*Article* **Hot Air-Assisted Radio Frequency (HARF) Drying on Wild Bitter Gourd Extract**

**Chang-Yi Huang 1, Yu-Huang Cheng 2 and Su-Der Chen 2,\***

**Abstract:** Wild bitter gourd (*Momordica charantia* L. var. *abbreviata* S.) is a kind of Chinese herbal medicine and is also a vegetable and fruit that people eat daily. Wild bitter gourd has many bioactive components, such as saponin, polysaccharide, and protein, and the extract is used to adjust blood sugar in patients with diabetes. The objective of this study was to investigate simultaneous hot air-assisted radio frequency (HARF) drying and pasteurization for bitter gourd extract, and then to evaluate its effects on blood sugar of type II diabetic mice. The results showed that the solid–liquid ratio of the wild bitter gourd powder to water was 1:10 and it was extracted using focused ultrasonic extraction (FUE) for only 10 min with 70 ◦C water. Then, 1 kg of concentrated bitter gourd extract was mixed with soybean fiber powder at a ratio of 2:1.1. It was dried by HARF, and the temperature of the sample could reach above 80 ◦C in only 12 min to simultaneously reduce moisture content (wet basis) from 58% to 15% and achieve a pasteurization effect to significantly reduce the total bacterial and mold counts. Type II diabetic mice induced by nicotinamide and streptozocin (STZ) for two weeks and then were fed four-week feeds containing 5% RF-dried wild gourd extract did not raise fasting blood glucose. Therefore, the dried powder of wild bitter gourd extracts by HARF drying had a hypoglycemic effect.

**Keywords:** wild bitter gourd; ultrasonic extraction; radio frequency (RF); drying; diabetic mice

#### **1. Introduction**

Wild bitter gourd (*Momordica charantia* L. var. abbreviata S.), also called wild bitter melon, is the Taiwanese endemic species of bitter gourds and features effective hypoglycemic components, such as saponin, polysaccharide, and peptide. Diabetic patients can consume fresh bitter gourd juice to reduce their blood glucose concentration and prevent postprandial hyperglycemia [1]. Bitter gourd saponins also promote glycogen storage and insulin secretion [2] and are involved in activating AMP-activated protein kinase phosphorylation to regulate energy metabolism [3]. Bitter gourd proteins can bond with insulin receptors to regulate blood sugar metabolism [4], and inhibit the activities of α-glucosidase and α-amylase to impede the degradation of starch and lower glucose content [5].

Traditional extraction methods used for plant extraction include mechanical stirring [6], boiling, and Soxhlet extraction [7]. Although traditional extraction methods are relatively inexpensive, they are subjected to the following limitations: lower extraction efficiency, longer extraction time, and larger solvent consumption [8]. In order to overcome these problems and to improve the extraction efficiency, ultrasonic extraction (UE) can be used. UE has three combined advantageous effects: cavitation, pressure, and thermodynamics. When ultrasonic waves propagate in the extraction liquid, ultrasonic vibration instantly causes the pressurization and decompression of the liquid, pushing the medium and generating cavitation. When countless small vacuum bubbles in the extraction liquid burst, high temperature and strong impact are instantly generated; therefore, the components

**Citation:** Huang, C.-Y.; Cheng, Y.-H.; Chen, S.-D. Hot Air-Assisted Radio Frequency (HARF) Drying on Wild Bitter Gourd Extract. *Foods* **2022**, *11*, 1173. https://doi.org/10.3390/ foods11081173

Academic Editors: Shaojin Wang and Rui Li

Received: 28 February 2022 Accepted: 16 April 2022 Published: 18 April 2022

**Publisher's Note:** MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

**Copyright:** © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).

of the extract can be separated to achieve an effective extraction efficiency. UE is a simple and inexpensive technology that can be easily applied to reduce solvent consumption, the extraction temperature, and time required to improve the extraction efficiency. Focused ultrasonic extraction (FUE) can promote and enhance biologically active ingredients from the plant in the extraction solvent.

The plant extracts are mixed with encapsulates, such as maltodextrin, gum, or soy protein; they are directly sprayed under pressure to raise the surface area of the droplets using high-temperature hot air drying (over 100 ◦C), which is commonly used in the pharmaceutical industry. Most of the heat of hot air is used to enhance moisture evaporation, and the temperature of the dried powder can be controlled at 60~70 ◦C. The bitter gourd aqueous extract is mixed with encapsulate (maltodextrin and gum) as an encapsulating agent in 1:1.5, 1:2, and 1:3 ratios, and studied by spray drying [10–12]. The optimal inlet and outlet temperatures of spray drying have been determined to be 140 ◦C and 80 ◦C, respectively [11].

Moreover, most plant extracts are sterilized at a high temperature to avoid excessively high bacterial counts or mold counts prior to the final freeze-drying procedure. Traditional freeze drying uses a hot plate to conduct heat into the frozen food for ice sublimation. Freeze-dried encapsulated extracts feature a lower degradation and longer shelf life compared with spray-dried samples [13]. Although the quality of the freeze-dried product is good, the process is time consuming and energy consuming, which results in the manufacturing process being expensive.

Radio frequency (RF) waves are part of the electromagnetic spectrum. Three RF frequencies (13.56, 27.12, and 40.68 MHz) are allowed to be used in science, medicine, and industry by the US Federal Communications Commission (FCC) to avoid interference with other communication systems. The mechanisms of RF heating are due to the migration of ions and the rotation of polarized molecules, resulting in friction that generates heat. RF heating is an effective thermal treatment for various food and agricultural products used for different purposes, such as disinfestation, pasteurization, thawing, enzyme inactivation, and drying [14,15].

When RF waves passe through food, the water molecules in the food produce dipole friction to generate heat, causing the food to heat up quickly. RF energy leads to simultaneous water evaporation, pasteurization, and hot air-assisted water vapor transfer. Therefore, hot air-assisted radio frequency (HARF) drying can overcome the drawbacks of traditional hot air drying, which is both time and energy consuming [15]. Moreover, the developed RF vacuum drying method has been successfully applied for the drying of kiwi fruit for lower-temperature RF heating [16].

RF treatment has been increasingly studied in food drying [14] and pasteurization [17]. However, there remains a lack of studies on the use of HARF heating to dry the extracted solution directly. This may be due to the high dielectric loss factor of the extract solution, which induces an exceeding RF power and leads to an unstable process. The main barrier of HARF drying is the non-uniform heating, especially causing areas with large cold spots and overheating in parts of the high moisture materials, which results in undesirable qualities in the final products [18]. Therefore, a two-stage drying process was developed to overcome the difficulties of RF drying. For example, one study showed the moisture of mango slices was reduced from 88% to 40% by the first stage of hot air drying at 60 ◦C for 5 h, then the HARF drying was applied in the second stage of drying to further reduce the moisture content from 40% to 18% within 45 min. Therefore, the length of time needed for combination hot air and HARF drying is apparently lower than that of hot air drying (8 h) or vacuum drying (7 h). The overall quality of mango slices after the two-stage drying process was better than that of mango dried by hot air drying and close to that of mango dried by vacuum drying [17]. Furthermore, HARF drying has also been used in the final

stage of drying in pre-dried carrot cubes (250 g) to reduce the moisture content from 40% to 10% using 4 h of drying [19].

