmental parameters: air temperature: 17 °C, ambient pressure: 1004 hPa, relative humidity: 38%. The temperatures distribution on the engine cylinder and on the exhaust manifold were analysed. Thermal imaging tests made it possible to relate the results of simulation tests to the real object by measuring the rib temperature of the cylinders. The results obtained are necessary to develop a CFD (Computational Fluid Dynamics) model of heat emission from the engine bay. The project/research was financed in the framework of the project Lublin University of Technology-Regional Excellence Initiative, funded by the Polish Ministry of Science and Higher Education (contract no. 030/RID/2018/19).Keywords: aircraft, piston engine, heat, emission
Procedia PDF Downloads 118183 A 1H NMR-Linked PCR Modelling Strategy for Tracking the Fatty Acid Sources of Aldehydic Lipid Oxidation Products in Culinary Oils Exposed to Simulated Shallow-Frying Episodes
Authors: Martin Grootveld, Benita Percival, Sarah Moumtaz, Kerry L. Grootveld
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Objectives/Hypotheses: The adverse health effect potential of dietary lipid oxidation products (LOPs) has evoked much clinical interest. Therefore, we employed a 1H NMR-linked Principal Component Regression (PCR) chemometrics modelling strategy to explore relationships between data matrices comprising (1) aldehydic LOP concentrations generated in culinary oils/fats when exposed to laboratory-simulated shallow frying practices, and (2) the prior saturated (SFA), monounsaturated (MUFA) and polyunsaturated fatty acid (PUFA) contents of such frying media (FM), together with their heating time-points at a standard frying temperature (180 oC). Methods: Corn, sunflower, extra virgin olive, rapeseed, linseed, canola, coconut and MUFA-rich algae frying oils, together with butter and lard, were heated according to laboratory-simulated shallow-frying episodes at 180 oC, and FM samples were collected at time-points of 0, 5, 10, 20, 30, 60, and 90 min. (n = 6 replicates per sample). Aldehydes were determined by 1H NMR analysis (Bruker AV 400 MHz spectrometer). The first (dependent output variable) PCR data matrix comprised aldehyde concentration scores vectors (PC1* and PC2*), whilst the second (predictor) one incorporated those from the fatty acid content/heating time variables (PC1-PC4) and their first-order interactions. Results: Structurally complex trans,trans- and cis,trans-alka-2,4-dienals, 4,5-epxy-trans-2-alkenals and 4-hydroxy-/4-hydroperoxy-trans-2-alkenals (group I aldehydes predominantly arising from PUFA peroxidation) strongly and positively loaded on PC1*, whereas n-alkanals and trans-2-alkenals (group II aldehydes derived from both MUFA and PUFA hydroperoxides) strongly and positively loaded on PC2*. PCR analysis of these scores vectors (SVs) demonstrated that PCs 1 (positively-loaded linoleoylglycerols and [linoleoylglycerol]:[SFA] content ratio), 2 (positively-loaded oleoylglycerols and negatively-loaded SFAs), 3 (positively-loaded linolenoylglycerols and [PUFA]:[SFA] content ratios), and 4 (exclusively orthogonal sampling time-points) all powerfully contributed to aldehydic PC1* SVs (p 10-3 to < 10-9), as did all PC1-3 x PC4 interaction ones (p 10-5 to < 10-9). PC2* was also markedly dependent on all the above PC SVs (PC2 > PC1 and PC3), and the interactions of PC1 and PC2 with PC4 (p < 10-9 in each case), but not the PC3 x PC4 contribution. Conclusions: NMR-linked PCR analysis is a valuable strategy for (1) modelling the generation of aldehydic LOPs in heated cooking oils and other FM, and (2) tracking their unsaturated fatty acid (UFA) triacylglycerol sources therein.Keywords: frying oils, lipid oxidation products, frying episodes, chemometrics, principal component regression, NMR Analysis, cytotoxic/genotoxic aldehydes
Procedia PDF Downloads 171182 The Psychological and Subjective Well-being of Ethiopian adults: Correlates, Explanations, and Cross-Cultural Constructions
Authors: Kassahun Tilahun
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The purpose of the study was two-fold: to examine the socio-demographic and psychological predictors of well-being and formulate a socio-culturally sound approach explaining the meaning and experience of psychological well-being among Ethiopian adults. Ryan and Deci’s Self-Determination Theory was duly considered as a theoretical framework of the study. The study followed a sequential explanatory mixed method design. Both quantitative and qualitative data were obtained, via scales and open-ended questionnaires, from 438 civil servants working in Addis Ababa. 30 interviews were also conducted to gain further information. An in-depth analysis of the reliability and validity of instruments was made before employing them to the main study. The results showed that adults were better off in both their scores of psychological and subjective well-being. Besides, adults’ well-being was found to be quite a function of their gender, age, marital status, educational level and household income. Males had a healthier psychological well-being status than females, where as females were better in their subjective well-being. A significant difference in psychological well-being was also observed between emerging and young adults, in favor of the young; and between cohabitated and married adults, married being advantageous. A significant difference in subjective well-being measures was also noticed among single, cohabitated and married adults, in favor of the married adults in all measures. The finding revealed that happiness level of adults decrease as their educational status increases while the reverse is true to psychological well-being. Besides, as adults’ household income boosts, so do their psychological well-being and satisfaction in life. The regression analysis also produced significant independent contributions of household income to overall well-being of adults. As such, subjective well-being was significantly predicted by dummy variable of sex and marital status. Likewise, the agreeableness, conscientiousness, neuroticism and openness dimensions of personality were notable significant predictors of adults’ psychological well-being where as extraversion and agreeableness were significant predictors of their subjective well-being. Religiosity was also a significant predictor of adults’ psychological