Search results for: trip duration
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1673

Search results for: trip duration

1373 Microstructure and Hardness Changes on T91 Weld Joint after Heating at 560°C

Authors: Suraya Mohamad Nadzir, Badrol Ahmad, Norlia Berahim

Abstract:

T91 steel has been used as construction material for superheater tubes in sub-critical and super critical boiler. This steel was developed with higher creep strength property as compared to conventional low alloy steel. However, this steel is also susceptible to materials degradation due to its sensitivity to heat treatment especially Post Weld Heat Treatment (PWHT) after weld repair process. Review of PWHT process shows that the holding temperature may different from one batch to other batch of samples depending on the material composition. This issue was reviewed by many researchers and one of the potential solutions is the development of weld repair process without PWHT. This process is possible with the use of temper bead welding technique. However, study has shown the hardness value across the weld joint with exception of PWHT is much higher compare to recommended hardness value. Based on the above findings, a study to evaluate the microstructure and hardness changes of T91 weld joint after heating at 560°C at varying duration was carried out. This study was carried out to evaluate the possibility of self-tempering process during in-service period. In this study, the T91 weld joint was heat-up in air furnace at 560°C for duration of 50 and 150 hours. The heating process was controlled with heating rate of 200°C/hours, and cooling rate about 100°C/hours. Following this process, samples were prepared for the microstructure examination and hardness evaluation. Results have shown full tempered martensite structure and acceptance hardness value was achieved after 50 hours heating. This result shows that the thin component such as T91 superheater tubes is able to self-tempering during service hour.

Keywords: T91, weld-joint, tempered martensite, self-tempering

Procedia PDF Downloads 359
1372 Beyond the Travel: The Impact of Public Transport on Quality of Life

Authors: Shadab Bahreini

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Public transportation is one of the most important aspects of cities, which impacts various factors of the Quality of Life (QoL) of citizens. A passenger's experience is influenced by a variety of indicators in addition to the cost and safety of the trip. This article intends to investigate how QoL is affected by public transport in an urban environment by introducing a literature review of QoL and Quality of Urban Life (QoUL), investigating the intersection of QoL and public transport, and reviewing the background theory for Transport Quality of Life (TQoL). The article proposes a Public Transport Quality of Life (PTQoL) framework comprised of a set of indicators that measure how public transport impacts QoL across personal (physical and mental), socioeconomic, and environmental dimensions. The study proposes using the framework to evaluate objective or subjective factors affecting a person's QoL regarding public transport. Finally, it concludes that public transport is a key component in shaping QoL in urban environments and that policymakers and urban planners should use the PTQoL framework to make evidence-based decisions to improve public transport systems and their impact on QoL.

Keywords: public transport, quality of life, subjective and objective indicators, urban environment

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1371 Retrospective Analysis of Facial Skin Cancer Patients Treated in the Department of Oral and Maxillofacial Surgery Kiel

Authors: Abdullah Saeidi, Aydin Gülses, Christan Flörke

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Skin cancer of the face region is the most common type of malignancy and surgical excision is the preferred approach. However, the clinical long term results reported in the literature are still controversial. Objectives: To describe; 1. Demographical characteristics 2. Affected site, distribution and TNM classification regarding tumor type 3. Surgical aspects • Surgical removal: excision principles, safety margins, the need for secondary resection, primary reconstruction/ defect closure, anesthesia protocol, duration of hospital stay (if any) • Secondary intervention for defect closure/reconstruction: Flap technique, anesthesia protocol, duration of hospital stay (if any), postoperative wound management etc. 4. Tumor recurrences 5. Clinical outcomes 6. Studying the possible therapy approach throw Biostatistical relation and correlation between multiple Histological, diagnostics and clinical Faktors. following surgical ablation of the skin cancer of the head and neck region. Methods: Selection and statistical analysis of medical records of patients who had admitted to the Department of Oral and Maxillofacial Surgery, Universitätsklinikum Schleswig Holstein, Campus Kiel during the period of 2015-2019 will be retrospectively evaluated. Data will be collected via ORBIS Information-Management-System (ORBIS AG, Saarbrücken, Germany).

Keywords: non melanoma skin cancer, face skin cancer, skin reconstruction, non melanoma skin cancer recurrence, non melanoma skin cancer metastases

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1370 Microalbuminuria in Patients with Hypertension Visiting Tertiary Care Centre, Western Nepal

Authors: Binaya Tamang, Buddhi R. Pokharel, Narayan Gautam, Puspa R. Dhakal, Yuresh Twayana

Abstract:

Background and Objective: Microalbuminuria is often regarded as a sign of end-organ damage due to hypertension, with an increased risk for renal diseases. The present study was designed to find the prevalence of microalbuminuria in hypertensive patients by determining albumin creatinine ratio (ACR) and the association of ACR and microalbuminuria status with different stages and duration of hypertension (HTN). Also, to establish the correlation of systolic and diastolic blood pressure (SBP and DBP) with various parameters viz; ACR, urinary microalbumin (UMA), estimated glomerular filtration rate (eGFR), urinary creatinine (Ucreat), serum creatinine (Screat), and find out their significance among HTN and ACR status. Materials and Methods: A hospital-based cross-sectional study was conducted in the Department of Biochemistry in collaboration with the Department of Internal Medicine, UCMS, Bhairahawa, Nepal from April 2019 to September 2019 after obtaining ethical approval from institutional review committee (IRC), UCMS. A total of 120 hypertensive patients were enrolled whose blood, and spot urine samples were taken. eGFR was calculated by using Cockcroft-Gault formula after determining Screat while ACR was calculated after measuring Ucreat and UMA from the spot urine sample. Creatinine was estimated from modified jaffes’ reaction, whereas urinary micro albumin was done by Mispa i3 analyzer. Data were analyzed by using SPSS. 20 using p-value ≤ 0.05 as statistically significant. Results: In our study, the highest enrolled were grade II HTN (36.7%) followed by normal (33.3%), grade I (20.8%) and grade III (9.2%). Evaluating the ACR status, 19.2% were microalbuminuria, and the rest were normal. Though the ACR status (normal and microalbuminuria) was not statistically significant with HTN status (P=0.860) and the duration of HTN status (P=0.165), 5 (45.5%) out of 11 grade III HTN were microalbuminuria and the prevalence was also higher for longer duration .i.e., more than 10 years. In microalbuminuria, both the SBP (p=0.023, r=0.471) and DBP (P=0.034, r= 0.444) were strongly and positively correlated with Screat, in contrast to eGFR, which was negatively but weakly correlated. With the significant difference between the HTN group, the mean ACR (P=0.047) and UMA (P=0.02) were found to be highest among grade III patients, i.e., 84.3 ± 113.3 mg/gm. and 88.4 ± 83.9 mg/l respectively. The mean eGFR (64.2 ± 24.8 vs 77.2 ± 18.1 ml/min) was considerably lower in microalbuminuria ( p=0.026) than the normal in contrast to the SBP (160 ± 33.7 vs. 146.6 ± 19.5 mm of Hg) which was significantly higher (P=0.008). Among the different BMI category, the mean ACR was found to be significantly different (P= 0.01) with the highest value in underweight (115.2 ± 51.5 mg/gm.) and lowest in overweight (31.8 ± 4.3 mg/gm.). Conclusion: The study recommends that the microalbuminuria can be a very useful and imperative predictor of deranged kidney functions in hypertensive patients. The high value of ACR and UMA in hypertensive patients along with significant increased Screat, SBP whereas decreased eGFR in microalbuminuria patients explicitly supports the above statement.

