Search results for: test case selection

Authors: Leigha C. Crout

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This paper will investigate the categorical disregard of the People’s Republic of China (PRC) in establishing and maintaining a baseline standard of civil guarantees for economic migrant women and their dependents. In light of the relative forward strides in terms of policy facilitating the ascension of female workers in China, this oft-invisible subgroup of women remains neglected from the modern-day “iron rice bowl” of the self-identified communist state. This study is being undertaken to rectify the absence of data on this subject and provide a baseline for future studies on the matter, as the human rights of migrants has become an established facet of transnational dialogue and debate. The basic methodology of this research will consist of the evaluation of China’s compliance with its own national guidelines, and the eight international human rights law treaties it has ratified. Data will be extracted and cross-checked from a number of relevant sources to monitor the extent of compliance, including but by no means limited to the United Nations Human Rights Council (UNHRC) Universal Periodic Review (UPR) reports and responses, submissions and responses of international human rights treaty bodies, local and international nongovernmental organizations (NGOs) and their annual reports, and articles and commentaries authored by specialists on the modern state and implementation of Chinese law. Together, these data will illuminate the vast network of compliance that has forced many migrant women to work within situations of extreme economic precarity. The structure will proceed as follows: first, an outline of the current status of migrant workers and the enforcement of stipulated protections will be provided; next, the analysis of the oft-debated regulations directing and the outline of mandatory services guaranteed to external and internal migrants; and finally, a conclusion incorporating various recommendations to improve transparency and gradually decrease the amount of migrant work turned forced labor that typifies the economic migrant experience, especially in the case of women. The internal and international migrant workers in China are bound by different and uncomplimentary systems. The first, which governs Chinese citizens moving to different regions or provinces to find more sustainable employment (internal migrants), is called the hukou (or huji) residency system. This law enforces strict regulation of the movement of peoples, while ensuring that residents of urban areas receive preferential benefits to those received by their so-called “agricultural” resident counterparts. Given the overwhelming presence of the Communist Party of China throughout the vast state, the management of internal migrants and the disregard for foreign domestic workers is, at minimum, a surprising oversight. This paper endeavors to provide a much-needed foundation for future commentary and discussion on the treatment of female migrant workers and their families in the People’s Republic of China.

Keywords: female migrant worker’s rights, the People’s Republic of China, forced labor, Hukou residency system

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Authors: Javad Jozaei, Rob G. Bell, Paula Blackett, Scott A. Stephens

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In the last few decades, Social Vulnerability Assessment (SVA) has been a favoured means in evaluating the susceptibility of social systems to drivers of change, including climate change and natural disasters. However, the application of SVA to inform responsive and practical strategies to deal with uncertain climate change impacts has always been challenging, and typically agencies resort back to conventional risk/vulnerability assessment. These challenges include complex nature of social vulnerability concepts which influence its applicability, complications in identifying and measuring social vulnerability determinants, the transitory social dynamics in a changing environment, and unpredictability of the scenarios of change that impacts the regime of vulnerability (including contention of when these impacts might emerge). Research suggests that the conventional quantitative approaches in SVA could not appropriately address these problems; hence, the outcomes could potentially be misleading and not fit for addressing the ongoing uncertain rise in risk. The second phase of New Zealand’s Resilience to Nature’s Challenges (RNC2) is developing a forward-looking vulnerability assessment framework and methodology that informs the decision-making and policy development in dealing with the changing coastal systems and accounts for complex dynamics of New Zealand’s coastal systems (including socio-economic, environmental and cultural). Also, RNC2 requires the new methodology to consider plausible drivers of incremental and unknowable changes, create mechanisms to enhance social and community resilience; and fits the New Zealand’s multi-layer governance system. This paper aims to analyse the conventional approaches and methodologies in SVA and offer recommendations for more responsive approaches that inform adaptive decision-making and policy development in practice. The research adopts a qualitative research design to examine different aspects of the conventional SVA processes, and the methods to achieve the research objectives include a systematic review of the literature and case study methods. We found that the conventional quantitative, reductionist and deterministic mindset in the SVA processes -with a focus the impacts of rapid stressors (i.e. tsunamis, floods)- show some deficiencies to account for complex dynamics of social-ecological systems (SES), and the uncertain, long-term impacts of incremental drivers. The paper will focus on addressing the links between resilience and vulnerability; and suggests how resilience theory and its underpinning notions such as the adaptive cycle, panarchy, and system transformability could address these issues, therefore, influence the perception of vulnerability regime and its assessment processes. In this regard, it will be argued that how a shift of paradigm from ‘specific resilience’, which focuses on adaptive capacity associated with the notion of ‘bouncing back’, to ‘general resilience’, which accounts for system transformability, regime shift, ‘bouncing forward’, can deliver more effective strategies in an era characterised by ongoing change and deep uncertainty.

Keywords: complexity, social vulnerability, resilience, transformation, uncertain risks

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Authors: Ashik Sarder

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Bangladesh is a disaster-prone and one of the most vulnerable countries to climate change. The country has a long coastal area which is frequently being affected by several types of natural disasters due to climate change. The disasters have impacts on the life and livelihood of different natural resources depending on communities living in the coastal areas. The Malo is a Hindu religious traditional fishing community living at Sarafpur Union of Dumuria Upazila of Khulna district of south-west coastal Bangladesh. Fishing is the only means of their livelihood and the community has been engaged in fishing practices inherently in rivers, estuaries, and sea for more than 300 years. and they are totally dependent on this traditional occupation. But, in recent year’s climate change has negative impacts on their only livelihood option. The study aims to examine the impacts of climate change on the livelihood of Malo fishing community in south-west coastal Bangladesh, identify the adaptation strategies undertaken and practiced by Malo fishing community to cope with climate change and sustain their livelihood and explore the changing adaptation strategies undertaken by Malo fishing community and others. The study has been conducted from both qualitative and quantitative perspectives. Data has been collected from both primary and secondary sources. The primary data has been collected in the participatory observation approach following both qualitative and quantitative method. The primary source of data includes village census, face-to-face interview and in-depth case studies using structured questionnaire. The secondary source of the literature includes different national and international documents, policy papers, books and articles; related websites and peer-viewed documents on climate change, vulnerability, adaptation, livelihood, and fisheries. The study has identified different practices of adaption to climate change by Malo fishing community and others in the selected area. Three types of adaption practices have been identified. Firstly, the indigenous adaptation practices by Malo fishing community to cope with climate change have been identified. These identified adaptation practices by Malo fishing community include; ensuring drinking water and sanitation facilities, planting trees to tackle impacts of cyclone, excavating dumps to preserve the valuable assets, growing vegetables and rearing domestic livestock to earn surplus money, taking loans for ensuring continuation of present livelihood and migrating to near city or towns for better livelihood options. Secondly, adaptation initiatives undertaken by the government have provided limited facility to this vulnerable fishing community and made them benefited. And thirdly, some adaptation initiatives commenced by few non-government and community-based organizations have also made the Malo fishing community as beneficiaries. The study has suggested recommendations for Malo fishing community to overcome the challenges and impacts of climate change for retaining their traditional fishing livelihood. The accumulated recommendations would be very useful for the researchers, academicians, policy-makers of Government and non-government organizations to conduct more researches and take initiatives for Malo fishing community to make them more capable to sustain their fishing livelihood.

Keywords: climate change, livelihood, adaptation, anthropology, vulnerability

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Authors: V. Vsevolozhskaia

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Since 1990, energy-efficient development concepts have constituted both a turning point in civil engineering and a challenge for an environmentally friendly future. Energy and water currently play an essential role in the sustainable economic growth of the world in general and Russia in particular: the efficiency of the water supply system is the second most important parameter for energy consumption according to the British assessment method, while the water-energy nexus has been identified as a focus for accelerating sustainable growth and developing effective, innovative solutions. The activities considered in this study were aimed at organizing and executing the renovation of the property in residential buildings located in St. Petersburg, specifically buildings with local or federal historical heritage status under the control of the St. Petersburg Committee for the State Inspection and Protection of Historic and Cultural Monuments (KGIOP) and UNESCO. Even after reconstruction, these buildings still fall into energy efficiency class D. Russian Government Resolution No. 87 on the structure and required content of project documentation contains a section entitled ‘Measures to ensure compliance with energy efficiency and equipment requirements for buildings, structures, and constructions with energy metering devices’. Mention is made of the need to install collectors and meters, which only calculate energy, neglecting the main purpose: to make buildings more energy-efficient, potentially even energy efficiency class A. The least-explored aspects of energy-efficient technology in the Russian Federation remain the water balance and the possibility of implementing rain and meltwater collection systems. These modern technologies are used exclusively for new buildings due to a lack of government directive to create project documentation during the planning of major renovations and reconstruction that would include the collection and reuse of rainwater. Energy-efficient technology for rain and meltwater collection is currently applied only to new buildings, even though research has proved that using rainwater is safe and offers a huge step forward in terms of eco-efficiency analysis and water innovation. Where conservation is mandatory, making changes to protected sites is prohibited. In most cases, the protected site is the cultural heritage building itself, including the main walls and roof. However, the installation of a second water supply system and collection of rainwater would not affect the protected building itself. Water efficiency in St. Petersburg is currently considered only from the point of view of the installation that regulates the flow of the pipeline shutoff valves. The development of technical guidelines for the use of grey- and/or rainwater to meet the needs of residential buildings during reconstruction or renovation is not yet complete. The ideas for water treatment, collection and distribution systems presented in this study should be taken into consideration during the reconstruction or renovation of residential cultural heritage buildings under the protection of KGIOP and UNESCO. The methodology applied also has the potential to be extended to other cultural heritage sites in northern countries and lands with an average annual rainfall of over 600 mm to cover average toilet-flush needs.