well-being. Besides, adults’ well-being was significantly predicted by the interaction between conscientiousness and religiosity. From goal pursuit dimensions, attainment of extrinsic life goals was a significant predictor of both psychological and subjective well-being. Importance and attainment of intrinsic life goals also significantly predicts adults’ psychological well-being. Finally, the subjective well-being of adults was significantly predicted by environmental mastery, positive relations with others, self-acceptance and overall psychological well-being scores of adults. The thematic analysis identified five major categories of themes, which are essential in explaining the psychological well-being of Ethiopian adults. These were; socio-cultural harmony, social cohesion, security, competence and accomplishment, and the self. Detailed discussion on the rational for including these themes was made and appropriate implications were proposed. Researchers are encouraged to expand the findings of this research and in turn develop a suitable approach taping the psychological well-being of adults living in countries like Ethiopia.Keywords: psychological well-being, subjective well-being, adulthood, Ethiopia
Procedia PDF Downloads 536181 Evaluation of the Risk Factors on the Incidence of Adjacent Segment Degeneration After Anterior Neck Discectomy and Fusion
Authors: Sayyed Mostafa Ahmadi, Neda Raeesi
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Background and Objectives: Cervical spondylosis is a common problem that affects the adult spine and is the most common cause of radiculopathy and myelopathy in older patients. Anterior discectomy and fusion is a well-known technique in degenerative cervical disc disease. However, one of the late undesirable complications is adjacent disc degeneration, which affects about 91% of patients in ten years. Many factors can be effective in causing this complication, but some are still debatable. Discovering these risk factors and eliminating them can improve the quality of life. Methods: This is a retrospective cohort study. All patients who underwent anterior discectomy and fusion surgery in the neurosurgery ward of Imam Khomeini Hospital between 2013 and 2016 were evaluated. Their demographic information was collected. All patients were visited and examined for radiculopathy, myelopathy, and muscular force. At the same visit, all patients were asked to have a facelift, and neck profile, as well as a neck MRI(General Tesla 3). Preoperative graphs were used to measure the diameter of the cervical canal(Pavlov ratio) and to evaluate sagittal alignment(Cobb Angle). Preoperative MRI of patients was reviewed for anterior and posterior longitudinal ligament calcification. Result: In this study, 57 patients were studied. The mean age of patients was 50.63 years, and 49.1% were male. Only 3.5% of patients had anterior and posterior longitudinal ligament calcification. Symptomatic ASD was observed in 26.6%. The X-rays and MRIs showed evidence of 80.7% radiological ASD. Among patients who underwent one-level surgery, 20% had symptomatic ASD, but among patients who underwent two-level surgery, the rate of ASD was 50%.In other words, the higher the number of surfaces that are operated and fused, the higher the probability of symptomatic ASD(P-value <0.05). The X-rays and MRIs showed 80.7% of radiological ASD. Among patients who underwent surgery at one level, 78% had radiological ASD, and this number was 92% among patients who underwent two-level surgery(P-value> 0.05). Demographic variables such as age, sex, height, weight, and BMI did not have a significant effect on the incidence of radiological ASD(P-value> 0.05), but sex and height were two influential factors on symptomatic ASD(P-value <0.05). Other related variables such as family history, smoking and exercise also have no significant effect(P-value> 0.05). Radiographic variables such as Pavlov ratio and sagittal alignment were also unaffected by the incidence of radiological and symptomatic ASD(P-value> 0.05). The number of surgical surfaces and the incidence of anterior and posterior longitudinal ligament calcification before surgery also had no statistically significant effect(P-value> 0.05). In the study of the ability of the neck to move in different directions, none of these variables are statistically significant in the two groups with radiological and symptomatic ASD and the non-affected group(P-value> 0.05). Conclusion: According to the findings of this study, this disease is considered to be a multifactorial disease. The incidence of radiological ASD is much higher than symptomatic ASD (80.7% vs. 26.3%) and sex, height and number of fused surfaces are the only factors influencing the incidence of symptomatic ASD and no variable influences radiological ASD.Keywords: risk factors, anterior neck disectomy and fusion, adjucent segment degeneration, complication
Procedia PDF Downloads 60180 Anaerobic Digestion of Spent Wash through Biomass Development for Obtaining Biogas
Authors: Sachin B. Patil, Narendra M. Kanhe
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A typical cane molasses based distillery generates 15 L of waste water per liter of alcohol production. Distillery waste with COD of over 1,00,000 mg/l and BOD of over 30,000 mg/l ranks high amongst the pollutants produced by industries both in magnitude and strength. Treatment and safe disposal of this waste is a challenging task since long. The high strength of waste water renders aerobic treatment very expensive and physico-chemical processes have met with little success. Thermophilic anaerobic treatment of distillery waste may provide high degree of treatment and better recovery of biogas. It may prove more feasible in most part of tropical country like India, where temperature is suitable for thermophilic micro-organisms. Researchers have reviled that, at thermophilic conditions due to increased destruction rate of organic matter and pathogens, higher digestion rate can be achieved. Literature review reveals that the variety of anaerobic reactors including anaerobic lagoon, conventional digester, anaerobic filter, two staged fixed film reactors, sludge bed and granular bed reactors have been studied, but little attempts have been made to evaluate the usefulness of thermophilic anaerobic treatment for treating distillery waste. The present study has