Keywords: albumin creatinine ratio, hypertension, microalbuminuria, renal disease

Procedia PDF Downloads 125
1369 Auditory Effects among 18-45 Years Old Workers of a Textile Plant in Seeduwa, Sri Lanka

Authors: P. G. S. Madushani, L. D. Illeperuma

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Abstract Noise is one of the most common physical hazards in industrial settings. The prevalence of Noise Induced Hearing Loss (NIHL) is on the rise with increasedduration of exposure and the increase in the severity of hearing loss. The purpose of the study was to determine auditory effects among textile workers and to establish associations between the degree of hearing loss and exposure duration, degree of hearing loss and noise level and the proportion of hearing related complaints. A cross sectional descriptive study using purposive sampling was carried out. An interviewer administered questionnaire and Distortion Product Oto Acoustic Emission (DPOAE) hearing screening on 127 (72 female and 55 male) textile workers of the selected textile plant in Seeduwa, Sri Lanka was done (Age: M= 31.16, SD=7.75). Noise measurements were done in six sections of the factory and average noise levels were obtained. Diagnostic hearing evaluations were done for 60 (57.75%) subjects, referred from the DPOAE hearing screening test. The degree of hearing loss and the exposure duration had a significant association in the high frequency region of 4 kHz to 8 kHz (p < 0.05). Noise levels fluctuated between 90.3±0.8 dBA and 50.6. ±0.52 dBA. 30.83% of workers reported having NIHL. Most of the workers (33.9%) complained difficulty in conversing in noisy backgrounds. Other complaints as tinnitus, dizziness, ear fullness and headache were reported in less than 30%. workers who were exposed to noise for more than 15 years were affected with NIHL in the high frequency region. Administrative controls and engineering controls need to be implemented to manage hazardous noise levels in industrial settings. Hearing Conservation Programs should be initiated and implemented for textile workers.

Keywords: textile industry, NIHL, degree of hearing loss, noise levels, auditory effects

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1368 Efficiency of Wood Vinegar Mixed with Some Plants Extract against the Housefly (Musca domestica L.)

Authors: U. Pangnakorn, S. Kanlaya

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The efficiency of wood vinegar mixed with each individual of three plants extract such as: citronella grass (Cymbopogon nardus), neem seed (Azadirachta indica A. Juss), and yam bean seed (Pachyrhizus erosus Urb.) were tested against the second instar larvae of housefly (Musca domestica L.). Steam distillation was used for extraction of the citronella grass while neem and yam bean were simple extracted by fermentation with ethyl alcohol. Toxicity test was evaluated in laboratory based on two methods of larvicidal bioassay: topical application method (contact poison) and feeding method (stomach poison). Larval mortality was observed daily and larval survivability was recorded until the survived larvae developed to pupae and adults. The study resulted that treatment of wood vinegar mixed with citronella grass showed the highest larval mortality by topical application method (50.0%) and by feeding method (80.0%). However, treatment of mixed wood vinegar and neem seed showed the longest pupal duration to 25 day and 32 days for topical application method and feeding method respectively. Additional, larval duration on treated M. domestica larvae was extended to 13 days for topical application method and 11 days for feeding method. Thus, the feeding method gave higher efficiency compared with the topical application method.

Keywords: housefly (Musca domestica L.), neem seed (Azadirachta indica), citronella grass (Cymbopogon nardus), yam bean seed (Pachyrhizus erosus), mortality

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1367 A Destination Marketing Study on Capitalising on the Cultural Link between Ireland and North America Using Social Media

Authors: Colm Barcoe, Garvan Whelan

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This study examines how a destination marketing organisation can use social media channels to engage the interests of the US and Canadian markets in a way that maximises the number of visits (and revisits) to Ireland. The research reveals how the cultural link between Ireland and North America is exploited through the use of social media strategies. The findings are based on quantitative and qualitative empirical data obtained through a survey of North American holidaymakers in the pre, during and post trip phases coupled with in-depth interviews of 20 industry experts who are responsible for the implementation of relationship marketing strategies for this segment. The qualitative data was analysed using Netnography in order to provide insights into the effectiveness of various social media channels in developing cultural links between Ireland and North American tourists. The findings of this investigation will extend an under-researched body of literature pertaining to Ireland and North America. The empirical evidence of this study will be of value to both academics and industry practitioners.

Keywords: Ireland, marketing, North America, relationship, strategies

Procedia PDF Downloads 169
1366 The Relationship between Level of Anxiety and the Development of Children with Growth Hormone Deficiency

Authors: Ewa Mojs, Katarzyna Wiechec, Maia Kubiak, Wlodzimierz Samborski

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Interactions between mother’s psychological condition and child’s health status are complex and derive from the nature of the mother-child relationship. The aim of the study was to analyze the issue of anxiety amongst mothers of short children in the aspect of growth hormone therapy. The study was based on a group of 101 mothers of originally short-statured children – 70 with growth hormone deficiency (GHD) treated with recombinant human growth hormone (rhGH) and 31 undergoing the diagnostic process, without any treatment. Collected medical data included child's gender, height and weight, chronological age, bone age delay, and rhGH therapy duration. For all children, the height SDS and BMI SDS were calculated. To evaluate anxiety in mothers, the Spielberger State-Trait Anxiety Inventory (STAI) was used. Obtained results revealed low trait anxiety levels, with no statistically significant differences between the groups. State anxiety levels were average when mothers of all children were analyzed together, but when divided into groups, statistical differences appeared. Mothers of children without diagnosis and treatment had significantly higher levels of state anxiety than mothers of children with GHD receiving appropriate therapy. These results show, that the occurrence of growth failure in children is not related to high maternal trait anxiety, but the lack of diagnosis and lack of appropriate treatment generates higher levels of maternal state anxiety than the process of rh GH therapy in the offspring. Commencement of growth hormone therapy induce a substantial reduction of the state anxiety in mothers, and the duration of treatment causes its further decrease.