Keywords: cultural heritage, energy efficiency, renovation, rainwater collection, reconstruction, water management, water supply

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Authors: Eleftheria Atta, Yianna Vovides, Marios Katsioloudes

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In the fusion of neoliberalism and globalization, Higher Education (HE) is becoming increasingly complex. The changing patterns of the economy worldwide caused the development of high value-added economy HE has been viewed as a social investment, significant for the development of knowledge-based societies and economies. In order to contribute to economic competitiveness universities are required to produce local and employable workers in order to fit into the neoliberal economic environment. The emergence of neoliberal performativity, which measures outcomes, is a key aspect in a neoliberal era. It facilitates the redesign of institutions making organizations and individuals to think about themselves in relation to their performance. Performativity and performance management systems lead academics to become more effective, professionally advance, improve and become better than others and therefore act competitively. Besides the aforementioned complexities, universities also encounter the challenge of maintaining a set of values to guide an institution’s actions and which have always been highly respected in developing a HE institution. The formulation of a clear set of values also determines the institutional culture which will be maintained. It is evident that values create a significant framework for the workplace and may determine positive institutional results. Universities are required to engage in activities for capacity building which will improve their students’ competence as well as offer opportunities to administrative and academic staff to professionally develop in light of neoliberal performativity. Additionally, the University is now considered as an innovation ecosystem playing a significant role in providing education, research and innovation to help create solutions to meet social, environmental and economic challenges. Thus, Universities become central in orchestrating multi-actor innovation networks. This presentation will discuss the establishment of an institutional unit entitled ‘Human Development Unit’ (HDU) in a European start-up university. The activities of the HDU are envisioned as drivers for innovation that would enable the university as a whole to maintain its position in a fast-changing world and be ready to face adaptive challenges. In addition, the HDU provides its students, staff, and faculty with opportunities to advance their academic and professional development through engagement in programs that align with institutional values. It also serves as a connector with the broader community. The presentation will highlight the functions of three centers which the unit will coordinate namely, the Student Development Center (SDC), the Faculty & Staff Development Center (FSDC) and the Continuing Education Center (CEC). The presentation aligns with the aim of the conference as it welcomes presentations to discuss innovations and challenges encountered in HE. Particularly, this presentation seeks to discuss the establishment of an innovative unit at a start-up university which will contribute to creating an institutional culture shaped by the value of academic excellence for students as well as for staff, shaping and defining the functions and activities of the unit. The establishment of the proposed unit is crucial in a start-up university both to differentiate from other competitors but also to sustain its presence given the pressures in a neoliberal HE context.

Keywords: academic excellence, globalization, human development unit, neoliberalism

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Authors: Osman Ali, Jeanne Kriek

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Introduction: The current instructional approach entrenched in memorizing does not assist conceptual understanding in science. Instructional approaches that encourage research, investigation, and experimentation, which depict how scientists work, should be encouraged. One such teaching strategy is problem-based learning (PBL). PBL has many advantages; enhanced self-directed learning and improved problem-solving and critical thinking skills. However, despite many advantages, PBL has challenges. Research confirmed is time-consuming and difficult to formulate ill-structured questions. Professional development interventions are needed for in-service educators to adopt the PBL strategy. The purposively selected educators had to implement PBL in their classrooms after the intervention to develop their practice and then reflect on the implementation. They had to indicate their achievements and challenges. This study differs from previous studies as the rural educators were subjected to implementing PBL in their classrooms and reflected on their experiences, beliefs, and attitudes regarding PBL. Theoretical Framework: The study reinforced Vygotskian sociocultural theory. According to Vygotsky, the development of a child's cognitive is sustained by the interaction between the child and more able peers in his immediate environment. The theory suggests that social interactions in small groups create an opportunity for learners to form concepts and skills on their own better than working individually. PBL emphasized learning in small groups. Research Methodology: An exploratory case study was employed. The reason is that the study was not necessarily for specific conclusive evidence. Non-probability purposive sampling was adopted to choose eight schools from 89 rural public schools. In each school, two educators were approached, teaching physical sciences in grades 10 and 11 (N = 16). The research instruments were questionnaires, interviews, and lesson observation protocol. Two open-ended questionnaires were developed before and after intervention and analyzed thematically. Three themes were identified. The semi-structured interviews and responses were coded and transcribed into three themes. Subsequently, the Reform Teaching Observation Protocol (RTOP) was adopted for lesson observation and was analyzed using five constructs. Results: Evidence from analyzing the questionnaires before and after the intervention shows that participants knew better what was required to develop an ill-structured problem during the implementation. Furthermore, indications from the interviews are that participants had positive views about the PBL strategy. They stated that they only act as facilitators, and learners’ problem-solving and critical thinking skills are enhanced. They suggested a change in curriculum to adopt the PBL strategy. However, most participants may not continue to apply the PBL strategy stating that it is time-consuming and difficult to complete the Annual Teaching Plan (ATP). They complained about materials and equipment and learners' readiness to work. Evidence from RTOP shows that after the intervention, participants learn to encourage exploration and use learners' questions and comments to determine the direction and focus of classroom discussions.

Keywords: problem-solving, self-directed, critical thinking, intervention

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Authors: Demet Devrimsel Dogan, Ecem Deniz Kirkpantur, Muharrem Dogan, Ahmet Aykut, Ebru Unal Akoglu, Ozge Ecmel Onur

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Introduction: Median Arcuate Ligament Syndrome (MALS) is a rare cause of chronic abdominal pain due to external compression of the celiac trunk by a fibrous arch that unites diaphragmatic crura on each side of the aortic hiatus. While 10-24% of the population may suffer from compression of celiac trunk, it rarely causes patients to develop symptoms. The typical clinical triad of symptoms includes postprandial epigastric pain, weight loss and vomiting. The diagnosis can be made using thin section multi-detector computed tomography (CT) scans which delineate the ligament and the compressed vessel. The treatment of MALS is aimed at relieving the compression of the celiac artery to restore adequate blood flow through the vessel and neurolysis to address chronic pain. Case: A 68-year-old male presented to our clinic with acute postprandial epigastric pain. This was patients’ first attack, and the pain was the worst pain of his life. The patient did not have any other symptoms like nausea, vomiting, chest pain or dyspnea. In his medical history, the patient has had an ischemic cerebrovascular stroke 5 years ago which he recovered with no sequel, and he was using 75 mg clopidogrel and 100 mg acetylsalicylic acid. He was not using any other medication and did not have a story of cardiovascular disease. His vital signs were stable (BP:113/72 mmHg, Spo2:97, temperature:36.3°C, HR:90/bpm). In his electrocardiogram, there was ST depression in leads II, III and AVF. In his physical examination, there was only epigastric tenderness, other system examinations were normal. Physical examination through his upper gastrointestinal system showed no bleeding. His laboratory results were as follows: creatinine:1.26 mg/dL, AST:42 U/L, ALT:17 U/L, amylase:78 U/L, lipase:26 U/L, troponin:10.3 pg/ml, WBC:28.9 K/uL, Hgb:12.7 gr/dL, Plt:335 K/uL. His serial high-sensitive troponin levels were also within normal limits, his echocardiography showed no segmental wall motion abnormalities, an acute myocardial infarction was excluded. In his abdominal ultrasound, no pathology was founded. Contrast-enhanced abdominal CT and CT angiography reported ‘thickened diaphragmatic cruras are compressing and stenosing truncus celiacus superior, this is likely compatible with MALS’. The patient was consulted to general surgery, and they admitted the patient for laparoscopic ligament release. Results: MALS is a syndrome that causes postprandial pain, nausea and vomiting as its most common symptoms. Affected patients are normally young, slim women between the ages of 30 and 50 who have undergone extensive examinations to find the source of their symptoms. To diagnose MALS, other underlying pathologies should initially be excluded. The gold standard is aortic angiography. Although diagnosis and treatment of MALS are unclear, symptom resolution has been achieved with multiple surgical modalities, including open, laparoscopic or robotic ligament release as well as celiac ganglionectomy, which often requires celiac artery revascularisation.

Keywords: differential diagnosis, epigastric pain, median arcuate ligament syndrome, celiac trunk

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Authors: Shah Rucksana Akhter Urme

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Agriculture is the main source of food for human consumption and feeding the world huge population, the pressure of food supply is increasing day by day. Undoubtedly, quality strain, improved plantation, farming technology, synthetic fertilizer, readily available irrigation, insecticides and harvesting technology are the main factors those to meet up the huge demand of food consumption all over the world. However, depended on this limited resources and excess amount of consuming lands, water, fertilizers leads to the end of the resources and severe climate effects has been left for our future generation. Agriculture is the most responsible to global warming, emitting more greenhouse gases than all other vehicles largely from nitrous oxide released by from fertilized fields, and carbon dioxide from the cutting of rain forests to grow crops . Farming is the thirstiest user of our precious water supplies and a major polluter, as runoff from fertilizers disrupts fragile lakes, rivers, and coastal ecosystems across the globe which accelerates the loss of biodiversity, crucial habitat and a major driver of wildlife extinction. It is needless to say that we have to more concern on how we can save the nutrients of the soil, storage of the water and avoid excessive depends on synthetic fertilizer and insecticides. In this case, eco- friendly cultivation could be a potential alternative solution to minimize effects of agriculture in our environment. The objective of this review paper is about organic cultivation following in particular biotechnological process focused on bio-fertilizer and bio-pesticides. Intense practice of chemical pesticides, insecticides has severe effect on both in human life and biodiversity. This cultivation process introduces farmer an alternative way which is nonhazardous, cost effective and ecofriendly. Organic fertilizer such as tea residue, ashes might be the best alternative to synthetic fertilizer those play important role in increasing soil nutrient and fertility. Ashes contain different essential and non-essential mineral contents that are required for plant growth. Organic pesticide such as neem spray is beneficial for crop as it is toxic for pest and insects. Recycled and composted crop wastes and animal manures, crop rotation, green manures and legumes etc. are suitable for soil fertility which is free from hazardous chemicals practice. Finally water hyacinth and algae are potential source of nutrients even alternative to soil for cultivation along with storage of water for continuous supply. Inorganic practice of agriculture, consuming fruits and vegetables becomes a threat for both human life and eco-system and synthetic fertilizer and pesticides are responsible for it. Farmers that practice eco-friendly farming have to implement steps to protect the environment, particularly by severely limiting the use of pesticides and avoiding the use of synthetic chemical fertilizers, which are necessary for organic systems to experience reduced environmental harm and health risk.