been carried out, to study feasibility of thermophilic anaerobic digestion to facilitate the design of full scale reactor. A pilot scale anaerobic fixed film fixed bed reactor (AFFFB) of capacity 25m3 was designed, fabricated, installed and commissioned for thermophilic (55-65°C) anaerobic digestion at a constant pH of 6.5-7.5, because these temperature and pH ranges are considered to be optimum for biogas recovery from distillery wastewater. In these conditions, working of the reactor was studied, for different hydraulic retention times (HRT) (0.25days to 12days) and variable organic loading rates (361.46 to 7.96 Kg COD/m3d). The parameters such as flow rate and temperature, various chemical parameters such as pH, chemical oxygen demands (COD), biogas quantity, and biogas composition were regularly monitored. It was observed that, with the increase in OLR, the biogas production was increased, but the specific biogas yield decreased. Similarly, with the increase in HRT, the biogas production got decrease, but the specific biogas yield was increased. This may also be due to the predominant activity of acid producers to methane producers at the higher substrate loading rates. From the present investigation, it can be concluded that for thermophilic conditions the highest COD removal percentage was obtained at an HRT of 08 days, thereafter it tends to decrease from 8 to 12 days HRT. There is a little difference between COD removal efficiency of 8 days HRT (74.03%) and 5 day HRT (78.06%), therefore it would not be feasible to increase the reactor size by 1.5 times for mere 4 percent more efficiency. Hence, 5 days HRT is considered to be optimum, at which the biogas yield was 98 m3/day and specific biogas yield was 0.385 CH4 m3/Kg CODr.Keywords: spent wash, anaerobic digestion, biomass, biogas
Procedia PDF Downloads 265179 Integration of a Protective Film to Enhance the Longevity and Performance of Miniaturized Ion Sensors
Authors: Antonio Ruiz Gonzalez, Kwang-Leong Choy
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The measurement of electrolytes has a high value in the clinical routine. Ions are present in all body fluids with variable concentrations and are involved in multiple pathologies such as heart failures and chronic kidney disease. In the case of dissolved potassium, although a high concentration in the blood (hyperkalemia) is relatively uncommon in the general population, it is one of the most frequent acute electrolyte abnormalities. In recent years, the integration of thin films technologies in this field has allowed the development of highly sensitive biosensors with ultra-low limits of detection for the assessment of metals in liquid samples. However, despite the current efforts in the miniaturization of sensitive devices and their integration into portable systems, only a limited number of successful examples used commercially can be found. This fact can be attributed to a high cost involved in their production and the sustained degradation of the electrodes over time, which causes a signal drift in the measurements. Thus, there is an unmet necessity for the development of low-cost and robust sensors for the real-time monitoring of analyte concentrations in patients to allow the early detection and diagnosis of diseases. This paper reports a thin film ion-selective sensor for the evaluation of potassium ions in aqueous samples. As an alternative for this fabrication method, aerosol assisted chemical vapor deposition (AACVD), was applied due to cost-effectivity and fine control over the film deposition. Such a technique does not require vacuum and is suitable for the coating of large surface areas and structures with complex geometries. This approach allowed the fabrication of highly homogeneous surfaces with well-defined microstructures onto 50 nm thin gold layers. The degradative processes of the ubiquitously employed poly (vinyl chloride) membranes in contact with an electrolyte solution were studied, including the polymer leaching process, mechanical desorption of nanoparticles and chemical degradation over time. Rational design of a protective coating based on an organosilicon material in combination with cellulose to improve the long-term stability of the sensors was then carried out, showing an improvement in the performance after 5 weeks. The antifouling properties of such coating were assessed using a cutting-edge quartz microbalance sensor, allowing the quantification of the adsorbed proteins in the nanogram range. A correlation between the microstructural properties of the films with the surface energy and biomolecules adhesion was then found and used to optimize the protective film.Keywords: hyperkalemia, drift, AACVD, organosilicon
Procedia PDF Downloads 123178 Glycemic Control in Rice Consumption among Households with Diabetes Patients: The Role of Food Security
Authors: Chandanee Wasana Kalansooriya
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Dietary behaviour is a crucial factor affecting diabetes control. With increasing rates of diabetes prevalence in Asian countries, examining their dietary patterns, which are largely based on rice, is timely required. It has been identified that higher consumption of some rice varieties is associated with increased risk of type 2 diabetes. Although diabetes patients are advised to consume healthier rice varieties, which contains low glycemic, several conditions, one of which food insecurity, make them difficult to preserve those healthy dietary guidelines. Hence this study tries to investigate how food security affects on making right decisions of rice consumption within diabetes affected households using a sample from Sri Lanka, a country which rice considered as the staple food and records the highest diabetes prevalence rate in South Asia. The study uses data from the Household Income and Expenditure Survey 2016, a nationally representative sample conducted by the Department of Census and Statistics, Sri Lanka. The survey used a two-stage stratified sampling method to cover different sectors and districts of the country and collected micro-data on demographics, health, income and expenditures of different categories. The study uses data from 2547 households which consist of one or more diabetes patients, based on the self-recorded health status. The Household Dietary Diversity Score (HDDS), which constructed based on twelve