Keywords: anxiety, development, growth hormone deficiency, motherhood

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1365 Dynamic Reroute Modeling for Emergency Evacuation: Case Study of Brunswick City, Germany

Authors: Yun-Pang Flötteröd, Jakob Erdmann

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The human behaviors during evacuations are quite complex. One of the critical behaviors which affect the efficiency of evacuation is route choice. Therefore, the respective simulation modeling work needs to function properly. In this paper, Simulation of Urban Mobility’s (SUMO) current dynamic route modeling during evacuation, i.e. the rerouting functions, is examined with a real case study. The result consistency of the simulation and the reality is checked as well. Four influence factors (1) time to get information, (2) probability to cancel a trip, (3) probability to use navigation equipment, and (4) rerouting and information updating period are considered to analyze possible traffic impacts during the evacuation and to examine the rerouting functions in SUMO. Furthermore, some behavioral characters of the case study are analyzed with use of the corresponding detector data and applied in the simulation. The experiment results show that the dynamic route modeling in SUMO can deal with the proposed scenarios properly. Some issues and function needs related to route choice are discussed and further improvements are suggested.

Keywords: evacuation, microscopic traffic simulation, rerouting, SUMO

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1364 Characterization of Oxide Layer Developed during Tribo-Interaction of Zircaloys

Authors: Bharat Kumar, Deepak Kumar, Vijay Chaudhry

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Zirconium alloys are used as core components of nuclear reactors due to their high wear resistance, good corrosion properties, and good mechanical stability at high temperatures. The present work simulates the contact between the calandria tube and the liquid injection shutdown system (LISS) nozzle. The Calandria tube is the outer covering of the pressure tube. Water flows inside the pressure tube through fuel claddings which produces vibration in the pressure tube along with vibration in the calandria tube. Fretting wear takes place at the point of contact between the calandria tube and the LISS nozzle. Fretting tests were performed under different conditions, such as; varying fretting duration (i.e., 1 to 4 hours), varying frequency (i.e., 5 to 6.5 Hz), and varying amplitude (100 to 400 µm). The formation of the oxide layer was observed during the fretting wear test; as a result, the worn product. The worn surfaces were analyzed with scanning electron microscopy (SEM) to analyze the wear mechanism involved in the fretting test, and Energy dispersive x-ray spectroscopy (EDS) and Raman spectroscopy were used to confirm the presence of an oxide layer on the worn surface. The oxide layer becomes more uniform with fretting duration in case of water submerged condition as compared to dry contact condition. The oxide layer is deeply removed at high amplitude due to the change of wear mechanism from adhesion to abrasion, as confirmed by the presence of micro ploughing and micro cutting. Low amplitude fretting favors the formation of the tribo-oxide layer.

Keywords: tribo-oxide layer, wear, mechanically mixed layer, zircaloy

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1363 Clinical Prediction Score for Ruptured Appendicitis In ED

Authors: Thidathit Prachanukool, Chaiyaporn Yuksen, Welawat Tienpratarn, Sorravit Savatmongkorngul, Panvilai Tangkulpanich, Chetsadakon Jenpanitpong, Yuranan Phootothum, Malivan Phontabtim, Promphet Nuanprom

Abstract:

Background: Ruptured appendicitis has a high morbidity and mortality and requires immediate surgery. The Alvarado Score is used as a tool to predict the risk of acute appendicitis, but there is no such score for predicting rupture. This study aimed to developed the prediction score to determine the likelihood of ruptured appendicitis in an Asian population. Methods: This study was diagnostic, retrospectively cross-sectional and exploratory model at the Emergency Medicine Department in Ramathibodi Hospital between March 2016 and March 2018. The inclusion criteria were age >15 years and an available pathology report after appendectomy. Clinical factors included gender, age>60 years, right lower quadrant pain, migratory pain, nausea and/or vomiting, diarrhea, anorexia, fever>37.3°C, rebound tenderness, guarding, white blood cell count, polymorphonuclear white blood cells (PMN)>75%, and the pain duration before presentation. The predictive model and prediction score for ruptured appendicitis was developed by multivariable logistic regression analysis. Result: During the study period, 480 patients met the inclusion criteria; of these, 77 (16%) had ruptured appendicitis. Five independent factors were predictive of rupture, age>60 years, fever>37.3°C, guarding, PMN>75%, and duration of pain>24 hours to presentation. A score > 6 increased the likelihood ratio of ruptured appendicitis by 3.88 times. Conclusion: Using the Ramathibodi Welawat Ruptured Appendicitis Score. (RAMA WeRA Score) developed in this study, a score of > 6 was associated with ruptured appendicitis.

Keywords: predictive model, risk score, ruptured appendicitis, emergency room

Procedia PDF Downloads 150
1362 Endoscopic Treatment of Esophageal Injuries Using Vacuum Therapy

Authors: Murad Gasanov, Shagen Danielyan, Ali Gasanov, Yuri Teterin, Peter Yartsev

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Background: Despite the advances made in modern surgery, the treatment of patients with esophageal injuries remains one of the most topical and complex issues. In recent years, high-technology minimally invasive methods, such as endoscopic vacuum therapy (EVT) in the treatment of esophageal injuries. The effectiveness of EVT has been sufficiently studied in case of failure of esophageal anastomoses, however the application of this method in case of mechanical esophageal injuries is limited by a small series of observations, indicating the necessity of additional study. Aim: The aim was to аnalyzed of own experience in the use of endoscopic vacuum therapy (EVT) in a comprehensive examination of patients with esophageal injuries. Methods: We analyzed the results of treatment of 24 patients with mechanical injuries of the esophagus for the period 2019-2021. Complex treatment of patients included the use of minimally invasive technologies, including percutaneous endoscopic gastrostomy (PEG), EVT and video-assisted thoracoscopic debridement. Evaluation of the effectiveness of treatment was carried out using multislice computed tomography (MSCT), endoscopy and laboratory tests. The duration of inpatient treatment and the duration of EVT, the number of system replacements, complications and mortality were taken into account. Result: EVT in patients with mechanical injuries of the esophagus allowed to achieve epithelialization of the esophageal defect in 21 patients (87.5%) in the form of linear scar on the site of perforation or pseudodiverticulum. Complications were noted in 4 patients (16.6%), including bleeding (2) and and esophageal stenosis in the perforation area (2). Lethal outcome was in one observation (4.2%). Conclusion. EVT may be the method of choice in complex treatment in patients with esophageal lesions.