Various encapsulating agents, such as polysaccharides, gum, lipids, and proteins, are added into the aqueous extract during spray and freeze drying [13]. Currently there is no research regarding drying aqueous extract using HARF drying. Therefore, soybean fiber powder was added into the extract solution as an encapsulating agent for reducing moisture content to solve the HARF drying problem. The objective of this study was to use HARF drying for the simultaneous drying and pasteurizing of the concentrated bitter gourd extract, and then to evaluate the hypoglycemic effect by adding 5% in the feed for type II diabetic mice.

#### **2. Materials and Methods**

#### *2.1. Materials*

Hot air dried wild bitter gourd was obtained from Asakusa Agriculture Processing Co. (Hualien, Taiwan). Bovine serum albumin (BSA), Coomassie brilliant blue G-250, 1,1- Diphenyl-2-picryl hydrazyl (DPPH), ascorbic acid (Vitamin C), glacial acetic acid synthetic and antioxidant butylated hydroxyl anisole (BHA) were bought from Sigma Chemical Co. (St. Louis, MO, USA). Ginsenoside Rg1 was bought from ChromaDex, Corp. (Los Angeles, CA, USA). Aerobic count plate (3M Petrifilm 6400), yeast, and mold count plates (3M Petrifilm 6477, 500 EA/CS), and papain (2000 FCCU/mg, Decken Biotech, Taichung, Taiwan) were acquired. Soybean fiber powder was bought from Prime Creative International CO., LTD (Hsinchu, Taiwan). Experimental male mice (BALB/c strain), MFG feed, and BETA chip were purchased from BioLASCO Taiwan Co. Ltd (Taipei, Taiwan). Streptozocin (STZ) and Nicotinamide were purchased from Sigma-Aldrich® (St. Louis, MO, USA)

#### *2.2. Equipment*

A focused ultrasonic extractor (20k Hz, 1400 W, Ever Great Ultrasonic Co., New Taipei City, Taiwan), spectrophotometer (Model U-2001, Hitachi Co., Tokyo, Japan), benchtop centrifuge (HERMLE Z300, Gosheim, Germany), mini-protein system (Bio-Rad, CA, USA), RF with hot air equipment (40.68 MHz, 10 kW, Yh-Da Biotech Co., LTD., Yilan, Taiwan), oven (Channel DCM-45, Yilan, Taiwan), digital pocket refractometer (Pocket, 3810, PAL-1, ATAGO Corp., Tokyo, Japan), and multifunctional infrared thermometer (Testo104-IR, Hot Instruments Co., LTD., New Taipei, Taiwan) were employed.

#### *2.3. Focused Ultrasonic Extraction (FAE) and Hot Water Extraction (HWE) of Wild Bitter Gourd*

The wild bitter gourd was ground using a 60 mesh, and 50 g of the ground wild bitter gourd was mixed with 500 mL of reverse osmosis (RO) water. Samples were extracted from the solutions at 20 kHz, 1400 W, and 70 ◦C for 10 min by FAE or using 100 ◦C hot water extraction for 1 h.

The solid content of the extract was converted from the measurement of ◦Brix by an analogue refractometer. The extract was centrifuged at 6000 rpm for 5 min and stored at 4 ◦C for analysis.

#### *2.4. Hot Air-Assisted Radio Frequency (HARF) Drying Extract from Wild Bitter Gourd*

The extract obtained by FUE from wild bitter gourd was concentrated six times under vacuum conditions to raise the solid content from 4◦Brix to 24◦Brix before HARF drying for time-saving, energy-saving, and high-efficiency purposes.

In this study, soybean fiber powder was used as encapsulate and mixed with extracts from wild bitter gourd to overcome the issue of the sample being too wet. The samples were prepared with 1 kg of wild gourd concentrated extract were homogeneously mixed with soybean fiber powder in three ratios of (A) 2:1, (B) 2:1.1, and (C) 2:1.2, respectively. Then, they were put into polypropylene (PP) plastic containers (31.3 × 6.9 × 20.5 cm3) and treated at a HARF equipment (Figure 1). HARF drying was carried out at 10 cm gap between the parallel electrode plates and 100 ◦C hot air. The surface temperatures of

the samples were measured at three points (at the center and 5 cm on either side of the center), and the weights by balance were measured at the time interval of 30 s to obtain the temperature profile and drying curve.

**Figure 1.** Schematic view of 10 kW, 40.68 MHz continuous radio frequency (RF) (10 kW, 40.68 MHz) with hot air heating system.

#### *2.5. Analytical Methods*

#### 2.5.1. Protein Content Measurement

Testing was conducted using the Bradford protein-binding assay by mixing 800 μL of wild bitter gourd extract with 200 μL of protein assay reagent. The solution was left idle for 10 min of reaction time. The absorbance at the 595 nm wavelength was measured three times, and the mean value was calculated. The BSA standard curve was employed to determine the protein concentration in the sample.

#### 2.5.2. Total Saponins Measurement

The saponins of the sample was measured by vanillin-perchloric acid colorimetry, and this experiment was modified from the method of [20]. The 50 mL extract was mixed well with 70% ethanol for 10 min of reaction. Then, it was centrifuged (6000 rpm, 5 min) to obtain 0.2 mL of the supernatant, into which 0.20 mL of 5% vanillin-glacial acetic acid solution and 0.80 mL of perchloric acid were then added, and the mixture was heated in a 60 ◦C water bath for 15 min. When it was cooled, 5 mL of glacial acetic acid was added for 20 min reaction and measured the absorbance at a wavelength of 548 nm three times. The mean value was calculated. The ginsenoside (Rg1) standard curve was employed to determine the total saponins concentration in the sample.

#### 2.5.3. DPPH Free Radical Scavenging Ability Test

For this test, 2 mL of the supernatant was evenly mixed with 2 mL of 0.2 mM DPPH MeOH solution and left idle away from light at room temperature for 30 min. The absorbance at the 517 nm wavelength was measured and applied to the following equation to calculate the DPPH scavenging ability. [21] The result was compared with that for the control group comprising 5 mg/mL of ascorbic acid and BHA.

#### 2.5.4. Microbiological Test

The extracts (1 mL) were each diluted 10, 100, and 1000 times with sterilized water. Subsequently, 0.5 mL of each diluted extract was cultured at 35 ◦C for 72 h and counted on an aerobic count plate for a total bacteria test, yeast count, and mold count. The results were observed and the bacterial colonies were counted.

#### *2.6. Hypoglycemic Effect of Wild Bitter Gourd Extract on STZ-Induced Mice*

#### 2.6.1. Experimental Animal and Raising Environment

Twenty-four 6-week-old BALB/c male mice (BioLASCO Taiwan Co., Ltd., Yilan, Taiwan) were quarantined for 1 week and acclimated in polyethylene cages at the experimental animal room of National Ilan University, where the temperature was 22 ± 2 ◦C, the relative humidity was 60 ± 5%, and the light cycle was 12 h light/12 h dark. They were fed with free water and MFG feed. The wood shavings (Beta Chips) and shredded aspen shavings were purchased from BioLASCO Taiwan Co. Ltd. and changed every 3 d. The body weights of all mice were measured before the experiment, and weekly thereafter. The fasting blood glucose of all mice was measured by ACCU-CHEK active blood glucose meter after one week of adaptation to being randomly assigned to control and treatment groups (8 mice in each group) based on body weight.

#### 2.6.2. Preparation of Feed 5% Bitter Gourd Extract Powder

The concentrated concentrate of bitter gourd extract was mixed with soybean fiber powder in the ratio of 2:1.1, and the bitter gourd extract was dried by RF energy, added to the original mouse feed and crushed, and a little sterile water was added to make a thick shape and then mixed homogeneously; and after cold air drying, the mouse feed containing 5% of the bitter gourd extract powder was made.

