Search results for: infant mortality rate

Authors: Rabeb Triki, Hassene Djemel, Mounir Baccar

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Surface scraping is a passive heat transfer enhancement technique that is directly used in scraped surface heat exchanger (SSHE). The scraping action prevents the accumulation of the product on the inner wall, which intensifies the heat transfer and avoids the formation of dead zones. SSHEs are widely used in industry for several applications such as crystallization, sterilization, freezing, gelatinization, and many other continuous processes. They are designed to deal with products that are viscous, sticky or that contain particulate matter. This research work presents a three-dimensional numerical simulation of the coupled thermal and hydrodynamic behavior within a SSHE which includes Archimedes’ screw instead of scraper blades. The finite volume Fluent 15.0 was used to solve continuity, momentum and energy equations using multiple reference frame formulation. The process fluid investigated under this study is the pure glycerin. Different geometrical parameters were studied in the case of steady, non-isothermal, laminar flow. In particular, attention is focused on the effect of the conicity of the rotor and the pitch of Archimedes’ screw on temperature and velocity distribution and heat transfer rate. Numerical investigations show that the increase of the number of turns in the screw from five to seven turns leads to amelioration of heat transfer coefficient, and the increase of the conicity of the rotor from 0.1 to 0.15 leads to an increase in the rate of heat transfer. Further studies should investigate the effect of different operating parameters (axial and rotational Reynolds number) on the hydrodynamic and thermal behavior of the SSHE.

Keywords: ANSYS-Fluent, hydrodynamic behavior, scraped surface heat exchange, thermal behavior

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Authors: Krzysztof Buczak, Sonia Lachowska, Pawel Kucharski, Agnieszka Antonczyk

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Tiletamine - zolazepam combination is increasingly used in veterinary anaesthesiology in wild animals, including snakes. The available literature shows a lack of information about anesthesia in this mixture in ovoviviparous snakes. The studies show the possibility of using the combination at a dose of 20 mg/kg or more for snake immobilization. This paper presents an anesthetic protocol with the use of a combination of tiletamine - zolazepam at the dose of 10 mg/kg intramuscularly and maintenance with inhalant anesthesia with isoflurane in pure oxygen. The objective of this study was to evaluate the usefulness of the anesthetic protocol to proceed with coeliotomy in Amazon Tree Boa. The patient was a five years old bicolor female Amazon Tree Boa (Corallus hortulanus) with dystocia. The clinical examination reveals significant emaciation (bodyweight 520g), high degree of dehydration, heart rate (HR = 60 / min), pale mucous membranes and poor reactivity. Meloxicam (1 mg/kg) and tramadol (10 mg/kg) were administered subcutaneously and the patient was placed in an incubator with access to fresh oxygen. Four hours later, the combination of tiletamine - zolazepam (10 mg/kg) was administered intramuscularly for induction of anesthesia. The snake was intubated and connected to inhalant anesthesia equipment. For maintenance, the anesthesia isoflurane in pure oxygen was used due to apnea, which occurs 30 minutes after the induction semi-closed system was attached and the ventilator was turned on (PCV system, four breaths per minute, 8 cm of H2O). Cardiopulmonary parameters (HR, RR, SPO2, ETCO2, ETISO) were assessed throughout the procedure. During the entire procedure, the operating room was heated to a temperature of 26 degrees Celsius. Additionally, the hose was placed on a heating mat, which maintained a temperature of 30 degrees Celsius. For 15 minutes after induction, the loss of muscle tone was observed from the head to the tail. Induction of general anesthesia was scored as good because of the possibility of intubation. During the whole procedure, the heart rate was at the rate of 58 beats per minute (bpm). Ventilation parameters were stable throughout the procedure. The recovery period lasts for about 4 hours after the end of general anesthesia. The muscle tension returned from tail to head. The snake started to breathe spontaneously within 1,5 hours after the end of general anesthesia. The protocol of general anesthesia with the combination of tiletamine- zolazepam with a dose of 10 mg/kg is useful for proceeding with the emergency coeliotomy in maintenance with isoflurane in oxygen. Further study about the impact of the combination of tiletamine- zolazepam for the recovery period is needed.

Keywords: anesthesia, corallus hortulanus, ovoviparous, snake, tiletamine, zolazepam

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Authors: Sarah K. Basudan, Ragad I. Al Jazzar, Zeinah Sulaihim, Hanan M. Al-Kadri

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Background: Cesarean section has been increasing in recent years, with a wide range of etiologies contributing to this rise. This study aimed to assess the indications, outcomes, and complications in Riyadh, Saudi Arabia. Methods: A Retrospective Cohort study was conducted at King Abdulaziz medical city. The study includes two cohorts: G1 (2009) and G2 (2020) groups who met the inclusion criteria. The data was transferred to the SPSS (statistical package for social sciences) version 24 for analysis. The initial descriptive statistics were run for all variables, including numerical and categorical data. The numerical data were reported as median, and standard deviation and categorical data were reported as frequencies and percentages. Results: The data were collected from 399 women who were divided into two groups, G1(199) and G2(200). The mean age of all participants is 32+-6​; G1 and G2 had significant differences in age means with 30+-6 and 34+-5, respectively, with a p-value of <0.001, which indicates delayed fertility by four years. Moreover, a breech presentation was less likely to occur in G2 (OR 0.64, CI: 0.21-0.62. P<0.001). Nonetheless, maternal causes such as repeated C-sections and maternal medical conditions were more likely to happen in G2 (OR 1.5, CI: 1.04-2.38, p=0.03) and (OR 5.4, CI: 1.12-23.9, P=0.01), respectively. Furthermore, postpartum hemorrhage showed an increase of 12% in G2 (OR 5.4, CI: 2.2-13.4, p<0.001). G2 was more likely to be admitted to the neonatal intensive care unit (NICU) (OR 16, CI: 7.4-38.7) and to special care baby (SCB) (OR 7.2, CI: 3.9-13.1), both with a p-value<0.001 compared to regular nursery admission. Conclusion: There are multiple factors that are contributing to the increase in c section rate in a Saudi tertiary hospitals. The factors were suggested to be previous c-sections, abnormal fetal heart rate, malpresentation, and maternal or fetal medical conditions.