Keywords: esophagus injuries, damage to the esophagus, perforation of the esophagus, spontaneous perforation of the esophagus, mediastinitis, endoscopic vacuum therapy

Procedia PDF Downloads 90
1361 Effect of Palatal Lift Prosthesis on Speech Clarity in Flaccid Dysarthria

Authors: Firas Alfwaress, Abdelraheem Bebers Abdelhadi Hamasha, Maha Abu Awaad

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Objectives: The aim of the present study was to investigate the effect of Palatal Lift Prosthesis (PLP) on speech clarity in patients with Flaccid Dysarthria. Five speech measures were investigated including Nasalance Scores, Diadchokinetic (DDK), Vowel Duration, airflow, and Sound Intensity. Participants: Twelve (7 Males and 5 females) native speakers of Jordanian Arabic with Flaccid Dysarthria following stroke, traumatic brain injury, and amyotrophic lateral sclerosis were included. The age of the participants ranged from 8–65 years with an average of 31.75 years. Design: Nasalance Scores, Diadchokinetic rate, Vowel Duration, and Sound Intensity were obtained using the Nasometer II, Model 6450 in three conditions. The first condition included obtaining the five measures without wearing the customized Palatal Lift Prosthesis. The second and third conditions included obtaining the five measures immediately after wearing the Palatal Lift Prosthesis and three months later. Results: Palatal lift prosthesis was found to be effective in individuals with flaccid dysarthria. Results showed decrease in the Nasalance Scores for the syllable repetition tasks and vowel prolongation tasks when comparing the means in the pre PLP with the post PLP at p≤0.001 except for the /m/ prolongation task. Results showed increased DDK repetition task, airflow amount, and sound intensity, and a decrease in vowel length at p≤0.001. Conclusions: The use of palatal lift prosthesis is effective in improving the speech of patients with flaccid dysarthria.

Keywords: palatal lift prosthesis, flaccid dysarthria, hypernasality, speech clarity, diadchokinetic rate

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1360 Difference in Virulence Factor Genes Between Transient and Persistent Streptococcus Uberis Intramammary Infection in Dairy Cattle

Authors: Anyaphat Srithanasuwan, Noppason Pangprasit, Montira Intanon, Phongsakorn Chuammitri, Witaya Suriyasathaporn, Ynte H. Schukken

Abstract:

Streptococcus uberis is one of the most common mastitis-causing pathogens, with a wide range of intramammary infection (IMI) durations and pathogenicity. This study aimed to compare shared or unique virulence factor gene clusters distinguishing persistent and transient strains of S. uberis. A total of 139 S. uberis strains were isolated from three small-holder dairy herds with a high prevalence of S. uberis mastitis. The duration of IMI was used to categorize bacteria into two groups: transient and persistent strains with an IMI duration of less than 1 month and longer than 2 months, respectively. Six representative S. uberis strains, three from each group (transience and persistence) were selected for analysis. All transient strains exhibited multi-locus sequence types (MLST), indicating a highly diverse population of transient S. uberis. In contrast, MLST of persistent strains was available in an online database (pubMLST). Identification of virulence genes was performed using whole-genome sequencing (WGS) data. Differences in genomic size and number of virulent genes were found. For example, the BCA gene or alpha-c protein and the gene associated with capsule formation (hasAB), found in persistent strains, are important for attachment and invasion, as well as the evasion of the antimicrobial mechanisms and survival persistence, respectively. These findings suggest a genetic-level difference between the two strain types. Consequently, a comprehensive study of 139 S. uberis isolates will be conducted to perform an in-depth genetic assessment through WGS analysis on an Illumina platform.

Keywords: Streptococcus Uberis, mastitis, whole genome sequence, intramammary infection, persistent S. Uberis, transient s. Uberis

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1359 Public Transport Planning System by Dijkstra Algorithm: Case Study Bangkok Metropolitan Area

Authors: Pimploi Tirastittam, Phutthiwat Waiyawuththanapoom

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Nowadays the promotion of the public transportation system in the Bangkok Metropolitan Area is increased such as the “Free Bus for Thai Citizen” Campaign and the prospect of the several MRT routes to increase the convenient and comfortable to the Bangkok Metropolitan area citizens. But citizens do not make full use of them it because the citizens are lack of the data and information and also the confident to the public transportation system of Thailand especially in the time and safety aspects. This research is the Public Transport Planning System by Dijkstra Algorithm: Case Study Bangkok Metropolitan Area by focusing on buses, BTS and MRT schedules/routes to give the most information to passengers. They can choose the way and the routes easily by using Dijkstra STAR Algorithm of Graph Theory which also shows the fare of the trip. This Application was evaluated by 30 normal users to find the mean and standard deviation of the developed system. Results of the evaluation showed that system is at a good level of satisfaction (4.20 and 0.40). From these results we can conclude that the system can be used properly and effectively according to the objective.

Keywords: Dijkstra algorithm, graph theory, public transport, Bangkok metropolitan area

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1358 Predictability of Pupil Mydriasis as a Biomarker for Diabetes

Authors: Naveen Kumar Challa, Pavan Verıkıcherla, Madhubalan, Ashısh Sharma

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Aim: Aim of the study was to find whether any difference exists in pupil mydriasis measured with Orbscan in non-diabetic and type 2 diabetic patients at various intervals after installation of Tropicamide 0.8% and Phenylephrine 5%. Methods: the Observational study conducted at a tertiary care eye hospital during September 2014 to March 2015. 240 eyes from 120 patients (40 non-diabetic, 80 diabetic) were dilated with Tropicamide 0.8% and Phenylephrine 5%. One drop of a drug was installed twice. The second drop is installed at 20 minutes after installation of the first drop. In two groups’ pupil diameter was measured before installation of drops and also at 15, 30, 45 and 60 minutes after installation of the first drop using both Orbscan. Result: Mean age of the non-diabetic group is 48.67 ± 7.93 years; Diabetic group is 59.97 ± 8.77 years. Mean duration of Diabetes was 7.01 ± 5.05 years. Mean pupil diameter measured with Orbscan before installation of the drops and also at 15, 30, 45 and 60 minutes after installation of first drop in non-diabetic group was 4.18 ± 0.64mm, 6.15 ± 0.41mm, 7.76 ±0.34, 9.59 ± 0.30, and 9.97 ± 0.10 mm respectively and for the diabetic group it was 4.00 ± 0.56 mm, 5.53 ± 0.52 mm, 7.018 ± 0.58mm, 8.25±0.51mm and 9.18 ± 0.46mm respectively. The mean difference between the mean pupil diameters of the non-diabetic and diabetic group shows a significant difference (P< 0.01) at all intervals except before dilatation. There is a significant negative correlation (r = 0.78 – 0.92) between the duration of diabetes and pupil dilatation at all intervals after installation of the drops. There is also significant difference (P< 0.005) in the mean values of pupil diameter between non retinopathy diabetic subjects and diabetic retinopathy subjects at all intervals after installation of drops. Conclusion: People attending eye clinic, whose pupil mydriasis values falls below the normal may be referred for diabetic evaluation. If normative data is established for the pupil size in Indian population using Orbscan then the values fall under normative data could be a predictor for diabetes. This would in turn help ophthalmologist to detect the diabetes at an early stage and prevent the complications resulting from the diabetes.