Keywords: organic farming, biopesticides, organic nutrients, water storage, global warming

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Authors: Sultana Afrin Nipa

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Life on Earth cannot thrive or survive without water. Water is intimately tied with community, culture, spirituality, identity, socio-economic progress, security, self-determination, and livelihood. Thus, access to water is a United Nations recognized human right due to its significance in these realms. However, there is often conflict between those who consider water as the spiritual and cultural value and those who consider it an economic value thus being threatened by economic development, corporate exploitation, government regulation, and increased privatization, highlighting the complex relationship between water and culture. The Colorado River basin is home to over 29 federally recognized tribal nations. To these tribes, it holds cultural, economic, and spiritual significance and often extends to deep human-to-non-human connections frequently precluded by the Westphalian regulations and settler laws. Despite the recognition of access to rivers as a fundamental human right by the United Nations, tribal communities and their water rights have been historically disregarded through inter alia, colonization, and dispossession of their resources. Law of the River such as ‘Winter’s Doctrine’, ‘Bureau of Reclamation (BOR)’ and ‘Colorado River Compact’ have shaped the water governance among the shareholders. However, tribal communities have been systematically excluded from these key agreements. While the Winter’s Doctrine acknowledged that tribes have the right to withdraw water from the rivers that pass through their reservations for self-sufficiency, the establishment of the BOR led to the construction of dams without tribal consultation, denying the ‘Winters’ regulation and violating these rights. The Colorado River Compact, which granted only 20% of the water to the tribes, diminishes the significance of international legal frameworks that prioritize indigenous self-determination and free pursuit of socio-economic and cultural development. Denial of this basic water right is the denial of the ‘recognition’ of their sovereignty and self-determination that questions the effectiveness of the international law. This review assesses the international legal frameworks concerning indigenous rights and water justice and aims to pinpoint gaps hindering the effective recognition and protection of Indigenous water rights in Colorado River Basin. This study draws on a combination of historical and qualitative data sets. The historical data encompasses the case settlements provided by the Bureau of Reclamation (BOR) respectively the notable cases of Native American water rights settlements on lower Colorado basin related to Arizona from 1979-2008. This material serves to substantiate the context of promises made to the Indigenous people and establishes connections between existing entities. The qualitative data consists of the observation of recorded meetings of the Central Arizona Project (CAP) to evaluate how the previously made promises are reflected now. The study finds a significant inconsistency in participation in the decision-making process and the lack of representation of Native American tribes in water resource management discussions. It highlights the ongoing challenges faced by the indigenous people to achieve their self-determination goal despite the legal arrangements.

Keywords: colorado river, indigenous rights, law of the river, water governance, water justice

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Authors: Kamyar Tolouei, Ehsan Moosavi

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In open-pit mines, the long-term production scheduling optimization problem (LTPSOP) is a complicated problem that contains constraints, large datasets, and uncertainties. Uncertainty in the output is caused by several geological, economic, or technical factors. Due to its dimensions and NP-hard nature, it is usually difficult to find an ideal solution to the LTPSOP. The optimal schedule generally restricts the ore, metal, and waste tonnages, average grades, and cash flows of each period. Past decades have witnessed important measurements of long-term production scheduling and optimal algorithms since researchers have become highly cognizant of the issue. In fact, it is not possible to consider LTPSOP as a well-solved problem. Traditional production scheduling methods in open-pit mines apply an estimated orebody model to produce optimal schedules. The smoothing result of some geostatistical estimation procedures causes most of the mine schedules and production predictions to be unrealistic and imperfect. With the expansion of simulation procedures, the risks from grade uncertainty in ore reserves can be evaluated and organized through a set of equally probable orebody realizations. In this paper, to synthesize grade uncertainty into the strategic mine schedule, a stochastic integer programming framework is presented to LTPSOP. The objective function of the model is to maximize the net present value and minimize the risk of deviation from the production targets considering grade uncertainty simultaneously while satisfying all technical constraints and operational requirements. Instead of applying one estimated orebody model as input to optimize the production schedule, a set of equally probable orebody realizations are applied to synthesize grade uncertainty in the strategic mine schedule and to produce a more profitable and risk-based production schedule. A mixture of metaheuristic procedures and mathematical methods paves the way to achieve an appropriate solution. This paper introduced a hybrid model between the augmented Lagrangian relaxation (ALR) method and the metaheuristic algorithm, the Harris Hawks optimization (HHO), to solve the LTPSOP under grade uncertainty conditions. In this study, the HHO is experienced to update Lagrange coefficients. Besides, a machine learning method called Random Forest is applied to estimate gold grade in a mineral deposit. The Monte Carlo method is used as the simulation method with 20 realizations. The results specify that the progressive versions have been considerably developed in comparison with the traditional methods. The outcomes were also compared with the ALR-genetic algorithm and ALR-sub-gradient. To indicate the applicability of the model, a case study on an open-pit gold mining operation is implemented. The framework displays the capability to minimize risk and improvement in the expected net present value and financial profitability for LTPSOP. The framework could control geological risk more effectively than the traditional procedure considering grade uncertainty in the hybrid model framework.

Keywords: grade uncertainty, metaheuristic algorithms, open-pit mine, production scheduling optimization

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Authors: K. Kamal

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Structural sandwich panels with core of Advanced Composites Laminates l Honeycombs / PU-foams are used in aerospace applications and are also fabricated for use now in some civil engineering applications. An all Advanced Composites Foot Over Bridge (FOB) system, designed and developed for pedestrian traffic is one such application earlier, may be cited as an example here. During development stage of this FoB, a profile of its decks was then spurred as a single corrugate sheet core sandwiched between two Glass Fibre Reinforced Plastics(GFRP) flat laminates. Once successfully fabricated and used, these decks did prove suitable also to form other structure on assembly, such as, erecting temporary shelters. Such corrugated sheet core profile sandwiched panels were then also tried using the construction materials but any conventional method of construction only posed certain difficulties in achieving the required core profile monolithically within the sandwiched slabs and hence it was then abended. Such monolithic construction was, however, subsequently eased out on demonstration by dispensing building materials mix through a suitably designed multi-dispenser system attached to a 3D Printer. This study conducted at lab level was thus reported earlier and it did include the fabrication of a 3D printer in-house first as ‘3DcMP’ as well as on its functional operation, some required sandwich core profiles also been 3D-printed out producing panels hardware. Once a number of these sandwich panels in single corrugated sheet core monolithically printed out, panels were subjected to load test in an experimental set up as also their structural behavior was studied analytically, and subsequently, these results were correlated as reported in the literature. In achieving the required more depths and also to exhibit further the stronger and creating sandwiched decks of better structural and mechanical behavior, further more complex core configuration such as stack corrugate sheets core with a flat mid plane was felt to be the better sandwiched core. Such profile remained as an outcome that turns out merely on stacking of two separately printed out monolithic units of single corrugated sheet core developed earlier as above and bonded them together initially, maintaining a different orientation. For any required sequential understanding of the structural behavior of any such complex profile core sandwiched decks with special emphasis to study of the effect in the variation of corrugation orientation in each distinct tire in this core, it obviously calls for an analytical study first. The rectangular,simply supported decks have therefore been considered for analysis adopting the ‘Advanced Composite Technology(ACT), some numerical results along with some fruitful findings were obtained and these are all presented here in this paper. From this numerical result, it has been observed that a mid flat layer which eventually get created monolethically itself, in addition to eliminating the bonding process in development, has been found to offer more effective bending resistance by such decks subjected to UDL over them. This is understood to have resulted here since the existence of a required shear resistance layer at the mid of the core in this profile, unlike other bending elements. As an addendum to all such efforts made as covered above and was published earlier, this unique stack corrugate sheet core profile sandwiched structural decks, monolithically construction with ease at the site itself, has been printed out from a 3D Printer. On employing 3DcMP and using some innovative building construction materials, holds the future promises of such research & development works since all those several aspects of a 3D printing in construction are now included such as reduction in the required construction time, offering cost effective solutions with freedom in design of any such complex shapes thus can widely now be realized by the modern construction industry.

Keywords: advance composite technology(ACT), corrugated laminates, 3DcMP, foot over bridge (FOB), sandwiched deck units

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Authors: Hirseland Andreas, Kerschbaumer Lukas

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In the case of Germany, there are about one million long-term unemployed – a figure that did not vary much during the past years. These long-term unemployed did not benefit from the prospering labor market while most short-term unemployed did. Instead, they are continuously dependent on welfare and sometimes precarious short-term employment, experiencing work poverty. Long-term unemployment thus turns into a main obstacle to become employed again, especially if it is accompanied by other impediments such as low-level education (school/vocational), poor health (especially chronical illness), advanced age (older than fifty), immigrant status, motherhood or engagement in care for other relatives. As can be shown by this current research project, in these cases the chance to regain employment decreases to near nil. Almost two-thirds of all welfare recipients have multiple impediments which hinder a successful transition from welfare back to sustainable and sufficient employment. Prospective employers are unlikely to hire long-term unemployed with additional impediments because they evaluate potential employees on their negative signaling (e.g. low-level education) and the implicit assumption of unproductiveness (e.g. poor health, age). Some findings of the panel survey “Labor market and social security” (PASS) carried out by the Institute of Employment Research (the research institute of the German Federal Labor Agency) spread a ray of hope, showing that unlikely does not necessarily mean impossible. The presentation reports on current research on these very scarce “success stories” of unlikely transitions from long-term unemployment to work and how these cases were able to perform this switch against all odds. The study is based on a mixed-method design. Within the panel survey (~15,000 respondents in ~10,000 households), only 66 cases of such unlikely transitions were observed. These cases have been explored by qualitative inquiry – in depth-interviews and qualitative network techniques. There is strong evidence that sustainable transitions are influenced by certain biographical resources like habits of network use, a set of informal skills and particularly a resilient way of dealing with obstacles, combined with contextual factors rather than by job-placement procedures promoted by Job-Centers according to activation rules or by following formal paths of application. On the employer’s side small and medium-sized enterprises are often found to give job opportunities to a wider variety of applicants, often based on a slow but steadily increasing relationship leading to employment. According to these results it is possible to show and discuss some limitations of (German) activation policies targeting the labor market and their impact on welfare dependency and long-term unemployment. Based on these findings, indications for more supportive small-scale measures in the field of labor-market policies are suggested to help long-term unemployed with multiple impediments to overcome their situation (e.g. organizing small-scale-structures and low-threshold services to encounter possible employers on a more informal basis like “meet and greet”).