food groups, is used to measure the level of food security. Rice is categorized into three groups according to their Glycemic Index (GI), high GI, medium GI and low GI, and the likelihood and impact made by food security on each rice consumption categories are estimated using a Two-part Model. The shares of each rice categories out of total rice consumption is considered as the dependent variable to exclude the endogeneity issue between rice consumption and the HDDS. The results indicate that the consumption of medium GI rice is likely to increase with the increasing household food security, but low GI varieties are not. Households in rural and estate sectors are less likely and Tamil ethnic group is more likely to consume low GI rice varieties. Further, an increase in food security significantly decreases the consumption share of low GI rice, while it increases the share of medium GI varieties. The consumption share of low GI rice is largely affected by the ethnic variability. The effects of food security on the likelihood of consuming high GI rice varieties and changing its shares are statistically insignificant. Accordingly, the study concludes that a higher level of food security does not ensure diabetes patients are consuming healthy rice varieties or reducing consumption of unhealthy varieties. Hence policy attention must be directed towards educating people for making healthy dietary choices. Further, the study provides a room for further studies as it reveals considerable ethnic and sectorial differences in making healthy dietary decisions.Keywords: diabetes, food security, glycemic index, rice consumption
Procedia PDF Downloads 102177 Detection of Egg Proteins in Food Matrices (2011-2021)
Authors: Daniela Manila Bianchi, Samantha Lupi, Elisa Barcucci, Sandra Fragassi, Clara Tramuta, Lucia Decastelli
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Introduction: The undeclared allergens detection in food products plays a fundamental role in the safety of the allergic consumer. The protection of allergic consumers is guaranteed, in Europe, by Regulation (EU) No 1169/2011 of the European Parliament, which governs the consumer's right to information and identifies 14 food allergens to be mandatorily indicated on food labels: among these, an egg is included. An egg can be present as an ingredient or as contamination in raw and cooked products. The main allergen egg proteins are ovomucoid, ovalbumin, lysozyme, and ovotransferrin. This study presents the results of a survey conducted in Northern Italy aimed at detecting the presence of undeclared egg proteins in food matrices in the latest ten years (2011-2021). Method: In the period January 2011 - October 2021, a total of 1205 different types of food matrices (ready-to-eat, meats, and meat products, bakery and pastry products, baby foods, food supplements, pasta, fish and fish products, preparations for soups and broths) were delivered to Food Control Laboratory of Istituto Zooprofilattico Sperimentale of Piemonte Liguria and Valle d’Aosta to be analyzed as official samples in the frame of Regional Monitoring Plan of Food Safety or in the contest of food poisoning. The laboratory is ISO 17025 accredited, and since 2019, it has represented the National Reference Centre for the detection in foods of substances causing food allergies or intolerances (CreNaRiA). All samples were stored in the laboratory according to food business operator instructions and analyzed within the expiry date for the detection of undeclared egg proteins. Analyses were performed with RIDASCREEN®FAST Ei/Egg (R-Biopharm ® Italia srl) kit: the method was internally validated and accredited with a Limit of Detection (LOD) equal to 2 ppm (mg/Kg). It is a sandwich enzyme immunoassay for the quantitative analysis of whole egg powder in foods. Results: The results obtained through this study showed that egg proteins were found in 2% (n. 28) of food matrices, including meats and meat products (n. 16), fish and fish products (n. 4), bakery and pastry products (n. 4), pasta (n. 2), preparations for soups and broths (n.1) and ready-to-eat (n. 1). In particular, in 2011 egg proteins were detected in 5% of samples, in 2012 in 4%, in 2013, 2016 and 2018 in 2%, in 2014, 2015 and 2019 in 3%. No egg protein traces were detected in 2017, 2020, and 2021. Discussion: Food allergies occur in the Western World in 2% of adults and up to 8% of children. Allergy to eggs is one of the most common food allergies in the pediatrics context. The percentage of positivity obtained from this study is, however, low. The trend over the ten years has been slightly variable, with comparable data.Keywords: allergens, food, egg proteins, immunoassay
Procedia PDF Downloads 136176 Generation & Migration Of Carbone Dioxid In The Lower Cretaceous Bahi Sandstone Reservoir Within The En-naga Sub Basin, Sirte Basin, Libya
Authors: Moaawia Abdulgader Gdara
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En -Naga sub - basin considered to be the most southern of the concessions in the Sirte Basin operated by HOO. En Naga Sub – basin have likely been point-sourced of CO₂ accumulations during the last 7 million years from local satellite intrusives associated with the Haruj Al Aswad igneous complex. CO2 occurs in the En Naga Sub-basin as a result of the igneous activity of the Al Harouge Al Aswad complex.Igneous extrusive have been pierced in the subsurface are exposed at the surface. The lower cretaceous Bahi Sandstone facies are recognized in the En Naga Sub-basin. They result from the influence of paleotopography on the processes associated with continental deposition over the Sirt Unconformity and the Cenomanian marine transgression In the Lower Cretaceous Bahi Sandstones, the presence of trapped carbon dioxide is proven within the En Naga Sub-basin. This makes it unique in providing an abundance of CO₂ gas reservoirs with almost pure magmatic CO₂, which can be easily sampled. Huge amounts of CO2 exist in the Lower Cretaceous Bahi Sandstones in the En-Naga sub-basin, where the economic value of CO₂ is related to its use for enhanced oil recovery (EOR) Based on the production tests for the drilled wells that makes Lower Cretaceous Bahi sandstones the principle reservoir rocks for CO2 where large volumes of CO2 gas have been discovered in the Bahi Formation on and near EPSA 120/136(En -Naga sub basin). The Bahi sandstones