Search results for: time history dynamic analysis
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 42159

Search results for: time history dynamic analysis

7149 The Relationship between Human Neutrophil Elastase Levels and Acute Respiratory Distress Syndrome in Patients with Thoracic Trauma

Authors: Wahyu Purnama Putra, Artono Isharanto

Abstract:

Thoracic trauma is trauma that hits the thoracic wall or intrathoracic organs, either due to blunt trauma or sharp trauma. Thoracic trauma often causes impaired ventilation-perfusion due to damage to the lung parenchyma. This results in impaired tissue oxygenation, which is one of the causes of acute respiratory distress syndrome (ARDS). These changes are caused by the release of pro-inflammatory mediators, plasmatic proteins, and proteases into the alveolar space associated with ongoing edema, as well as oxidative products that ultimately result in severe inhibition of the surfactant system. This study aims to predict the incidence of acute respiratory distress syndrome (ARDS) through human neutrophil elastase levels. This study examines the relationship between plasma elastase levels as a predictor of the incidence of ARDS in thoracic trauma patients in Malang. This study is an observational cohort study. Data analysis uses the Pearson correlation test and ROC curve (receiver operating characteristic curve). It can be concluded that there is a significant (p= 0.000, r= -0.988) relationship between elastase levels and BGA-3. If the value of elastase levels is limited to 23.79 ± 3.95, the patient will experience mild ARDS. While if the value of elastase levels is limited to 57.68 ± 18.55, in the future, the patient will experience moderate ARDS. Meanwhile, if the elastase level is between 107.85 ± 5.04, the patient will likely experience severe ARDS. Neutrophil elastase levels correlate with the degree of severity of ARDS incidence.

Keywords: ARDS, human neutrophil elastase, severity, thoracic trauma

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7148 Fuel Inventory/ Depletion Analysis for a Thorium-Uranium Dioxide (Th-U) O2 Pin Cell Benchmark Using Monte Carlo and Deterministic Codes with New Version VIII.0 of the Evaluated Nuclear Data File (ENDF/B) Nuclear Data Library

Authors: Jamal Al-Zain, O. El Hajjaji, T. El Bardouni

Abstract:

A (Th-U) O2 fuel pin benchmark made up of 25 w/o U and 75 w/o Th was used. In order to analyze the depletion and inventory of the fuel for the pressurized water reactor pin-cell model. The new version VIII.0 of the ENDF/B nuclear data library was used to create a data set in ACE format at various temperatures and process the data using the MAKXSF6.2 and NJOY2016 programs to process the data at the various temperatures in order to conduct this study and analyze cross-section data. The infinite multiplication factor, the concentrations and activities of the main fission products, the actinide radionuclides accumulated in the pin cell, and the total radioactivity were all estimated and compared in this study using the Monte Carlo N-Particle 6 (MCNP6.2) and DRAGON5 programs. Additionally, the behavior of the Pressurized Water Reactor (PWR) thorium pin cell that is dependent on burn-up (BU) was validated and compared with the reference data obtained using the Massachusetts Institute of Technology (MIT-MOCUP), Idaho National Engineering and Environmental Laboratory (INEEL-MOCUP), and CASMO-4 codes. The results of this study indicate that all of the codes examined have good agreements.

Keywords: PWR thorium pin cell, ENDF/B-VIII.0, MAKXSF6.2, NJOY2016, MCNP6.2, DRAGON5, fuel burn-up.

Procedia PDF Downloads 76
7147 Free Radical Study of Papua’s Candy as the Consumption Culture of the Papuans

Authors: Livy Febria Tedjamulia, Aas Nurasyiah, Ivana Josephin Purnama, Monika Diah Maharani Kusumastuti, Achmad Ridwan Ariyantoro

Abstract:

Papua's candy is one of Indonesia’s indigenous consumption consisting of areca nut (Areca catechu), forest betel fruit (Piper aduncum), and CaCO3. This research aims to determine the concentration of tannins in areca nut, alkaloids in areca nut, flavonoids in forest betel fruit; detect their interaction and CaCO3; also toform a standardize consumption recommendation. The research methodwas includingDPPH assay for papua’s candy mixture, which resulted in IC50 value. Data analysis used is mathematical linear regression for each experiment. The test result of alkaloid is a Rf value of 0.773, while concentration of tannin and flavonoidare 0.603 mgGAE/g and 125.402 gQE/g, respectively. The IC50 value shows number of 3.0403, showing high antioxidant capacity.Other antioxidant assays were being studied using literature review, namely trolox and oxygen radical absorbance capacity, to figure out interaction among the bioactive compounds. It turned out that the interaction detected is antagonistic, which means the compound that is joined already has a stable molecular structure so that could reduce free radicals by donating hydrogen atoms. The recommendation consumptions given are 4 areca nuts, 5 forest betels, and 1 gram of lime betel. Therefore, papua's candy has its potential to be developed into functional food.

Keywords: antioxidant, bioactive compounds interaction, free radical, papua’s candy

Procedia PDF Downloads 182
7146 Physician and Theologian: An Analysis of Ibn Rabban’s Approach on Sīra Nabawiyya

Authors: Ahmad Sanusi Azmi, Amiruddin Mohd Sobali, Zulhilmi Mohamed Nor, Mohd Yusuf Ismail, Amran Abdul Halim

Abstract:

The non-Muslim communities’ reactions to the denials of the prophethood of Muḥammad in the ninth century created an impact on the development of Islamic prophetology. Vigorous refutations from non-Muslim community, specifically the Jews, Christians and Brahmins urged Muslims to develop a solid mechanism in defense of the status of their beloved prophet. One of the works that has been recognized as an apparatus to defend the Prophet Muḥammad veracity is al-Dīn wa al-Dawla composed by Ibn Rabban, a physician of the Caliph’s court. This study analyses the novelty of his approaches in exploring Sīra Nabawiyya and defending the prophethood of Muḥammad. The study employed a descriptive, comparative and critical approach where it analyses and extracts the author original approach in explaining the legitimacy of Muḥammad’s prophethood and enlightening the Prophet’s biography. The study in its finding argues that most of Ibn Rabban arguments in this work are actually developed from the foundations of Biblical scripture. His style of interpreting Biblical passages indicates a possible dependence on Ibn al-Layth’s letter. However, the way in which he presents Qur’ānic references seems not to be in accordance with Ibn al-Layth’s perspective. This is where the novelty of his approach is distinguished. As a result, the study also affirms that Ibn Rabban imposes his own standards of selection and interpretation of Qur’ānic verses when he applies it as reference to the Prophet life.