#### 2.6.3. Regulated Blood Glucose Function Evaluation Method

According to the evaluation of blood sugar regulation method by the Ministry of Health and Welfare, Executive Yuan. Except for the normal group, all mice were intraperitoneally injected with Nicotinamide (230 mg/kg) and then STZ (75 mg/kg) for two weeks. Then, the experimental mice were divided into three groups of eight mice each (normal, STZ, and STZ-fed extract). The STZ mice were fed a diet containing 5% of dried extract powder from wild bitter gourd bitter, and the normal diet mice and STZ mice were used as control groups. Because each group of eight mice was not fed one mouse in one cage, it was difficult to obtain the accurate data on water and feed intake of each mouse, and the data are not shown here. During the test period, the changes in body weight of each mouse were recorded, and fasting blood glucose values were measured at the initial week and final fourth week to provide a basis for evaluation of the hypoglycemic effect.

#### *2.7. Statistical Analysis*

The test results were expressed as mean ± SD and analyzed using the Statistical Package for Social Science 14.0 (SPSS Inc., Data Statistical Analysis Corporation, Chicago, IL, USA). Differences between the data were examined through one-way analysis of variance, and the significance of the differences was investigated through Duncan's multiple range test (α = 0.05).

#### **3. Results and Discussion**

#### *3.1. Focused Ultrasonic Extraction (FUE) of Wild Bitter Gourd*

Table 1 shows the extraction qualities of the wild bitter gourd powder mixed with water at a solid to liquid ratio of 1:10. The extraction ratios of the extract from ultrasonic extraction at 70 ◦C for 10 min and conventional hot water extraction at 100 ◦C for 60 min were 22.4% and 21%, respectively. The contents of total saponins and total proteins extracted by hot water were higher than those of the extract by ultrasonic extraction. However, the scavenge DPPH free radicals extract by ultrasonic was 79.2% and was significantly higher than 59.6% of hot water extract.

**Table 1.** Effect of focused ultrasonic extraction (FUE) and hot water extraction (HWE) on yield, active components, and antioxidant activity of wild bitter gourd.

Data are expressed as mean ± S.D. (*n* = 3). Means with \* in the same row were significantly different (*p* < 0.05). Scavenging DPPH ability (%) of 10 mg/mL Vitamin C and BHA were 95.5 ± 0.1 and 95.3 ± 0.1, respectively.

Garude et al. [9] contended that the phenol and flavonoid contents in bitter gourd peel extracts by ultrasonic extraction were higher than those in extracts by hot water extraction. The ultrasonic water extract of fresh bitter gourd exhibited a strong antioxidant ability of scavenging DPPH free radicals and a higher inhibition of α-amylase and α-glycosidase activity [22].

Therefore, traditional high-temperature long-duration extraction degraded the antioxidant properties of the bioactive components; however, short-duration and low-temperature ultrasonic extraction could avoid damaging the bioactive components and antioxidant properties of the extract. Compared with traditional extraction, FUE took only 10 min; therefore, it could also achieve the time-saving and energy-saving effects. Considering the cost of extraction, previous studies have recommended that the optimal conditions for the focused ultrasonic extraction of wild bitter gourd powder are mixed with water in a solid–liquid ratio of 1:10 at 70 ◦C for 10 min to obtain 6◦Brix. The extraction yield has been shown to be higher than that of bitter gourd aqueous mixture made using a shaking water bath with a solid–liquid ratio of 1:20 at 40 ◦C water for 15 min, where only a 2% total solid content was obtained [10].

#### *3.2. Hot Air-Assisted Radio Frequency (HARF) Drying of Extract from Wild Bitter Gourds*

Therefore, the moisture content decreased with the increasing level of additional soybean fiber powder. Figure 2 shows the temperature profiles and drying curves of these three samples during 10 kW radio frequency (RF electrode gap of 10 cm) combined with 100 ◦C hot air drying. With the same loading of 1 kg of sample, the drying time was reduced from 14 to 10 min as the ratio of mixed soybean fiber powder increased. In addition, the surface temperature of the sample quickly reached above 70 ◦C during the first 4 min of RF heating, then the temperature of sample gradually increased to 80 ◦C, as most RF-induced heat was absorbed for latent heat of water evaporation.

Table 2 shows that the period of constant drying rate appeared during the RF drying. Increasing the soybean fiber powder addition from (A) 2:1 to (B) 2:1.1 and (C) 2:1.2 caused higher drying rates of 36.881, 43.836, and 53.968 g/min, respectively. The moisture contents of the final products were 14.2%, 16.7%, and 12%, respectively. The HARF drying time may be extended by 1 min more to further reduce the moisture content for storage. The level of additional soybean fiber powder in the original extract solution was about 33~37.5% in HARF drying. The encapsulate (maltodextrin and gum powder 1:1) addition in the bitter gourd aqueous extract was about 20~25% [11,12] by spray drying with inlet and outlet temperatures of 140 ◦C and 80 ◦C, respectively [10]. In this study, the final temperatures of samples were also near 80 ◦C, and the drying time was much less than that of spray drying

and freeze drying, because the feed rate of spray drying was only 10 mL/min [10] and freeze drying required at least 24 h.

**Figure 2.** Temperature profiles and drying curves of wild bitter gourd extract mixed with soybean fiber: (**A**) 2:1, (**B**) 2:1.1, and (**C**) 2:1.2 during HARF heating.

**Table 2.** Drying rate of wild bitter gourd extract (E) mixed with soybean fiber powder (F) by 10 kW radio frequency heating.

W is weight of sample (g), and t is drying time (min) in linear regression equation.

#### *3.3. HARF Pasteurizing of Wild Bitter Gourd Extract*

The analyses of total bacterial counts are shown in Table 3. The original total bacterial counts for ultrasonic extract from the wild bitter gourd and soybean fiber powder were 523,000 CFU/mL and 9400 CFU/g, respectively. However, after HARF drying, the counts became only 30 CFU/mL in the 2:1.1 ratio of mixture of wild bitter gourd extract to soybean fiber. Both the mold and yeast counts were significantly reduced after the HARF drying. It was found that RF induced heating for the samples to achieve a pasteurization effect (above 70 ◦C) within the first 4 min. Then, the rest time of HARF heating could keep the temperature in a range of 70~80 ◦C due to the induced heat absorbed as latent heat for water evaporation. The moisture contents of the samples were also reduced from 58% to 15%, and the mold and yeast counts were significantly reduced. Therefore, HARF heating could proceed simultaneously for the drying and pasteurizing of the extracts.

**Table 3.** Total counts and mold and yeast counts for wild bitter gourd extract, soybean fiber powder, and RF product.

#### *3.4. Hypoglycemic Effect of Radio Frequency Dried Wild Bitter Gourd Extract*

The average water intake of STZ mice was 2.8 g at week 0, which was lower than that of normal mice (3.8 g); there was no significant difference between the three groups after one week of feeding. Furthermore, the average feed intake of STZ mice was 3 g at week 0, which was slightly lower than the 3.2 g of normal mice. Similarly, there was no significant difference in average feed intake of about 3.2 g between the three groups after one week of feeding. The STZ mice had litter less body weight, especially in the STZ-fed extract group (Table 4) and the higher blood glucose 105~107 mg/dL than normal mice (74.88 mg/dL) (Table 5). The mice were injected with nicotinamide and STZ to induce them to become type II diabetic mice, which had higher blood glucose levels at beginning. However, it did not completely destroy the pancreas; the consequences would thus be minimal.

