**Abstract**

Assisted reproductive technology (ART) has been widely used for infertility treatment, but many people have concern about their baby's health. The objective of this chapter is to provide some detailed data about the effect of ART on human birth babies by analyzing the data from in vitro fertilization (IVF) centers in two countries. All recent records related to a baby's birth including mother's age, gestational days, baby's sex, and birth weight data were collected and analyzed according to fresh or frozen embryo transfer procedure. Normal delivery data without ART were used as control. The result showed that ART patient age is significantly older than non-IVF women; the gestation of fresh and frozen embryo transfer is the same as normal spontaneous conception gestation days, but women pregnant with multiple gestations have shorter gestational period and early birth rate as well as low birth weight; and there is no significant difference in the baby's weight between ART singleton babies and normal conception babies, but male babies weight is more than female babies, and multiple gestation's birth weights are significantly lower than singletons, while frozen embryo transfer babies have significantly heavier birth weight than fresh embryo transfer. Also, the frozen embryo transfer technique may significantly decrease premature birth rate. Thus, frozen embryo transfer may be recommended as a health strategy in ART.

**Keywords:** in vitro fertilization, frozen embryo transfer, baby birth, outcome


*2.3. Analysis*

All audio recordings were transcribed verbatim. The transcripts of the interviews were anonymized and analyzed in a deductive-inductive process according to Mayring's qualitative content analysis [19] by means of the software MAXQDA Analytics Pro, version 12 (VERBI Software GmbH, Berlin, Germany) [20]. An iterative process was applied in which the authors identified and refined codes, categories, and sub-categories. The coding was mutually checked for accuracy and was thoroughly discussed until consensus regarding the final coding system was reached. The final coding system was summarized in a separate document in which the material was further reduced and compacted. During the course of analysis, reflexivity and transparency regarding the potential influence of the researchers' objectives and preconceptions on the results and interpretations were encouraged. Transcripts and results were not returned to the interviewees. All quotes that were used for publication purposes were translated into English.

### **3. Results**

#### *3.1. Sample Characteristics*

As illustrated in Tables 2 and 3, seven women were aged between 31 and 40 years old; 10 women were married; seven women reported to work full-time, two worked part-time, and five were currently on maternity or parental leave; and eight women were mothers of children living in the household at the time of the study. The partners of 10 women had worked offshore from the beginning of their partnership. Furthermore, 12 offshore partners were currently working in a regular 14/14 work

schedule, and two partners were working in a different schedule at the time of the interview but did have experience with the 14/14 schedule. Additionally, seven partners had at least three years of offshore work experience.

### *3.2. Single Life without the O*ff*shore Partner*

#### 3.2.1. Advantages

As a major advantage of living the single life, many women found themselves to be more independent and self-reliant in their scheduling of activities and appointments. This was also reported regarding duties and routines within the household and parenting:

"*Very simple things, like, for example, when to make purchases, what to buy, when to clean certain things (* ... *).*" *(Interviewee #8)*

**Table 2.** Participant characteristics.

\* in years \*\* in turns with o

ffice weeks for specific trainings.

**3.**Participant characteristics (in detail).

**Table**

#### *Int. J. Environ. Res. Public Health* **2019**, *16*, 241

A further advantage of the time spent alone was that the women pursued their own interests to a greater extent and were able to become engaged in several leisure activities:

"*Advantages, perhaps, that one deals with being alone and tries to find strategies to better cope with it. You do not rely on the fact that there is always someone there, but you put more thoughts in your own leisure activities.*" *(Interviewee #4)*

Meeting friends and family, doing sports, and following diverse hobbies were stressed by the women as important leisure activities in this phase.

### 3.2.2. Disadvantages

An important disadvantage of living the single life was reported to consist of the management and organization of daily life without the partner's general support. Spare time was described to be affected by the partner's absence in such way that the women perceived being forced to spend big parts of their social life alone:

"*A disadvantage is, of course, that you can only maintain your social contacts alone. If there are invitations or birthday parties, or if you just want to spend a nice evening with friends, this doesn't work.*" *(Interviewee #13)*

During their time alone, there were moments in which the women especially missed their partners. These often concerned moments that both partners usually shared, in particular regarding time during the evenings or weekends. Difficult situations such as sickness, problems at work, or issues with childcare were also mentioned. Moreover, the partner's being missing on special occasions, e.g., weddings or special moments in the children's development, was emphasized. Some interviewees indicated emotional changes, e.g., feeling lonely or more tense than usual:

"*I realize that I'm not feeling well when he's not there. Sometimes I do not sleep for nights because I cannot stand it.*" *(Interviewee #5)*

Another disadvantage consisted of perceived insecurities related to child care and parenting. Some interviewees described that they considered themselves as single mothers when their partners were offshore:

"*Well, more or less, I am a single parent for two weeks.*" *(Interviewee #9)*

The perceived unpredictability, e.g., regarding the exact time of the partner's arrival back home, was also seen as disadvantageous. Moreover, the awareness of constraints in reachability when the partner was offshore—especially in cases of emergency—was highlighted as burdening.

Many women spoke about changes in their work routines when their partners were away. They described often working overtime during this phase in order to be able to work less or leave on time when the partner was at home:

"*Of course, when my husband is not there, I work more. When he's at home, I scale that back a bit, so that we have more time for each other.*" *(Interviewee #9)*

Especially women with children found themselves to be less flexible and more constrained in their work times when they were alone, e.g., due to their children's schedules. Some mothers also described that their children's ill-health seemed to be connected to the absence of their father:

"*It also happens that the children get sick if he is not there for a long time.*" *(Interviewee #6)*

#### 3.2.3. Communication and Contact Styles

Staying in contact with the partner during his offshore assignments was reported to be crucial for the women. Most of them described being able to contact their partners on a daily basis. The scheduling of contact was stated to depend on the shifts and workloads of the partner:

"*During his shift, I can write him and if he reads it in between, he can also answer me. But we rather talk on the phone during his free shifts.*" *(Interviewee #12)*

Certain difficulties and restrictions to make contact were also described by some women; however, contact that could be initiated by both partners was reported to be the rule. The usage of several media (phone, messenger services, video telephony) was mentioned by the majority of the women. In particular, improved communication technologies were stated to enable more intensive contact and direct exchange. All in all, the majority of the women stated being satisfied with both the frequency and regularity of contact. Reasons for dissatisfaction were related to the time of contact and the general notion that technology-mediated contacts were not comparable to personal contacts.

#### *3.3. Life as a Couple*

#### 3.3.1. Advantages

Advantages of the 14/14 work schedule were often attributed to the time spent together as a couple during the partners' free turn. This time was stated to provide the couple with much time for joint activities and family life. The family life was perceived as being even more intensive due to the previous phase of separation, providing the couple with an opportunity to miss and look forward to seeing each other again. This was indicated to contribute to the liveliness of the relationship:


*2.1. Titratable Acidity*

Titratable acidity levels for 10 days old cotyledons were at approximately 50–60 μeq gFW−1 (FW = Fresh Weight; Figure 1). At 10 days, the control groups and water-stressed leaves showed a slight acid fluctuation of 10–20 μeq gFW−1 from a.m. to p.m. (Figure 1). There was no significant difference between a.m. and p.m. acid levels. At 20–25 days old, cotyledons, under control conditions, there was no acid fluctuation observed from a.m. to p.m. levels. Under water stress, cotyledons showed a small significant titratable acid fluctuation from the morning to the evening (Figure 1). Continued water stress to 7 days of the 20–25 days old cotyledons induced a large and significant acid fluctuation of 83 μeq gFW−1 in both the cotyledons and primary leaves of *P. grandiflora* (Figure 2). The a.m. acid levels had increased to more than double the control cotyledons.

**Figure 1.** Titratable acidity of *Portulaca grandiflora* in 10 days and 25 days old cotyledons under control and 3 days water-stress conditions. Bars represent the means (SEM). For 10 days old, N = 9–11 leaves per treatment; 25 days old, N = 8–13 leaves per treatment; and \* indicates a significant difference between a.m. and p.m. acid levels for 25 days old treatment. Con = Control; WS = Water Stress for all figures.

**Figure 2.** Diurnal titratable acidity levels in cotyledons and primary leaves of *P. grandiflora* after 7 days of water stress. Bars represent the means (SEM). Bars with different letters are significantly different (*p* < 0.05, N = 4).


**4. People-centred approaches to recovery**

People-centred—or community-centred—approaches are considered 'the gold standard' in successful disaster recovery. This is emphasised regularly in research and also in policy of responding agencies. Gibbs et al. record that 'community-based approaches … are regarded as the optimal approach to sustainable disaster recovery, fostering self-reliance and self-determination' [14]. In Australia, the State-level agency Resilience NSW affirms that 'successful recovery is community-centred, responsive and flexible, engaging with community and supporting them to move forward' [15].

Taking a people/community-centred approach to recovery seeks to ensure that skills and abilities of affected people are used, built on, and not unduly eroded. This is emphasised because, too often, response actions can fail to adequately engage with affected populations, leading to wasted investments in relief and recovery, or worse still, actively damaging meaningful recovery actions. People themselves may find themselves excluded form decisions that affect them. Unfortunately, despite some recent advances (see below), an adequate people-centred approach can be lacking. Anderson *et al.'s* report, 'Time to listen', found that, of the 6000 or so people interviewed who were caught up in emergencies across the world, the overwhelming response was for humanitarian actors to listen better to what was actually needed [16]. Following the 2015 Nepal earthquakes, one survey of community satisfaction of response efforts found that 'almost half of respondents feel they are not heard at all'; also that 'When women were asked if their particular problems are being addressed, a resounding 73 per cent said "very little" or "not at all"' [17].

There is a wealth of literature on people-centred approaches emerging from development practice [18]. One popular approach is an asset/capital-based understanding. Assets/capital can be tangible (such goods and belongings), and intangible, such as skills (human assets) and friends and networks (social assets). Social capital is a particularly powerful and important asset for post-disaster relief and recovery (see e.g. Archer and Boonyabancha, 2011). Social capital can be understood as **relationships and acquaintances that people develop over time.** As the adage in disaster management goes, *it's your neighbours that pull you out of the rubble*. There has been considerable interest in the importance of social capital and its types. Three types of social capital often agreed on are bridging capital (creating new relationships), bonding

capital (existing relationships that deepen over time) and linking capital (building relationships with those who hold power). It therefore follows, broadly speaking, that the more social capital people and communities possess, the less vulnerable they are to disasters. Conversely, people and communities with lower social capital are at greater risk.