Keywords: diabetes mellitus, pupil diameter, orbscan, tropicamide

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1357 Hole Characteristics of Percussion and Single Pulse Laser-Incised Radiata Pine and the Effects of Wood Anatomy on Laser-Incision

Authors: Subhasisa Nath, David Waugh, Graham Ormondroyd, Morwenna Spear, Andy Pitman, Paul Mason

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Wood is one of the most sustainable and environmentally favourable materials and is chemically treated in timber industries to maximise durability. To increase the chemical preservative uptake and retention by the wood, current limiting incision technologies are commonly used. This work reports the effects of single pulse CO2 laser-incision and frequency tripled Nd:YAG percussion laser-incision on the characteristics of laser-incised holes in the Radiata Pine. The laser-incision studies were based on changing laser wavelengths, energies and focal planes to conclude on an optimised combination for the laser-incision of Radiata Pine. The laser pulse duration had a dominant effect over laser power in controlling hole aspect ratio in CO2 laser-incision. A maximum depth of ~ 30 mm was measured with a laser power output of 170 W and a pulse duration of 80 ms. However, increased laser power led to increased carbonisation of holes. The carbonisation effect was reduced during laser-incision in the ultra-violet (UV) regime. Deposition of a foamy phase on the laser-incised hole wall was evident irrespective of laser radiation wavelength and energy. A maximum hole depth of ~20 mm was measured in the percussion laser-incision in the UV regime (355 nm) with a pulse energy of 320 mJ. The radial and tangential faces had a significant effect on laser-incision efficiency for all laser wavelengths. The laser-incised hole shapes and circularities were affected by the wood anatomy (earlywoods and latewoods in the structure). Subsequently, the mechanism of laser-incision is proposed by analysing the internal structure of laser-incised holes.

Keywords: CO2 Laser, Nd: YAG laser, incision, drilling, wood, hole characteristics

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1356 Patterns of Gear Substitution in Norwegian Trawl Fishery

Authors: Tannaz Alizadeh Ashrafi

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Seasonal variability in biological and ecological factors together with relevant socio-economic determinants affect the choice of fishing gear, frequency of its usage and decision about gear conversion under multi-species situation. In order to deal with the complex dynamics of fisheries, fishers, constantly, have to make decisions about how long to fish, when to go fishing, what species to target, and which gear to deploy. In this regard, the purpose of this study is to examine the dynamics of gear/ species combination in Norwegian fishery. A comprehensive vessel-level set of data for the main economically important species including: cod, haddock, saithe, shrimp and mixed catch have been obtained from the Norwegian Directorate of Fisheries covering the daily data in 2010. The present study further analyzes the level of flexibility and rationality of the fishers operating in the trawl fishery. The results show the disproportion between intention of the trawl fishers to maximize profitability of each fishing trip and their harvesting behavior in reality. Discussion is based on so-called maximizing behavior.

Keywords: trawl fishery, gear substitution, rationality, profit maximizing behavior

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1355 Prevalence and Occupational Factors Associated with Low Back Pain among the Female Garment Workers: A Cross-Sectional Study in Bangladesh

Authors: Fazle Rabbi, Mashuda Khanom Tithi, Tasnim Mirza, Sanjida Rowshan Anannya, Ahmed Hossain

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Background: Low Back Pain (LBP) is one of the common health problems among the garment workers that causes workers absenteeism from the work. The purpose of the study is to identify the association between occupational factors and LBP among the female garment workers in Bangladesh. Materials and Methods: A cross-sectional study was conducted with 487 female garment workers from three compliant garment factories of Bangladesh. Face-to-face interview on four different LBP measures along with questions on socio-demographic, occupational, and physical factors were used to collect the data. Result: The prevalence rates for LBP lasts for at least one day during the last six months, chronic pain, intense pain, and seeking medical care for LBP were found 63.04%, 38.60%, 13.76%, and 18.89%, respectively among the female garments workers. The multivariate logistic regression analysis indicates that duration of employment (>5 years), regular weight bearing and extended weekly working hours (>48 hours) are positively associated with LBP. Besides, age, BMI, family income, marital status and number of children are also found positively associated with the LBP measures. Conclusion: The prevalence of LBP among female garment workers in Bangladesh is found high. The duration of employment (>5 years), regular weight bearing and extended weekly working hours (>48 hours) play a significant role in developing LBP among the female workers. Factories need to consider training programs on the appropriate technique of weight bearing. It is also important to conduct regular screening programs to identify LBP, especially with married, overweight/obese and older age group to reduce the occurrence of LBP.

Keywords: Bangladesh, garment workers, low back pain, occupational health

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1354 Rheological Properties of Red Beet Root Juice Squeezed from Ultrasounicated Red Beet Root Slices

Authors: M. Çevik, S. Sabancı, D. Tezcan, C. Çelebi, F. İçier

Abstract:

Ultrasound technology is the one of the non-thermal food processing method in recent years which has been used widely in the food industry. Ultrasound application in the food industry is divided into two groups: low and high intensity ultrasound application. While low intensity ultrasound is used to obtain information about physicochemical properties of foods, high intensity ultrasound is used to extract bioactive components and to inactivate microorganisms and enzymes. In this study, the ultrasound pre-treatment at a constant power (1500 W) and fixed frequency (20 kHz) was applied to the red beetroot slices having the dimension of 25×25×50 mm at the constant temperature (25°C) for different application times (0, 5, 10, 15 and 20 min). The red beet root slices pretreated with ultrasonication was squeezed immediately. The changes on rheological properties of red beet root juice depending on ultrasonication duration applied to slices were investigated. Rheological measurements were conducted by using Brookfield viscometer (LVDV-II Pro, USA). Shear stress-shear rate data was obtained from experimental measurements for 0-200 rpm range by using spindle 18. Rheological properties of juice were determined by fitting this data to some rheological models (Newtonian, Bingham, Power Law, Herschel Bulkley). It was investigated that the best model was Power Law model for both untreated red beet root juice (R2=0.991, χ2=0.0007, RMSE=0.0247) and red beetroot juice produced from ultrasonicated slices (R2=0.993, χ2=0.0006, RMSE=0.0216 for 20 min pre-treatment). k (consistency coefficient) and n (flow behavior index) values of red beetroot juices were not affected from the duration of ultrasonication applied to the slices. Ultrasound treatment does not result in any changes on the rheological properties of red beetroot juice. This can be explained by lack of ability to homogenize of the intensity of applied ultrasound.