**Table 4.** The changes of body weight (g) in mice for feeding RF-dried bitter gourd extract.

Data are expressed as mean ± S.D. (*n* = 8). 0 week: after 2 weeks injecting nicotinamide and STZ; 1~4 weeks: free feeding for 1~4 weeks. a,b Means at different times with different superscript letter in the same column were significantly different (*p* < 0.05).

**Table 5.** The changes of fasting blood glucose (mg/dL) in mice for feeding RF-dried bitter gourd extract.

Data are expressed as mean ± S.D. (*n* = 8). 0 week: after 2 weeks of injection of nicotinamide and STZ; 4 weeks: free feeding for 4 weeks. a–c Means at different times with different superscript letter in the same column were significantly different (*p* < 0.05).

After four weeks of treatment, the average body weight of these three groups of mice increased to 24.78~25.35 g with no significant difference (*p* > 0.05). However, after one week of feeding with RF-dried bitter gourd extract, the average body weight of the STZ-fed extract group mice was the same as that of the normal group. The average body weight of the STZ-fed extract group mice for the next three weeks was even slightly higher than that of the normal group (*p* > 0.05) (Table 4).

After four weeks of feeding, the blood glucose of mice in the normal group was 90 mg/dL as the feeding time increased, while the blood glucose of mice in the STZ group increased from 107 mg/dL to 115 mg/dL, but the blood glucose of mice in the STZ-fed extract group did not increase and remained at 105 mg/dL. Although the 5% RF-dried extracts from the STZ mice did not reach the blood glucose level of normal mice, they could control the increase in blood glucose. This suggests that the dried powder of ultrasonic extracts by HARF had a hypoglycemic effect.

The MCP was isolated from the water-soluble polysaccharide form of the bitter gourd and was orally administered once a day though water after 3 d of alloxan-induction type II diabetic mice at 300 mg/kg body weight for 28 d, exhibiting a hypoglycemic effect. Hence, MCP can be incorporated as a supplement in health care food, drugs, and/or combined with other hypoglycemic medicines [23].

#### **4. Conclusions**

In this study, wild bitter gourd powder at a solid–liquid ratio of 1:10 was extracted with ultrasonication for 10 min with hot water at 70 ◦C. The total protein and saponin contents were 1.198 mg/g and 0.288 mg/g, respectively. The ability of these samples to scavenge DPPH free radicals was better than that of the 100 ◦C hot water extracts. HARF for drying the mixture of 1 kg of concentrated wild bitter gourd extract and soybean fiber powder (at a ratio of 2:1.1) took only 4 min to achieve the pasteurization effect due to the temperature being above 70 ◦C, and the moisture content of the sample was reduced from 58% to 15% by a total of 12 min of HARF heating. This indicates that using ultrasonic extraction and HARF drying to prepare extracts for the herb and pharmaceutical industries can save time and energy. Type II diabetic mice were fed with a free diet containing 5% RF-dried wild bitter gourd extract for four weeks and their blood sugar levels did not rise. As a result, the dried powder of ultrasonic wild bitter gourd extracts by HARF heating also had a hypoglycemic effect.

**Author Contributions:** S.-D.C.: supervision and project administration; C.-Y.H.: preparation of extracted sample, data analysis, and writing of original draft; Y.-H.C.: assisting with the animal experiment. All authors have read and agreed to the published version of the manuscript.

**Funding:** This research received no external funding.

**Institutional Review Board Statement:** Not applicable.

**Informed Consent Statement:** This experiment was reviewed and approved by the Laboratory Animal Care and Use Team of National Ilan University, project number 109-5.

**Data Availability Statement:** The data and samples presented in this study are available on request from the corresponding author. Data is contained within the article.

**Acknowledgments:** We thank the Department of Biotechnology and Animal Science, National Ilan University, for providing animal housing for mice experiments. We thank Ying-Chen Yang for her assistance in the animal experiment. We thank Ching-Tung Kuo for checking the English manuscript draft.

**Conflicts of Interest:** The authors declare no conflict of interest.

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2008;38(6):6.

## **Author details**

Ying Zhu, Wenhua H. Zhu and Bruce J. Tatarchuk\* *Center for Microfibrous Materials Department of Chemical Engineering Auburn University, Auburn, AL, 36849, USA*

## **Acknowledgement**

This work was performed under a U.S. Army contract at Auburn University (W56HZV-05- C0686) administered through TARDEC. The authors would like to thank members from the Center for Microfibrous Materials for their assistance and contribution to this work.

## **6. References**

<sup>\*</sup> Corresponding Author

This chapter emphasizes the existing necessities for the improvement and development of energy storage and conversion systems and highlights the competence of Electrochemical Impedance Spectroscopy (EIS) to dynamically characterize electrochemical systems. As the background, this chapter briefly provided fundamental knowledge of impedance measurement and data interpretation. The EIS applications are mainly focused on Pb-acid batteries, Ni-MH batteries, conventional proton exchange membrane (PEM) fuel cells, and high temperature PEM fuel cells based on phosphoric acid (H3PO4, abbreviated to PA) doped polybenzimidazole (PBI) membranes. For the rechargeable batteries and the conventional PEM fuel cells, investigation examples are presented with discussions on research challenges and further development. The high temperature PEM fuel cell is a freshly emergent research area. There are obvious differences between the behavior and variation tendency of impedance data collected from different systems. Several equivalent circuit (EC) diagrams and their physical interpretations were proposed for different high temperature PEM fuel cells. However, more experiments and impedance data are required to develop a consistent, validated, and generally accepted theory. Developed for over a hundred years, EIS will continuously contribute to the characterization, diagnosis, quality control, and further advanced areas of energy storage and conversion systems for energy

This work was performed under a U.S. Army contract at Auburn University (W56HZV-05- C0686) administered through TARDEC. The authors would like to thank members from the

[1] Tatarchuk BJ, Yang H, Kalluri R, Cahela DR, inventors. Microfibrous Media for Optimizing and Controlling Highly Exothermic and Highly Endothermic

[2] Sheng M, Cahela DR, Yang H, Tatarchuk BJ. Application of Microfiber Entrapped Catalyst in Fischer-Tropsch Synthesis. AIChE Annual Meeting, 2009; Nashville, TN,

Center for Microfibrous Materials for their assistance and contribution to this work.

Reactions/Processes. 2011; Patent No: WO2011/057150A1.

**5. Conclusions**

economic considerations.

*Center for Microfibrous Materials Department of Chemical Engineering*

**Acknowledgement**

**6. References**

United States.

Corresponding Author

 \*

Ying Zhu, Wenhua H. Zhu and Bruce J. Tatarchuk\*

*Auburn University, Auburn, AL, 36849, USA*

**Author details**

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**Chapter 11**

© 2013 Blonbou et al., licensee InTech. This is an open access chapter distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2013 Blonbou et al., licensee InTech. This is a paper distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

**Dynamic Energy Storage Management for**

Ruddy Blonbou, Stéphanie Monjoly and Jean-Louis Bernard

Additional information is available at the end of the chapter

networks and on the safety of the electric systems.

deployment of distributed renewable electricity generation.

http://dx.doi.org/10.5772/52411

**1. Introduction**

and statutory incentives.