**4.1. Dry test rig**

480 Smart Actuation and Sensing Systems – Recent Advances and Future Challenges

to reduce energy losses.

generator production.

If the load is composed by a combination of continuous small absorptions with occasional high requests of energy, it can be useful to combine the above storage technologies in order

The first prototype was not developed using an independent control system and energy converter, but using an integrated solution were all the three elements are included into one single chip. Two different boards were developed using two chips from Linear Technologies. The first solution used the LTC3108, a buck-boost converter without MPPT algorithm but capable of converting input voltages lower than 200mV. This solution was adopted due to the extremely low power coming out from the generator in the first prototype developed. Increasing the generator production, it was possible to move to the LTC3105 regulator, that is capable of converting input voltages higher than 500mV till to 5V, including an internal MPPT control in order to adapt the load absorption according to the

**Figure 11.** DC/DC converter: LTC3108 controller (1), output voltage selectors (2), input terminal, switching inductance and filters (3), regulated output 2.3V÷5V (4), 5.25V storage battery or capacitor (5)

(< 3V) during switch-off period to prevent irreversible damage to the cells.

**4. Experimental validation**

In the test board two different topologies were tested. The first one used an output voltage set to 2.2÷2.3V connected to a 1F 2.3V super-capacitor (see Fig. 11). This solution was adopted to supply a very light load like a microcontroller (PIC16F886) that run a simple code to only switch on and off one led. The second solution used an output voltage of 4V to supply directly the load and to recharge the 3.6V 220mA battery; specifically, when the converter was on, the remaining current that was not used by the load was employed to recharge the battery, whereas when the input generator was off, the OUT pin was disconnected from the converter so that all the energy required was provided by the battery. A custom external controller is necessary to ensure battery protection from deep discharges

The system described in the previous sections was implemented and experimental tests were carried out to verify the correspondence between the design model and the real To characterize the electric generator, a "dry" test rig was developed as shown in Fig. 12. It is constituted of a DC electric motor (2), which is used to drive the generator's rotor, and the generator's stator (1). A DC power supply is used to energize the drive motor and to put the generator rotor into rotation at different rotational speeds. The values of induced EMF measured during the tests are compared to the FE model in Fig. 13.

Different configurations of the generator have been implemented and investigated with several values of the air gap *t*: 0.5 mm for the nominal configuration as reported in Tab. 7, 1 mm for the preliminary supply of claw poles generators tested in the dry test rig, and 1.25 mm for claw poles generators compliant with the wet test rig. The experimental values represent the RMS value of the voltage measured between the two ends of the stator coil, whereas the FE model results were obtained by using Eq. 6 and Eq. 7 with the data corresponding to the above mentioned configuration. The obtained experimental results show good correlations with the numerical values resulting from the model simulation.

In Fig. 14 the generated power is plotted as function of the rotating speed of the generator for the different air gaps. It is clear that the rated generated power is significantly less than the 100 mW required. This is due to the fact that it was not possible to find a ferrite with a value of the permanent magnet induction equal to 0.42T but only 0.27T, with a consequent loss in performance. It must also be emphasized the drastic lack of performance in terms of power generated by the increasing of the air gap from the nominal value of 0.5 mm up to the value of the wet test rig equal to 1.25 mm.

**Figure 13.** Induced emf for different values of the air gap : *t*=0.5mm (dashed line) vs exp. (star markers); *t*=1mm (dotted line) vs exp. (circular markers); *t*=1.25mm (solid line) vs exp. (square markers).

**Figure 14.** Air gap Sensitivity Analysis: generated power with external load equal to generator resistance. *t*=0.5 mm (dashed line), *t*=1 mm (dotted line), *t*=1.25mm (solid line).

**Figure 15.** Number of coils Sensitivity Analysis: generated power with external load equal to generator resistance. Nominal *N*=1200 (dashed line), *N*=800 (dash dotted line), *N*=620 (dotted line) and *N*=490 (solid line).

A lower influence has been found with the variation of the number of coils of the generator stator *N* as shown in Fig. 15, leaving a certain degree of freedom from this point of view.

#### **4.2. Wet test rig**

482 Smart Actuation and Sensing Systems – Recent Advances and Future Challenges

value of the wet test rig equal to 1.25 mm.

power generated by the increasing of the air gap from the nominal value of 0.5 mm up to the

**Figure 13.** Induced emf for different values of the air gap : *t*=0.5mm (dashed line) vs exp. (star markers);

*t*=1mm (dotted line) vs exp. (circular markers); *t*=1.25mm (solid line) vs exp. (square markers).

**Figure 14.** Air gap Sensitivity Analysis: generated power with external load equal to generator

resistance. *t*=0.5 mm (dashed line), *t*=1 mm (dotted line), *t*=1.25mm (solid line).

A second test rig has been developed in order to test the electrical generator coupled with the hydraulic turbine, which makes it possible to characterize both the generator and the hydraulic machine as shown in Fig. 16. This wet test rig is composed by the scavenger (1), connected in series to a flow meter (2), which are both supplied by a domestic water pipeline, where the water flow is adjustable by a tap (3). The measuring system consists of a flow meter (2), a multimeter (4) and an oscilloscope (5) in order to correlate the generated power with the available flow rate. In the lower left box of Fig. 16 an enlarged view of the rapid prototyping realization of the scavenger (1) is also shown.

In Fig. 17 a cross-section of the scavenger is reported; the device incorporates a eighteen blades Banki turbine (1) (see Tab. 5 for other specifications) and a claw-poles voltage generator (2) (see Tab. 7 for nominal specifications). The design of the integration between the two parts required special attention, in particular to ensure the sealing between rotating and fixed parts and to prevent the direct contact between the main water flow and the electrical generator. The presence of the magnet in the generator rotor and ferromagnetic residues in the water may lead to choking risk. To solve the problem of sealing an O-ring (4) has been introduced; to limit as much as possible the choking risk labyrinth seals have been used among the rotor housing and the runner.

**Figure 16.** Wet Test Rig: scavenger (1), flow meter (2), domestic water supply and tap (3), multimeter (4) and oscilloscope (5).

**Figure 17.** Cross-section view of the scavenger: Banki turbine (1), claw pole generator (2), permanent magnet rotor (3) and O-ring (4).

Owing to manufacturing problems related to the choice of the rapid prototyping process, the implementation of the first scavenger prototype presented an air gap equal to 1.25 mm which is greater than the nominal value. This fact has a significant impact on the system performances as shown in Fig. 18. Comparing the data of the power generated by the wet test rig with those of the dry test rig, it is noticed a further drop of performance of the generated power. It goes from 9.1 mW produced at 1000 rpm on the dry test rig to 5.2 mW generated by the wet test rig. This decay can be explained with stick-slip phenomena present among rotating and non rotating parts of the turbine, and it will be addressed and fixed in future studies.

**Figure 18.** Wet Test Rig: generated power with external load equal to generator resistance. Nominal *N*=1200 (dashed line), *N*=800 (dash dotted line), *N*=620 (dotted line) and *N*=490 (solid line).

### **5. Conclusions**

484 Smart Actuation and Sensing Systems – Recent Advances and Future Challenges

used among the rotor housing and the runner.

(4) and oscilloscope (5).

magnet rotor (3) and O-ring (4).

residues in the water may lead to choking risk. To solve the problem of sealing an O-ring (4) has been introduced; to limit as much as possible the choking risk labyrinth seals have been

**Figure 16.** Wet Test Rig: scavenger (1), flow meter (2), domestic water supply and tap (3), multimeter

**Figure 17.** Cross-section view of the scavenger: Banki turbine (1), claw pole generator (2), permanent

Owing to manufacturing problems related to the choice of the rapid prototyping process, the implementation of the first scavenger prototype presented an air gap equal to 1.25 mm which is greater than the nominal value. This fact has a significant impact on the system performances as shown in Fig. 18. Comparing the data of the power generated by the wet test rig with those of the dry test rig, it is noticed a further drop of performance of the generated power. It goes from 9.1 mW produced at 1000 rpm on the dry test rig to 5.2 mW This study presents the trade-off analysis, the design, and the experimental validation of an Hydraulic Energy Scavenger applied to a motorized valve for domestic heating systems. The trade-off analysis conducted on the hydraulic and electric machines has identified the Banki turbine coupled to a claw poles generator as the solution to investigate and design. In this configuration the axis of rotation of the machine results to be perpendicular to the flow of the water thereby limiting problems of choking. The models underlying the design are validated from the electrical perspective by the dry test rig, and for the whole system by the wet test rig. The investigation was performed for different values of the air gap t, of the number of coils N, and of the resistive load of the device. The comparison between model and experiments show a good correlation, even though the power generated by the device resulted to be lower than the desired design value. This lower power production is essentially related to manufacturing issues, namely an higher value of the air gap and a lower value of the permanent magnet induction. However, the good correlation between the experimental and theoretical data makes it possible to predict the achievement of the desired performance in case the indicated designed parameters are respected.


**5. Older adults**

Persons 50 and older comprise approximately 10-15% of all AIDS cases in the U.S. (CDC, 2002; Goodroad, 2003; Inelmen et al., 2005; Jacobs & Kane, 2009; Manfredi, 2002; Ory, et al., 1998; Radda, et al., 2003; Williams & Donnelly, 2002; Zelenetz & Epstein, 1998). However, these numbers may be subject to underreporting bias because they do not include those persons over 50 who are HIV-seropositive but have not developed AIDS (Altschuler et al., 2004; Heckman et al., 2006) or adults diagnosed with AIDS prior to 50 (Altschuler et al., 2004). More recent data indicates that older adults may account for a much higher percentage of people with HIV/AIDS. From 2001-2004 the percentage of all HIV cases in the U.S. for adults age 50 and older increased from 17% to 23% (CDC, 2004; Emlet et al., 2009; Gebo, 2006; Kirk, & Goetz, 2009; Orel et al., 2010). Moreover, the CDC forecasts that by the year 2015 half of all cases of HIV/AIDS will be in persons age 50 and older (Heckman et al., 2006). In creating the definition of "older adult", the CDC assumed a bell-shaped demographic distribution of people with HIV/AIDS infection. Using this approach, a person aged ≥ 50 meets the definition of older adult (CDC, 1992; Luther & Wilkin, 2007 Manfredi, 2002; Orel et al., 2005). The increases in incidence and prevalence of HIV diagnoses within this population are particularly important in lieu of the phenomenon of age transition6 (UN, 2007). This factor is heightened by the efficacy of Highly Active Antiretroviral Therapy (HAART) rendering HIV/AIDS a chronic disease with declining mortality and fewer AIDS- related opportunistic infections (Manfredi, 2002; Stark, 2006). Consequently, the net effect is a growing, vulnerable, graying HIV-positive population. Older adults experience specific health challenges (Siegel et al., 1999), HAART treatment issues (Grabar et al., 2006; Nogueras et al., 2006; Silverburg et al., 2007), and social stigma associated with the infection (Emlet, 2006; Goodroad, 2003; Stark, 2006). These health

challenges are unique to this subpopulation and create barriers to the receipt of care, and

 6The age transition refers to a predictable shift from a predominantly younger population when fertility is high to a predominantly older population when fertility is low.