Keywords: against-all-odds, mixed-methods, Welfare State, long-term unemployment

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Authors: Olga Kokoulina

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Today, algorithms are assuming a leading role in various areas of decision-making. Prompted by a promise to provide increased economic efficiency and fuel solutions for pressing societal challenges, algorithmic decision-making is often celebrated as an impartial and constructive substitute for human adjudication. But in the face of this implied objectivity and efficiency, the application of algorithms is also marred with mounting concerns about embedded biases, discrimination, and exclusion. In Europe, vigorous debates on risks and adverse implications of algorithmic decision-making largely revolve around the potential of data protection laws to tackle some of the related issues. For example, one of the often-cited venues to mitigate the impact of potentially unfair decision-making practice is a so-called 'right to explanation'. In essence, the overall right is derived from the provisions of the General Data Protection Regulation (‘GDPR’) ensuring the right of data subjects to access and mandating the obligation of data controllers to provide the relevant information about the existence of automated decision-making and meaningful information about the logic involved. Taking corresponding rights and obligations in the context of the specific provision on automated decision-making in the GDPR, the debates mainly focus on efficacy and the exact scope of the 'right to explanation'. In essence, the underlying logic of the argued remedy lies in a transparency imperative. Allowing data subjects to acquire as much knowledge as possible about the decision-making process means empowering individuals to take control of their data and take action. In other words, forewarned is forearmed. The related discussions and debates are ongoing, comprehensive, and, often, heated. However, they are also frequently misguided and isolated: embracing the data protection law as ultimate and sole lenses are often not sufficient. Mandating the disclosure of technical specifications of employed algorithms in the name of transparency for and empowerment of data subjects potentially encroach on the interests and rights of IPR holders, i.e., business entities behind the algorithms. The study aims at pushing the boundaries of the transparency debate beyond the data protection regime. By systematically analysing legal requirements and current judicial practice, it assesses the limits of the transparency requirement and right to access posed by intellectual property law, namely by copyrights and trade secrets. It is asserted that trade secrets, in particular, present an often-insurmountable obstacle for realising the potential of the transparency requirement. In reaching that conclusion, the study explores the limits of protection afforded by the European Trade Secrets Directive and contrasts them with the scope of respective rights and obligations related to data access and portability enshrined in the GDPR. As shown, the far-reaching scope of the protection under trade secrecy is evidenced both through the assessment of its subject matter as well as through the exceptions from such protection. As a way forward, the study scrutinises several possible legislative solutions, such as flexible interpretation of the public interest exception in trade secrets as well as the introduction of the strict liability regime in case of non-transparent decision-making.

Keywords: algorithms, public interest, trade secrets, transparency

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Authors: Andrés Lara Guillén, José M. Soriano Disla, Gemma Castejón Martínez, David Fernández-Gutiérrez

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The worldwide population is exponentially increasing, which causes a rising demand for food, energy and non-renewable resources. These demands must be attended to from a circular economy point of view. Under this approach, the obtention of strategic products from biowaste is crucial for the society to keep the current lifestyle reducing the environmental and social issues linked to the lineal economy. This is the main objective of the VALUEWASTE project. VALUEWASTE is about valorizing urban biowaste into proteins for food and feed and biofertilizers, closing the loop of this waste stream. In order to achieve this objective, the project validates three value chains, which begin with the anaerobic digestion of the biowaste. From the anaerobic digestion, three by-products are obtained: i) methane that is used by microorganisms, which will be transformed into microbial proteins; ii) digestate that is used by black soldier fly, producing insect proteins; and iii) a nutrient-rich effluent, which will be transformed into biofertilizers. VALUEWASTE is an innovative solution, which combines different technologies to valorize entirely the biowaste. However, it is also required to demonstrate that the solution is greener than other traditional technologies (baseline systems). On one hand, the proteins from microorganisms and insects will be compared with other reference protein production systems (gluten, whey and soybean). On the other hand, the biofertilizers will be compared to the production of mineral fertilizers (ammonium sulphate and synthetic struvite). Therefore, the aim of this study is to provide that biowaste valorization can reduce the environmental impacts linked to both traditional proteins manufacturing processes and mineral fertilizers, not only at a pilot-scale but also at an industrial one. In the present study, both baseline system and VALUEWASTE solution are evaluated through the Environmental Life Cycle Assessment (E-LCA). The E-LCA is based on the standards ISO 14040 and 14044. The Environmental Footprint methodology was the one used in this study to evaluate the environmental impacts. The results for the baseline cases show that the food proteins coming from whey have the highest environmental impact on ecosystems compared to the other proteins sources: 7.5 and 15.9 folds higher than soybean and gluten, respectively. Comparing feed soybean and gluten, soybean has an environmental impact on human health 195.1 folds higher. In the case of biofertilizers, synthetic struvite has higher impacts than ammonium sulfate: 15.3 (ecosystems) and 11.8 (human health) fold, respectively. The results shown in the present study will be used as a reference to demonstrate the better environmental performance of the bio-based products obtained through the VALUEWASTE solution. Other originalities that the E-LCA performed in the VALUEWASTE project provides are the diverse direct implications on investment and policies. On one hand, better environmental performance will serve to remove the barriers linked to these kinds of technologies, boosting the investment that is backed by the E-LCA. On the other hand, it will be a germ to design new policies fostering these types of solutions to achieve two of the key targets of the European Community: being self-sustainable and carbon neutral.

Keywords: anaerobic digestion, biofertilizers, circular economy, nutrients recovery

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Authors: Marina Gold, Yves Jackson, David Parrat

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The high predominance of Latin American migrants in Geneva from countries where Chagas disease is endemic (Bolivia, Brazil, Argentina, Colombia) is increasing the incidence of chronic Chagas-related problems, especially cardiovascular complications. The precarious migratory status of what are mostly undocumented migrants complicates access to health and affects patients’ and doctors’ health perceptions regarding screening, treatment and monitoring of Chagas-related health concerns. This project results from a 3 year collaboration between the Geneva University Hospital and the NGO Mundo Sano to understand the following questions: 1) how do Latin American migrants perceive their health? 2) What do they understand from Chagas disease? 3) Are patients’ and doctors’ health perceptions similar or do they have competing agendas? This paper aims to present the results of a long-term study that interrogates health perceptions among Latin American migrants in Geneva. The first phase consisted in completing surveys at three community screening events (2016, 2017. 2018), and the results of these surveys reveal the subordination of the importance of health to that of having met economic family obligation. That is, health is important only when it becomes an impediment to economic gain. The contradictory result emerged that people are aware of the importance of health prevention in order to ensure long-term health, but they do not always have agency over their life-style habits (healthy food, regular exercise, emotional stability). The second phase of the research collected open-ended interviews with selected participants, in order to explore in more detail how Latin American migrants deal with Chagas in a different socio-political and economic context to that of endemic countries. These interviews (5 in total) reveal mixed methods of managing health: social networks, access to health care transnationally (in Geneva, Spain and back in their home country), and different valuations of health problems in each situation. The third phase consisted in observations of doctor-patient consultations and further extended interviews with patients to determine doctor/patient health perceptions around Chagas disease. This phase is ongoing, but it has yielded preliminarily observations regarding the expectations that patients’ have of doctors, and the understanding of doctors’ to patients’ complex situations. Positive and complementary health perceptions include patients’ feeling that doctors in Geneva are more understanding, more knowledgeable and less racist than those in their home country, who do not provide detailed information about Chagas or its treatment and discriminate against them for being indigenous or from poor rural areas, enabling a better communication between doctors and patients. Possible conflicting health perceptions include patients addressing their health concerns more holistically and encountering the specialist’s limitations to only treating one health concern, given time limitations and lack of competition with their colleagues (the general practitioner that referred the patient, for example). The implications of this study extend the case of Chagas disease in Geneva and is relevant for all chronic concerns and migratory contexts of precarity.

Keywords: chagas disease, health perceptions, Latin American Migrants, non-endemic countries

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Authors: Emma Pope, Demos Parapanos

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Rural tourism has become more obvious and prevalent, with tourists’ increasingly seeking authentic experiences. This movement accelerated post-Covid, putting destinations in danger of reaching levels of saturation called ‘overtourism’. Whereas the phenomenon of overtourism has been frequently discussed in the urban context by academics and practitioners over recent years, it has hardly been referred to in the context of rural tourism, where perhaps it is even more difficult to manage. Rural tourism was historically considered small-scale, marked by its traditional character and by having little impact on nature and rural society. The increasing number of rural areas experiencing overtourism, however, demonstrates the need for new approaches, especially as the impacts and enablers of overtourism are context specific. Cumbria, with approximately 47 million visitors each year, and 23,000 operational enterprises, is one of these rural areas experiencing overtourism in the UK. Using the county of Cumbria as an example, this paper aims to explore better planning and management in rural destinations by clustering the area into rural and ‘urban-rural’ tourism zones. To achieve the aim, this study uses secondary data from a variety of sources to identify variables relating to visitor economy development and demand. These data include census data relating to population and employment, tourism industry-specific data including tourism revenue, visitor activities, and accommodation stock, and big data sources such as Trip Advisor and All Trails. The combination of these data sources provides a breadth of tourism-related variables. The subsequent analysis of this data draws upon various validated models. For example, tourism and hospitality employment density, territorial tourism pressure, and accommodation density. In addition to these statistical calculations, other data are utilized to further understand the context of these zones, for example, tourist services, attractions, and activities. The data was imported into ARCGIS where the density of the different variables is visualized on maps. This study aims to provide an understanding of the geographical context of visitor economy development and tourist behavior in rural areas. The findings contribute to an understanding of the spatial dynamics of tourism within the region of Cumbria through the creation of thematized maps. Different zones of tourism industry clusters are identified, which include elements relating to attractions, enterprises, infrastructure, tourism employment and economic impact. These maps visualize hot and cold spots relating to a variety of tourism contexts. It is believed that the strategy used to provide a visual overview of tourism development and demand in Cumbria could provide a strategic tool for rural areas to better plan marketing opportunities and avoid overtourism. These findings can inform future sustainability policy and destination management strategies within the areas through an understanding of the processes behind the emergence of both hot and cold spots. It may mean that attract and disperse needs to be reviewed in terms of a strategic option. In other words, to use sector or zonal policies for the individual hot or cold areas with transitional zones dependent upon local economic, social and environmental factors.