**Dependable Renewable Electricity Generation**

The administrators of the distribution networks have to face the insertion of the decentralized electricity production of renewable origin. In particular, wind and photovoltaic electricity generation know a fast development supported by satisfying technical maturity, greater environmental concern and political will expressed by financial

However, one of the main handicaps of many renewable energies - and quite particularly wind energy and solar energy - is the temporal variation of the resource and the weak previsibility of its availability. Thus, connecting wind or photovoltaic farms to electrical networks is an important challenge for the administrators of distribution and transport networks of electricity. They impact on the planning, on the operation of distribution

For grid connected renewable generation, as long as the penetration rates of these productions are marginal, the network compensates, within few minutes, for the fast variations thanks to the power reserves, which is for example mobilized hydroelectric power reserve, or gas turbines in rotating reserve (which produce greenhouse gases). These power reserves have a cost that must be take into account in the economic analysis of the

On a regional scale, the presence of renewable generators often induces additional costs for network reinforcement to limit the risks of congestion. Indeed, the favorable conditions for wind energy exploitation are often found in remote area (windy coast, offshore) where the network infrastructures are weak or non-existent. Since a regional network is sized according to the maximum transit power, to prevent power congestion, it is necessary to size the network infrastructures to match the total installed capacity. As the load factor of


**1. Introduction**

Water governance describes the legislation, policies, regulation, and institutional frameworks related to the management of water resources, which affect human activities and nature's sustainability. Water governance is a complex process that requires the participation of not only technical experts and the scientific community, but also of the different stakeholder groups in water decision-making [1]. More specifically, the development and implementation of water policies are characterized by challenges which concern the integration of legal requirements, technical issues, scientific knowledge, socio-economic aspects, and the competitive uses of the resource [2] in all stages of the process. For the minimization of conflicts and the measures' success assurance, all voices should be heard, making intensive multi-stakeholder consultations be required for effective, equitable, and sustainable water governance [3]. Lately, the participation of stakeholders in water governance is considered a key element for improving water resources management and is strongly supported (suggested or mandatory) in the majority of water-related EU directives [1,4]. In particular, the Water Framework Directive (WFD) (2000/60/EC) establishes a legal framework to protect and improve the status of aquatic ecosystems, including—among other factors—public participation. It is now documented that stakeholder consultations based on communication and group interaction depend on trust-building science-policy collaborations [5,6]. Common understanding and interpretation of local water issues and solutions, and collaborative production of scientific, local, and bureaucratic knowledge are essential for legitimate decision-making processes and the effective co-creation and implementation of measures [5–7]. The contribution of stakeholders to the design of a good

**Citation:** Karasani, M.; Latinopoulos, D.; Ioannidou, N.; Spiliotis, M.; Kagalou, I. Bridging the Gap between Science and Policy: A Prerequisite for Effective Water Governance. *Environ. Sci. Proc.* **2023**, *25*, 12. https:// doi.org/10.3390/ECWS-7-14241

Academic Editor: Athanasios Loukas

Published: 16 March 2023

**Copyright:** © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).

governance scenario together with the gaps in data are considered the most important dependencies in the management of Greek river basins [8]. Having the above in mind when considering the peculiarities of the Lissos basin as concerns stakeholders' identity, this paper aims to outline the participatory bottom-up approach for this basin's management, having the bridging between science and policy as its supreme goal.

### **2. Materials and Methods**

A participatory workshop was conducted under the framework Eye4water, which aims to strengthen the local water management practices in the Lissos river basin by developing supporting technological tools as a result of systematic monitoring of the quality of natural water bodies. To our knowledge, this is the first participatory assessment of a local river basin being applied to the Lissos river basin. Our methodology was conducted in four stages: (1) Process design; (2) Workshop process; (3) Results analysis; and (4) Follow-up.

### *2.1. Study Area*

The Lissos river basin (Rhodope, Thrace, Greece) covers an area of 1486 km2 and is partly protected by Ramsar. It is a Heavily Modified Water Body (HMWB), which suffers from several anthropogenic pressures such as landfill, Wastewater Treatment Plant, intensive agricultural and industrial activities, livestock, sand extractions, and flow-intercepting construction [9]. It is considered a lesser-researched river of primary importance for the local community [9], of a higher trophic state, receiving important pollution loads in a segmented hydrological network.

### *2.2. Process Design*

### 2.2.1. Stakeholder Mapping

Firstly, we identified the social system engaged to the Lissos river basin through stakeholders' mapping. We organized a list of stakeholders and we complemented it through Internet searches (Google maps and business lists), on-site contacts, and the use of our own network (NGOs, academic community, farmers, entrepreneurs, administrative authorities). The identified stakeholders were categorized into three groups: (1) farmers, (2) practitioners, and (3) experts. Before the invitations, equal representation and gender equality among the participants were taken into account. The invitations were sent via email, phone calls, posted on the website, and on the social media accountes (Twitter, Facebook, Linkedin, Instagram) of the Eye4water project. The workshop was also announced through a press release (to about 140 media members). A reminder was also sent.

### 2.2.2. Questionnaires Development

Based on a SWOT-PEST analysis combined with monitoring results, a number of questions were developed. The main aim of the questions was to gather local knowledge and to further understand how the stakeholders value the resource, prioritize pressures, and jointly identify solutions. For each group, a different set of 12 questions was developed, considering each one's relation to the water sector. The context of the questionnaires covered the water uses, the river pressures, the water management and governance, and the possible solutions. The set of questions included open-close, multiple selection, and importance-grading questions where the participants had the liberty to answer as many questions as they wanted from all groups' questionnaires.

### 2.2.3. Workshop Process

The process was divided into two sessions. In the first session, a formal briefing of the monitoring findings were communicated to the participants, and then the stakeholders were encouraged to participate in two exercises in a free and open manner with the aid of nine facilitators, where a different color of Post-it was attributed to each group. Exercise 1: In this exercise, the stakeholders were invited to answer the questions anonymously by placing a Post-it somewhere on one of three big panels, allowing for the ability to

further comment on each question, thereby promoting meaningful discussions. Exercise 2: A follow-up round after the first exercise took place. In this exercise, the stakeholders were asked willingly to answer the questions of the other two groups. The objective was to identify any conflicts and to evaluate their impact on water management.

### 2.2.4. Workshop Material Analysis

All produced material from the workshop was photo-documented, and processed as follows: The Post-its from the panels were transferred to a database with the qualitative details from the related discussion notes. A categorization followed, aiming to identify thematic convergences and divergences.

### **3. Results Discussion**

We consider the resulting representation marginally sufficient, since, from more than 100 invitations, at least six representatives from each group attended the workshop. The representatives of each group were urged to reply to the questions posed to other groups. Figure 1 is indicative of the participation and interaction among stakeholders. Using this method, each question gathered about five replies. The exercises were complemented by a continuous discussion and a short evaluation feedback of the entire process. The sub-aim of developing simple and understandable queries for linking science to the tools used by both stakeholders and practitioners and further encouraging action and innovation among all stakeholders [10] was achieved, since none of the moderators noticed any misinterpretations or conceptual errors.

**Figure 1.** Given answers per group for the experts' questionnaire, indicative of participation and interaction among stakeholder groups.

The results deriving from common queries dealing with the main water uses, pressures, and main issues are presented in Figure 2. It can be clearly seen that irrigation is the major need according to farmers, acknowledging at the same time that agriculture and livestock are among the main activities posing pressure on the watershed. On the contrary, experts and practitioners are more "afraid" of agriculture, livestock, and waste disposal effects, and less of industrial effluents. Different opinions are expressed by the three groups regarding water resource uses or, more simply, their beliefs regarding the needs for water resources allocation, downgrading the importance of biodiversity, industry, and recreation. Despite the large number of low-water crossings and the frequent announcements of flooded areas, floodings were not one of the locals' primary issues.