Keywords: ultrasonication, rheology, red beet root slice, juice

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1353 Study of the Influence of Non Genetic Factors Affecting over Nutrition Students in Ayutthaya Province, Thailand

Authors: Thananyada Buapian

Abstract:

Overnutrition is emerging as a morbid disease in developing and Westernized countries. Because of its comorbidity diseases, it is cost-effective to prevent and manage this disease earlier. In Thailand, this alarming disease has long been studied, but the prevalence is still higher than that in the past. Physicians should recognize it well and have a definite direction to face and combat this dangerous disease. Rapid changes in the tremendous figure of overnutrition students indicate that genetic factors are not the primary determinants since human genes have remained unchanged for a century. This study aims to assess the prevalence of overnutrition students and to investigate the non-genetic factors affecting over nutrition students. A cross-sectional school-based survey was conducted. A two-stage sampling was adopted. Respondents included 1,850 students in grades 4 to 6 in Ayutthaya Province. An anthropometric measurement and questionnaire were developed. Childhood over nutrition was defined as a weight-for-height Z-score above +2SD of NCHS/WHO references. About thirty three percent of the children were over nutrition in Ayutthaya province. Stepwise multiple logistic regression analysis showed that 8 statistically significant non genetic factors explain the variation of childhood over nutrition by 18 percent. Sex is the prime factor to explain the variation of childhood over nutrition, followed by duration of light physical activities, duration of moderate physical activities, having been breastfed, the presence of a healthy role model of the caregiver, number of siblings, birth order, and occupation of the caregiver, respectively. Non genetic factors, especially the subjects’ demographic and physical activities, as well as the caregivers’ background and family environment, should be considered in viable approach to remedy this health imbalance in children.

Keywords: non genetic factors, non-genetic, over nutrition, over nutrition students

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1352 Changes on Some Physical and Chemical Properties of Red Beetroot Juice during Ultrasound Pretreatment

Authors: Serdal Sabanci, Mutlu Çevik, Derya Tezcan, Cansu Çelebi, Filiz Içier

Abstract:

Ultrasound is defined as sound waves having frequencies higher than 20 kHz, which is greater than the limits of the human hearing range. In recent years, ultrasonic treatment is an emerging technology being used increasingly in the food industry. It is applied as an alternative technique for different purposes such as microbial and enzyme inactivation, extraction, drying, filtration, crystallization, degas, cutting etc. Red beetroot (Beta vulgaris L.) is a root vegetable which is rich in mineral components, folic acid, dietary fiber, anthocyanin pigments. In this study, the application of low frequency high intensity ultrasound to the red beetroot slices and red beetroot juice for different treatment times (0, 5, 10, 15, 20 min) was investigated. Ultrasonicated red beetroot slices were also squeezed immediately. Changes on colour, betanin, pH and titratable acidity properties of red beetroot juices (the ultrasonicated juice (UJ) and the juice from ultrasonicated slices (JUS)) were determined. Although there was no significant difference statistically in the changes of color value of JUS samples due to ultrasound application (p>0.05), the color properties of UJ samples ultrasonicated for low durations were statistically different from raw material (p<0.05). The difference between color values of UJ and raw material disappeared (p>0.05) as the ultrasonication duration increased. The application of ultrasound to red beet root slices adversely affected and decreased the betanin content of JUS samples. On the other hand, the betanin content of UJ samples increased as the ultrasonication duration increased. Ultrasound treatment did not affect pH and titratable acidity of red beetroot juices statistically (p>0.05). The results suggest that ultrasound technology is the simple and economical technique which may successfully be employed for the processing of red beetroot juice with improved color and betanin quality. However, further investigation is still needed to confirm this.

Keywords: red beetroot, ultrasound, color, betanin

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1351 The Effects of the Introduction of a One-day Waiting Period on Absences for Ordinary Illness of Public Employees

Authors: Mohamed Ali Ben Halima, Malik Koubi, Joseph Lanfranchi, Yohan Wloczysiak

Abstract:

This article assesses the consequences on the frequency and duration of ordinary sick leave of the January 2012 and 2018 reforms modifying the scope of sick leave reimbursement in the French civil service. These reforms introduce a one-day waiting period which removes the compensation for the first day of ordinary sick leave. In order to evaluate these reforms, we use an administrative database from the National Pension Fund for local public employees (FPT). The first important result of our data analysis is that the one-day waiting period was not introduced at the same time in the French Local Public Service establishments, or even never in some. This peculiarity allows for an identification strategy using a difference-in-differences method based on the definition at each date of groups of employees treated and not treated by the reform, since establishments that apply the one-day waiting period coexist with establishments that do not apply it. Two types of estimators are used for this evaluation: individual and time fixed effects estimators and DIDM estimators which correct for the biases of the Two Way Fixed Effects one. The results confirm that the change in the sick pay system decreases the probability of having at least one ordinary sick leave as well as the number and duration of these episodes. On the other hand, the estimates show that longer leave episodes are not less affected than shorter ones. Finally, the validity tests of the estimators support the results obtained for the second period of 2018-2019, but suggest estimation biases for the period 2012-2013. The extent to which the endogeneity of the choices of implementation of the reform at the local level impact these estimates needs to be further tested.

Keywords: sick leave, one-day waiting period, territorial civil service, public policy evaluation

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1350 Informational Support, Anxiety and Satisfaction with Care among Family Caregivers of Patients Admitted in Critical Care Units of B.P. Koirala Institute of Health Sciences, Nepal

Authors: Rosy Chaudhary, Pushpa Parajuli

Abstract:

Background and Objectives: Informational support to family members has a significant potential for reducing this distress related to hospitalization of their patient into the critical care unit, enabling them to cope better and support the patient. The objective of the study is to assess family members’ perception of informational support, anxiety, satisfaction with care and to reveal the association with selected socio-demographic variables and to investigate the correlation between informational support, anxiety and satisfaction with care. Materials and Methods: A descriptive cross-sectional study was conducted in 39 family caregivers of patients admitted in critical care unit of BPKIHS(B.P. Koirala Institute of Health Sciences). Consecutive sampling technique was used wherein data was collected over duration of one month using interview schedule. Descriptive and inferential statistics were used. Results: The mean age of the respondents was 34.97 ± 10.64 and two third (66.70%) were male. Mean score for informational support was 25.72(SD = 5.66; theoretical range of 10 - 40). Mean anxiety was 10.41 (SD = 5.02; theoretical range of 7 - 21). Mean score for satisfaction with care was 40.77 (SD = 6.77; theoretical range of 14 - 64). A moderate positive correlation was found between informational support and satisfaction with care (r = 0.551, p < .001) and a moderate negative correlation was found between anxiety and satisfaction with care (r = -0.590; p = 0.000). No relationship was noted between informational support and anxiety. Conclusion: The informational support and satisfaction of the family caregivers with the care provided to their patients was satisfactory. More than three fourth of the family caregivers had anxiety; the factors associated being educational status of the caregivers, the family income and duration of visiting hours. There was positive correlation between informational support and satisfaction with care provided justifying the need for comprehensive information to the family caregivers by the health personnel. There was negative correlation between anxiety and satisfaction with care.