Keywords: overtourism, rural tourism, sustainable tourism, tourism planning, tourism zones

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Authors: Vasundhara Arora, Anupam Jhobta, Suresh Thakur, Sanjiv Sharma

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Aims and Objectives: Intracranial tuberculosis (TB) is one of the most devastating manifestations of TB and a challenging public health issue of considerable importance and magnitude world over. This study elaborates on the imaging spectrum of neurotuberculosis on magnetic resonance imaging (MRI) in 29 clinically suspected cases from a tertiary care hospital. Materials and Methods: The prospective hospital based evaluation of MR imaging features of neuro-tuberculosis in 29 clinically suspected cases was carried out in Department of Radio-diagnosis, Indira Gandhi Medical Hospital from July 2017 to August 2018. MR Images were obtained on a 1.5 T Magnetom Avanto machine and were analyzed to identify any abnormal meningeal enhancement or parenchymal lesions. Microbiological and Biochemical CSF analysis was performed in radio-logically suspected cases and the results were compared with the imaging data. Clinical follow up of the patients started on anti-tuberculous treatment was done to evaluate the response to treatment and clinical outcome. Results: Age range of patients in the study was between 1 year to 73 years. The mean age of presentation was 11.5 years. No significant difference in the distribution of cerebral tuberculosis was noted among the two genders. Imaging findings of neuro-tuberculosis obtained were varied and non specific ranging from lepto-meningeal enhancement, cerebritis to space occupying lesions such as tuberculomas and tubercular abscesses. Complications presenting as hydrocephalus (n= 7) and infarcts (n=9) was noted in few of these patients. 29 patients showed radiological suspicion of CNS tuberculosis with meningitis alone observed in 11 cases, tuberculomas alone were observed in 4 cases, meningitis with parenchymal tuberculomas in 11 cases. Tubercular abscess and cerebritis were observed in one case each. Tuberculous arachnoiditis was noted in one patient. Gene expert positivity was obtained in 11 out of 29 radiologically suspected patients; none of the patients showed culture positivity. Meningeal form of the disease alone showed higher positivity rate of gene Xpert (n=5) followed by combination of meningeal and parenchymal forms of disease (n=4). The parenchymal manifestation of disease alone showed least positivity rates (n= 3) with gene xpert testing. All 29 patients were started on anti tubercular treatment based on radiological suspicion of the disease with clinical improvement observed in 27 treated patients. Conclusions: In our study, higher incidence of neuro- tuberculosis was noted in paediatric population with predominance of the meningeal form of the disease. Gene Xpert positivity obtained was low due to paucibacillary nature of cerebrospinal fluid (CSF) with even lower positivity of CSF samples in parenchymal form of the manifestation. MRI showed high accuracy in detecting CNS lesions in neuro-tuberculosis. Hence, it can be concluded that MRI plays a crucial role in the diagnosis because of its inherent sensitivity and specificity and is an indispensible imaging modality. It caters to the need of early diagnosis owing to poor sensitivity of microbiological tests more so in the parenchymal manifestation of the disease.

Keywords: neurotuberculosis, tubercular abscess, tuberculoma, tuberculous meningitis

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Authors: Vinod Kumar

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Background: Tissue Plasminogen Activator (tPA) showed a level 1 benefit in acute stroke (within 3-6 hrs). Intracarotid sodium nitroprusside (ICSNP) has been studied in this context with a wide treatment window, fast recovery and affordability. This work proposes two mechanisms for acute cases and one mechanism for chronic cases, which are interrelated, for physiological recovery. a)Retrograde Neurotransmission (acute cases): 1)Normal excitatory impulse: at the synaptic level, glutamate activates NMDA receptors, with nitric oxide synthetase (NOS) on the postsynaptic membrane, for further propagation by the calcium-calmodulin complex. Nitric oxide (NO, produced by NOS) travels backward across the chemical synapse and binds the axon-terminal NO receptor/sGC of a presynaptic neuron, regulating anterograde neurotransmission (ANT) via retrograde neurotransmission (RNT). Heme is the ligand-binding site of the NO receptor/sGC. Heme exhibits > 10,000-fold higher affinity for NO than for oxygen (the 10,000-fold effect) and is completed in 20 msec. 2)Pathological conditions: normal synaptic activity, including both ANT and RNT, is absent. A NO donor (SNP) releases NO from NOS in the postsynaptic region. NO travels backward across a chemical synapse to bind to the heme of a NO receptor in the axon terminal of a presynaptic neuron, generating an impulse, as under normal conditions. b)Vasospasm: (acute cases) Perforators show vasospastic activity. NO vasodilates the perforators via the NO-cAMP pathway. c)Long-Term Potentıatıon (LTP): (chronic cases) The NO–cGMP-pathway plays a role in LTP at many synapses throughout the CNS and at the neuromuscular junction. LTP has been reviewed both generally and with respect to brain regions specific for memory/learning. Aims/Study Des’gn: The principles of “generation of impulses from the presynaptic region to the postsynaptic region by very potent RNT (10,000-fold effect)” and “vasodilation of arteriolar perforators” are the basis of the authors’ hypothesis to treat stroke cases. Case-control prospective study. Mater’als And Methods: The experimental population included 82 stroke patients (10 patients were given control treatments without superfusion or with 5% dextrose superfusion, and 72 patients comprised the ICSNP group). The mean time for superfusion was 9.5 days post-stroke. Pre- and post-ICSNP status was monitored by NIHSS, MRI and TCD. Results: After 90 seconds in the ICSNP group, the mean change in the NIHSS score was a decrease of 1.44 points, or 6.55%; after 2 h, there was a decrease of 1.16 points; after 24 h, there was an increase of 0.66 points, 2.25%, compared to the control-group increase of 0.7 points, or 3.53%; at 7 days, there was an 8.61-point decrease, 44.58%, compared to the control-group increase of 2.55 points, or 22.37%; at 2 months in ICSNP, there was a 6.94-points decrease, 62.80%, compared to the control-group decrease of 2.77 points, or 8.78%. TCD was documented and improvements were noted. Conclusions: ICSNP is a swift-acting drug in the treatment of stroke, acting within 90 seconds on day 9.5 post-stroke with a small decrease after 24 hours. The drug recovers from this decrease quickly.

Keywords: brain infarcts, intracarotid sodium nitroprusside, perforators, vasodilatıons, retrograde transmission, the 10, 000-fold effect

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Authors: Masood Otarod, Ronald M. Supkowski

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This abstract discusses a method that reduces the general dispersion model in cylindrical coordinates to a second order linear ordinary differential equation with constant coefficients so that it can be utilized to conduct kinetic studies in packed bed tubular catalytic reactors at a broad range of Reynolds numbers. The model was tested by 13CO isotope transient tracing of the CO adsorption of Boudouard reaction in a differential reactor at an average Reynolds number of 0.2 over Pd-Al2O3 catalyst. Detailed experimental results have provided evidence for the validity of the theoretical framing of the model and the estimated parameters are consistent with the literature. The solution of the general dispersion model requires the knowledge of the radial distribution of axial velocity. This is not always known. Hence, up until now, the implementation of the dispersion model has been largely restricted to the plug-flow regime. But, ideal plug-flow is impossible to achieve and flow regimes approximating plug-flow leave much room for debate as to the validity of the results. The reduction of the general dispersion model transpires as a result of the application of a factorization theorem. Factorization theorem is derived from the observation that a cross section of a catalytic bed consists of a solid phase across which the reaction takes place and a void or porous phase across which no significant measure of reaction occurs. The disparity in flow and the heterogeneity of the catalytic bed cause the concentration of reacting compounds to fluctuate radially. These variabilities signify the existence of radial positions at which the radial gradient of concentration is zero. Succinctly, factorization theorem states that a concentration function of axial and radial coordinates in a catalytic bed is factorable as the product of the mean radial cup-mixing function and a contingent dimensionless function. The concentration of adsorbed compounds are also factorable since they are piecewise continuous functions and suffer the same variability but in the reverse order of the concentration of mobile phase compounds. Factorability is a property of packed beds which transforms the general dispersion model to an equation in terms of the measurable mean radial cup-mixing concentration of the mobile phase compounds and mean cross-sectional concentration of adsorbed species. The reduced model does not require the knowledge of the radial distribution of the axial velocity. Instead, it is characterized by new transport parameters so denoted by Ωc, Ωa, Ωc, and which are respectively denominated convection coefficient cofactor, axial dispersion coefficient cofactor, and radial dispersion coefficient cofactor. These cofactors adjust the dispersion equation as compensation for the unavailability of the radial distribution of the axial velocity. Together with the rest of the kinetic parameters they can be determined from experimental data via an optimization procedure. Our data showed that the estimated parameters Ωc, Ωa Ωr, are monotonically correlated with the Reynolds number. This is expected to be the case based on the theoretical construct of the model. Computer generated simulations of methanation reaction on nickel provide additional support for the utility of the newly conceptualized dispersion model.