Keywords: cesarean sections, maternal indications, maternal complications, neonatal condition

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Authors: Eka Candra Lina, Indah Widhianingrum, Mita Eka Putri, Nur Afni Evalia, Muhammad Makky

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The emulsifiable concentrate (EC) and wettable powder (WP) of Piper aduncum and Tephrosia vogelii mixed formulations were tested for their activities in the laboratory and their effectiveness in the field against cabbage pest Plutella xyostella. Cabbage leaves soaked in six different mixed formulation concentrations were tested to 2ⁿᵈ instar larvae of P. xylostella with six replications. The observation was conducted everyday until larvae reached 4ᵗʰ instar stage. Correlation between concentration and larvae mortality was analyzed using probit (POLO-PC). The survived larvae was observed by looking at the growth and development, as well as the antifeedant effects. Field efficacy test was based on LC₉₅ value from laboratory test result. The experiment used a randomized block design with 5 treatments and 3 replications to test the populations of P. xylostella larvae and insecticide effectivity. The results showed that the EC and WP mixed formulations showed insecticidal activity against P. xylostella larvae, with LC₉₅ value of 0.35% and 0.37%, respectively. The highest antifeedant effect on EC mixed formulation was 85.01% and WP mixed formulation was 86.23%. Both mixed formulations also slowed the development of larvae when compared with control. Field effication result showed that applications of EC mixed formulation were able to restrain the population of P. xylostella, with effectivity value of 71.06%. Insecticide effectivity value of EC mixed formulation was higher than WP mixed formulation and Bacillus thuringiensis formulation.

Keywords: botanical insecticide, efficacy, emulsifiable concentrate (EC), Plutella xylostella, wettable powder (WP)

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Authors: Mukta Singh, Ratan Kumar Saha, Himadri Saha, Paramveer Singh

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The present study evaluated the effect of sub-lethal doses of antifungal drug miconazole nitrate (MCZ) on immunological responses including immune-related gene expression and its role as a prophylactic drug against S. parasitica in Labeo rohita fingerlings. Fish were fed with sub lethal doses of MCZ i.e., T1- 6.30 mg MCZ kgBW⁻¹, T2- 12.61 mg MCZ kgBW⁻¹ and T3- 25.22 mg MCZ kgBW⁻¹ and sampling was done at different time intervals for 240 h. Immunological parameters viz. lysozyme activity, oxygen radical production and plasma anti-protease activity showed significant enhancement (p < 0.05) in fish fed with T2 and T3 doses. Significant reduction in plasma protein content was observed in all the dietary groups as compared to control. Expression of immune-relevant genes like TLR-22 and β2-M showed significantly higher expression at six h and 24 h of sampling in both liver and head-kidney. However, these genes showed a down-regulation after 120 h of sampling in both the tissues. Preventive efficacy study showed that single dose of MCZ provides protection against oomycetes up to the fourth day of infection. Significantly higher mortality was observed in control diet-fed fish as compared to fish fed with MCZ medicated diet. Thus, from the study, it can be concluded that the MCZ can act as a potent antifungal agent for preventing oomycetes infection as well as to enhance the immune response.

Keywords: antifungal, immune gene, immunological, miconazole nitrate, prophylactic

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Authors: Juan Huang, Hugo Ninanya

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Oil has been used as a source of energy and supply to make materials, such as asphalt or rubber for many years. This is the reason why new technologies have been implemented through time. However, research still needs to continue increasing due to new challenges engineers face every day, just like unconventional reservoirs. Various numerical methodologies have been applied in petroleum engineering as tools in order to optimize the production of reservoirs before drilling a wellbore, although not all of these have the same efficiency when talking about studying fracture propagation. Analytical methods like those based on linear elastic fractures mechanics fail to give a reasonable prediction when simulating fracture propagation in ductile materials whereas numerical methods based on the cohesive zone method (CZM) allow to represent the elastoplastic behavior in a reservoir based on a constitutive model; therefore, predictions in terms of displacements and pressure will be more reliable. In this work, a hydro-geomechanical coupled model of horizontal wells in fractured rock was developed using ABAQUS; both extended element method and cohesive elements were used to represent predefined fractures in a model (2-D). A power law for representing the rheological behavior of fluid (shear-thinning, power index <1) through fractures and leak-off rate permeating to the matrix was considered. Results have been showed in terms of aperture and length of the fracture, pressure within fracture and fluid loss. It was showed a high infiltration rate to the matrix as power index decreases. A sensitivity analysis is conclusively performed to identify the most influential factor of fluid loss.

Keywords: fracture, hydro-geomechanical model, non-Newtonian fluid, numerical analysis, sensitivity analysis

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Authors: Abdullah A. Al Qurashi, Hattan A. Hassani, Bader K. Alaslap

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Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy (ARVD/C) is an uncommon, inheritable cardiac disorder characterized by the progressive substitution of cardiac myocytes by fibro-fatty tissues. This pathologic substitution predisposes patients to ventricular arrhythmias and right ventricular failure. The underlying genetic defect predominantly involves genes encoding for desmosome proteins, particularly plakophilin-2 (PKP2). These aberrations lead to impaired cell adhesion, heightening the susceptibility to fibrofatty scarring under conditions of mechanical stress. Primarily, ARVD/C affects the right ventricle, but it can also compromise the left ventricle, potentially leading to biventricular heart failure. Clinical presentations can vary, spanning from asymptomatic individuals to those experiencing palpitations, syncopal episodes, and, in severe instances, sudden cardiac death. The establishment of a diagnostic criterion specifically tailored for ARVD/C significantly aids in its accurate diagnosis. Nevertheless, the task of early diagnosis is complicated by the disease's frequently asymptomatic initial stages, and the overall rarity of ARVD/C cases reported globally. In some cases, as exemplified by the adult female patient in this report, the disease may advance to terminal stages, rendering therapies like Ventricular Tachycardia (VT) ablation ineffective. This case underlines the necessity for increased awareness and understanding of ARVD/C to aid in its early detection and management. Through such efforts, we aim to decrease morbidity and mortality associated with this challenging cardiac disorder.

Keywords: arrhythmogenic right ventricular dysplasia, cardiac disease, interventional cardiology, cardiac electrophysiology

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Authors: Hela Fathallah

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With 6,500 spoken languages all over the world but 80 percent of online content available only in 10 languages – English, Chinese, Spanish, Japanese, Arabic, Portuguese, German, French, Russian, and Korean – language represents a barrier to the universal access to knowledge, information and services that the internet wants to provide. Translation and its related fields of localization, interpreting, globalization, and internationalization, remove that barrier for billions of people worldwide, unlocking new markets for technology companies, mobile device makers, service providers and language vendors as well. This paper gathers different surveys conducted in different regions of the world that demonstrate a growing demand for consumption of web content with distinctive values and in languages others than the aforementioned ones. It also adds new insights to the contribution of translation in languages preservation. The idea that English is the language of internet and that, in a globalized world, everyone should learn English to cope with new technologies is no longer true. This idea has reached its limits. It collides with cultural diversity and differences around the world and generates an accelerated rate of languages extinction. Studies prove that internet exacerbates this rate and web giants such as Facebook or Google are, today, facing the impact of such a misconception of globalization. For internet and dot-com companies, localization is the solution; they are spending a significant amount of time to understand what people want and to figure out how to provide it. They are committed to making their content accessible, if not in all the languages spoken today, at least in most of them, and to adapting it to most cultures. Technology has broken down the barriers of time and space, and it will break down the language barrier as well by undertaking a process of translation and localization and through a new definition of globalization that takes into consideration these two processes.

