Search results for: Christian Castro Samaniego

Authors: Christian Perrin, Nicholas Blagden, Louise Allen, Sarah Impey

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Social workers in the UK and professionals globally are faced with a particular challenge when dealing with allegations of child sexual abuse (CSA) in the community. In the absence of a conviction or incontestable evidence, staff can often find themselves unable to take decisive action to remove a child from harm, even though there may be a credible threat to their welfare. Conversely, practitioners may over-calculate risk through fear of being accountable for harm. This is, in part, due to the absence of a structured and evidence-based risk assessment tool which can predict the likelihood of a person committing child sexual abuse. Such assessments are often conducted by forensic professionals who utilise offence-specific data and personal history information to calculate risk. In situations where only allegations underpin a case, this mode of assessment is not viable. There are further ethical issues surrounding the assessment of risk in this area which require expert consideration and sensitive planning. This paper explores this entangled problem extant in the wider call to prevent sexual and child sexual abuse in the community. To this end, 32 qualitative interviews were undertaken with social workers dealing with CSA cases. Results were analysed using thematic analysis and operationalised to formulate a risk and protection protocol for use in case management. This paper reports on the early findings associated with the initial indications of protocol reliability. Implications for further research and practice are discussed.

Keywords: sexual offending, child sexual offence, offender rehabilitation, risk assessment, offence prevention

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Authors: Ana Bermudez de Castro Muela, Xiomara Santos Salas, Silvia Cayon Somacarrera

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The aim of this review is to explain what is the intracranial hypotension and its main causes, and also to approach to the diagnostic management in the different clinical situations, understanding radiological findings, and physiopathological substrate. An approach to the diagnostic management is presented: what are the guidelines to follow, the different tests available, and the typical findings. We review the myelo-CT and myelo-RM studies in patients with suspected CSF fistula or hypotension of unknown cause during the last 10 years in three centers. Signs of intracranial hypotension (subdural hygromas/hematomas, pachymeningeal enhancement, venous sinus engorgement, pituitary hyperemia, and lowering of the brain) that are evident in baseline CT and MRI are also sought. The intracranial hypotension is defined as a lower opening pressure of 6 cmH₂O. It is a relatively rare disorder with an annual incidence of 5 per 100.000, with a female to male ratio 2:1. The clinical features it’s an orthostatic headache, which is defined as development or aggravation of headache when patients move from a supine to an upright position and disappear or typically relieve after lay down. The etiology is a decrease in the amount of cerebrospinal fluid (CSF), usually by loss of it, either spontaneous or secondary (post-traumatic, post-surgical, systemic disease, post-lumbar puncture etc.) and rhinorrhea and/or otorrhea may exist. The pathophysiological mechanisms of hypotension and CSF hypertension are interrelated, as a situation of hypertension may lead to hypotension secondary to spontaneous CSF leakage. The diagnostic management of intracranial hypotension in our center includes, in the case of being spontaneous and without rhinorrhea and/or otorrhea and according to necessity, a range of available tests, which will be performed from less to more complex: cerebral CT, cerebral MRI and spine without contrast and CT/MRI with intrathecal contrast. If we are in a situation of intracranial hypotension with the presence of rhinorrhea/otorrhea, a sample can be obtained for the detection of b2-transferrin, which is found in the CSF physiologically, as well as sinus CT and cerebral MRI including constructive interference steady state (CISS) sequences. If necessary, cisternography studies are performed to locate the exact point of leakage. It is important to emphasize the significance of myelo-CT / MRI to establish the diagnosis and location of CSF leak, which is indispensable for therapeutic planning (whether surgical or not) in patients with more than one lesion or doubts in the baseline tests.

Keywords: cerebrospinal fluid, neuroradiology brain, magnetic resonance imaging, fistula

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Authors: Finley Lawson

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The triune nature of God is one of the most complex doctrines of Christianity, and its complexity is further compounded when one considers the incarnation. However, many of the difficulties and paradoxes associated with our idea of the divine arise from our adherence to reductionist ontology. In order to move our theological discourse forward, in respect to divine and human nature, a holistic interpretation of our profession of faith is necessary. The challenge of a holistic interpretation is that it questions our ability to make any statement about the genuine, ontological individuation of persons (both divine and human), and in doing so raises the issue of whether we are, ontologically, bound to descend in to a form of pan(en)theism. In order to address the ‘inevitable’ slide in to pan(en)theism. The impact of two forms of holistic interpretation, Boolean and Non-Boolean, on our concept of personhood will be examined. Whilst a Boolean interpretation allows for a greater understanding of the relational nature of the Trinity, it is the Non-Boolean interpretation which has greater ontological significance. A Non-Boolean ontology, grounded in our scientific understanding of the nature of the world, shows our quest for individuation rests not in ontological fact but in epistemic need, and that it is our limited epistemology that drives our need to divide that which is ontologically indivisible. This discussion takes place within a ‘methodological’, rather than ‘doctrinal’ approach to science and religion - examining assumptions and methods that have shaped our language and beliefs about key doctrines, rather than seeking to reconcile particular Christian doctrines with particular scientific theories. Concluding that Non-Boolean holism is the more significant for our doctrine is, in itself, not enough. A world without division appears much removed from the distinct place of man and divine as espoused in our creedal affirmation, to this end, several possible interpretations for understanding Non-Boolean human – divine relations are tentatively put forward for consideration.

Keywords: holism, individuation, ontology, Trinitarian relations

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Authors: Christian Kapuku, Seung-Young Kho

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An accurate representation of the transportation system serving the region is one of the important aspects of transportation modeling. Such representation often requires developing an abstract model of the system elements, which also requires important amount of data, surveys and time. However, in some cases such as in developing countries, data deficiencies, time and budget constraints do not always allow such accurate representation, leaving opportunities to assumptions that may negatively affect the quality of the analysis. With the emergence of Internet open source data especially in the mapping technologies as well as the advances in Geography Information System, opportunities to tackle these issues have raised. Therefore, the objective of this paper is to demonstrate such application through a practical case of the development of the transportation network for the city of Kinshasa. The GIS geo-referencing was used to construct the digitized map of Transportation Analysis Zones using available scanned images. Centroids were then dynamically placed at the center of activities using an activities density map. Next, the road network with its characteristics was built using OpenStreet data and other official road inventory data by intersecting their layers and cleaning up unnecessary links such as residential streets. The accuracy of the final network was then checked, comparing it with satellite images from Google and Bing. For the validation, the final network was exported into Emme3 to check for potential network coding issues. Results show a high accuracy between the built network and satellite images, which can mostly be attributed to the use of open source data.