**Figure 2.** Comparative results regarding common queries from the three stakeholder groups dealing with pressures and uses.

An interesting finding is that experts propose agitation as a measure for land use/land cover alteration in favor of the river system, along with the need for a better irrigation system. Farmers are more anxious of the resource sufficiency, either surface or groundwater. No group deems that there is a seasonal/warm period problem related with water quality. It should be noted that we intentionally omitted queries using a rating scale as a type of answer from the results. The last ones will be used to generate weights for more indepth analyses through advanced mathematics to suggest some optimal solutions for management of the Lissos basin. It can be stated, though, as a general direction, that better awareness on water issues from the part of higher administrative authorities' and targeted small infrastructure interventions are major components of the solution.

This workshop aimed to bridge the gap between science and policy, and successfully managed to take a "snapshot" of stakeholders' perspective on the management of the Lissos basin. The findings seem to be applicable to decision-making for strategic design and measures implementation, incorporating information of great value that is also based on local knowledge, which could not be gained otherwise. Similar to other research findings [11], Lissos stakeholders seem to be able to implement some management measures (i.e., pollution prevention, channel creation, methodological approach) without official governmental support.

The participation was affected by stakeholders' financial constraints (transport, agricultural duties) while the COVID-19 pandemic situation prevailed in some remote villages. Conflicts between stakeholder groups (farmers vs. practitioners) affected the participatory process. The expressed perception of the different stakeholders' groups did not coincide, except for the activities posing pressure on the watershed. Some points supported by our research and the literature (i.e., seasonal quality and quantity variation, touristic growth potential, and biodiversity) were not supported by public opinion. A major finding can be concluded that "primary production" should not be altered, but rather, should be eased as a measure of water stewardship.

**Author Contributions:** Conceptualization, I.K. and D.L.; methodology, M.K.; formal analysis, M.K. and N.I.; investigation, D.L.; resources, D.L., M.K. and N.I.; data curation, N.I.; writing—original draft preparation, M.K.; writing—review and editing, D.L. and M.S.; visualization, D.L.; supervision, I.K. and M.S.; project administration, I.K.; funding acquisition, I.K. All authors have read and agreed to the published version of the manuscript.

**Funding:** Produced for the Eye4Water project, MIS 5047246, implemented under the action: "Support for Research Infrastructure and Innovation" by the Operational Program "Competitiveness, Entrepreneurship and Innovation" in the framework of the Co-financed by Greece and the European Union-European Regional Development Fund.

**Informed Consent Statement:** Informed consent was obtained from all subjects involved in the study.

**Data Availability Statement:** Supporting data can be given upon demand in eye4water.com.

**Acknowledgments:** The authors want to express their gratitude to Ch. Akratos, F. Maris for their contribution to the workshop organization and their presence, to Ntougias S., Adamidis A. for their participation in the first session of the workshop and to C. Papadopoulos, T. Bakas, C. Bakalakou, Ch. Ntislidou, V. Papaevangelou for their working moderation of the workshop and K. Basdeki for the social media and promotion campaign.

**Conflicts of Interest:** The authors declare no conflict of interest.


**26. New defense gene**

The SbPRP gene putatively encodes a bimodular protein with 126 amino acids similar to de‐ velopmentally regulated proteins in other plants. It has a distinct proline-rich domain (17

amino acids) and a long hydrophobically cysteine-rich domain (84 amino acids). Its steadystate mRNA level accumulated differentially in response to salicylic acid, and to the inocula‐ tion of soybean mosaic virus Sa strain. It responded to drought treatment and salt stress. It appears that SbPRP plays a defense role in soybean [29].


**Abstract**

Gestational hypertension and pre-eclampsia are the most prevalent in Sub-Saharan Africa leading to undesirable perinatal and maternal outcomes. In South Africa, a high rate of maternal death was noted due to pre-eclampsia. However, the use of digital maternal health in South Africa has become of significance for reinforcement of health care. Digital health initiatives such as mobile health technologies were developed to improve better access to communities in low and middle-income countries. The implementation and practices of digital health seem to be growing expandable to achieve the UHC goals in the provision of care to all globally and nationally. This review aims to review existing literature on the use of digital maternal health to minimise admission of pre-eclampsia and early identification of gravid women who are at risk of developing pre-eclampsia.

**Keywords:** digital health, early detection maternal health, pre-eclampsia

## **1. Introduction**

Maternal mortality remains a burden across the globe with 295,000 reported by the World Health Organisation. This burden continues to increase despite Primary Health Care (PHC) being are regarded as the cornerstone to curve the rise of maternal deaths due to pregnancy-related complications [1]. One of the leading causes of maternal death is reported to be pre-eclampsia [1]. Pre-eclampsia is the elevation of blood pressure (> 140 systolic mmHg and > 90 mmHg diastolic) after 20 weeks of gestation with a significant amount of protein in the urine in gravid women [2]. It accounts for approximately 5–11% of pregnancies and remains the leading cause of maternal and perinatal morbidity and mortality worldwide [3]. Also, it is reported to account for approximately 63,000 yearly maternal mortality worldwide [4].

Approximately 6% of pregnancies develop mild pre-eclampsia and 1 to 2% develop severe pre-eclampsia in the United Kingdom (UK) [5]. Furthermore, one in six women with a history of pre-eclampsia is predicted to be most likely to have pre-eclampsia in the next pregnancy. As a result, the development of digital health solutions such as mobile health initiative applications, telemonitoring and SAFE@ HOME to diagnose and manage pre-eclampsia has been implemented and designed for use in health facilities and homes by health care providers and patients respectively. The digital health applications assist by providing recommendations on treatment, reassessment and referral [6, 7].

Digital Health is the utilisation of digital, mobile, and wireless technologies for health [8]. Digital Health innovation has become of significance in Sub-Saharan Africa for the reinforcement of health care [9]. Digital Health initiative such as telemonitoring was applied in Parkinstan to support women at risk of developing preeclampsia by close monitoring of blood pressure at home for earliest signs. The use of telemonitoring could lead to early detection of pre-eclampsia and the required need for treatment and admission of women with pre-eclampsia [10]. South Africa implemented mobile health initiatives such as Mom-Connect to improve foetalmaternal well-being at home by targeted communications to pregnant women with various disorders including pre-eclampsia [8].


**4. Conclusions**

Currently, the role of bacterial gut microbiota is described as a key factor in the development of Crohn's disease, we do know that, for the disease to develop, dysbiosis or a definitive change in the intestinal microbiota must occur. This study may provide additional evidence regarding potential non-invasive tools such as microbiota-based biomarkers of the response before and after anti-TNF therapy in Crohn's disease as a starting point for future clinical trials. These trials could determine the most effective treatment among not only these therapies but all therapies used in the management of Crohn's disease based on patient microbiota and provide more appropriate, inexpensive and non-invasive tools for predicting clinical response to treatment, reduce morbidity rates and improve efficiency.

**Author Contributions:** L.S.-A. participated in the design of the study and drafted the manuscript, revising for important intellectual content, and fully approved the final version for submission. J.F.M.-B. participated in the design of the study, contributed to the statistical analysis plan and was also involved in the drafting of the manuscript. S.M.-V. participated in design of the study related to gut microbiota analysis and contributed to the statistical analysis plan. E.C.-C. participated in the design of the study, contributed to the statistical analysis plan and was also involved in the drafting of the manuscript, revising for important intellectual content, and fully approved the final version for submission. J.R.-M. participated in the design of the study and its coordination. X.C.-R. conceived of the study and was involved in the overall design and helped to draft the manuscript revising for important intellectual content, and fully approved the final version for submission. All authors have read and agreed to the published version of the manuscript.