are generally described as a good reservoir rock. Intergranular porosities and permeabilities are highly variable and can exceed 25% and 100 MD. In the (En Naga sub – basin), three main developed structures (Barrut I, En Naga A and En Naga O) are thought to be prospective for the lower Cretaceous Bahi sandstone reservoir. These structures represents a good example for the deep over pressure potential in (En Naga sub - basin). The very high pressures assumed associated with local igneous intrusives may account for the abnormally high Bahi (and Lidam) reservoir pressures. The best gas tests from this facies are at F1-72 on the (Barrut I structure) from part of a 458 feet+ section having an estimated high value of CO2 as 98% overpressured. Bahi CO) en naga sub basin, 2)al harouge al aswad igneous complex., 3) lower cretaceous bahi reservoir, 4)co) en naga sub basin, 2)al harouge al aswad igneous complex., 3) lower cretaceous bahi reservoir, 4)co) en naga sub basin, 2)al harouge al aswad igneous complex., 3) lower cretaceous bahi reservoir, 4)co) en naga sub basin, 2)al harouge al aswad igneous complex., 3) lower cretaceous bahi reservoir, 4)co₂ generation and migration to the bahi sandstone reservoir generation and migration to the bahi sandstone reservoir generation and migration to the bahi sandstone reservoir generation and migration to the bahi sandstone reservoir prospectivity is thought to be excellent in the central to western areas where At U1-72 (En Naga O structure) a significant CO2 gas kick occurred at 11,971 feet and quickly led to blowout conditions due to uncontrollable leaks in the surface equipment. Which reflects a better reservoir quality sandstones associated with Paleostructural highs. Condensate and gas prospectivity increases to the east as the CO₂) en naga sub basin, 2)al harouge al aswad igneous complex., 3) lower cretaceous bahi reservoir, 4)co) en naga sub basin, 2)al harouge al aswad igneous complex., 3) lower cretaceous bahi reservoir, 4)co₂ generation and migration to the bahi sandstone reservoir generation and migration to the bahi sandstone reservoir prospectivity decreases with distance away from the Al Haruj Al Aswad igneous complex. To date, it has not been possible to accurately determine the volume of these strategically valuable reserves although there are positive indications that they are very large.Keywords: 1) en naga sub basin, 2)al harouge al aswad igneous complex., 3) lower cretaceous bahi reservoir, 4)co2 generation and migration to the bahi sandstone reservoir
Procedia PDF Downloads 71175 Direct Current Electric Field Stimulation against PC12 Cells in 3D Bio-Reactor to Enhance Axonal Extension
Authors: E. Nakamachi, S. Tanaka, K. Yamamoto, Y. Morita
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In this study, we developed a three-dimensional (3D) direct current electric field (DCEF) stimulation bio-reactor for axonal outgrowth enhancement to generate the neural network of the central nervous system (CNS). By using our newly developed 3D DCEF stimulation bio-reactor, we cultured the rat pheochromocytoma cells (PC12) and investigated the effects on the axonal extension enhancement and network generation. Firstly, we designed and fabricated a 3D bio-reactor, which can load DCEF stimulation on PC12 cells embedded in the collagen gel as extracellular environment. The connection between the electrolyte and the medium using salt bridges for DCEF stimulation was introduced to avoid the cell death by the toxicity of metal ion. The distance between the salt bridges was adopted as the design variable to optimize a structure for uniform DCEF stimulation, where the finite element (FE) analyses results were used. Uniform DCEF strength and electric flux vector direction in the PC12 cells embedded in collagen gel were examined through measurements of the fabricated 3D bio-reactor chamber. Measurement results of DCEF strength in the bio-reactor showed a good agreement with FE results. In addition, the perfusion system was attached to maintain pH 7.2 ~ 7.6 of the medium because pH change was caused by DCEF stimulation loading. Secondly, we disseminated PC12 cells in collagen gel and carried out 3D culture. Finally, we measured the morphology of PC12 cell bodies and neurites by the multiphoton excitation fluorescence microscope (MPM). The effectiveness of DCEF stimulation to enhance the axonal outgrowth and the neural network generation was investigated. We confirmed that both an increase of mean axonal length and axogenesis rate of PC12, which have been exposed 5 mV/mm for 6 hours a day for 4 days in the bioreactor. We found following conclusions in our study. 1) Design and fabrication of DCEF stimulation bio-reactor capable of 3D culture nerve cell were completed. A uniform electric field strength of average value of 17 mV/mm within the 1.2% error range was confirmed by using FE analyses, after the structure determination through the optimization process. In addition, we attached a perfusion system capable of suppressing the pH change of the culture solution due to DCEF stimulation loading. 2) Evaluation of DCEF stimulation effects on PC12 cell activity was executed. The 3D culture of PC 12 was carried out adopting the embedding culture method using collagen gel as a scaffold for four days under the condition of 5.0 mV/mm and 10mV/mm. There was a significant effect on the enhancement of axonal extension, as 11.3% increase in an average length, and the increase of axogenesis rate. On the other hand, no effects on the orientation of axon against the DCEF flux direction was observed. Further, the network generation was enhanced to connect longer distance between the target neighbor cells by DCEF stimulation.Keywords: PC12, DCEF stimulation, 3D bio-reactor, axonal extension, neural network generation
Procedia PDF Downloads 184174 Comparison of GIS-Based Soil Erosion Susceptibility Models Using Support Vector Machine, Binary Logistic Regression and Artificial Neural Network in the Southwest Amazon Region
Authors: Elaine Lima Da Fonseca, Eliomar Pereira Da Silva Filho