Weeks et al., 1996; Zambrana et al., 2004). Moreover, this lack of knowledge limits coalition building, which is critical to HIV/AIDS prevention in women, among women in communities of color (Weeks, et al., 1996). To address these gaps in the research literature, limited enrollment in HIV clinical trials and limited treatment access, in 2003 the Center for Disease Control (CDC) created the Minority HIV/AIDS Research Initiative (Fitzpatrick et al., 2006). This program is designed to provide junior investigators assistance to conduct gap research in communities of color. The rationale for this program highlights the need to; (1) research HIV/AIDS in Black and Latino communities, (2); addressing evident research gaps can only be accomplished by understanding culture-specific nuances ascribed to Blacks and Latinos, and (3); the similarity between researcher and community would remove barriers to conducting effective research (Fitzpatrick et al., 2006). Weeks et al., highlight the need for indigenous female educators and organizers with an understanding of cultural issues to educate women of color about their risk potential (1996). Similarly, these women can also serve as principle investigators and direct research questions to build greater understanding of the social context within which Black and Latino women can make decisions and

Persons 50 and older comprise approximately 10-15% of all AIDS cases in the U.S. (CDC, 2002; Goodroad, 2003; Inelmen et al., 2005; Jacobs & Kane, 2009; Manfredi, 2002; Ory, et al., 1998; Radda, et al., 2003; Williams & Donnelly, 2002; Zelenetz & Epstein, 1998). However, these numbers may be subject to underreporting bias because they do not include those persons over 50 who are HIV-seropositive but have not developed AIDS (Altschuler et al., 2004; Heckman et al., 2006) or adults diagnosed with AIDS prior to 50 (Altschuler et al., 2004). More recent data indicates that older adults may account for a much higher percentage of people with HIV/AIDS. From 2001-2004 the percentage of all HIV cases in the U.S. for adults age 50 and older increased from 17% to 23% (CDC, 2004; Emlet et al., 2009; Gebo, 2006; Kirk, & Goetz, 2009; Orel et al., 2010). Moreover, the CDC forecasts that by the year 2015 half of all cases of HIV/AIDS will be in persons age 50 and older (Heckman et al., 2006). In creating the definition of "older adult", the CDC assumed a bell-shaped demographic distribution of people with HIV/AIDS infection. Using this approach, a person aged ≥ 50 meets the definition of older adult (CDC, 1992; Luther & Wilkin, 2007 Manfredi, 2002; Orel et al., 2005). The increases in incidence and prevalence of HIV diagnoses within this population are particularly important in lieu of the phenomenon of age transition6 (UN, 2007). This factor is heightened by the efficacy of Highly Active Antiretroviral Therapy (HAART) rendering HIV/AIDS a chronic disease with declining mortality and fewer AIDS- related opportunistic infections (Manfredi, 2002; Stark, 2006). Consequently, the net effect is a growing, vulnerable, graying HIV-positive population. Older adults experience specific health challenges (Siegel et al., 1999), HAART treatment issues (Grabar et al., 2006; Nogueras et al., 2006; Silverburg et al., 2007), and social stigma associated with the infection (Emlet, 2006; Goodroad, 2003; Stark, 2006). These health challenges are unique to this subpopulation and create barriers to the receipt of care, and

6The age transition refers to a predictable shift from a predominantly younger population when fertility

is high to a predominantly older population when fertility is low.

influence their sexual partners.

**5. Older adults**

mediate the rising trend of a geriatric HIV positive population. Symptom ambiguity between HIV/AIDS infection and diseases associated with aging (such as diabetes mellitus, decreased renal function, and cardiac disease) often leading to misdiagnosis (Siegel et al., 1999; Zelentz & Epstein, 1998) and delays in diagnosing HIV. Moreover, due to physiologic changes associated with aging, there is a more rapid rate of progression of HIV to AIDS, and increased susceptibility to opportunistic illnesses in older adults (Gebo, 2006; Goodroad, 2003; Mack & Bland, 1999; Manfredi, 2002) (See figure 5). Other health challenges faced by older adults who are diagnosed with HIV include treatment complications due to comorbidities and polypharmacy (Grabar et al., 2006; Luther & Wilkin, 2007; McLennon, 2003).

Fig. 5. Concurrent HIV/AIDS among Persons Diagnosed With HIV in 2006, By Age Group in The United States.

In addition to the issues associated with diagnosis of HIV, not too many advances have been made in the provision of effective HAART therapy, amongst older populations. Late diagnosis, impaired immune response, toxicities associated with HAART therapy and lack of knowledge about efficacy of HAART treatment among older adults contribute to high rates of mortality soon after diagnosis (Goetz et al., 2001; Mack & Bland, 1999; Manfredi & Chiodo, 2000; Nokes et al., 2000). Advanced age at seroconversion have always been important prognostic factors in the progression of HIV infection and survival mediated only by the widespread introduction of HAART therapy (Grabar et al., 2006; Manfredi, 2002). However, older patients are often excluded from clinical trials, and studies evaluating efficacy of HAART therapy in older adults are characterized by small numbers and short follow up (Grabar et al., 2006).

Social issues surrounding HIV/AIDS in the older adult are just as important as the biomedical and pharmacotherapeutic aspects. Adults aged ≥50 experience a multidimensional form of HIV-related social stigma. Initially, ageist ideologies among many health care workers contribute to the general lack of understanding and recognition of HIV

Impact of Socio-Medical Factors on the

for youth to adhere to HAART (Garvie et al., 2010).

**6.1 Interventions**

Prevention and Treatment of HIV/AIDS Among Specific Subpopulations 301

The identification of adolescents with HIV proves difficult because of medicolegal difficulties regarding consent and testing of adolescents, and procurement of this at risk group (Earl, 1993). Historically, these rates of HIV infection have been viewed as a function of adolescent risky sexual and drug use behavior (Di Clemente, 1997; Di Clemente & Wingood, 2000). Initiation of sexual activity often begins in mid adolescences (13-17) (Earl, 1993). Additionally, rates of STD infections are highest for sexually active persons between the ages of 15-24 (Balassone et al., 1993). Findings indicate that a majority of sexually active adolescents do not consistently take precautions to avoid contracting HIV/AIDS and other STDs (Balassone et al., 1993). Adolescence represents a developmental period characterized by risk taking behaviors prefaced on denial, invulnerability, and succumbing to peer influence (Garvie et al., 2009). Yet other risk factors unique to this group, such as, childhood sexual abuse and homelessness contribute to this sub-populations rate of HIV infections.   Many adolescents who experience childhood abuse resort to escapism often becoming homeless runaways (Di Clemente, 1992; National Commission on AIDS, 1994). Consequently, this group may practice survival strategies such as prostitution or pornography that contribute to increased risk for HIV infection (Di Clemente, 1992; Lyon & D' Angelo, 2006; Whitmire et al., 1999). The residential instability of this group of adolescents, dysfunctional family history, lack of perceived life chances, and mental and physical deterioration and may not only contribute to HIV infection, but to rapid progression from HIV to AIDS, compared to their non homeless counterparts (Di Clemente, 1992; Lyon & D' Angelo, 2006; Whitmire et al., 1999). Interesting additional risk factors that influence the contraction of HIV by youths include many of the aforementioned populations in this chapter. These include adolescents who may be; (1) young MSMs; (2) IDUs; (3) racial and ethnic minorities; (4) and heterosexual females; (Kalichman, 2005). The diversity among this group and overlapping needs makes developing effective intervention programs challenging. However, regardless of risk factor experienced adolescents are less likely than adults to adhere to HAART therapy (Belzer, et al., 1999; Lyons & D'Angelo, 2006; Williams et al., 2006). Psychosocial, mental health and substance use problems often make it difficult

Adolescents as a group need sensitive and appropriate anticipatory guidance as they transition into adulthood. Adolescents with HIV need considerably more support. Most interventions are designed with an individualistic perspective and are sexual behavior modification interventions, aimed at reducing adolescent vulnerability to HIV by enhancing intrapersonal and interpersonal mediators of preventive behavior (Di Clemente, 1997; Di Clemente & Wingood, 2000). Appropriately tailored interventions addressing; (1) maintaining good physical health; (2) reducing transmission risk behavior and; (3) and promoting and maintaining positive mental health (Kalichman, 2005; Murphy et al., 2000) have been developed. Numerous avenues of dissemination are currently employed in intervention/education efforts and include telephone, internet (Noia et al., 2004) focus group, and individual delivery mechanisms. Current interventions stress the importance of

in the older adult (Goodroad, 2003; Stark, 2006). Research indicates relatively high sexual activity and some risk taking behavior among older adults (Gott, C.M., 2001; Inelman et al., 2005; Jacobs & Thomlison, 2009; Neundorfer et al., 2005; Steinke, 1994). However, ageism and myths concerning elderly populations and infrequent sexual activity, drug use, and other risk taking behavior have made routine screening less common, HIV/AIDS cases more often ignored, and diagnosis of disease delayed (Grabar et al., 2006; Mack & Bland, 1999; Orel et al., 2005). After diagnosis many older adults refrain from disclosing their HIV status to family and friends. Emlet found that older adults were less likely to disclose HIV to relatives, partners, mental health workers, neighbors, and church members than those 20-39 years of age (2006). Limiting the disclosure of HIV status controls the possibility of being stigmatized and facing discrimination (Emlet, 2006; Goodroad, 2003). A latent consequence of such behavior is the forgoing of much needed social support during this health crisis.