Keywords: factorization, general dispersion model, isotope transient kinetic, partial differential equations

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Authors: Amenah Dhannoon, Ciaran Martin Hurley, Laura Wrafter, Podraic J. Regan

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Introduction: The COVID-19 pandemic continues to present unprecedented challenges for healthcare systems. This has resulted in the pragmatic shift in the practice of plastic surgery units worldwide. During this period, many units reported a significant fall in urgent melanoma referrals, leading to patients presenting with advanced disease requiring more extensive surgery and inferior outcomes. Our objective was to evaluate our unit's experience with both non-invasive and invasive melanoma during the COVID-19 pandemic and characterize our experience and contrast it to that experienced by our neighbors in the UK, mainland Europe and North America. Methods: a retrospective chart review was performed on all patients diagnosed with invasive and non-invasive cutaneous melanoma between March to December of 2019 (control) compared to 2020 (COVID-19 pandemic) in a single plastic surgery unit in Ireland. Patient demographics, referral source, surgical procedures, tumour characteristics, radiological findings, oncological therapies and follow-up were recorded. All data were anonymized and stored in Microsoft Excel. Results: A total of 589 patients were included in the study. Of these, 314 (53%) with invasive melanoma, compared to 275 (47%) with the non-invasive disease. Overall, more patients were diagnosed with both invasive and non-invasive melanoma in 2020 than in 2019 (p<0.05). However, significantly longer waiting times in 2020 (64 days) compared to 2019 (28 days) (p<0.05), with the majority of the referral being from GP in 2019 (83%) compared to 61% in 2020. Positive sentinel lymph node were higher in 2019 at 56% (n=28) compared to 24% (n=22) in 2020. There was no statistically significant difference in the tutor characteristics or metastasis status. Discussion: While other countries have noticed a fall in the melanoma diagnosis. Our units experienced a higher number of disease diagnoses. This can be due to multiple reasons. In Ireland, the government reached an early agreement with the private sector to continue elective surgery on an urgent basis in private hospitals. This allowed access to local anesthetic procedures and local skin cancer cases were triaged to non-COVID-19 provider centers. Our unit also adapted a fast, effective and minimal patient contact strategy for triaging skin cancer based on telemedicine. Thirdly, a skin cancer nurse specialist maintained patient follow-ups and triaging a dedicated email service. Finally, our plastic surgery service continued to maintain a virtual complex skin cancer multidisciplinary team meeting during the pandemic, ensuring local clinical governance has adhered to each clinical case. Conclusion: Our study highlights that with the prompt efficient restructuring of services, we could reserve successful management of skin cancer even in the most devastating times. It is important to reflect on the success during the pandemic and emphasize the importance of preparation for a potentially difficult future

Keywords: malignant melanoma, skin cancer, COVID-19, triage

Procedia PDF Downloads 149

Authors: Ling Ai, Ziyu Zhao, Zeyu Zhou, Xiaochen Yang, Heng Zhai, Stuart Holmes

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Optimizing the catalyst layer structure is crucial for enhancing the performance of proton exchange membrane fuel cells (PEMFCs) with low Platinum (Pt) loading. Current works focused on the utilization, durability, and site activity of Pt particles on support, and performance enhancement has been achieved by loading Pt onto porous support with different morphology, such as graphene, carbon fiber, and carbon black. Some schemes have also incorporated cost considerations to achieve lower Pt loading. However, the design of the catalyst layer (CL) structure in the membrane electrode assembly (MEA) must consider the interactions between the layers. Addressing the crucial aspects of water management, low contact resistance, and the establishment of effective three-phase boundary for MEA, multi-walled carbon nanotubes (MWCNTs) are promising CL support due to their intrinsically high hydrophobicity, high axial electrical conductivity, and potential for ordered alignment. However, the drawbacks of MWCNTs, such as strong agglomeration, wall surface chemical inertness, and unopened ends, are unfavorable for Pt nanoparticle loading, which is detrimental to MEA processing and leads to inhomogeneous CL surfaces. This further deteriorates the utilization of Pt and increases the contact resistance. Robust chemical oxidation or nitrogen doping can introduce polar functional groups onto the surface of MWCNTs, facilitating the creation of open tube ends and inducing defects in tube walls. This improves dispersibility and load capacity but reduces length and conductivity. Consequently, a trade-off exists between maintaining the intrinsic properties and the degree of functionalization of MWCNTs. In this work, MWCNTs were modified based on the operational requirements of the MEA from the viewpoint of interlayer interactions, including the search for the optimal degree of oxidation, N-doping, and micro-arrangement. MWCNT were functionalized by oxidizing, N-doping, as well as micro-alignment to achieve lower contact resistance between CL and proton exchange membrane (PEM), better hydrophobicity, and enhanced performance. Furthermore, this work expects to construct a more continuously distributed three-phase boundary by aligning MWCNT to form a locally ordered structure, which is essential for the efficient utilization of Pt active sites. Different from other chemical oxidation schemes that used HNO3:H2SO4 (1:3) mixed acid to strongly oxidize MWCNT, this scheme adopted pure HNO3 to partially oxidize MWCNT at a lower reflux temperature (80 ℃) and a shorter treatment time (0 to 10 h) to preserve the morphology and intrinsic conductivity of MWCNT. The maximum power density of 979.81 mw cm-2 was achieved by Pt loading on 6h MWCNT oxidation time (Pt-MWCNT6h). This represented a 59.53% improvement over the commercial Pt/C catalyst of 614.17 (mw cm-2). In addition, due to the stronger electrical conductivity, the charge transfer resistance of Pt-MWCNT6h in the electrochemical impedance spectroscopy (EIS) test was 0.09 Ohm cm-2, which was 48.86% lower than that of Pt/C. This study will discuss the developed catalysts and their efficacy in a working fuel cell system. This research will validate the impact of low-functionalization modification of MWCNTs on the performance of PEMFC, which simplifies the preparation challenges of CL and contributing for the widespread commercial application of PEMFCs on a larger scale.

Keywords: carbon nanotubes, electrocatalyst, membrane electrode assembly, proton exchange membrane fuel cell

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Authors: Olga A. Momot, Boris I. Synzynys, Alla A. Oudalova

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Obninsk is situated in the Kaluga region 100 km southwest of Moscow on the left bank of the Protva River. Several enterprises utilizing nuclear energy are operating in the town. A special attention in the region where radiation-hazardous facilities are located has traditionally been paid to radioactive gas and aerosol releases into the atmosphere; liquid waste discharges into the Protva river and groundwater pollution. Municipal intakes involve 34 wells arranged 15 km apart in a sequence north-south along the foot of the left slope of the Protva river valley. Northern and southern water intakes are upstream and downstream of the town, respectively. They belong to river valley intakes with mixed feeding, i.e. precipitation infiltration is responsible for a smaller part of groundwater, and a greater amount is being formed by overflowing from Protva. Water intakes are maintained by the Protva river runoff, the volume of which depends on the precipitation fallen out and watershed area. Groundwater contamination with tritium was first detected in a sanitary-protective zone of the Institute of Physics and Power Engineering (SRC-IPPE) by Roshydromet researchers when realizing the “Program of radiological monitoring in the territory of nuclear industry enterprises”. A comprehensive survey of the SRC-IPPE’s industrial site and adjacent territories has revealed that research nuclear reactors and accelerators where tritium targets are applied as well as radioactive waste storages could be considered as potential sources of technogenic tritium. All the above sources are located within the sanitary controlled area of intakes. Tritium activity in water of springs and wells near the SRC-IPPE is about 17.4 – 3200 Bq/l. The observed values of tritium activity are below the intervention levels (7600 Bq/l for inorganic compounds and 3300 Bq/l for organically bound tritium). The risk has being assessed to estimate possible effect of considered tritium concentrations on human health. Data on tritium concentrations in pipe-line drinking water were used for calculations. The activity of 3H amounted to 10.6 Bq/l and corresponded to the risk of such water consumption of ~ 3·10-7 year-1. The risk value given in magnitude is close to the individual annual death risk for population living near a NPP – 1.6·10-8 year-1 and at the same time corresponds to the level of tolerable risk (10-6) and falls within “risk optimization”, i.e. in the sphere for planning the economically sound measures on exposure risk reduction. To estimate the chemical risk, physical and chemical analysis was made of waters from all springs and wells near the SRC-IPPE. Chemical risk from groundwater contamination was estimated according to the EPA US guidance. The risk of carcinogenic diseases at a drinking water consumption amounts to 5·10-5. According to the classification accepted the health risk in case of spring water consumption is inadmissible. The compared assessments of risk associated with tritium exposure, on the one hand, and the dangerous chemical (e.g. heavy metals) contamination of Obninsk drinking water, on the other hand, have confirmed that just these chemical pollutants are responsible for health risk.

Keywords: radiation-hazardous facilities, water intakes, tritium, heavy metal, health risk

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Authors: Francesco Pandolfi, Georgios Baltzopoulos, Iunio Iervolino

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The impact of extreme winds on industrial assets and the built environment is gaining increasing attention from stakeholders, including the corporate insurance industry. This has led to a progressively more in-depth study of building vulnerability and fragility to wind. Wind vulnerability models are used in probabilistic risk assessment to relate a loss metric to an intensity measure of the natural event, usually a gust or a mean wind speed. In fact, vulnerability models can be integrated with the wind hazard, which consists of associating a probability to each intensity level in a time interval (e.g., by means of return periods) to provide an assessment of future losses due to extreme wind. This has also given impulse to the world- and regional-scale wind hazard studies.Another approach often adopted for the probabilistic description of building vulnerability to the wind is the use of fragility functions, which provide the conditional probability that selected building components will exceed certain damage states, given wind intensity. In fact, in wind engineering literature, it is more common to find structural system- or component-level fragility functions rather than wind vulnerability models for an entire building. Loss assessment based on component fragilities requires some logical combination rules that define the building’s damage state given the damage state of each component and the availability of a consequence model that provides the losses associated with each damage state. When risk calculations are based on numerical simulation of a structure’s behavior during extreme wind scenarios, the interaction of component fragilities is intertwined with the computational procedure. However, simulation-based approaches are usually computationally demanding and case-specific. In this context, the present work introduces the ExtReMe wind risk assESsment prototype Software, ERMESS, which is being developed at the University of Naples Federico II. ERMESS is a wind risk assessment tool for insurance applications to industrial facilities, collecting a wide assortment of available wind vulnerability models and fragility functions to facilitate their incorporation into risk calculations based on in-built or user-defined wind hazard data. This software implements an alternative method for building-specific risk assessment based on existing component-level fragility functions and on a number of simplifying assumptions for their interactions. The applicability of this alternative procedure is explored by means of an illustrative proof-of-concept example, which considers four main building components, namely: the roof covering, roof structure, envelope wall and envelope openings. The application shows that, despite the simplifying assumptions, the procedure can yield risk evaluations that are comparable to those obtained via more rigorous building-level simulation-based methods, at least in the considered example. The advantage of this approach is shown to lie in the fact that a database of building component fragility curves can be put to use for the development of new wind vulnerability models to cover building typologies not yet adequately covered by existing works and whose rigorous development is usually beyond the budget of portfolio-related industrial applications.