Keywords: globalization, internet, localization, translation

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Authors: Yasin Akgül, Yusuf Polat, Emine Canbay, Ali Kılıç

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Electrospinning is the most common method to produce nanofibers. However, low production rate is still a big challenge for industrial applications of this method. In this study, morphology of nanofibers obtained from namely centrifugal spinning was investigated. Dominant process parameters acting on the fiber diameter and fiber orientation were discussed.

Keywords: centrifugal spinning, electrospinning, nanofiber, TPU nanofibers

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Authors: A. B. A. Ahmed, D. I. Amar, R. M. Taha

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This research aims to investigate callus induction, somatic embryogenesis and indirect plant regeneration of Crassula ovata (Mill.) Druce – the famous ornamental plant. Experiment no.1: Callus induction was obtained from leaf and stem explants on Murashige and Skoog (MS) medium supplemented with various plant growth regulators (PGRs). Effects of different PGRs, plant regeneration and subsequent plantlet conversion were also assessed. Indirect plant regeneration was achieved from the callus of stem explants by the addition of 1.5 mg/L Kinetin (KN) alone. Best shoot induction was achieved (6.5 shoots/per explant) after 60 days. For successful rooting, regenerated plantlets were sub-cultured on the same MS media supplemented with 1.5 mg/L KN alone. The rooted plantlets were acclimatized and the survival rate was 90%. Experiment no.2: Results revealed that 0.5 mg/L 2,4-D alone and in combination with 1.0 mg/L 6-Benzyladenine (BA) gave 89.8% callus from the stem explants as compared to leaf explants. Callus proliferation and somatic embryo formation were also evaluated by ‘Double Staining Method’ and different stages of somatic embryogenesis were revealed by scanning electron microscope. Full Strength MS medium produced the highest number (49.6%) of cotyledonary stage somatic embryos (SEs). Mature cotyledonary stage SEs developed into plantlets after 12 weeks of culture. Well-rooted plantlets were successfully acclimatized at the survival rate of 85%. Indirectly regenerated plants did not show any detectable variation in morphological and growth characteristics when compared with the donor plant.

Keywords: callus induction, indirect plant regeneration, double staining, somatic embryogenesis, Crassula ovata

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Authors: Sujeet Poudyal

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Introduction: Renal cell carcinoma is the most common malignancy associated with Inferior vena cava (IVC) thrombosis. Radical nephrectomy with tumor thrombectomy provides durable cancer-free survival. Other renal malignancies like Wilms’ tumors are also associated with IVC thrombus. We describe our experience with the management of renal malignancies associated with IVC thrombus. Methods: This prospective study included 28 patients undergoing surgery for renal malignancies associated with IVC thrombus from February 2017 to March 2023. Demographics of patients, types of renal malignancy, level of IVC thrombus, intraoperative details, need for venovenous bypass, cardiopulmonary bypass and postoperative outcomes were all documented. Results: Out of a total of 28 patients, 24 patients had clear cell Renal Cell Carcinoma,1 had renal osteosarcoma and 3 patients had Wilms tumor. The levels. of thrombus were II in eight, III in seven, and IV in six patients. The mean age of RCC was 62.81±10.2 years, renal osteosarcoma was 26 years and Wilms tumor was 23 years. There was a need for venovenous bypass in four patients and cardiopulmonary bypass in four patients, and the Postoperative period was uneventful in most cases except for two mortalities, one in Level III due to pneumonia and one in Level IV due to sepsis. All cases followed up till now have no local recurrence and metastasis except one case of RCC with Level IV IVC thrombus, which presented with paraaortic nodal recurrence and is currently managed with sunitinib. Conclusion: The complexity in the management of renal malignancy with IVC thrombus increases with the level of IVC thrombus. As radical nephrectomy with tumor thrombectomy provides durable cancer-free survival in most cases, the surgery should be undertaken in an expert and experienced setup with a strong cardiovascular backup to minimize morbidity and mortality associated with the procedure.

Keywords: renal malignancy, IVC thrombus, radical nephrectomy with tumor thrombectomy, renal cell carcinoma

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Authors: Cinzia Federico, Gaetano Giudice, Salvatore Inguaggiato, Marco Liuzzo, Maria Pedone, Fabio Vita, Christoph Kern, Leonardo La Pica, Giovannella Pecoraino, Lorenzo Calderone, Vincenzo Francofonte

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The periods of increased fumarolic activity at La Fossa volcano have been characterized, since early 80's, by changes in the gas chemistry and in the output rate of fumaroles. Excepting the direct measurements of the steam output from fumaroles performed from 1983 to 1995, the mass output of the single gas species has been recently measured, with various methods, only sporadically or for short periods. Since 2008, a scanning DOAS system is operating in the Palizzi area for the remote measurement of the in-plume SO₂ flux. On these grounds, the need of a cross-comparison of different methods for the in situ measurement of the output rate of different gas species is envisaged. In 2015, two field campaigns have been carried out, aimed at: 1. The mapping of the concentration of CO₂, H₂S and SO₂ in the fumarolic plume at 1 m from the surface, by using specific open-path diode tunable lasers (GasFinder Boreal Europe Ltd.) and an Active DOAS for SO₂, respectively; these measurements, coupled to simultaneous ultrasonic wind speed and meteorological data, have been elaborated to obtain the dispersion map and the output rate of single species in the overall fumarolic field; 2. The mapping of the concentrations of CO₂, H₂S, SO₂, H₂O in the fumarolic plume at 0.5 m from the soil, by using an integrated system, including IR spectrometers and specific electrochemical sensors; this has provided the concentration ratios of the analysed gas species and their distribution in the fumarolic field; 3. The in-fumarole sampling of vapour and measurement of the steam output, to validate the remote measurements. The dispersion map of CO₂, obtained from the tunable laser measurements, shows a maximum CO₂ concentration at 1m from the soil of 1000 ppmv along the rim, and 1800 ppmv in the inner slopes. As observed, the largest contribution derives from a wide fumarole of the inner-slope, despite its present outlet temperature of 230°C, almost 200°C lower than those measured at the rim fumaroles. Actually, fumaroles in the inner slopes are among those emitting the largest amount of magmatic vapour and, during the 1989-1991 crisis, reached the temperature of 690°C. The estimated CO₂ and H₂S fluxes are 400 t/d and 4.4 t/d, respectively. The coeval SO₂ flux, measured by the scanning DOAS system, is 9±1 t/d. The steam output, recomputed from CO₂ flux measurements, is about 2000 t/d. The various direct and remote methods (as described at points 1-3) have produced coherent results, which encourage to the use of daily and automatic DOAS SO₂ data, coupled with periodic in-plume measurements of different acidic gases, to obtain the total mass rates.