#### **5.1 Interventions**

Despite being one of the fastest growing segments of the HIV/AIDS caseload, persons age 50 and older have been largely neglected in both education and intervention efforts. While many public health campaigns are designed to target at risk populations and youth in the 13-24 age range, older adults are being ignored in terms of age-specific epidemiology, prevention, intervention and treatment programs (Mack & Ory, 2003; Ory et al., 1998). Hence older adults with HIV/AIDS have been coined in the literature as "the invisible ten percent" and the "hidden population" (Orel et al., 2005). Efforts to understand the rationale behind the unmet need for educational and intervention programs among older adults highlighted the role of state departments of public health in the distribution of current HIV/AIDS health- related information (Orel et al., 2004; Orel et al., 2005). However, findings indicate that only 15 of the 50 state health departments (30%) reported providing HIV/AIDS publications that were specifically intended for older adults (Orel et al., 2004). Successful intervention strategies include embedding and personalizing HIV/AIDS education for older adults with other provided health information. Emlet and colleagues advocate for national collaboration between aging network organizations and AIDS service organizations (ASOs), thereby providing seamless access to services /programs for AIDS and aging service providers (2009). Additionally, the use of HIV peer educators for older adults has been explored by the Senior Intervention Project (SHIP) in south Florida and proven successful not only in education, but also in linking and referring HIV positive patients to care and treatment services (Agate et al., 2003).

#### **6. Adolescents**

Adolescents and young adults represent one of the at risk groups for contracting HIV infections in the United States (Belzer et al., 1999). Approximately one quarter of new infections occur among adolescents and young adult (ages 13-29) (CDC, 2008). The definition for adolescence varies depending on the organization and the type of report being produced. The CDC often refers to adolescence between the ages 10-19 and young adults between the ages 20-24 (Wilson et al., 2010). Conversely, the World Health Organization often refers to young people and includes individuals between the ages of 10 to 24 years of age. Due to this variance both adolescents and young adults up till the age of 25 will be discussed in this chapter.

The identification of adolescents with HIV proves difficult because of medicolegal difficulties regarding consent and testing of adolescents, and procurement of this at risk group (Earl, 1993). Historically, these rates of HIV infection have been viewed as a function of adolescent risky sexual and drug use behavior (Di Clemente, 1997; Di Clemente & Wingood, 2000). Initiation of sexual activity often begins in mid adolescences (13-17) (Earl, 1993). Additionally, rates of STD infections are highest for sexually active persons between the ages of 15-24 (Balassone et al., 1993). Findings indicate that a majority of sexually active adolescents do not consistently take precautions to avoid contracting HIV/AIDS and other STDs (Balassone et al., 1993). Adolescence represents a developmental period characterized by risk taking behaviors prefaced on denial, invulnerability, and succumbing to peer influence (Garvie et al., 2009). Yet other risk factors unique to this group, such as, childhood sexual abuse and homelessness contribute to this sub-populations rate of HIV infections.   Many adolescents who experience childhood abuse resort to escapism often becoming homeless runaways (Di Clemente, 1992; National Commission on AIDS, 1994). Consequently, this group may practice survival strategies such as prostitution or pornography that contribute to increased risk for HIV infection (Di Clemente, 1992; Lyon & D' Angelo, 2006; Whitmire et al., 1999). The residential instability of this group of adolescents, dysfunctional family history, lack of perceived life chances, and mental and physical deterioration and may not only contribute to HIV infection, but to rapid progression from HIV to AIDS, compared to their non homeless counterparts (Di Clemente, 1992; Lyon & D' Angelo, 2006; Whitmire et al., 1999). Interesting additional risk factors that influence the contraction of HIV by youths include many of the aforementioned populations in this chapter. These include adolescents who may be; (1) young MSMs; (2) IDUs; (3) racial and ethnic minorities; (4) and heterosexual females; (Kalichman, 2005). The diversity among this group and overlapping needs makes developing effective intervention programs challenging. However, regardless of risk factor experienced adolescents are less likely than adults to adhere to HAART therapy (Belzer, et al., 1999; Lyons & D'Angelo, 2006; Williams et al., 2006). Psychosocial, mental health and substance use problems often make it difficult for youth to adhere to HAART (Garvie et al., 2010).

#### **6.1 Interventions**

300 Social and Psychological Aspects of HIV/AIDS and Their Ramifications

in the older adult (Goodroad, 2003; Stark, 2006). Research indicates relatively high sexual activity and some risk taking behavior among older adults (Gott, C.M., 2001; Inelman et al., 2005; Jacobs & Thomlison, 2009; Neundorfer et al., 2005; Steinke, 1994). However, ageism and myths concerning elderly populations and infrequent sexual activity, drug use, and other risk taking behavior have made routine screening less common, HIV/AIDS cases more often ignored, and diagnosis of disease delayed (Grabar et al., 2006; Mack & Bland, 1999; Orel et al., 2005). After diagnosis many older adults refrain from disclosing their HIV status to family and friends. Emlet found that older adults were less likely to disclose HIV to relatives, partners, mental health workers, neighbors, and church members than those 20-39 years of age (2006). Limiting the disclosure of HIV status controls the possibility of being stigmatized and facing discrimination (Emlet, 2006; Goodroad, 2003). A latent consequence of such behavior is the forgoing of much needed social support during this health crisis.

Despite being one of the fastest growing segments of the HIV/AIDS caseload, persons age 50 and older have been largely neglected in both education and intervention efforts. While many public health campaigns are designed to target at risk populations and youth in the 13-24 age range, older adults are being ignored in terms of age-specific epidemiology, prevention, intervention and treatment programs (Mack & Ory, 2003; Ory et al., 1998). Hence older adults with HIV/AIDS have been coined in the literature as "the invisible ten percent" and the "hidden population" (Orel et al., 2005). Efforts to understand the rationale behind the unmet need for educational and intervention programs among older adults highlighted the role of state departments of public health in the distribution of current HIV/AIDS health- related information (Orel et al., 2004; Orel et al., 2005). However, findings indicate that only 15 of the 50 state health departments (30%) reported providing HIV/AIDS publications that were specifically intended for older adults (Orel et al., 2004). Successful intervention strategies include embedding and personalizing HIV/AIDS education for older adults with other provided health information. Emlet and colleagues advocate for national collaboration between aging network organizations and AIDS service organizations (ASOs), thereby providing seamless access to services /programs for AIDS and aging service providers (2009). Additionally, the use of HIV peer educators for older adults has been explored by the Senior Intervention Project (SHIP) in south Florida and proven successful not only in education, but also in linking and referring HIV positive patients to care and

Adolescents and young adults represent one of the at risk groups for contracting HIV infections in the United States (Belzer et al., 1999). Approximately one quarter of new infections occur among adolescents and young adult (ages 13-29) (CDC, 2008). The definition for adolescence varies depending on the organization and the type of report being produced. The CDC often refers to adolescence between the ages 10-19 and young adults between the ages 20-24 (Wilson et al., 2010). Conversely, the World Health Organization often refers to young people and includes individuals between the ages of 10 to 24 years of age. Due to this variance both adolescents and young adults up till the age of 25 will be

**5.1 Interventions**

treatment services (Agate et al., 2003).

**6. Adolescents**

discussed in this chapter.

Adolescents as a group need sensitive and appropriate anticipatory guidance as they transition into adulthood. Adolescents with HIV need considerably more support. Most interventions are designed with an individualistic perspective and are sexual behavior modification interventions, aimed at reducing adolescent vulnerability to HIV by enhancing intrapersonal and interpersonal mediators of preventive behavior (Di Clemente, 1997; Di Clemente & Wingood, 2000). Appropriately tailored interventions addressing; (1) maintaining good physical health; (2) reducing transmission risk behavior and; (3) and promoting and maintaining positive mental health (Kalichman, 2005; Murphy et al., 2000) have been developed. Numerous avenues of dissemination are currently employed in intervention/education efforts and include telephone, internet (Noia et al., 2004) focus group, and individual delivery mechanisms. Current interventions stress the importance of

Impact of Socio-Medical Factors on the

1758-1052 (electronic)

475-488, ISSN: 0190-7409

(electronic)

(electronic).

Prevention and Treatment of HIV/AIDS Among Specific Subpopulations 303

Bakeman, R.; & Peterson, J. (2007). Do beliefs about HIV treatments affect peer norms and

Balassone, M.; Baker, S.; Gillmore, M.; Morrison, D.; & Dickstein, D. (1993). Interventions to

Barrett, D.;Bolan, G.; & Douglas, J. (1998).  Medical treatment for men who have sex with men and

Belzer, M.; Fuchs, D.; Luftman, G.; & Tucker, D. (1999). Antiretroviral adherence issues

Benotsch, E.; Kalichman, S.; & Cage, M. (2002). Men who have met sex partners via the

Bing, E.; & Soto, T. (1991). Treatment issues for African-Americans and Hispanics with AIDS. *Psychiatric Medicine,* Vol.9, No.3, pp. 455-467, ISBN: 978-0-7817-8408-5 Blackwell, C. (2008).  Risk-based prevalence of infection drug users in

Brennan, D.; Welles, S.; Miner, M.; Ross, M.; Mayer, K.; & Rosser, B. (2009). Development of

Vol.21, No.9, pp. 1090-1097, ISSN: 0954-0121 (print), 1360-0451 (electronic) Brennan, D.; Welles, S.; Miner, M.; Ross, M.; & Rosser, B. (2010). HIV treatment optimism

Brewer, D.; Golden, M.; & Handsfield, H. (2006).

Vol.22, No.2, pp. 126-137, ISSN: 0899-9546.

 *International Journal of STD and AIDS,* Vol.18, pp. 105-108, ISSN: 0956-4624 (print),

decrease the risk of HIV/AIDS and other sexually transmitted diseases among high-risk heterosexual adolescents. *Children and Youth Services Review,* Vol.15, pp.