**Funding:** This research received no external funding.

**Acknowledgments:** The authors thank Maria Repice and Ian Johnstone for their help with the English version of the text.

**Conflicts of Interest:** The authors declare that there are no conflicts of interest to disclose.


**4. Perspective and future developments**

With energy consumption as a whole on the increase, coupled with the rapid economic de‐ velopment of countries such as Brazil, China, India, and Russia there will be a concerted ef‐ fort to improve how energy is utilised. This expansion in industrialisation has already and will continue to lead to a further increase in the price of oil. Coupled to the rise in fossil fuel costs are drivers of an ageing energy infrastructure system and demand for a low-carbon emission economy through the use of renewable energy [155]. To help accommodate all these factors the supply and demand challenge may be addressed by tapping into otherwise wasted energy. Low grade heat, if effectively harvested can prove to be a viable source of power. Thermal converters have the potential to increase the efficiency of current energy conversion systems. Energy storage also plays a key role in providing a solution to the ener‐ gy problem. Energy must be efficiently stored, when it is in excess, and released at a time of high demand. This is extremely important for renewables that are not load-following [156].

advancements will not only enable better automotive and portable electronics, but they will revolutionise the fields of medicine, defence and consumer goods thus providing a step

Intelligent Polymer Research Institute, Australian Institute of Innovative Materials, Innova‐

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\*Address all correspondence to<EMAIL_ADDRESS>
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**Author details**

Dennis Antiohos\*

**References**

687-689.

With these energy challenges and ongoing research and development, including those that have been conducted over the last decade, the awareness of the benefits of electrochemical capacitors is increasing. As the research and development into energy storage and conver‐ sion has increased, the applications of electrochemical capacitors has increased with the technology becoming more diverse meaning that systems can better be tailored /targeted for specific applications ranging from higher energy density to high power densities where fast charge / discharge efficiencies are needed [156]. The most commonly used material for su‐ percapacitors has been activated carbon with new nanostructured materials such as carbon nanotubes and its derivatives coming to the forefront of the current fundamental research. It can be seen that the way forward in terms of trying to improve energy density and power density is in the use of CNT with composite materials such as other carbons, and conducting polymers or metal oxides in order to take advantage of the pseudocapacitative effects that these materials provide.

The research on thermogalvanic systems in the past has been generally limited to platinum electrodes [100]. This has enhanced the understanding of these electrochemical systems but has not advanced the research in terms of commercialisation due to its cost. The use of car‐ bon nanomaterials has improved the performance of these devices immensely because of their fast transfer kinetics and large electroactive surface area and is also economically via‐ ble. A record threefold increase in power conversion efficiency (as compared to convention‐ al systems wherein platinum is used) has been realised with the use of MWNT electrodes [114]. Flexible electrodes are now possible due to CNTs. These can be used as scroll electro‐ des or for thermocells that can be wrapped around pipes will make this system more versa‐ tile in terms of its possible applications. Further increase in thermocell performance may be realised with the use of CNTs-graphene composite materials.

Future development will most likely see supercapacitors and thermocells become a central part of hybrid energy storage and power delivery systems for large scale and domestic de‐ mand strategies. The integration of these two systems into one device will allow the convert‐ ed waste heat to be stored then released when deemed necessary. These future advancements will not only enable better automotive and portable electronics, but they will revolutionise the fields of medicine, defence and consumer goods thus providing a step change in energy storage technology [5].


*3.1. Mineralogy*

The results presented here are for a particular area of interest that is presented and displayed in Figure 2a (backscattered electron micrograph) and Figure 2b with the false-colored mineral map from Mineralogic. The analysis was carried out of a 360,000-μm2 region where a quantified EDX analysis was taken at every 200 nm, and therefore results in approximately 1.8 million quantified analyses.

Figure 2a displays the BSE data acquired from the region of interest and provides some initially information on the mineralogy based on the average atomic number of the mineral. However, the BSE gray-level intensity is not suitable to quantify mineral abundance and texture in these samples. As Figure 2a,b outlines, minerals such as illite and epidote appear to have almost identical gray-level signatures, as do hornblende, quartz, and anorthite.

However, Figure 2b displays the overlaid false-colored mineral data that was acquired at a 200-nm spatial resolution. The false-color minerals clearly display the mineralogy and the textural variation across this sample.

Combined with the modal mineralogy data (Table 1), these results clearly show how anorthite (c. 39%), illite (c. 20%), hornblende (c. 20%), and quartz (c. 13%) are the dominant mineral in this sample. It is also clear from Figure 2b and Table 1 that all the minerals show predominantly fine-grained sizes (200 nm); however, rare large clasts of quartz and anorthite are observed while hornblende, illite, and epidote mainly consist of a fine-grained matrix.

The 200-nm resolution of the scan was able to identify two distinct mineralogical and textural groups in this region (Figure 5). Textural group 1 is formed by the former amphibolite minerals and their reaction products. It can be found in the center of Figure 2, and is dominated by an epidote- and hornblende-dominated matrix that is populated with large (up to 80 microns in length) remnants of the orthogneiss, mainly consisting of single grains of quartz and anorthite. A second textural group can be found that encapsulates textural group 1 and is dominated by an illite and fine-grained anorthite matrix, which represents the remnants of the orthogneiss. In this textural group, hornblende is a minor phase in the matrix. Figure 5c,d shows that this mineralogical and textural group is dominated by anorthite, illite, and quartz with a small amount of epidote intergrown within this matrix.

#### *3.2. Grain Size Distributions*

Whilst the hornblende is relatively granular within this matrix, the epidote is often found as relatively coarse grains up to 20 microns in length (Figure 6). The anorthite grains display bimodal distribution as they are found in the matrix as grains of 1–5 microns in size, and also as much coarser remnant clasts that can be 50 microns in length or more.

The average grain size in textural group 2 is clearly much larger than that in textural group 1, and the matrix is dominated by illite and anorthite with only minor amounts of epidote and hornblende. Quartz grains are more common and of a larger grain size than those within textural group 1 (Table 2).

**Table 1.** Modal mineralogy data from the selected region of interest displayed in the graphical abstract. This data displays the mineral, its area % occurrence in the sample, the average grain size of that mineral with its standard deviation, and its average composition in wt.%.

**Figure 5.** Two details of Figure 2: Combined false-colored mineral map (**a**,**c**) and BSE images (**b**,**d**) for textural group 1 (**a**,**b**) and textural group 2 (**c**,**d**). The width of view for each field is 46 microns.

**Table 2.** Modal mineralogy and grain size distribution data for textural groups 1 (TG1) and 2 (TG2) and comparative modal mineralogy and grain size distribution

*Minerals* **2019**, *9*, 665

**Figure 6.** Grain size distribution for anorthite, hornblende, quartz, illite, and epidote in the analyzed fault gouge for textural groups 1 (TG1) and 2 (TG2). The distribution is shown as grain area in μm2 and was measured as a 2D grain size distribution. Most grains are in the smallest bin that corresponds to grain diameters down to 200 nm.

The grain size distribution per mineral can be extracted from the Mineralogic output. Figure 6 presents the grain size distribution for one of the originally present grains, quartz, and for one of the reaction products, illite, which formed after the breakdown of feldspar minerals. Both minerals show a considerable decrease in grain size, with most grains in the bin down to 200 nm.