Keywords: geographic information system (GIS), network construction, transportation database, open source data

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Authors: Piyanee Klainin-Yobas, Debbie Ramirez, Zenaida Fernandez, Jenneth Sarmiento, Wareerat Thanoi, Jeanette Ignacio, Ying Lau

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In many countries, university students experience various stressors that may negatively affect their psychological well-being (PWB). Hence, they are at risk for physical and mental problems. This research aimed to examine the predicting effects of mindfulness, self-efficacy, and social support on psychological well-being among undergraduate students. A non-experimental research was conducted at a university in the Philippines. All students enrolled in undergraduate programs were eligible for this study unless they had chronic medical or mental health problems. Power analysis was used to calculate an adequate sample size and a convenience sampling of 630 was recruited. Data were collected through online self-reported questionnaires from year 2013 to 2015. All self-reported scales used in this study had sound psychometric properties. Descriptive statistics, correlational analyses, and structural equation modeling were performed to analyze the research data. Results showed that the participants were mostly Filipino, female, Christian, and in Schools of Nursing. Mindfulness, self-efficacy, support from family, support from friends, and support from significant others were significant predictors of psychological well-being. Mindfulness was the strongest predictor of positive psychological well-being whereas self-efficacy was the strongest predictor of negative psychological well-being. In conclusion, findings from this study add knowledge to the existing literature regarding the predictors of psychological well-being. Psychosocial interventions, with the focus on strengthening mindfulness and self-efficacy, could be delivered to undergraduate students to help them enhance psychological well-being. More studies can be undertaken to test the interventions and multi-centered research can be conducted to enhance generalizability of research findings.

Keywords: mindfulness, self-efficacy, social support, psychological wellbeing

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Authors: Christian Ndubisi Madu, Benjamin C. Ozumba, Ifeanyi E. Madu, Valentine E. Nnadi, Ikenna C. Ezeasor

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The ability to generate power and achieve energy security is one of the driving forces behind the emerging ‘microgrid’ concept. Traditional power supply often operates with centralized infrastructure for generating, transmitting and distributing electricity. The inefficiency and the incessant power outages associated with the centralized power supply system in Nigeria has alienated many users who frequently turn to electric power generator sets to power their homes and offices. Such acts are unsustainable and lead to increase in the use of fossil fuels, generation of carbon dioxide emissions and other gases, and noise pollution. They also pose significant risks as they entail random purchases and storage of gasolines which are fire hazards. It is therefore important that organizations rethink their relationships to centralized power suppliers in other to improve energy accessibility and security. This study explores the energy planning processes and learning taking place at the University of Nigeria Enugu Campus as the school lead microgrid feasibility studies in its community. There is need to develop community partners to deal with the issue of energy efficiency and also to create a strategic alliance to confront political, regulatory and economic barriers to locally-based energy planning. Community-based microgrid can help to reduce the cost of adoption and diversify risks. This study offers insights into the ways in which microgrids can further democratize energy planning, procurement, and access, while simultaneously promoting efficiency and sustainability.

Keywords: microgrid, energy efficiency, sustainability, energy security

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Authors: Tatyana Suvorkina

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It is indisputable that the problem of the origin of Manichaeism is very complex. Manichaeism is characterized as a syncretic religion, which was influenced by many teachings, but it is difficult to define one which can be called fundamental. The aim of this paper is an attempt to regard Jewish apocalyptic tradition as one of the most defining source of formation of Manichaean systems. To realize this aim a comparison of the Manichean texts and the Jewish apocryphal literature is made. Consideration is given first to the Coptic Manichaean treatise Kephalaia, The Cologne Mani Codex and to books of Enoch. Under the article it is not denied that Manichaeism was influenced by different doctrines and, passed through centuries, it could adapt and strengthen this influence at an even deeper level. But the fact that the Judeo-Christian environment where Mani grew up and where the first sprouts of his teaching were formed had impact on future prophet seems obvious. Nevertheless, attempts to analyze the system of Mani within the Jewish tradition are quite rare, although such studies were carried out for Gnosticism. But Manichaeism, despite the Gnostic features it contains, is not 'one of the Gnostics' to place it under this term among the rest. Frequently, gnostic currents are pointed out as the main sources for the formation of Mani’s teachings. But it seems possible that Mani's interest in Gnosticism was motivated by the fact that he considered it as something close to that interpretation of Hebrew texts, which he aspired to undertake. The question of understanding the Manichaean system is connected not only with Manichaeism but also with other dualistic teachings, which were recognized by contemporaries as Manichaean. It is seen that polemics between Manicheans and Hellenized Christianity separated from Judaism and continued to separate with every century, were polemics between adherents of initially two different worldviews who had, however, a common source. Therefore an analysis of the controversy in the context of interpretations of this common source by disputing parties is seen very important for further study.

Keywords: dualism, Jewish apocalypticism, Manichaeism, syncretism

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Authors: Johannes Dregger, Michael Schmidt, Christian Prasse, Michael ten Hompel

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Most of the today’s companies face increasing need to operate efficiently. Driven by global trends like shorter product cycles, mass customization and the rising speed of delivery, manufacturing value chains are becoming more and more distributed. Manufacturing processes are becoming highly integrated, e.g. 3D printing. All these changes are affecting companies´ organization. They are leading towards individual, small scale, and ad-hoc logistics processes and structures, and finally, towards a significant increase in the importance of logistics itself since traditional value chains transform into agile value networks. In the past logistics has been following manufacturing but in the future industry, this role allocation might change. With this increase in the logistics practice of companies and businesses, the relevance of logistics research as the methodological foundation of logistics networks and processes is gaining importance. Logistics research is evolving into a central and highly interdisciplinary science for the future industry. Using the example of Germany, this paper discusses ways to establish logistics as a central scientific discipline of the future industry. About three million people work in the logistics sector in Germany. Only automotive and retail industry have more employees. Even though there is a bunch of logistics degree programs at more than 100 institutions of higher education, a common understanding of logistics as a research discipline is missing. In this paper an innovative approach will be presented, including; identified perspectives on logistics, such as process orientation, IT orientation or employees orientation, relevant scientific disciplines for logistics science, a concept for interdisciplinary research approaches to unify the perspectives of the different scientific disciplines on logistics and the methodological base of logistics science.