Implications for HIV prevention and research. *The Journal of Sex Research,* Vol.35,

are living with HIV/AIDS. *American Journal of Men's Health,* Vol.3, No.4, pp. 319-

among HIV-positive adolescents and young adults. *Journal of Adolescent Health,*

internet: Prevalence, predictors, and implications for HIV prevention.*Archives of Sexual Behavior,* Vol.31, No.2, pp. 177-183, ISSN: 0004-0002 (print), 1573-2800

internet: Implications for STI and HIV prevention and client education. *American Journal of Men's Health,* Vol.2, No.4, pp. 306-313, ISSN: 1557-9883 (print), 1557-9891

Senterfitt, W.; Berk, M.; Morton, S.; & Shapiro, M. (2003). The care of HIV-infected adults in the United States. *The New England Journal of Medicine,* Vol.*339 No.26,*

the U.S. and in large U.S. metropolitan areas from 1992-2002. *Journal of Urban Health*, *Bulletin of the New York Academy of Medicine* Vol., 85, pp 323-351. ISSN: 1099-

a treatment optimism scale for HIV-positive gay and bisexual men.  *AIDS Education and Prevention,*

risk in a probability sample of men who have sex with men in the era of highly

using the parental-child relationship (National commission on AIDS, 1994) and the schools as an intervention setting for risk reduction among adolescents (Di Clemente, 1992; National Commission on AIDS, 1994).


*Edited by Michael Aide and Takahito Nakajima*

This book describes the recent evolution of rare earth elements and their mineralogy, both natural and synthetic analogues. Authors review and document rare earth element chemistry in the aqueous environment and the petrology of the rare earth element-bearing mineral Allanite. Synthetic rare earth minerals and their applications is a rapidly evolving discipline important to medicine, advanced digital technologies, and solid-state physics. Authors report on the synthesis of a macrocyclic gadolinium complex and also gadolinium complexes and their applications in medicine. Authors present compelling advances in gadolinium isotopes and oxides as substrates for induced excitation and luminescent material sciences.

Published in London, UK © 2020 IntechOpen © g-miner / iStock

Rare Earth Elements and Their Minerals

Rare Earth Elements

and Their Minerals

*Edited by Michael Aide*

*and Takahito Nakajima*


**2. Problem statement**

Jobsite safety management performance can be enhanced by using RFID technology for in‐ formation sharing and communication. There are many jobsite safety checkpoints locations need for tracked and inspected for jobsite safety management. Information acquisition prob‐ lems in inspection management follow from information being gathered from jobsite safety checkpoints locations. The effectiveness of information and data acquisition influences the efficiency of jobsite inspection management. Usually, project managers and safety staff members generally use sheets of paper and/or field notes for jobsite safety inspection prog‐ ress in Taiwan construction jobsite. Restated, existing means of processing information and accumulating data are not only time-consuming and ineffective, but also compromise jobsite safety management in information acquisition. Such means of communicating information between jobsite safety checkpoints locations and jobsite office, and among all participants, are ineffective and inconvenient. The primary problems in inspection regarding to data cap‐ ture and sharing based on experts interviews are as follows: (1) the efficiency and quality are low, especially in the safety inspection progress in construction jobsite through docu‐ ment-based media, (2) there are serious rework progress regarding the data capture and in‐ put in safety inspection progress, and (3) there are serious problems regarding to inspection information collection and responding during safety inspection progress. However, few suitable platforms are developed to assist jobsite office with capturing and sharing the job‐ site safety inspection information when jobsite office needs to handle inspection information and inspection management work. Therefore, to capture data effective and enhance inspec‐ tion information collection and respond in construction jobsite will be primary and signifi‐ cant challenge in the study.

### **3. Research objectives**

This study utilizes the RFID and web technology to enhance the inspection management progress and effectiveness in jobsite safety management. This system is controlled by the management division, and provides project managers and safety staff members with realtime checkpoints-related information-sharing services, enabling them to dynamically re‐ spond to the entire jobsite safety management network. This study develops Mobile RFIDbased Safety Inspection Management (RFIDSIM) system to improve efficiency and costeffectiveness of jobsite safety management, improve practical communication among participants, and increase flexibility in terms of service delivery and response times. RFID‐ SIM system is a web-based system for effectively integrating managers, safety staff members and relative members, to enhance the jobsite safety management in the construction. Utiliz‐ ing smartphone with NFC technologies can extend RFIDSIM systems from offices to jobsite safety checkpoints locations. Data collection efficiency can also be enhanced using RFID-en‐ abled smartphone with NFC technology to enter and edit data on the jobsite safety check‐ points locations. By using web technology and RFID-enabled smartphone with NFC technologies, the RFIDSIM system for the management division has tremendous potential to increase the efficiency and effectiveness of information respond and management, thus streamlining services jobsite safety management processes with other participants. The por‐ tal and RFID-enabled smartphone with NFC technology enable safety staff members to up‐ date data from the jobsite safety checkpoints locations and immediately upload it to the system; project managers can receive inspection information and make better decisions re‐ garding future jobsite safety management and control. The main purposes of this study in‐ clude (1) developing a framework for a mobile jobsite safety inspection system; (2) applying such a system that integrates RFID-enabled smartphone with NFC technology to increase the efficiency of safety inspection data collection in the jobsite, and (3) designing a webbased portal for jobsite safety management and control, providing real-time information and wireless communication between jobsite office and jobsite safety checkpoints locations. Figure 1 illustrates solutions used in a polite test utilized RFIDSIM system in Taiwan con‐ struction jobsite. With appropriate modifications, the RFIDSIM system can be utilized at any jobsite safety inspection and management application in construction.

**Figure 1.** RFIDSIM System Framework Overview

Integrating Near field communication (NFC) technology and mobile devices such as NFC Smartphone, Radio Frequency Identification (RFID) scanning and data entry mechanisms, can help improve the effectiveness and convenience of information flow in the safety inspec‐ tion management. The combined results demonstrate that, an RFIDSIM system can be a use‐ ful mobile RFID-based jobsite safety management platform by utilizing the NFC and web technologies. With appropriate modifications, the RFIDSIM system can be utilized at any jobsite inspection and management progress for jobsite safety management divisions or sup‐

Jobsite safety management performance can be enhanced by using RFID technology for in‐ formation sharing and communication. There are many jobsite safety checkpoints locations need for tracked and inspected for jobsite safety management. Information acquisition prob‐ lems in inspection management follow from information being gathered from jobsite safety checkpoints locations. The effectiveness of information and data acquisition influences the efficiency of jobsite inspection management. Usually, project managers and safety staff members generally use sheets of paper and/or field notes for jobsite safety inspection prog‐ ress in Taiwan construction jobsite. Restated, existing means of processing information and accumulating data are not only time-consuming and ineffective, but also compromise jobsite safety management in information acquisition. Such means of communicating information between jobsite safety checkpoints locations and jobsite office, and among all participants, are ineffective and inconvenient. The primary problems in inspection regarding to data cap‐ ture and sharing based on experts interviews are as follows: (1) the efficiency and quality are low, especially in the safety inspection progress in construction jobsite through docu‐ ment-based media, (2) there are serious rework progress regarding the data capture and in‐ put in safety inspection progress, and (3) there are serious problems regarding to inspection information collection and responding during safety inspection progress. However, few suitable platforms are developed to assist jobsite office with capturing and sharing the job‐ site safety inspection information when jobsite office needs to handle inspection information and inspection management work. Therefore, to capture data effective and enhance inspec‐ tion information collection and respond in construction jobsite will be primary and signifi‐

This study utilizes the RFID and web technology to enhance the inspection management progress and effectiveness in jobsite safety management. This system is controlled by the management division, and provides project managers and safety staff members with realtime checkpoints-related information-sharing services, enabling them to dynamically re‐

pliers in support of the RFIDSIM system.

268 Radio Frequency Identification from System to Applications

**2. Problem statement**

cant challenge in the study.

**3. Research objectives**


2.1. Non-edible oil crops in South-East Asia

Jatropha (Jatropha curcas) was not the only prominent non-edible oil crop. Other crops such as karanja (Pongamia pinnata), polanga (Calophyllum inophyllum), and neem (Azadirachta indica) were also found to be promising as alternative biodiesel feedstocks [11]. Rubber (Hevea brasiliensis) and mahua (Madhuca indica) have also shown potential and needs to be explored as biodiesel feedstock (Figure 1). The oil from the seed of these plants (Figure 2) has been considered as a waste material as it is non-edible; hence, they have the significant potential for biodiesel production.

2.1.1. Jatropha (Jatropha curcas L.)

Jatropha curcas L., a member of the family Euphorbiaceae, is a large drought-resistant multipurpose shrub with several attributes and considerable potential, and has evoked interest all over the tropics as a potential biofuel crop [12]. The lifespan of this perennial bush is more than 50 years, and it can grow on marginal soils with low nutrient content [12, 13]. Seed

Figure 2. Seeds of six different species of non-edible vegetable oils as renewable sources for biodiesel.

Figure 1. Six different species of non-edible vegetable oils as renewable sources for biodiesel.

Non-Edible Vegetable Oils as Renewable Resources for Biodiesel Production: South-East Asia Perspective

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203

Non-Edible Vegetable Oils as Renewable Resources for Biodiesel Production: South-East Asia Perspective http://dx.doi.org/10.5772/intechopen.73304 203

Figure 1. Six different species of non-edible vegetable oils as renewable sources for biodiesel.

Figure 2. Seeds of six different species of non-edible vegetable oils as renewable sources for biodiesel.

#### 2.1.1. Jatropha (Jatropha curcas L.)

higher demand for food and energy. Utilizing non-edible oils as a biodiesel feedstock assists the sustainability of biodiesel production and minimizes the impact directly on food supply [1].

Deforestation and destruction of ecosystem due to urbanization and plantation expansion is a big issue in utilizing edible oil as biodiesel feedstock. Furthermore, the boundary line between food and fuel is blurred since both the fields are competing for the same resources. Debating over food versus fuel is still a dilemma. There are large surplus of food crops in developed countries. However, millions of people in developing countries still face the scarcity of food. Conversion of food crops such as palm oil, coconut oil, corn, soybean, and sugarcane to biodiesel could lead to serious food shortage. Countries in South-East Asia fall in the tropical belt and have many species of crops both edible as well as non-edible ones. Developing biodiesel production based on non-edible oil is one of the scenarios for fuel security without interfering with the food supply. This is especially true for palm oil which makes up about onethird of vegetable oil as biodiesel feedstock and has become the hottest environmental topic in

High price of high quality refined edible oil makes them not feasible as tent to uneconomic for developing countries like India due to high production cost of methyl or ethyl ester from the edible oil. The cost is about four times higher compared to the cost of diesel [4]. Valuable nutrient elements in edible oil such as essential amino acids, β-carotene, α-carotene, vitamin-E, lycopene, tocotrienols, and carotenoids will be neglected, if this oil is converted to fuel.