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The modeling of areas susceptible to soil loss by hydro erosive processes consists of a simplified instrument of reality with the purpose of predicting future behaviors from the observation and interaction of a set of geoenvironmental factors. The models of potential areas for soil loss will be obtained through binary logistic regression, artificial neural networks, and support vector machines. The choice of the municipality of Colorado do Oeste in the south of the western Amazon is due to soil degradation due to anthropogenic activities, such as agriculture, road construction, overgrazing, deforestation, and environmental and socioeconomic configurations. Initially, a soil erosion inventory map constructed through various field investigations will be designed, including the use of remotely piloted aircraft, orbital imagery, and the PLANAFLORO/RO database. 100 sampling units with the presence of erosion will be selected based on the assumptions indicated in the literature, and, to complement the dichotomous analysis, 100 units with no erosion will be randomly designated. The next step will be the selection of the predictive parameters that exert, jointly, directly, or indirectly, some influence on the mechanism of occurrence of soil erosion events. The chosen predictors are altitude, declivity, aspect or orientation of the slope, curvature of the slope, composite topographic index, flow power index, lineament density, normalized difference vegetation index, drainage density, lithology, soil type, erosivity, and ground surface temperature. After evaluating the relative contribution of each predictor variable, the erosion susceptibility model will be applied to the municipality of Colorado do Oeste - Rondônia through the SPSS Statistic 26 software. Evaluation of the model will occur through the determination of the values of the R² of Cox & Snell and the R² of Nagelkerke, Hosmer and Lemeshow Test, Log Likelihood Value, and Wald Test, in addition to analysis of the Confounding Matrix, ROC Curve and Accumulated Gain according to the model specification. The validation of the synthesis map resulting from both models of the potential risk of soil erosion will occur by means of Kappa indices, accuracy, and sensitivity, as well as by field verification of the classes of susceptibility to erosion using drone photogrammetry. Thus, it is expected to obtain the mapping of the following classes of susceptibility to erosion very low, low, moderate, very high, and high, which may constitute a screening tool to identify areas where more detailed investigations need to be carried out, applying more efficient social resources.Keywords: modeling, susceptibility to erosion, artificial intelligence, Amazon
Procedia PDF Downloads 66173 De-Securitizing Identity: Narrative (In)Consistency in Periods of Transition
Authors: Katerina Antoniou
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When examining conflicts around the world, it is evident that the majority of intractable conflicts are steeped in identity. Identity seems to be not only a causal variable for conflict, but also a catalytic parameter for the process of reconciliation that follows ceasefire. This paper focuses on the process of identity securitization that occurs between rival groups of heterogeneous collective identities – ethnic, national or religious – as well as on the relationship between identity securitization and the ability of the groups involved to reconcile. Are securitized identities obstacles to the process of reconciliation, able to hinder any prospects of peace? If the level to which an identity is securitized is catalytic to a conflict’s discourse and settlement, then which factors act as indicators of identity de-securitization? The level of an in-group’s identity securitization can be estimated through a number of indicators, one of which is narrative. The stories, views and stances each in-group adopts in relation to its history of conflict and relation with their rival out-group can clarify whether that specific in-group feels victimized and threatened or safe and ready to reconcile. Accordingly, this study discusses identity securitization through narrative in relation to intractable conflicts. Are there conflicts around the world that, despite having been identified as intractable, stagnated or insoluble, show signs of identity de-securitization through narrative? This inquiry uses the case of the Cyprus conflict and its partitioned societies to present official narratives from the two communities and assess whether these narratives have transformed, indicating a less securitized in-group identity for the Greek and Turkish Cypriots. Specifically, the study compares the official historical overviews presented by each community’s Ministry of Foreign Affairs website and discusses the extent to which the two official narratives present a securitized collective identity. In addition, the study will observe whether official stances by the two communities – as adopted by community leaders – have transformed to depict less securitization over time. Additionally, the leaders’ reflection of popular opinion is evaluated through recent opinion polls from each community. Cyprus is currently experiencing renewed optimism for reunification, with the leaders of its two communities engaging in rigorous negotiations, and with rumors calling for a potential referendum for reunification to be taking place even as early as within 2016. Although leaders’ have shown a shift in their rhetoric and have moved away from narratives of victimization, this is not the case for the official narratives used by their respective ministries of foreign affairs. The study’s findings explore whether this narrative inconsistency proves that Cyprus is transitioning towards reunification, or whether the leaders are risking sending a securitized population to the polls to reject a potential reunification. More broadly, this study suggests that in the event that intractable conflicts might be moving towards viable peace, in-group narratives--official narratives in particular--can act as indicators of the extent to which rival entities have managed to reconcile.Keywords: conflict, identity, narrative, reconciliation
Procedia PDF Downloads 324172 Morphology, Qualitative, and Quantitative Elemental Analysis of Pheasant Eggshells in Thailand
Authors: Kalaya Sribuddhachart, Mayuree Pumipaiboon, Mayuva Youngsabanant-Areekijseree