Keywords: component wind fragility, probabilistic risk assessment, vulnerability model, wind-induced losses

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Authors: Corneliu-Ioan Dimitriu, Gheorghe Frățilă

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Romania and Bulgaria have high rates of road deaths per million inhabitants. Directive (EU) 2019/1936, known as the RISM Directive, has been transposed into national law by each Member State. The research focuses on the amendments made to Romanian legislation through Government Ordinance no. 3/2022, which aims to improve road safety management on infrastructure. The aim of the research is two-fold: to sensitize the Romanian Government and decision-making entities to develop an integrated and competitive management system and to establish a safe and proactive mobility system that ensures efficient and safe roads. The research includes a critical analysis of European and Romanian legislation, as well as subsequent normative acts related to road infrastructure safety management. Public data from European Union and national authorities, as well as data from the Romanian Road Authority-ARR and Traffic Police database, are utilized. The research methodology involves comparative analysis, criterion analysis, SWOT analysis, and the use of GANTT and WBS diagrams. The Excel tool is employed to process the road accident databases of Romania and Bulgaria. Collaboration with Bulgarian specialists is established to identify common road infrastructure safety issues. The research concludes that the legislative changes have resulted in a relaxation of road safety management in Romania, leading to decreased control over certain management procedures. The amendments to primary and secondary legislation do not meet the current safety requirements for road infrastructure. The research highlights the need for legislative changes and strengthened administrative capacity to enhance road safety. Regional cooperation and the exchange of best practices are emphasized for effective road infrastructure safety management. The research contributes to the theoretical understanding of road infrastructure safety management by analyzing legislative changes and their impact on safety measures. It highlights the importance of an integrated and proactive approach in reducing road accidents and achieving the "zero deaths" objective set by the European Union. Data collection involves accessing public data from relevant authorities and using information from the Romanian Road Authority-ARR and Traffic Police database. Analysis procedures include critical analysis of legislation, comparative analysis of transpositions, criterion analysis, and the use of various diagrams and tools such as SWOT, GANTT, WBS, and Excel. The research addresses the effectiveness of legislative changes in road infrastructure safety management in Romania and the impact on control over management procedures. It also explores the need for strengthened administrative capacity and regional cooperation in addressing road safety issues. The research concludes that the legislative changes made in Romania have not strengthened road safety management and emphasize the need for immediate action, legislative amendments, and enhanced administrative capacity. Collaboration with Bulgarian specialists and the exchange of best practices are recommended for effective road infrastructure safety management. The research contributes to the theoretical understanding of road safety management and provides valuable insights for policymakers and decision-makers in Romania.

Keywords: management, road infrastructure safety, legislation, amendments, collaboration

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Authors: V. K. Tewari, M. Hussain, H. K. D. Gupta

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Background: Nitric Oxide Donars (NODs) (intrathecal sodium nitroprusside (ITSNP) and oral tadalafil 20mg post ITSNP) has been studied in this context in cerebral palsy patients for fast recovery. This work proposes two mechanisms for acute cases and one mechanism for chronic cases, which are interrelated, for physiological recovery. a) Retrograde Neurotransmission (acute cases): 1) Normal excitatory impulse: at the synaptic level, glutamate activates NMDA receptors, with nitric oxide synthetase (NOS) on the postsynaptic membrane, for further propagation by the calcium-calmodulin complex. Nitric oxide (NO, produced by NOS) travels backward across the chemical synapse and binds the axon-terminal NO receptor/sGC of a presynaptic neuron, regulating anterograde neurotransmission (ANT) via retrograde neurotransmission (RNT). Heme is the ligand-binding site of the NO receptor/sGC. Heme exhibits > 10,000-fold higher affinity for NO than for oxygen (the 10,000-fold effect) and is completed in 20 msec. 2) Pathological conditions: normal synaptic activity, including both ANT and RNT, is absent. A NO donor (SNP) releases NO from NOS in the postsynaptic region. NO travels backward across a chemical synapse to bind to the heme of a NO receptor in the axon terminal of a presynaptic neuron, generating an impulse, as under normal conditions. b) Vasopasm: (acute cases) Perforators show vasospastic activity. NO vasodilates the perforators via the NO-cAMP pathway. c) Long-Term Potentiation (LTP): (chronic cases) The NO–cGMP-pathway plays a role in LTP at many synapses throughout the CNS and at the neuromuscular junction. LTP has been reviewed both generally and with respect to brain regions specific for memory/learning. Aims/Study Design: The principles of “generation of impulses from the presynaptic region to the postsynaptic region by very potent RNT (10,000-fold effect)” and “vasodilation of arteriolar perforators” are the basis of the authors’ hypothesis to treat cerebral palsy cases. Case-control prospective study. Materials and Methods: The experimental population included 82 cerebral palsy patients (10 patients were given control treatments without NOD or with 5% dextrose superfusion, and 72 patients comprised the NOD group). The mean time for superfusion was 5 months post-cerebral palsy. Pre- and post-NOD status was monitored by Gross Motor Function Classification System for Cerebral Palsy (GMFCS), MRI, and TCD studies. Results: After 7 days in the NOD group, the mean change in the GMFCS score was an increase of 1.2 points mean; after 3 months, there was an increase of 3.4 points mean, compared to the control-group increase of 0.1 points at 3 months. MRI and TCD documented the improvements. Conclusions: NOD (ITSNP boosts up the recovery and oral tadalafil maintains the recovery to a well-desired level) acts swiftly in the treatment of CP, acting within 7 days on 5 months post-cerebral palsy either of the three mechanisms.

Keywords: cerebral palsy, intrathecal sodium nitroprusside, oral tadalafil, perforators, vasodilations, retrograde transmission, the 10, 000-fold effect, long-term potantiation

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Authors: Lhoussain Simour

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This paper discusses the reordering and reorientation Moroccan Oossified and frozen histories in national and colonial archives. It attempts to reexamine Moroccan non-canonical voices beyond borders, their forgotten experiences and itineraries, with the aim of uncovering cultural discourses pertaining to early cultural and artistic interactions between Morocco and the western countries, namely Britain and America. In fact, less attention has been given to the presence of Moroccan entertainers beyond borders in the archives of history. Moroccan historians and cultural critics seem to have paid little critical consideration to Moroccan artistic encounters with the west, Europe and America as a case in point. They have overlooked to deal with travel performances, professional entertainments, and artistic spectacles, initiated by acrobats, as instances of visual cross-cultural encounters between Morocco and the west. The narratives of these professional artists have hardly found their ways into historiographical writing. This contribution attempts to locate the contesting beginnings of Moroccan professional entertainers in western show business in the nineteenth century which witnessed intricate artistic, discursive and cultural junctures by emphasizing connections between theatrical performances, ethnic exhibition and world fair expositions. Moroccan professional performances grew in Europe and America within a zealous context marked by the rise of a paradigmatic racial consciousness that sought to authenticate and legitimate ethnic discourses of power and exclusion. The ethnic taxonomies and racial hierarchies governed by ethnographic and anthropological documentation fueled up entertainment venues and popular theatrical performances and helped in developing a distinctive view about Self and Other paradigms. Moroccan travelers started their journeys to visit European and American countries to exhibit their acrobatics acts. They, in a certain sense, continued, albeit in varying degrees and circumstances, the whole tradition of travel initiated previously by their ancestor diplomats and ambassadors. Professional entertainers embarked on daring journeys across the Mediterranean and the Atlantic to discover new geographies and cultural spaces, and perform their spectacles beyond borders. These travelers left rich archival documents that reflect important cultural and historical moments. The routes of travel started from the margins of the empire towards metropolitan centers of nineteenth century Europe and America included Moroccan women travelers as acrobats and dancing professional artists as well. These also crossed the straits of Gibraltar and journeyed through the Atlantic Ocean to visit western countries. Moroccan women travelers took part in various Euro-American theatre performances and in circus shows as early as 1850 according to newspapers archives and passengers shipping lists. Najat Amburg, Zahar Ben Tahar, Torquia, Fadma, and many more whose names are now lost to us, moved freely in various western capital cities to entertain nineteenth century western audiences.