Keywords: Sīra Nabawiyya, Ibn Rabban, al-Dīn wa al-Dawla, Christian, Dalāil Nubuwwa

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7145 Micro-Arc Oxidation Titanium and Post Treatment by Cold Plasma and Graft Polymerization of Acrylic Acid for Biomedical Application

Authors: Shu-Chuan Liao, Chia-Ti Chang, Ko-Shao Chen

Abstract:

Titanium and its alloy are widely used in many fields such as dentistry or orthopaedics. Due to their high strength low elastic modulus that chemical inertness and bio inert. The micro-arc oxidation used to formation a micro porous ceramic oxide layer film on Titanium surface and also to improve the resistance corrosion. For improving the biocompatibility, micro-arc oxidation surfaces bio-inert need to introduce reactive group. We introduced boundary layer by used plasma enhanced chemical vapor deposition of hexamethyldisilazane (HMDS) and organic active layer by UV light graft reactive monomer acrylic acid (AAc) therefore we can immobilize Chondroitin sulphate on surface easily by crosslinking EDC/NHS. The surface properties and composition of the modified layer were measured by scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS) and X-ray diffraction (XRD) and water contact angle. Water contact angle of the plasma-treated Ti surface decreases from 60° to 38°, which is an indication of hydrophilicity. The results of electrochemical polarization analysis showed that the sample plasma treated at micro-arc oxidation after plasma treatment has the best corrosion resistance. The result showed that we can immobilize chondroitin sulfate successful by a series of modification and MTT assay indicated the biocompatibility has been improved in this study.

Keywords: MAO, plasma, graft polymerization, biomedical application

Procedia PDF Downloads 246
7144 Analysis of the Internal Mechanical Conditions in the Lower Limb Due to External Loads

Authors: Kent Salomonsson, Xuefang Zhao, Sara Kallin

Abstract:

Human soft tissue is loaded and deformed by any activity, an effect known as a stress-strain relationship, and is often described by a load and tissue elongation curve. Several advances have been made in the fields of biology and mechanics of soft human tissue. However, there is limited information available on in vivo tissue mechanical characteristics and behavior. Confident mechanical properties of human soft tissue cannot be extrapolated from e.g. animal testing. Thus, there is need for non invasive methods to analyze mechanical characteristics of soft human tissue. In the present study, the internal mechanical conditions of the lower limb, which is subject to an external load, is studied by use of the finite element method. A detailed finite element model of the lower limb is made possible by use of MRI scans. Skin, fat, bones, fascia and muscles are represented separately and the material properties for them are obtained from literature. Previous studies have been shown to address macroscopic deformation features, e.g. indentation depth, to a large extent. However, the detail in which the internal anatomical features have been modeled does not reveal the critical internal strains that may induce hypoxia and/or eventual tissue damage. The results of the present study reveals that lumped material models, i.e. averaging of the material properties for the different constituents, does not capture regions of critical strains in contrast to more detailed models.

Keywords: FEM, tissue, indentation, properties

Procedia PDF Downloads 348
7143 Investigation of Preschool Children's Mathematics Concept Acquisition in Terms of Different Variables

Authors: Hilal Karakuş, Berrin Akman

Abstract:

Preschool years are considered as critical years because of shaping the future lives of individuals. All of the knowledge, skills, and concepts are acquired during this period. Also, basis of academic skills is based on this period. As all of the developmental areas are the fastest in that period, the basis of mathematics education should be given in this period, too. Mathematics is seen as a difficult and abstract course by the most people. Therefore, the enjoyable side of mathematics should be presented in a concrete way in this period to avoid any bias of children for mathematics. This study is conducted to examine mathematics concept acquisition of children in terms of different variables. Screening model is used in this study which is carried out in a quantity way. The study group of this research consists of total 300 children, selected from each class randomly in groups of five, who are from public and private preschools in Çankaya, which is district of Ankara, in 2014-2015 academic year and attending children in the nursery classes and preschool institutions are connected to the Ministry of National Education. The study group of the research was determined by stage sampling method. The schools, which formed study group, are chosen by easy sampling method and the children are chosen by simple random method. Research data were collected with Bracken Basic Concept Scale–Revised Form and Child’s Personal Information Form generated by the researcher in order to get information about children and their families. Bracken Basic Concept Scale-Revised Form consists of 11 sub-dimensions (color, letter, number, size, shape, comparison, direction-location, and quantity, individual and social awareness, building- material) and 307 items. Subtests related to the mathematics were used in this research. In the “Child Individual Information Form” there are items containing demographic information as followings: age of children, gender of children, attending preschools educational intuitions for children, school attendance, mother’s and father’s education levels. At the result of the study, while it was found that children’s mathematics skills differ from age, state of attending any preschool educational intuitions , time of attending any preschool educational intuitions, level of education of their mothers and their fathers; it was found that it does not differ by the gender and type of school they attend.

Keywords: preschool education, preschool period children, mathematics education, mathematics concept acquisitions

Procedia PDF Downloads 336
7142 Ideological Framing in Television News: The Case of “Settlement Process”

Authors: Mete Kazaz, Birol Gülnar

Abstract:

Television news has gained a new dimension in terms of ideological approaches as a result of such factors as globalization, cross monopolization, presence of international companies etc. and certain strategies have been developed at the production, presentation and distribution stages of news. In this study, television news about a process called “settlement process” was investigated. In this framework, news about the settlement process on TV channels of TRT 1, ATV, FOX TV, NTV, HABERTÜRK, TRT HABER and STV was investigated using the content analysis method in terms of the strategies the ideology construction, attitude towards the party in power, attitude towards parties in opposition and attitude towards BDP (Peace and Democracy Part) and Imrali (the island where Abdullah Ocalan, head of PKK, is kept). First, the aforementioned TV channels were selected randomly from 3 groups in order to be able to reveal the representational capacity of commercial, news and public channels. The study covers 557 news items broadcast in the main news bulletins between the dates of 15 March 2013 and 15 March 2013. While there was a positive attitude towards the government in a sizable portion of the news about the settlement process (63.6%), the attitude of 25.3% of the news was impartial towards the government and 11.3% had a negative attitude. On the other hand, there was a negative attitude towards the Opposition in a considerable portion of the news about the settlement process (56.1%). The attitude of 35.9% of the news towards the Opposition was impartial whereas 8.0% had a positive attitude. While 34.9% of the news about the settlement process used the legitimization strategy from among the ideology construction strategies, 22.8% used the unification strategy, 15.7% the reification strategy, 15.6% fractional and 11% concealment/mystification strategy.