Keywords: logistics, logistics science, logistics management, future challenges

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Authors: Ali Christian Chinedu, Asogwa Vincent Chidindu, Ejiofor Toochukwu Eleazar, Okadi Ashagwu Ojang

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The increasing rate of Boko Haram insurgency, farmer-herder clashes, and kidnapping in Nigeria has resulted in food shortages and high cost of protein sources like beef and fish. This challenge could be curbed with the production of edible insects, which contain several nutritional benefits like calories, protein, fat, vitamins, and minerals, depending on their species, metamorphic stage, and diet. Unfortunately, the benefits and competencies in producing, preserving, and marketing edible insects are still unknown to the public, including prospective farmers in Nigeria. Hence, this study determined teachers’ perception of integrating edible insects into the Animal Husbandry Curriculum in Senior Secondary Schools in Nigeria to equip the future generation with the relevant competencies for alternative sustainable protein supply. The study was carried out in Enugu State, Nigeria. The participants for the study comprised 162 agricultural science teachers. A questionnaire titled: Edible Insects Integration in Animal Husbandry Curriculum Questionnaire (EIIAHCQ) was used to collect data using a descriptive survey research design. We conducted data collection with the help of six research assistants. The study identified 11 objectives, 11 contents, 10 teaching methods, and 9 evaluation methods that could be integrated into the existing curriculum of animal husbandry in Nigeria. Among others, the Ministry of Education should integrate the finding of this study into the curriculum of Animal Husbandry in Nigeria to enhance the protein supply and curb food insecurity now and in the future.

Keywords: animal husbandry curriculum, edible insects, entomophagy, integration, secondary school, Nigeria

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Authors: V. R. Venugopal

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Human being evolved 200,000 years ago in an area which is now the Sahara desert and lived all along in the northern part of Africa. It was around 10,000 to15,00 years that he moved out of Africa. Various ancient civilizations – mainly the Egyptian, Mesopotamian, Indus valley and the Chinese yellow river valley civilizations - developed and perished till the beginning of the Christian era. Strangely the regions where all these civilizations flourished are no deserts. After the ancient civilizations the two major religions of the world the Christianity and Islam evolved. These too evolved in the regions of Jerusalem and Mecca which are now in the deserts of the present Israel and Saudi Arabia. Human activity since ancient age right from his origin was in areas which are now deserts. This is only because wherever Man lived in large numbers he has turned them into deserts. Unfortunately, this is not the case with the ancient days alone. Over the last 500 years the forest cover on the earth is reduced by 80 percent. Even more currently Just over the last forty decades human population has doubled but the number of bugs, beetles, worms and butterflies (micro fauna) have declined by 45%. Deforestation and defaunation are the first signs of desertification and Desertification is a process parallel to the extinction of life. There is every possibility that soon most of the earth will be in deserts. This writer has been involved in the process of forestation and increase of fauna as a profession since twenty years and this is a report of his efforts made in the process, the results obtained and concept generated to revert the ongoing desertification of this earth. This paper highlights how desertification can be reverted by applying these basic principles. 1) Man is not owner of this earth and has no right destroy vegetation and micro fauna. 2) Land owner shall not have the freedom to do anything that he wishes with the land. 3) The land that is under agriculture shall be reduced at least by a half. 4) Irrigation and modern technology shall be used for the forest growth also. 5) Farms shall have substantial permanent vegetation and the practice of all in all out shall stop.

Keywords: desertification, extinction, micro fauna, reverting

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Authors: Hecson Christian, Joel Macwan

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Landfill site selection in an urban area is a critical issue in the planning process. With the growth of the urbanization, it has a mammoth impact on the economy, ecology, and environmental health of the region. Outsized amount of wastes are produced and the problem gets soared every day. Hence, selection of ideal site for sanitary landfill is a challenge for urban planners and solid waste managers. Disposal site is a function of many parameters. Among all, Geotechnical parameters are very vital as the same is related to surrounding open land. Moreover, the accessible safe and acceptable land is also scarce. Therefore, in this paper geotechnical parameters are used to develop a GIS model to identify an ideal location for landfill purpose. Metropolitan city of Surat is highly populated and fastest growing urban area in India. The research objectives are to conduct field experiments to collect data and to transfer the facts in GIS platform to evolve a model, to find ideal location. Planners’ preferences were obtained to use analytical hierarchical process (AHP) to find weights of each parameter. Integration of GIS and Multi-Criteria Decision Analysis (MCDA) techniques are applied to improve decision-making. It augments an environment for transformation and combination of geographical data and planners’ preferences. GIS performs deterministic overlay and buffer operations. MCDA methods evaluate alternatives based on the decision makers’ subjective values and priorities. Research results have shown many alternative locations. Economic analysis of selected site from actual operations point of view is not included in this research.

Keywords: GIS, AHP, MCDA, Geo-technical

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Authors: Nasim Hossein Hamzeh, Karim Shukurov, Abbas Ranjbar Saadat Abadi, Alaa Mhawish, Christian Opp

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Deserts are the main dust sources in the world. Also, recently driedLake beds have caused environmental problems inthe surrounding areas in the world. In this study, the Urmia Lake was the source of dustfromApril 24 to April 25, 2017.The local dust storm was combined with another large-scale dust storm that originated from Saudi Arabia and Iraq 1-2 days earlier. Synoptic investigation revealed that the severe dust storm was made by a strong Black Sea cyclone and a low-pressure system over the Middle East and Central Iraq in conjunction a high-pressure system and associated with a high gradient contour and a quasi-stationary long-wave trough over the east and south of the Mediterranean Sea. Based on HYSPLIT 72 hours backward and forward trajectories, the most probable dust transport routes to and from the Urmia Lake region are estimated. Using the concentration weighted trajectory (CWT) method based on 24 hours backward and 24 hours forward trajectories, the spatial distributions of potential sources of PM10 observed in the Urmia Lake region on April 23-26, 2017. Also, the vertical profile of dust particles using the WRF-Chem model with two dust schemes showed dust ascending up to 5 km from the lake. Also, the dust schemes outputs shows that the PM10 fluctuating changes are 12 hours earlier than the measured surface PM10 at five air pollution monitoring stations around the Urmia Lake in 23-26 April 2017.

Keywords: dust storm, synoptic investigation, WRF-chem model, urmia lake, lagrangian trajectory

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Authors: Saman Keshavarzi

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The process of planning, designing and building neighborhoods is a complex and multidimensional part of urban planning. Understanding the elements that give a neighborhood a sense of identity can lead to successful city planning and result in a cohesive and functional community where people feel a sense of belonging. These factors are important in ensuring that the needs of the urban population are met to live in a safe, pleasant and healthy society. This research paper aims to identify the elements of the identity of traditional neighborhoods in Isfahan and analyzes ways of using these elements in the design of modern neighborhoods to increase social interaction between communities and cultural reunification of people. The neighborhood of Jolfa in Isfahan has a unique socio-cultural identity as it dates back to the Safavid Dynasty of the 16^th century, and most of its inhabitants are Christian Armenians of a religious minority. The elements of the identity of Jolfa were analyzed through the following research methods: field observations, distribution of questionnaires and qualitative analysis. The basic methodology that was used to further understand the Jolfa neighborhood and deconstruct the identity image that residents associate with their respective neighborhoods was a qualitative research method. This was done through utilizing questionnaires that respondents had to fill out in response to a series of research questions. From collecting these qualitative data, the major finding was that traditional neighborhoods that have elements of identity embedded in them are seen to have closer-knit communities whose residents have strong societal ties. This area of study in urban planning is vital to ensuring that new neighborhoods are built with concepts of social cohesion, community and inclusion in mind as they are what lead to strong, connected, and prosperous societies.