Non-edible crops can grow in waste and unproductive land which may be helpful for reclaiming the land [1, 5, 6]. Furthermore, non-edible oils may contain toxic substances such as triterpenoids and strong odor in neem oil, and furanoflavones, furanoflavonols, chromenoflavones, flavones, and furanodiketones in karanja oil [7]. Rubber seed oil contains cyanogenic glucoside that yields poisonous prussic acid (HCN) due to enzymatic reaction [8]. Jatropha oil contains toxic phorbol esters (0.03–3.4%) [9] or curcain [10], depending on the variety. Hence, it

Jatropha (Jatropha curcas) was not the only prominent non-edible oil crop. Other crops such as karanja (Pongamia pinnata), polanga (Calophyllum inophyllum), and neem (Azadirachta indica) were also found to be promising as alternative biodiesel feedstocks [11]. Rubber (Hevea brasiliensis) and mahua (Madhuca indica) have also shown potential and needs to be explored as biodiesel feedstock (Figure 1). The oil from the seed of these plants (Figure 2) has been considered as a waste material as it is non-edible; hence, they have the significant potential for

is better to exploit these non-edible oils as feedstocks for biodiesel production.

2.1. Non-edible oil crops in South-East Asia

biodiesel production.

2. Non-edible oil merits as biodiesel feedstock

South-East Asia.

202 Advances in Biofuels and Bioenergy

Jatropha curcas L., a member of the family Euphorbiaceae, is a large drought-resistant multipurpose shrub with several attributes and considerable potential, and has evoked interest all over the tropics as a potential biofuel crop [12]. The lifespan of this perennial bush is more than 50 years, and it can grow on marginal soils with low nutrient content [12, 13]. Seed production is from 0.2 kg to more than 2 kg per plant [5]. The average weight per 1000 seeds is about 500–800 g, which is equivalent to 1333 seeds per kg. The seed coats constitute about 35– 40% of the total seeds. The oil content in seeds ranges from 35 to 40% and the kernels 55–60% (www.jartropha.org) [14]. Many investigations have been done on the composition and content of the jatropha seeds [15]. Optimal seed yield in good condition area is around 5 t dry seed ha1 y1 [16]. Seed oil contain 22.50% saturated fatty acid (16.00% palmitic acid, 6.50% stearic acid) and 78.70% unsaturated fatty acid (43.50% oleic acid, 34.40% linoleic acid, 0.80% linolenic acid) [6].

seeds is about 300–500 kg/ha/year [24]. Rubber seed kernels (50–60% of seed) contain 40–50% of pale yellow oil [25–27]. Rubber seed oil does not contain any unusual fatty acids, but is rich in polyunsaturated fatty acids C18:2 and C18:3 that make up 52% of its total fatty acid composition [28]. Rubber seed oil contains 18.90% saturated fatty acid (10.20% palmitic acid, 8.70% stearic acid) and 80.50% unsaturated fatty acid (24.60% oleic acid, 39.605 linoleic acid,

Non-Edible Vegetable Oils as Renewable Resources for Biodiesel Production: South-East Asia Perspective

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205

Madhuca indica is a member of the family Sapotaceae and is commonly known as Butter Tree. Mahua oil is obtained from the seed kernel. The tree is medium to large and found in Asia. Average productivity of mahua seed is about 1.6 kg/tree [30]. The seeds contain 30–40% fatty oil, which is non-edible and used in the manufacture of various products such as soap and glycerin. It contains 31.80% saturated fatty acid (17.80% palmitic acid, 14.00% stearic acid) and

Characteristics of vegetable fats and oils depend on the length and degree of un-saturation of the fatty alkyl chains. Thus, the fatty acid plays an important role in determining biodiesel characteristics. Amount of each fatty acid, chain length, and number of double bond present in the hydrocarbon chain influences the biodiesel properties [31]. The stability of biodiesel also depends on the feedstock properties used for biodiesel production. The most abundant fatty acids in the oil samples were oleic, linoleic, linolenic, palmitic, and stearic fatty acid. Oleic acid comprises of a major portion of the total fatty acid irrespective of non-edible oil summarized in Table 1. All oils have high unsaturated fatty acids (up to 80%) which mean they have good low

Properties Jatropha Karanja Polanga Rubber Mahua Neem Diesel

Palmitic (C16:0) 16.0 11.7 12.0 10.2 17.8 14.9 — Stearic (C18:0) 6.5 7.5 12.9 8.7 14.0 14.4 — Total 22.5 19.2 24.9 18.9 31.8 29.3 —

Oleic (C18:1) 43.5 51.6 34.1 24.6 46.3 61.9 — Linoleic (C18:2) 34.4 16.5 38.3 39.6 17.9 7.5 — Linolenic (C18:3) 0.80 2.7 0.30 16.3 — —— Total 78.7 70.8 72.4 80.5 64.2 69.4 — Cetane number 52.3 55.8 57.3 — 40 57.8 46 Oilseed content, %w 55 33 65 40–50 50 44.5 — FFA %w 14 2.5 22 17 20 — — Specific gravity 0.92 0.91 0.90 0.91 — — 0.84

64.20% unsaturated fatty acid (46.30% oleic acid, 17.90% linoleic acid) [11].

16.30% linolenic acid) [29].

Saturated fatty acid

Unsaturated fatty acid

2.1.6. Mahua (Madhuca indica)

3. Characteristic of non-edible oils


**1. Introduction**

Classically, acute kidney injury (AKI) is defined as a decrease in the glomerular filtration rate (eGFR) in a period of less than 3 months accompanied by the retention of nitrogenous products and changes in the internal environment, and anuria or oliguria may or may not be present [1].

In 2004, the Acute Dialysis Quality Initiative (ADQI) group considered that staging the damage is important in the diagnosis of AKI because small increases in creatinine or decreased diuresis are associated with greater morbidity and mortality and longer hospital stay [2].

In the Acute Kidney Injury Network (AKIN) Classification System, the value of increased serum creatinine (sCr) greater than 0.3 mg/dl is added with greater diagnostic sensitivity and eliminates the Loss and ESRD stages [3]. The Kidney Disease Improving Global Outcomes (KDIGO) workgroup in 2012 [4] encompasses an elevation of sCr greater than 0.3 mg/dl or an increase greater than 50% above the baseline value in a period of 7 days; in each of the three stages, a range is placed in relation to the fold

increase in creatinine in relation to the basal range, and the other parameter that is taken into account is urine production [4]. Comparison of the KDIGO criteria, creatinine has greater predictive ability than urinary volume.

After reaching consensus on the definition of AKI by the Acute Disease Quality Initiative (ADQI) group, the AKI incidence in the general ward has been 20% [5], with rates increasing by approximately 10% per year [6]. The incidence of AKI in the intensive care unit (ICU) has been 30 to 50%, and 10% require kidney replacement therapy (KRT) [7, 8]. The hospital mortality of AKI has been 27.5% in those who did not require KRT and from 33 to 53% [9] in those who required KRT. This incidence has not changed over time probably due to more serious pathologies and increasingly long-living patients.

The development of AKI in the ICU is considered a predictor of mortality with a specificity of 71% and a sensitivity of 93% similar to the APACHE II score with a specificity of 75% and a sensitivity of 93% and where the relationship between AKI and mortality in the ICU is significant (odds ratio 3.99; 95% CI 2.125–7.481) [10].

### **2. Classification and biomarkers**

The KDIGO guidelines classify the severity of ARF into three stages according to functional 2os2rome (sCr and diuresis), one of which is the elevation of creatinine with respect to baseline, and if the baseline value is not known, the corresponding creatinine values are taken into account, depending on sex, age and race; another variable is the reduction in urinary 2os2rom as a function of time. It is known that creatinine is not the best marker of renal function, in addition to being a late marker, and can be interpreted in different clinical situations such as states of fluid overload (FO), and the creatinine value should be corrected by the FO. There are also drugs that affect the tubular secretion of creatinine (trimethoprim-sulfamethoxazole, cimetidine, and ranitidine) and changes in the rate of sCr production (muscle hypercatabolism, the elderly).

It is important to identify predisposing and susceptibility factors that may develop AKI, such as heart failure, diabetes mellitus, liver disease, chronic kidney disease (CKD), sepsis, emergency surgery, cardiac surgery, and the use of nephrotoxic drugs. The use of biomarkers in populations at clinical risk will allow the detection of subclinical AKI in those at risk of renal complications after exposure to a noxa and allow opportunities for preventive intervention strategies to improve clinical outcomes and reduce the need for KRT [11]. The ADQI consensus conference (**Table 1**) recommends a combination of damage and functional biomarkers (**Table 2**) to improve the diagnostic accuracy of AKI and has made it possible to modify the KDIGO classification in stage 1 AKI with three subcategories (1S, 1A, and 1B) and AKI stage 2 and 3 with subcategories (2 A biomarker negative, 2B biomarker positive) (recommendation grade B) [12, 13].

### **3. Considerations at the start of kidney replacement therapy**

The question of when to start KRT dates back 60 years, where Parsons F. et al. described a retrospective cohort of 17 patients with sepsis of surgical origin with AKI and who underwent intermittent hemodialysis with BUN values >180 mg/dl and had an 88% mortality. One year later, the same work group reported another cohort of 17 *Timing of Initiation of Kidney Replacement Therapy in Acute Kidney Injury… DOI: http://dx.doi.org/10.5772/intechopen.112156*

*The ADQI consensus conference recommends a combination of damage and functional biomarkers to improve the diagnostic accuracy of AKI and have allowed modification of the KDIGO classification in stage 1 AKI with three subcategories (1S, 1A, and 1B) and stages 2 and 3 from AKI with subcategories (2A biomarker negative and 2B biomarker positive) [12].*

#### **Table 1.**

*AKI classification.*

*Biomarkers are classified into glomerular filtration, tubular function, tubular damage, injury response, and cell regulation [12].*

*Urinary insulin-like growth factor-binding protein (IGFBP-7) and tissue inhibitor of metalloproteinase (TIMP-2), neutrophil gelatinase-associated lipocalin (NGAL), interleukin-6, interleukin-10, interleukin-18, Kidney Injury Molecule-1 (KIM-1), liver-type fatty acid-binding protein (L-FABP), Fractional Excretion of Sodium (FENa), and Fractional Excretion of Urea (FEUrea).*

#### **Table 2.**

*Biomarker IN AKI.*

patients with AKI due to sepsis with daily BUN increases of 30 mg/dl in which early intervention in dialysis treatment decreased mortality to 25% [14].