Keywords: attitude, ideological framing, television news, social sciences

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7141 Cortical and Subcortical Dementias: A Psychoneurolinguistic Perspective

Authors: Sadeq Al Yaari, Fayza Alhammadi, Ayman Al Yaari, Montaha Al Yaari, Aayah Al Yaari, Adham Al Yaari, Sajedah Al Yaari, Saleh Al Yami

Abstract:

Background: A rapidly increasing number of studies that focus on the relationship between language and cortical (CD) and subcortical dementias (SCD) have recently shown that such correlation is existent. Mounting evidence suggests that cognitive impairments should be investigated against language disorders. Aims: This study aims at investigating how language is associated with dementia diseases namely CD &SCD in light of psychoneurolinguistic approach. Method: Data from multiple sources (e.g., theses, dissertations, articles, research, medical records, direct testing, staff reports, and client observations) have been integrated to provide a detailed analysis of the relationship between language and CD&SCD. The researchers identified over 20 most of dementia types, and described them. Having collected and described data, the researchers then analyzed these data independently to see to what extent CD&SCD are involved in matters concerning language. Results: Results of the present study demonstrate that language and CD&SCD are undoubtedly correlated with each other. The loss of the ability of some organs to perform certain functions (due to any of the dementia diseases) results in no way to the loss of some language aspects and /or speech skills. In clearer terms, it is rare to find a patient with dementia who is not suffering from partial or complete linguistic difficulties. Many deficits run through the current interpretation of linguistic disorders: language disorders, speech disorders, articulation disorders, or voice disorders.

Keywords: cortical dementia, subcortical dementia, diseases, psychoneurolinguistics, language, impairments, relationship

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7140 Profiles of Physical Fitness and Enjoyment among Children: Associations with Sport Participation

Authors: Norjali Wazir M. R. W., Pion P., Mostaert M., De Meester A., Lenoir M., Bardid F.

Abstract:

Background and study aim: Most of the people assume that someone will perform well on something they like. A tool evaluating how much an individual likes an activity can also be guidance for talent detection and to keep youngster doing what they like as a recreational sport. The purpose of this study was to identify the relationship between physical performances with something that they like. Material and methods: In this cross-sectional study, 558 pupils age between 8 years to 11 years were tested using test battery containing 7 physical performance tests (I Do) compared to a pictorial scale containing 7 pictures (I Like) referring to the physical performance tests. Pearson correlation was computed to investigate the relation between the actual performance and the enjoyment. Results: Moderate significant correlations between each of the respective I Do, and I Like components were found. It appears that the correlation between the endurance items is higher as compared to the other six characteristics. Rerunning the analysis for age and sex groups separately resulted in only one significant correlation across all age group, namely between the evaluations of cardiovascular endurance. Conclusions: Information on enjoyment appears to be a useful and cost-effective addition to current multidimensional test batteries in a sport. By providing a clear picture on activities the young child or athlete likes or dislikes, attrition can be increased if a child starts his ‘career’ in a sport that alludes to skills or tasks he/she likes. This enjoyment will increase the intrinsic motivation, which is beneficial for sustained sports participation as well as for avoiding dropout in promising young athletes.

Keywords: I Do, I Like, physical performance, enjoyment

Procedia PDF Downloads 144
7139 A Qualitative Investigation on the Effect of COVID-19 on the Views Concerning Marriage and Divorce

Authors: Leman Korkmaz, Bahar Bahtiyar-Saygan

Abstract:

Objective: The COVID-19 pandemic has been affecting the whole world since the beginning of 2020. In addition to health-related and financial effects, there seem to be significant psychological effects as well, among them those related to people’s views and representations of marriage and divorce. Background: Although various impacts of COVID-19 have been investigated since the beginning of the pandemic, there is a limited number of studies on its effects concerning relationships. This research aims to understand how the COVID-19 pandemic affects the views on and representations of marriage and divorce by conducting two studies. Method: In the first study, one-to-one semi-structured interviews were conducted with 31 participants (20 single and 11 married individuals) to investigate their evaluations regarding the effect of COVID-19 on people’s views of marriage in general and their own views of marriage in particular. In the second study, 298 entries on the most frequently used online social platform in Turkey (EkşiSözlük) under two separate headings for COVID-19 impact on marriage and divorce were analyzed, and meaningful thematic units were formed. Results: The findings of the thematic analysis indicated that participants mostly mentioned both the positive and negative effects of COVID-19 on the views and representations of marriage. There were both common (e.g., loneliness, violence, etc.) and distinct (e.g., sexuality, positive and negative effects on attitudes towards marriage, etc.) thematic units between the results of the two studies. Implications: There are considerable implications discussed in light of the literature on Terror Management Theory, Attachment Theory, stress research, and growth perspective.

Keywords: COVID-19 pandemic, divorce, marriage, relationships, representations, views

Procedia PDF Downloads 56
7138 Machine Learning Based Approach for Measuring Promotion Effectiveness in Multiple Parallel Promotions’ Scenarios

Authors: Revoti Prasad Bora, Nikita Katyal

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Promotion is a key element in the retail business. Thus, analysis of promotions to quantify their effectiveness in terms of Revenue and/or Margin is an essential activity in the retail industry. However, measuring the sales/revenue uplift is based on estimations, as the actual sales/revenue without the promotion is not present. Further, the presence of Halo and Cannibalization in a multiple parallel promotions’ scenario complicates the problem. Calculating Baseline by considering inter-brand/competitor items or using Halo and Cannibalization's impact on Revenue calculations by considering Baseline as an interpretation of items’ unit sales in neighboring nonpromotional weeks individually may not capture the overall Revenue uplift in the case of multiple parallel promotions. Hence, this paper proposes a Machine Learning based method for calculating the Revenue uplift by considering the Halo and Cannibalization impact on the Baseline and the Revenue. In the first section of the proposed methodology, Baseline of an item is calculated by incorporating the impact of the promotions on its related items. In the later section, the Revenue of an item is calculated by considering both Halo and Cannibalization impacts. Hence, this methodology enables correct calculation of the overall Revenue uplift due a given promotion.