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The ultrastructure of 20 species of pheasant eggshells in Thailand, (Simese Fireback, Lophura diardi), (Silver Pheasant, Lophura nycthemera), (Kalij Pheasant, Lophura leucomelanos crawfurdii), (Kalij Pheasant, Lophura leucomelanos lineata), (Red Junglefowl, Gallus gallus spadiceus), (Crested Fireback, Lophura ignita rufa), (Green Peafowl, Pavo muticus), (Indian Peafowl, Pavo cristatus), (Grey Peacock Pheasant, Polyplectron bicalcaratum bicalcaratum), (Lesser Bornean Fireback, Lophura ignita ignita), (Green Junglefowl, Gallus varius), (Hume's Pheasant, Syrmaticus humiae humiae), (Himalayan Monal, Lophophorus impejanus), Golden Pheasant, Chrysolophus pictus, (Ring-Neck Pheasant, Phasianus sp.), (Reeves’s Pheasant, Syrmaticus reevesi), (Polish Chicken, Gallus sp.), (Brahma Chicken, Gallus sp.), (Yellow Golden Pheasant, Chrysolophus pictus luteus), and (Lady Amhersts Pheasant, Chrysolophus amherstiae) were studied by Secondary electron imaging (SEI) and Energy dispersive X-ray analysis (EDX) detectors of scanning electron microscope. Generally, all pheasant eggshells showed 3 layers of cuticle, palisade, and mammillary. The total thickness was ranging from 190.28±5.94-838.96±16.31µm. The palisade layer is the most thickness layer following by mammillary and cuticle layers. The palisade layer in all pheasant eggshells consisted of numerous vesicle holes that were firmly forming as network thorough the layer. The vesicle holes in all pheasant eggshells had difference porosity ranging from 0.44±0.11-0.23±0.05 µm. While the mammillary layer was the most compact layer with a variable shape (broad-base V and U-shape) connect to shell membrane. Elemental analysis by of 20 specie eggshells showed 9 apparent elements including carbon (C), oxygen (O), calcium (Ca), phosphorous (P), sulfur (S), magnesium (Mg), silicon (Si), aluminum (Al), and copper (Cu) at the percentage of 28.90- 8.33%, 60.64-27.61%, 55.30-14.49%, 1.97-0.03%, 0.08-0.03%, 0.50-0.16%, 0.30-0.04%, 0.06-0.02%, and 2.67-1.73%, respectively. It was found that Ca, C, and O showed highest elemental compositions, which essential for pheasant embryonic development, mainly presented as composited structure of calcium carbonate (CaCO3) more than 97%. Meanwhile, Mg, S, Si, Al, and P were major inorganic constituents of the eggshells which directly related to an increase of the shell hardness. Finally, the percentage of heavy metal copper (Cu) has been observed in 4 eggshell species. There are Golden Pheasant (2.67±0.16%), Indian Peafowl (2.61±0.13%), Green Peafowl (1.97±0.74%), and Silver Pheasant (1.73±0.11%), respectively. A non-significant difference was found in the percentages of 9 elements in all pheasant eggshells. This study is useful to provide the information of biology and taxonomic of pheasant study in Thailand for conservation.Keywords: pheasants eggshells, secondary electron imaging (SEI) and energy dispersive X-ray analysis (EDX), morphology, Thailand
Procedia PDF Downloads 235171 Application of 2D Electrical Resistivity Tomographic Imaging Technique to Study Climate Induced Landslide and Slope Stability through the Analysis of Factor of Safety: A Case Study in Ooty Area, Tamil Nadu, India
Authors: S. Maniruzzaman, N. Ramanujam, Qazi Akhter Rasool, Swapan Kumar Biswas, P. Prasad, Chandrakanta Ojha
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Landslide is one of the major natural disasters in South Asian countries. Applying 2D Electrical Resistivity Tomographic Imaging estimation of geometry, thickness, and depth of failure zone of the landslide can be made. Landslide is a pertinent problem in Nilgris plateau next to Himalaya. Nilgris range consists of hard Archean metamorphic rocks. Intense weathering prevailed during the Pre-Cambrian time had deformed the rocks up to 45m depth. The landslides are dominant in the southern and eastern part of plateau of is comparatively smaller than the northern drainage basins, as it has low density of drainage; coarse texture permitted the more of infiltration of rainwater, whereas in the northern part of the plateau entombed with high density of drainage pattern and fine texture with less infiltration than run off, and low to the susceptible to landslide. To get comprehensive information about the landslide zone 2D Electrical Resistivity Tomographic imaging study with CRM 500 Resistivity meter are used in Coonoor– Mettupalyam sector of Nilgiris plateau. To calculate Factor of Safety the infinite slope model of Brunsden and Prior is used. Factor of Safety can be expressed (FS) as the ratio of resisting forces to disturbing forces. If FS < 1 disturbing forces are larger than resisting forces and failure may occur. The geotechnical parameters of soil samples are calculated on the basis upon the apparent resistivity values for litho units of measured from 2D ERT image of the landslide zone. Relationship between friction angles for various soil properties is established by simple regression analysis from apparent resistivity data. Increase of water content in slide zone reduces the effectiveness of the shearing resistance and increase the sliding movement. Time-lapse resistivity changes to slope failure is determined through geophysical Factor of Safety which depends on resistivity and site topography. This ERT technique infers soil property at variable depths in wider areas. This approach to retrieve the soil property and overcomes the limit of the point of information provided by rain gauges and porous probes. Monitoring of slope stability without altering soil structure through the ERT technique is non-invasive with low cost. In landslide prone area an automated Electrical Resistivity Tomographic Imaging system should be installed permanently with electrode networks to monitor the hydraulic precursors to monitor landslide movement.Keywords: 2D ERT, landslide, safety factor, slope stability
Procedia PDF Downloads 317170 Supply Side Readiness for Universal Health Coverage: Assessing the Availability and Depth of Essential Health Package in Rural, Remote and Conflict Prone District
Authors: Veenapani Rajeev Verma