The KDIDO-2012 guideline recommends the Initiate KRT emergently when lifethreatening changes in fluid, electrolyte, and acid-base balance exist (Not Graded). The clinical context should be considered, and trends from laboratory tests should be evaluated, rather than single nitrogen values (Not Graded). These appraisals are far from being practical and we hope that, with the updated evidence of recent years and the forthcoming recommendations from the KDIGO, they will provide a clearer guideline [15].

The decision to start KRT should not only be based on kidney function or KDIGO stage, but many aspects mentioned below should also be evaluated (**Figure 1**).

The kidneys have a finite capacity; when the demands exceed the renal capacity in the context of AKI, an imbalance with non-renal organ dysfunction is generated. Renal demands and capacity should be assessed taking the following considerations:

#### **Figure 1.**

*Considerations at the start of kidney replacement therapy. To consider the initiation of KRT, patient comorbidities, severity of acute illness, severity of AKI, and the expressed will of the patient, family, human resources, and available machines and costs are taken into account [16].*

*Timing of Initiation of Kidney Replacement Therapy in Acute Kidney Injury… DOI: http://dx.doi.org/10.5772/intechopen.112156*

#### **Figure 2.**

*Kidney capacity and demand. The relationship of renal capacity and demands refers to the state of functional reserve of the kidneys. They are not able to withstand the severity of acute illness, fluid overload, and metabolic overload, where previous comorbid conditions may be a factor in a lower tolerance to the development of AKI [16].*

6. It is important to know the wishes of the patient and family, to evaluate with the medical team whether dialysis is part of a therapeutic plan of the multidisciplinary team and that it does not represent a futile measure, and to consider the availability of nursing staff, machines, and costs [16].


*Edited by Zouhair O. Amarin*

Globally, there is a shortage of family planning services. This shortage is associated with unacceptably high rates of maternal and perinatal morbidity and mortality that are mostly preventable. The current situation does not comply with the United Nations Millennium Declaration, signed in September 2000. Family planning needs to be widely available and easily accessible. In addition, it is vital that research intensifies to further cover the safety, effectiveness, affordability, and acceptability of family planning methods and accessibility to family planning services. This book is designed as an additional contribution to the family planning spectrum. It covers some aspects of family planning and deals with a number of issues that pertain to reproductive health.

Published in London, UK © 2022 IntechOpen © LeszekCzerwonka / iStock

Studies in Family Planning

Studies in Family Planning

*Edited by Zouhair O. Amarin*


*2.1.3. Some examples of classical two-dimensional nonautonomous systems*

Consider three classical nonlinear ordinary differential equations of the second order with periodic coefficients such as Duffing-Holmes equation

$$
\ddot{\mathbf{x}} + k\dot{\mathbf{x}} + a\rho^2 \mathbf{x} + \mu \mathbf{x}^3 = f\_0 \cos \Omega t,\tag{6}
$$

Universality of Transition to Chaos in All Kinds of Nonlinear Differential Equations 141

**Figure 6.** Original cycle (a), cycle of period two (b), Feigenbaum attractor (c), cycle of period three (d) from subharmonic cascade and more complex singular attractor (e) in the Croquette equation (8).

Consider a smooth family of three-dimensional nonlinear dissipative autonomous systems

It is shown by the author in (Magnitskii & Sidorov, 2006; Magnitskii, 2008) that if a threedimensional system of Eqs. (9) has a singular cycle of period *T* defined by complex Floquet exponents with equal imaginary parts (i.e. Moebius bands are its stable and unstable invariant manifolds), then by passing to a coordinate system rotating around the cycle, one can reduce such system to a two-dimensional nonautonomous system in coordinates, transversal to the singular cycle with zero rotor-type singular point corresponding to the cycle. So, all arguments listed in the previous section hold completely for autonomous three-

Therefore, three-dimensional autonomous system with singular cycle should have the same FSM scenario of transition to chaos as two-dimensional nonautonomous system with periodic coefficients and zero rotor-type singular point. As an example, consider the

> 22 22 1 2 1 1 2 11 2 2 3 22 22 2 1 2 1 2 11 2 2 3

> >

( ) ( ), ( ),(0,0,1) , 0 0 *T Qt x t x t* one can reduce the system of Eqs. (10) to two-dimensional

*x x x x x xx x x x x x x x x xx x x x*

>

[(( 1) )( 1) (2 / 2) ],

in the plane of variables 1 2 (,) *x x* . By

(10)

and limit cycle

[(( 1) )( 1) (2 / 2) ],

with 2 /

2 2 3 2 12 1 3

with period 2 / *T*

changing the variables 0 1 2 ( , ) , ( , )(0, ( ), ( ))*T xt x t Qt u t u t*

>

*x x xx x x*

( / 4)( 1) 2( 1 ) .

system of Eqs.(10) has the singular point (0,0, / 8( 1))

.

*М R I R FC* , ,, (9)

**2.2. Three-dimensional autonomous systems**

 3 *x Fx x* ( , ),

depending on a scalar system parameter

dimensional systems with singular cycles.

*2.2.1. FSM – scenario of transition to chaos*

autonomous three-dimensional system

0 , (cos ,sin ,0)*T xt t t*

nonautonomous system with 2 /

For 1

of ordinary differential equations

modified dissipative Mathieu equation

$$
\ddot{\mathbf{x}} + \mu \dot{\mathbf{x}} + (\delta + \mathbf{z} \cos \alpha t)\mathbf{x} + \alpha \mathbf{x}^3 = \mathbf{0},\tag{7}
$$

and Croquette dissipative equation

$$
\ddot{\mathbf{x}} + \mu \dot{\mathbf{x}} + \alpha \sin \mathbf{x} + \beta \sin(\mathbf{x} - \alpha \vartheta) = \mathbf{0}.\tag{8}
$$

All these equations are equivalent to two-dimensional nonlinear dissipative systems of ordinary differential equations with periodic coefficients and all of them have the same universal FSM scenario of transition to dynamical chaos (Magnitskii & Sidorov, 2006). For these equations, some important stable cycles and singular subharmonic attractors in accordance with the Sharkovskii order are presented in Fig. 4 - Fig. 6.

**Figure 4.** Original cycle (a), cycle of period two (b), Feigenbaum attractor (c), cycle of period six (d) from subharmonic cascade and more complex singular attractor (e) in the Duffing-Holmes equation (6).

**Figure 5.** Original cycle (a), cycle of period two (b), Feigenbaum attractor (c), cycle of period three (d) from subharmonic cascade and more complex singular attractor (e) in the Mathieu equation (7).

Note that double period bifurcations were found also in (Awrejcewicz, 1989; Awrejcewicz 1991) for some other nonlinear ordinary differential equations of the second order with periodic coefficients.

**Figure 6.** Original cycle (a), cycle of period two (b), Feigenbaum attractor (c), cycle of period three (d) from subharmonic cascade and more complex singular attractor (e) in the Croquette equation (8).


**6. Ecological and environmental adversities**

Since the prehistoric era, changes in irrigation system have a strong link with climate change [39]. Due to the increase in agricultural area and productivity, the human population has been increased in the Indus basin, followed by urbanization and industrialization, boosting the water demands for household, food production, and energy and industrial sectors. Population increased due to the availability of resources and settlement areas. A large area was converted into the urbanized area, and some of the native species vanished from the Indus Basin. In order to protect the urban area, a natural path of the Indus River should be restored along with its natural floodplains and wetland area. The presence of highly populated areas in the floodplains of rivers makes a large number of people prone to the flooding. In such circumstances, more economic loss has been observed by the flood as it happened in 2010 in Pakistan. In Kashmir region, the majority of the dams are constructed in a hazard-prone area and are called as "water bombs" by a glaciologist. About 15 dams were built by the Indian Government in the Himalayas, which were not recommended due to fragile mountainous land. The temperature in this mountainous region is increasing by human-induced global warming, and glaciers are retreating, creating a temporarily high flow in the Indus River, which may cause damage to the structures built [43]. The sediment load is constantly increasing in the river resulting in avulsion. With the passage of time, the storage capacity of the reservoirs started to decline due to the siltation increasing the area under inundation [53]. Reduction in the storage capacity increases the chances of flooding in the surrounding areas in high flow seasons. A detailed information about the impacts on the Indus River and mitigation measures is provided in **Table 3**.

**91**

*Vulnerability of Environmental Resources in Indus Basin after the Development of Irrigation…*

Since 1851, the salinity problem has been observed in different areas of the Indus basin. Firstly, the salinity issue was identified in the Jammu and Kashmir regions. Similarly, in Punjab, salinity problems were also reported. To check the overall groundwater level in the basin, a series of observatory wells were installed across the basin. In open water table wells, Punjab showed the remarkable increase in the water table level induced by man-made irrigation system in the area. The main reason for the high level of the water table, salinity, and water logging observed in the basin, although it was not that much prominent, was considered to be the diversion of the river channel and the construction of unlined irrigation canals during 1850–1950. The situation in Punjab is still considered better than Sindh because in this area water logging was more common than salinity due to salt-free upper layers and better drainage and topography. Salinity problems in Punjab were only confined to the areas with poor drainage and topography. In the central Indus basin, i.e., lower Punjab and upper Sindh, the water table was found to be highest in the 1940–1950s followed by the highest level of waterlogging in the 1960–1980s. Salinity conditions in this area are in transition to the upper and lower areas of the basin. The productivity of 20–30% of irrigated land was affected due to salinity and waterlogging during 1970–1980s [63]. A shift in climatic patterns and over the use of surface water reduced the availability of water, forcing the people to rely on groundwater aquifers, resulting in rapid depletion of subsurface water resources. The shift from surface irrigation to groundwater is the inability of the Indus basin irrigation system to accommodate the changing water requirements of crops over different seasons due to inefficient water management. Increase in food requirements due to population growth and economic competition emerged due to over demand of crop yield, and the farmer community moved from a conventional irrigated agriculture to more water-intensive agriculture that was beyond the capacity of the existing irrigation system. More than 80% of groundwater is extracted by small tube wells because of cheaper installation and easy operation. In the irrigated areas, groundwater is of poor quality, and its frequent use in agricultural has resulted in salinity of a large portion of the agricultural area in the Indus basin [53]. The Indus River delta is facing the high risk of salinity in upper parts due to vertical and lateral movement of saline groundwater into the fresh shallow aquifers [64]. Secondary salinization has been observed in 4.5 million hectares of land, and half of the lands are in the Indus basin irrigation area. About one million hectares of agricultural land is facing waterlogging problems due to seepage of canal water and poor irrigation techniques [45]. Food grain crops have been replaced with high-price crops, which require more water than the food grains, resulting in increased water demand. The canal water system, fed by Indus River, adds almost 16.6 million tons of salts into the irrigated and deserted strata of Indus basin including groundwater aquifers. Rainstorms cause a lot of agricultural and economic damages due to the restricted surface and subsurface water drainage, because of the plain topography of Indus basin [40].