Keywords: DOAS, fumaroles, plume, tunable laser

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Authors: Henry Munoz, Muhammad Mohsan, Takashi Kiyota

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Strength and deformability characteristics of a liquefiable sand deposit including the development of earthquake-induced shear stress and shear strain as well as soil softening via the progressive degradation of shear modulus were studied via shaking table experiments. To do so, a model of a liquefiable sand deposit was constructed and densely instrumented where accelerations, pressures, and displacements at different locations were continuously monitored. Furthermore, the confinement effects on the strength and deformation characteristics of the liquefiable sand deposit due to an external surcharge by placing a heavy concrete slab (i.e. the model of an actual structural rigid pavement) on the ground surface were examined. The results indicate that as the number of seismic-loading cycles increases, the sand deposit softens progressively as large shear strains take place in different sand elements. Liquefaction state is reached after the combined effects of the progressive degradation of the initial shear modulus associated with the continuous decrease in the mean principal stress, and the buildup of the excess of pore pressure takes place in the sand deposit. Finally, the confinement effects given by a concrete slab placed on the surface of the sand deposit resulted in a favorable increasing in the initial shear modulus, an increase in the mean principal stress and a decrease in the softening rate (i.e. the decreasing rate in shear modulus) of the sand, thus making the onset of liquefaction to take place at a later stage. This is, only after the sand deposit having a concrete slab experienced a higher number of seismic loading cycles liquefaction took place, in contrast to an ordinary sand deposit having no concrete slab.

Keywords: liquefaction, shear modulus degradation, shaking table, earthquake

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Authors: Yogesh Kumar, Adarsh Kumar

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A body farm is a research facility where research is done on forensic investigation and medico-legal disciplines like forensic entomology, forensic pathology, forensic anthropology, forensic archaeology, and related areas of forensic veterinary. All the research is done to collect data on the rate of decomposition (animal and human) and forensically important insects to assist in crime detection. The data collected is used by forensic pathologists, forensic experts, and other experts for the investigation of crime cases and further research. The research work includes different conditions of a dead body like fresh, bloating, decay, dry, and skeleton, and data on local insects which depends on the climatic conditions of the local areas of that country. Therefore, it is the need of time to collect appropriate data in managed conditions with a proper set-up in every country. Hence, it is the duty of the scientific community of every country to establish/propose such facilities for justice and social management. The body farms are also used for training of police, military, investigative dogs, and other agencies. At present, only four countries viz. U.S., Australia, Canada, and Netherlands have body farms and related facilities in organised manner. There is no body farm in Asia also. In India, we have been trying to establish a body farm in A&N Islands that is near Singapore, Malaysia, and some other Asian countries. In view of the above, it becomes imperative to discuss the matter with Asian countries to collect the data on decomposition in a proper manner by establishing a body farm. We can also share the data, knowledge, and expertise to collaborate with one another to make such facilities better and have good scientific relations to promote science and explore ways of investigation at the world level.

Keywords: body farm, rate of decomposition, forensically important flies, time since death

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Authors: Wilai Masanga, Chirapha Tannanonta, Sangutid Thongsawad, Sasikarn Chamchod, Todsaporn Fuangrod

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The major factors of radiotherapy for head and neck (HN) cancers include patient’s anatomical changes and tumour shrinkage. These changes can significantly affect the planned dose distribution that causes the treatment plan deterioration. A measured transit EPID images compared to a predicted EPID images using gamma analysis has been clinically implemented to verify the dose accuracy as part of adaptive radiotherapy protocol. However, a global gamma analysis dose not sensitive to some critical organ changes as the entire treatment field is compared. The objective of this feasibility study is to evaluate the dosimetric response to patient anatomical changes during the treatment course in HN IMRT (Head and Neck Intensity-Modulated Radiation Therapy) using a novel comparison method; organ-of-interest gamma analysis. This method provides more sensitive to specific organ change detection. Random replanned 5 HN IMRT patients with causes of tumour shrinkage and patient weight loss that critically affect to the parotid size changes were selected and evaluated its transit dosimetry. A comprehensive physics-based model was used to generate a series of predicted transit EPID images for each gantry angle from original computed tomography (CT) and replan CT datasets. The patient structures; including left and right parotid, spinal cord, and planning target volume (PTV56) were projected to EPID level. The agreement between the transit images generated from original CT and replanned CT was quantified using gamma analysis with 3%, 3mm criteria. Moreover, only gamma pass-rate is calculated within each projected structure. The gamma pass-rate in right parotid and PTV56 between predicted transit of original CT and replan CT were 42.8%( ± 17.2%) and 54.7%( ± 21.5%). The gamma pass-rate for other projected organs were greater than 80%. Additionally, the results of organ-of-interest gamma analysis were compared with 3-dimensional cone-beam computed tomography (3D-CBCT) and the rational of replan by radiation oncologists. It showed that using only registration of 3D-CBCT to original CT does not provide the dosimetric impact of anatomical changes. Using transit EPID images with organ-of-interest gamma analysis can provide additional information for treatment plan suitability assessment.