Keywords: development, housing, identity, neighborhood, policy, urbanization

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Authors: Amy Guidera, Steven Busby, Christian Williams, David Phillippi

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College students are a priority preventative healthcare population that can engage in high-risk behaviors which may concurrently increase the potential for unsafe sexual practices, including contracting sexually transmitted infections (STIs). Early education, screening, treatment, and partner notification are important interventions for breaking the chain of transmission and recurrence in relation to preventing poor health outcomes and mitigating college dropout rates. The aim of this quality improvement project was to determine if the reduction in STI screening costs for college students (aged 18-30 years old) would increase the amount of STI screenings conducted at a university health center over the course of an academic semester while evaluating our ability to achieve an improved quality of care at a reduced cost, along with improved STI reporting and documentation. This study was conducted through retrospective chart reviews of STI-related visits and utilized the RADAR matrix to provide a guiding, iterative mechanism to continuously reassess goals and outcomes defined in a memorandum of agreement (MOA) between a university health center and the state department of health (DOH) laboratory. The project failed to increase the amount of STI screenings, most likely due to the emergence of COVID-19, but resulted in improved quality of care for students, improved STI-related visit documentation and reporting, and significantly reduced costs for STI screening for collegiate students at a southeastern private university campus.

Keywords: college health, college students, preventive health, reproductive health, sexually transmitted infections, young adults

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Authors: Cemil Kutluturk

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This is a comparative study of the incarnation of God according to Hinduism and Christianity. After dealing with their basic ideas on the concept of the incarnation of God, the main similarities and differences between each other will be examined by quoting references from their sacred texts. In Hinduism, the term avatara is used in order to indicate the concept of the incarnation of God. The word avatara is derived from ava (down) and tri (to cross, to save, attain). Thus avatara means to come down or to descend. Although an avatara is commonly considered as an appearance of any deity on earth, the term refers particularly to descents of Vishnu. According to Hinduism, God becomes an avatara in every age and entering into diverse wombs for the sake of establishing righteousness. On the Christian side, the word incarnation means enfleshment. In Christianity, it is believed that the Logos or Word, the Second Person of Trinity, presumed human reality. Incarnation refers both to the act of God becoming a human being and to the result of his action, namely the permanent union of the divine and human natures in the one Person of the Word. When the doctrines of incarnation and avatara are compared some similarities and differences can be found between each other. The basic similarity is that both doctrines are not bound by the laws of nature as human beings are. They reveal God’s personal love and concern, and emphasize loving devotion. Their entry into the world is generally accompanied by extraordinary signs. In both cases, the descent of God allows for human beings to ascend to God. On the other hand, there are some distinctions between two religious traditions. For instance, according to Hinduism there are many and repeated avataras, while Christ comes only once. Indeed, this is related to the respective cyclic and linear worldviews of the two religions. Another difference is that in Hinduism avataras are real and perfect, while in Christianity Christ is also real, yet imperfect; that is, he has human imperfections, except sin. While Christ has never been thought of as a partial incarnation, in Hinduism there are some partial and full avataras. The other difference is that while the purpose of Christ is primarily ultimate salvation, not every avatara grants ultimate liberation, some of them come only to save a devotee from a specific predicament.

Keywords: Avatara, Christianity, Hinduism, incarnation

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Authors: Naser Kazemi Eilaki, Ilona Heldal, Carolyn Ahmer, Bjarne Christian Hagen

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Elderly people and people with disabilities are recognized as at-risk groups when it comes to egress and travel from hazard zone to a safe place. One's disability can negatively influence her or his escape time, and this becomes even more important when people from this target group live alone. While earlier studies have frequently addressed quantitative measurements regarding at-risk groups' physical characteristics (e.g., their speed of travel), this paper considers the influence of at-risk groups’ characteristics on their decision and determining better escape routes. Most of evacuation models are based on mapping people's movement and their behaviour to summation times for common activity types on a timeline. Usually, timeline models estimate required safe egress time (RSET) as a sum of four timespans: detection, alarm, premovement, and movement time, and compare this with the available safe egress time (ASET) to determine what is influencing the margin of safety.This paper presents a cross-sectional study for identifying the most critical items on RSET and people's decision-making and with possibilities to include safety knowledge regarding people with physical or cognitive functional impairments. The result will contribute to increased knowledge on considering at-risk groups and disabilities for designing and developing safe escape routes. The expected results can be an asset to predict the probabilistic behavioural pattern of at-risk groups and necessary components for defining a framework for understanding how stakeholders can consider various disabilities when determining the margin of safety for a safe escape route.

Keywords: fire safety, evacuation, decision-making, at-risk groups

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Authors: I. Valdez, J. Perdomo, M. Colindres, N. Castro

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Today, digital servo systems are extensively used in industrial manufacturing processes, robotic applications, vehicles and other areas. In such control systems, control action is provided by digital controllers with different compensation algorithms, which are designed to meet specific requirements for a given application. Due to the constant search for optimization in industrial processes, it is of interest to design digital controllers that offer ease of realization, improved computational efficiency, affordable return rates, and ease of tuning that ultimately improve the performance of the controlled actuators. There is a vast range of options of compensation algorithms that could be used, although in the industry, most controllers used are based on a PID structure. This research article compares different types of digital compensators implemented in a servo system for DC motor position control. PID compensation is evaluated on its two most common architectures: PID position form (1 DOF), and PID speed form (2 DOF). State feedback algorithms are also evaluated, testing two modern control theory techniques: discrete state observer for non-measurable variables tracking, and a linear quadratic method which allows a compromise between the theoretical optimal control and the realization that most closely matches it. The compared control systems’ performance is evaluated through simulations in the Simulink platform, in which it is attempted to model accurately each of the system’s hardware components. The criteria by which the control systems are compared are reference tracking and disturbance rejection. In this investigation, it is considered that the accurate tracking of the reference signal for a position control system is particularly important because of the frequency and the suddenness in which the control signal could change in position control applications, while disturbance rejection is considered essential because the torque applied to the motor shaft due to sudden load changes can be modeled as a disturbance that must be rejected, ensuring reference tracking. Results show that 2 DOF PID controllers exhibit high performance in terms of the benchmarks mentioned, as long as they are properly tuned. As for controllers based on state feedback, due to the nature and the advantage which state space provides for modelling MIMO, it is expected that such controllers evince ease of tuning for disturbance rejection, assuming that the designer of such controllers is experienced. An in-depth multi-dimensional analysis of preliminary research results indicate that state feedback control method is more satisfactory, but PID control method exhibits easier implementation in most control applications.