*Environmental and ecological problems in Indus Basin, their mitigation and recommendations [53–62].*

*DOI: http://dx.doi.org/10.5772/intechopen.86722*

**Table 3.**

*Vulnerability of Environmental Resources in Indus Basin after the Development of Irrigation… DOI: http://dx.doi.org/10.5772/intechopen.86722*

#### **Table 3.**

*Irrigation - Water Productivity and Operation, Sustainability and Climate Change*

at the expense of Sindh's share of the Indus River [45].

**6. Ecological and environmental adversities**

Indus River and mitigation measures is provided in **Table 3**.

Similarly, interprovincial conflicts also exist in Pakistan over the unequal distribution of Indus waters among the dominant province of Punjab and other smaller provinces mainly Sindh [52]. Unlike India, these conflicts have been limited to the political platforms. In the mid-nineteenth century, the construction of large canal structures by the British Government in Punjab gave birth to these conflicts. In 1945, Interprovincial water distribution was ensured by signing a treaty in which the Indus River water along with its tributaries was distributed between Sindh and Punjab. According to this treaty, majority of water from the eastern tributaries of Indus (94%) were allocated to Punjab and remaining to the Sindh. Meanwhile, Sindh was allocated with 75% water of the Indus main channel and Punjab with the remaining 25%. The Indus Water Treaty made the construction of link canals necessary for Pakistan in order to compensate for the upstream loss of water. As a majority of the link canals and storage reservoirs were to be constructed in the Punjab region, Sindh's population perceived it as a conspiracy to compensate Punjab

To settle the issues among the provinces, the "Water Accord 1991" was endorsed in which Indus water was distributed on the basis of average flow. Even after the accord, some insecurities existed in smaller provinces because the large quantity of water was allocated to only Punjab and Sindh [52]. Kalabagh Dam has been a focus of attention for many years due to political insecurities on the construction of the dam. People of Sindh claim that after the construction of the dam, water flow will be reduced causing droughts and saltwater intrusion in downstream areas. They also claim that Sindh is far more dependent on river waters because more than 80% of groundwater is saline in the region and construction of the dam will compromise their water requirements. This project was developed in the light of past destructive events of droughts in Sindh and subjected to opposition from politicians and bureaucrats of the Sindh province [45].

Since the prehistoric era, changes in irrigation system have a strong link with climate change [39]. Due to the increase in agricultural area and productivity, the human population has been increased in the Indus basin, followed by urbanization and industrialization, boosting the water demands for household, food production, and energy and industrial sectors. Population increased due to the availability of resources and settlement areas. A large area was converted into the urbanized area, and some of the native species vanished from the Indus Basin. In order to protect the urban area, a natural path of the Indus River should be restored along with its natural floodplains and wetland area. The presence of highly populated areas in the floodplains of rivers makes a large number of people prone to the flooding. In such circumstances, more economic loss has been observed by the flood as it happened in 2010 in Pakistan. In Kashmir region, the majority of the dams are constructed in a hazard-prone area and are called as "water bombs" by a glaciologist. About 15 dams were built by the Indian Government in the Himalayas, which were not recommended due to fragile mountainous land. The temperature in this mountainous region is increasing by human-induced global warming, and glaciers are retreating, creating a temporarily high flow in the Indus River, which may cause damage to the structures built [43]. The sediment load is constantly increasing in the river resulting in avulsion. With the passage of time, the storage capacity of the reservoirs started to decline due to the siltation increasing the area under inundation [53]. Reduction in the storage capacity increases the chances of flooding in the surrounding areas in high flow seasons. A detailed information about the impacts on the

**90**

*Environmental and ecological problems in Indus Basin, their mitigation and recommendations [53–62].*

Since 1851, the salinity problem has been observed in different areas of the Indus basin. Firstly, the salinity issue was identified in the Jammu and Kashmir regions. Similarly, in Punjab, salinity problems were also reported. To check the overall groundwater level in the basin, a series of observatory wells were installed across the basin. In open water table wells, Punjab showed the remarkable increase in the water table level induced by man-made irrigation system in the area. The main reason for the high level of the water table, salinity, and water logging observed in the basin, although it was not that much prominent, was considered to be the diversion of the river channel and the construction of unlined irrigation canals during 1850–1950. The situation in Punjab is still considered better than Sindh because in this area water logging was more common than salinity due to salt-free upper layers and better drainage and topography. Salinity problems in Punjab were only confined to the areas with poor drainage and topography. In the central Indus basin, i.e., lower Punjab and upper Sindh, the water table was found to be highest in the 1940–1950s followed by the highest level of waterlogging in the 1960–1980s. Salinity conditions in this area are in transition to the upper and lower areas of the basin. The productivity of 20–30% of irrigated land was affected due to salinity and waterlogging during 1970–1980s [63].

A shift in climatic patterns and over the use of surface water reduced the availability of water, forcing the people to rely on groundwater aquifers, resulting in rapid depletion of subsurface water resources. The shift from surface irrigation to groundwater is the inability of the Indus basin irrigation system to accommodate the changing water requirements of crops over different seasons due to inefficient water management. Increase in food requirements due to population growth and economic competition emerged due to over demand of crop yield, and the farmer community moved from a conventional irrigated agriculture to more water-intensive agriculture that was beyond the capacity of the existing irrigation system. More than 80% of groundwater is extracted by small tube wells because of cheaper installation and easy operation. In the irrigated areas, groundwater is of poor quality, and its frequent use in agricultural has resulted in salinity of a large portion of the agricultural area in the Indus basin [53].

The Indus River delta is facing the high risk of salinity in upper parts due to vertical and lateral movement of saline groundwater into the fresh shallow aquifers [64]. Secondary salinization has been observed in 4.5 million hectares of land, and half of the lands are in the Indus basin irrigation area. About one million hectares of agricultural land is facing waterlogging problems due to seepage of canal water and poor irrigation techniques [45]. Food grain crops have been replaced with high-price crops, which require more water than the food grains, resulting in increased water demand. The canal water system, fed by Indus River, adds almost 16.6 million tons of salts into the irrigated and deserted strata of Indus basin including groundwater aquifers. Rainstorms cause a lot of agricultural and economic damages due to the restricted surface and subsurface water drainage, because of the plain topography of Indus basin [40].

Development of irrigation system structures such as dams and barrages has led to the fragmentation of Indus River into 17 sections which resulted in extirpation of dolphins from 10 sections. They were found to be present in only 6 out of 17 sections of the river due to the usage of river water for irrigation and low water discharges in the dry season. Spatial and temporal distribution patterns were affected by habitat fragmentation, and, combined with habitat degradation, it contributed to the decline of the dolphin population [55]. The whole length of the Indus River used to be the habitat of dolphins, but this area has now been restricted to only 20% of total length due to habitat fragmentation. Chemical pollution and accidental death by fishing gears are some of the potential factors for the decline in the dolphin population [65]. Sometimes, dolphins get trapped in the canals, fail to return back into the river, and eventually die. In the downstream area of Sukkur Barrage, the river channel is highly constricted, and dolphins are subjected to intensive fishing activities mainly in the winter season [66].

Natural processes have the potential to contaminate water resources, but with the development of irrigation system and residential colonies, the agricultural system became widespread, and a large number of industries came into existence. Anthropogenic activities in agriculture and industries cause discharges of fertilizers, pesticides, chemicals, heavy metals, and pathogens that can degrade the water quality and can cause negative effects on human health. Fertilizers and pesticides used in the agricultural areas are washed off and drained into surface and groundwater aquifers. The water requirements are high in the urban areas, and they contribute to water pollution by the production of municipal sewerage and leaching from solid waste generated. Water affected both qualitatively and quantitatively making it unsuitable for the human and animal consumption. As the Indus River flows downward, the effects of deterioration are intensified as a large volume of untreated effluents from agricultural, industrial, domestic, and commercial areas enter into the river on its way. Throughout the river channel, concentrations of nitrogen, phosphorus organic matter, pesticides, and mercury are present at an alarming level. Most of the effluent dumped into the river comes from the agricultural sector alone, while industries, households, and urbanized areas being the other major sources [67].

Indus delta is rich in biodiversity, and mangroves were a very important ecological resource in the lower Indus basin. Reduced water flow, pollution of rivers, and usage of mangroves as fodder and fuel have reduced the mangrove species. The population of mangroves has declined to a threatened level by pollution and anthropogenic activities [68]. With the decline in mangrove population, the spawning and rearing sites of many fish and macroinvertebrate species have been destroyed causing a decline in the population of those species. The flow of water in Sutlej River has almost gone to zero due to upstream storage by India. The river channel has been converted into a sandy desert with no water at all losing all the scenic values associated with its original aquatic ecosystem. As the river dried up, agriculture declined, and biodiversity was rapidly declined which disturbed the regional ecology. People moved from the dry areas, and all the developed infrastructure was destroyed. Sutlej Valley developed because the river began to die as the people migrated out of the area due to perished livelihood. Much of the culture of this valley has already been lost, and if not managed for a few more years, the civilization will be completely vanished [69].