Keywords: archives, cultural encounters, self and other, Morocco, travel, Moroccan acrobats, Moorish dancing women

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Authors: Yaser S. Kishawi, Sadi R. Ali

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Part of Palestine, Gaza Strip (365 km2 and 1.8 million inhabitants) is considered a semi-arid zone relies solely on the Coastal Aquifer. The coastal aquifer is only source of water with only 5-10% suitable for human use. This barely cover the domestic and agricultural needs of Gaza Strip. Palestinian Water Authority Strategy is finding non-conventional water resource from treated wastewater to cover agricultural requirements and serve the population. A new WWTP project is to replace the old-overloaded Biet Lahia WWTP. The project consists of three parts; phase A (pressure line & infiltration basins - IBs), phase B (a new WWTP) and phase C (Recovery and Reuse Scheme – RRS – to capture the spreading plume). Currently, only phase A is functioning. Nearly 23 Mm3 of partially treated wastewater were infiltrated into the aquifer. Phase B and phase C witnessed many delays and this forced a reassessment of the RRS original design. An Environmental Management Plan was conducted from Jul 2013 to Jun 2014 on 13 existing monitoring wells surrounding the project location. This is to measure the efficiency of the SAT system and the spread of the contamination plume with relation to the efficiency of the proposed RRS. Along with the proposed location of the 27 recovery wells as part of the proposed RRS. The results of monitored wells were assessed compared with PWA baseline data. This was put into a groundwater model to simulate the plume to propose the best suitable solution to the delays. The redesign mainly manipulated the pumping rate of wells, proposed locations and functioning schedules (including wells groupings). The proposed simulations were examined using visual MODFLOW V4.2 to simulate the results. The results of monitored wells were assessed based on the location of the monitoring wells related to the proposed recovery wells locations (200m, 500m and 750m away from the IBs). Near the 500m line (the first row of proposed recovery wells), an increase of nitrate (from 30 to 70mg/L) compare to a decrease in Chloride (1500 to below 900mg/L) was found during the monitoring period which indicated an expansion of plume to this distance. On this rate with the required time to construct the recovery scheme, keeping the original design the RRS will fail to capture the plume. Based on that many simulations were conducted leading into three main scenarios. The scenarios manipulated the starting dates, the pumping rate and the locations of recovery wells. A simulation of plume expansion and path-lines were extracted from the model monitoring how to prevent the expansion towards the nearby municipal wells. It was concluded that the location is the most important factor in determining the RRS efficiency. Scenario III was adopted and showed an effective results even with a reduced pumping rates. This scenario proposed adding two additional recovery wells in a location beyond the 750m line to compensate the delays and effectively capture the plume. A continuous monitoring program for current and future monitoring wells should be in place to support the proposed scenario and ensure maximum protection.

Keywords: soil aquifer treatment, recovery and reuse scheme, infiltration basins, north gaza

Procedia PDF Downloads 290

Authors: T. N. Tran Thi, J. Morse, C. Detlefs, P. K. Cook, C. Yıldırım, A. C. Jakobsen, T. Zhou, J. Hartwig, V. Zurbig, D. Caliste, B. Fernandez, D. Eon, O. Loto, M. L. Hicks, A. Pakpour-Tabrizi, J. Baruchel

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The ability to grow boron-doped diamond epilayers of high crystalline quality is a prerequisite for the fabrication of diamond power electronic devices, in particular high voltage diodes and metal-oxide-semiconductor (MOS) transistors. Boron and intrinsic diamond layers are homoepitaxially overgrown by microwave assisted chemical vapour deposition (MWCVD) on single crystal high pressure, high temperature (HPHT) grown bulk diamond substrates. Various epilayer thicknesses were grown, with dopant concentrations ranging from 1021 atom/cm³ at nanometer thickness in the case of 'delta doping', up 1016 atom/cm³ and 50µm thickness or high electric field drift regions. The crystalline quality of these overgrown layers as regards defects, strain, distortion… is critical for the device performance through its relation to the final electrical properties (Hall mobility, breakdown voltage...). In addition to the optimization of the epilayer growth conditions in the MWCVD reactor, other important questions related to the crystalline quality of the overgrown layer(s) are: 1) what is the dependence on the bulk quality and surface preparation methods of the HPHT diamond substrate? 2) how do defects already present in the substrate crystal propagate into the overgrown layer; 3) what types of new defects are created during overgrowth, what are their growth mechanisms, and how can these defects be avoided? 4) how can we relate in a quantitative manner parameters related to the measured crystalline quality of the boron doped layer to the electronic properties of final processed devices? We describe synchrotron-based techniques developed to address these questions. These techniques allow the visualization of local defects and crystal distortion which complements the data obtained by other well-established analysis methods such as AFM, SIMS, Hall conductivity…. We have used Grazing Incidence X-ray Diffraction (GIXRD) at the ID01 beamline of the ESRF to study lattice parameters and damage (strain, tilt and mosaic spread) both in diamond substrate near surface layers and in thick (10–50 µm) overgrown boron doped diamond epi-layers. Micro- and nano-section topography have been carried out at both the BM05 and ID06-ESRF) beamlines using rocking curve imaging techniques to study defects which have propagated from the substrate into the overgrown layer(s) and their influence on final electronic device performance. These studies were performed using various commercially sourced HPHT grown diamond substrates, with the MWCVD overgrowth carried out at the Fraunhofer IAF-Germany. The synchrotron results are in good agreement with low-temperature (5°K) cathodoluminescence spectroscopy carried out on the grown samples using an Inspect F5O FESEM fitted with an IHR spectrometer.

Keywords: synchrotron X-ray diffaction, crystalline quality, defects, diamond overgrowth, rocking curve imaging

Procedia PDF Downloads 234

Authors: Aurora Sheehy, Caitlin Prince

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Within current orthodox medical protocols, trauma and mental health issues are deemed to reside within the realm of cognitive or psychological therapists and are marginalised in these areas, in part due to limited drugs option available, mostly manipulating neurotransmitters or sedating patients to reduce symptoms. By contrast, this research presents examples from the clinical practice of how trauma can be assessed and treated physiologically. Adverse Childhood Experiences (ACEs) are a tally of different types of abuse and neglect. It has been used as a measurable and reliable predictor of the likelihood of the development of autoimmune disease. It is a direct way to demonstrate reliably the health impact of traumatic life experiences. A second assessment tool is Allostatic Load, which refers to the cumulative effects that chronic stress has on mental and physical health. It records the decline of an individual’s physiological capacity to cope with their experience. It uses a specific grouping of serum testing and physical measures. It includes an assessment of neuroendocrine, cardiovascular, immune and metabolic systems. Allostatic load demonstrates the health impact that trauma has throughout the body. It forms part of an initial intake assessment in clinical practice and could also be used in research to evaluate treatment. Examining medicinal plants for their physiological, neurological and somatic effects through the lens of Polyvagal theory offers new opportunities for trauma treatments. In situations where Polyvagal theory recommends activities and exercises to enable parasympathetic activation, many herbs that affect Effector Memory T (TEM) cells also enact these responses. Traditional or Indigenous European herbs show the potential to support the polyvagal tone, through multiple mechanisms. As the ventral vagal nerve reaches almost every major organ, plants that have actions on these tissues can be understood via their polyvagal actions, such as monoterpenes as agents to improve respiratory vagal tone, cyanogenic glycosides to reset polyvagal tone, volatile oils rich in phenyl methyl esters improve both sympathetic and parasympathetic tone, bitters activate gut function and can strongly promote parasympathetic regulation. Auricular Acupuncture uses a system of somatotopic mapping of the auricular surface overlaid with an image of an inverted foetus with each body organ and system featured. Given that the concha of the auricle is the only place on the body where the Vagus Nerve neurons reach the surface of the skin, several investigators have evaluated non-invasive, transcutaneous electrical nerve stimulation (TENS) at auricular points. Drawn from an interdisciplinary evidence base and developed through clinical practice, these assessment and treatment tools are examples of practitioners in the field innovating out of necessity for the best outcomes for patients. This paper draws on case studies to direct future research.

Keywords: polyvagal, auricular acupuncture, trauma, herbs

Procedia PDF Downloads 54

Authors: Lourenco Camnahas, Eileen Willis, Greg Fisher, Jessie Gunson, Pascale Dettwiller, Charlene Thornton

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Stock-out of pharmaceuticals is a common issue at all level of health services in Timor-Leste, a small post-conflict country. This lead to the research questions: what are the current methods used to quantify pharmaceutical supplies; what factors contribute to the on-going pharmaceutical stock-out? The study examined factors that influence the pharmaceutical supply chain system. Methodology: Privett and Goncalvez dependency model has been adopted for the design of the qualitative interviews. The model examines pharmaceutical supply chain management at three management levels: management of individual pharmaceutical items, health facilities, and health systems. The interviews were conducted in order to collect information on inventory management, logistics management information system (LMIS) and the provision of pharmaceuticals. Andersen' behavioural model for healthcare utilization also informed the interview schedule, specifically factors linked to environment (healthcare system and external environment) and the population (enabling factors). Forty health professionals (bureaucrats, clinicians) and six senior officers from a United Nations Agency, a global multilateral agency and a local non-governmental organization were interviewed on their perceptions of factors (healthcare system/supply chain and wider environment) impacting on stock out. Additionally, policy documents for the entire healthcare system, along with population data were collected. Findings: An analysis using Pozzebon’s critical interpretation identified a range of difficulties within the system from poor coordination to failure to adhere to policy guidelines along with major difficulties with inventory management, quantification, forecasting, and budgetary constraints. Weak logistics management information system, lack of capacity in inventory management, monitoring and supervision are additional organizational factors that also contributed to the issue. There were various methods of quantification of pharmaceuticals applied in the government sector, and non-governmental organizations. Lack of reliable data is one of the major problems in the pharmaceutical provision. Global Fund has the best quantification methods fed by consumption data and malaria cases. There are other issues that worsen stock-out: political intervention, work ethic and basic infrastructure such as unreliable internet connectivity. Major issues impacting on pharmaceutical quantification have been identified. However, current data collection identified limitations within the Andersen model; specifically, a failure to take account of predictors in the healthcare system and the environment (culture/politics/social. The next step is to (a) compare models used by three non-governmental agencies with the government model; (b) to run the Andersen explanatory model for pharmaceutical expenditure for 2 to 5 drug items used by these three development partners in order to see how it correlates with the present model in terms of quantification and forecasting the needs; (c) to repeat objectives (a) and (b) using the government model; (d) to draw a conclusion about the strength.

Keywords: inventory management, pharmaceutical forecasting and quantification, pharmaceutical stock-out, pharmaceutical supply chain management

Procedia PDF Downloads 194