Keywords: control, DC motor, discrete PID, discrete state feedback

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Authors: Slim Naifar, Sonia Bradai, Christian Viehweger, Olfa Kanoun

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Vibration provides an interesting source of energy since it is available in many indoor and outdoor applications. Nevertheless, in order to have an efficient design of the harvesting system, vibration converters have to satisfy some criterion in terms of robustness, compactness and energy outcome. In this work, an electromagnetic converter based on mechanical spring principle is proposed. The designed harvester is formed by a coil oscillating around ten ring magnets using a mechanical spring. The proposed design overcomes one of the main limitation of the moving coil by avoiding the contact between the coil wires with the mechanical spring which leads to a better robustness for the converter. In addition, the whole system can be implemented in a cavity of a screw. Different parameters in the harvester were investigated by finite element method including the magnet size, the coil winding number and diameter and the excitation frequency and amplitude. A prototype was realized and tested. Experiments were performed for 0.5 g to 1 g acceleration. The used experimental setup consists of an electrodynamic shaker as an external artificial vibration source controlled by a laser sensor to measure the applied displacement and frequency excitation. Together with the laser sensor, a controller unit, and an amplifier, the shaker is operated in a closed loop which allows controlling the vibration amplitude. The resonance frequency of the proposed designs is in the range of 24 Hz. Results indicate that the harvester can generate 612 mV and 1150 mV maximum open circuit peak to peak voltage at resonance for 0.5 g and 1 g acceleration respectively which correspond to 4.75 mW and 1.34 mW output power. Tuning the frequency to other values is also possible due to the possibility to add mass to the moving part of the or by changing the mechanical spring stiffness.

Keywords: energy harvesting, electromagnetic principle, vibration converter, moving coil

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Authors: Nkatow Mafany Christian

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No other period in human history has offered such great opportunities for grievances not only to last long but also to be manifested across international boundaries. This state of affairs is likely a common feature of the advent of social media. The Anglophone Question in Cameroon has been a problem of poor constitutional arrangements that can be traced to 1961 when the former French Cameroon reunified with former British Southern Cameroons following a plebiscite in which the latter overwhelmingly voted to reunify with the former. Though Southern/Anglophone Cameroons complained of perceived marginalization and an attempt by the majority French section to assimilate them, the manifestation was subtle and took place only through protests, petitions, strikes movements and demonstrations. However, with the advent of social media, a new cream of leaders emerged in the diaspora, including the US, Canada, Europe, Asia and the Middle East, to champion the manifestations leading to violence and conflicts that have bedeviled the region since 2017. The feeling of political subjugation, economic exploitation, social suppression and cultural assimilation among Anglophone Cameroonians united them under diaspora leaders against the government of Cameroon, calling for the creation of a separate state for Anglophones. This paper draws from this lead-up to analyze the current Anglophone Crisis in Cameroon in the light of the Grievance Theory and Transnationalism. The paper makes an appeal to field experience, interviews, official sources, documentation, and the internet to succor its central thesis. From the fertility of its sources, the paper submits that social media is a potent source of conflicts and makes nonsense of the principle of sovereignty and territorial integrity by its capacity to promote the transnational manifestation of grievances.

Keywords: grievance, transnationalism, anglophone crisis, Cameroon, crisis and social media

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Authors: Leila Zarei

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The primary objective of the 2014 Survey of The Capacity Assessment of Kish Island in Visa Exchange and its Effect of Tourism Development was to obtain more comprehensive statistical information relating to foreign tourists who aimed to renew their visa in Kish Island. Kish Island the pearl of Persian Gulf is well known as a destination for visa exchange to many alien who work and live in the country located around Persian Gulf. Foreign visitors fly to Kish with aim of visa exchange and after passing through official procedures they return back to their country of resident. The present thesis studied the subject of capacity and potential of Kish Island in visa exchange. In accordance with it a survey had been conducted in English written form of a questionnaire which was researcher's made composed of 120 questions which covers diverse aspects of the field of this study (airport, public transportation, accommodate and medical centers and travel agencies). The data collected were obtained at the airport, hotels and other places from the international tourists and covered the following items: a) the profile of the tourists (sex, age, occupation, purpose of visit, etc.) b) The Rating of services and Prices. The target population was all international tourists who master English and non Iranian. Main findings: 56% of tourists interviewed were males and 44% were females. The age of arrived tourist was 30 – 39 years with the highest percentage of 47%. The highest percentage frequencies of income belong to the 1000- 2500 Dhrs. (26%). In addition, that 50 percentage of the population was married and rest was single. Concerning the religion, 26 percent of the travelers were Muslim and 65% Christian and the rest from the other branches which all these populations reach Kish via air. The majority (56%) of visa exchangers hold diploma.

Keywords: Kish Island, tourism development, visa exchange, Iran

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Authors: Jenny Radeva, Anke-Gundula Roth, Christian Goebbert, Robert Niestroj-Pahl, Lars Daehne, Axel Wolfram, Juergen Wiese

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Ceramic membranes for water purification combine excellent stability with long-life characteristics and high chemical resistance. Layer-by-Layer coating is a well-known technique for customization and optimization of filtration properties of membranes but is mostly used on polymeric membranes. Ceramic membranes comprising a metal oxide filtration layer of Al2O3 or TiO2 are charged and therefore highly suitable for polyelectrolyte adsorption. The high stability of the membrane support allows efficient backwash and chemical cleaning of the membrane. The presented study reports metal oxide/organic composite membrane with an increased rejection of bivalent salts like MgSO4 and the organic micropollutant Diclofenac. A self-build apparatus was used for applying the polyelectrolyte multilayers on the ceramic membrane. The device controls the flow and timing of the polyelectrolytes and washing solutions. As support for the Layer-by-Layer coat, ceramic mono-channel membranes were used with an inner capillary of 8 mm diameter, which is connected to the coating device. The inner wall of the capillary is coated subsequently with polycat- and anions. The filtration experiments were performed with a feed solution of MgSO4 and Diclofenac. The salt content of the permeate was detected conductometrically and Diclofenac was measured with UV-Adsorption. The concluded results show retention values of magnesium sulfate of 70% and diclofenac retention of 60%. Further experimental research studied various parameters of the composite membrane-like Molecular Weight Cut Off and pore size, Zeta potential and its mechanical and chemical robustness.