Keywords: Halo, Cannibalization, promotion, Baseline, temporary price reduction, retail, elasticity, cross price elasticity, machine learning, random forest, linear regression

Procedia PDF Downloads 160
7137 Depth-Averaged Modelling of Erosion and Sediment Transport in Free-Surface Flows

Authors: Thomas Rowan, Mohammed Seaid

Abstract:

A fast finite volume solver for multi-layered shallow water flows with mass exchange and an erodible bed is developed. This enables the user to solve a number of complex sediment-based problems including (but not limited to), dam-break over an erodible bed, recirculation currents and bed evolution as well as levy and dyke failure. This research develops methodologies crucial to the under-standing of multi-sediment fluvial mechanics and waterway design. In this model mass exchange between the layers is allowed and, in contrast to previous models, sediment and fluid are able to transfer between layers. In the current study we use a two-step finite volume method to avoid the solution of the Riemann problem. Entrainment and deposition rates are calculated for the first time in a model of this nature. In the first step the governing equations are rewritten in a non-conservative form and the intermediate solutions are calculated using the method of characteristics. In the second stage, the numerical fluxes are reconstructed in conservative form and are used to calculate a solution that satisfies the conservation property. This method is found to be considerably faster than other comparative finite volume methods, it also exhibits good shock capturing. For most entrainment and deposition equations a bed level concentration factor is used. This leads to inaccuracies in both near bed level concentration and total scour. To account for diffusion, as no vertical velocities are calculated, a capacity limited diffusion coefficient is used. The additional advantage of this multilayer approach is that there is a variation (from single layer models) in bottom layer fluid velocity: this dramatically reduces erosion, which is often overestimated in simulations of this nature using single layer flows. The model is used to simulate a standard dam break. In the dam break simulation, as expected, the number of fluid layers utilised creates variation in the resultant bed profile, with more layers offering a higher deviation in fluid velocity . These results showed a marked variation in erosion profiles from standard models. The overall the model provides new insight into the problems presented at minimal computational cost.

Keywords: erosion, finite volume method, sediment transport, shallow water equations

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7136 The Influence of Shear Wall Position on Seismic Performance in Buildings

Authors: Akram Khelaifia, Nesreddine Djafar Henni

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Reinforced concrete shear walls are essential components in protecting buildings from seismic forces by providing both strength and stiffness. This study focuses on optimizing the placement of shear walls in a high seismic zone. Through nonlinear analyses conducted on an eight-story building, various scenarios of shear wall positions are investigated to evaluate their impact on seismic performance. Employing a performance-based seismic design (PBSD) approach, the study aims to meet acceptance criteria related to inter-story drift ratio and damage levels. The findings emphasize the importance of concentrating shear walls in the central area of the building during the design phase. This strategic placement proves more effective compared to peripheral distributions, resulting in reduced inter-story drift and mitigated potential damage during seismic events. Additionally, the research explores the use of shear walls that completely infill the frame, forming compound shapes like Box configurations. It is discovered that incorporating such complete shear walls significantly enhances the structure's reliability concerning inter-story drift. Conversely, the absence of complete shear walls within the frame leads to reduced stiffness and the potential deterioration of short beams.

Keywords: performance level, pushover analysis, shear wall, plastic hinge, nonlinear analyses

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7135 Morphological Characteristics and Bioreactivity of Inhalable Particles during the Temple Fair in Kaifeng

Authors: Qiao Yushuang, Shao Longyi

Abstract:

This paper presents the result of plasmid assay of inhalable particulates PM10 and PM2.5 that were collected during the period of the 11th Hanyuan temple fair of ancestor worship in Kaifeng City. By use of a high-resolution Field Emission Scanning Electron Microscopy (FESEM) and image analysis (IA) technology, the morphological characteristics and Particle Size Distribution (PSD) of each were analyzed and the Bioreactivity of PM10 was evaluated by using plasmid DNA assay. The result shows that, as the dominant component of the samples taken in the urban area of Kaifeng City, the mineral particles, compared with the other components including the soot aggregates, coal ash, and unidentified particles, have a much greater amount and volume. The mineral particles exhibited a decentralized quantity - size distribution, whose presence could be available among the particles sizing 2.5μm or smaller. In contrast, the volume-size distribution of mineral particles is scattered in a relatively narrow range of between1μm and 2.5μm. According to the plasmid assay the TD50 (toxic dose of PM causing 50% of plasmid damage, expressed in μg/ml) of water-soluble PM10 and whole fraction of Kaifeng airborne PM10 was measured respectively at 220-208μg/ml and 300-400μg/ml versus 160μg/ml and 190μg/ml for PM2.5. It can be seen that the whole fraction of airborne particles caused more oxidative damage than the water-soluble fractions, and the PM2.5 has a greater oxidative capacity than the PM10.

Keywords: inhalable particulates (PM10 and PM2.5), morphological features, bioreactivity, Kaifeng

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7134 Designing Modified Nanocarriers Containing Selenium Nanoparticles Extracted from the Lactobacillus acidophilus and Their Anticancer Properties

Authors: Mahnoosh Aliahmadi, Akbar Esmaeili

Abstract:

This study synthesized new modified imaging nanocapsules (NCs) of gallium@deferoxamine/folic acid/chitosan/polyaniline/polyvinyl alcohol (Ga@DFA/FA/CS/PANI/PVA) containing Morus nigra extract by selenium nanoparticles prepared from Lactobacillus acidophilus. Se nanoparticles were then deposited on (Ga@DFA/FA/CS/PANI/PVA) using the impregnation method. The modified contrast agents were mixed with M. nigra extract, and their antibacterial activities were investigated by applying them to L929 cell lines. The influence of variable factors including surfactant, solvent, aqueous phase, pH, buffer, minimum Inhibitory concentration (MIC), minimum bactericidal concentration (MBC), cytotoxicity on cancer cells, antibiotic, antibiogram, release and loading, stirring effect, the concentration of nanoparticle, olive oil, and thermotical methods was investigated. The structure and morphology of the synthesized contrast agents were characterized by zeta potential sizer analysis (ZPS), X-Ray diffraction (XRD), Fourier-transform infrared (FT-IR), and energy-dispersive X-ray (EDX), ultraviolet-visible (UV-Vis) spectra, and scanning electron microscope (SEM). The experimental section was conducted and monitored by response surface methods (RSM) and MTT conversion assay. Antibiogram testing of NCs on Pseudomonas aeruginosa bacteria was successful, and the MIC=2 factor was obtained with a less harmful effect.