Keywords: re-plan, anatomical change, transit electronic portal imaging device, EPID, head, and neck

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Authors: Mahshid Arabi

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In recent years, remarkable advancements in the fields of artificial intelligence and machine learning have led to the development of facial recognition technologies. These technologies are now employed in a wide range of applications, including security, surveillance, healthcare, and education. In the field of education, the identification of university entrance exam candidates has been one of the fundamental challenges. Traditional methods such as using ID cards and handwritten signatures are not only inefficient and prone to fraud but also susceptible to errors. In this context, utilizing advanced technologies like facial recognition can be an effective and efficient solution to increase the accuracy and reliability of identity verification in entrance exams. This article examines the use of FaceMatch software for recognizing the faces of university entrance exam candidates in Iran. The main objective of this research is to evaluate the efficiency and accuracy of FaceMatch software in identifying university entrance exam candidates to prevent fraud and ensure the authenticity of individuals' identities. Additionally, this research investigates the advantages and challenges of using this technology in Iran's educational systems. This research was conducted using an experimental method and random sampling. In this study, 1000 university entrance exam candidates in Iran were selected as samples. The facial images of these candidates were processed and analyzed using FaceMatch software. The software's accuracy and efficiency were evaluated using various metrics, including accuracy rate, error rate, and processing time. The research results indicated that FaceMatch software could accurately identify candidates with a precision of 98.5%. The software's error rate was less than 1.5%, demonstrating its high efficiency in facial recognition. Additionally, the average processing time for each candidate's image was less than 2 seconds, indicating the software's high efficiency. Statistical evaluation of the results using precise statistical tests, including analysis of variance (ANOVA) and t-test, showed that the observed differences were significant, and the software's accuracy in identity verification is high. The findings of this research suggest that FaceMatch software can be effectively used as a tool for identifying university entrance exam candidates in Iran. This technology not only enhances security and prevents fraud but also simplifies and streamlines the exam administration process. However, challenges such as preserving candidates' privacy and the costs of implementation must also be considered. The use of facial recognition technology with FaceMatch software in Iran's educational systems can be an effective solution for preventing fraud and ensuring the authenticity of university entrance exam candidates' identities. Given the promising results of this research, it is recommended that this technology be more widely implemented and utilized in the country's educational systems.

Keywords: facial recognition, FaceMatch software, Iran, university entrance exam

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Authors: Baguma Daniel Kajura

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The study explores socio-economic factors, health related and individual factors that influence the breastfeeding habits of mothers and their effect on the nutritional status of their infants in the Rwenzori region of Western Uganda. A cross-sectional research design was adopted, and it involved the use of self-administered questionnaires, interview guides, and focused group discussion guides to assess the extent to which socio-demographic factors associated with breastfeeding practices influence child malnutrition. Using this design, data was collected from 276 mother-paired infants out of the selected 318 mother-paired infants over a period of ten days. Using a sample size formula by Kish Leslie for cross-sectional studies N= Zα2 P (1- P) / δ2, where N= sample size estimate of paired mother paired infants. P= assumed true population prevalence of mother–paired infants with malnutrition cases, P = 29.3%. 1-P = the probability of mother-paired infants not having malnutrition, so 1-P = 70.7% Zα = Standard normal deviation at 95% confidence interval corresponding to 1.96.δ = Absolute error between the estimated and true population prevalence of malnutrition of 5%. The calculated sample size N = 1.96 × 1.96 (0.293 × 0.707) /0,052= 318 mother paired infants. Demographic and socio-economic data for all mothers were entered into Microsoft Excel software and then exported to STATA 14 (StataCorp, 2015). Anthropometric measurements were taken for all children by the researcher and the trained assistants who physically weighed the children. The use of immunization card was used to attain the age of the child. The bivariate logistic regression analysis was used to assess the relationship between socio-demographic factors associated with breastfeeding practices and child malnutrition. The multivariable regression analysis was used to draw a conclusion on whether or not there are any true relationships between the socio-demographic factors associated with breastfeeding practices as independent variables and child stunting and underweight as dependent variables in relation to breastfeeding practices. Descriptive statistics on background characteristics of the mothers were generated and presented in frequency distribution tables. Frequencies and means were computed, and the results were presented using tables, then, we determined the distribution of stunting and underweight among infants by the socioeconomic and demographic factors. Findings reveal that children of mothers who used milk substitutes besides breastfeeding are over two times more likely to be stunted compared to those whose mothers exclusively breastfed them. Feeding children with milk substitutes instead of breastmilk predisposes them to both stunting and underweight. Children of mothers between 18 and 34 years of age are less likely to be underweight, as were those who were breastfed over ten times a day. The study further reveals that 55% of the children were underweight, and 49% were stunted. Of the underweight children, an equal number (58/151) were either mildly or moderately underweight (38%), and 23% (35/151) were severely underweight. Empowering community outreach programs by increasing knowledge and increased access to services on integrated management of child malnutrition is crucial to curbing child malnutrition in rural areas.

Keywords: infant and young child feeding, breastfeeding, child malnutrition, maternal health

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Authors: Emily Adams, Eddie Donaghy, David Henderson, Lauren Ng, Caroline Sanders, Rowena Stewart, Maria Wolters, Stewart Mercer

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Ongoing review abstract: Older People Experiencing Homelessness (OPEH) can have mental and physical indicators of aging 10–20 years earlier than the general population and experience premature mortality due to age-related chronic conditions. Emerging literature suggests digital interventions could positively impact PEH’s well-being. However, the increased reliance on digital delivery may also perpetuate digital inequalities for socially excluded groups, including PEH. The potential triple disadvantage of being older, homeless, and digitally excluded creates a uniquely problematic situation that warrants further research. This scoping review aims to investigate and synthesise the range and type of digital interventions available to OPEH and the organisations that support OPEH. The following databases were searched on 28th July 2023: Medline, Scopus, International Bibliography of the Social Sciences (IBSS)‎, Applied Social Sciences Index & Abstracts (ASSIA)‎, Association for Computing Machinery Digital Library (ACMDL) and Policy commons. A search strategy was developed in collaboration with an academic librarian. The presentation will include: An introduction to OPEH and digital exclusion Overview of the results of this review: OPEH usage of digital platforms Current digital interventions available The role of support organisations Current gaps in the evidence, future research and recommendations for policy and practice

Keywords: homeless, digital exclusion, aging, technology

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Authors: Paria Saadatjoo

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Given that HVAC systems are the main sources of carbon dioxide producers, developing ways to reduce dependence on these systems and making use of natural resources is too important to achieve environmentally friendly buildings. A major part of building potential in terms of using natural energy resources depends on its physical features. So architectural decisions at the first step of the design process can influence the building's energy efficiency significantly. Implementation of semi-open spaces into solid apartment blocks inspired by the concept of courtyard in ancient buildings as a passive cooling strategy is currently enjoying great popularity. However, the analysis of these features and their effect on wind behavior at initial design steps is a difficult task for architects. The main objective of this research was to investigate the influence of semi-open to closed space ratio on airflow patterns in and around midrise buildings and introduce the best ratio in terms of harnessing natural ventilation. The main strategy of this paper was semi-experimental, and the research methodology was descriptive statistics. At the first step, by changing the terrace area, 6 models with various open to closed space ratios were created. These forms were then transferred to CFD software to calculate the primary indicators of natural ventilation potentials such as wind force coefficient, air flow rate, age of air distribution, etc. Investigations indicated that modifying the terrace area and, in other words, the open to closed space ratio influenced the wind force coefficient, airflow rate, and age of air distribution.