**1. Introduction**

#### **1.1 Infection prevention and control (IPC)**

Infection prevention and control (IPC) is a scientific approach and practical solution designed to prevent harm caused by infection to patients and health workers. In health facilities, IPC cannot be met without water, sanitation, and hygiene (WASH) services that provide the basis for adequate IPC. In the context of COVID-19, poor or inadequate WASH and IPC services and practices lead to transmission of the infection from healthcare facilities to communities and exacerbate the outbreak and spread of infections. The World Health Organization (WHO) in collaboration with the United Nations Children's Fund (UNICEF) 2015 Report underlined the importance of adequate WASH in healthcare facilities for the prevention of infections and spread of disease and for protecting staff and patients' health, dignity, and privacy [1]. WASH services strengthen the resilience of healthcare systems to prevent disease outbreaks, allowing effective responses to emergencies (including natural disasters and outbreaks), and bringing emergencies under control when they occur.

IPC has an immense role in reducing disease transmission generally and in healthcare facilities specifically; this fact has been well established in many studies. Madge et al. (1992) concluded that several IPC measures significantly reduced the incidence of nosocomial respiratory syncytial virus in the sample groups they observed [2]. According to Ershova et al. (2018), in middle-income countries, the employment of the IPC programme was highly effective in preventing nosocomial infection and in reducing antibiotic resistance [3]. Conducting evaluation studies for IPC in healthcare facilities helps find gaps and mistakes that should be corrected for the IPC programme to be more efficient and effective. In Jordan, this type of evaluation is seldom carried out. A survey of nosocomial IPC capacity among radiographers in Jordan reported moderate knowledge of IPC practices and that future training and improvement are needed [4]. Another study was conducted among nurses from 9 different hospitals in Jordan regarding safe injection handling. The study recommended focused and effective infection control educational programmes in Jordanian hospitals [5].

#### **1.2 Water, sanitation, and hygiene (WASH)**

WASH is the acronym of Water, Sanitation, and Hygiene. It has a major impact on public health and its importance is recognized globally. In 2015 members of the United Nations agreed on 17 Sustainable Development Goals; these goals require urgent actions from all countries [6]. The first two targets in SDG 6 (Ensure availability and sustainable management of water and sanitation for all) are focused on the availability of clean affordable water and proper conditions of sanitation and hygiene [7].

Proper WASH conditions are essential for the protection of human health during all types of disease outbreaks including the ongoing COVID-19 pandemic. According to WHO, routinely applied WASH and waste management in homes, communities, schools, marketplaces, and healthcare facilities help to prevent the viral transmission that causes COVID-19 [8]. Prüss et al. (2002) have estimated the global disease burden from water, sanitation, and hygiene to be 4.0 per cent of all deaths and 5.7 per cent of the total disease burden (in DALYs) [9].

*Water, Sanitation, and Hygiene (WASH) and Infection Prevention and Control (IPC)… DOI: http://dx.doi.org/10.5772/intechopen.99523*

According to Khader (2017), despite the major advancement Jordan has made in IPC by providing access to drinking water and improving sanitation and health waste management, several areas are yet to be improved in the Jordanian healthcare setting. Also, it is advisable to establish and implement a WASH monitoring system for the healthcare system [10].

#### **1.3 Water**

Water is essential to humans, not only for nourishment but also for better sanitation and hygiene. Each year, about 3,000 children under the age of 5 years old die from diarrhoeal disease resulting from lack of safe drinking water, hygiene, and sanitation; it also causes death to more than 829,000 humans each year [11]. The availability and quality of water are very strong factors in public health. According to the UNICEF, 663 million people do not have access to clean drinking water and nearly 60 million people use untreated water from unsafe sources like rivers [12, 13]. Jordan is ranked as the world's-second most-water scarce country with 100 m3 per person, 400 m3 less than the severe water scarcity threshold, and more than 50 per cent receive water once every week [12]. Regarding COVID-19, clean water is very crucial in controlling the pandemic as about 1.8 billion people globally use fecal contaminated water; this water can serve as an alternative route of infection [14]. The Hospital Water Supply as a Source of Nosocomial Infections study by Anaissie et al. (2002) mentioned that an estimated number of 1,400 annual deaths in the United States due to waterborne nosocomial lung infections caused by Pseudomonas aeruginosa alone [15]. A recently published article in Infection Control and Hospital Epidemiology by Stuckey et al. (2020) reviewed the National Health care Safety Network annual reports from 4929 hospitals in the United States. They reported that 1 in 10 hospitals did not have a water management programme and some hospitals did not include some basic practices like water temperature and disinfectant monitoring [16]. Hospitals in Low- and middle-income countries suffer from water shortage. Chawla et al. (2016) reported in their study, a systematic review that included 22 hospital in the LMICs area providing surgical services, that more than one-third of the hospital did not have a reliable water source. They recommended that both governments and non-governmental organizations should direct more effort to enhance the water infrastructure of hospitals [17].

#### **1.4 Medical waste and sanitation facilities**

Medical waste is a dangerous pollutant that may contain viruses, bacteria, chemical substances, and even radioactive waste. It must not be taken for granted as it can act as a source of infection and limit the efforts in controlling an outbreak, not to mention its environmental impact. Since the beginning of COVID-19 pandemic medical waste has increased significantly and managing it became more difficult [18]. It is important to evaluate waste management for an accurate infection prevention assessment. In Jordan, less than 78 per cent of sanitation systems are managed safely and one-third of schools have basic sanitation services [12]. Several studies found that viral materials of the SARS-COV2 virus (RNA) can be found in human waste like blood and stool [19–21]. A recent study by Chen et al. (2020) tested human waste for SARS-COV2 viral shedding and found that fecal samples of COVID-19 patients remained positive for the virus after the pharyngeal swaps turned negative; this means that a patient that tests negative might excrete the virus by fecal route. The study also suggests that the fecal-oral transmission may be another way for this virus to be transmitted. Wastewater epidemiology is a relatively new discipline and it was mainly used to detect drugs in wastewater to

estimate drug use in a population. However, it is now applied to detect pathogens including SARS-COV2 as the first report of its detection in an Australian study by Ahmed et al. (2020) was followed by a number of studies that all recommended a safe wastewater management to help fighting the pandemic [22].


**5. Summary**

Convolution neural network (CNN) has been developing rapidly and used widely for many computer science domains in the past few years, such as image recognition, speech recognition, game play, etc. In the image recognition filed, the recognition accuracy of ResNet exceeded human accuracy in 2015. The outstanding performance makes CNN more and more popular in the artificial intelligence applications. Many researches increase the depth of CNN model to improve the accuracy; in the meanwhile, it brings great pressure to the hardware. Therefore, many specific CNN accelerators are designed and used for CNN computing, including FPGA designs, GPU designs, and ASIC designs, which aim to improve the computing performance and reduce the energy consumption of CNN computing.

In this chapter, we reviewed the history of CNN and introduce the basic and principle of CNN. Following we presented a real-life CNN model, namely VGG-16. We illustrated several CNN accelerators and then we introduced and analyzed two optimization methods of CNN accelerators, including reducing data precision and data-reusing. Based on the analysis, we enumerated all legal design possibilities of CNN accelerator and the optimal design space for CNN accelerator can be obtained. By depicting the design space groups on a graph, we obtained the appropriate design space of CNN accelerator according to our design requirements.