Keywords: water purification, polyelectrolytes, membrane modification, layer-by-layer coating, ceramic membranes

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Authors: Opeyemi Atiba-Oyewo, Maurice S. Onya, Christian Wolkersdorfer

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Nanostructure formation and characterization of eco-friendly banana peels nanosorbent are thoroughly described in this paper. The transformation of material during mechanical milling to enhance certain properties such as changes in microstructure and surface area to solve the current problems involving water pollution and water quality were studied. The mechanical milling was employed using planetary continuous milling machine and ethanol as process control agent, the sample were taken at time interval between 10 h to 30 h to examine the structural changes. The samples were characterised by X-ray diffraction (XRD), scanning electron microscopy (SEM), Fourier transform infra-red (FTIR), Transmission electron microscopy (TEM) and Brunauer Emmett and teller (BET). Results revealed that the three typical structures with different grain-size, lattice strain and shapes were observed, and the deformation mechanisms in these structures were found to be different, further particles fracturing results to surface area increment which was confirmed by Brunauer Emmett and teller (BET) analysis. X-ray diffraction (XRD) shows high densities of dislocations in large crystallites, implying that dislocation slip is the dominant deformation mechanism. Scanning electron microscopy revealed the morphological properties of the materials at different milling time, nanostructure of the particles and fibres were confirmed by Transmission electron microscopy and FT-IR identified the functional groups responsible for its capacity to coordinate and remove metal ions, such as the carboxylic and amine groups at absorption bands of 1730 and 889 cm-1, respectively. However, the choice of this sorbent material for the sorption of any contaminants will depend on the composition of the effluent to be treated.

Keywords: banana peels, eco-friendly, mechanical milling, nanosorbent, nanostructure water quality

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Authors: Luz Stella Cadavid-Rodriguez, Viviana E. Castro-Lopez

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Fish waste (FW) has a high content of potentially biodegradable components, so it is amenable to be digested anaerobically. In this line, anaerobic digestion (AD) of FW has been studied for biogas production. Nevertheless, intermediate products such as volatile fatty acids (VFA), generated during the acidogenic stage, have been scarce investigated, even though they have a high potential as a renewable source of carbon. In the literature, there are few studies about the Inoculum-Substrate (I/S) ratio on acidogenesis. On the other hand, it is well known that pH is a critical factor in the production of VFA. The optimum pH for the production of VFA seems to change depending on the substrate and can vary in a range between 5.25 and 11. Nonetheless, the literature about VFA production from protein-rich waste, such as FW, is scarce. In this context, it is necessary to deepen on the determination of the optimal operating conditions of acidogenic fermentation for VFA production from protein-rich waste. Therefore, the aim of this research was to optimize the volatile fatty acid production from artisanal fishing waste, studying the effect of pH and the I/S ratio on the acidogenic process. For this research, the inoculum used was a methanogenic sludge (MS) obtained from a UASB reactor treating wastewater of a slaughterhouse plant, and the FW was collected in the port of Tumaco (Colombia) from the local artisanal fishers. The acidogenic fermentation experiments were conducted in batch mode, in 500 mL glass bottles as anaerobic reactors, equipped with rubber stoppers provided with a valve to release biogas. The effective volume used was 300 mL. The experiments were carried out for 15 days at a mesophilic temperature of 37± 2 °C and constant agitation of 200 rpm. The effect of 3 pH levels: 5, 7, 9, coupled with five I/S ratios, corresponding to 0.20, 0.15, 0.10, 0.05, 0.00 was evaluated taking as a response variable the production of VFA. A complete randomized block design was selected for the experiments in a 5x3 factorial arrangement, with two repetitions per treatment. At the beginning and during the process, pH in the experimental reactors was adjusted to the corresponding values of 5, 7, and 9 using 1M NaOH or 1M H2SO4, as was appropriated. In addition, once the optimum I/S ratio was determined, the process was evaluated at this condition without pH control. The results indicated that pH is the main factor in the production of VFA, obtaining the highest concentration with neutral pH. By reducing the I/S ratio, as low as 0.05, it was possible to maximize VFA production. Thus, the optimum conditions found were natural pH (6.6-7.7) and I/S ratio of 0.05, with which it was possible to reach a maximum total VFA concentration of 70.3 g Ac/L, whose major components were acetic acid (35%) and butyric acid (32%). The findings showed that the acidogenic fermentation of FW is an efficient way of producing VFA and that the operating conditions can be simple and economical.

Keywords: acidogenesis, artisanal fishing waste, inoculum to substrate ratio, volatile fatty acids

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Authors: Raya Kathreen T. Fuentes, Christian Owen P. Domingo, Kaisha V. Durana, Kristine Chelsea Shynne M. Evangelista, Nicole A. Feliciano, Kathleen Patricia Q. Ferido, Christianna Joy J. Ferrer

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Diabetes Mellitus (DM) is a global public health concern. The foot ulcer is one of the most serious and costly complications of DM. Among the components of diabetes self-management (DSM), foot self-care was found to be one of the best preventive measures for foot ulcers yet is seldom performed. Thus, the purpose of this study is to determine how adequate foot self-care practices (FSP) are among Filipino adults with DM with the following objectives: 1) determine their DSM, 2) describe their FSP, 3) determine the relationship between FSP and DSM, and 4) determine the relationship of FSP to sociodemographic characteristics, disease-related characteristics, social support, and knowledge. A descriptive correlational design was utilized. 114 respondents aged 19-65 were selected through purposive sampling from diabetes clinics. A self-administered questionnaire regarding FSP, DSM, sociodemographic and disease-related characteristics, social support, and knowledge on diabetes were used. Pearson's correlation was utilized to determine the relationship between FSP and DSM while simple linear regression was used to determine the relationship of FSP to the factors aforementioned. Results showed that majority of the respondents have desirable DSM but inadequate FSP. FSP and DSM were shown to be positively correlated but not statistically significant (p = 0.8). Disparity among the two suggests that there is less emphasis on foot self-care compared to other components of DSM. Findings further revealed that patients diagnosed with DM for < 5 years demonstrated more adequate FSP compared to patients diagnosed for > 5 years which may suggest that newly diagnosed patients are more receptive to new information about DSM. Health education on DSM should place more emphasis on FSP. Reiteration of health education and continuous motivation should be done to all DM patients, not just to newly diagnosed patients, to improve compliance to FSP and enhance patient empowerment regarding self-care.