Keywords: natural ventilation, wind, midrise, open space, energy

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Authors: Huma Shareef, Ghazala H. Rizwani, Ahsana Dar

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In traditional medicine Cardiospermum halicacabum L. (Sapindeaceae) is used against various ailments. In current investigation searching a new remedy that will available easily, non expensive, able to lower hypertension and standardize blood pressure, made us to develop an herbal medicine. Crude ethanol extract of C. halicacabum and its various fractions ethyl acetate and butanol showed a dose-dependent hypotensive effect in anaesthetized rats. The trachea was exposed and freed from connective tissue and incubated by cannula to facilitate spontaneous respiration. The right carotid artery and left jugular vein were cannulated with polyethylene tubing PE-50 for monitoring blood pressure changes via pressure transducer (Gould P23 ID) connected to a Grass model 79D polygraph and for i.v. injection, respectively. Drugs or the plant extracts were administered at a constant volume of 0.5 ml/kg, followed by injection of 0.2 ml of saline that flushed the cannula. Systolic, diastolic and mean arterial blood pressure (MABP) was measured in mm Hg and heart rate in beats/min. Ethanol extract of C. halicacabum showed a significant activity at 50 mg/kg dose. Ethyl acetate fraction (10, 20, 30, 40, and 50 mg/kg) induced dose dependent fall in systolic and diastolic blood pressure, heart rate of rats. At 10-30 mg/kg the hypotensive effect was non significantly reduced by 10 -15%. However, the extract at 40 mg/kg induced significant hypotensive effect calculated as 30.95±3.2% MABP and this effect persists till 50 mg/kg. The higher polar fraction (butanol) of the whole plant failed to produce any significant response against MABP at all the tested doses (10-50 mg/kg). C. halicacabum lowers blood pressure, exerts a dose-dependent hypotensive effect, can be used as hypotensor.

Keywords: cardiospermum halicacabum, calcium channel blocker, hypotensive, various extracts

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Authors: Ratnakumar V. Kappagantula, Gordon D. Ingram, Hari B. Vuthaluru

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This paper analyzes a three reactor chemical looping process for hydrogen production from natural gas, allowing for carbon dioxide capture through chemical looping technology. An oxygen carrier is circulated to separate carbon dioxide, to reduce steam for hydrogen production and to supply oxygen for combustion. In this study, the emphasis is placed on the steam conversion in the steam reactor by investigating the hydrogen efficiencies of the complete system at steam conversions of 15.8% and 50%. An Aspen Plus model was developed for a Three Reactor Chemical Looping process to study the effects of operational parameters on hydrogen production is investigated. Maximum hydrogen production was observed under stoichiometric conditions. Different conversions in the steam reactor, which was modelled as a Gibbs reactor, were found when Gibbs-identified products and user identified products were chosen. Simulations were performed for different oxygen carriers, which consist of an active metal oxide on an inert support material. For the same metal oxide mass flowrate, the fuel reactor temperature decreased for different support materials in the order: aluminum oxide (Al2O3) > magnesium aluminate (MgAl2O4) > zirconia (ZrO2). To achieve the same fuel reactor temperature for the same oxide mass flow rate, the inert mass fraction was found to be 0.825 for ZrO2, 0.7 for MgAl2O4 and 0.6 for Al2O3. The effect of poisoning of the oxygen carrier was also analyzed. With 3000 ppm sulfur-based impurities in the feed gas, the hydrogen product energy rate of the process were found to decrease by 0.4%.

Keywords: aspen plus, chemical looping combustion, inert support balls, oxygen carrier

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Authors: Ya-Yi Yen

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The operating room is a medical environment full of high-risk, high-complexity and high-cost. In addition to assuring patient safety, the operating room should effort on the efficient and safe medical quality for the surgical patients of high risk, elders, and children. If the nursing staffs of operation room carry on the pre-operative visiting prior to surgery, the patient's anxiety and complications are expected to be alleviated, and the hospitalization days may also be shortened. Purpose: Applying the information system to enhance pre-operative visiting, case tracking, and effectiveness recording Method: (I) Application the information system to screen cases by integrating the operation scheduling, and linking the severe surgery codes, for to shorten the time to track cases of operative visiting. Through the improvement, the time required decreased to 1.5 minutes per day from 20 minutes per day, and nursing staffs’ satisfaction with satisfaction for tracking and visiting procedure of case increased to 86% from 54%. (II)The electronic establishment of the operative visiting record enhanced the integrity of the operative visiting record. The integrity rate was rise to 92% from 66%, while nursing staffs’ satisfaction with the visiting record increased to 82% from 61.3%. Since information technology continues evolving, the application of information technology is helpful to the integration of nursing information, simplification of processes, and saving of man-hours. This article introduces the application of information systems to simplify the processes and improve the effectiveness of operation visiting and tracking, including the saving of time, improving the integrity rate of record, and improving the satisfaction of nursing staffs.

Keywords: effectiveness, information system, perioperative nursing, pre-operative visiting

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Authors: Deepika, Kashika Kapoor, Nistha Khanna, Lakshmi, Archna Kumar

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Plant-parasitic nematodes cause major loss in global food production and destroying at least 21.3% of food annually. About 4100 species of plant-parasitic nematodes are reported, out of this, Meloidogyne species is prominent and worldwide in distribution. Observing the harmful effects of chemical based nematicides, there is a great need for an eco-friendly, highly efficient, sustainable control measure for Meloidogyne. Therefore, In vitro study was carried out to observe the impact of volatile cues obtained from the Tagetes erecta leaves on plant parasitic nematodes. Volatile cues were collected from marigold leaves. For chemical characterization, GCMS (Gas Chromatography Mass Spectrometry) profiling was conducted. VOCs (Volatile Organic Compounds) profile of marigold indicated the presence of several types of alkanes, alkenes varying in number and quantity. Status of nematodes population by counting the live and dead individuals after applying a definite volume (100µl) of extract was recorded at different concentrations (100%, 50%, 25%) with contrast of control (hexane) during different time durations i.e.,24hr, 48hr and 72hr. Result indicated that mortality increases with increasing time (72hr) and concentration (100%) i.e., 50%. Thus, application of prominent compound present in Marigold in pure form may be tested individually or in combination to find out the most efficient active compound/s, which may be highly useful in eco-friendly management of targeted plant parasitic nematode.