Keywords: imaging contrast agent, nanoparticles, response surface method, Lactobacillus acidophilus, selenium

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7133 Comparative Evaluation of Different Extenders and Sperm Protectors to Keep the Spermatozoa Viable for More than 24 Hours

Authors: A. M. Raseona, D. M. Barry, T. L. Nedambale

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Preservation of semen is an important process to ensure that semen quality is sufficient for assisted reproductive technology. This study evaluated the effectiveness of different extenders to preserve Nguni bull semen stored at controlled room temperature 24 °C for three days, as an alternative to frozen-thawed semen straws used for artificial insemination. Semen samples were collected from two Nguni bulls using an electro-ejaculator and transported to the laboratory for evaluation. Pooled semen was aliquot into three extenders Triladyl, Ham’s F10 and M199 at a dilution ratio of 1:4 then stored at controlled room temperature 24 °C. Sperm motility was analysed after 0, 24, 48 and 72 hours. Morphology and viability were analysed after 72 hours. The study was replicated four times and data was analysed by analysis of variance (ANOVA). Triladyl showed higher viability percentage and consistent total motility for three days. Ham’s F10 showed higher progressive motility compared to the other extenders. There was no significant difference in viability between Ham’s F10 and M199. No significant difference was also observed in total abnormality between the two Nguni bulls. In conclusion, Nguni semen can be preserved in Triladyl or Ham’s F10 and M199 culture media stored at 24 °C and stay alive for three days. Triladyl proved to be the best extender showing high viability and consistency in total motility as compared to Ham’s F10 and M199.

Keywords: bull semen, artificial insemination, Triladyl, Ham’s F10, M199, viability

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7132 The Last of Centuries Old Cardamom Farming in Eastern Nepal: Crop Disease, Coping Strategies and Institutional Innovation

Authors: K. C. Sony

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This paper investigates the coping strategies of households confronting disease in large cardamom (Amomum Subulatum Roxb.) in eastern Nepal. Cardamom farmers draw on various coping strategies to reduce the impact of crop disease in their livelihoods. Yet farmers face tremendous decline in production with a constant effort for revival. Past evidences provides dearth of information about coping strategies employed by farmers and institutional intervention to combat disease. Using factual data from Ilam district, and conducting a political economic analysis, this research addresses the gap by 1) understanding the impact of crop disease in farmers’ livelihoods, 2) identifying the coping strategies adopted by farmers and, 3) examining the existing institutional arrangements to address the disease. Coping strategies vary by household’s status defined by size of land, alternative income, and access to supporting institutions. Measures adopted are burning the cardamom field, changing land use pattern, diversifying crops, and visiting institutions for support. The local government’s support is limited to providing trainings and producing new varieties of cardamom. During crisis, farmers expect institutions to help revive the cardamom production, despite customary practice to combat disease. To retain and improve the livelihoods of farmers, there needs to be institutional innovation at the community level and policies that endorse immediate and sustainable support during hazards.

Keywords: cardamom, coping strategy, disease, institutions, Nepal

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7131 Equilibrium, Kinetic and Thermodynamic Studies of the Biosorption of Textile Dye (Yellow Bemacid) onto Brahea edulis

Authors: G. Henini, Y. Laidani, F. Souahi, A. Labbaci, S. Hanini

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Environmental contamination is a major problem being faced by the society today. Industrial, agricultural, and domestic wastes, due to the rapid development in the technology, are discharged in the several receivers. Generally, this discharge is directed to the nearest water sources such as rivers, lakes, and seas. While the rates of development and waste production are not likely to diminish, efforts to control and dispose of wastes are appropriately rising. Wastewaters from textile industries represent a serious problem all over the world. They contain different types of synthetic dyes which are known to be a major source of environmental pollution in terms of both the volume of dye discharged and the effluent composition. From an environmental point of view, the removal of synthetic dyes is of great concern. Among several chemical and physical methods, adsorption is a promising technique due to the ease of use and low cost compared to other applications in the process of discoloration, especially if the adsorbent is inexpensive and readily available. The focus of the present study was to assess the potentiality of Brahea edulis (BE) for the removal of synthetic dye Yellow bemacid (YB) from aqueous solutions. The results obtained here may transfer to other dyes with a similar chemical structure. Biosorption studies were carried out under various parameters such as mass adsorbent particle, pH, contact time, initial dye concentration, and temperature. The biosorption kinetic data of the material (BE) was tested by the pseudo first-order and the pseudo-second-order kinetic models. Thermodynamic parameters including the Gibbs free energy ΔG, enthalpy ΔH, and entropy ΔS have revealed that the adsorption of YB on the BE is feasible, spontaneous, and endothermic. The equilibrium data were analyzed by using Langmuir, Freundlich, Elovich, and Temkin isotherm models. The experimental results show that the percentage of biosorption increases with an increase in the biosorbent mass (0.25 g: 12 mg/g; 1.5 g: 47.44 mg/g). The maximum biosorption occurred at around pH value of 2 for the YB. The equilibrium uptake was increased with an increase in the initial dye concentration in solution (Co = 120 mg/l; q = 35.97 mg/g). Biosorption kinetic data were properly fitted with the pseudo-second-order kinetic model. The best fit was obtained by the Langmuir model with high correlation coefficient (R2 > 0.998) and a maximum monolayer adsorption capacity of 35.97 mg/g for YB.

Keywords: adsorption, Brahea edulis, isotherm, yellow Bemacid

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7130 The Tourism in the Regional Development of South Caucasus

Authors: Giorgi Sulashvili, Vladimer Kekenadze, Olga Khutsishvili, Bela Khotenashvili, Tsiuri Phkhakadze, Besarion Tsikhelashvili

Abstract:

The article dealt with the South Caucasus is a complex economic policy, which consists of strands: The process of deepening economic integration in the South Caucasus region; deepening economic integration with the EU in the framework of "Neighbourhood policy with Europe" and in line with the Maastricht criteria; the development of bilateral trade and economic relations with many countries of the world community; the development of sufficient conditions for the integration of the South Caucasus region in the world to enter the market. According to the author, to determine the place of Georgia in the regional policy of the South Caucasus, it is necessary to consider two views about Georgia: The first is the view of Georgia, as a part of global economic and political processes and the second look at Georgia, as a country located in the geo-economic and geopolitical space of the South Caucasus. Such approaches reveal the place of Georgia in two dimensions; in the global and regional economies. In the countries of South Caucasus, the tourism has been developing fast and has a great social and economic importance. Tourism influences deeply on the social and economic growth of the regions of the country. Tourism development formulates thousand new jobs, fixes the positions of small and middle businesses, ensures the development of the education and culture of the population. In the countries of South Caucasus, the Tourist Industry can be specified as the intersectoral complex, which consists of travel transport and it’s technical service network, tourist enterprises which are specialized in various types, wide network services. Tourists have a chance to enjoy all of these services. At the transitional stage of shifting to the market economy, tourism is among the priorities in the development of the national economy of our country. It is true that the Georgian tourism faces a range of problems at present, but its recognition and the necessity for its development may be considered as a fact. Besides, we would underline that the revitalization of the Georgian tourism is not only the question of time. This area can bring a lot of benefits as to private firms, as to specific countries. It also has many negative effects were conducted fundamental research and studies to consider both, positive and negative impacts of tourism. In the future such decisions will be taken that will bring, the maximum benefit at minimum cost, in order for tourism to take its place in Georgia it is necessary to understand the role of the tourism sector in the economic structure.