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Context: Assessing facility readiness is paramount as it can indicate capacity of facilities to provide essential care for resilience to health challenges. In the context of decentralization, estimation of supply side readiness indices at sub national level is imperative for effective evidence based policy but remains a colossal challenge due to lack of dependable and representative data sources. Setting: District Poonch of Jammu and Kashmir was selected for this study. It is remote, rural district with unprecedented topographical barriers and is identified as high priority by government. It is also a fragile area as is bounded by Line of Control with Pakistan bearing the brunt of cease fire violations, military skirmishes and sporadic militant attacks. Hilly geographical terrain, rudimentary/absence of road network and impoverishment are quintessential to this area. Objectives: Objective of the study is to a) Evaluate the service readiness of health facilities and create a concise index subsuming plethora of discrete indicators and b) Ascertain supply side barriers in service provisioning via stakeholder’s analysis. Study also strives to expand analytical domain unravelling context and area specific intricacies associated with service delivery. Methodology: Mixed method approach was employed to triangulate quantitative analysis with qualitative nuances. Facility survey encompassing 90 Subcentres, 44 Primary health centres, 3 Community health centres and 1 District hospital was conducted to gauge general service availability and service specific availability (depth of coverage). Compendium of checklist was designed using Indian Public Health Standards (IPHS) in form of standard core questionnaire and scorecard generated for each facility. Information was collected across dimensions of amenities, equipment, medicines, laboratory and infection control protocols as proposed in WHO’s Service Availability and Readiness Assesment (SARA). Two stage polychoric principal component analysis employed to generate a parsimonious index by coalescing an array of tracer indicators. OLS regression method used to determine factors explaining composite index generated from PCA. Stakeholder analysis was conducted to discern qualitative information. Myriad of techniques like observations, key informant interviews and focus group discussions using semi structured questionnaires on both leaders and laggards were administered for critical stakeholder’s analysis. Results: General readiness score of health facilities was found to be 0.48. Results indicated poorest readiness for subcentres and PHC’s (first point of contact) with composite score of 0.47 and 0.41 respectively. For primary care facilities; principal component was characterized by basic newborn care as well as preparedness for delivery. Results revealed availability of equipment and surgical preparedness having lowest score (0.46 and 0.47) for facilities providing secondary care. Presence of contractual staff, more than 1 hr walk to facility, facilities in zone A (most vulnerable) to cross border shelling and facilities inaccessible due to snowfall and thick jungles was negatively associated with readiness index. Nonchalant staff attitude, unavailability of staff quarters, leakages and constraint in supply chain of drugs and consumables were other impediments identified. Conclusions/Policy Implications: It is pertinent to first strengthen primary care facilities in this setting. Complex dimensions such as geographic barriers, user and provider behavior is not under precinct of this methodology.Keywords: effective coverage, principal component analysis, readiness index, universal health coverage
Procedia PDF Downloads 121169 A Case of Myelofibrosis-Related Arthropathy: A Rare and Underrecognized Entity
Authors: Geum Yeon Sim, Jasal Patel, Anand Kumthekar, Stanley Wainapel
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A 65-year-old right-hand dominant African-American man, formerly employed as a security guard, was referred to Rehabilitation Medicine with bilateral hand stiffness and weakness. His past medical history was only significant for myelofibrosis, diagnosed 4 years earlier, for which he was receiving scheduled blood transfusions. Approximately 2 years ago, he began to notice stiffness and swelling in his non-dominant hand that progressed to pain and decreased strength, limiting his hand function. Similar but milder symptoms developed in his right hand several months later. There was no history of prior injury or exposure to cold. Physical examination showed enlargement of metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints with finger flexion contractures, Swan-neck and Boutonniere deformities, and associated joint tenderness. Changes were more prominent in the left hand. X-rays showed mild osteoarthritis of several bilateral PIP joints. Anti-nuclear antibodies, rheumatoid factor, and cyclic citrullinated peptide antibodies were negative. MRI of the hand showed no erosions or synovitis. A rheumatology consultation was obtained, and the cause of his symptoms was attributed to myelofibrosis-related arthropathy with secondary osteoarthritis. The patient was tried on diclofenac cream and received a few courses of Occupational Therapy with limited functional improvement. Primary myelofibrosis (PMF) is a rare myeloproliferative neoplasm characterized by clonal proliferation of myeloid cells with variable morphologic maturity and hematopoietic efficiency. Rheumatic manifestations of malignancies include direct invasion, paraneoplastic presentations, secondary gout, or hypertrophic osteoarthropathy. PMF causes gradual bone marrow fibrosis with extramedullary metaplastic hematopoiesis in the liver, spleen, or lymph nodes. Musculoskeletal symptoms are not common and are not well described in the literature. The first reported case of myelofibrosis related arthritis was seronegative arthritis due to synovial invasion of myeloproliferative elements. Myelofibrosis has been associated with autoimmune diseases such as systemic lupus erythematosus, progressive systemic sclerosis, and rheumatoid arthritis. Gout has been reported in patients with myelofibrosis, and the underlying mechanism is thought to be related to the high turnover of nucleic acids that is greatly augmented in this disease. X-ray findings in these patients usually include erosive arthritis with synovitis. Treatment of underlying PMF is the treatment of choice, along with anti-inflammatory medications. Physicians should be cognizant of recognizing this rare entity in patients with PMF while maintaining clinical suspicion for more common causes of joint deformities, such as rheumatic diseases.Keywords: myelofibrosis, arthritis, arthralgia, malignancy
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