Keywords: plant-parasitic nematode, meloidogyne, tagetes erecta, volatile organic compounds

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Authors: M. T. Asadollahzadeh, A. Ghasemian, A. R. Saraeian, H. Resalati, P. R. Lennartsson, M. J. Taherzadeh

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Since filamentous fungi are capable of assimilating several types of sugars (hexoses and pentoses), they are potential candidates for bioconversion of spent sulfite liquor (SSL). Three filamentous fungi such as Aspergillus oryzae, Mucor indicus, and Rhizopus oryzae were investigated in this work. The SSL was diluted in order to obtain concentrations of 50, 60, 70, 80, and 90% and supplemented with two types of nutrients. The results from cultivations in shake flask showed that A. oryzae and M. indicus were not able to grow in pure SSL and SSL90% while R. oryzae could grow only in SSL50% and SSL60%. Cultivation with A. oryzae resulted in the highest yield of produced fungal biomass, while R. oryzae cultivation resulted in the lowest fungal biomass yield. Although, the mediums containing yeast extract, (NH₄)₂SO₄, KH₂PO₄, CaCl₂∙2H₂O, and MgSO₄∙7H₂O as nutrients supplementations produced higher fungal biomass compared to the mediums containing NH₄H₂PO₄ and ammonia, but there was no significant difference between two types of nutrients in terms of sugars and acetic acid consumption rate. The sugars consumption in M. indicus cultivation was faster than A. oryzae and R. oryzae cultivation. Acetic acid present in SSL was completely consumed during cultivation of all fungi. M. indicus was the best and fastest ethanol producer from SSL among the fungi examined, when yeast extract and salts were used as nutrients supplementations. Furthermore, no further improvement in ethanol concentration and rate of sugars consumption was obtained in medium supplemented with NH₄H₂PO₄ and ammonia compared to medium containing yeast extract, (NH₄)₂SO₄, KH₂PO₄, CaCl₂∙2H₂O, and MgSO₄∙7H₂O. On the other hand, the higher dilution of SSL resulted in a better fermentability, and better consumption of sugars and acetic acid.

Keywords: ethanol, filamentous fungi, fungal biomass, spent sulfite liquor

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Authors: Shashank Gupta, Iteash Agarwal, Vijayalaxmi Mogiligidda, Rajesh Kumar Krishnan, Sruthi Chennuri, Deepika Aggarwal, Anwesha Hoodati, Sheroy Cooper, Ranjan, Mohammad Bilal Sheik, Bhavya K. M., Manasa Hegde, M. Naveen Krishna, Amit Kumar Chauhan, Mallikarjun Korrapati, Sumit Singh, J. B. Singh, Sunil Sud, Sunil Gupta, Sidhartha Pant, Sankar, Neha Agrawal, Ashish Ranjan, Piyush Mohapatra, Roopak T., Arsh Ahmad, Nanjunda M., Dilip Singh

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Major research interests on quantum key distribution (QKD) are primarily focussed on increasing 1. point-to-point transmission distance (1000 Km), 2. secure key rate (Mbps), 3. security of quantum layer (device-independence). It is great to push the boundaries on these fronts, but these isolated approaches are neither scalable nor cost-effective due to the requirements of specialised hardware and different infrastructure. Current and future QKD network requires addressing different sets of challenges apart from distance, key rate, and quantum security. In this regard, we present ChaQra -a sub-quantum network with core features as 1) Crypto agility (integration in the already deployed telecommunication fibres), 2) Software defined networking (SDN paradigm for routing different nodes), 3) reliability (addressing denial-of-service with hybrid quantum safe cryptography), 4) upgradability (modules upgradation based on scientific and technological advancements), 5) Beyond QKD (using QKD network for distributed computing, multi-party computation etc). Our results demonstrate a clear path to create and accelerate quantum secure Indian subcontinent under the national quantum mission.

Keywords: quantum network, quantum key distribution, quantum security, quantum information

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Authors: Haaris Khan, Farhad Udwadia

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South Asians are the fastest-growing immigrant population in Canada and are 3-4 times more likely to develop diabetes. In a primary care setting, language barriers continue to persist as a prominent obstacle when delivering crucial health information. Given the abundance of languages in the South Asian community and the varying levels of English fluency, there is compelling evidence that these language barriers can adversely impact health outcomes. The microvascular and macrovascular complications of poor diabetic management are well established and universally recognized. However, these are often difficult concepts to grasp for even individuals fluent in English. In order to lessen the burden of language barriers, we developed a comprehensive guide in various languages that discuss the complications and screening guidelines for diabetic and prediabetic patients. The guide is presented in the form of a pamphlet, with an electronic version being constructed as well, that provides basic information on diabetic retinopathy, neuropathy and nephropathy as well as the screening recommendations. We also conducted a review of the literature around the topic and incorporated our findings into our project. Our goal is for primary care physicians to have this resource and to be able to provide the link or pamphlet to patients in need. Our presentation also provides a comprehensive overview of some of the other barriers that individuals in the South Asian community face when seeking care. Given the staggering number of individuals in the South Asian community with diabetes and the morbidity and mortality associated with diabetes and its complications, effective community-specific strategies are needed to mitigate the potential consequences of poor diabetes management.

Keywords: diabetes, patient education, ophthalmology, vascular surgery

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Authors: Taraneh Estedlal

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The objective of this study was to review in-vivo and in-vitro studies to compare the effectiveness of bulk-fill and conventional resin composites with regard to marginal adaptation, polymerization shrinkage, and other mechanical properties.PubMed and Scopus databases was investigated for in-vitro studies and randomized clinical trials comparing incidence of fractures, color stability, marginal adaptation, pain and discomfort, recurrent caries, occlusion, pulpal reaction, and proper proximal contacts of restorations made with conventional and bulk resins. The failure rate of conventional and flowable bulk-fill resin composites was not significantly different to sculptable bulk-fill resin composites. The objective of this study was to review in-vivo and in-vitro studies to compare the effectiveness of bulk-fill and conventional resin composites with regard to marginal adaptation, polymerization shrinkage, and other mechanical properties. PubMed and Scopus databases was investigated for in-vitro studies and randomized clinical trials comparing one of the pearlier mentioned properties between bulk-fill and control composites. Despite differences in physical and in-vitro properties, failure rate of conventional and flowable bulk-fill resin composites was not significantly different to sculptable bulk-fill resin composites.