Keywords: transitional stage, national economy, Georgian tourism, positive and negative impacts

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7129 The Impact of Streptococcus pneumoniae Colonization on Viral Bronchiolitis

Authors: K. Genise, S. Murthy

Abstract:

Introductory Statement: The results of this retrospective chart review suggest the effects of bacterial colonization in critically ill children with viral bronchiolitis, currently unproven, are clinically insignificant. Background: Viral bronchiolitis is one of the most prevalent causes of illness requiring hospitalization among children worldwide and one of the most common reasons for admission to pediatric intensive care. It has been hypothesized that co-infection with bacteria results in more severe clinical outcomes. Conversely, the effects of bacterial colonization in critically ill patients with bronchiolitis are poorly defined. Current clinical management of colonized patients consists primarily of supportive therapies with the role of antibiotics remaining controversial. Methods: A retrospective review of all critically ill children admitted to the BC Children’s Hospital Pediatric Intensive Care Unit (PICU) from 2014-2017 with a diagnosis of bronchiolitis was performed. Routine testing in this time frame consisted of complete pathogen testing, including PCR for Streptococcus pneumoniae. Analyses were performed to determine the impact of bacterial colonization and antibiotic use on a primary outcome of PICU length-of-stay, with secondary outcomes of hospital length-of-stay and duration of ventilation. Results: There were 92 patients with complete pathogen testing performed during the assessed timeframe. A comparison between children with detected Streptococcus pneumoniae (n=22) and those without (n=70) revealed no significant (p=0.20) differences in severity of illness on presentation as per Pediatric Risk of Mortality III scores (mean=3.0). Patients colonized with S. pneumoniae had significantly shorter PICU stays (p=0.002), hospital stays (p=0.0001) and duration of non-invasive ventilation (p=0.002). Multivariate analyses revealed that these effects on length of PICU stay and duration of ventilation do not persist after controlling for antibiotic use, presence of radiographic consolidation, age, and severity of illness (p=0.15, p=0.32). The relationship between colonization and duration of hospital stay persists after controlling for these variables (p=0.008). Conclusions: Children with viral bronchiolitis colonized with S. pneumoniae do not appear to have significantly different PICU length-of-stays or duration of ventilation compared to children who are not colonized. Colonized children appear to have shorter hospital stays. The results of this study suggest bacterial colonization is not associated with increased severity of presenting illness or negative clinical outcomes.

Keywords: bronchiolitis, colonization, critical care, pediatrics, pneumococcal, infection

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7128 E-Immediacy in Saudi Higher Education Context: Female Students’ Perspectives

Authors: Samar Alharbi, Yota Dimitriadi

Abstract:

The literature on educational technology in Saudi Arabia reveals female learners’ unwillingness to study fully online courses in higher education despite the fact that Saudi universities have offered a variety of online degree programmes to undergraduate students in many regions of the country. The root causes keeping female students from successfully learning in online environments are limited social interaction, lack of motivation and difficulty with the use of e-learning platforms. E-immediacy remains an important method of online teaching to enhance students’ interaction and support their online learning. This study explored Saudi female students’ perceptions, as well as the experiences of lecturers’ immediacy behaviours in online environments, who participate in fully online courses using Blackboard at a Saudi university. Data were collected through interviews with focus groups. The three focus groups included five to seven students each. The female participants were asked about lecturers’ e-immediacy behaviours and which e-immediacy behaviours were important for an effective learning environment. A thematic analysis of the data revealed three main themes: the encouragement of student interaction, the incorporation of social media and addressing the needs of students. These findings provide lecturers with insights into instructional designs and strategies that can be adopted in using e-immediacy in effective ways, thus improving female learners’ interactions as well as their online learning experiences.

Keywords: e-learning, female students, higher education, immediacy

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7127 Daily Probability Model of Storm Events in Peninsular Malaysia

Authors: Mohd Aftar Abu Bakar, Noratiqah Mohd Ariff, Abdul Aziz Jemain

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Storm Event Analysis (SEA) provides a method to define rainfalls events as storms where each storm has its own amount and duration. By modelling daily probability of different types of storms, the onset, offset and cycle of rainfall seasons can be determined and investigated. Furthermore, researchers from the field of meteorology will be able to study the dynamical characteristics of rainfalls and make predictions for future reference. In this study, four categories of storms; short, intermediate, long and very long storms; are introduced based on the length of storm duration. Daily probability models of storms are built for these four categories of storms in Peninsular Malaysia. The models are constructed by using Bernoulli distribution and by applying linear regression on the first Fourier harmonic equation. From the models obtained, it is found that daily probability of storms at the Eastern part of Peninsular Malaysia shows a unimodal pattern with high probability of rain beginning at the end of the year and lasting until early the next year. This is very likely due to the Northeast monsoon season which occurs from November to March every year. Meanwhile, short and intermediate storms at other regions of Peninsular Malaysia experience a bimodal cycle due to the two inter-monsoon seasons. Overall, these models indicate that Peninsular Malaysia can be divided into four distinct regions based on the daily pattern for the probability of various storm events.