Keywords: diabetes mellitus, diabetes self-management, foot self-care practices, foot ulcer

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Authors: Hellen L. De Castro e Silva, Ana A. Robles Aguilar, Erik Meers

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Digestates are residual by-products, rich in nutrients and trace elements, which can be used as organic fertilisers on soils. However, due to the non-digestibility of these elements and reduced dry matter during the anaerobic digestion process, metal concentrations are higher in digestates than in feedstocks, which might hamper their use as fertilisers according to the threshold values of some country policies. Furthermore, there is uncertainty regarding the required assimilated amount of these elements by some crops, which might result in their bioaccumulation. Therefore, further processing of the digestate to obtain safe fertilizing products has been recommended. This research aims to analyze the effect of applying the hydrothermal carbonization process to manure-derived digestates as a thermal treatment to reduce the bioavailability of heavy metals in mono and co-digestates derived from pig manure and maize from contaminated land in France. This study examined pig manure collected from a novel stable system (VeDoWs, province of East Flanders, Belgium) that separates the collection of pig urine and feces, resulting in a solid fraction of manure with high up-concentration of heavy metals and nutrients. Mono-digestion and co-digestion processes were conducted in semi-continuous reactors for 45 days at mesophilic conditions, in which the digestates were dried at 105 °C for 24 hours. Then, hydrothermal carbonization was applied to a 1:10 solid/water ratio to guarantee controlled experimental conditions in different temperatures (180, 200, and 220 °C) and residence times (2 h and 4 h). During the process, the pressure was generated autogenously, and the reactor was cooled down after completing the treatments. The solid and liquid phases were separated through vacuum filtration, in which the solid phase of each treatment -hydrochar- was dried and ground for chemical characterization. Different fractions (exchangeable / adsorbed fraction - F1, carbonates-bound fraction - F2, organic matter-bound fraction - F3, and residual fraction – F4) of some heavy metals (Cd, Cr, Ni, and Cr) have been determined in digestates and derived hydrochars using the modified Community Bureau of Reference (BCR) sequential extraction procedure. The main results indicated a difference in the heavy metals fractionation between digestates and their derived hydrochars; however, the hydrothermal carbonization operating conditions didn’t have remarkable effects on heavy metals partitioning between the hydrochars of the proposed treatments. Based on the estimated potential ecological risk assessment, there was one level decrease (considerate to moderate) when comparing the HMs partitioning in digestates and derived hydrochars.

Keywords: heavy metals, bioavailability, hydrothermal treatment, bio-based fertilisers, agriculture

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Authors: Svitlana Panchenko

Abstract:

Tourism in Ukraine is an underdeveloped branch of the economy, religious tourism is in its infancy. New challenges of the time, the Covid-19 pandemic and the war are making adjustments, and religious tourism is now in a difficult situation. Although, as scientists describe, it was religious tourism during the pandemic that proved to be a sustainable form of tourism, surviving due to the stability of faith of believers. Tourism in Germany is quite developed and profitable industry, so its interesting for studing such places of pilgrimage in Bavaria as: Passau, Regensburg, Munich, these cities are rich in their shrines and sacred places. In Germany, religious tourism is a well-developed economic sector, so it is necessary to study this issue from the point of view of attracting foreign tourists to Ukrainian lands to visit the shrines. For example, the city of Trier received a large part of the relics of Saint Matthew the Apostle, the relics of the Saint have remained a place of world Christian pilgrimage for centuries. This is the only city in Germany where there are relics of the apostle. Basically, all the relics of the holy apostles are kept in Italy, some in Spain and France. It is important to study different confessional groups, their psychology, the purpose of the pilgrimage, description of shrines. The subject of the study is religious tourism in the cities and villages of Transcarpathia and Bavaria, taking into account the psychological characteristics of pilgrims from a multi-confessional point of view. The article used the culturological, phenomenological, religious studies methods, which allows to analyze the problems of religious tourism from this point of view, taking into account the specifics of this sphere. The results of the research consist in the study of multi-confessional shrines on the example of Ukrainian and German towns to study the importance of cultural heritage and pilgrimage routes, taking into account the psychological factors of pilgrims.

Keywords: communications, cultural heritage, pilgrimage, religious tourism

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Authors: Frederic Barth, Wouter Vanhoudt, Marc Londo, Jaap C. Jansen, Karine Veum, Javier Castro, Klaus Nürnberger, Matthias Altmann

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Hydrogen is expected to play a key role in the transition towards a low-carbon economy, especially within the transport sector, the energy sector and the (petro)chemical industry sector. However, the production and use of hydrogen only make sense if the production and transportation are carried out with minimal impact on natural resources, and if greenhouse gas emissions are reduced in comparison to conventional hydrogen or conventional fuels. The CertifHy project, supported by a wide range of key European industry leaders (gas companies, chemical industry, energy utilities, green hydrogen technology developers and automobile manufacturers, as well as other leading industrial players) therefore aims to: 1. Define a widely acceptable definition of green hydrogen. 2. Determine how a robust Guarantee of Origin (GoO) scheme for green hydrogen should be designed and implemented throughout the EU. It is divided into the following work packages (WPs). 1. Generic market outlook for green hydrogen: Evidence of existing industrial markets and the potential development of new energy related markets for green hydrogen in the EU, overview of the segments and their future trends, drivers and market outlook (WP1). 2. Definition of “green” hydrogen: step-by-step consultation approach leading to a consensus on the definition of green hydrogen within the EU (WP2). 3. Review of existing platforms and interactions between existing GoO and green hydrogen: Lessons learnt and mapping of interactions (WP3). 4. Definition of a framework of guarantees of origin for “green” hydrogen: Technical specifications, rules and obligations for the GoO, impact analysis (WP4). 5. Roadmap for the implementation of an EU-wide GoO scheme for green hydrogen: the project implementation plan will be presented to the FCH JU and the European Commission as the key outcome of the project and shared with stakeholders before finalisation (WP5 and 6). Definition of Green Hydrogen: CertifHy Green hydrogen is hydrogen from renewable sources that is also CertifHy Low-GHG-emissions hydrogen. Hydrogen from renewable sources is hydrogen belonging to the share of production equal to the share of renewable energy sources (as defined in the EU RES directive) in energy consumption for hydrogen production, excluding ancillary functions. CertifHy Low-GHG hydrogen is hydrogen with emissions lower than the defined CertifHy Low-GHG-emissions threshold, i.e. 36.4 gCO2eq/MJ, produced in a plant where the average emissions intensity of the non-CertifHy Low-GHG hydrogen production (based on an LCA approach), since sign-up or in the past 12 months, does not exceed the emissions intensity of the benchmark process (SMR of natural gas), i.e. 91.0 gCO2eq/MJ.

Keywords: green hydrogen, cross-cutting, guarantee of origin, certificate, DG energy, bankability

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Authors: Francisco J. Cedano, Laura M. Pinzón, Camila I. Castro, Felipe Salcedo, Juan P. Casas, Juan C. Briceño