Keywords: polymerization shrinkage, color stability, marginal adaptation, recurrent caries, occlusion, pulpal reaction

Procedia PDF Downloads 146

Authors: Marjan Mahdavi-Roshan, Arsalan Salari, Mahbobeh Gholipour

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Hypertension is one of the important reasons of morbidity and mortality in countries, including Iran. It has been shown that hypertension is a consequence of the interaction of genetics and environment. Nutrients have important roles in the controlling of blood pressure. We assessed dietary habit and anthropometric status in patients with hypertension in the north of Iran, and that have special dietary habit and according to their culture. This study was conducted on 127 patients with newly recognized hypertension and the 120 normotensive participants. Anthropometric status was measured and demographic characteristics, and medical condition were collected by valid questionnaires and dietary habit assessment was assessed with 3-day food recall (two weekdays and one weekend). The mean age of participants was 58 ± 6.7 years. The mean level of energy intake, saturated fat, vitamin D, potassium, zinc, dietary fiber, vitamin C, calcium, phosphorus, copper and magnesium was significantly lower in the hypertensive group compared to the control (p < 0.05). After adjusting for energy intake, positive association was observe between hypertension and some dietary nutrients including; Cholesterol [OR: 1.1, P: 0.001, B: 0.06], fiber [OR: 1.6, P: 0.001, B: 1.8], vitamin D [OR: 2.6, P: 0.006, B: 0.9] and zinc [OR: 1.4, P: 0.006, B: 0.3] intake. Logistic regression analysis showed that there was not significant association between hypertension, weight and waist circumference. In our study, the mean intake of some nutrients was lower in the hypertensive individuals compared to the normotensive individual. Health training about suitable dietary habits and easier access to vitamin D supplementation in patients with hypertension are cost-effective tools to improve outcomes in Iran.

Keywords: hypertension, north of Iran, dietary intake, weight

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Authors: Elizabeth O. Odewale, Sachithra T. Wanasinghe, Aaron S. Rury

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Cavity polaritons form when molecular excitons strongly couple to photons in carefully constructed optical cavities. These polaritons, which are hybrid light-matter states possessing a unique combination of photonic and excitonic properties, present the opportunity to manipulate the properties of various semiconductor materials. The systematic manipulation of materials through polariton formation could potentially improve the functionalities of many optoelectronic devices such as lasers, light-emitting diodes, photon-based quantum computers, and solar cells. However, the prospects of leveraging polariton formation for novel devices and device operation depend on more complete connections between the properties of molecular chromophores, and the hybrid light-matter states they form, which remains an outstanding scientific goal. Specifically, for most optoelectronic applications, it is paramount to understand how polariton formation affects the spectra of light absorbed by molecules coupled strongly to cavity photons. An essential feature of a polariton state is its dispersive energy, which occurs due to the enhanced spatial delocalization of the polaritons relative to bare molecules. To leverage the spatial delocalization of cavity polaritons, angle-resolved photoluminescence excitation spectroscopy was employed in characterizing light emission from the polaritonic states. Using lasers of appropriate energies, the polariton branches were resonantly excited to understand how molecular light absorption changes under different strong light-matter coupling conditions. Since an excited state has a finite lifetime, the photon absorbed by the polariton decays non-radiatively into lower-lying molecular states, from which radiative relaxation to the ground state occurs. The resulting fluorescence is collected across several angles of excitation incidence. By modeling the behavior of the light emission observed from the lower-lying molecular state and combining this result with the output of angle-resolved transmission measurements, inferences are drawn about how the behavior of molecules changes when they form polaritons. These results show how the intrinsic properties of molecules, such as the excitonic lifetime, affect the rate at which the polaritonic states relax. While it is true that the lifetime of the photon mediates the rate of relaxation in a cavity, the results from this study provide evidence that the lifetime of the molecular exciton also limits the rate of polariton relaxation.

Keywords: flourescece, molecules in cavityies, optical cavity, photoluminescence excitation, spectroscopy, strong coupling

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Authors: Ying-Jung Hsieh, Angela S. Huang, Chu-Ming Chiu, Yu-Min Chou, Chin-Hui Yang

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Background and Objectives: Hepatitis A is primarily acquired by the fecal-oral route through person-to-person contact or ingestion of contaminated food or water. During 2010 to 2014, an average of 83 cases of locally-acquired disease was reported to Taiwan’s notifiable disease system. Taiwan Centers for Disease Control (TCDC) identified an outbreak of acute hepatitis A which began in June 2015. Of the 126 cases reported in 2015, 103 (82%) cases were reported during June–December and 95 cases (92%) of them were male. The average age of all male cases was 31 years (median, 29 years; range, 15–76 years). Among the 95 male cases, 49 (52%) were also infected with HIV, and all reported to have had sex with other men. To control this outbreak, TCDC launched a free hepatitis A vaccination program in January 2016 for close contacts of confirmed hepatitis A cases, including family members, sexual partners, and household contacts. Effect of the vaccination program was evaluated. Methods: All cases of hepatitis A reported to the National Notifiable Disease Surveillance System were included. A case of hepatitis A was defined as a locally-acquired disease in a person who had acute clinical symptoms include fever, malaise, loss of appetite, nausea or abdominal discomfort compatible with hepatitis, and tested positive for anti-HAV IgM during June 2015 to June 2016 in Taiwan. The rate of case accumulation was calculated using a simple regression model. Results: During January–June 2016, there were 466 cases of hepatitis A reported; of the 243 (52%) who were also infected with HIV, 232 (95%) had a history of having sex with men. Of the 346 cases that were followed up, 259 (75%) provided information on contacts but only 14 (5%) of them provided the name of their sexual partners. Among the 602 contacts reported, 349 (58%) were family members, 14 (2%) were sexual partners, and 239 (40%) were other household contacts. Among the 602 contacts eligible for free hepatitis A vaccination, 440 (73%) received the vaccine. There were 87 (25%) cases that refused to disclose their close contacts. The average case accumulation rate during January–June 2016 was 21.7 cases per month, which was 6.8 times compared to the average case accumulation rate during June–December 2015 of 3.2 cases per month. Conclusions: Despite vaccination program aimed to provide free hepatitis A vaccine to close contacts of hepatitis A patients, the outbreak continued and even gained momentum in transmission. Refusal by hepatitis A patients to provide names of their close contacts and rejection of contacts to take the hepatitis A vaccine may have contributed to the poor effect of the program. Targeted vaccination efforts of all MSM may be needed to control the outbreak among this population in the short term. In the long term, universal vaccination program is needed to prevent the infection of hepatitis A.

Keywords: hepatitis A, HIV, men who have sex with men, vaccination

Procedia PDF Downloads 256