Keywords: daily probability model, monsoon seasons, regions, storm events

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7126 Prognostic Value of C-Reactive Protein (CRP) in SARS-CoV-2 Infection: A Simplified Biomarker of COVID-19 Severity in Sub-Saharan Africa

Authors: Teklay Gebrecherkos, Mahmud Abdulkader, Tobias Rinke De Wit, Britta C. Urban, Feyissa Chala, Yazezew Kebede, Dawit Welday

Abstract:

Background: C-reactive protein (CRP) levels are a reliable surrogate for interleukin-6 bioactivity that plays a pivotal role in the pathogenesis of cytokine storm associated with severe COVID-19. There is a lack of data on the role of CRP as a determinant of COVID-19 severity status in the African context. Methods: We determined the longitudinal kinetics of CRP levels on 78 RT-PCR-confirmed COVID-19 patients (49 non-severe and 29 severe cases) and 50 PCR-negative controls. Results: COVID-19 patients had overall significantly elevated CRP at baseline when compared to PCR-negative controls [median 11.1 (IQR: 2.0-127.8) mg/L vs. 0.9 (IQR: 0.5-1.9) mg/L; p=0.0004)]. Moreover, severe COVID-19 patients had significantly higher median CRP levels than non-severe cases [166.1 (IQR: 48.6-332.5) mg/L vs. 2.4 (IQR: 1.2-7.6) mg/L; p<0.00001)]. In addition, persistently elevated levels of CRP were exhibited among those with comorbidities and higher age groups. Area under receiver operating characteristic curve (AUC) analysis of CRP levels distinguished PCR-confirmed COVID-19 patients from the ones with PCR-negative non-COVID-19 individuals, with an AUC value of 0.77 (95% CI: 0.68-0.84; p=0.001). Moreover, it clearly distinguished severe from non-severe COVID-19 patients, with an AUC value of 0.83 (95% CI: 0.73-0.91). After adjusting for age and the presence of comorbidities, CRP levels above 30 mg/L were significantly associated with an increased risk of developing severe COVID-19 (adjusted relative risk 3.99 (95%CI: 1.35-11.82; p=0.013). Conclusions: Determining CRP levels in COVID-19 patients in African settings may provide a simple, prompt, and inexpensive assessment of the severity status at baseline and monitoring of treatment outcomes.

Keywords: CRP, COVID-19, SARS-CoV-2, biomarker

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7125 Comparison of Effectiveness When Ketamine was Used as an Adjuvant in Intravenous Patient-Controlled Analgesia Used to Control Cancer Pain

Authors: Donghee Kang

Abstract:

Background: Cancer pain is very difficult to control as the mechanism of pain is varied, and the patient has several co-morbidities. The use of Intravenous Patient-Controlled Analgesia (IV-PCA) can effectively control underlying pain and breakthrough pain. Ketamine is used in many pain patients due to its unique analgesic effect. In this study, it was checked whether there was a difference in the amount of analgesic usage, pain control degree, and side effects between patients who controlled pain with fentanyl-based IV-PCA and those who added Ketamine for pain control. Methods: Among the patients referred to this department for cancer pain, IV-PCA was applied to patients who were taking sufficient oral analgesics but could not control them or had blood clotting disorders that made the procedure difficult, and this patient group was targeted. In IV-PCA, 3000 mcg of Fentanyl, 160 mg of Nefopam, and 0.3 mg of Ramosetrone were mixed with normal saline to make a total volume of 100 ml. Group F used this IV-PCA as it is, and group K mixed 250 mg of Ketamine with normal saline to make a total volume of 100 ml. For IV-PCA, the basal rate was 0.5ml/h, the bolus was set to 1ml when pressed once, and the lockout time was set to 15 minutes. If pain was not controlled after IV-PCA application, 500 mcg of Fentanyl was added, and if excessive sedation or breathing difficulties occurred, the use was stopped for one hour. After that, the degree of daily pain control, analgesic usage, and side effects were investigated for seven days using this IV-PCA. Results: There was no difference between the two groups in the demographic data. Both groups had adequate pain control. Initial morphine milligram equivalents did not differ between the two groups, but the total amount of Fentanyl used for seven days was significantly different between the two groups [p=0.014], and group F used more Fentanyl through IV-PCA. In addition, the amount of sleeping pills used during the seven days was higher in Group F [p<0.01]. Overall, there was no difference in the frequency of side effects between the two groups, but the nausea was more frequent in Group F [p=0.031]. Discussion: When the two groups were compared, pain control was good in both groups. This seems to be because Fentanyl-based IV-PCA showed an adequate pain control effect. However, there was a significant difference in the total amount of opioid (Fentanyl) used, which is thought to be the opioid-sparing effect of Ketamine. Also, among the side effects, nausea was significantly less, which is thought to be possible because the amount of opioids used in the Ketamine group was small. The frequency of requesting sleeping pills was significantly less in the group using Ketamine, and it seems that Ketamine also helped improve sleep quality. In conclusion, using Ketamine with an opioid to control pain seems to have advantages. IV-PCA, which can be used effectively when other procedures are difficult, is more effective and safer when used together with Ketamine than opioids alone.

Keywords: cancer pain, intravenous patient-controlled analgesia, Ketamine, opioid

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7124 “It Takes a Community to Save a Child”: A Qualitative Analysis of Child Trafficking Interventions from Practitioner Perspectives

Authors: Crispin Rakibu Mbamba

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Twenty-two years after the adoption of the United Nation Trafficking Protocol, evidence suggest that child trafficking continues to rise. Community level factors, like poverty which creates the conditions for children’s vulnerability is key to the rise in trafficking cases in Ghana. Albeit, growing evidence suggestthat despite the vulnerabilities, communities have the capacity to prevent and address child trafficking issues. This study contributes to this positive agenda by exploring the ways in which communities (and the key actors) in Ghana contribute to child trafficking interventions.The study objective is explored through in-depth interviews with practitioners (including social workers) from an organization working in trafficking hotspots in Ghana. Interviews wereanalyzed thematically with the help of HyperRESEARCH software. From the in-depth interviews, three themes were identified as the ways in which communities are involved in child trafficking interventions: 1) engagement of community leaders, 2) community-led anti-trafficking committees and 3) knowledge about trafficking. Albeit the cultural differences, evidence on the instrumental role of community chiefs and leaders provide important learning on how to harness trafficking intervention measures and ensure better child protection practices. Based on the findings, we recommend the need to intensify trafficking awareness campaigns in rural communities where education is lacking to contribute to United Nations (UN) promoting Just, Peaceful and Inclusive societies’ mandate.

Keywords: child trafficking, community interventions, knowledge on trafficking, human trafficking intervention

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7123 Postoperative Emergence Delirium in Children: An Incomprehensible Scenario For Parents’

Authors: Jenny Ringblom, Marie Proczkowska, Laura Korhonen, Ingrid Wåhlin

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Background: Emergence delirium is a well-known behaviour of perceptual disturbances that may occur after general anaesthesia in children. Children with emergence delirium are often confused; they cry, are involuntarily physically active and are almost impossible to console. The prevalence varies considerably between about 13% and 53%. Research has mainly focused on how different medication accents affect the incidence of emergence delirium, but less is known about parents’ experiences of emergence delirium during the recovery process. Aim: The aim of this study was to describe parents’ experiences and reflections during their child's emergence delirium behaviour when recovering from anaesthesia. Method: The study has a qualitative design, and the data has been analyzed using thematic analysis. A total of 16 parents were interviewed at two county hospitals in Sweden. Results: When the parents reunited with their child at the recovering unit, they felt as if they were encountering an incomprehensible scenario. When watching their child demonstrating emergence delirium, they experienced fear and insecurity and had feelings of powerlessness and guilt. Information and previous experience turned out to offer relief and being seen by the healthcare staff when they, in their vulnerability, failed to reach or console their child gave hope and energy. Conclusion: Emergence delirium must be extensively considered in children undergoing general anaesthesia. Healthcare staff needs to be aware of the parental difficulties it may cause. There is also important to know what parents experience as relieving, such as receiving information and when staff members are being available, responsive and supportive during the wake-up period.