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Complex fractures located in articular surfaces are challenging to treat and their reduction with conventional treatments could compromise the functionality of the affected limb. An adhesive material to treat those fractures is desirable for orthopedic surgeons. This adhesive must be biocompatible and have a high adhesion to bone surface in an aqueous environment. The proposed adhesive is based on chitosan, given its adhesive and biocompatibility properties. Chitosan is mixed with calcium carbonate and hydroxyapatite, which contribute to structural support and a gel like behavior, and glutaraldehyde is used as a cross-linking agent to keep the adhesive mechanical performance in aqueous environment. This work aims to evaluate the rheological, adhesion strength and biocompatibility properties of the proposed adhesive using in vitro tests. The gelification process of the adhesive was monitored by oscillatory rheometry in an ARG-2 TA Instruments rheometer, using a parallel plate geometry of 22 mm and a gap of 1 mm. Time sweep experiments were conducted at 1 Hz frequency, 1% strain and 37°C from 0 to 2400 s. Adhesion strength is measured using a butt joint test with bovine cancellous bone fragments as substrates. The test is conducted at 5 min, 20min and 24 hours after curing the adhesive under water at 37°C. Biocompatibility is evaluated by a cytotoxicity test in a fibroblast cell culture using MTT assay and SEM. Rheological results concluded that the average gelification time of the adhesive is 820±107 s, also it reaches storage modulus magnitudes up to 106 Pa; The adhesive show solid-like behavior. Butt joint test showed 28.6 ± 9.2 kPa of tensile bond strength for the adhesive cured for 24 hours. Also there was no significant difference in adhesion strength between 20 minutes and 24 hours. MTT showed 70 ± 23 % of active cells at sixth day of culture, this percentage is estimated respect to a positive control (only cells with culture medium and bovine serum). High vacuum SEM observation permitted to localize and study the morphology of fibroblasts presented in the adhesive. All captured fibroblasts presented in SEM typical flatted structure with filopodia growth attached to adhesive surface. This project reports an adhesive based on chitosan that is biocompatible due to high active cells presented in MTT test and these results were correlated using SEM. Also, it has adhesion properties in conditions that model the clinical application, and the adhesion strength do not decrease between 5 minutes and 24 hours.

Keywords: bioadhesive, bone adhesive, calcium carbonate, chitosan, hydroxyapatite, glutaraldehyde

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Authors: Shikuku Emmanuel Tsikhungu

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Theatre and religion have enjoyed a symbiotic relationship from time immemorial, each transforming in different epochs and into different forms of practice but gaining from each other’s growth. Despite the fact that religion has more or less looked at the theatre and its dramatic rituals with distaste, the two human engagements have had dynamic and reciprocal relationships. In Kenya, there is an emerging innovation and transformation of theatre for religion in which churches and sects are consciously developing a youth wing that is vibrant in theatre practice. The imagination that youth and children derive pleasure and vibrancy in theatre has led to a lively competition among churches that is now creating a new form of theatre in Kenya. This has given rise to a practice in which art engages the religious not at the spiritual level but at the social-cultural level. Thus theatre is finding itself in sanctums that it had been banished; not for its own sake but as a tool for keeping the youth nearer the church if not the church This article analyses findings of a study carried out in December of 2017 among theatre festivals for the Catholic Church held in Kitui School, KituiCounty, and the Methodist Church of Kenya festival held in Ntemwene Church, Nkubu, Meru County, Kenya. One of the findings of interest was that while they were not theatres of religion nor religious theatres since they did not fuse the religious rituals with the dramatic rituals, the festivals never the less qualify as theatres for religion for they link the former to the latter. Secondly, while they claimed to be youth or children theatre festivals, they lacked youth-centredness nor child-centredness associated with such. Thirdly and most importantly the style of dramatic execution ranged from bibliodramatic to secular drama with Christian messages. Fourthly, by this stroke of acceptance in formerly forbidden sanctums, theatre is re-inventing itself back to its ‘old’ nature and function. It may be argued conclusively that this sprouting movement of theatre for religion may be comparable to the Jesuit Theatre fronted by Ignatius Loyola but clothed in modern African theatre practice.

Keywords: theatre, religion, theatre for religion, social constructs, socio-cultural

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Authors: Daniela Magalhaes, Jorge Pedro, Pedro Souteiro, Joao S. Neves, Sofia Castro-Oliveira, Vanessa Guerreiro, Rita Bettencourt- Silva, Maria M. Costa, Ana Varela, Joana Queiros, Paula Freitas, Davide Carvalho

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Introduction: Obesity is an independent risk factor for renal dysfunction. Our aims were: (1) evaluate the impact of bariatric surgery (BS) on renal function; (2) clarify the factors determining the postoperative evolution of the glomerular filtration rate (GFR); (3) access the occurrence of oxalate-mediated renal complications. Methods: We investigated a cohort of 1448 obese patients who underwent bariatric surgery. Those with basal GFR (GFR0) < 30mL/min or without information about the GFR 2-year post-surgery (GFR2) were excluded. Results: We included 725 patients, of whom 647 (89.2%) women, with 41 (IQR 34-51) years, a median weight of 112.4 (IQR 103.0-125.0) kg and a median BMI of 43.4 (IQR 40.6-46.9) kg/m2. Of these, 459 (63.3%) performed gastric bypass (RYGB), 144 (19.9%) placed an adjustable gastric band (AGB) and 122 (16.8%) underwent vertical gastrectomy (VG). At 2-year post-surgery, excess weight loss (EWL) was 60.1 (IQR 43.7-72.4) %. There was a significant improve of metabolic and inflammatory status, as well as a significant decrease in the proportion of patients with diabetes, arterial hypertension and dyslipidemia (p < 0.0001). At baseline, 38 (5.2%) of subjects had hyperfiltration with a GFR0 ≥ 125mL/min/1.73m2, 492 (67.9%) had a GFR0 90-124 mL/min/1.73m2, 178 (24.6%) had a GFR0 60-89 mL/min/1.73m2, and 17 (2.3%) had a GFR0 < 60 mL/min/1.73m2. GFR decreased in 63.2% of patients with hyperfiltration (ΔGFR=-2.5±7.6), and increased in 96.6% (ΔGFR=22.2±12.0) and 82.4% (ΔGFR=24.3±30.0) of the subjects with GFR0 60-89 and < 60 mL/min/1.73m2, respectively ( p < 0.0001). This trend was maintained when adjustment was made for the type of surgery performed. Of 321 patients, 10 (3.3%) had a urinary albumin excretion (UAE) > 300 mg/dL (A3), 44 (14.6%) had a UAE 30-300 mg/dL (A2) and 247 (82.1%) has a UAE < 30 mg/dL (A1). Albuminuria decreased after surgery and at 2-year follow-up only 1 (0.3%) patient had A3, 17 (5.6%) had A2 and 283 (94%) had A1 (p < 0,0001). In multivariate analysis, the variables independently associated with ΔGFR were BMI (positively) and fasting plasma glucose (negatively). During the 2-year follow-up, only 57 of the 725 patients had transient urinary excretion of calcium oxalate crystals. None has records of oxalate-mediated renal complications at our center. Conclusions: The evolution of GFR after BS seems to depend on the initial renal function, as it decreases in subjects with hyperfiltration, but tends to increase in those with renal dysfunction. Our results suggest that BS is associated with improvement of renal outcomes, without significant increase of renal complications. So, apart the clear benefits in metabolic and inflammatory status, maybe obese adults with nondialysis-dependent CKD should be referred for bariatric surgery evaluation.

Keywords: albuminuria, bariatric surgery, glomerular filtration rate, renal function

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