Keywords: anxiety, caregivers, critical care unit, informational support, family

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1349 The Moderating Roles of Bedtime Activities and Anxiety and Depression in the Relationship between Attention-Deficit/Hyperactivity Disorder and Sleep Problems in Children

Authors: Lian Tong, Yan Ye, Qiong Yan

Abstract:

Background: Children with attention-deficit/hyperactivity disorder (ADHD) often experience sleep problems, but the comorbidity mechanism has not been sufficiently studied. This study aimed to determine the comorbidity of ADHD and sleep problems as well as the moderating effects of bedtime activities and depression/anxiety symptoms on the relationship between ADHD and sleep problems. Methods: We recruited 934 primary students from third to fifth grade and their parents by stratified random sampling from three primary schools in Shanghai, China. This study used parent-reported versions of the ADHD Rating Scale-IV, Children’s Sleep Habits Questionnaire, and Achenbach Child Behavior Checklist. We used hierarchical linear regression analysis to clarify the moderating effects of bedtime activities and depression/anxiety symptoms. Results: We found that children with more ADHD symptoms had shorter sleep durations and more sleep problems on weekdays. Screen time before bedtime strengthened the relationship between ADHD and sleep-disordered breathing. Children with more screen time were more likely to have sleep onset delay, while those with less screen time had more sleep onset problems with increasing ADHD symptoms. The high bedtime eating group experienced more night waking with increasing ADHD symptoms compared with the low bedtime eating group. Anxiety/depression exacerbated total sleep problems and further interacted with ADHD symptoms to predict sleep length and sleep duration problems. Conclusions: Bedtime activities and emotional problems had important moderating effects on the relationship between ADHD and sleep problems. These findings indicate that appropriate bedtime management and emotional management may reduce sleep problems and improve sleep duration for children with ADHD symptoms.

Keywords: ADHD, sleep problems, anxiety/depression, bedtime activities, children

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1348 Application of an Analytical Model to Obtain Daily Flow Duration Curves for Different Hydrological Regimes in Switzerland

Authors: Ana Clara Santos, Maria Manuela Portela, Bettina Schaefli

Abstract:

This work assesses the performance of an analytical model framework to generate daily flow duration curves, FDCs, based on climatic characteristics of the catchments and on their streamflow recession coefficients. According to the analytical model framework, precipitation is considered to be a stochastic process, modeled as a marked Poisson process, and recession is considered to be deterministic, with parameters that can be computed based on different models. The analytical model framework was tested for three case studies with different hydrological regimes located in Switzerland: pluvial, snow-dominated and glacier. For that purpose, five time intervals were analyzed (the four meteorological seasons and the civil year) and two developments of the model were tested: one considering a linear recession model and the other adopting a nonlinear recession model. Those developments were combined with recession coefficients obtained from two different approaches: forward and inverse estimation. The performance of the analytical framework when considering forward parameter estimation is poor in comparison with the inverse estimation for both, linear and nonlinear models. For the pluvial catchment, the inverse estimation shows exceptional good results, especially for the nonlinear model, clearing suggesting that the model has the ability to describe FDCs. For the snow-dominated and glacier catchments the seasonal results are better than the annual ones suggesting that the model can describe streamflows in those conditions and that future efforts should focus on improving and combining seasonal curves instead of considering single annual ones.

Keywords: analytical streamflow distribution, stochastic process, linear and non-linear recession, hydrological modelling, daily discharges

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1347 Receptor-Independent Effects of Endocannabinoid Anandamide on Contractility and Electrophysiological Properties of Rat Ventricular Myocytes

Authors: Lina T. Al Kury, Oleg I. Voitychuk, Ramiz M. Ali, Sehamuddin Galadari, Keun-Hang Susan Yang, Frank Christopher Howarth, Yaroslav M. Shuba, Murat Oz

Abstract:

A role for anandamide (N-arachidonoyl ethanolamide; AEA), a major endocannabinoid, in the cardiovascular system in various pathological conditions has been reported in earlier studies. In the present work, we have hypothesized that the antiarrhythmic effects reported for AEA are due to its negative inotropic effect and altered action potential (AP) characteristics. Therefore, we tested the effects of AEA on contractility and electrophysiological properties of rat ventricular myocytes. Video edge detection was used to measure myocyte shortening. Intracellular Ca2+ was measured in cells loaded with the fluorescent indicator fura-2 AM. Whole-cell patch-clamp technique was employed to investigate the effect of AEA on the characteristics of APs. AEA (1 μM) caused a significant decrease in the amplitudes of electrically-evoked myocyte shortening and Ca2+ transients and significantly decreased the duration of AP. The effect of AEA on myocyte shortening and AP characteristics was not altered in the presence of pertussis toxin (PTX, 2 µg/ml for 4 h), AM251 and SR141716 (cannabinoid type 1 receptor antagonists) or AM630 and SR 144528 (cannabinoid type 2 receptor antagonists). Furthermore, AEA inhibited voltage-activated inward Na+ (INa) and Ca2+ (IL,Ca) currents; major ionic currents shaping the APs in ventricular myocytes, in a voltage and PTX-independent manner. Collectively, the results suggest that AEA depresses ventricular myocyte contractility, by decreasing the action potential duration (APD), and inhibits the function of voltage-dependent Na+ and L-type Ca2+ channels in a manner independent of cannabinoid receptors. This mechanism may be importantly involved in the antiarrhythmic effects of anandamide.