Keywords: emergence delirium, experiences, pediatrics, parents, postoperative care

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7122 Synchronized Vehicle Routing for Equitable Resource Allocation in Food Banks

Authors: Rabiatu Bonku, Faisal Alkaabneh

Abstract:

Inspired by a food banks distribution operation for non-profit organization, we study a variant synchronized vehicle routing problem for equitable resource allocation. This research paper introduces a Mixed Integer Programming (MIP) model aimed at addressing the complex challenge of efficiently distributing vital resources, particularly for food banks serving vulnerable populations in urban areas. Our optimization approach places a strong emphasis on social equity, ensuring a fair allocation of food to partner agencies while minimizing wastage. The primary objective is to enhance operational efficiency while guaranteeing fair distribution and timely deliveries to prevent food spoilage. Furthermore, we assess four distinct models that consider various aspects of sustainability, including social and economic factors. We conduct a comprehensive numerical analysis using real-world data to gain insights into the trade-offs that arise, while also demonstrating the models’ performance in terms of fairness, effectiveness, and the percentage of food waste. This provides valuable managerial insights for food bank managers. We show that our proposed approach makes a significant contribution to the field of logistics optimization and social responsibility, offering valuable insights for improving the operations of food banks.

Keywords: food banks, humanitarian logistics, equitable resource allocation, synchronized vehicle routing

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7121 Environmental Related Mortality Rates through Artificial Intelligence Tools

Authors: Stamatis Zoras, Vasilis Evagelopoulos, Theodoros Staurakas

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The association between elevated air pollution levels and extreme climate conditions (temperature, particulate matter, ozone levels, etc.) and mental consequences has been, recently, the focus of significant number of studies. It varies depending on the time of the year it occurs either during the hot period or cold periods but, specifically, when extreme air pollution and weather events are observed, e.g. air pollution episodes and persistent heatwaves. It also varies spatially due to different effects of air quality and climate extremes to human health when considering metropolitan or rural areas. An air pollutant concentration and a climate extreme are taking a different form of impact if the focus area is countryside or in the urban environment. In the built environment the climate extreme effects are driven through the formed microclimate which must be studied more efficiently. Variables such as biological, age groups etc may be implicated by different environmental factors such as increased air pollution/noise levels and overheating of buildings in comparison to rural areas. Gridded air quality and climate variables derived from the land surface observations network of West Macedonia in Greece will be analysed against mortality data in a spatial format in the region of West Macedonia. Artificial intelligence (AI) tools will be used for data correction and prediction of health deterioration with climatic conditions and air pollution at local scale. This would reveal the built environment implications against the countryside. The air pollution and climatic data have been collected from meteorological stations and span the period from 2000 to 2009. These will be projected against the mortality rates data in daily, monthly, seasonal and annual grids. The grids will be operated as AI-based warning models for decision makers in order to map the health conditions in rural and urban areas to ensure improved awareness of the healthcare system by taken into account the predicted changing climate conditions. Gridded data of climate conditions, air quality levels against mortality rates will be presented by AI-analysed gridded indicators of the implicated variables. An Al-based gridded warning platform at local scales is then developed for future system awareness platform for regional level.

Keywords: air quality, artificial inteligence, climatic conditions, mortality

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7120 Utilization of Cervical Cancer Screening Among HIV Infected Women in Nairobi, Kenya

Authors: E. Njuguna, S. Ilovi, P. Muiruri, K. Mutai, J. Kinuthia, P. Njoroge

Abstract:

Introduction: Cervical cancer is the commonest cause of cancer-related morbidity and mortality among women in developing countries in Sub Saharan Africa. Screening for cervical cancer in all women regardless of HIV status is crucial for the early detection of cancer of the cervix when treatment is most effective in curing the disease. It is particularly more important to screen HIV infected women as they are more at risk of developing the disease and progressing faster once infected with HPV (Human Papilloma Virus). We aimed to determine the factors affecting the utilization of cervical cancer screenings among HIV infected women above 18 years of age at Kenyatta National Hospital (KNH) Comprehensive Care Center (CCC). Materials and Methods: A cross-sectional mixed quantitative and qualitative study involving randomly and purposefully selected HIV positive female respectively was conducted. Qualitative data collection involved 4 focus group discussions of eligible female participants while quantitative data were acquired by one to one interviewer administered structured questionnaires. The outcome variable was the utilization of cervical cancer screening. Data were entered into Access data base and analyzed using Stata version 11.1. Qualitative data were analyzed after coding for significant clauses and transcribing to determine themes arising. Results: We enrolled a total of 387 patients, mean age (IQ range) 40 years (36-44). Cervical cancer screening utilization was 46% despite a health care provider recommendation of 85%. The screening results were reported as normal in 72 of 81 (88.9%) and abnormal 7 of 81(8.6%) of the cases. Those who did not know their result were 2 of 81(2.5%). Patients were less likely to utilize the service with increasing number of years attending the clinic (OR 0.9, 95% CI 0.86-0.99, p-value 0.02), but more likely to utilize the service if recommendation by a staff was made (OR 10, 95% CI 4.2-23.9, p<0.001), and if cervical screening had been done before joining KNH CCC (OR 2.9, 95% CI 1.7-4.9, p < 0.001). Similarly, they were more likely to rate the services on cervical cancer screening as good (OR 5.0, 95% CI 1.7-3.4, p <0.001) and very good (OR 8.1, 95% CI 2.5-6.1, p<0.001) if they had utilized the service. The main barrier themes emerging from qualitative data included fear of screening due to excessive pain or bleeding, lack of proper communication on screening procedures and increased waiting time. Conclusions: Utilization of cervical cancer screening services was low despite health care recommendation. Patient socio-demographic characteristics did not influence whether or not they utilized the services, indicating the important role of the health care provider in the referral and provision of the service.

Keywords: cervical, cancer, HIV, women, comprehensive care center

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