Keywords: action potential, anandamide, cannabinoid receptor, endocannabinoid, ventricular myocytes

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1346 Organic Contaminant Degradation Using H₂O₂ Activated Biochar with Enhanced Persistent Free Radicals

Authors: Kalyani Mer

Abstract:

Hydrogen peroxide (H₂O₂) is one of the most efficient and commonly used oxidants in in-situ chemical oxidation (ISCO) of organic contaminants. In the present study, we investigated the activation of H₂O₂ by heavy metal (nickel and lead metal ions) loaded biochar for phenol degradation in an aqueous solution (concentration = 100 mg/L). It was found that H₂O₂ can be effectively activated by biochar, which produces hydroxyl (•OH) radicals owing to an increase in the formation of persistent free radicals (PFRs) on biochar surface. Ultrasound treated (30s duration) biochar, chemically activated by 30% phosphoric acid and functionalized by diethanolamine (DEA) was used for the adsorption of heavy metal ions from aqueous solutions. It was found that modified biochar could remove almost 60% of nickel in eight hours; however, for lead, the removal efficiency reached up to 95% for the same time duration. The heavy metal loaded biochar was further used for the degradation of phenol in the absence and presence of H₂O₂ (20 mM), within 4 hours of reaction time. The removal efficiency values for phenol in the presence of H₂O₂ were 80.3% and 61.9%, respectively, by modified biochar loaded with nickel and lead metal ions. These results suggested that the biochar loaded with nickel exhibits a better removal capacity towards phenol than the lead loaded biochar when used in H₂O₂ based oxidation systems. Meanwhile, control experiments were set in the absence of any activating biochar, and the removal efficiency was found to be 19.1% when only H₂O₂ was added in the reaction solution. Overall, the proposed approach serves a dual purpose of using biochar for heavy metal ion removal and treatment of organic contaminants by further using the metal loaded biochar for H₂O₂ activation in ISCO processes.

Keywords: biochar, ultrasound, heavy metals, in-situ chemical oxidation, chemical activation

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1345 An Investigation of the Science Process Skills of 48-66 Months Old Children

Authors: Nilüfer Kuru, Berrin Akman

Abstract:

In this study, science process skills of children with ages varying between 48-months and 66-months are analyzed. Science process skills of children are investigated in terms of factors including gender of children, attendance of children to the previous educational institution and duration of their attendance, educational background of their parents, ages of children and teachers, professional experience of teachers, educational background, and department of graduation of teachers, type of pre-school education institution of teachers and children. Sample of research consists of 250 children aged between 48-months and 66-months who attend state and private kindergartens under the Ministry of National Education, nursery classes of elementary schools and kindergartens of establishments in central districts of Ankara and 50 teachers who serve in these children’s classes. Science Observation Form, reached from the website of Alaska Department of Education & Early, are analyzed in terms of language, content, construct validity, and reliability by the researchers. Additionally, Personal Information Form is also developed by the researchers. Data obtained in the study are analyzed with SPSS 16.0 package program to obtain percentage and frequency, Kruskal Wallis H-test, and Mann- Whitney U test, which are one of the non-parametric tests, are used. Within the context of this study it has been seen that independent variables of age, type of school attending and status of attendance to pre-school education, educational background of children’s father are meaningful expositive in gaining science process skills for children. It has been seen that period of service of teachers, duration of attendance to pre-school education for children, gender of children and educational background of children’s mother are not meaningful expositive in gaining science process skills for children.

Keywords: preschool, science process skills, early childhood education, science

Procedia PDF Downloads 354
1344 Lamivudine Continuation/Tenofovir Add-on Adversely Affects Treatment Response among Lamivudine Non-Responder HIV-HBV Co-Infected Patients from Eastern India

Authors: Ananya Pal, Neelakshi Sarkar, Debraj Saha, Dipanwita Das, Subhashish Kamal Guha, Bibhuti Saha, Runu Chakravarty

Abstract:

Presently, tenofovir disoproxil fumurate (TDF) is the most effective anti-viral agent for the treatment of hepatitis B virus (HBV) in individuals co-infected with HIV and HBV as TDF has activity to suppress both wild-type and lamivudine (3TC)-resistant HBV. However, suboptimal response to TDF was reported in HIV-HBV co-infected individuals with prior 3TC therapy from different countries recently. The incidence of 3TC-resistant HBV strains is quite high in HIV-HBV co-infected patients experiencing long-term anti-retroviral therapy (ART) in eastern India. In spite of this risk, most of the patients with long-term 3TC treatment are continued with the same anti-viral agent in this country. Only a few have received TDF in addition to 3TC in the ART regimen since TDF has been available in India for the treatment of HIV-infected patients in 2012. In this preliminary study, we investigated the virologic and biochemical parameters among HIV-HBV co-infected patients who are non-responders to 3TC treatment during the continuation of 3TC or TDF add-on to 3TC in their ART regimen. Fifteen HIV-HBV co-infected patients who experienced long-term 3TC (mean duration months 36.87 ± 24.08 months) were identified with high HBV viremia ( > 20,000 IU/ml) or harbouring 3TC-resistant HBV. These patients receiving ART from School of Tropical Medicine Kolkata, the main ART centre in eastern India were followed-up semi-annually for next three visits. Different virologic parameters including quantification of plasma HBV load by real-time PCR, detection of hepatitis B e antigen (HBeAg) by commercial ELISA and anti-viral resistant mutations by sequencing were studied. During three follow-up among study subjects, 86%, 47%, and 43% had 3TC-mono-therapy (mean treatment-duration 41.54±18.84, 49.67±11.67, 54.17±12.37 months respectively) whereas 14%, 53%, and 57% experienced TDF in addition to 3TC (mean treatment duration 4.5±2.12, 16.56±11.06, and 23±4.07 months respectively). Mean CD4 cell-count in patients receiving 3TC was tended to be lower during third follow-up as compared to the first and the second [520.67±380.30 (1st), 454.8±196.90 (2nd), and 397.5±189.24 (3rd) cells/mm3) and similar trend was seen in patients experiencing TDF in addition to 3TC [334.5±330.218 (1st), 476.5±194.25 (2nd), and 461.17±269.89 (3rd) cells/mm3]. Serum HBV load was increased during successive follow-up of patients with 3TC-mono-therapy. Initiation of TDF lowered serum HBV-load among 3TC-non-responders at the time of second visit ( < 2,000 IU/ml), interestingly during third follow-up, mean HBV viremia increased >1 log IU/ml (mean 3.56±2.84 log IU/ml). Persistence of 3TC-resistant double and triple mutations was also observed in both the treatment regimens. Mean serum alanine aminotransferase remained elevated in these patients during this follow-up study. Persistence of high HBV viraemia and 3TC-resistant mutation in HBV during the continuation of 3TC might lead to major public health threat in India. The inclusion of TDF in the ART regimen of 3TC non-responder HIV-HBV co-infected patients showed adverse treatment response in terms of virologic and biochemical parameters. Therefore, serious attention is necessary for proper management of long-term 3TC experienced HIV-HBV co-infected patients with high HBV viraemia or 3TC-resistant HBV mutants in India.

Keywords: HBV, HIV, TDF, 3TC-resistant

Procedia PDF Downloads 355